My daughter recently asked for my advice. She’s been having some elbow and shoulder pain since joining a climbing gym near her home in Pennsylvania. That’s too far away to ask her to just come in to Foothills for a physical therapy assessment, so I had to get creative in order to give her some long distance tips.

In the process of looking up exercises specifically relevant to climbing, I came across Grassroots Physical Therapy out of Salt Lake City, Utah. Their website has some excellent free exercise videos and it referenced an article titled, Hang Right: Shoulder Maintenance for Climbers, that focuses on disproving the old axiom, “hang like a bag of rocks” or simply, “hang loose.” The author points out that “hanging” can cause pain for climbers because of the undue stress that it places on joints and muscles. That statement reminded me of my patients who hang like a bag of rocks on their hips or knees.

So why is this “hang loose” posture so bad?

In the human body, a joint is formed when two bones come together. Ligaments do the job of holding these bones together and are considered a type of connective or soft tissue, made up of both collagen (stiff) and elastin (loose) fibers. This means ligaments create stability and mobility at the same time—we can bend our knees without the bones falling apart. The amount of collagen or elastin in a ligament determines if you are stiff- or loose- jointed. If you think you are double jointed, you most likely have more elastin than collagen in your ligaments, allowing the joint to move too far and thus creating the illusion of a joint that moves in two ways instead of just one. In the medical world, this can also be referred to as hypermobility.

This is an example of standing with both the knees at their end range of motion. Notice the knees are “locked” back, therefore stressing the ligaments of the joint and requiring no muscular effort. The orange line represents where the body weight is centered; notice that it goes through the front of the knee joint, therefore compressing the joint in the front and gapping the joint in the back.

Muscles, on the other hand, control and create the motion in a joint. Muscles connect to bones by tendons and tendons cross joints to create movement and give strength and stability to a joint. When we lift weights at the gym, we are improving the ability of our muscles to support our joints and move our body. Tendons and muscles are also considered part of our connective and soft tissue system.

Back to the statement, “don’t hang like a bag of rocks.” Both ligaments and muscles support or “hold together” a joint. Ligaments do it passively, meaning we have no control over their work. Muscles do it actively, meaning we have total control. When we stand with our knees locked back or hyperextended, we are relying only on our ligaments for support and we are therefore not using any muscular effort. This puts too much stress on the ligaments of the joint to the point where the ligaments become stretched out and can’t hold the joint together. This is called instability.

Hanging on your ligaments also causes abnormal stress on the bones in the joint, and that stress can lead to bony changes we recognize as arthritis. If the ligaments can’t passively support a joint, the muscles have to work even harder. All of that can lead to muscle imbalance, weakness and ultimately pain.

This picture shows good alignment, with the joint being held in its normal position, supported by both the ligaments and muscles. The orange line represents where the body weight is centered. In this picture, the orange line goes straight through the knee joint, loading the joint in the center, therefore distributing the weight across the broadest part of the joint.

Another good example of hanging on our ligaments is when we carry something heavy in our hand and let the elbow just hang down. When we go to bend the elbow from that overstretched position, it hurts. Imagine how that would feel if you held your arm like that all day long!

It’s really important not to abuse one of your major support systems for your joints!

The solution is to support your joints! Use your muscles. Stand with your knees unlocked or “soft.” Keep your pelvis under your shoulders, not pushed forward in a way that puts all your weight on your hip ligaments. And, rock climbers should never hang like a bag of rocks, but they should support their arms and shoulders by engaging the muscles and holding themselves up. Simply put, don’t stand or sit with your joints at the end of their range of motion. A common, everyday example is when people slouch in their chairs or hang their heads down, looking at their phones. Both are hanging the spine at the end of its range.

Whether you are sitting at your desk, standing at the copy machine or climbing the steep vertical face of a rock, be kind to your body and support your joints by engaging your muscles and actively hold yourself up. Your muscles and joints will thank you.

~ Brigitte Cook PT

2 thoughts on “Hang Loose? Think Again and Consider Your Ligaments!

  • April 18, 2019 at 8:19 pm

    Nice, clear explanation of a very important concept that impacts us every day. Thanks Brigitte!

  • April 19, 2019 at 1:39 am

    Hey Brigitte !
    Good concrete examples of a concept that can be elusive. ???? Thank you!


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