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Ehiogu U, Schöffl VR, Jones G, Buckthorpe M, Patterson S. Developing consensus for upper limb rehabilitation, physical preparation and return to climbing in adults: protocol for an international e-Delphi study. BMJ Open Sport Exerc Med 2025; 11:e002584. [PMID: 40396148 PMCID: PMC12090856 DOI: 10.1136/bmjsem-2025-002584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Accepted: 04/16/2025] [Indexed: 05/22/2025] Open
Abstract
Climbing has grown into a grassroots participation sport and Olympic discipline. The high loads expressed through the upper limb may increase the risk of injury in this population. This may also affect rehabilitation and return to sport (RTS) considerations after injury. Treatment, management, rehabilitation and RTS parameters after injury are poorly documented. The aim of this study is to reach international expert consensus on the postinjury and surgical rehabilitation, physical preparation and RTS strategies in a range of climbers. This will provide a framework for the safe RTS of climbers. The study will be reported in accordance with guidance on conducting and reporting Delphi Studies guidelines. Panel members will be recruited with expertise in either the delivery of healthcare and/or physical preparation of climbers. The electronic Delphi is anticipated to consist of three irritative rounds. Round 1 will consist of open and closed questions to generate a broad range of statements on the rehabilitation, RTS and outcome measures used after climbing injury. In round 2, all participants will be provided with a summary of the current literature of the rehabilitation and RTS strategies for upper limb sports injuries. Rounds 2 and 3 will consist of a summary of the results from the previous round including any dissonance. Participants will be asked to anonymously rate responses on a 5-point Likert scale. The study steering group and patient public involvement representatives will be involved from conceptualisation until final dissemination.
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Affiliation(s)
- Uzo Ehiogu
- School of Medical Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK
- Royal Orthopaedic Hospital, Birmingham, UK
| | | | - Gareth Jones
- School of Health, Leeds Beckett University, Leeds, UK
| | - Matthew Buckthorpe
- Education and Research Department, FIFA Medical Centre of Excellence, Bologna, Italy
- St Mary’s University, London, UK
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Mena L, Zanesco L, Assunção JH, Checchia C, Gracitelli M, Malavolta EA. Prevalence and Risk Factors of Upper Extremity Injuries in Indoor Bouldering: A Cross-Sectional Study. Cureus 2024; 16:e69729. [PMID: 39429319 PMCID: PMC11490268 DOI: 10.7759/cureus.69729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2024] [Indexed: 10/22/2024] Open
Abstract
OBJECTIVES To describe the prevalence and risk factors associated with upper extremity injuries among indoor bouldering practitioners, focusing on dynamic movements and specific training methods. METHODS We conducted a cross-sectional study with 35 indoor bouldering climbers from a metropolitan area. Data were collected through an adapted online questionnaire and in-person orthopedic evaluations by certified specialists. Statistical analysis was performed using Stata 18 (StataCorp LLC, College Station, TX), calculating the prevalence of pain and injuries and associations between dynamic movements and specific injuries. RESULTS The sample was predominantly male (80%, n = 28/35), with a mean age of 25.9 years. Shoulder anterior apprehension was significantly associated with dynamic climbing styles (p = 0.028), with a prevalence difference of 0.3 (95% CI: 0.04, 0.57). Finger pulley and shoulder injuries affected 22.9% (n = 8/35) and 25.7% (n = 9/35) of participants, respectively. CONCLUSIONS Our study found a significant association between dynamic movements and upper extremity injuries in bouldering climbers, highlighting the pressing need for injury prevention strategies. Despite climbing being an overhead sport, our findings suggest distinct pathophysiology from the thrower's shoulder, necessitating further investigation.
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Affiliation(s)
- Lucas Mena
- Orthopaedics and Traumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA
| | - Leonardo Zanesco
- Orthopaedics and Traumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA
| | - Jorge H Assunção
- Orthopaedics and Traumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA
- Orthopaedics, Diagnósticos da América (Dasa) Hospital Nove de Julho, São Paulo, BRA
| | - Caio Checchia
- Orthopaedics and Traumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA
- Orthopaedics, Hospital Sírio-Libanês, São Paulo, BRA
| | - Mauro Gracitelli
- Orthopaedics and Traumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA
| | - Eduardo A Malavolta
- Orthopaedics and Traumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA
- Orthopaedics, Hospital do Coração (Hcor), São Paulo, BRA
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Grønhaug G, Saeterbakken A, Casucci T. Painfully ignorant? Impact of gender and aim of training on injuries in climbing. BMJ Open Sport Exerc Med 2024; 10:e001972. [PMID: 39081465 PMCID: PMC11288151 DOI: 10.1136/bmjsem-2024-001972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Climbing has evolved from an obscure outdoor sport to a predominantly indoor sport with the rise of mainstream climbing on artificial walls. Reported climbing-related injuries were predominantly chronic and may be avoided with proper planning of training. All climbers, regardless of age and gender, are training on the same routes and perform similar movements; however, few studies have investigated gender-specific injuries in climbing. Objectives Assess the distribution of chronic climbing injuries in an international population with gender-specific analyses and assess the impact of the person's training focus or aim of training on those injuries. Methods A cross-sectional survey using a web-based item-driven questionnaire was created and promoted using social media and several climbing media stakeholders. All climbers engaged in either sport climbing, bouldering or traditional climbing were included. Results The survey received 1513 responses (877 men, 427 women and 9 not reporting gender), of which 50.3% (n=665; 51.4% men and 48.0% women) had experienced an injury in the past 12 months. There were significant differences in injuries in feet/ankle (p=0.014), neck (p=0.03), head (p=0.0001), shoulder (p=0.001), elbow (p=0.021) and fingers (p=0.003). Conclusion Over 50% of the climbers experienced an injury in the past 12 months. The most common injuries were to the shoulders (women) and fingers (men). There were significant differences between the genders regarding injury site and prevalence. The gender differences may be affected by the aim for training and the style of climbing.
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Affiliation(s)
- Gudmund Grønhaug
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences Faculty of Teacher Education and Sport, Sogndal, Norway
| | - Atle Saeterbakken
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences Faculty of Teacher Education and Sport, Sogndal, Norway
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Eichler M, Lutter C, Morris PD, Schöffl V. "Run-and-jump failure": new injury patterns in indoor bouldering. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2024; 38:27-30. [PMID: 38049098 DOI: 10.1055/a-2197-6017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
In recent years, professional and non-professional bouldering have seen a fundamental change in movement patterns towards complex movement sequences. This is associated with increased demands on the musculoskeletal system, especially the lower extremities, which can lead to new injury patterns. In the course of our clinical work, we have already seen an increasing number of lower extremity injuries after run-and-jump sequences, with a severe one being highlighted in this case report.
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Affiliation(s)
- Mathis Eichler
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg Germany
| | - Christoph Lutter
- Universitätsmedizin Rostock, Universitatsmedizin Rostock, Orthopedics, Rostock, Germany
- School of Health, Leeds Becket University, UK
| | | | - Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg Germany
- Department of Orthopedic and Trauma Surgery, Friedrich Alexander Universität Erlangen-Nürnberg, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine at the University of Colorado School of Medicine, USA
- School of Health, Leeds Becket University, UK
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Saeterbakken AH, Stien N, Pedersen H, Langer K, Scott S, Michailov ML, Gronhaug G, Baláš J, Solstad TEJ, Andersen V. The Connection Between Resistance Training, Climbing Performance, and Injury Prevention. SPORTS MEDICINE - OPEN 2024; 10:10. [PMID: 38240903 PMCID: PMC10798940 DOI: 10.1186/s40798-024-00677-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Climbing is an intricate sport composed of various disciplines, holds, styles, distances between holds, and levels of difficulty. In highly skilled climbers the potential for further strength-specific adaptations to increase performance may be marginal in elite climbers. With an eye on the upcoming 2024 Paris Olympics, more climbers are trying to maximize performance and improve training strategies. The relationships between muscular strength and climbing performance, as well as the role of strength in injury prevention, remain to be fully elucidated. This narrative review seeks to discuss the current literature regarding the effect of resistance training in improving maximal strength, muscle hypertrophy, muscular power, and local muscular endurance on climbing performance, and as a strategy to prevent injuries. MAIN BODY Since sport climbing requires exerting forces against gravity to maintain grip and move the body along the route, it is generally accepted that a climber`s absolute and relative muscular strength are important for climbing performance. Performance characteristics of forearm flexor muscles (hang-time on ledge, force output, rate of force development, and oxidative capacity) discriminate between climbing performance level, climbing styles, and between climbers and non-climbers. Strength of the hand and wrist flexors, shoulders and upper limbs has gained much attention in the scientific literature, and it has been suggested that both general and specific strength training should be part of a climber`s training program. Furthermore, the ability to generate sub-maximal force in different work-rest ratios has proved useful, in examining finger flexor endurance capacity while trying to mimic real-world climbing demands. Importantly, fingers and shoulders are the most frequent injury locations in climbing. Due to the high mechanical stress and load on the finger flexors, fingerboard and campus board training should be limited in lower-graded climbers. Coaches should address, acknowledge, and screen for amenorrhea and disordered eating in climbers. CONCLUSION Structured low-volume high-resistance training, twice per week hanging from small ledges or a fingerboard, is a feasible approach for climbers. The current injury prevention training aims to increase the level of performance through building tolerance to performance-relevant load exposure and promoting this approach in the climbing field.
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Affiliation(s)
- Atle Hole Saeterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway.
| | - Nicolay Stien
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Helene Pedersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Kaja Langer
- Department of Human Sciences, Institute of Sports Science, Technical University Darmstadt, Darmstadt, Germany
| | - Suzanne Scott
- School of Anatomy, Faculty of Health and Life Sciences, University of Bristol, Bristol, UK
| | | | - Gudmund Gronhaug
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Jiří Baláš
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Tom Erik Jorung Solstad
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Vidar Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
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Quarmby A, Zhang M, Geisler M, Javorsky T, Mugele H, Cassel M, Lawley J. Risk factors and injury prevention strategies for overuse injuries in adult climbers: a systematic review. Front Sports Act Living 2023; 5:1269870. [PMID: 38162697 PMCID: PMC10756908 DOI: 10.3389/fspor.2023.1269870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/09/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Climbing is an increasingly popular activity and imposes specific physiological demands on the human body, which results in unique injury presentations. Of particular concern are overuse injuries (non-traumatic injuries). These injuries tend to present in the upper body and might be preventable with adequate knowledge of risk factors which could inform about injury prevention strategies. Research in this area has recently emerged but has yet to be synthesized comprehensively. Therefore, the aim of this study was to conduct a systematic review of the potential risk factors and injury prevention strategies for overuse injuries in adult climbers. Methods This systematic review was conducted in accordance with the PRISMA guidelines. Databases were searched systematically, and articles were deemed eligible based upon specific criteria. Research included was original and peer-reviewed, involving climbers, and published in English, German or Czech. Outcomes included overuse injury, and at least one or more variable indicating potential risk factors or injury prevention strategies. The methodological quality of the included studies was assessed with the Downs and Black Quality Index. Data were extracted from included studies and reported descriptively for population, climbing sport type, study design, injury definition and incidence/prevalence, risk factors, and injury prevention strategies. Results Out of 1,183 records, a total of 34 studies were included in the final analysis. Higher climbing intensity, bouldering, reduced grip/finger strength, use of a "crimp" grip, and previous injury were associated with an increased risk of overuse injury. Additionally, a strength training intervention prevented shoulder and elbow injuries. BMI/body weight, warm up/cool downs, stretching, taping and hydration were not associated with risk of overuse injury. The evidence for the risk factors of training volume, age/years of climbing experience, and sex was conflicting. Discussion This review presents several risk factors which appear to increase the risk of overuse injury in climbers. Strength and conditioning, load management, and climbing technique could be targeted in injury prevention programs, to enhance the health and wellbeing of climbing athletes. Further research is required to investigate the conflicting findings reported across included studies, and to investigate the effectiveness of injury prevention programs. Systematic Review Registration https://www.crd.york.ac.uk/, PROSPERO (CRD42023404031).
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Affiliation(s)
- Andrew Quarmby
- Sports Medicine & Sports Orthopaedics, University of Potsdam, University Outpatient Clinic, Potsdam, Germany
| | - Martin Zhang
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Moritz Geisler
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Tomas Javorsky
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Hendrik Mugele
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Michael Cassel
- Sports Medicine & Sports Orthopaedics, University of Potsdam, University Outpatient Clinic, Potsdam, Germany
| | - Justin Lawley
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
- EURAC Research, Institute for Mountain Emergency Medicine, Bolzano, Italy
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Leung J, Petrin Z, Southern W. Self-Reported Injuries in Indoor Gym-Based Rock Climbers: A Retrospective Study of Predictors of Prolonged Injury and Seeking Medical Care. Wilderness Environ Med 2023; 34:311-317. [PMID: 37330337 DOI: 10.1016/j.wem.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/30/2023] [Accepted: 05/05/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Indoor climbing injuries are often related to overuse, and climbers choose between self-management and seeing a medical practitioner. This study evaluated predictors of prolonged injury and seeking medical care for indoor climbing injuries. METHODS A convenience sample of adult climbers from 5 gyms in New York City was interviewed about injuries over the past 3 y, because of which they stopped climbing for at least a week or saw a medical practitioner. RESULTS In total, 122 of 284 (43%) participants had at least 1 injury, for a total of 158 injuries. Fifty (32%) were prolonged, lasting at least 12 wk. Predictors of prolonged injury included older age (odds ratio [OR], 2.28, per 10-y increase; 95% CI, 1.31-3.96), hours per week spent climbing (OR, 1.14, per 1-h increase; 95% CI, 1.06-1.24), climbing difficulty (OR, 2.19, per difficulty group increase; 95% CI, 1.31-3.66), and years of climbing experience (OR, 3.99, per 5-y increase; 95% CI, 1.61-9.84). Only 38% of injuries were seen by a medical practitioner. Predictors of seeking care included prolonged injury (OR, 3.04; 95% CI, 1.39-6.64) and rope climbing preference (OR, 1.98; 95% CI, 1.02-3.82). The most common theme for seeking care was serious pain or interference with climbing or daily activities. CONCLUSIONS Despite prolonged injuries being common, especially in older, more experienced, and higher-level climbers, only a third of climbers with injuries seek medical care. Outside of injuries causing minimal pain or limitation, those who self-managed reported receiving advice from other climbers or online research as a prominent reason for that choice.
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Affiliation(s)
- Jonathan Leung
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
| | - Ziva Petrin
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ
| | - William Southern
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
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Ginszt M, Saito M, Zięba E, Majcher P, Kikuchi N. Body Composition, Anthropometric Parameters, and Strength-Endurance Characteristics of Sport Climbers: A Systematic Review. J Strength Cond Res 2023; 37:1339-1348. [PMID: 36930882 DOI: 10.1519/jsc.0000000000004464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
ABSTRACT Ginszt, M, Saito, M, Zięba, E, Majcher, P, and Kikuchi, N. Body composition, anthropometric parameters, and strength-endurance characteristics of sport climbers: a systematic review. J Strength Cond Res XX(X): 000-000, 2023-Sport climbing was selected to be part of the Summer Olympic Games in Tokyo 2021 with 3 subdisciplines: lead climbing, speed climbing, and bouldering. The nature of physical effort while speed climbing, lead climbing, and bouldering performance is different. This literature review aimed to describe differences between body composition, anthropometric parameters, and upper-limb strength-endurance variables between sport climbers with different ability levels and nonclimbers. The following databases were searched: PubMed and Scopus. The following keywords were used: "sport climbing," "rock climbing," "lead climbing," and "bouldering." Articles were considered from January 2000 to October 2021 if they concerned at least one of the following parameters: body composition (mass, body mass index, body fat, lean muscle mass, bone mineral density), anthropometric parameters (height, ape index), muscle strength (MVC finger strength in half-crimp grip, MVC finger strength to body mass, handgrip strength), and muscle endurance (force time integral, pull-ups). A review shows that body mass and body fat content were lower in the sport climbers compared with controls and in elite sport climbers compared with those less advanced. Sport climbers presented higher values of MVC finger strength in half-crimp grip, MVC finger strength to body mass, handgrip strength, and force time integral parameter than control subjects. Significantly higher MVC values in half-crimp grip were observed in elite sport climbers than in advanced athletes. None of the analyzed work showed differences between sport climber groups in the ape index. The abovementioned parameters may be a key factor in elite sport climbing performance.
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Affiliation(s)
- Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Lublin, Poland; and
| | - Mika Saito
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Estera Zięba
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Lublin, Poland; and
| | - Piotr Majcher
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Lublin, Poland; and
| | - Naoki Kikuchi
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
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Yoon JH, Armstrong W, Philippopolous E, Dilworth N, Cheng I. Head Injuries in Rock Climbing: A Scoping Review. Wilderness Environ Med 2022; 33:479-487. [PMID: 36202720 DOI: 10.1016/j.wem.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/21/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022]
Abstract
Rock climbing was recognized as a sport at the 2020 Tokyo Olympics. Despite its increasing participation, there is no knowledge synthesis of head injuries (HIs), defined as any injury to the head, associated with climbing, making it challenging for clinicians to provide evidence-based care. Our aim was to synthesize HI literature within rock climbing and identify knowledge gaps. Six databases (Medline, Embase, Sports Medicine & Education Index, SPORTDiscus, CINAHL, and Cochrane) were searched. Two reviewers screened 345 studies and 31 studies were selected for data abstraction. We found the quality of individual studies mainly "fair" to "good." Both HI and traumatic brain injury (TBI) had inconsistent definitions and categorization. The HIs represented between 0 to 36% of reported climbing injuries. Between 11 to 100% of HIs were TBIs, defined as an HI with permanent or temporary neurological sequelae. The most common causes of HIs were outdoor falls and falling objects. Climbing-specific factors associated with the causes were infrequently examined in the literature. Data sources of safety practices were incomplete. Overall, there was a lack of literature examining HIs, mechanisms of injury, and safety practices associated with climbing. To improve the tracking of HIs in climbing, we suggest the use of consistent reporting standards and the creation of a climbing injury surveillance system.
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Affiliation(s)
- Joo Hyung Yoon
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.
| | - Wes Armstrong
- Division of Emergency Medicine, University of Toronto, Toronto, Canada
| | | | - Neil Dilworth
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada; Cleveland Clinic Midtown, Toronto, Canada; Halton Healthcare, Georgetown, Canada
| | - Ivy Cheng
- Division of Emergency Medicine, University of Toronto, Toronto, Canada; Cleveland Clinic Midtown, Toronto, Canada; Sunnybrook Health Sciences Centre, Toronto, Canada
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Mohn S, Spörri J, Mauler F, Kabelitz M, Schweizer A. Nonoperative Treatment of Finger Flexor Tenosynovitis in Sport Climbers—A Retrospective Descriptive Study Based on a Clinical 10-Year Database. BIOLOGY 2022; 11:biology11060815. [PMID: 35741336 PMCID: PMC9220062 DOI: 10.3390/biology11060815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/12/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022]
Abstract
Simple Summary Finger flexor tenosynovitis is among the most frequent overuse injuries in sport climbers. Targeted therapy is currently based mostly on reports of the anecdotal practical experience of single centers rather than scientific investigations, as there is very little research available on this pathology. The aim of this study was to describe the nonoperative treatment outcomes of finger flexor tenosynovitis treatments in sport climbers by retrospectively asking patients about injury triggers, therapy contents and outcomes. All patients were initially treated conservatively, and only one of the patients needed further therapy in the form of a single injection with hyaluronic acid; none of them underwent further operative treatment. The average symptom duration was 30.5 weeks, and all patients were able to resume climbing, with approximately 75% of them regaining or exceeding their initial climbing level. These good to excellent outcomes and no correlation between particular therapy contents and therapy outcome suggest that finger flexor tenosynovitis in sport climbers has a favorable natural course without requiring invasive therapy. However, further cohort studies and, ultimately, randomized controlled trials are needed to conclusively confirm our promising observations from this study. Abstract The aim of this study was to describe the nonoperative treatment outcomes of finger flexor tenosynovitis in sport climbers and to evaluate the association with baseline measures and therapy contents. Sixty-five sport climbers (49 males, mean age 34.1 years) diagnosed with tenosynovitis of the finger flexors were retrospectively asked about injury triggers, therapy contents and outcomes. Pulley thickness was measured by ultrasound. All patients were initially treated conservatively, and only one of the patients needed further therapy (single injection with hyaluronic acid); none of them underwent surgical treatment. The most frequently applied therapy was climbing-related load reduction (91%). The treatment resulted in a statistically significant reduction in pain intensity during climbing (before/after therapy ratio [Visual Analog Scale (VAS)/VAS] = 0.62, 95% CI = 0.55, 0.68). The average duration of the symptoms was 30.5 weeks (range 1–120 weeks). In a multiple linear regression analysis, initial daily life pain intensity and a climbing level higher than 7b according to the French/sport grading scale were the only predictive parameters for the relative change in pain intensity and symptom duration, respectively. All patients were able to resume climbing, with 75% regaining or even exceeding their initial climbing level. The good to excellent outcomes and no correlation between particular therapy contents and therapy outcome may suggest that finger flexor tenosynovitis in sport climbers has a favorable natural course without requiring invasive therapy. However, further cohort studies and, ultimately, randomized controlled trials are needed to conclusively confirm our promising observations.
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Affiliation(s)
- Sabrina Mohn
- Division of Hand Surgery, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland; (M.K.); (A.S.)
- Correspondence:
| | - Jörg Spörri
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 319, 8008 Zurich, Switzerland;
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Lengghalde 5, 8008 Zurich, Switzerland
| | - Flavien Mauler
- Department of Plastic Surgery and Hand Surgery, Kantonsspital Aarau, Tellstrasse 25, 5001 Aarau, Switzerland;
| | - Method Kabelitz
- Division of Hand Surgery, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland; (M.K.); (A.S.)
| | - Andreas Schweizer
- Division of Hand Surgery, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland; (M.K.); (A.S.)
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Characteristics of bouldering injuries based on 430 patients presented to an urban emergency department. Injury 2022; 53:1394-1400. [PMID: 35144805 DOI: 10.1016/j.injury.2022.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Bouldering is a climbing sport that has been attracting a greater number of recreational and professional athletes over recent decades, which has led to an increase in sport-related injuries. The aim of this study was to determine the characteristics and the types of acute injuries caused by bouldering. Further athlete-specific factors and covariates for the trauma types were investigated. MATERIALS AND METHODS In this retrospective analysis, all patients presented to the level 1 trauma center at the hospital of the Technical University of Munich after an acute trauma related to bouldering were identified via the hospital documentation system. The period of observation was ten years, from 2010 until 2020. Epidemiological and injury-specific information as well as the initial treatment were registered. In a second step, the affected patients were invited to participate in an online survey in order to collect information about their skills, experience, and details about the trauma. RESULTS A total of 430 patients with 447 acute injuries were identified. There were 244 injuries among female and 203 injuries among male patients. The most common anatomical region affected was ankle (36.7%), knee (16.8%), elbow (12.3%), spine (7.2%) and shoulder (6.3%). The majority of 273 (61.1%) injuries were located at the lower extremities. The most frequent types of injury were sprains (53.0%), fractures (22.8%) or joint dislocations (11.9%). Surgical treatment was necessary for 89 (19.9%) patients. A return to bouldering was more likely in male patients 50 (75.8%) than in females 47 (59.5%) (p = 0.038). Subjectively, inexperienced boulderers were also less likely to return to the sport than advanced boulderers with greater experience (p = 0.001) CONCLUSION: The incidence of bouldering injuries is rising. Typical bouldering injuries could be identified and quantified at least for those patients who were presented to a hospital emergency department. Injuries in this setting do differ from the injury types known from rock climbing injuries as they are located on the lower extremity more often. Injuries of the fingers and hand, which are common climbing injuries, have been barely encountered in the emergency center.
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Relative Contributions of Handgrip and Individual Finger Strength on Climbing Performance in a Bouldering Competition. Int J Sports Physiol Perform 2022; 17:768-773. [PMID: 35235904 DOI: 10.1123/ijspp.2021-0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine the relative contributions of handgrip and individual finger strength for the prediction of climbing performance in a bouldering competition. A secondary aim was to examine the influence of body size, bouldering experience, and training habits. METHODS Sixty-seven boulderers (mean [SD], age = 21.1 [4.0] y; body mass = 69.5 [9.8] kg) volunteered for this study. Data collection occurred immediately before an indoor bouldering competition and involved the assessment of handgrip and individual finger maximal force production using an electronic handheld dynamometer. The bouldering competition consisted of 70 routes graded V0 to V8, with higher point values awarded for completing more difficult routes. Stepwise multiple regression analysis was used to examine the relative contributions of handgrip and individual finger strengths, body mass, height, bouldering experience, and bouldering frequency to the prediction of performance scores in the competition. RESULTS Ring finger pinch strength, bouldering experience, and bouldering frequency significantly (P < .05) contributed to the model (R2 = .373), whereas body mass; height; full handgrip strength, as well as index, middle, and little finger pinch strengths did not. The β weights showed that ring finger pinch strength (β = .430) was the most significant contributor, followed by bouldering experience (β = .331) and bouldering frequency (β = .244). CONCLUSIONS The current findings indicated that trainable factors contributed to the prediction of bouldering performance. These results suggest greater bouldering frequency and experience likely contribute to greater isolated individual finger strength, thereby optimizing preparation for the diverse handholds in competitive rock climbing.
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Schöffl V, Schöffl I, Flohé S, El-Sheikh Y, Lutter C. Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers. Am J Sports Med 2022; 50:229-237. [PMID: 34817275 DOI: 10.1177/03635465211056956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending. PURPOSE To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers. STUDY DESIGN Case series; Level of evidence, 4. METHODS On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d'Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score. RESULTS Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3. CONCLUSION The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.
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Affiliation(s)
- Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany
- School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
- Section of Wilderness Medicine, Department of Emergency Medicine, School of Medicine, University of Colorado, Denver, Colorado, USA
- Department of Orthopedic and Trauma Surgery, University Erlangen-Nuremberg, Erlangen, Germany
| | - Isabelle Schöffl
- School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
- Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany
| | - Sascha Flohé
- Department of Orthopedic and Trauma Surgery, Klinikum Solingen, Solingen, Germany
| | - Yasser El-Sheikh
- Department of Surgery, North York General Hospital, Toronto, Canada
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Christoph Lutter
- School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
- Department of Orthopedic Surgery, University Hospital Rostock, Rostock, Germany
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Sabbagh RS, Hoge C, Kanhere AP, Coscia AC, Grawe BM. The epidemiology of indoor and outdoor rock climbing injuries presenting to United States emergency departments. J Sports Med Phys Fitness 2021; 62:1095-1102. [PMID: 34132515 DOI: 10.23736/s0022-4707.21.12578-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The popularity of both indoor and outdoor rock climbing has dramatically increased over the last decade. The purpose of this study is to evaluate trends in United States climbing injury rates as well as assess specific injury characteristics, especially in the context of indoor and outdoor climbing. METHODS The National Electronic Injury Surveillance System database was queried (2010-2019) to compare national weighted injury estimates and compare various injury characteristics from climbers presenting to US emergency departments. RESULTS The annual national estimates of rock climbing-related injuries presenting to US emergency rooms increased significantly (p=0.030) from 2010 (N=2,381; CI 1,085-3,676) to 2019 (N= 4,596; CI 492-8,699). 58.7% of the injuries in this study that could be classified by location occurred climbing outdoors. Ankle injuries were 2.25 times more likely (CI 1.03-3.08) to occur indoors than outdoors. Outdoor climbers were 2.25 times more likely to sustain an injury via falling and 13.8 times more likely to be injured by being struck by an object than indoor climbers (CI 1.05-2.42, CI 10.67-17.78). CONCLUSIONS Indoor and outdoor rock climbing are associated with different injury characteristics and risks. Therefore proper safety precautions, equipment, and training specific to terrain should be observed by all climbers in order to help decrease the rising trend of rock climbing-related injuries in the United States.
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Affiliation(s)
- Ramsey S Sabbagh
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA -
| | - Connor Hoge
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Arun P Kanhere
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Atticus C Coscia
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Brian M Grawe
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
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Auer J, Schöffl VR, Achenbach L, Meffert RH, Fehske K. Indoor Bouldering-A Prospective Injury Evaluation. Wilderness Environ Med 2021; 32:160-167. [PMID: 33966976 DOI: 10.1016/j.wem.2021.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Bouldering has become a sport of growing interest, but little prospective evidence exists about injury proportions and patterns. The purpose of this study was to prospectively evaluate the cause of injuries sustained during indoor bouldering, proportion of affected body location, and injury severity. METHODS Proportions and patterns of injury among German-speaking indoor boulderers were evaluated prospectively in an explorative cohort study. Participants completed a baseline questionnaire assessing anthropometric data and sport-specific potential preventive and risk factors, followed by monthly injury questionnaires including injury location and injury severity over a period of 12 mo. RESULTS Out of 507 boulderers, 222 (44%) sustained 305 injuries. Of those, 78% (n=238) were classified as Union Internationale de Associations d'Alpinisme (UIAA) 1, 19% (n=57) as UIAA 2, and 3% (n=10) as UIAA 3. Injuries of the upper extremities accounted for 63% (n=191) of all injuries. Injuries of the lower extremities accounted for 23% (n=71) but were more often classified as UIAA≥2 (P=0.0071; odds ratio [OR] 2.23; 95% CI 1.23-4.04) and were more often caused by falling (P=0.0005; OR 2.92; 95% CI 1.57-5.42) and jumping off the wall (P<0.0001; OR 4.39; 95% CI 2.25-8.56) than injuries of other body locations. There was no statistically significant protective effect of the evaluated potential preventive measures. Participants who used heavily downturned climbing shoes had a higher risk of sustaining a UIAA ≥2 injury (P=0.0034; OR 2.58; 95% CI 1.34-4.95). CONCLUSIONS Injuries in indoor bouldering are common. Lower extremity injuries are associated with higher injury severity. Preventive measures need to be established to reduce bouldering injuries, especially during falls and landings.
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Affiliation(s)
- Jonas Auer
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Volker R Schöffl
- Department of Sports Medicine-Sports Orthopedics, Klinikum Bamberg, Bamberg, Germany
| | - Leonard Achenbach
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Rainer H Meffert
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Kai Fehske
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany.
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Lutter C, Tischer T, Schöffl VR. Olympic competition climbing: the beginning of a new era-a narrative review. Br J Sports Med 2020; 55:857-864. [PMID: 33036996 DOI: 10.1136/bjsports-2020-102035] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/19/2022]
Abstract
Climbing as a competition sport has become increasingly popular in recent years, particularly the sub-discipline of bouldering. The sport will debut in the Tokyo Summer Olympic Games. National and international competitions have three disciplines: lead (climbing with rope protection), bouldering (climbing at lower heights with mattress floor protection) and speed (maximum speed climbing on a standardised route in 1-on-1 mode). There is also a 'combined mode' of all three disciplines (combined) which forms the Olympic competition format; all competition formats are held on artificial walls. Existing literature describes a predominantly low injury frequency and severity in elite climbing. In comparison to climbing on real rock, artificial climbing walls have recently been associated with higher injury rates. Finger injuries such as tenosynovitis, pulley lesions and growth plate injuries are the most common injuries. As finger injuries are sport-specific, medical supervision of climbing athletes requires specific medical knowledge for diagnosis and treatment. There is so far little evidence on effective injury prevention measures in top athletes, and antidoping measures, in general, requiring further work in this field. An improved data situation regarding high-performance climbing athletes is crucial to ensure that the sport continues to be largely safe and injury-free and to prevent doping cases as extensively as possible.
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Affiliation(s)
- Christoph Lutter
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Thomas Tischer
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Volker Rainer Schöffl
- Section of Sports Medicine, Department of Trauma and Orthopedic Surgery, Klinikum Bamberg, Bamberg, Germany.,Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.,Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado, USA.,School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
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Lutter C, Tischer T, Cooper C, Frank L, Hotfiel T, Lenz R, Schöffl V. Mechanisms of Acute Knee Injuries in Bouldering and Rock Climbing Athletes. Am J Sports Med 2020; 48:730-738. [PMID: 32004071 DOI: 10.1177/0363546519899931] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There is limited insight into the mechanisms of knee injuries in rock climbing and bouldering in noncompetitive and competitive athletes. PURPOSE To examine the traumatic mechanisms of injury, demographics, distribution, and severity of knee injuries in affected athletes. STUDY DESIGN Case series; Level of evidence, 4. METHODS During a 4-year period, we performed a retrospective multicenter analysis of acute knee injuries in competitive and noncompetitive climbing athletes. Traumatic mechanisms were inquired and severity levels, therapies, and outcomes recorded with visual analog scale, Tegner, Lysholm, and climbing-specific outcome scores. RESULTS Within the observation period, 71 patients (35% competitive athletes, 65% noncompetitive athletes) with 77 independent acute knee injuries were recorded. Four trauma mechanisms were identified: high step (20.8%), drop knee (16.9%), heel hook (40.3%), and (ground) fall (22.1%). The leading structural damage was a medial meniscal tear (28.6%), found significantly more often in the noncompetitive group. A specific climbing injury is iliotibial band strain during the heel hook position. Most injuries resulted from indoor bouldering (46.8%). Surgical procedures were predominantly necessary in noncompetitive climbers. One year after the injury, the Tegner score was 5.9 ± 0.8 (mean ± SD; range, 3-7); the Lysholm score was 97 ± 4.8 (range, 74-100); and the climbing-specific outcome score was 4.8 ± 0.6 (range, 2-5). CONCLUSION Increased attention should be placed on the climber's knee, especially given the worldwide rise of indoor bouldering. Sport-specific awareness and training programs for noncompetitive and competitive climbing athletes to reduce knee injuries should be developed, and sports medical supervision is mandatory.
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Affiliation(s)
- Christoph Lutter
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Thomas Tischer
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | | | - Luisa Frank
- Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Thilo Hotfiel
- Department of Orthopedics, Trauma and Hand Surgery, Klinikum Osnabrück, Osnabrück, Germany.,Department of Orthopedic Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Robert Lenz
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Volker Schöffl
- Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany.,Section Sports Orthopedics & Sports Medicine, Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany.,Wilderness Medicine Section, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado, USA.,School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
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18
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Rauch S, Wallner B, Ströhle M, Dal Cappello T, Brodmann Maeder M. Climbing Accidents-Prospective Data Analysis from the International Alpine Trauma Registry and Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010203. [PMID: 31892182 PMCID: PMC6981967 DOI: 10.3390/ijerph17010203] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/23/2019] [Accepted: 12/24/2019] [Indexed: 01/17/2023]
Abstract
Climbing has become an increasingly popular sport, and the number of accidents is increasing in parallel. We aim at describing the characteristics of climbing accidents leading to severe (multisystem) trauma using data from the International Alpine Trauma Registry (IATR) and at reporting the results of a systematic review of the literature on the epidemiology, injury pattern, severity and prevention of climbing accidents. We found that climbing accidents are a rare event, since approximately 10% of all mountain accidents are climbing related. Climbing accidents mainly affect young men and mostly lead to minor injuries. Fall is the most common mechanism of injury. Extremities are the most frequently injured body part. However, in multisystem climbing-related trauma, the predominant portion of injuries are to head/neck, chest and abdomen. The fatality rate of climbing accidents reported in the literature varies widely. Data on climbing accidents in general are very heterogeneous as they include different subspecialties of this sport and report accidents from different regions. A number of risk factors are accounted for in the literature. Appropriate training, preparation and adherence to safety standards are key in reducing the incidence and severity of climbing accidents.
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Affiliation(s)
- Simon Rauch
- Institute of Mountain Emergency Medicine, Eurac research, Viale Druso 1, 39100 Bolzano, Italy; (B.W.); (M.B.M.)
- Department of Anesthesia and Intensive Care Medicine, “F. Tappeiner” Hospital, Via Rossini 12, 39012 Merano, Italy
- Correspondence:
| | - Bernd Wallner
- Institute of Mountain Emergency Medicine, Eurac research, Viale Druso 1, 39100 Bolzano, Italy; (B.W.); (M.B.M.)
- Department of Anesthesiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
- Department of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Anichstraße 356020 Innsbruck, Austria;
| | - Mathias Ströhle
- Department of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Anichstraße 356020 Innsbruck, Austria;
| | - Tomas Dal Cappello
- Institute of Mountain Emergency Medicine, Eurac research, Viale Druso 1, 39100 Bolzano, Italy; (B.W.); (M.B.M.)
| | - Monika Brodmann Maeder
- Institute of Mountain Emergency Medicine, Eurac research, Viale Druso 1, 39100 Bolzano, Italy; (B.W.); (M.B.M.)
- Department of Emergency Medicine, Bern University Hospital and Medical University of Bern, 3010 Bern, Switzerland
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Buzzacott P, Schöffl I, Chimiak J, Schöffl V. Rock Climbing Injuries Treated in US Emergency Departments, 2008-2016. Wilderness Environ Med 2019; 30:121-128. [PMID: 30857822 DOI: 10.1016/j.wem.2018.11.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/29/2018] [Accepted: 11/30/2018] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Previous research identified a trend for increasing numbers of injuries sustained while rock climbing. This study investigates whether that trend continued and describes characteristics of climbing injuries. METHODS The National Electronic Injury Surveillance System registry was searched for rock climbing injuries in US emergency departments in 2008 through 2016 among patients aged ≥7 y. Variables included each patient's age, diagnosis, injured body part, mechanism of injury, and disposition. Injuries were graded using International Mountaineering and Climbing Federation injury grades. National estimates were generated using sample weighting. RESULTS An estimated 34,785 rock climbing injuries were seen in emergency departments nationally, a mean of 3816 per year (SD 854). The median age of injured climbers was 24 y (range 7-77), with those aged 20 to 39 y accounting for 60% and males for 66%, respectively. Fractures (27%) and sprains and strains (26%) were the most common types of injuries. The most frequently injured body parts were lower extremities (47%), followed by upper extremities (25%). The most commonly fractured body part (27%) was the ankle. The knee and lower leg accounted for 42% of all lacerations and were 5.8 times as likely as lacerations to other body parts. Falls were the most common mechanism, accounting for 60% of all injuries. CONCLUSIONS This study reports continued increase in annual numbers of climbing injuries. Whether this is based on a higher injury rate or on a higher number of climbers overall cannot be stated with certainty because no denominator is presented to estimate the injury rate among climbers.
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Affiliation(s)
- Peter Buzzacott
- Divers Alert Network, Durham, NC; School of Sports Science Exercise and Health, University of Western Australia, Crawley, Australia.
| | | | | | - Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany; Department of Emergency Medicine, Section of Wilderness Medicine, University of Colorado School of Medicine, Aurora, CO; Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
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Grønhaug G. Lean and mean? Associations of level of performance, chronic injuries and BMI in sport climbing. BMJ Open Sport Exerc Med 2019; 5:e000437. [PMID: 30687516 PMCID: PMC6326274 DOI: 10.1136/bmjsem-2018-000437] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 01/23/2023] Open
Abstract
Objectives To assess possible associations between performance level (achieved level of difficulty), chronic injuries and body mass index (BMI) in sport climbing. Method Retrospective survey. Setting Web-based questionnaire. Participants 667 active climbers (385 reported having chronic injuries). Outcome measure BMI, performance level in sport climbing, onset of a climbing-related injury, preferred style of climbing, education, gender. Statistics Descriptive statistics and general linear model(GLM) performed with SPSS V.25 for windows. Result No associations were found between level of performance in sport climbing, onset of a climbing-related injury, preferred style of climbing, education, gender and BMI. Conclusion BMI is not associated with climbing-related chronic injury or level of performance in climbing. The average BMI of climbers up to the elite level is similar to that of a lower rate of performance. Clinical relevance The findings in this study suggest that there is no need for maintaining a low BMI to be able to reach elite levels in climbing.
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Affiliation(s)
- Gudmund Grønhaug
- Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, Grålum, Norway
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21
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Ginszt M, Michalak-Wojnowska M, Gawda P, Wojcierowska-Litwin M, Korszeń-Pilecka I, Kusztelak M, Muda R, Filip AA, Majcher P. ACTN3 Genotype in Professional Sport Climbers. J Strength Cond Res 2018; 32:1311-1315. [PMID: 29401200 PMCID: PMC5916482 DOI: 10.1519/jsc.0000000000002457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Ginszt, M, Michalak-Wojnowska, M, Gawda, P, Wojcierowska-Litwin, M, Korszeń-Pilecka, I, Kusztelak, M, Muda, R, Filip, AA, and Majcher, P. ACTN3 genotype in professional sport climbers. J Strength Cond Res 32(5): 1311–1315, 2018—The functional RR genotype of the alpha-actinin-3 (ACTN3) gene has been reported to be associated with elite sprint/power athlete status. Although large and rapidly increasing number of studies have investigated the associations between the ACTN3 genotypes and athletic performance in various sport disciplines, there is a lack of studies on the genetic predisposition in sport climbing, which was selected to be part of the next Summer Olympic Games in Tokyo 2020 with three subdisciplines (“lead climbing,” “speed climbing,” and “bouldering”). The aim of the study is to determine the frequency distribution of ACTN3 genotypes and alleles in professional lead climbers and boulderers. 100 professional sport climbers from Poland, Russia, and Austria were divided into 2 equal groups: professional boulderers and professional lead climbers were involved in the study. ACTN3 allele frequencies and genotypes were compared with 100 sedentary controls. Genotypes were determined using polymerase chain reaction–restriction fragment length polymorphism method. The percent distribution of RR genotype in the boulderers was significantly higher than in lead climbers and controls (62 vs. 26%; 33%, respectively; χ2 = 17.230, p = 0.0017). The frequencies of ACTN3 R allele in boulderers differed significantly from lead climbers and controls (77 vs. 51%; 58%, respectively; χ2 = 15.721, p = 0.0004). The proportion of the ACTN3 RR genotype is significantly higher in boulderers than in lead climbers and may be related to the specific type of predisposition to this subdiscipline.
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Affiliation(s)
- Michał Ginszt
- Chair and Department of Rehabilitation, Physiotherapy, and Balneotherapy, Medical University of Lublin, Lublin, Poland
| | | | - Piotr Gawda
- Chair and Department of Rehabilitation, Physiotherapy, and Balneotherapy, Medical University of Lublin, Lublin, Poland
| | | | | | | | - Rafał Muda
- Department of Banking, Maria Curie-Skłodowska University of Lublin, Lublin, Poland
| | - Agata A Filip
- Department of Cancer Genetics, Medical University of Lublin, Lublin, Poland
| | - Piotr Majcher
- Chair and Department of Rehabilitation, Physiotherapy, and Balneotherapy, Medical University of Lublin, Lublin, Poland
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22
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Schöffl V, Lutter C, Woollings K, Schöffl I. Pediatric and adolescent injury in rock climbing. Res Sports Med 2018; 26:91-113. [DOI: 10.1080/15438627.2018.1438278] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Volker Schöffl
- Section Sportorthopedics, Klinikum Bamberg, Bamberg, Germany
- Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Germany
- Section Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO, USA
| | - Christoph Lutter
- Section Sportorthopedics, Klinikum Bamberg, Bamberg, Germany
- CvPath Institute, Gaithersburg, MD, USA
| | - Kaikanani Woollings
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Schöffl V, Lutter C. The “Newbie” Syndrome. Wilderness Environ Med 2017; 28:377-380. [DOI: 10.1016/j.wem.2017.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 07/22/2017] [Accepted: 07/24/2017] [Indexed: 01/03/2023]
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24
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Jones G, Johnson MI. A Critical Review of the Incidence and Risk Factors for Finger Injuries in Rock Climbing. Curr Sports Med Rep 2016; 15:400-409. [DOI: 10.1249/jsr.0000000000000304] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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25
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Injury trends in rock climbers: evaluation of a case series of 911 injuries between 2009 and 2012. Wilderness Environ Med 2016; 26:62-7. [PMID: 25712297 DOI: 10.1016/j.wem.2014.08.013] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 08/02/2014] [Accepted: 08/26/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Rock climbing is a widely performed sport. This prospective single-institution study evaluated the demographics of climbing-related injuries to improve our comprehension of current injury characteristics. METHODS During a 4-year period, 836 patients with a total of 911 independent climbing injuries were prospectively evaluated using a standard questionnaire and examination protocol. RESULTS Of all injuries, 833 were on the upper extremities, 58 on the lower. Seventeen injuries were Union International des Associations d'Alpinisme (UIAA) grade 1 injuries, 881 were grade 2, and 13 were grade 3. No higher UIAA graded injuries occurred. Overall, 380 were acute injuries (359 were seen in clinic, 21 were seen through the emergency department), and 531 were overstrain injuries (all seen in clinic). Finger injuries accounted for 52% of all injuries, the shoulder being the second most frequent location. Pulley injuries were the most frequent finger injuries. Of 20 injured young climbers under the age of 15 years, 14 had an epiphyseal fracture (all epiphyseal fractures: mean age 14 years, range 12 to 15 years). Male climbers were significantly older (P < .05), had more climbing years (P < .05), and were climbing at a higher climbing level (P < .01). Older, more experienced climbers had significantly more overstrain injuries than acute injuries (P < .05). CONCLUSIONS When comparing this study with our previous study from 1998 to 2001, there are some notable differences. Although pulley injuries are still the most common climbing injury, there are now more A4 pulley injuries than A2. Shoulder injuries are becoming more common, as are epiphyseal fractures among young climbers. It is important to understand current patterns of climbing injuries so that health providers can target interventions appropriately.
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26
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27
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Lion A, van der Zwaard BC, Remillieux S, Perrin PP, Buatois S. Risk factors of hand climbing-related injuries. Scand J Med Sci Sports 2015; 26:739-44. [DOI: 10.1111/sms.12505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 01/03/2023]
Affiliation(s)
- A. Lion
- Sports Medicine Research Laboratory; Luxembourg Institute of Health; Luxembourg Luxembourg
- EA 3450 DevAH - Développement; Adaptation et Handicap - Faculté de Médecine et UFR STAPS; Université de Lorraine; Nancy France
- Laboratoire d'Analyse de la Posture; de l'Equilibration et de la Motricité (LAPEM); CHU de Nancy; Vandœuvre-lès-Nancy France
| | - B. C. van der Zwaard
- EMGO + Institute for Health and Care Research; Department of general practice and elderly care medicine; VU University Medical Centre; Amsterdam The Netherlands
| | | | - P. P. Perrin
- EA 3450 DevAH - Développement; Adaptation et Handicap - Faculté de Médecine et UFR STAPS; Université de Lorraine; Nancy France
- Laboratoire d'Analyse de la Posture; de l'Equilibration et de la Motricité (LAPEM); CHU de Nancy; Vandœuvre-lès-Nancy France
| | - S. Buatois
- EA 3450 DevAH - Développement; Adaptation et Handicap - Faculté de Médecine et UFR STAPS; Université de Lorraine; Nancy France
- Laboratoire d'Analyse de la Posture; de l'Equilibration et de la Motricité (LAPEM); CHU de Nancy; Vandœuvre-lès-Nancy France
- Institut Lorrain de Formation en Masso-Kinésithérapie (ILFMK) de Nancy; Nancy France
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28
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Woollings KY, McKay CD, Emery CA. Risk factors for injury in sport climbing and bouldering: a systematic review of the literature. Br J Sports Med 2015; 49:1094-9. [DOI: 10.1136/bjsports-2014-094372] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2015] [Indexed: 11/04/2022]
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29
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Woollings KY, McKay CD, Kang J, Meeuwisse WH, Emery CA. Incidence, mechanism and risk factors for injury in youth rock climbers. Br J Sports Med 2014; 49:44-50. [DOI: 10.1136/bjsports-2014-094067] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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30
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Durand-Bechu M, Chaminade B, Belleudy P, Gasq D. Les blessures lors de la pratique de l’escalade en France de 2004 à 2011. Sci Sports 2014. [DOI: 10.1016/j.scispo.2013.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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31
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Schöffl V, Küpper T. Feet injuries in rock climbers. World J Orthop 2013; 4:218-28. [PMID: 24147257 PMCID: PMC3801241 DOI: 10.5312/wjo.v4.i4.218] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 07/17/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023] Open
Abstract
While injuries of the upper extremity are widely discussed in rock climbers, reports about the lower extremity are rare. Nevertheless almost 50 percent of acute injuries involve the leg and feet. Acute injuries are either caused by ground falls or rock hit trauma during a fall. Most frequently strains, contusions and fractures of the calcaneus and talus. More rare injuries, as e.g., osteochondral lesions of the talus demand a highly specialized care and case presentations with combined iliac crest graft and matrix associated autologous chondrocyte transplantation are given in this review. The chronic use of tight climbing shoes leads to overstrain injuries also. As the tight fit of the shoes changes the biomechanics of the foot an increased stress load is applied to the fore-foot. Thus chronic conditions as subungual hematoma, callosity and pain resolve. Also a high incidence of hallux valgus and hallux rigidus is described.
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Acute Injury Risk and Severity in Indoor Climbing—A Prospective Analysis of 515,337 Indoor Climbing Wall Visits in 5 Years. Wilderness Environ Med 2013; 24:187-94. [DOI: 10.1016/j.wem.2013.03.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 03/08/2013] [Accepted: 03/18/2013] [Indexed: 01/17/2023]
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33
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Sandmann GH, Siebenlist S, Lenich A, Neumaier M, Ahrens P, Kirchhoff C, Braun KF, Lucke M, Biberthaler P. Ellenbogenluxationsverletzungen beim Trendsport Bouldern. Unfallchirurg 2013; 117:274-80. [PMID: 23732615 DOI: 10.1007/s00113-013-2419-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- G H Sandmann
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
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34
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Folkl AK. Characterizing the Consequences of Chronic Climbing-Related Injury in Sport Climbers and Boulderers. Wilderness Environ Med 2013; 24:153-8. [DOI: 10.1016/j.wem.2012.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 10/22/2012] [Accepted: 11/14/2012] [Indexed: 11/24/2022]
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Pieber K, Angelmaier L, Csapo R, Herceg M. Acute injuries and overuse syndromes in sport climbing and bouldering in Austria: a descriptive epidemiological study. Wien Klin Wochenschr 2012; 124:357-62. [PMID: 22661041 DOI: 10.1007/s00508-012-0174-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 05/02/2012] [Indexed: 01/05/2023]
Abstract
BACKGROUND The increasing popularity of climbing activities is associated with a rise in the number of respective injuries and overuse syndromes. However, a comprehensive scrutiny of the incidence, kind and severity of climbing-related ailments in Austria is so far outstanding. We aimed to evaluate injuries and overuse syndromes in sport climbing and bouldering in Austria and to investigate whether the injury incidence differs between specific groups of climbers. DESIGN Retrospective cross-sectional self-report study. METHODS A self-report questionnaire to assess (a) demographic and anthropometric characteristics, (b) climbing experience and skill level, and (c) detailed information on climbing-related injuries was made available in climbing halls and on the Internet. Data from 193 climbers (133 males and 60 females; age 30.4 ± 8.1 years; average climbing experience 9.3 ± 7.7 years) were acquired. RESULTS A total of 374 injuries were reported by 130 participants (67.4 %). The single most common differential diagnoses, accounting for 56.7 % of all injuries, were strains and ruptures of annular ligaments of the fingers, lateral epicondylitis of the elbow, and sprains or fractures of the ankle joint. The odds for strains of the annular ligaments and lateral epicondylitis were greater in men and increased with older age and higher exposure to climbing stress. CONCLUSIONS This is the first comprehensive study investigating climbing-related injuries in Austria. The incidence and kind of the ailments reported confirm results of previous studies. Moreover, our results suggest that the risk to suffer climbing-related overuse syndromes, but not acute injuries, is dependent on sex, age, and exposure to climbing stress.
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Affiliation(s)
- Karin Pieber
- Department of Physical Medicine and Rehabilitation, General Hospital of Vienna, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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36
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Macdonald JH, Callender N. Athletic Profile of Highly Accomplished Boulderers. Wilderness Environ Med 2011; 22:140-3. [DOI: 10.1016/j.wem.2010.11.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 10/30/2010] [Accepted: 11/23/2010] [Indexed: 11/25/2022]
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The UIAA Medical Commission Injury Classification for Mountaineering and Climbing Sports. Wilderness Environ Med 2011; 22:46-51. [DOI: 10.1016/j.wem.2010.11.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 11/09/2010] [Accepted: 11/10/2010] [Indexed: 02/08/2023]
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Measuring Lifting Forces in Rock Climbing: Effect of Hold Size and Fingertip Structure. J Appl Biomech 2011; 27:40-6. [DOI: 10.1123/jab.27.1.40] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigates the hypothesis that shallow edge lifting force in high-level rock climbers is more strongly related to fingertip soft tissue anatomy than to absolute strength or strength to body mass ratio. Fifteen experienced climbers performed repeated maximal single hand lifting exercises on rectangular sandstone edges of depth 2.8, 4.3, 5.8, 7.3, and 12.5 mm while standing on a force measurement platform. Fingertip soft tissue dimensions were assessed by ultrasound imaging. Shallow edge (2.8 and 4.3 mm) lifting force, in newtons or body mass normalized, was uncorrelated with deep edge (12.5 mm) lifting force (r< .1). There was a positive correlation (r= .65,p< .05) between lifting force in newtons at 2.8 mm edge depth and tip of bone to tip of finger pulp measurement (r< .37 at other edge depths). The results confirm the common perception that maximum lifting force on a deep edge (“strength”) does not predict maximum force production on very shallow edges. It is suggested that increased fingertip pulp dimension or plasticity may enable increased deformation of the fingertip, increasing the skin to rock contact area on very shallow edges, and thus increase the limit of force production. The study also confirmed previous assumptions of left/right force symmetry in climbers.
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Schweizer A. Biomechanics of the interaction of finger flexor tendons and pulleys in rock climbing. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/19346182.2008.9648482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schöffl V, Morrison A, Schwarz U, Schöffl I, Küpper T. Evaluation of injury and fatality risk in rock and ice climbing. Sports Med 2010; 40:657-79. [PMID: 20632737 DOI: 10.2165/11533690-000000000-00000] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Rock and ice climbing are widely considered to be 'high-risk' sporting activities that are associated with a high incidence of severe injury and even death, compared with more mainstream sports. However, objective scientific data to support this perception are questionable. Accordingly, >400 sport-specific injury studies were analysed and compared by quantifying the injury incidence and objectively grading the injury severity (using the National Advisory Committee for Aeronautics score) per 1000 hours of sporting participation. Fatalities were also analysed. The analysis revealed that fatalities occurred in all sports, but it was not always clear whether the sport itself or pre-existing health conditions contributed or caused the deaths. Bouldering (ropeless climbing to low heights), sport climbing (mostly bolt protected lead climbing with little objective danger) and indoor climbing (climbing indoors on artificial rock structures), showed a small injury rate, minor injury severity and few fatalities. As more objective/external dangers exist for alpine and ice climbing, the injury rate, injury severity and fatality were all higher. Overall, climbing sports had a lower injury incidence and severity score than many popular sports, including basketball, sailing or soccer; indoor climbing ranked the lowest in terms of injuries of all sports assessed. Nevertheless, a fatality risk remains, especially in alpine and ice climbing. In the absence of a standard definition for a 'high-risk' sport, categorizing climbing as a high-risk sport was found to be either subjective or dependent on the definition used. In conclusion, this analysis showed that retrospective data on sport-specific injuries and fatalities are not reported in a standardized manner. To improve preventative injury measures for climbing sports, it is recommended that a standardized, robust and comprehensive sport-specific scoring model should be developed to report and fully evaluate the injury risk, severity of injuries and fatality risk in climbing sports.
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Affiliation(s)
- Volker Schöffl
- Department of Sportorthopedics, Orthopedics and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany.
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41
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Rock climbing injuries treated in emergency departments in the U.S., 1990-2007. Am J Prev Med 2009; 37:195-200. [PMID: 19666157 DOI: 10.1016/j.amepre.2009.04.025] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 03/25/2009] [Accepted: 04/24/2009] [Indexed: 01/28/2023]
Abstract
BACKGROUND Rock climbing is an increasingly popular sport in the U.S., with approximately nine million participants annually. The sport holds an inherent risk of falls and stress-related injuries. As indoor climbing facilities become more common, more people are participating in the sport. PURPOSE The objective of this study is to describe the prevalence, characteristics, and trends of rock climbing-related injuries treated in U.S. emergency departments from 1990 through 2007. METHODS A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission for all ages from 1990 through 2007. Sample weights provided by NEISS were used to calculate national estimates of rock climbing-related injuries. Trend significance of the number of rock climbing-related injuries over time was analyzed using linear regression. Analysis was conducted in 2008. RESULTS An estimated 40,282 patients were treated in emergency departments for rock climbing-related injuries in the U.S. over the 18-year period. Patients aged 20-39 years accounted for more than half of all injuries. Fractures, sprains, and strains accounted for the largest portion of injuries (29.0% and 28.6%, respectively). The lower extremities were the most frequently injured body part, accounting for 46.3% of all injuries; ankle injuries accounted for 19.2%. Men were more likely to sustain lacerations (OR=1.65; 95% CI=1.03, 2.67) and fractures (OR=1.54; 95% CI=1.10, 2.17), whereas women were more likely to sustain a sprain or strain (OR=1.68; 95% CI=1.13, 2.51). Overexertion injuries were more likely to occur to the upper extremities (OR=5.32; 95% CI=1.99, 14.23). Falls were responsible for three quarters of all injuries (77.5%). Overall, 11.3% of patients were hospitalized. CONCLUSIONS Our results indicate that the most common rock climbing-related injuries are to the lower extremities and are fractures, sprains, and strains. More research is needed to determine how rock-climbers' characteristics, climbing setting, style of climbing, and use of safety equipment and training may affect their risk for certain injury patterns.
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Moor BK, Nagy L, Snedeker JG, Schweizer A. Friction between finger flexor tendons and the pulley system in the crimp grip position. Clin Biomech (Bristol, Avon) 2009; 24:20-5. [PMID: 19041166 DOI: 10.1016/j.clinbiomech.2008.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2008] [Revised: 10/10/2008] [Accepted: 10/14/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND Disruption of the finger flexor tendon pulleys are the most often occurring injury in rock climbers due to bowstringing of tendons during crimp grip position. The aim of this study was to quantify friction between the flexor tendons and pulleys and the influence of high load and speed of movement as a potential factor of pulley disruption. METHODS Friction between the flexor tendons and pulleys of eight human cadaver fingers was indirectly determined using an isokinetic movement device. During flexion and extension movement with rotational speed from 30 to 210 deg/s in the proximal interphalangeal joint and with load from 20 to 100 N to the flexor tendons the flexion force at the tip of the finger was measured. FINDINGS With 40 N loaded flexor tendons the force at the fingertip was 14.5 N (SD1.5) during extension and 12.6N (SD1.3) during flexion movement. Corresponding force difference of 12.9% and 3.77 N (SD0.6) force of friction can be calculated. Friction peaked at 85.8 degrees (SD2.05) of flexion of the proximal interphalangeal joint. Different speed of motion and load to the flexor tendons did not influence force difference other than linear. INTERPRETATION Considerable friction between flexor tendons and pulleys is apparent and therefore may have an influence on pulley injuries. Particularly during the crimp grip position where the proximal interphalangeal joint is flexed about 90 degrees shows the greatest amount of friction. However there was no change of friction during high speed motion and no other than linear increase during high load.
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Affiliation(s)
- Beat K Moor
- Department of Orthopaedics, Balgrist, University of Zurich, Switzerland Forchstrasse 340, 8008 Zurich, Switzerland
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