Injury

Research > Research Inventory > Kinesiology: Injury

Long-Term Evolution of Cartilage Abnormalities and Osteophytes in the Fingers of Elite Sport Climbers: A 10-Year Follow-Up

Authors: Pastor T, Schweizer A, Reissner L, Spörri J, Fröhlich S. | Year: 2022
Summary: Researchers followed the same group of elite male climbers across a decade to see how long-term loading shapes their finger joints. Cartilage in the proximal and distal finger joints became thinner over time, yet still remained thicker than in non-climbers, while osteophytes became increasingly common across nearly all fingers. Even with these marked structural changes, climbers did not report pain tied to the imaging findings, suggesting that long-term adaptations can look degenerative without producing symptoms.
Reference: #1376 – Conference abstract / follow-up study
Open source: Link to paper

The epidemiology of indoor and outdoor rock climbing injuries presenting to USA emergency departments

Authors: Sabbagh RS, Hoge CG, Kanhere AP, Coscia AC, Grawe BM. | Year: 2022
Summary: This study used ten years of U.S. emergency-department records to track how often climbers are injured and whether indoor and outdoor settings show different injury patterns. Reported cases almost doubled over the decade, with outdoor terrain accounting for most injuries, while indoor gyms saw proportionally more ankle issues and outdoor climbers faced greater risks from falls and falling objects. Because these data capture only injuries serious enough for hospital care, the findings mainly outline the higher-consequence events that should guide environment-specific safety practices.
Reference: J Sports Med Phys Fitness. 2022 Aug;62(8):1095-1102. doi: 10.23736/S0022-4707.21.12578-2
Not Open Source: https://pubmed.ncbi.nlm.nih.gov/34132515/

Diagnostic Imaging of A2 Pulley Injuries: A Review of the Literature

Authors: Berrigan W, White W, Cipriano K, Wickstrom J, Smith J, Hager N. | Year: 2022
Summary: The authors compiled 22 cadaver and clinical studies on A2 pulley injuries to see which imaging method actually helps clinicians most. Ultrasound is recommended as the first-line option because it is accessible and highly accurate, especially when the PIP is flexed to about 40° with fingertip resistance to highlight tendon bowstringing. However, studies used different finger positions and tendon-to-bone distance cutoffs (for example, calling a “complete” tear at ≥2 mm in some papers and ≥3 mm in others), so the authors argue that ultrasound protocols need standardization before strict millimeter thresholds are used to guide treatment.
Reference: J Ultrasound Med. 2021;41(5):1047–1059. doi:10.1002/jum.15796
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292555/

Evaluation of a Four-Week Adjunct Compensatory Training for Climbing-Specific Shoulder Overuse

Authors: Laura Sofie Grohnert, Marcellus Bonato, Volker Schöffl | Year: 2022
Summary: Researchers explored whether a brief, guided shoulder routine could ease symptoms tied to climbing-related overuse. After a month of practicing six targeted exercises, participants reported less pain, smoother daily function, and modest improvements in shoulder movement—indicating the approach might help manage mild shoulder irritation in active climbers. Because the study lacked a comparison group and used a small sample, the gains could reflect both the exercises themselves and simply adding structured, consistent training.
Beta-angel note: They used the Adjunct Compensatory Training (ACT) manual for exercises. Highly recommend. You can find a free open-source copy here.
Reference: Sportverletz Sportschaden. 2022 Aug;36(3):138-144. doi: 10.1055/a-1397-1466
Not Open Source: https://pubmed.ncbi.nlm.nih.gov/35016244/

Pulley Rupture in Rock Climber after Collagenase Treatment for Dupuytren Contracture

Authors: Ilse Degreef, Sebastiaan Kellens | Year: 2022
Summary: The authors describe a sport climber with Dupuytren contracture who underwent collagenase injection and, about 2 months later, sustained a finger pulley tear while climbing, followed by a second pulley rupture as the contracture worsened. A collagenase injection uses an enzyme to break down the thickened collagen cords that pull the fingers into a bent position in Dupuytren’s contracture. The authors highlight that this appears to be the first published case linking collagenase treatment and pulley failure in a climber, suggesting clinicians should be cautious with return-to-climbing timelines and loading after injection. As a single Level V case report, it raises a safety question rather than providing firm risk estimates.
Reference: J Hand Surg Asian Pac Vol. 2022 Feb;27(1):187-190. doi: 10.1142/S2424835522720018
Not Open Source: https://doi.org/10.1142/S2424835522720018

Characteristics of Bouldering Injuries Based on 430 Patients Presented to an Urban Emergency Department

Authors: Müller M, Heck J, Pflüger P, Greve F, Biberthaler P, Crönlein M. | Year: 2022
Summary: This review of a decade’s worth of emergency-room visits mapped out which injuries show up when bouldering falls go wrong. Most problems involved the lower limbs—especially ankles—with sprains, breaks, and dislocations forming the bulk of serious cases, and a notable share needing surgical care. Because the dataset reflects only climbers who were injured badly enough to seek hospital treatment, it highlights the high-impact accidents that produce substantial damage rather than the overuse complaints common in everyday training.
Reference: Injury. 2022;53(4):1394–1400. doi:10.1016/j.injury.2022.02.003
Not Open Source: https://doi.org/10.1016/j.injury.2022.02.003

Injury Rates, Patterns, Mechanisms, and Risk Factors Among Competitive Youth Climbers in the United States

Authors: Barrile AM, Feng S-Y, Nesiama J, Huang C. | Year: 2022
Summary: This study surveyed competitive youth climbers to estimate how often injuries occur and what drives them. Reported injury rate was low overall, but overuse—especially in the fingers—dominated, and risk climbed with harder bouldering, longer sessions, unsupervised climbing, and returning while still hurt. And although the data come from a small, self-reported sample, the consistent links to training behaviors suggest coaches can meaningfully lower injury risk by addressing workload and return-to-climb decisions.
Beta-Angel note: In this sample, finger taping and “climbing while still in pain” both tracked with higher injury odds, which suggests tape is often a badge of “I’m still hurt but climbing anyway,” not true prevention. For coaches and parents, a kid who is taped up and insisting they’re fine is probably a red-flag.
Reference: Wilderness Environ Med. 2022;33(1):25-32. doi:10.1016/j.wem.2021.09.005
Open Source: https://doi.org/10.1016/j.wem.2021.09.005

Shoulder Pathology on Magnetic Resonance Imaging in Asymptomatic Elite-Level Rock Climbers

Authors: Cooper JD, Seiter MN, Ruzbarsky JJ, Poulton R, Dornan GJ, Fitzcharles EK, Ho CP, Hackett TR. | Year: 2022
Summary: Researchers scanned both shoulders of 50 elite climbers with no shoulder pain to see how often “injury-like” changes appear on magnetic resonance imaging. Around four out of five shoulders showed rotator cuff or biceps tendon changes, about two-thirds had labrum abnormalities (over half with clear tears), and most also showed humeral head cartilage wear, despite full strength and motion. These findings suggest that in high-level climbers, shoulder MRI often looks “abnormal” even when athletes feel fine, so images should be weighed cautiously against clinical examination.
Reference: Orthop J Sports Med. 2022;10(2):23259671211073137. doi:10.1177/23259671211073137
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842184/

Upper Extremity Injuries in Rock Climbers: Diagnosis and Management

Authors: Sims LA | Year: 2022
Summary: This review walks through the injury patterns hand surgeons are most likely to see in climbers—pulley strains, growth-plate stress in youth, lumbrical shifts, and hook-of-hamate fractures—and explains how climbing loads create them. It also outlines practical steps for identifying and managing these conditions so athletes can return to high-level use. Guidance is useful but based mainly on clinical experience rather than controlled studies.
Reference: J Hand Surg Am. 2022 Jul;47(7):662–672. doi: 10.1016/j.jhsa.2022.01.009
Not Open Source: https://pubmed.ncbi.nlm.nih.gov/35256226/

Case Report: Using Telehealth to Treat Triceps Tendinopathy in a Rock Climber

Authors: Vagy J. | Year: 2022
Summary: This report describes a 38-year-old climber with persistent elbow pain who was assessed entirely through telehealth, forcing the clinician to depend on posture review, movement observation, and guided self-palpation rather than direct manual tests. A targeted home routine—centered on improving scapular control and gradually loading the triceps—led to complete symptom resolution and a return to her prior bouldering level within 10 weeks. Because this is a single remote case without in-person verification, the findings suggest promise but should be viewed as preliminary.
Reference: Front Sports Act Living. 2022 Mar 21;4:829480. doi: 10.3389/fspor.2022.829480
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8978669/

Epidemiological Study of Foot Injuries in the Practice of Sport Climbing

Authors: Cobos-Moreno P, Astasio-Picado Á, Gómez-Martín B. | Year: 2022
Summary: This study looked at how often climbers develop long-term foot problems and whether experience influences risk. Among 53 regular climbers, most showed some combination of curled toes from shoe pressure, swollen tissue around the big toe joint, or limited big-toe movement, and nearly half felt toe pain while climbing; more years in the sport—not age—predicted these issues. Because the study relied on a small, single-group sample and basic screening, the findings point to patterns worth monitoring rather than firm injury rates.
Reference: Int J Environ Res Public Health. 2022 Apr 3;19(7):4302. doi: 10.3390/ijerph19074302
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998933/

Injuries in outdoor climbing: a retrospective single-centre cohort study at a level 1 emergency department in Switzerland

Authors: Krieger CS, Vesa D-V, Ziegenhorn S, Exadaktylos AK, Klukowska-Rötzler J, Brodmann Maeder M. | Year: 2022
Summary: This report looked back at 78 outdoor climbing and ice-climbing accidents treated at a major Swiss trauma hospital from 2012–2018 to show what kinds of injuries actually reach emergency care. Although these incidents made up only a tiny share of total ER visits, most involved significant falls or rock/ice striking the climber, often producing fractures, head injuries, or several injured regions at once, with more than half requiring hospital admission and expensive treatment. The authors suggest that while major outdoor accidents are rare, they can be severe, and they urge larger nationwide tracking—including details like helmet use and climber background—to better shape prevention efforts, noting that a single trauma centre mainly receives the most serious cases.
Reference: BMJ Open Sport Exerc Med. 2022;8(1):e001281. doi: 10.1136/bmjsem-2021-001281
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971760/

Case reports on bone avulsion in closed flexor pulley injury: A new or neglected radiological finding?

Authors: Pereira Dias R, Guerini H, Mihoubi Bouvier F, Leclercq C, Drapé J-L. | Year: 2022
Summary: No abstract available. Anyone have the paper?
Reference: Hand Surg Rehabil. 2022 Sep;41(4):523–525. doi: 10.1016/j.hansur.2022.05.004
Not Open Source: https://pubmed.ncbi.nlm.nih.gov/35569793/

Transosseous Multiple Finger Flexor Tendon Pulley Reconstruction

Authors: Simon M, Lutter C, Tischer T, Schöffl V | Year: 2022
Summary: This paper reports a new surgical method for repairing multiple pulley injuries (pulley = the ligament “rings” that hold the flexor tendons close to the finger bone). The approach threads a tendon graft through a small tunnel drilled in the phalanx (finger bone) instead of wrapping it around the outside of the bone, and the graft comes from the palmaris longus (a small wrist tendon people don’t usually need). This aims to avoid bone damage seen in older techniques. Most patients regained good function and returned to sport with very few complications, though the evidence is early and lacks direct comparison to other methods.
Reference: Video J Sports Med. 2022;2(3):26350254221079624. doi:10.1177/26350254221079624
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904823/

Cortical Bone Thickness, Base Osteophyte Occurrence and Radiological Signs of Osteoarthritis in the Fingers of Male Elite Sport Climbers: A Cross-Sectional 10-Year Follow-Up Study

Authors: Pastor T, Fröhlich S, Pastor T, Spörri J, Schweizer A. | Year: 2022
Summary: This study followed 31 elite male climbers over ten years to see how decades of high finger loading reshape bone and joints. Climbers showed continued thickening of cortical bone and a sharp rise in radiographic osteoarthritis (OA) markers—especially at the distal finger joints—while non-climbing controls showed far fewer changes. The authors interpret these findings as long-term mechano-adaptation to climbing, though the small sample and lack of original controls limit broader conclusions. These results highlight how long careers under high load may change joint structure, but the paper does not link these changes to pain or reduced performance.
OPEN SOURCE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9203125/
Reference: Front Physiol. 2022 Jun 2;13:893369. doi:10.3389/fphys.2022.893369

Nonoperative Treatment of Finger Flexor Tenosynovitis in Sport Climbers

Authors: Mohn S, Spörri J, Mauler F, Kabelitz M, Schweizer A. | Year: 2022
Summary: This study reviewed ten years of cases to understand how finger flexor tenosynovitis responds to conservative care, since climbers often get told to rest or tape without much evidence behind those choices. Most climbers improved steadily over months, showed a clear drop in pain, and three-quarters returned to or surpassed their previous level—all without surgery or meaningful differences between specific treatments. The authors suggest the injury generally follows a favorable natural healing path, though the findings rely on retrospective reports and symptom timelines that varied widely.
Reference: Biology (Basel). 2022;11(6):815. doi:10.3390/biology11060815
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9220062/

Flexor Tendon Pulley Injuries: A Systematic Review of the Literature and Current Treatment Options

Authors: Artiaco S, Bosco F, Lusso A, Cioffi LL, Battiston B, Massè A. | Year: 2022
Summary: This review examined four clinical studies on finger pulley injuries, many involving climbers, to compare how well conservative care and surgery work across injury severities. Both management strategies generally restored good function and allowed athletes to resume activity, with surgical repair more commonly used—and more successful—in higher-grade ruptures. Because the evidence comes from small retrospective case series with different scoring systems and surgical styles, the current recommendations remain tentative and no single technique stands out as superior.
Reference: J Hand Microsurg. 2022;15(4):247–252. doi: 10.1055/s-0042-1749420
OPEN SOURCE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495204/

A Biomechanical Analysis of the H-Taping Method Used by Rock Climbers as Prophylactic or Stabilizing Fixation of Partial A2 Pulley Tears

Authors: Salas C, McIver ND, Telis A, Tufaro R, Qeadan F, Gross J, Mercer D. | Year: 2023
Summary: Researchers tested whether H-taping protects or supports partially torn A2 pulleys using 14 matched cadaver hands (56 comparisons). Across intact, torn, taped, and untaped conditions, taping did not meaningfully increase failure force or fingertip force, suggesting little practical benefit. Evidence is limited by cadaver models that cannot mimic real climbing load patterns.
Reference: Salas C, McIver ND, Telis A, Tufaro R, Qeadan F, Gross J, Mercer D. A Biomechanical Analysis of the H-Taping Method Used by Rock Climbers as Prophylactic or Stabilizing Fixation of Partial A2 Pulley Tears. J Hand Surg Am. 2023 Dec;48(12):1272.e1-1272.e8. doi: 10.1016/j.jhsa.2022.05.002. Epub 2022 Jul 20. PMID: 35870957.
Not Open Source: https://pubmed.ncbi.nlm.nih.gov/35870957/

To tape or not to tape: annular ligament (pulley) injuries in rock climbers — a systematic review

Authors: Larsson R, Nordeman L, Blomdahl C. | Year: 2022
Summary/Results: This review examined whether finger taping helps climbers with pulley injuries (grades 1–3) by pulling together nine small, mixed-quality studies (206 climbers, plus cadaver work). Across the evidence, taping consistently reduced bowstringing of the flexor tendons by roughly 15–22%, but showed no reliable benefits for pain, grip strength, return-to-sport speed, or preventing ruptures—largely because most studies were tiny, used weak designs, or relied on cadavers. Moderate-quality evidence showed taping does not increase force production or muscle activation in healthy climbers. Overall, the authors conclude that taping has one fairly dependable effect (reducing tendon lift-off) while everything else remains unclear due to low certainty and inconsistent methods.
Beta-Angel note: Reducing bowstringing means taping slightly limits how far the tendon pulls away from the bone during hard crimping—a small mechanical assist that might matter during rehab. Additionally, the authors posit that the 11-12% decrease in shearing force (force that pulls the pulley away) suggests it could be used to return to training earlier. However, evidence here isn’t strong enough to claim clear performance or recovery advantages for climbers.
Reference: BMC Sports Sci Med Rehabil. 2022;14:148.
OPEN SOURCE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344739/

Bouldering: a sport with a high risk of intraarticular fractures

Authors: Kornherr P, Kühne C, Kopp F, Preiss A, Menzdorf L. | Year: 2022
Summary/Results: This review notes that bouldering has a surprisingly high rate of serious joint injuries—mainly ankles and knees—because falls create large impact forces despite the short height. Injury numbers are rising, but current data are limited due to poor documentation. The authors suggest better floor design and better reporting as key steps toward injury-prevention research.
Reference: Sportverletz Sportschaden. 2022 Aug;36(3):129–137. doi: 10.1055/a-1376-9730
Not Open Source: https://pubmed.ncbi.nlm.nih.gov/35973436/

Closed flexor pulley injuries: A literature review and current practice

Authors: Bosco F, Giustra F, Lusso A, Faccenda C, Artiaco S, Massè A. | Year: 2022
Summary/Results: This review looked at how finger pulley ruptures happen (mostly in climbers using a crimp grip), how to diagnose them, and when conservative care versus surgery makes sense. Evidence came from a mix of small studies and case series, so the authors leaned on Schöffl’s grading system: they recommend non-surgical management for lower-grade injuries (grades 1–2), routine surgery for the most severe patterns (grade 4), and note that grade-3 injuries fall into a “both can work” zone with good return-to-climbing outcomes either way. For climbers and coaches, the practical takeaway is that early imaging (ultrasound first) and fast grading matter—because correct classification is what determines whether taping and rest are enough, or whether the athlete risks chronic bowstringing and needs a reconstruction.
Reference: J Orthop. 2022;34:246–249.
OPEN SOURCE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483560

Head Injuries in Rock Climbing: A Scoping Review

Authors: Yoon JH, Armstrong W, Philippopolous E, Dilworth N, Cheng I. | Year: 2022
Summary/Results: This scoping review combined 31 studies and found head-injury rates in climbing vary wildly (0–36%) because reporting methods, definitions, and injury categories were inconsistent, making the true burden—especially mild concussion—unclear. Most serious head injuries came from outdoor falls or falling rock, while indoor rates were low, but many cases likely go unrecorded because climbers rarely seek care and severe injuries often occur before hospital arrival. Helmet use outdoors was low across studies, and there was very little data on climbing-specific factors (belay errors, rope systems, rock quality), leaving major gaps for coaches and clinicians trying to build concussion protocols.
Reference: Wilderness Environ Med. 2022;33(4):479–487.
Open Source: https://www.sciencedirect.com/science/article/pii/S1080603222001168

Epidemiology of sport climbing injuries caused by a climbing fall among climbers of the French Federation of Mountain and Climbing

Authors: Luiggi M, Lafaye P, Martha C. | Year: 2023
Summary/Results: This survey of 3,919 French climbers asked about fall-related injuries in the past year (with the usual limits of self-reported data). About 9% had a fall-related injury, and the biggest risk group was newer climbers who climb well for their experience level—the ones who progress fast but don’t yet have years of falling and belaying experience. Most injuries came from unexpected events (foot pops, broken holds) or poor belaying (static catches, inattention), not from hard moves alone. The authors suggest coaches teach newer climbers how to fall safely and belayers how to give dynamic catches, especially on easier terrain where attention often drops.
Reference: J Sports Med Phys Fitness. 2023.
OPEN SOURCE: https://hal.science/hal-04401061v1

Pectoralis Major Tendon Rupture While Bouldering

Authors: Forrester JD, Chona DV, McAdams TR. | Year: 2022
Summary/Results: This case report describes a rare pec major tendon rupture in a 37-year-old climber who felt a pop while mantling; although based on a single case, the authors note that diagnosis is usually clear from exam and confirmed with imaging. Because active athletes recover much better with surgery than without, the key point is that early recognition and rapid surgical repair—ideally within the first week—gives the best chance of returning to previous climbing levels. Practically, sudden chest/shoulder pain with bruising or loss of the normal armpit contour after a mantle should prompt immediate stop-climbing and urgent evaluation.
Reference: Wilderness Environ Med. 2022.
OPEN SOURCE: https://doi.org/10.1016/j.wem.2022.09.004

Persistent unilateral force deficits after hand injury in experienced climbers

Authors: Orth D, Slebioda N, Cavada A, van Bergen N, Deschle N, Hoozemans M. | Year: 2022
Summary/Results: This study tested 32 intermediate–advanced climbers and found that a climbing-specific crimp strength test was reliable, though the small sample and self-reported ability limit certainty. Climbers with a past one-hand injury showed lingering deficits—about 7% lower max force and 13% lower fast-force production—while healthy climbers showed almost no left–right difference, suggesting real asymmetry is a warning sign rather than normal. Practically, the authors recommend targeted higher intensity, climbing-specific rehab to restore symmetry, especially when the nondominant hand was injured, since this group showed the largest gaps.
Reference: Wilderness Environ Med. 2022;33(4):288–301.
Open Source: https://journals.sagepub.com/doi/pdf/10.1016/j.wem.2022.10.001

Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression

Authors: Katharina Luttenberger, Nina Karg-Hefner, Matthias Berking, Leona Kind, Maren Weiss, Johannes Kornhuber, Lisa Dorscht | Year: 2022
Summary/Results: This study tested whether a 10-week group program combining bouldering and psychotherapy (BPT) was as effective as the more traditional group Cognitive Behavioral Therapy (CBT) for treating depression. Both groups improved from moderate to mild symptoms. MADRS (a measure of depression severity) scores decreased by 8.06 points in BPT and 5.99 in CBT, with similar reductions in PHQ-9. BPT was not inferior to CBT and maintained effects for at least one year.
Sample Size and Ability: 156 adults with depression (PHQ-9 ≥8), randomized to BPT (n = 79) or CBT (n = 77).
Training Implications: Bouldering-based therapy can serve as an alternative format to traditional CBT, combining movement and group interaction while targeting psychological outcomes.
Reference: Luttenberger, K., Karg-Hefner, N., Berking, M., Kind, L., Weiss, M., Kornhuber, J. and Dorscht, L. (2022), Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: A randomized controlled trial. Br J Clin Psychol, 61: 465-493. https://doi.org/10.1111/bjc.12347
Open Source: https://open.fau.de/server/api/core/bitstreams/6dee1e39-2d56-4b74-a18d-7236e58ba6b2/content

Review of studies on the impact of climbing as a complementary form of depression treatment and their evaluation according to the QUADAS-2 tool

Authors: Zieliński, G., Zięba, E., & Byś, A. | Year: 2021
Summary/Results: This review examined four studies on how sport climbing, especially bouldering, affects symptoms of depression. All studies reported positive effects on mood and functioning, and the review indicated a low possibility of bias based on evaluation with the QUADAS-2 tool. The studies measured changes using standardized depression scales. While each study used different tools, they all showed symptom improvement after climbing sessions, and the review noted consistency in findings despite small sample sizes. The four included studies focused on individuals with depression and varied in size; exact participant numbers were not reported, but all used beginner-friendly bouldering sessions.
Training Implications: Bouldering can be structured as a therapeutic intervention, using accessible problems and group formats to encourage emotional and social benefits. Programs aiming to use climbing for mental health should prioritize supportive environments and short climbing routes that encourage success and self-efficacy.
Open Source: https://www.researchgate.net/publication/358248056_Przeglad_prac_dotyczacych_wplywu_wspinaczki_jako_uzupelniajacej_formy_leczenia_depresji_i_ich_ocena_wedlug_narzedzia_QUADAS-2_Review_of_studies_on_the_impact_of_climbing_as_a_complementary_form_of_dep
Reference: Zieliński G, Zięba E, Byś A. Review of studies on the impact of climbing as a complementary form of depression treatment and their evaluation according to the QUADAS-2 tool. Psychiatria Polska. 2021;55(6):1341–1356. https://doi.org/10.12740/PP/126445

The Role of Hand Therapy in Facilitating Participation in Rock Wall Climbing: A Case Report of a Woman with Cerebral Palsy

Authors: Weinstock-Zlotnick G, Janowski LC, Wolff A. | Year: 2020
Summary: This case report follows a 31-year-old woman with long-standing movement limitations on one side of her body who entered hand therapy specifically to climb, not to recover from injury. Over 11 months, therapists used problem-solving, route-specific simulations, and customized tools (including a digit-positioning cuff to prevent involuntary finger flexing) to improve wrist motion and grip strength enough for her to climb, belay, and use the arm more spontaneously in daily life. As a single-case design built on patient-reported gains, it offers early but practical insight into structuring therapy around a meaningful physical activity rather than traditional tasks.
Reference: J Hand Ther. 2020. doi: 10.1016/j.jht.2020.10.013
Not open source: Link to academia paper

Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression

Authors: Kratzer, A., Luttenberger, K., Karg-Hefner, N., Weiss, M., & Dorscht, L. | Year: 2021
Summary/Results: This study compared bouldering psychotherapy (BPT), home-based physical exercise (EP), and group cognitive behavioral therapy (CBT) on self-efficacy (confidence in handling challenges), measured using the General Self-Efficacy Scale (GSE). BPT produced greater improvements than home exercise (3.04 vs. 1.26 points) and showed similar effects to CBT (d = 0.39). All groups started below average, but only BPT and CBT reached average levels after the intervention. The sample included 233 adults with moderate depression (PHQ-9 ≈ 13.6), assigned to BPT (n = 79), EP (n = 77), or CBT (n = 77).
Training Implications: Structured bouldering sessions may help develop problem-solving confidence and emotional resilience. Incorporating achievable tasks, visible progress, and group support may improve motivation and ability to handle challenge.
Reference: Kratzer, A., Luttenberger, K., Karg-Hefner, N., Weiss, M., & Dorscht, L. (2021). Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression: results from a multicenter randomized controlled trial. BMC Psychology, 9, 126. https://doi.org/10.1186/s40359-021-00627-1
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393466/

Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy – results from a randomized controlled trial

Authors: Larissa Schwarzkopf, Lisa Dorscht, Ludwig Kraus, Katharina Luttenberger | Year: 2021
Summary/Results: This randomized trial compared bouldering psychotherapy (BPT) to group CBT for depression. BPT showed slightly greater symptom improvements (MADRS −2.58; PHQ-9 −1.35) but higher costs (+€754), with wide individual variability. Differences between groups were not statistically significant.
Sample Size and Ability: 156 adults with mild to severe depression (67.3% female) across multiple German sites.
Training Implications: Bouldering-based interventions can be structured to target psychological outcomes when combined with therapeutic elements. Movement-based approaches may offer an alternative or complementary format to traditional therapy, though cost-effectiveness relative to CBT remains unclear.
Open Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC8549311/
Reference: Schwarzkopf L, Dorscht L, Kraus L, Luttenberger K. Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy – results from a randomized controlled trial. BMC Health Services Research. 2021;21:1162. https://doi.org/10.1186/s12913-021-07153-1

Safety Analysis of Sport Climbing Falls

Authors: Rainer Schad, Nico F. Schad, Yannick F. Schad, Heike Schad, et al. | Year: 2022
Summary/Results: Controlled lead fall testing showed actual fall distances can reach ~1.8× nominal fall height due to rope stretch and belayer lift. Ground falls were possible even at the third bolt depending on slack and belayer mass. Peak forces reached ~4× bodyweight, and belayers were lifted up to ~1.5 m.
Sample Size and Ability: Repeated tests using a 73.7 kg climber with varied belayer weights; no grades reported.
Training Implications: Practice falling and catching under varied conditions rather than relying on simple rules. Belayers under ~80% of climber weight should anchor or use high-friction devices. Heavier belayers should use dynamic techniques to reduce peak force.
Open Source: https://pages.physics.ua.edu/faculty/schad/research/Manuscript%20C.pdf
Reference: Schad R, Schad NF, Schad YF, Schad H, et al. Safety Analysis of Sport Climbing Falls. SSRN Electronic Journal. 2022. https://doi.org/10.2139/ssrn.4094000

Application of Closed Kinematic Chain, Eccentric, and Strength Exercises for Shoulder Injury Prevention in Student Rock Climbers

Authors: Serhii Kozin, Marian Cretu, Zhanneta Kozina, Andrii Chernozub, Olena Ryepko, Tetiana Shepelenko, Iryna Sobko, Mariia Oleksiuk | Year: 2021
Summary/Results: A year-long intervention using closed-chain, eccentric, and strength exercises reduced shoulder injuries in student climbers compared to controls. The program included eccentric shoulder loading, assisted one-arm hangs with trunk/leg engagement, and 3-point contact coordination drills to distribute load beyond the upper limb.
Sample Size and Ability: 40 amateur climbers in the intervention group and 44 in control.
Training Implications: One-arm hangs with active trunk and opposite leg engagement may reduce shoulder strain. Include eccentric shoulder work and full-body coordination drills where limbs stay fixed while the torso moves to distribute load.
Open Source: https://www.researchgate.net/publication/354916196_Application_of_closed_kinematic_chain_exercises_with_eccentric_and_strength_exercises_for_the_shoulder_injuries_prevention_in_student_rock_climbers_a_randomized_controlled_trial
Reference: Kozin S, Cretu M, Kozina Z, Chernozub A, Ryepko O, Shepelenko T, Sobko I, Oleksiuk M. Application of closed kinematic chain exercises with eccentric and strength exercises for the shoulder injuries prevention in student rock climbers: a randomized controlled trial. Journal of Physical Education and Sport. 2021;21(5):2582–2589.

Triceps Rupture and Repair in a Healthy, Young Woman following Rock Climbing

Authors: Charles Qin, Sean Clancy, Jason Strelzow | Year: 2021
Summary/Results: This case study reports a distal triceps tendon rupture in a 27-year-old female climber during bouldering, treated with a hybrid surgical repair (bone tunnels + knotless suture anchor). Recovery showed improved DASH (35.3 → 18.3), PREE (58 → 42), stable Mayo score (85), and elbow range of motion improving to 3–140° over 22 weeks.
Sample Size and Ability: Single case; healthy 27-year-old recreational female boulderer.
Training Implications: Sudden eccentric loading at the elbow (e.g., catching falls) may pose risk for rare but severe triceps ruptures, even in young climbers.
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616681/
Reference: Qin C, Clancy S, Strelzow J. Triceps Rupture and Repair in a Healthy, Young Woman following Rock Climbing. Case Rep Orthop. 2021;2021:3340479. doi:10.1155/2021/3340479.

Patterns of Traumatic Outdoor Rock-Climbing Injuries in Sweden Between 2008 and 2019

Authors: Fredrik Identeg, Ebba Orava, Mikael Sansone, Jon Karlsson, Henrik Hedelin | Year: 2021
Summary/Results: Falls caused 84–100% of outdoor climbing injuries, with the foot and ankle involved in 72–100% of cases across bouldering, sport, and trad. Fractures accounted for 60% of injuries. In sport climbing, 31% of incidents were linked to belayer rope management errors, with even higher error rates during rappelling.
Sample Size and Ability: 38 climbers (mean age 34, ~8.8 years experience), average grade ~UIAA 7.0, injuries confirmed via medical records.
Training Implications: Emphasize landing mechanics and lower-limb injury prevention, especially in bouldering. Reinforce rope safety and belayer technique in sport climbing and rappelling. Injury prevention should be discipline-specific, as most severe injuries result from falls rather than overuse.
Open Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC8502181/
Reference: Identeg F, Orava E, Sansone M, Karlsson J, Hedelin H. Patterns of Traumatic Outdoor Rock-Climbing Injuries in Sweden Between 2008 and 2019. J Exp Orthop. 2021;8:89.

Long term evolution of soft tissue response in the fingers of high-level sport climbers: A cross-sectional 10 Year follow-up study

Authors: Fröhlich S, Schweizer A, Reissner L, Pastor T, Spörri J, Pastor T | Year: 2021
Summary/Results: Over 10 years, climbers showed increased thickness in A2/A4 pulleys and flexor tendons, with no change in palmar plates. Only palmar plate thickness was associated with body weight and highest redpoint level.
Sample Size and Ability: 31 male elite climbers (7b+–9a+, bouldering up to 8c+) with 25–41 years experience, plus 15 matched non-climbers.
Training Implications: Palmar plate thickness may reflect accumulated load or performance level. Long-term monitoring of finger soft tissues may help guide injury prevention in experienced climbers.
Open Source: https://doi.org/10.1016/j.ptsp.2021.09.006
Reference: Fröhlich S, Schweizer A, Reissner L, Pastor T, Spörri J, Pastor T. Long term evolution of soft tissue response in the fingers of high-level sport climbers: A cross-sectional 10 Year follow-up study. Physical Therapy in Sport. 2021. https://doi.org/10.1016/j.ptsp.2021.09.006

Longer Tendon-Bone Distances of the A2 and A4 Annular Pulleys in Experienced High-Level Sport Climbers: Injury or Adaptation?

Authors: Konrad J, Sichting JF, Riechelmann LS, Kohn DF, Hammer N | Year: 2021
Summary/Results: Ultrasound showed climbers had greater tendon-bone distances than controls (+25% at A2, +35% at A4). About 20% of pulleys exceeded the 2 mm rupture threshold despite no pain or functional issues, suggesting these values may reflect adaptation rather than injury.
Sample Size and Ability: 28 high-level climbers (mean ~8b French, range 8a–8c, ≥10 years experience) and 13 active non-climbers.
Training Implications: Structural changes may mimic injury on imaging in asymptomatic climbers, so fixed diagnostic cutoffs should be used cautiously. Pain-free function and performance may be more relevant indicators than ultrasound alone. Load management and return-to-play decisions should consider symptoms and history, not just imaging.
Open Source: https://doi.org/10.1016/j.wem.2021.07.008
Reference: Konrad J, Sichting JF, Riechelmann LS, Kohn DF, Hammer N. Longer Tendon-Bone Distances of the A2 and A4 Annular Pulleys in Experienced High-Level Sport Climbers: Injury or Adaptation? Wilderness & Environmental Medicine. 2021;32(4):451–457. https://doi.org/10.1016/j.wem.2021.07.008

Acute Septic Carpal Tunnel Syndrome in a Rock Climber.

Authors: Zbeda RM, Rabinovich RV, Vialonga M, Seigerman DA | Year: 2021
Summary/Results: This case report describes a rare deep hand infection leading to acute carpal tunnel syndrome in a 33-year-old climber, likely from bacteria entering through small skin abrasions. The athlete developed numbness and swelling, tested positive for Staphylococcus epidermidis, and required emergency surgery plus antibiotics, with full recovery after 6 weeks.
Sample size and Ability: Single case study of an experienced indoor climber (grade not reported).
Training Implications: Small skin abrasions can allow serious infection; climbers should monitor and protect skin integrity. Early symptoms like numbness or swelling post-climbing may require urgent medical evaluation. Gym hygiene and hold disinfection may reduce infection risk.
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310637/
Reference: Zbeda RM, Rabinovich RV, Vialonga M, Seigerman DA. Acute Septic Carpal Tunnel Syndrome in a Rock Climber. J Orthop Case Rep. 2021;11(4):100–103.

A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson’s disease

Authors: Langer A, Hasenauer S, Flotz A, Gassner L, Pokan R, Dabnichki P, Wizany L, Gruber J, Roth D, Zimmel S, Treven M, Schmoeger M, Willinger U, Maetzler W, Zach H | Year: 2021
Summary/Results: This randomized controlled trial tested a 12-week sport climbing intervention in Parkinson’s disease patients. Climbing significantly improved motor symptoms (−12.9 points on MDS-UPDRS-III) compared to unsupervised training (−3.0 points), with improvements in bradykinesia, rigidity, and tremor. Adherence was extremely high (99%) with low dropout (8%) and no adverse events, indicating strong feasibility.
Sample Size and Ability: 48 Parkinson’s patients (Hoehn & Yahr stage 2–3; mean age ~64), all climbing-naive.
Training Implications: Climbing may serve as an effective whole-body intervention combining strength, coordination, balance, and mobility, leading to meaningful improvements in motor symptoms. High adherence suggests it may be a sustainable long-term training modality for clinical populations.
Open Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192917/
Reference: Langer A, Hasenauer S, Flotz A, et al. A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson’s disease. NPJ Parkinsons Dis. 2021;7:49. doi:10.1038/s41531-021-00193-8

Indoor Bouldering—A Prospective Injury Evaluation

Authors: Jonas Auer, Volker Schöffl, Leonard Achenbach, Rainer Meffert, Kai Fehske | Year: 2021
Summary/Results: 44% of indoor boulderers reported at least one injury over 12 months. Upper limb injuries made up 63% of all injuries, with fingers (28%) and shoulders (16%) most common. Lower limb injuries accounted for 23% but were more severe and strongly linked to falls and jumping. Use of heavily downturned shoes was associated with higher risk of severe injuries, while no tested preventive strategies significantly reduced injury risk.
Sample Size and Ability: 507 indoor boulderers of mixed experience levels (<1 year to >5 years), no grades reported.
Training Implications: Emphasize finger strength and tendon resilience to manage upper limb load. Train fall and landing mechanics, especially for newer climbers. Consider limiting use of heavily downturned shoes during general training to reduce risk of severe lower limb injuries.
Open Source: https://www.researchgate.net/publication/351381582_Indoor_Bouldering-A_Prospective_Injury_Evaluation
Reference: Auer J, Schöffl VR, Achenbach L, Meffert RH, Fehske K. Indoor Bouldering—A Prospective Injury Evaluation. Wilderness Environ Med. 2021. doi:10.1016/j.wem.2021.02.002

Finger Flexor Pulley Injuries in Rock Climbers

Authors: Paulo H. Miro, Eric vanSonnenberg, Diana Sierra, Volker Schöffl | Year: 2021
Summary/Results: The crimp grip produces high forces on the A2, A3, and A4 pulleys, especially during eccentric loading, making them common injury sites. Climbers generate forces of ~380–700 N, which can exceed A2 pulley strength (~431 N) and cause rupture. Diagnosis and treatment include ultrasound, H-taping (shown to reduce bowstringing), splints, and MRI when needed.
Sample Size and Ability: Narrative review; force data drawn from cadaver and in vivo studies across recreational to elite climbers.
Training Implications: Limit crimp grip use, especially under fatigue or dynamic conditions, and favor open-hand or half-crimp positions. Use progressive warm-ups (~100 moves) to improve tendon readiness. For rehab, use ultrasound to assess bowstringing and apply H-taping or pulley-protection splints; avoid ineffective taping methods like circumferential or figure-8.
Open Source: https://doi.org/10.1016/j.wem.2021.01.011
Reference: Miro PH, vanSonnenberg E, Sierra D, Schöffl V. Finger Flexor Pulley Injuries in Rock Climbers. Wilderness Environ Med. 2021;32(2). https://doi.org/10.1016/j.wem.2021.01.011

Unusual rupture of the middle finger flexor digitorum superficialis tendon in a climber: Biomechanical analysis

Authors: Caso H, Vigouroux L, Valerio T, et al. | Year: 2021
Summary/Results: A climber using a rare “hook” grip (deep flexion at middle and distal joints with minimal knuckle flexion) ruptured the FDS tendon. Biomechanical analysis showed this grip produced over 5× higher stress on the FDS compared to a crimp grip. Despite full rupture, the climber regained equal grip strength in both hands after 8 months of physiotherapy. Testing with an elite climber showed the hook grip required high internal tendon force relative to external grip force, indicating mechanical inefficiency and high strain.
Sample Size and Ability: Case study of 1 intermediate climber (~6c UIAA) with FDS rupture, plus biomechanical testing on 1 elite climber (~8c+).
Training Implications: Avoid “hook” and “nail” grip types on shallow or ring holds due to high tendon strain and low efficiency. After injury, load may shift to other tendons (e.g., FDP), increasing risk if unmanaged. Favor grip styles that distribute load more evenly (e.g., slope or crimp without thumb) and consider tools like force sensors or rehab hangboards to assess tendon loading.
Open Source: https://www.researchgate.net/publication/351129907_Unusual_rupture_of_the_middle_finger_flexor_digitorum_superficialis_tendon_in_a_climber_Biomechanical_analysis
Reference: Caso H, Vigouroux L, Valerio T, et al. Unusual rupture of the middle finger flexor digitorum superficialis tendon in a climber: Biomechanical analysis. Hand Surgery and Rehabilitation. 2021.

Impact of 30 years’ high-level rock climbing on the shoulder: a magnetic resonance imaging study of 31 climbers

Authors: Silvan Beeler, Torsten Pastor, Benjamin Fritz, Lukas Filli, Andreas Schweizer, Karl Wieser | Year: 2021
Summary/Results: Climbers showed higher rates of labral damage (82% vs. 52%), biceps tendon changes (53% vs. 23%), and cartilage defects (28% vs. 3%) compared to nonclimbers, with prevalence increasing alongside climbing intensity. Rotator cuff and acromioclavicular degeneration were similar between groups. Despite structural changes, climbers had slightly better shoulder function scores (median 94 vs. 93).
Sample Size and Ability: 31 high-level male climbers (best grade ~French 8b+; range 6b–9a) with 25+ years of experience, compared to age-matched nonclimbers.
Training Implications: Long-term climbing is associated with structural shoulder changes but not necessarily reduced function. Coaches should monitor symptoms rather than rely solely on imaging. Individualized strategies may help manage long-term joint stress without reducing performance.
Open Source: https://www.sciencedirect.com/science/article/pii/S105827462100077X
Reference: Beeler S, Pastor T, Fritz B, Filli L, Schweizer A, Wieser K. Impact of 30 years’ high-level rock climbing on the shoulder: a magnetic resonance imaging study of 31 climbers. Journal of Shoulder and Elbow Surgery. 2021;30(9):2022–2031. https://doi.org/10.1016/j.jse.2020.12.017

An Ankle-Foot Prosthesis for Rock Climbing Augmentation

Authors: Emily A. Rogers, Matthew E. Carney, Seong Ho Yeon, Tyler R. Clites, Dana Solav, Hugh M. Herr
Summary/Results: This study developed a robotic ankle-foot prosthesis with both vertical and side-to-side movement, controlled by muscle signals from the residual limb. One elite climber with a below-knee amputation climbed a French 5+ route using both a passive and robotic prosthesis. The robotic version improved ankle mobility and reduced compensatory hip and knee bending, with the climber reporting better comfort and foot placement precision. The population was one elite adaptive climber (French 5+, ~IRCRA 10).
Training Implications: EMG-controlled prostheses may reduce compensatory strain and improve training efficiency in adaptive climbers. Coaches should evaluate how foot placement precision and joint control affect overall movement when using advanced prosthetics.
Open Source: https://www.researchgate.net/publication/346391936_An_Ankle-Foot_Prosthesis_for_Rock_Climbing_Augmentation
Reference: Rogers EA, Carney ME, Yeon SH, Clites TR, Solav D, Herr HM. An Ankle-Foot Prosthesis for Rock Climbing Augmentation. IEEE Transactions on Neural Systems and Rehabilitation Engineering.

Olympic Competition Climbing: The Beginning of a New Era — A Narrative Review

Authors: Christoph Lutter, Thomas Tischer, Volker Rainer Schöffl | Year: 2021
Summary/Results: The Olympic format combines lead, bouldering, and speed climbing, each with distinct movement and injury profiles. Artificial walls may carry higher injury risk than outdoor climbing, particularly for finger injuries such as pulley strains, tenosynovitis, and growth plate injuries in youth. Medical support requires sport-specific expertise, but evidence on prevention strategies and doping trends remains limited.
Training Implications: Early detection of finger injuries and careful load management—especially in youth—should be prioritized. Training should reflect the different physical and mechanical demands of lead, bouldering, and speed to reduce injury risk and improve performance.
Sample Size and Ability: Narrative review (no primary data collection). IRCRA Categories: Not applicable.
Paywall: https://bjsm.bmj.com/content/55/15/857.long
Reference: Lutter C, Tischer T, Schöffl VR. Olympic competition climbing: the beginning of a new era—a narrative review. British Journal of Sports Medicine. 2021;55(15):857–863.

Head and Neck Injuries from Rock Climbing: A Query of the National Electronic Injury Surveillance System

Authors: David W. Chou, Rijul Kshirsagar, Jonathan Liang | Year: 2020
Goal: This study analyzed U.S. emergency department data to determine the frequency, types, and severity predictors of head and neck injuries in rock climbing.
Summary/Results: From 2009–2018, an estimated 5,067 climbers sustained head or neck injuries requiring emergency care. The most common were concussions/closed head injuries (44%) and lacerations (23%). Males were more likely to experience severe trauma (e.g., skull fractures, cervical spine fractures, intracranial hemorrhage). Falls over 20 feet were strongly associated with severe injuries and higher hospitalization risk.
Sample Size and Ability: 129 reported cases extrapolated to ~5,067 national injuries over 10 years (NEISS data); mixed ability population.
Training Implications: Greater caution is needed in situations with high fall potential (e.g., outdoor climbing, highball bouldering). Helmet use may reduce severity of head injuries.
Paywall: https://doi.org/10.1177/0003489420936710
Reference: Chou DW, Kshirsagar R, Liang J. Head and neck injuries from rock climbing: A query of the National Electronic Injury Surveillance System. Annals of Otology, Rhinology & Laryngology. 2020;130(1).

Ultrasonographic Diagnosis of A2 or A4 Flexor Tendon Pulley Injury: A Systematic Review

Authors: Iruretagoiena-Urbieta X., De la Fuente-Ortiz de Zarate J., Rodríguez-López E.S., Blasi M., et al. | Year: 2020
Summary/Results:
The authors reviewed research on how ultrasound is used to diagnose tears of the A2 and A4 pulleys in the fingers (common climbing injuries that stabilize the flexor tendons). From 3,447 studies screened, only 7 met the criteria for inclusion. These papers showed that tendon-to-bone distance (how far the tendon bows away from the bone when the pulley is torn) was the most used measure, but the cutoff values were inconsistent. Reported thresholds for diagnosing a complete rupture ranged from 1.9–5.1 mm for the A2 pulley and 1.8–3.1 mm for the A4 pulley. The review concluded there is currently no standard agreement on ultrasound criteria for pulley rupture, and more precise definitions are needed for reliable diagnosis.
Beta-Angel note: For coaches and climbers, this highlights why “getting an ultrasound” isn’t a guaranteed answer. Different clinicians may use different thresholds, meaning a borderline reading could be interpreted in different ways. Until standardized criteria are established, it’s worth pushing athletes to combine imaging with functional assessments before making return-to-climb decisions.
Reference:
Iruretagoiena-Urbieta, X., De la Fuente-Ortiz de Zarate, J., Rodríguez-López, E. S., Blasi, M., et al. (2020). Ultrasonographic diagnosis of A2 or A4 flexor tendon pulley injury: A systematic review. Wilderness & Environmental Medicine, 31(4), 448–456. https://doi.org/10.1016/j.wem.2020.07.007
https://www.researchgate.net/publication/346607915_Ultrasonographic_Diagnosis_of_A2_or_A4_Flexor_Tendon_Pulley_Injury_A_Systematic_Review

The role of hand therapy in facilitating participation in rock wall climbing: A case report of a woman with cerebral palsy

Authors: Weinstock-Zlotnick, G., Janowski, C., & Wolff, A. | Year: 2022
Summary/Results:
This case report followed a 31-year-old woman with hemiplegic cerebral palsy (a condition where one side of the body has weakness or limited movement due to brain injury at birth). She had reduced motion, strength, and control in her right arm and hand but wanted to participate in adaptive climbing. Over eleven therapy sessions across eleven months, therapists used activity analysis, specific exercises, and task modifications to address climbing barriers. She improved wrist flexion (+33°), wrist extension (+8°), and grip strength (+35 lbs). She also reported greater control, reduced finger spasticity, and improved ability to shift weight. Most importantly, she was able to climb once or twice a week, demonstrating that targeted therapy can enable participation in adaptive sports.
Reference:
Weinstock-Zlotnick, G., Janowski, C., & Wolff, A. (2022). The role of hand therapy in facilitating participation in rock wall climbing: A case report of a woman with cerebral palsy. Journal of Hand Therapy, 35(1), 142–147. https://doi.org/10.1016/j.jht.2020.10.013
Full text: https://www.sciencedirect.com/science/article/abs/pii/S0894113020302039

Rupture of the Short Head of the Biceps Brachii Muscle Belly Caused by a Rock-Climbing Accident

Authors: Michael Simon, Christoph Lutter, Volker Schöffl | Year: 2020
Summary/Results:
This report details a 42-year-old climber who sustained a rare rupture of the short head of the biceps brachii muscle belly after striking his arm on a wall volume during a bouldering fall. The injury was surgically repaired with direct sutures, followed by rehabilitation. Within six months, the patient regained full range of motion without pain, and 2.5 years later returned to climbing at nearly his previous level, with only a minor reduction in ability. The authors suggest early surgical repair may be an effective treatment for this uncommon injury.
Reference:
Simon, M., Lutter, C., & Schöffl, V. (2020). Rupture of the short head of the biceps brachii muscle belly caused by a rock-climbing accident. Wilderness & Environmental Medicine, 31(3), 331–337. https://journals.sagepub.com/doi/full/10.1016/j.wem.2020.04.006

Olympic competition climbing: the beginning of a new era—a narrative review

Authors: Lutter C, Tischer T, Schöffl V. | Year: 2020
Summary/Results:
This review discusses the development of sport climbing as it entered the Olympic Games, where athletes compete in lead, bouldering, speed, and a combined format on artificial walls. Injury rates in elite competition are generally low, but climbing indoors has been linked with more frequent injuries than outdoor climbing. Fingers are the most common site of chronic problems, with conditions such as pulley strains, tendon sheath inflammation, and growth plate injuries especially in younger climbers. Because these injuries are unique to climbing, healthcare providers need sport-specific knowledge for effective treatment. The authors also highlight the lack of solid evidence on preventive strategies and emphasize the importance of better injury surveillance and anti-doping measures as the sport expands.
Reference:
Lutter, C., Tischer, T., & Schöffl, V. (2020). Olympic competition climbing: the beginning of a new era—a narrative review. British Journal of Sports Medicine, 55(15), bjsports-2020-102035. https://doi.org/10.1136/bjsports-2020-102035

No pain no gain: a survey of use of healthcare and reasons not to seek healthcare by Norwegian climbers with chronic injuries

Authors: Grønhaug G, Saeterbakken A. | Year: 2019
Summary/Results:
This survey of 667 Norwegian climbers found that 385 had a chronic injury in the past 6 months, yet most did not seek healthcare. The main reasons were believing the injury was not serious (70%) or doubting professionals could help (60%). Finger injuries were most common but least likely to receive medical attention. Men and more experienced climbers were less likely to seek care than women or recreational climbers, reflecting limited trust in healthcare. Many continued climbing with reduced training rather than stopping. These patterns suggest a strong culture of self-diagnosis and self-treatment, especially for finger injuries, which may increase the risk of reinjury.
Beta Angel Note: For coaches and medical staff, the key challenge may be building trust. If experienced climbers remain skeptical of healthcare, they risk passing that attitude on to younger athletes, leaving preventable injuries untreated.
Reference:
Grønhaug, G., & Saeterbakken, A. (2019). No pain no gain: a survey of use of healthcare and reasons not to seek healthcare by Norwegian climbers with chronic injuries. BMJ Open Sport & Exercise Medicine, 5(1), e000513. https://pmc.ncbi.nlm.nih.gov/articles/PMC6539184/

Mechanisms of Acute Knee Injuries in Bouldering and Rock Climbing Athletes.

Authors: Lutter C, Tischer T, Cooper C, Frank L, Hotfiel T, Lenz R, Schöffl V. | Year: 2020
Summary/Results:
The authors conducted a 4-year retrospective multicenter analysis of 71 climbers (35% competitive, 65% noncompetitive) who sustained 77 acute knee injuries. Four injury mechanisms were identified: high step (20.8%), drop knee (16.9%), heel hook (40.3%), and ground fall (22.1%). Medial meniscal tears (28.6%) were the most frequent injury, especially in noncompetitive climbers, while iliotibial band strain was unique to heel hooks. ACL injuries were strongly linked to uncontrolled falls. Nearly half of all injuries occurred during indoor bouldering (46.8%). One year post-injury, most athletes returned to climbing with high function (Lysholm score 97 ± 4.8; climbing-specific outcome 4.8 ± 0.6). Noncompetitive climbers required more surgeries and had more meniscal tears than competitive athletes. The findings emphasize the knee as a vulnerable joint in climbing, particularly with the rise of indoor bouldering, and highlight the need for targeted injury prevention and training programs.
Reference:
Am J Sports Med. 2020;48(3):730-738. doi:10.1177/0363546519899931. https://open.fau.de/server/api/core/bitstreams/67f2939f-4225-4b83-9df1-75d9ba4feb44/content

Influence of regular climbing on depression, generalized anxiety and lower back pain

Authors: Zieliński, G., Byś, A., Zięba, E., Ginszt, M., Wilkowicz, W., Libera, O., Zawadka, M., Saran, T., & Gawda, P. | Year: 2021
Summary/Results:
This study examined 113 adult climbers (average age ~30; 88 men, 35 women) using questionnaires for depression (PHQ-9), generalized anxiety (GAD-7), and back pain (Oswestry Disability Index). About one quarter of participants showed mild depression (27%), moderate anxiety (27%), and mild lumbar back pain (26%). Climbing level (intermediate, advanced, elite) did not significantly change these outcomes. Club membership was associated with climbing harder routes but also with higher anxiety. Compared with rope climbers, boulderers reported more frequent lower back pain and more injuries, while rates of depression and anxiety were similar across sub-disciplines.
Beta Angel note: The link between bouldering and back pain is a standout—likely tied to repeated falls and impact on mats. Coaches might weigh this when recommending training styles to athletes with spine concerns.
Reference:
Zieliński, G., Byś, A., Zięba, E., Ginszt, M., Wilkowicz, W., Libera, O., Zawadka, M., Saran, T., & Gawda, P. (2021). Influence of regular climbing on depression, generalized anxiety and lower back pain. Annals of Agricultural and Environmental Medicine, 28(3), 463–468. https://www.aaem.pl/pdf-124189-68440?filename=Influence%20of%20regular.pdf

Hospital Readmission After Climbing-Related Injury in the United States

Authors: Forrester JD, Hunter KA, Spain DA. | Year: 2020
Summary/Results:
This study analyzed U.S. hospital data (2012–2014) to track readmissions following climbing-related injuries. Over 1,300 hospitalizations were identified, most in young adults (18–44 years) and primarily involving men. Nearly half of cases were isolated extremity injuries, and about two-thirds required surgery. Mortality was low (<1%), and only 2% of patients were readmitted within 6 months, most often with orthopedic issues. Female patients had a significantly higher chance of readmission compared to males.
Beta Angel note: It is interesting that despite climbing’s physical risks, readmission rates were low and similar to other trauma populations. The finding that women face a higher readmission risk raises questions about sex-specific equipment design, medical follow-up, and injury prevention that deserve more attention.
Reference:
Forrester, J. D., Hunter, K. A., & Spain, D. A. (2020). Hospital readmission after climbing-related injury in the United States. Wilderness & Environmental Medicine, 31(3), 261–267. https://doi.org/10.1016/j.wem.2020.05.005

Head and Neck Injuries from Rock Climbing: A Query of the National Electronic Injury Surveillance System

Authors: Chou DW, Kshirsagar R, Liang J. | Year: 2020
Summary/Results: The authors analyzed ten years (2009–2018) of U.S. emergency department data to identify head and neck injuries from rock climbing, estimating over 5,000 cases nationwide. Concussions were most common, followed by facial lacerations, soft tissue injuries, and less frequent but severe outcomes such as skull fractures, cervical spine fractures, and intracranial bleeding. Males more often experienced severe injuries, and falls over 20 feet were strongly linked to serious trauma and hospitalization. The study highlights the need for protective measures and fall prevention in climbing.
Reference: Chou, D. W., Kshirsagar, R., & Liang, J. (2020). Head and neck injuries from rock climbing: A query of the National Electronic Injury Surveillance System. Annals of Otology, Rhinology & Laryngology, 130(1), 18–23. https://doi.org/10.1177/0003489420936710

Grip Force Measurement as a Complement to High-Resolution Ultrasound in the Diagnosis and Follow-Up of A2 and A4 Finger Pulley Injuries

Authors: Iruretagoiena-Urbieta, X., De la Fuente-Ortiz de Zarate, J., Blasi, M., Obradó-Carriedo, F., Ormazabal-Aristegi, A., & Rodríguez-López, E.S. | Year: 2020
Summary/Results:
This study examined whether finger pulley injuries (A2 or A4) in climbers reduce grip strength and how this relates to ultrasound imaging and pain symptoms. Thirty-nine rock climbers with pulley injuries and ten healthy controls were tested using a Bindar device, which measures finger grip force directly on a climbing hold. Three grip types were analyzed: one-finger crimp, open crimp, and close crimp. Injured climbers showed a clear reduction in grip strength during the one-finger crimp, and to a lesser degree in the open crimp, but not in the close crimp. A tendon–bone distance (TBD) greater than 2 mm on ultrasound strongly correlated with decreased grip strength in the one-finger crimp, but not in other grip types. Pain was also an important factor: climbers with both pain and ultrasound abnormalities had the largest strength deficits. The study concludes that grip strength testing, especially with a one-finger crimp, is a valuable complement to ultrasound and clinical exams for diagnosing and tracking A2 and A4 pulley injuries.
Beta Angel note: This paper highlights the one-finger crimp as the most injury-revealing grip — reinforcing why climbers and coaches should be cautious with this grip type in both training and rehab.
Reference:
Iruretagoiena-Urbieta, X., De la Fuente-Ortiz de Zarate, J., Blasi, M., Obradó-Carriedo, F., Ormazabal-Aristegi, A., & Rodríguez-López, E.S. (2020). Grip force measurement as a complement to high-resolution ultrasound in the diagnosis and follow-up of A2 and A4 finger pulley injuries. Diagnostics, 10(4), 206. https://doi.org/10.3390/diagnostics10040206
https://pmc.ncbi.nlm.nih.gov/articles/PMC7235872/

Effort Thrombosis Presenting as Unilateral “Pumped” Arm in a Climber

Authors: Musi ME, Melher A, Davis CB. | Year: 2020
Summary/Results: This case study describes a 38-year-old climber who noticed one arm becoming unusually “pumped” after an indoor session. Instead of normal muscle fatigue, the arm developed swelling (edema), redness, and pain. Doctors found a blood clot in the large veins of the shoulder (upper extremity deep vein thrombosis, also called effort thrombosis). He was treated right away, which restored blood flow and prevented long-term damage.
Most climbing injuries affect muscles or tendons, but this report shows that rare vascular problems can also occur. Climbers and healthcare providers should be alert—if swelling and discomfort do not ease with rest, it may signal a more serious condition.
Reference: Musi, M. E., Melher, A., & Davis, C. B. (2020). Effort thrombosis presenting as unilateral “pumped” arm in a climber. Wilderness & Environmental Medicine, 31(3), 333–338. https://doi.org/10.1016/j.wem.2020.05.001

Custom-Made Total Talonavicular Replacement in a Professional Rock Climber

Authors: Giannini S, Cadossi M, Mazzotti A, Ramponi L, Belvedere C, Leardini A. | Year: 2016
Summary/Results: This case report describes the first known custom-made replacement of the talonavicular joint (part of the ankle/foot complex) in a professional rock climber who developed severe arthritis after a complex fracture. Using 3D imaging and advanced metal printing, surgeons built a personalized implant. At 30 months follow-up, the climber had excellent function, returned fully to sport, and showed no signs of implant failure. This case highlights how tailored surgical solutions can help elite athletes regain high-level performance when standard treatments, such as fusion, would limit mobility.
Reference: J Foot Ankle Surg. 2016 Nov-Dec;55(6):1271-1275. doi: 10.1053/j.jfas.2015.04.012
https://pubmed.ncbi.nlm.nih.gov/26232176/

Comprehensive Review of Rock Climbing Injuries

Authors: Cole KP, Uhl RL, Rosenbaum AJ. | Year: 2020
Summary/Results: This review outlines the wide range of injuries seen in rock climbers, reflecting the sport’s rapid growth and Olympic recognition. Climbers often put extreme stress on their upper body and move their legs into unusual positions, leading to both sudden traumatic injuries (like falls and impacts) and slow-developing overuse injuries. A distinctive climbing-specific injury is rupture of the finger flexor tendon pulley system, but shoulders, elbows, and other joints are also frequently injured. In more severe cases, climbers may need surgical treatment. The authors emphasize that healthcare providers must understand climbing’s unique injury patterns in order to provide accurate diagnosis, treatment, and prevention advice for this athletic group.
Beta Angel note: It’s notable that finger pulley injuries—rare outside of climbing—are so central to the sport that they represent a defining injury pattern, a reminder of just how specialized climbing stress is compared to traditional sports.
Reference: J Am Acad Orthop Surg. 2020 Jun 15;28(12):e501-e509. doi: 10.5435/JAAOS-D-19-00575.
https://pubmed.ncbi.nlm.nih.gov/32015250/

Bouldering psychotherapy is more effective in the treatment of depression than physical exercise alone: results of a multicentre randomised controlled intervention study

Authors: Nina Karg, Lisa Dorscht, Johannes Kornhuber, Katharina Luttenberger | Year: 2020
Summary/Results:
This randomized trial compared bouldering psychotherapy (BPT) with a home-based physical exercise program (EP) in 133 adults with depression. After 10 weeks, both groups showed improvement, but those in the BPT group had a significantly greater reduction in depression scores (−8.4 vs. −3.0 on the MADRS scale) and also showed more improvement in anxiety, self-esteem, and body image. The BPT included group climbing sessions with therapeutic themes and mindfulness (focusing awareness on the present moment without judgment). Depression was measured by clinician-rated interviews and self-report scales. The results suggest that bouldering combined with structured psychological support may be more effective than exercise alone in reducing depressive symptoms.
Reference: BMC Psychiatry. 2020 Mar 12;20:116. doi: 10.1186/s12888-020-02518-y
https://pmc.ncbi.nlm.nih.gov/articles/PMC7066840/

Acute Hamstring Muscle Tears in Climbers—Current Rehabilitation Concepts

Authors: Ehiogu UD, Stephens G, Jones G, Schöffl V | Year: 2020
Summary/Results:
This paper reviews the causes and rehabilitation of acute hamstring injuries specific to climbers. It focuses on the heel hook—a climbing technique that places high stress on the hamstrings, especially during overhanging or strenuous climbs. Unlike running-based hamstring injuries (which usually result from eccentric muscle lengthening), heel hook injuries involve intense concentric (muscle shortening under load) and isometric (static holding) work. Because of this, the authors question whether the standard rehab approach—eccentric-only training—is enough. They propose a more climbing-specific rehabilitation strategy that also includes concentric strength development to match the real-world demands of heel hook movement.
Reference:
Wilderness Environ Med. 2020;31(4):441–453. doi: 10.1016/j.wem.2020.07.002
https://www.researchgate.net/publication/345942785_Acute_Hamstring_Muscle_Tears_in_Climbers-Current_Rehabilitation_Concepts

Closed disruption of a single flexor digitorum superficialis tendon slip: 3 cases.

Authors: Schweizer, Bayer | Year: 2019
Summary: Case studies of three flexor digitorum superficialis (FDS) tendon injuries that presented as flexor tendon injuries but had no functional deficit. The injury was a full disruption to only one side of the tendon after the tendon branches off into two “slips.” The authors present this injury as a potential important differential diagnosis to the more commonly reported flexor tendon injury and used (in these cases) conservative treatment for full return to sport.
Reference: Hand Surg Rehabil. 2019 Apr;38(2):121-124.
https://www.ncbi.nlm.nih.gov/pubmed/30708121

Rock climbing injuries and time to return to sport in the recreational climber.

Authors: Lum, Park | Year: 2019
Summary: Authors examined 432 injuries in 237 climbers. Most injuries do not need surgical treatment (89%). Climbers with injuries that needed surgery took longer to get back into climbing (9.1 month) compared with those who did not need surgery (3.9 month). There were no differences in terms of rates of climbers getting back into the sport and leaving the sport after the injury.
Reference: J Orthop. 2019 Apr 12;16(4):361-363.
https://www.ncbi.nlm.nih.gov/pubmed/31024194

Retrospective survey of sport climbing injuries and self-care in the Gunma prefecture.

Authors: Asakawa, Sakamoto | Year: 2019
Summary: Overview of self-reported injuries in 85 climbers. The authors found that overuse injuries are most common and that the fingers are the most common site of injury. The authors suggest that given the high rate of finger injuries it may be protective to promote rest and perform “low grade tasks” and stretching of the intrinsic (thumb, little finger, lumbrical, and interossei) and extrinsic (long flexors and extensors) muscles of the fingers.
Reference: J Phys Ther Sci. 2019 Apr;31(4):332-335.
https://www.ncbi.nlm.nih.gov/pubmed/31037004

Cartilage abnormalities and osteophytes in the fingers of elite sport climbers: An ultrasonography-based cross-sectional study.

Authors: Pastor, Fröhlich, Spörri, Schreiber, Schweizer | Year: 2019
Summary: In this cross-sectional (data from a representational sub-set of a population) study the authors found that cartilage changes in the fingers may be a result of climbing. By using an ultrasound imaging technique, the study found that cartilage thickness is increased, especially in the middle finger PIP (second joint back from the tip) joint. The authors discuss if this is a possible driver for injuries. Beta-Angel note from external reviewer: Cartilage thickness is a sign of the adaptive response of the body to avoid injuries so whether this specific climbing related response in the cartilage is protective or harmful is debatable.
Reference: Eur J Sport Sci. 2020 Mar;20(2):269-276.
https://www.ncbi.nlm.nih.gov/pubmed/31184978

[Sport climbing, bouldering and associated injuries in childhood and adolescence]

Authors: Schweizer, Schweizer | Year: 2019
Summary: German-language paper summing up adolescent injuries in sport climbing. The authors suggest overuse injuries are more common than acute injuries and that the epiphyseal fracture is the most common injury.
Reference: Orthopade. 2019 Dec;48(12):998-1004.
https://www.ncbi.nlm.nih.gov/pubmed/31696262

Efficacy of corticosteroid injection in rock climber’s tenosynovitis

Author: Schöffl, Strohm, Lutter | Year: 2019
Summary/Results: Authors studied the effect of corticosteroid injection in 42 patients with pain lasting 6 weeks or more or after conservative therapy failed (4 weeks). “During climbing, 24 climbers (57%) were pain free and 18 (43%) suffered from occasional pain.” Of those 18, half received further treatment, and the other half climbed accepted the pain and climbed with full load. Only 7 received “satisfactory” scores indicating decreased load capacity. Beta-Angel note: a little spooky, the wrong injection technique, or not following the doctor’s advice for rest after the injection, could lead to tendon rupture. Splendid.
Reference: Hand Surg Rehabil. 2019 Oct;38(5):317-322
https://www.ncbi.nlm.nih.gov/pubmed/31386924

Finger and Shoulder Injuries in Rock Climbing

Author: Schöffl, Simon, Lutter | Year: 2019
Summary/Results: German-language research paper primarily on incidence of climbing injuries in a large patient population. The authors reiterate a previous point they make that they expect shoulder injuries to continue rising due to new competition types and increased interest in bouldering. Beta-angel note: particularly worth the read because it has a table that compares the incidence from their 1998-2001 sample to 2009-2012 sample to a 2017-2018 sample. Also, of note is that epicondylitis continues to drop from #2 to #5, then #8. There could be a number of reasons for changing diagnoses, including updated methods of diagnosis, as well as increased information about certain injuries to the general climbing community.
Reference: Springer Medizin Verlag GmbH, ein Tell von Springer Nature 2019
https://www.ncbi.nlm.nih.gov/pubmed/31705177

Doping in Sport Climbing: Status Quo in a New Olympic Discipline

Author: Lutter, Tischer, El-Sheikh, Schöffl| Year: 2019
Summary/Results: Four climbing injury researchers make recommendations about doping in climbing. Their recommendations include increased awareness of ethics, increased antidoping education, sports medical supervision, collaboration between national climbing and sports ethics organizations, and increased monitoring and controls. These recommendations are primarily aimed at elite climbers within both a competition and outdoor context, but also include an educational component for fans, athletes, trainers, and officials.
Reference: Curr Sports Med Rep. 2019 Oct;18(10):351-352.
https://journals.lww.com/acsm-csmr/Citation/2019/10000/Doping_in_Sport_Climbing__Status_Quo_in_a_New.3.aspx

Radial extracorporeal shock wave therapy in flexor tendon pathology of the hand: a feasibility study

Author: Lutter et al. | Year: 2019
Summary/Results: The authors used pressure sensitive film to determine whether Radial Extracorporeal shock wave therapy (rESWT) will penetrate soft tissue in human hand cadavers. The researchers believe the treatment may be promising as an alternative to corticosteroid injections for partial tears to finger tendons, but encourage further research for effectiveness of both pain mitigation and healing.
Reference: Technol Health Care. 2019 Jul 5. doi: 10.3233/THC-191654.
https://www.ncbi.nlm.nih.gov/pubmed/31282446

Evaluation of Rock Climbing Related Injuries in Older Athletes.

Author: Lutter et al. | Year: 2019
Summary/Results: The authors looked at three groups of older climbers from ages 35-49, 50-64, and 65+ in order to understand injury distributions. They found that while the injury distributions were similar to younger age groups, there were some distinctions: notably a higher incidence of degenerative, nonreversible injuries such as shoulder impingement and osteoarthritis of the fingers.
Reference: Wilderness Environ Med. 2019 Dec;30(4):362-368.
https://www.ncbi.nlm.nih.gov/pubmed/31668938

Climbing Accidents-Prospective Data Analysis from the International Alpine Trauma Registry and Systematic Review of the Literature.

Author: Rauch et al. | Year: 2019
Summary/Results: Authors present data collected from the International Alpine Trauma Registry (IATR) showing statistics behind the 306 “mountain accidents” of which 12.1% were climbing-related. The authors review the factors involved, such as belay-related (32.4%) or not using a harness (8.1%) as well as other factors, like use of helicopters or pain medication at the site of the incident. Beta-Angel note: noteworthy for performance-related reasons due to the literature review which seeks to differentiate different types of climbing, and statistics about belaying and harnesses.
Reference: Int J Environ Res Public Health. 2019 Dec 27;17(1). pii: E203.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981967/

Long-term effects of bouldering psychotherapy on depression: benefits can be maintained across a 12-month follow-up

Author: Schwarz et al. | Year: 2019
Summary/Results: The authors sought to determine whether a once-a-week, three-hour bouldering session was effective against a control group for reducing depression, and also whether the effectiveness (Beck Depression Inventory II) remained stable across the course of a year. Those who participated in the bouldering session had a significantly lower score than those in the control group, and the scores appear to remain stable over the long-term. Beta-Angel note: this study was intended to build on previous research (Stelzer et al 2018 and Luttenberger 2015) suggesting bouldering is a legitimate therapeutic approach for those suffering from depression by using a more rigorous methodology. Additionally, this study shares members with the even more rigorous protocol entitled “A German climbing study on depression…” also published this year and in the inventory.
Reference: Heliyon. 2019 Dec; 5(12): e02929.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911955/

Rock Climbing Injuries Treated in US Emergency Departments, 2008_2016

Authors: Buzzacott, I. Schöffl, Chimiak, V. Schöffl | Year: 2019
Summary/Results: The authors looked at US emergency room data for rock climbing injuries between 2008 and 2016 and classified those injuries based on a scale of 1 (mild) to 6 (immediate death). The authors found that the number of injuries is increasing (still unknown is whether this is due to a higher injury rate or higher number of climbers), falls accounted for 60% of injuries, and that most of the falls (73%) were less than six meters, and that the most common reported injuries were fractures (27%) and sprains or strains (26%) followed by soft-tissue injuries (11%), lacerations (11%), dislocations (4%), and “other” injuries (21%). Lower and upper body injuries were 47% and 25% respectively, with the torso and head making up 15% and 12% respectively. Beta-Angel note: This study has some great tables and builds off the Nelson and Mackenzie study looking at data from 1990 to 2007 and uses the same criteria for evaluation.
Reference: Wilderness Environ Med. 2019 Jun;30(2):121-128
https://www.ncbi.nlm.nih.gov/pubmed/30857822

Outcomes following an adaptive rock climbing program in a person with an incomplete spinal cord injury: A case report.

Authors: DelGrande B, LaCoppola C, Moriello G, Sanicola K. | Year: 2019
Summary/Results: A 61-year-old male with a C6 cervical spinal cord injury completed a physical therapy (PT) session and indoor climbing session each week for 19 weeks. The physical therapists made adjustments to the traditional PT sessions to target his climbing weaknesses (external rotation while stepping, etc.). Muscle strength, arm girth, balance (MiniBEST), distance climbed (with and without assistance), climbing performance, and the Quality of Life Profile for Adults with Physical Disabilities were recorded. After the 19 weeks, the man improved in most measurements, except the balance test; however, by the end he could walk independently on the compliant surface of the gym. The researchers suggest climbing PT interventions can improve health, wellness, and quality of life in individuals with post-spinal cord injuries.
Reference: Physiother Theory Pract. 2019 Mar 14:1-10. doi: 10.1080/09593985.2019.1587799. https://www.ncbi.nlm.nih.gov/pubmed/30870058

Semi-dynamic MRI of climbing-associated injuries of the finger.

Authors: Schellhammer F, Vantorre A. | Year: 2019
Summary/Results: Injuries to the A2 and A4 pulleys are common amongst climbers and are readily detected by static MRI. Identification of A3 lesions (wounds) remains challenging. 22 fingers (14 volunteers & 3 injured climbers) were scanned using a sagittal (divides left and right) T1 turbo spin echo sequence (a reference to a high-speed MRI technique) in 5 consecutive finger positions ranging from stretched to fully flexed. The sagittal T1 turbo spin echo sequence enabled the researchers to discriminate the tenophalangeal (tendon-to-bone) distance, which may help identify A3 pulley lesions.
Reference: Skeletal Radiol. 2019 Sep;48(9):1435-1437. doi: 10.1007/s00256-019-03216-x. https://www.ncbi.nlm.nih.gov/pubmed/31037344

How do the new Olympic sports compare with the traditional Olympic sports? Injury and illness at the 2018 Youth Olympic Summer Games in Buenos Aires, Argentina.

Authors: Steffen K, Soligard T, Mountjoy M, Dallo I, Gessara AM, Giuria H, Perez Alamino L, Rodriguez J, Salmina N, Veloz D, Budgett R, Engebretsen L. | Year: 2019
Summary/Results: Injuries and illnesses were recorded during the Buenos Aires 2018 Youth Olympic Summer Games. 1 male and 21 female climbers were present during this event. Only 1 male was injured (classified as a strain/muscle rupture/tear in the shoulder/clavicle). Climbing was one of the lowest injury incidence sports.
Reference: Br J Sports Med. 2019 Dec 3. pii: bjsports-2019-101040. doi: 10.1136/bjsports-2019-101040 https://www.ncbi.nlm.nih.gov/pubmed/31796464
Tags: Kinesiology > Injury

Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis

Authors: Weber CD, Horst K, Nguyen AR, Lefering R, Pape HC, Hildebrand F; TraumaRegister DGU. | Year: 2018
Summary/results: The authors analyze data from the TraumaRegister DGU database to assess severe and fatal injuries in extreme and contact sports presented at European trauma units from 2002-2012. Climbers experienced high rates of chest and spinal injuries, similar to airborne activities (hang-gliding, kiting, parachuting). The climber mortality rate was 5.7% compared to 7.6% airborne, 14.9% skating (skateboarding, longboarding, in-line skating), and 2.9% contact sports (hockey, football, soccer, etc.).
Reference: Arch Orthop Trauma Surg. 2018 Jul;138(7):963-970.
https://www.ncbi.nlm.nih.gov/pubmed/29675749
Kinesiology > Injury

Death on the Dome: Epidemiology of Recreational Deaths on Half Dome in Yosemite National Park.

Authors: Richardson GD, Spano SJ. | Year: 2018
Summary/results: The authors investigated the causes of 31 deaths on Half Dome in 85 years. At time of death, their activities were technical rock climbing (36%), suicide (26%), utilizing cable handrails (16%), hiking (16%), and base jumping (6%). Contrary to media coverage, cable handrail falls due to overcrowding (1) and weather (2) are actually minimal based on the authors’ findings.
Reference: Wilderness Environ Med. 2018 Sep;29(3):338-342.
https://www.ncbi.nlm.nih.gov/pubmed/29887349
Kinesiology > Injury

Valuing the Benefits of Rock Climbing and the Welfare Gains from Decreasing Injury Risk

Authors: Nicita L, Shaw WD, Signorello G. | Year: 2018
Summary/Results: The authors used the Kuhn-Tucker approach to estimate Sicily’s demand for rock climbing, the recreational value of different climbing sites, and the welfare impact of reducing injury risk. The authors found that Sicilian climbing sites with higher number of routes, scenic views, and less risk are more likely to be visited. There is an economic advantage to produce these types of climbing sites by improving the bolting of existing routes.
Reference: Risk Anal. 2018 Nov;38(11):2258-2274.
https://www.ncbi.nlm.nih.gov/pubmed/30129047
Kinesiology > Injury

Climbing-Related Injury Among Adults in the United States: 5-Year Analysis of the National Emergency Department Sample

Authors: Forrester JD, Tran K, Tennakoon L, Staudenmayer K | Year: 2018
Summary/Results: In this paper, the authors estimated the national morbidity, mortality, and healthcare cost due to climbing-related injuries presented at US emergency departments (ED) using a retrospective analysis of the National Emergency Department Sample (NEDS) database from 2010-2014. Out of 15,116 estimated climbing-related ED visits, only 11% (1610) of climbing patients were admitted as inpatients. Less than 1% of climbing related ED visits resulted in death. Overall, climbing related injuries cost the healthcare system ~$20 million per year.
Reference: Wilderness Environ Med. 2018 Dec;29(4):425-430.
https://www.ncbi.nlm.nih.gov/pubmed/30241931
Kinesiology > Injury

Treatment of finger problems in climbers with the local-osteopathic Isele-method: a Pilot study

Author: K. Isele, AG Hay, B. Schrank, A. Schweikart | Year: 2018
Summary/Results: Researchers discuss the testing of Klaus Isele’s (Austrian National Team Physio) finger injury treatment method on 60 subjects (19.4% female) which involved questionnaires at three separate times with treatment between the second and third. Treatment includes pulling the finger to create “traction” (a stretching motion or force), inducing pressure on the sensitive area, and flexing the finger. Authors conclude the method works for improvement of pain at any stage of a finger issue.
Reference: Front Psychol. 2018 Dec 17;9:2383.
https://physioandclimb.com/wp-content/uploads/2018/08/PilotStudy_IseleMethod_KlausIsele_ShortVersion_Engl.pdf
Kinesiology > Injury

Epidemiology of injuries and pain in rock climbers – A review of the literature and new epidemiological data

Author: R. Vilella | Year: 2018
Summary/Results: Author conducts a literature review of articles discussing pain and/or injury in climbing and used a survey of 59 responses to collect data on pain in climbers in Minas Gerais, Brazil. The author suggests that the incidence of pain in climbers at different levels does not progress in a straightforward way from lower levels of difficult climbing (and lower levels of pain) to higher levels of difficult climbing (and higher levels of pain), but rather peaks at an intermediate level of difficult climbing. Additionally, climbers that climb both outdoors and indoors are more likely to feel pain than those who specialize.
Reference: Researchgate, December 2018
https://www.researchgate.net/publication/329567388_Epidemiology_of_injuries_and_pain_in_rock_climbers_-_A_review_of_the_literature_and_new_epidemiological_data
Kinesiology > Injury

Incidence, Diagnosis, and Management of Injury in Sport Climbing and Bouldering: A Critical Review

Author: G. Jones, V. Schöffl, MI Johnson | Year: 2018
Summary/Results: Analysis of eight studies which calculate injury incidence per 1000 hours (a typical measurement for calculating injury potential) concluded that sport climbing and bouldering have an injury rate of 2.71±4.49 per 1000 hours. The authors further suggest that ensuring the correct diagnosis of finger injuries and shoulder injuries is challenging, and that early identification of growth plate injuries in children is extremely important. Beta-Angel note: the authors include a new chart which identifies diagnosis and therapy options for acute trauma in addition to chronic overuse injury for both adults and children. It’s also important to note that the wide variation in the injury rate is due to a number of large distinctions in the eight different studies, including the type of population surveyed.
Reference: Curr Sports Med Rep. 2018 Nov;17(11):396-401.
https://www.ncbi.nlm.nih.gov/pubmed/30407948
Kinesiology > Injury

Climber’s Knuckle Excoriation

Author: S. Ohmori, Y. Sawada, M. Nakamura | Year: 2018
Summary/Results: Japanese dermatology researchers submitted a letter to the editor of a journal with a case study of a climber who had an infected open wound from scraping the knuckle on a climbing wall. The authors note that it’s common for this type of injury to occur when the fingers suddenly fail while on a small crimp, with the knuckles subsequently scraping the wall “vigorously.” They recommend keeping the open wound clean and to try to avoid scarring due to a potential impact on performance.
Reference: J Dermatol. 2018 Sep;45(9):e264-e265.
https://www.ncbi.nlm.nih.gov/pubmed/29572907
Kinesiology > Injury

UIAA Medical Commission Recommendations for Mountaineers, Hillwalkers, Trekkers, and Rock and Ice Climbers with Diabetes

Author: D. Hillebrandt, A Gurtoo, T. Kupper, P. Richards, V. Schöffl, P. Shah, R. van der Spek, N. Wallis, J. Milledge | Year: 2018
Summary/Results: The authors provide information and recommendations for diabetic individuals who participate in climbing, which primarily revolve around monitoring and preparation. Preparation should include knowledge of the speed of dropping blood glucose levels, back-up food and insulin, knowledge of medical conditions they may be more prone to at altitude, such as frostbite, infection and loss of sight, or with tight climbing shoes, such as small blood vessel and nerve damage, and also the preparation of equipment and medicines. The authors also recommend several management options, including treatment with and without rescue facilities in remote areas, issues for technology and the different kinds of medication, and knowledge about the primary issues including hypoglycemia, hyperglycemia, and ketoacidosis. It’s clear that well-informed partners also play a role. Beta-Angel note: a practical management primer for climbers with diabetes.
Reference: High Alt Med Biol. 2018 Nov 3.
https://www.ncbi.nlm.nih.gov/pubmed/30335516
Kinesiology > Injury

Wilderness Falls: An Analysis and Comparison of Rock Climbers and Nonclimbers

Author: M. Bernard, R. Wright, H. Anderson, A. Bernard | Year: 2018
Summary/Results: In an analysis of a level 1 trauma center’s data of 151 patients who “fell from a cliff,” 26.5% were climbers, 78.4% were male, there was no difference in severity scores between climbers and non-climbers, but climbers were younger (26.1 vs. 32.8), there was no significant difference in intoxication (23% for climbers, and 39% for non-climbers). Data for managed care insurance (higher for climbers), the time of transport (day for climbers), the use of air transport (higher for climbers), and climber transport time (lower) were significantly different. Soft tissue injuries were also higher among climbers, as were upper extremity injuries.
Reference: J Surg Res. 2019 Feb;234:149-154.
https://www.ncbi.nlm.nih.gov/pubmed/30527467
Kinesiology > Injury

Ultrasound evaluation of stress injuries and physiological adaptations in the fingers of adolescent competitive rock climbers

Author: K. Garcia, D. Jaramillo, E. Rubesova | Year: 2018
Summary/Results: Researchers evaluated 20 male/female climbers divided up into 3 different levels of climbing and compared them to 6 male/female non-climbers using different types of radiographic imaging, and a questionnaire. The climbers were divided up based on: (1) climbing grade, (2) use of supplemental finger exercises, (3) number of years climbing, and (4) hours per week spent climbing/training. The authors suggest that climbing results in adaptive changes (flexor tendons, volar plates, and soft tissues) in the fingers of young climbers but that these adaptive changes also involve the potential for stress injuries. The authors also suggested that there are both advantages and disadvantages in the use of MRI imaging over Ultrasound imaging.
Reference: Pediatr Radiol. 2018 Mar;48(3):366-373.
https://www.ncbi.nlm.nih.gov/pubmed/29218364
Kinesiology > Injury

Traumatic Urethraggia in Adolescence: Ushering in the New Age of “Extreme Sports”

Author: I. Hodge, A. Adam, M. Chennapragada, A. Tiu, AV. Deshpande | Year: 2018
Summary/Results: The authors present a single case report of a 14-year-old boy who fell onto a poll while participating in indoor rock climbing, sustaining a “blunt” non-penetrating trauma. The injury was considered “blunt” trauma, but nonetheless caused injury to an artery that led to blood loss. Though not a widely-known or common injury, the authors suggest these types of injuries may increase due to recent trends in extreme sports.
Reference: Urology. 2018 Apr;114:181-183.
https://www.ncbi.nlm.nih.gov/pubmed/29305941
Kinesiology > Injury

MRI sport-specific pulley imaging

Author: MN Hoff, TD Greenberg | Year: 2018
Summary/Results: The researchers tested a novel climbing-specific crimp position using an MRI in a single individual in order to determine the MRI’s efficacy in measuring the bone to tendon distance (BTD), a traditional measure associated with diagnosing pulley (a stabilizing tendon that holds a finger-pulling tendon to the finger bone) injury injuries. The technique identified the BTD as 1.5 mm (which is less than 2 mm – the distance used to indicate a weakened pulley) across 3 images; one image of a relaxed crimp and two images of a stress crimped position. The authors note a wide range of benefits (e.g. outcome of surgery; rehab, etc.) to using a climbing-specific grip position using a relaxed and stressed method.
Reference: Skeletal Radiol. 2018 Jul;47(7):989-992.
https://www.ncbi.nlm.nih.gov/pubmed/29018907
Kinesiology > Injury

Diagnosis of A3 Pulley Injuries Using Ultrasound.

Author: I. Schöffl, J. Deeg, C. Lutter, T. Bayer, V. Schöffl | Year: 2018
Summary/Results: The authors suggest a new approach to investigating whether an A3 pulley has been ruptured due to the distinction in origin (the volar plate: a thick ligament which limits hyperextension and provides reinforcement and stability) of the A3 pulley (a stabilizing tendon that holds a finger-pulling tendon to the finger bone) vs. the A2 and A4 pulleys. Rather than measuring the tendon-to-bone distance in the case of the A2 and A4, the authors were able to predict rupture of the A3 using a cut-off distance between the volar plate and the tendon of 0.9 mm.
Reference: Sportverletz Sportschaden. 2018 Dec;32(4):251-259.
https://www.ncbi.nlm.nih.gov/pubmed/30537790
Kinesiology > Injury

Autologous Conditioned Plasma Versus Placebo Injection Therapy in Lateral Epicondylitis of the Elbow: A Double Blind, Randomized Study

Author: V. Schöffl, W. Willauschus, F. Sauer, T. Küpper, I. Schöffl, C. Lutter, K. Gelse, J. Dickschas | Year: 2018
Summary/Results: Researchers tested autologous conditioned plasma (a concentrated form of blood that reacts quickly to clump and clot) to see whether it had a statistically significant effect vs. a placebo injection in 50 patients with lateral epicondylitis. Unfortunately, it had no significant effect vs. the placebo injection but the authors hypothesize that the issues may have to do with the use of a local anesthetic which recent research is showing produce an inhibitory effect on the proliferation of tendon cells. Beta-Angel note: while not technically a study of climbers, the authors chose to include this because (a) it was completed by climbing researchers, AND (b) other research has shown elbow injuries are high in climbing.
Reference: Sportverletz Sportschaden. 2017 Jan;31(1):31-36.
https://www.ncbi.nlm.nih.gov/pubmed/28222465
Kinesiology > Injury

Feasibility of a New Pulley Repair: A Cadaver Study

Author: I. Schöffl, J. Meisel, C. Lutter, V. Schöffl | Year: 2018
Summary/Results: The authors used cadaver tendons to test a new pulley repair which combines two previous methods in order to improve function without reducing strength. The authors found that the amount of force required to cause breakage in the system was comparable with previous studies of tendon strength, and that the drill tunnel did not appear to weaken the bone. Beta-Angel note: this new technique also has the potential to correct a problem with the previous surgical method which causes irritation to the extensor tendon (a tendon which extends, instead of flexes, the wrist and fingers) that lead to challenging complications in the fingers.
Reference: J Hand Surg Am. 2018 Apr;43(4):380.e1-380.e7.
https://www.ncbi.nlm.nih.gov/pubmed/28985979
Kinesiology > Injury

Knee Injuries in Rock Climbing and Bouldering – an Update

Author: C. Lutter, D. Popp, V. Schöffl | Year: 2018
Summary/Results: The authors examined 50 climbers who had pain in their knee (with 7 reporting a “snapping” sound) while performing a heel hook. The injury deferred between different ligaments in the knee, the meniscus, and the hamstrings. The authors suggest these types of injuries will increase due to trends in modern training and competition-style setting, that MRI can provide a proper diagnosis, and that the best approach is conservative treatment. Further, they recommend a good warm-up routine, shoring up muscular imbalances, and flexibility training.
Reference: The Orthopaedic Journal of Sports Medicine, 6(4)(suppl 2)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954325/
Kinesiology > Injury

Comparative functional outcomes of patients with adhesive capsulitis receiving intra-articular versus sub-acromial steroid injections: case-control study

Author: T. Goyal, A. Singh, P. Negi, B. Kharkwal | Year: 2018
Summary/Results: Researchers studied the effect of an injection of methylprednisolone acetate, both directly into the joint and into the tissue surrounding the shoulder, in 105 individuals with “frozen shoulder” – a disorder marked by pain, inflammation, and stiffness. The patients were divided into controls (no injection), the location of the injection (along with physical therapy), and physical therapy (which included wall climbing). Injections, regardless of location, were associated with improvement in pain relief and function. Beta-Angel note: we included this paper because the physical therapy protocol involved climbing.
Reference: Musculoskelet Surg. 2018 May 23.
https://www.ncbi.nlm.nih.gov/pubmed/29796762
Kinesiology > Injury

Surgical Management of Proximal Interphalangeal Joint Repetitive Stress Epiphyseal Fracture Nonunion in Elite Sport Climbers

Author: Y. El-Sheikh, C. Lutter, I. Schöffl, V. Schöffl, S. Flohe | Year: 2018
Summary/Results: Researchers discuss a case study of surgery in an elite youth competition climber with a 9-month incidence of middle finger pain diagnosed as a growth-plate fracture. The surgery involved spot drilling with wire emplacements in one hand, and non-surgical “conservative” therapy in the other. At 3 months post-surgery, the climber had complete range of motion and resolution of symptoms, and was allowed to gradually return to climbing. Beta-Angel note: The authors note that in the past, chronic “non-union” left previous adolescent climbers with pain, deformity, and stiffness. As a result, they chose to attempt a surgical procedure. Please note that this was taken from a conference paper. The published version appears to include a second case study.
Reference: J Hand Surg Am. 2018 Jun;43(6):572.e1-572.e5
https://www.ncbi.nlm.nih.gov/pubmed/29146511
Kinesiology > Injury

Lumbrical muscle tear: clinical presentation, imaging findings and outcome

Author: C. Lutter, A. Schweizer, V. Schöffl, Römer, t. Bayer | Year: 2018
Summary/Results: Authors analyze 60 patients and provide recommendations for diagnosis and therapy for lumbrical muscles, a series of four muscles that are primarily injured in the ring finger, occasionally middle finger, when the finger was isolated and extended and the neighboring fingers were actively flexed (think mono pocket). The authors found higher rates of injury severity with higher performance levels, recommend a stress test involving use of the non-injured finger, followed by ultrasound if the stress test is positive and additional diagnostics depending on the injury. Therapy is conservative and runs from 4 to 10 weeks (with “buddy taping” technique in most severe cases for an additional 10 weeks).
Reference: J Hand Surg Eur Vol. 2018 Sep;43(7):767-775.
https://www.ncbi.nlm.nih.gov/pubmed/29591320
Kinesiology > Injury

Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial

Author: EM Stelzer, S. Books, E. Graessel, B. Hofner, J. Kornhuber, K. Luttenberger | Year: 2018
Summary/Results: Researchers compared a “Bouldering” + therapy intervention with a therapy intervention in 56 individuals using two depression-related tests (SCL-90-R and BDI-II). The bouldering therapy intervention appeared to be effective even when taking physical activity, psychology, and medication into account. Beta-Angel note: the researchers find it important to note that this bouldering program is different than a typical bouldering program at your average gym. How was it different? It’s an eight-week program where each session: (1) began with a meditative or mindfulness exercise; (2) had a topic “focused on a specific psychological process”. Topics included: building group cohesion, old habits – new ways, expectation vs. experience, self-efficacy, fear and trust, trusting yourself and others, transfer to daily life, and reflections on lessons learned, and (3) was directed by therapist trained by the “Institute for Therapeutic Rock Climbing” – http://www.therapieklettern.com
Reference: Heliyon. 2018 Mar 23;4(3):e00580. doi: 10.1016/j.heliyon.2018.e00580. eCollection 2018 Mar.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968135/
Kinesiology > Injury

Lean and mean? Associations of level of performance, chronic injuries and BMI in sport climbing

Author: G. Grønhaug | Year: 2018
Summary/Results: Author reached 481 males and 186 females, with 49% climbing at an intermediate level (6b+-7a+), 34% at an experienced level (7b-8b), 3.5% at an elite level (8b+-8c+), and .2% at an international elite level (9a). The author found no association between climbing level, chronic injuries, training volume, and/or BMI. Beta-Angel note: this is a fascinating study which challenges some “accepted wisdom” between injuries, climbing level, and BMI. However, the author notes that although the amount of respondents was high and their climbing level mostly representative of Norway’s climbing population, the number of climbers at the international elite level taking part inf the survey (N=1) is problematic.
Reference: BMJ Open Sport & Exercise Medicine 5(1):e000437
https://www.researchgate.net/publication/330139027_Lean_and_mean_Associations_of_level_of_performance_chronic_injuries_and_BMI_in_sport_climbing
Kinesiology > Injury

Self-reported chronic injuries in climbing: who gets injured when?

Author: G. Grønhaug | Year: 2018
Summary/Results: The researcher used an internet survey to assess 667 active climbers (beginner to elite) for chronic injuries within the previous 6 months and differentiated climbers based on gender, level, and preference for type of climbing (e.g. indoor/outdoor, boulder/lead)). The author found that fingers, elbows, and shoulders make up a majority (80%) of chronic injuries, that there are some gender differences, such that the relative impact of shoulder injuries and foot/ankle injuries in females is higher, and that the relative impact of elbow injuries in males appears to be higher, and also found that male outdoor climbers have a higher likelihood of reporting chronic injuries.
Reference: BMJ Open Sport Exerc Med. 2018 Jul 17;4(1):e000406.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6059297/
Kinesiology > Injury

Physeal fracture in the wrist and hand due to stress injury in a child climber: A case report

Author: SW Kwon, SJ Hong, JH Nho, SI Moon, KJ Jung | Year: 2018
Summary/Results: Case description of 11-year old girl with a growth plate injury of the left radial bone, and (later) a growth plate injury of the right ring finger at the location of the PIP (middle joint) of the finger on the opposite hand. Conservative treatment (rest, bracing, and physical therapy) was applied in both cases, and the authors note that chronic pain should be quickly evaluated and radiographs obtained, and that “avoiding intensive power training” would mitigate the risk.
Reference: Medicine (Baltimore). 2018 Aug;97(34):e11571.
https://www.ncbi.nlm.nih.gov/pubmed/30142752
Kinesiology > Injury

Long-Term Radiographic Adaptations to Stress of High-Level and Recreational Rock Climbing in Former Adolescent Athletes: An 11-Year Prospective Longitudinal Study

Author: VR Schöffl, PM Hoffman, A. Imhoff, T. Küpper, Isabelle Schöffl, T. Hochholzer, S. Hinterwimmer | Year: 2018
Summary/Results: Researchers followed up on a 1999 study involving 19 climbers from the German National Junior Team and 18 recreational climbers in order to determine the long-term adaptations of rock climbing on the fingers. The authors found a higher prevalence of “stress reactions” in the team members (80%) than the recreational climbers (46%) and early-onset osteoarthritis (wearing down of protective tissue at the end of bone – 27% vs. 15% respectively). They also found 1999 training intensity and 1999 body weight to be associated with stress reactions, and overall training years, campus board, and climbing level to be associated with early-onset osteoarthritis. Beta Angel note: It should be noted that “stress reactions” are defined as physiological adaptations, or those which aren’t defined as osteoarthritic. We recommend reading the discussion section which highlights how this research into youth synthesizes with other research (often on adults) into the long-term impact of climbing stress on the fingers.
Reference: Orthop J Sports Med. 2018 Sep; 6(9): 2325967118792847.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125860/
Kinesiology > Injury

Circular wrist tape – How to correctly use this technique in climbing and bouldering

Author: C. Lutter, V. Schöffl | Year: 2017
Summary/Results: Authors review the literature on wrist taping and make recommendations based on anatomical analysis and clinical practice.  The authors recommend taping the wrist in a slightly abducted (movement of the wrist to the thumb side), slightly dorsal (movement of the wrist to the back) using ~2.5 cm tape tightly wrapped three times at a location that partially covers the skinfold where the palm meets the wrist.  Beta Angel Note: We’ve highlighted a picture on the Beta Angel Instagram.  The authors note that tight wrist taping (1) may be just a placebo-effect, and (2) has been shown to slightly decrease grip strength in a non-climbing related study.
Reference: Sports Orthop. Traumatol. 33, 410-413 (2017) 
https://www.sciencedirect.com/science/article/pii/S0949328X17302028
Tags: Kinesiology; injury

Sport Climbing: medical considerations for this new Olympic discipline

Author: C. Lutter, Y. El-Sheikh, I. Schöffl, V. Schöffl | Year: 2017

Summary/Results: This is a commentary by several leading climbing injury researchers on the medical considerations of climbing given its inclusion within the 2020 Olympics.  The authors discuss some of the newer trends in climbing injuries, such as heel hooks and bone marrow edema (excess watery fluid collection in certain areas of the body) injuries, and make two recommendations.  The recommendations are: (1) closer sports-specific medical supervision of elite athletes, and (2) monitoring of training and competition facilities for more careful route setting, attention to more ergonomic, less injury inducing hold use, and age-specific training programs.

Reference: Br J Sports Med. 2017 Jan;51(1):2-3.

http://bjsm.bmj.com/content/51/1/2 or PDF: http://dl.yums.ac.ir/bitstream/Hannan/188969/1/2017%20Sports%20Medicine%20%282%29.pdf

Rock climbing related bone marrow edema of the hand: a follow-up study

Author: C. Lutter, T. Hochholzer, T. Bayer, V. Schöffl | Year: 2017

Summary/Results: The researchers studied cases of hand and wrist injury in 31 climbers averaging between 5.10d and 5.14c.  They found bone bruising and classified them according to the area of the wrist, primarily in the bones of the palm and the bones just above the wrist.  The authors recommended avoidance of stress in all climbers, and the effects of the bone bruising lasted between 6 – 32 weeks.  Most were classified with conservative treatment as having good outcomes, however 3 required surgery.

Reference: Clin J Sport Med. 2017 Jul 6.

https://www.ncbi.nlm.nih.gov/pubmed/28696958

Sagittal Band, Boutonniere, and pulley injuries in the athlete

Author: LC Grandizio, JC Klena | Year: 2017

Summary/Results: Researchers looked at recent literature on injuries important to climbers, namely the “pulley” (a stabilizing tendon that holds a finger-pulling tendon to the finger bone) injury tendons which wrap around each finger.  They reviewed research on how to evaluate finger injuries, found new research on the pervasiveness of pulley injuries in the rock climbing community, the flexor tendon’s ability to pull away from the bone (called bowstringing), contradictory research on which pulleys are more important to “bowstringing”, and reviewed two different approaches to fixing torn pulley tendons.

Reference: Curr Rev Musculoskelet Med. 2017 Mar; 10(1): 17–22.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344850/

Ankle Fracture Associated with Rupture of the Achilles Tendon: Case Report and Review of the Literature

Author: M. Elmajee, A. Rafee, T. Williams | Year: 2017

Summary/Results: Researchers examined a case study of a rare combination of Achilles tendon rupture and ankle (Medial Malleolus) fracture.  The rupture was initially missed and only identified during surgery, later confirmed with ultrasound and MRI.  Reported patterns (a fall from height) make this combination of injury more likely to happen in climbing.  Doctors recommend a thorough clinical assessment of musculoskeletal and neurovascular structure in such instances.

Reference: J Foot Ankle Surg. 2017 Nov – Dec;56(6):1320-1322.

https://www.ncbi.nlm.nih.gov/pubmed/29079241

Functional and sports-specific outcome after surgical repair of rotator-cuff tears in rock climbers

Author: M. Simon, D. Popp, C. Lutter, V. Schöffl | Year: 2017

Summary/Results: Researchers assessed 12 rock climbers with both chronic and acute rotator cuff (shoulder) injuries for their ability to come back to the sport of climbing after surgery.  They found that arthroscopic (minimally invasive surgery) repair generally provides a good outcome [all climbers had started climbing by re-evaluation (defined as 27 +/- 12 months), but only 5 had reached pre-surgery climbing ability] toward returning to climbing, and that it’s slightly better in cases of acute injury than in cases of chronic injury.

Reference: Wilderness Environ Med. 2017 Dec;28(4):342-347

https://www.ncbi.nlm.nih.gov/pubmed/28939274

An uncommon location of black heels in a free climbing instructor

Author: A. Tammaro, F. Magri, E. Moliterni, FR Parisella, M. Mondello, S. Persechino | Year: 2017

Summary/Results: Researchers note a case of a climbing instructor who developed black spots on his feet.  They confirmed that the case was benign, and that the atypical location of “black heels” was likely due to the configuration of climbing shoes which have a soft sole.  However, they recommend consulting with a doctor to remove any doubt if others are afflicted with similar black spots. Beta-Angel note: this research will not help you heel hook, but it may cause you to check your heels regularly… no we’re not freaking out unnecessarily.

Reference: Int Wound J. 2018 Apr;15(2):313-315

https://www.ncbi.nlm.nih.gov/pubmed/29250899

Descriptive epidemiology, medical evaluation, and outcomes of rock climbing injuries

Author: JM McDonald, AM Henrie, M. Teramoto, E. Medina, SE Willick | Year: 2017

Summary/Results: Researchers conducted a survey of 553 males and 155 females on mountainproject.com to understand injury patterns by type of injury and to identify healthcare provider patterns for climbers, and also identify issues with returning to climbing. In addition to confirming injury rates from other studies, the authors found that 80.1% of all climbers who seek medical treatment for an injury get referred to a specialist, half of all climbers were not fully healed when returning to climbing, and a similar percentage developed chronic pain after injury, and the factors affecting return to climbing were: smoking, fractures, age, and surgery.

Reference: Wilderness Environ Med. 2017 Sep;28(3):185-196.

https://www.ncbi.nlm.nih.gov/pubmed/28755819

MRI sport-specific pulley injury

Author: MN Hoff, TD Greenberg | Year: 2017

Summary/Results: The researchers tested a novel climbing-specific crimp position using an MRI in a single individual in order to determine the MRI’s efficacy in measuring the bone to tendon distance (BTD), a traditional measure associated with diagnosing pulley (a stabilizing tendon that holds a finger-pulling tendon to the finger bone) injury injuries.  The technique identified the BTD as 1.5 mm (which is less than 2 mm – the distance used to indicate a weakened pulley) across 3 images; one image of a relaxed crimp and two images of a stress crimped position. The authors note a wide range of benefits (e.g. outcome of surgery; rehab, etc.) to using a climbing-specific grip position using a relaxed and stressed method.

Reference: Skeletal Radiol. 2017 Oct 10

https://www.ncbi.nlm.nih.gov/pubmed/29018907

Pulley injuries in rock climbers: hand therapy clinical application

Author: L. Algar, M. Moschetto | Year: 2017

Summary/Results: The authors outline how to conservatively treat rock climbing pulley (a stabilizing tendon that holds a finger-pulling tendon to the finger bone) injuries.  Specifically, they summarize the two mechanisms identified to date which reduce the distance between the tendon and the bone.  This effect protects the pulley tendon.  They are: (1) the H-taping method developed by Schöffl and his colleagues, and (2) the pulley protection orthosis (brace) developed by Schneeberger and Schweizer.

Reference: J Hand Ther. 2017 Oct 14

https://www.sciencedirect.com/science/article/pii/S0894113017301084

Flexor tendon pulley injuries in rock climbers

Author: EA King, JR Lien | Year: 2017

Summary/Results: Authors reviewed the state of pulley (a stabilizing tendon that holds a finger-pulling tendon to the finger bone) injury literature and provide recommendations regarding diagnosis, therapy, and surgical technique.  They recommend the use of dynamic ultrasound for diagnosis; conservative therapy (time off, splinting, taping/bracing) for a single pulley injury and surgical reconstruction for multiple pulley injuries (while noting cases of successful conservative management of multiple pulley injuries), including the author’s preferred surgical method: a graft with three loops for the A2 (closer to the palm) and a graft with a single loop for the A4 (nearer the tip of the finger).

Reference: Hand Clin. 2017 Feb;33(1):141-148

https://www.ncbi.nlm.nih.gov/pubmed/27886830

Survey of hand and upper extremity injuries among rock climbers

Author: CE Nelson, GM Rayan, DI Judd, K. Ding, JA Stoner | Year: 2017

Summary/Results: Authors surveyed 397 climbers in order to identify and compare injuries between males and females.  The authors found that females were both more likely to report shoulder injuries than males and also more likely to report surgery.  In a literature review, the authors noted that other studies found an association between females and shoulder injuries, especially in some upper body sports (water polo, martial arts, tennis) and that this is due to instability and weakness around specific shoulder stability muscles such as the periscapular (trapezius, rhomboids, pectoralis minor, etc.) muscles and the rotator cuff. Beta-Angel note: the authors note that the shoulder injury reporting was separate from the surgery reporting, suggesting the two can’t be taken together.

Reference: Hand (N Y). 2017 Jul;12(4):389-394.

https://www.ncbi.nlm.nih.gov/pubmed/28644933

Pregnant Women in Sport Climbing – Is there a Higher Risk for Preterm Birth?

Author: J. Drastig, D. Hillebrandt, W. Rath, T. Küpper | Year: 2017

Summary/Results: Researchers assessed 32 female climbers using a self-report online questionnaire to determine whether pre-term birth is more likely in the climbing community than in the general population.  Two women in the study reported a pre-term birth, and the study discusses the information provided by the questionnaire for these two subjects as well as the overall population.  Based on this survey, the authors do not see climbing as being a risk factor for pre-term birth.

Reference: Z Geburtshilfe Neonatol. 2017 Feb;221(1):25-29.

https://www.ncbi.nlm.nih.gov/pubmed/28103619

Recovery of rock climbing performance after surgical reconstruction of finger pulleys

Author: M. Bouyer, A. Forli, A. Semere, BJ Chedal Bornu, D. Corcella, F. Moutet | Year: 2016
Summary/Results: Authors conducted a follow-up study of 38 patients with a pulley tendon surgical reconstruction.  Authors found a strong association between climbing level recovery and the amount of flexor bowstringing correction.
Reference: Journal of Hand Surgery [European Volume], Vol. 41E(4) 406-412 (2016)
https://journals.sagepub.com/doi/pdf/10.1177/1753193415623914

Custom-made total talonavicular replacement in a professional rock climber

AUTHORS: S. Giannini, M. Cadossi, A. Mazzotti, L. Ramponi, C. Belvedere, A. Leardini | Year: 2016

SUMMARY/RESULTS: Researchers evaluated the utility of a custom-made ankle prosthesis that was inserted into a rock-climber who had developed arthritis from a fracture. The researchers noted that the prosthesis was an effective solution for a complex ankle injury in a patient who desires high functionality.

REFERENCE: J Foot Ankle Surg. 2016 Nov – Dec;55(6):1271-1275

https://www.ncbi.nlm.nih.gov/pubmed/26232176

Climbing has a positive impact on low back pain: a prospective randomized controlled trial

AUTHORS: M. Schinhan, B. Neubauer, K Pieber, M. Gruber, F. Kainberger, C. Castellucci, B. Olischar, A. Maruna, R. Windhager, M. Sabeti-Aschraf | Year: 2016

SUMMARY/RESULTS: The authors studied 30 patients with chronic lower back pain and divided them up into two groups: one group where the patients climbed, and one group where they did not. Improvements were found in climber vs. non-climber lower back pain, in the size of spinal disc protrusion and in the ability to stretch the lower back and hamstrings.

REFERENCE: Clin J Sport Med. 2016 May;26(3):199-205. 

https://www.ncbi.nlm.nih.gov/pubmed/26247548

First overview on chronic injuries in sport climbing: proposal for a change in reporting of injuries in sport climbing

Author: Gudmund Grønhaug, Marius Norberg | Year: 2015
Summary: Review of 47 risk factor research papers with 17 distinct chronic-climbing-related injuries. Identifies discriminating features between lead climbing and bouldering – relative intensity of movement but notes a similarity in the degree of repetitive movement. Authors suggest it’s not currently possible to identify most prevalent chronic injury in climbing and recommend greater consistency of reporting climbing ability, use of methods, and generally how the injuries are reported on, and demographic data. Beta-Angel note: we found an interesting hypothesis of the study to be that tracking the ‘planning’ time of a route or boulder might possibly lead to more information about chronic injury.
Reference: BMJ Open Sport & Exercise Medicine, March 2016
https://bmjopensem.bmj.com/content/2/1/e000083

Caring for climbers

AUTHOR: C. Peterson, A. Ceraulo | Year: 2015
SUMMARY/RESULTS: The authors seek to provide familiarity with common climbing injuries and treatment for clinicians. The authors recommend general guidelines for physicians including: adequate preparation of tendon strengthening, opposing muscle groups, and flexibility. They recommend low weight and high repetition training, as well as body weight and training boards. They also suggest taping (they note H-taping method evaluated by Schoffl), ample recovery time, and give guidelines for rehabilitation, and emphasize the need for physicians to understand when surgical intervention is needed. Beta-Angel note: recommended reading due to the fact that the entire article is available to read online. That being said, a careful read is recommended, due to the fact that some of general recommendations may be outside the scope of what is directly referenced in the article (e.g. training board as finger ‘hardening’ tools).
REFERENCE: Curr Sports Med Rep. 2015 Sep-Oct;14(5):397-403
https://www.ncbi.nlm.nih.gov/pubmed/26359842

Indoor rock climbing (bouldering) as a new treatment for depression: study design of a waitlist-controlled randomized group pilot study and the first results

AUTHORS: K. Luttenberger, EM Stelzer, S. Forst, M. Schopper, J. Kornhuber, S. book | Year: 2015

SUMMARY/RESULTS: Researchers assessed the use of bouldering as an intervention for people with depression in two sets of two groups (2 intervention vs. 2 non-intervention) over the course of eight weeks using 27 females and 20 males. The researchers conclude that bouldering works as an intervention for depression. Beta-Angel note: the authors note that the waitlisted group had a somewhat higher initial depression score.

REFERENCE: BMC Psychiatry 2015 15:201

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548691/

Footwear in rock climbing: current practice

AUTHORS: RD McHenry, GP Arnold, W Wang, RJ Abboud | Year: 2015

Summary/Results: Researchers investigated the use of tight footwear in 56 rock climbers with over a year experience. They found that 55 out of 56 rock climbers use excessively tight footwear and that foot pain during activity was common in 91% of climbers, and that 4 UK shoe sizes on average was found between normal shoes and climbing shoes.

REFERENCE: Foot (Edinb). 2015 Sep;25(3):152-8. 

https://www.ncbi.nlm.nih.gov/pubmed/26261058

Climber’s hand injuries

AUTHORS: F. Moutet, F. Quaine | Year: 2015

SUMMARY/RESULTS: Researchers described the diagnosis of finger injuries using a review of literature. Additionally, they describe the mechanics of finger injuries by discussing the posture and stability of the body (in relation to the fingers) during climbing, finger behavior during gripping, and how the internal tendon structure engages during climbing. Beta-Angel note: oh! So much potential to be a good, short overview for the layman. But alas, we must keep searching.

REFERENCE: GIPSA-Lab, Grenoble University, France.

https://isbs2015.sciencesconf.org/74202/document

Evaluation of finger A3 pulley rupture in the crimp grip position: a magnetic resonance imaging cadaver study

AUTHORS: T. Bayer, W. Adler, A. Schweizer, I. Schoffl, M. Uder, R. Janka | Year: 2015

SUMMARY/RESULTS: Researchers attempted to identify good indicators for a pulley tendon rupture (full tear in the A3 – a tendon that holds your long flexor tendon [explained lower] to the bone). They found that a reduction of the distance between the volar plate (ligament holding two bones at the second knuckle from the tip of the finger) relative to the base of the middle phalange (the part of the finger between the tip and the part closest to the knuckle), and an increase in the distance of the flexor tendon (long tendon that controls movement in the fingers) with the volar plate body, were the most ideal indicators, while the distance between the flexor tendon and bone were not. Beta-Angel note: sorry for the wording – I think I could have done better. But the fact remains that this is just a bunch of nerds doing nerd things so they can diagnose the impact of you being dumb faster.

REFERENCE: Skeletal Radiol. 2015 Sep;44(9):1279-85.

https://www.ncbi.nlm.nih.gov/pubmed/25930946

Effects of a therapeutic climbing program on muscle activation and SF-36 scores of patients with lower back pain

AUTHORS: S. Kim, D. Seo | Year: 2015

SUMMARY/RESULTS: The researchers measured (using a questionnaire and an instrument which measures electricity in the muscles) thirty adults with chronic back pain by dividing them up into two groups: one which did middle-to-lower back stabilization exercises and the other which climbed. While both groups improved on their questionnaire, the stabilization group showed greater muscle electricity in the mid-to-lower back, while the climbing group showed greater increase in three stomach muscles on the front and side – which provide stability to the trunk.

REFERENCE: J Phys Ther Sci. 2015 Mar; 27(3): 743–746.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395705/

Complete spinal accessory nerve palsy from carrying climbing gear

AUTHORS: JM Coulter, WJ Warme | Year: 2015

SUMMARY/RESULTS: Researchers looked at a case study of a climber who hiked for 2.5 hours while carrying their load over one shoulder and across the body which resulted in compression of a nerve which controls shrugging of the shoulders and turning of the head. The researchers suggest proper load-carrying should distribute weight more evenly over a greater surface area. Beta-Angel note: not sure why this is in here….

REFERENCE: Wilderness Environ Med. 2015 Sep;26(3):384-6. 

https://www.ncbi.nlm.nih.gov/pubmed/25937552

Isolated lateral collateral ligament complex injury in rock climbing and Brazilian Jiu-jitsu

AUTHORS: BA Davis, LP Hiller, SG Imbesi, EY Chang | Year: 2015

SUMMARY/RESULTS: A case study about how force applied to the inside of the knee, on a part of the knee which stabilizes rotation, during a heel hook has the potential to cause injury. The authors recommended conservative management consisting of non-weight bearing for 1-2 weeks followed by physical therapy, with full function by 6 months. Beta-Angel note: The authors suggest that these are a majority of all heel-hooks, but while they (1) recognize that not all heel hooks involve downward force to the inside of the knee in external rotation, (2) they suggest that a majority do. We at the Beta-Angel Research Project note the discrepancy but can find no data on prevalence of the “side-heel” hook vs “downward-heel” hook.

REFERENCE::Skeletal Radiol. 2015 Aug;44(8):1175-9.

https://www.ncbi.nlm.nih.gov/pubmed/25672946

Effect of climbing therapy on gait function in children and adolescents with cerebral palsy — a randomized, controlled crossover trial

AUTHORS: H. Bohm, MK Rammelmayr, L. Doderlein | Year: 2015

SUMMARY/RESULTS: Researchers compared climbing and physical therapy interventions in order to test whether climbing can improve the manner of walking in children with cerebral palsy. The outcomes caused the researchers to be concerned about the potential for climbing therapy to deteriorate walking manner in children with cerebral palsy, and recommend changing climbing therapy protocols to strengthen the knee.

REFERENCE: European Journal of Physiotherapy, 7 (1), 2015

http://www.tandfonline.com/doi/abs/10.3109/21679169.2014.955525

Injury trends in rock climbers: evaluation of a case series of 911 injuries between 2009 and 2012

AUTHORS: Schoffl, et al.  |  Year: 2015

SUMMARY/RESULTS: A4 Pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) Injuries, bone or “growth plate” fractures, and (probably) shoulder injuries are increasing. More A4 than A2 pulley injuries are being seen, a change since previous study which noted A2 over A4 – suggesting change in biomechanics of grip. More shoulder injuries are being seen as well – likely a cross between rising shoulder injuries and sample bias. Bone or “growth plate” fractures increased by 600%, likely due to increasing interest in adolescents.

REFERENCE: Wilderness & Environmental Medicine, 26 (1), 62-67 (2015)

https://www.ncbi.nlm.nih.gov/pubmed/25712297

Common neuromusculoskeletal injuries amongst rock climbers in the Western Cape

AUTHORS: Liezel Wegner, Jarryd E. Pagel, Ashley W. Smit, Aimee Straszacker, Sarah L. Swart and St John Taft  |  Year: 2015

SUMMARY/RESULTS: Research focused on indoor and outdoor climbers in the Western Cape. Most common injuries affected fingers, hands, and elbows. Risk of injuries correlated with gender, setting, grade, and type of climbing, but not frequency of climbing.

REFERENCE: Wegner, L., Pagel, J.E., Smit, A.W., Straszacker, A., Swart, S.L. & Taft, St.J., 2015, ‘Common neuromusculoskeletal injuries amongst rock climbers in the Western Cape’, South African Journal of Physiotherapy 71(1), Art. #227, 4 pages.

https://www.ircra.rocks/research-2015

Preparticipation evaluation for climbing sports

AUTHORS: A.D. Campbell, C. Davis, R. Paterson, T.A. Cushing, P. Ng, C.S. Peterson, P.E. Sedgwick and S.E. McIntosh  |  Year: 2015

SUMMARY/RESULTS: Research focused on determining a more effective way to pre-screen people planning to participate in a climbing activity and determine their risk for injuries.

REFERENCE: Preparticipation Evaluation for Climbing Sports. Clinical Journal Of Sport Medicine, 25(5), 412-417.

http://europepmc.org/abstract/med/26340733

Previous injury as a risk factor for reinjury in rock climbing: a secondary analysis of data from a retrospective cross-sectional cohort survey of active rock climbers

AUTHORS: Gareth Jones, David Llewellyn and Mark I. Johnson  |  Year: 2015

SUMMARY/RESULTS: Research found that the existence of a previous injury increased likelihood of experiencing reinjury, especially in the fingers.

REFERENCE: Previous injury as a risk factor for reinjury in rock climbing: a secondary analysis of data from a retrospective cross-sectional cohort survey of active rock climbers. BMJ Open Sport Exerc Med, 1(1), bmjsem-2015-000031.

http://bmjopensem.bmj.com/content/1/1/bmjsem-2015-000031.full

Rock climbing injuries: acute and chronic repetitive trauma

AUTHORS: Connie Y. Chang, MD, Martin Torriani, MD, Ambrose J. Huang, MD  |  Year: 2015

SUMMARY/RESULTS: Review of climbing injuries, including acute and chronic injuries in the upper and lower extremities. Repetitive chronic injuries were more common, while acute injuries tended to be more severe.

REFERENCE: Rock Climbing Injuries: Acute and Chronic Repetitive Trauma. Current Problems in Diagnostic Radiology.

http://www.cpdrjournal.com/article/S0363-0188(15)00106-1/fulltext

Risk factors for injury in sport climbing and bouldering: a systematic review of the literature

AUTHORS: Woollings, K.Y., McKay, C.D. and Emery, C.A.  |  Year: 2015

SUMMARY/RESULTS: A systematic literature review to explore common climbing injuries and determine how they could be prevented. Certain risk factors like climbing experience, age, skill level, “climbing intensity score”, and participation in lead climbing were established as potential risk factors.

REFERENCE: Risk factors for injury in sport climbing and bouldering:a systematic review of the literature. British Journal of Sports Medicine, 49 (17). pp. 1094-1099. ISSN 0306-3674

http://opus.bath.ac.uk/44613/3/Accepted_version.pdf

Rock climbing-related subclavian vein thrombosis

AUTHORS: Christoph Lutter, Erik Monasterio, Volker Schöffl   |  Year: 2015

SUMMARY/RESULTS: A case study of two climbers who developed Paget-Schroetter syndrome, a rare condition where blood clots form in the veins of the arm. Boulderers may be at increased risk of this condition due to the high amount of stress placed on the upper extremities.

REFERENCE: BMJ Case Reports 2015 Researchgate.net.

https://www.researchgate.net/profile/Erik_Monasterio2/publication/282355544_Rock_climbing-related_subclavian_vein_thrombosis/links/561ec24408aecade1acd085a.pdf?_iepl%5BhomeFeedVariantCode%5D=d_EU&_iepl%5Bcontexts%5D%5B0%5D=pdp&_iepl%5BinteractionType%5D=publicationDownload&origin=publication_detail&ev=pub_int_prw_xdl&msrp=Dd6tsiYSPE7kxQqzfHJfCyjOWeFv7NymNYcYnBYNGqru97dtwdZZNtvRuNVFEulDuVGn0PvDB__t0D6P00veBA.V5xjSwu6fZvpIOxjD-mK69lBvdz4HZEf8_GeekQrBOo28JJqptNdU_A1TX6b8hUpk72kMbevNUG-yxJUHuvjGQ.CphvHYqPb9ZoXJoad9QPwqEsPCKtZNDte6tW-7jnm7TwpB88rVaGIVBBoZCN86iDjwpCO91g3aItI43EmIlHHQ

The roles of experience, participation rates and judgment in the injury rates of weekend warriors

AUTHORS: Jon Heshka, Jeff Jackson   |  Year: 2015

SUMMARY/RESULTS: This article refutes the idea that people are more likely to get injured on weekends due to lack of experience, and suggests that increased injury rates are seen because of overall increased participation.

REFERENCE: Canadian Journal Of Surgery, 58(1), E1-E2.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309770/

Stress examination of flexor tendon pulleyrupture in the crimp grip position: a 1.5-Tesla MRI cadaver study

AUTHORS: Bayer T, Fries S, Schweizer A, Schöffl I, Janka R, Bongartz G.  |  Year: 2015

SUMMARY/RESULTS: Researchers ran MRIs on cadaver fingers with artificially created pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) ruptures in neutral and crimp positions. The crimp position was found to cause an increased distance between the bone and tendon, placing more stress on the pulley.

REFERENCE: Stress examination of flexor tendon pulley rupture in the crimp grip position: a 1.5-Tesla MRI cadaver study. PubMed – NCBI.

http://www.ncbi.nlm.nih.gov/pubmed/25253170

The “weekend warrior”: fact or fiction for major trauma

AUTHORS: DJ Roberts, JF Ouellet, PB Mcbeth, AW Kirkpatrick, E Dixon, CG Ball | Year: 2014

SUMMARY/RESULTS: Researchers investigated whether individuals who participate in physical activities on weekends tend to become injured more often than those who participate in activities during the week from 1995 to 2009. Significantly more were injured on the weekend than the week, hiking or mountain/rock climbing was the second most common activity for injury, while ground-level or higher fall while hiking, mountain climbing or rock climbing was the most common method of injury.

REFERENCE: Can J Surg. 2014 Jun;57(3):E62-8.

https://www.ncbi.nlm.nih.gov/pubmed/24869618

Fracture of the lateral tubercle of the posterior talar process caused by a rock-climbing fall: a case report

AUTHORS: MA Blanchette, JM Grenier | Year: 2014

SUMMARY/RESULTS: Researchers presented a case study of a 29 year old male whose foot hit a wall during a fall and was diagnosed as an ankle fracture. The authors warn clinicians to be aware that a fracture of the ankle could be very similar in symptom to an ankle sprain and recommend 4 to 6 weeks of immobilization.

REFERENCE: J Can Chiropr Assoc. 2014 Sep;58(3):286-90.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139761/pdf/jcca_58_3_286.pdf

Common musculoskeletal injuries in rock climbers

AUTHORS: A. Dabholkar, S. Tejani, S. Yardi | Year: 2014

SUMMARY/RESULTS: Researchers in India gathered information on rock climbing injuries from 40 climbers using a questionnaire. They found that ankle sprains were the most common injury, but that small climbing shoes and use of the crimp grip were risk factors in climbing.

REFERENCE: Indian Journal of Public Health Research & Development . Oct-Dec2014, Vol. 5 Issue 4, p184-189. 6p.

https://www.researchgate.net/publication/280927162_Common_Musculoskeletal_Injuries_in_Rock_Climbers

Talus fractures in climbers

AUTHORS: K. Bonetti, C. Bonizzoni, F. Di Giovanni, S. Nella, S. Cattaneo, M. Macchia, L. Briatico | Year: 2014

SUMMARY/RESULTS: The authors used a survey and subsequent statistical analysis of heel fractures in order to determine their cause, consequence, treatment, and likely outcome. 37.5% of fractures were on multi-pitch routes, 3.5% were at a “crag”, and 4% were indoor bouldering, while 21% were classified as “other.” While the authors note that heel fractures are most likely to occur as a result of a fall against ground, wall, or crash pad, the significant difference in the heel fractures and the small sample size did not allow the authors to come to conclusions about “best” treatment. Beta-Angel note: Considering the author’s own note that so few bouldering-related injuries were found due to the lack of boulderers participating in the study, the author’s probably did not find it helpful to differentiate “crag” between bouldering and sport-climbing.

REFERENCE: 2^nd International Rock Climbing Research Congress, Sep 2014

https://docs.wixstatic.com/ugd/441095_f52f11ccc489434bb70b78ee10563b95.pdf

Pulley ruptures in rock climbers: outcome of conservative treatment with pulley protection splint — first results

AUTHORS: M. Schneeberger, A. Schweizer | Year: 2014

SUMMARY/RESULTS: The authors used a survey to evaluate the effectiveness of a device to reduce flexor tendon “bowstringing” of 47 pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) ruptures. The authors primarily measured the distance between the tendon and the bone and provide useful statistics regarding the impact of the injury on the climbing of 44 subjects. From this information, the authors suggest that bowstringing (which forces the “finger flexor” tendons to attempt to pull away from the bone) can be reduced with conservative treatment using the device and that outcomes are solid. Beta-Angel note: previous work helps to explain why “bowstringing” exacerbates injury in pulley tendons – the tendons which hold other tendons (called long flexor tendons) to the bone and allow you to bend your fingers. See work by both Schoffl and Schweizer for more.

REFERENCE: 2^nd International Rock Climbing Research Congress, Sep 2014

https://docs.wixstatic.com/ugd/441095_f52f11ccc489434bb70b78ee10563b95.pdf

Or Full text: https://www.wemjournal.org/article/S1080-6032(15)00477-9/fulltext

Dupuytren’s disease in a rock climber with an unaffected identical twin

AUTHORS: H Beleta, J Fores | Year: 2014

SUMMARY/RESULTS: Beta-Angel note: ugh, no access. Foiled!

REFERENCE: J Hand Surg Eur Vol. 2014 Mar;39(3):313-4.

https://www.ncbi.nlm.nih.gov/pubmed/22879605

Acute injury risk and severity in indoor climbing — a prospective analysis of 515,337 indoor climbing wall visits in 5 years

AUTHOR: Schoffl, et al.  |  Year: 2013

Summary/Results: Tracked gym climbers over a 5 year period to identify rate of injuries during 1000 hours of climbing – a standard measurement in sports. 515,337 visits tracked, 63.6% male, ages 8 – 80, median of 34 years, average climb time 2 hours 47 minutes, thirty climbing injuries, 22 in males, acute injuries: 6 in bouldering, 16 in leading, 7 top roping, 1 third person 15 Were grade 2, 13 grade 3, 2 grade 4 based on Medical Commission standards. Overall injury rate was 0.02 per 1000 hours.

REFERENCE: Wilderness and Environmental Medicine, 24 (3), 187-194

https://www.ncbi.nlm.nih.gov/pubmed/23877045

Feet injuries in rock climbers

AUTHORS: V. Schoffl, T. Kupper | Year: 2013

SUMMARY/RESULTS: Researchers looked at lower body injury research. Findings suggest that approximately 50 percent of acute injuries involve the leg and feet and most frequently are strains, contusions, and fractures of the heel bone. However, the “tightness” of the modern climbing shoe is also concerning, and recommend a looser-fitting “training” shoe.

REFERENCE: World J Orthop. 2013 Oct 18; 4(4): 218–228.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3801241/

Tendon injuries of the hand

AUTHORS: Schoffl, Heid, and Kupper  |  Year: 2012

SUMMARY/RESULTS: Analysis of multiple finger injuries and discussion of their treatments, including tendon injuries (surgical), bone fracture (conservative therapy), flexor tendon sheath or single pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone – conservative treatment recommended), multiple pulley injury (surgical), postoperative, early passive movement is important to trigger “intrinsic” tendon healing.  Substances were evaluated, little evidence was found. Hyaluronic acid may be worthwhile. Beta-Angel note: hyaluronic acid is a compound that we have found conflicting evidence regarding. Caution is warranted.

REFERENCE: World Journal of Orthopedics 2012 June 18 3(6): 62-69

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377907/

Injuries to the upper extremity in rock-climbers

AUTHORS: A. Schweizer, H.P. Bircher | Year: 2012

SUMMARY/RESULTS: The authors’ purpose is to provide an overview of common climbing injuries, as well as diagnosis and treatment options, for physicians and therapists. The authors emphasize overuse injuries in the upper body. Beta-Angel note: a good overview if you have access, but primarily intended for clinicians.

REFERENCE: Sports Technology, Volume 5, 2012, 3-4: climbing technology

http://www.tandfonline.com/doi/full/10.1080/19346182.2012.686506

The effects of therapeutic climbing in patients with chronic low back pain

AUTHORS: K. Engbert, M. Weber | Year: 2011

SUMMARY/RESULTS: Researchers studied 28 patients with chronic lower back pain to determine whether therapeutic climbing is comparable or superior to other forms of exercise in promoting physical and mental well-being. While climbing was comparable to a standard exercise regime in promoting physical and mental well-being, it was superior in promoting two components of physical and mental well-being: perceived general health and physical functioning.

REFERENCE: Spine Volume 36, Number 11, pp 1-8, 2011

http://www.kai-engbert-sportpsychologie.de/fileadmin/user_upload/pdfs/Publikationen/Engbert___Weber__2011_.pdf

Injury risk evaluation in sport climbing

AUTHORS: A. Neuhof, FF Hennig, V. Schoffl | Year: 2011

SUMMARY/RESULTS: The authors evaluated 1962 climbers with 699 injuries using a survey in order to determine how common injuries are in climbers and what factors are associated with injury. The authors found that years of climbing experience, difficulty level, and climbing time per week during the summer and winter months were associated with injury.

REFERENCE: Int J Sports Med. 2011 Oct;32(10):794-800

https://www.ncbi.nlm.nih.gov/pubmed/21913158 

Comparisons of bone mineral density and bone quality in adult rock climbers, resistance-trained men, and untrained men

AUTHORS: VD Sherk, MG Bemben, DA Bemben | Year: 2010

SUMMARY/RESULTS: Researchers compared bone mineral density (such as calcium) in the body, forearm, lower back, and upper leg and bone quality (a series of measurements beyond bone density associated with bone strength) in the lower leg and forearm in 15 rock climbers, 16 resistance trained men, and 16 untrained males. The researchers found that resistance-trained men had higher bone density in the center part of their body than rock climbers but bone quality in the lower leg and forearm were similar between the resistance trained men and rock climbers.

REFERENCE: J Strength Cond Res. 2010 Sep;24(9):2468-74

https://www.ncbi.nlm.nih.gov/pubmed/20093970

Evaluation of injury and fatality risk in rock and ice climbing

AUTHORS: V Schoffl, A Morrison, U Schwarz, I Schoffl, T Kupper | Year: 2010

SUMMARY/RESULTS: The authors reviewed over 400 sport-specific injury studies to determine whether climbing (and its sub-disciplines) can be classified as a “high-risk sport.” The authors compared a standardized score for injury severity across the sports and determined (a) that while in some sub-disciplines of climbing (Alpinism and ice climbing) a fatality risk is evidenced, a determination of climbing being “high-risk” is subjective, and (b) that they recommend more work be done in researching how to evaluate injury risk and severity in climbing.

Reference: Sports Med. 2010 Aug 1;40(8):657-79

https://www.ncbi.nlm.nih.gov/pubmed/20632737

Isolated cruciate pulley injuries in rock climbers

AUTHORS: Schoffl and Schoffl  |  Year: 2010

SUMMARY/RESULTS: Analysis of 347 pulley injuries on 332 rock climbers and 15 non-climbers. Recommendation to treat cruciate (similar to annular, but found in an x-pattern and helpful for stability of the finger) pulley injuries with similar, conservative, treatment to annular pulleys (a tendon that holds the tendon you use to “flex” your fingers to the bone).

REFERENCE: The journal of hand surgery Vol. 35E No. 3 March 2010

http://www.ncbi.nlm.nih.gov/pubmed/20200084

The influence of concentric and eccentric loading on the finger pulley system

AUTHORS: Schoffl, et al.  | Year: 2009

SUMMARY/RESULTS: Study looked at concentric vs. eccentric loading on 39 cadaver fingers using an isokinetic loading device.  In concentric, A2 and A4 pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) ruptures including fracture of finger bone or tearing of flexor tendons, whereas A2 pulley rupture was most common in eccentric loading and other events were rare.  Ruptures occurred at lower loads in eccentric (lengthening of muscle) loading, concluding that friction may be advantageous for holding force, but disadvantageous in potential for injury

REFERENCE: Journal of Biomechanics 42 (2009) 2124-2128

http://www.ncbi.nlm.nih.gov/pubmed/19646704

The influence of the crimp and slope grip position on the finger pulley system

AUTHORS: Schoffl, et al.  |  Year: 2009

SUMMARY/RESULTS: 9 fingers loaded into isokinetic device in slope grip position, 12 in crimp grip position.  Rupture in A4 pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) mostly occurs in crimp, but not in slope, but alternative injuries more common in slope.

REFERENCE: Journal of Biomechanics 42 (2009) 2183-2187

http://www.ncbi.nlm.nih.gov/pubmed/19665129

The epidemiology of rock-climbing injuries

AUTHORS: G Jones, A Asghar, DJ Llewellyn | Year: 2008

SUMMARY/RESULTS: Researchers looked at the injury history in 163 male and 38 female climbers between the ages of 16 and 62 years. Over 50% of climbers had at least one injury in the year prior to the study. 10% of injuries were acute from a fall, 33% were chronic overuse injuries, and 28% were acute injuries by a strenuous climbing move. The authors found that climbing frequency and technical difficulty were associated with climbing injuries both inside and outside, particularly through a repetitive accumulation of trauma in the upper body.

REFERENCE: Br J Sports Med. 2008 Sep;42(9):773-8

https://www.ncbi.nlm.nih.gov/pubmed/18065444

Finger pain in rock climbers: reaching the right differential diagnosis and therapy

AUTHORS: Schoffl and Schoffl |  Year: 2007

SUMMARY/RESULTS: Analysis of diagnostic and therapeutic procedures for the evaluation and treatment of finger pain.  The ultrasound is most effective, with MRI for difficult cases. Shows tables of Acute, vs. Chronic vs. slow onset injuries.  Identifies pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) rupture severity grades. Physiological adaptations due to high impact of rock climbing onto fingers need to be strictly separated from injury change. Article has information on growth plate fractures in youth climbers.

REFERENCE: J Sports Med phys fitness 2007; 47:70-8

http://www.ncbi.nlm.nih.gov/pubmed/17369801

Impact of taping after finger flexor tendon pulley ruptures in rock climbers

AUTHORS: Schoffl, et al.  |  Year: 2007

SUMMARY/RESULTS: Evaluate new “H” taping method in relation to flexor tendon bowstringing against pulleys (a tendon that holds the tendon you use to “flex” your fingers to the bone) by reducing tendon-bone distance using ultrasound AND evaluate strength of injured finger using a force platform on 12 subjects. New taping method decreased tendon-bone distance 16% vs. other taping methods.  Strength was 13% better in crimp grip, but no effect observed in hanging grip. Prophylactic taping not indicated. Renew tape after every route. Beta-Angel note: See work by Schweizer and Schneeberger (2014) as well as Schoffl for more on bowstringing and why it’s injurious.

REFERENCE: Journal of Applied biomechanics 2007; 23:52-62. Copyright 2007 Human Kinetics, Inc.

http://www.ncbi.nlm.nih.gov/pubmed/17585178

Strength measurement and clinical outcome after pulley ruptures in climbers

AUTHORS: Schoffl, et al.  |  Year: 2006

SUMMARY/RESULTS: Evaluation of 21 rock climbers with grade 2-4 pulley injury were re-evaluated using a standard questionnaire and ultrasound 3-4 years after injury. Nonsurgical treatment of single pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) ruptures is recommended. Outcome was good to excellent, and no long-term strength deficit observed. Recommend surgical reconstruction for grade 4 injuries involving clinical bowstringing.

REFERENCE: American College of Sports Medicine, 2006.

http://www.ncbi.nlm.nih.gov/pubmed/16679977

Injuries to the finger flexor pulley

AUTHORS: Schoffl and Schoffl | Year: 2006

SUMMARY/RESULTS: Article provides anatomy, biomechanics, injury patterns, clinical findings, diagnostics, grading, therapy, conservative therapy, and surgical repair information on pulleys (a tendon that holds the tendon you use to “flex” your fingers to the bone).

REFERENCE: The Journal of Hand Surgery Vol. 31A No. 4 April 2006

http://divrad.com/uploads/main/FINGER_PULLEY_LESIONS_HAND_SURG.pdf

Can rock climbing lead to Dupuytren’s disease?

AUTHORS: AJ Logan, G Mason, J Dias, N Makwana | Year: 2005

SUMMARY/RESULTS: Researchers used a survey of 1100 members of the climbers’ club of Great Britain to determine whether Dupuytren’s disease, which is the permanent bending of one or more fingers in a flexed position, is significant in climbers. Researchers found that there was a higher prevalence of the disease in rock climbers compared to the normal population, that climbers with the disease climbed with more intensity than other climbers, and that more severe examples of the disease was associated with a younger age of first presenting with symptoms.

REFERENCE: British Journal of Sports Medicine, Volume 39, Issue 9, 2005

http://bjsm.bmj.com/content/39/9/639

Pulley injuries in rock climbing

AUTHOR:Schoffl, et al.  | Year: 2003

SUMMARY/RESULTS: Creates a grading system for severity of pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) injuries which are used to set therapeutic pathways. Evaluates 604 injured rock climbers from 1998 to 2001. 39% are grade 1, 25% are grade 2, 30% grade 3, and 6% grade 4. Grade 1-3 injuries respond well to conservative treatment. Grade 4 require surgical repair with recommended “loop and a half” technique.

https://www.ncbi.nlm.nih.gov/pubmed/12825883

Effect of simulated rock climbing finger postures on force sharing among the fingers

AUTHORS: F. Quaine, L. Vigoroux, L. Martin | Year: 2003

SUMMARY/RESULTS: The authors studied the absolute pressure of fingers, as well as relative differences in pressure between the fingers, of six climbers using both what is traditionally called an “open hand” or slope grip, as well as a grip usually associated with “crimping.” The authors found that the middle finger provided the most absolute force, while the “relative involvement” of the ring finger was greatest during the grip associated with crimping – suggesting these are factors in the injury of these fingers. Beta-Angel note: we recommend reading this in combination with Konstantin Fuss/Niegl’s work on friction in individual fingers.

REFERENCE: Clinical biomechanics 18 (2003) 385-388

https://www.ncbi.nlm.nih.gov/pubmed/12763433 

Biomechanical properties of the crimp grip position in rock climbers

AUTHOR: Schweizer, Ochsner | Year: 2001

SUMMARY/RESULTS: Researchers attempted to measure bowstringing and the forces on the crimp grip position using two devices, one of which was to measure the force and distance of bowstringing, while the other was meant to measure the force at the fingertip. Measurements were taken on 16 fingers of 4 living participants. Results support the theory that bowstringing causes more friction against the pulleys in the crimp grip position, but less so in the open hand grip position with the PIP joint extended. Researchers also found that over the course of a warm-up, bowstringing against the A2 pulley (a tendon that holds the tendon you use to “flex” your fingers to the bone) increased by 30%. Researchers recommend use of the open hand “slope” position while rehabbing from a pulley injury to reduce loads on the pulley. Beta-Angel note: See work by Schweizer and Schneeberger (2014) as well as Schoffl for more on bowstringing and why it’s injurious.

REFERENCE: J Biomech. 2001 Feb;34(2):217-23.

https://isbweb.org/images/conf/2001/Longabstracts/PDF/1000_1099/1046.pdf

Getting a grip of rock climbing injuries

AUTHOR: D.M. Binney | Year: 2001

SUMMARY/RESULTS: The author goes over cause, diagnosis, and treatment in three case studies of common climbing-related injuries of the shoulder, elbow, and finger. The author’s primary concern is that so few climbers seek advice from a primary care practitioner, but that when they do, those doctors should be aware of common climbing-related injuries and the demands of the sport.

REFERENCE: Binney DM. Sport & Medicine Today, autumn, 2001.

https://www.thebmc.co.uk/bmcNews/media/u_content/File/competitions/high_perfomance_archive/getting_a_grip.pdf

Injuries and associated training and performance characteristics in recreational rock climbers

AUTHORS: R. Doran, M. Reay | Year: 1999

SUMMARY/RESULTS: The authors used a survey to evaluate type of injury, location, frequency, and severity in 111 British climbers. They found that perceived importance of climbing over non-climbing related sport activities, not “warming-down” after climbing, technical level of climbing, and duration of warm-up were all associated with injuries in climbers. Strikingly, a longer warm-up was associated with injury. Beta-Angel note: frustratingly, parts of this article are missing. We recommend this one for a read and discussion as the authors found some conclusions (e.g. warm-up) which the authors note contradict past findings on warm-up (Bollen, 1988).

REFERENCE: International Conference on Science and Technology in Climbing and Mountaineering, 1999 University of Leeds, UK.

http://dk.mors.si/Dokument.php?id=21&lang=slv

Effect of habitual knuckle cracking on hand function

AUTHOR: Castelanos, Axelrod  |  Year: 1990

SUMMARY/RESULTS: 300 patients screened for knuckle cracking along with a number of other variables. No correlation identified with arthritis, however, correlation identifies with lower grip strength, likelihood of family members doing it, smoking, drinking alcohol, and biting nails.

REFERENCE: Annals of the Rheumatic Diseases 1990; 49: 308-309

http://ard.bmj.com/content/49/5/308.full.pdf+html