Comprehensive Review of Rock Climbing Injuries

Abstract

Increasing numbers of people are participating in the sport of rock climbing, and its growth is expected to continue with the sport's Olympic debut in 2020. Extreme loading of the upper extremities, contorted positioning of the lower extremities, rockfall, and falling from height create an elevated and diverse injury potential that is affected by experience level and quantity of participation. Injuries vary from acute traumatic injuries to chronic overuse injuries. Unique sport-specific injuries to the flexor tendon pulley system exist, but the remaining musculoskeletal system is not exempt from injury. Orthopaedic evaluation and surgery is frequently required. Understanding the sport of rock climbing and its injury patterns, treatments, and prevention is necessary to diagnose, manage, and counsel the rock-climbing athlete.

Rock Climbing Emergencies in the Austrian Alps: Injury Patterns, Risk Analysis and Preventive Measures

“…Survey studies among active climbers show a predominance of minor injuries, but there are inconsistent results with regard to the distribution of injury types. Results range from almost equal percentages of overuse, acute atraumatic, and acute traumatic injuries to a proportion as high as 93% for overuse and only 7% for traumatic injuries [ 6 , 7 , 14 , 16 , 18 , 19 ]. Clearly hindering comparability are differences in patients included, depending on the study design (surveys, questionnaires, in-hospital, or rescue data).…”

“…Similarly, rope use must be seen as a very effective preventive measure. Whether rope-free climbing is performed by professional athletes in the form of free solo tours or by recreational climbers simply underestimating or possibly even seeking risks, falling when not using a rope almost always leads to severe or fatal injuries [ 6 ]. Interesting are the circumstances prior to the emergency, as getting stuck or merely performing bouldering may also lead to emergencies classified as rope-free.…”

“…When analyzing injury patterns related to rock climbing, differentiation between acute traumatic (e.g., fall from height, rockfall), atraumatic (supraphysiological loading), and chronic overuse injuries (e.g., pulley strain) seems wise. In alpine and ice climbing, higher risks for acute traumatic injuries have been described due to apparent dangers (e.g., falls, rockfall, technical failure) [ 2 , 3 , 4 , 5 ], while atraumatic and chronic overuse injuries seem to occur more often in sports climbing where increased protection may result in athletes pushing their limits [ 6 , 7 , 8 ]. A bulk of the recent literature has mainly focused on injuries reported in questionnaires or on climbers treated in an emergency department [ 3 , 7 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ].…”

Rock climbing confers distinct injury risk in pediatric versus adult populations: an analysis of twenty-year national trends

“…The sport of rock climbing -often used as an umbrella term to include top rope climbing, sport climbing, traditional climbing, and bouldering -has exploded in popularity in recent years. This popularity is due in part to its recognition and adoption by noncompetitive athletes as an interactive physical activity with a level of intensity that can be self-regulated [1]. Rock climbing has myriad recognized health benefits, including increasing VO 2 max, improving both explosive and isometric muscle strength, and enhancing positive mood [2][3][4].…”

“…The most common causes of injury include chronic overuse, atraumatic supraphysiologic loading, and acute traumatic mechanisms (e.g. falls) [1]. Injuries of the upper extremity mainly arise due to acute atraumatic and chronic overuse injuries, whereas those affecting the lower extremity are most often due to fractures, sprains, or strains associated with acute traumatic mechanisms [1,5,6].…”