Finger- und Schulterverletzungen im Klettersport

Evaluation of finger cartilage composition in recreational climbers with 7 Tesla T2 mapping magnetic resonance imaging

Purpose

Sport climbing may lead to tissue adaptation including finger cartilage before apparent surface damage is detectable. The main aim was to assess finger cartilage composition with T2 mapping in young, active climbers and to compare the results to a non-climbers' collective. A secondary aim was to compare whether differences in cartilage T2 times are observed between older vs. younger volunteers.

Methods and materials

7 Tesla MRI of the fingers Dig.2-4 was performed using a multi-echo spin echo sequence. Manual segmentation of 3 ROIs at the metacarpal heads, 1 ROI at the base phalanx and 1 ROI at the proximal interphalangeal joint was performed. Included were 13 volunteers without history of trauma who are regularly performing climbing activities as a recreational sport (>20 h/month). These were age-matched with 10 control subjects not performing climbing activities.

Results

Mean age was 32.4 years for the climbing group and 25.8 years for the controls. Mean T2 values for the 5 different ROIs were 42.2 ± 7.8 msec for climbers and 41.4 ± 6.8 msec for non-climbers. No significant differences were observed for T2 values between both groups. However, higher age had a significant impact on T2 values for all assessed ROIs (higher age 44.2 ± 9.5, younger age 32.9 ± 5.7, p = 0.001).

Discussion

This study evaluated the cartilage composition of young, engaged climbers with a T2 mapping MRI technique with the purpose to depict early onset joint changes. No negative impact on cartilage composition due to the sport activity was found, whereas age-related effects on the cartilage seemed to be more prominent.

Functional and Sport-Specific Outcome Following Traumatic First-Time Shoulder Dislocation and Arthroscopic Surgical Repair in Rock Climbers

INTRODUCTION

Traumatic shoulder dislocations rank among the most common shoulder injuries in climbers, with rising numbers over the last years. The objective of this study was to analyze the outcome following traumatic first-time shoulder dislocation and subsequent surgical treatment in this population.

METHODS

In a retrospective study, climbers who experienced a traumatic shoulder dislocation were treated with an arthroscopic repair of the labrum-ligament complex (LLC). The functional outcome was assessed with a standardized questionnaire and clinical examination, including the Constant Murley and Single Assessment Numeric Evaluation scores. The sport-specific outcome was analyzed using the Union Internationale des Associations d'Alpinisme (UIAA) scale of difficulty and a sport-specific outcome score.

RESULTS

The functional and sport-specific outcome for 27 climbers (20 men; 7 women; 3 with bilateral injuries; age, 34±11 [17-61] y; data presented as mean±SD [range]) was assessed 53±29 (12-103) mo after surgery. The postoperative Constant Murley score was 95±8 (67-100) points. At follow-up, 93% (n=25) of patients had started climbing again. Twenty-one climbers (78%) reached a climbing level within the range of ±0.33 UIAA grades of their initial capability or even exceeded their preinjury grade. Only 7% (n=2) of the patients had a recurrent shoulder dislocation, leading to a secondary surgery, and, therefore, required ongoing postoperative treatment at the time of follow-up.

CONCLUSIONS

Arthroscopic repair of the LLC following first-time traumatic shoulder dislocation in climbers shows a good outcome and a low recurrence rate. After surgery, most patients are able to regain a high level of rock-climbing ability.

Balancing the Bar-Influence of Social Behaviour on Sport Climbing Performance

Background: For high performance in sport climbing, various factors must be taken into account, however, social interactions during climbing sessions have not yet been considered. Methods: For this study, four assumptions were made: (1) elite climbers share similar patterns of behaviour; (2) these behaviour patterns influence the climbing performance in a positive way; (3) the behaviour patterns had to be formed over time, and the process of changing behaviour was catalysed by formative experiences; and, (4) the social behaviour of elite climbers shows a tendency to be on their own rather than in the centre of social events, while their behavioural roots date back to their school life. Six male higher-elite-level climbers participated in semi-structured in-depth interviews. Results: In school, all participants perceived themselves as not being at the centre of social interactions. Moreover, all participants described a development from egoistic behaviour towards more supportive behaviour. Two participants were able to outline specific, formative experiences (crucibles), that drastically shaped their behaviour. Conclusion: All participants performed best in the absence of social tensions and when the atmosphere between the climbing partners was positive. Positive atmosphere was achieved by finding the optimal personal balance between supportive and egoistic behaviour.

[Bouldering: a sport with a high risk of intraarticular fractures]

Bouldering is a famous new sport with an increasing number of athletes. It became an Olympic sport in 2020. As no major sports equipment is required, everybody can take up bouldering even with little knowledge. However, despite the low climbing height there is a high risk of severe joint injuries, especially in the lower limb. Increasing numbers of climbers have led to an increase in injuries. New floor designs are supposed to reduce these risks. Improved documentation and specific research in bouldering should provide more insight into risks, injury patterns and prevention.

Upper Extremity Injuries in Rock Climbers: Diagnosis and Management

Rock climbing places substantial stress on the upper extremities and can lead to unique injuries not common to other sports. With increasing popularity of the sport, hand surgeons are expected to see more patients with these pathologies. An understanding of the sport, accurate diagnoses, and appropriate treatment protocols are critical to maintain climbers' competitive abilities.

Characteristics of bouldering injuries based on 430 patients presented to an urban emergency department

INTRODUCTION

Bouldering is a climbing sport that has been attracting a greater number of recreational and professional athletes over recent decades, which has led to an increase in sport-related injuries. The aim of this study was to determine the characteristics and the types of acute injuries caused by bouldering. Further athlete-specific factors and covariates for the trauma types were investigated.

MATERIALS AND METHODS

In this retrospective analysis, all patients presented to the level 1 trauma center at the hospital of the Technical University of Munich after an acute trauma related to bouldering were identified via the hospital documentation system. The period of observation was ten years, from 2010 until 2020. Epidemiological and injury-specific information as well as the initial treatment were registered. In a second step, the affected patients were invited to participate in an online survey in order to collect information about their skills, experience, and details about the trauma.

RESULTS

A total of 430 patients with 447 acute injuries were identified. There were 244 injuries among female and 203 injuries among male patients. The most common anatomical region affected was ankle (36.7%), knee (16.8%), elbow (12.3%), spine (7.2%) and shoulder (6.3%). The majority of 273 (61.1%) injuries were located at the lower extremities. The most frequent types of injury were sprains (53.0%), fractures (22.8%) or joint dislocations (11.9%). Surgical treatment was necessary for 89 (19.9%) patients. A return to bouldering was more likely in male patients 50 (75.8%) than in females 47 (59.5%) (p = 0.038). Subjectively, inexperienced boulderers were also less likely to return to the sport than advanced boulderers with greater experience (p = 0.001) CONCLUSION: The incidence of bouldering injuries is rising. Typical bouldering injuries could be identified and quantified at least for those patients who were presented to a hospital emergency department. Injuries in this setting do differ from the injury types known from rock climbing injuries as they are located on the lower extremity more often. Injuries of the fingers and hand, which are common climbing injuries, have been barely encountered in the emergency center.

Evaluation of a four-week Adjunct Compensatory Training for the treatment of climbing-specific overstrain syndromes of the shoulder

BACKGROUND

 Although climbing is an increasingly popular sport, there is a lack of scientific evaluation of suitable training methods for climbers, especially with a view to prevention and rehabilitation. A specific rehabilitation program, Adjunct Compensatory Training (ACT), has recently been presented, but it has not been evaluated scientifically to date.

OBJECTIVE

 To investigate the effects of Adjunct Compensatory Training on climbing-specific overstrain syndromes of the shoulder.

METHODS

 Twenty active boulderers and climbers with an average age of 28.9 (± 7.4) years performed a guided shoulder program of six specific exercises from the ACT program over a period of four weeks. They were examined before and after the intervention. Pre- and post-interventional measurements included the Constant-Murley Score, the QuickDASH Score and the measurement of shoulder ROM (range of motion).

RESULTS

 The Constant-Murley Score increased from 82 (± 10.0) to 104.1 (± 8.2) at follow-up (p < 0.001). The VAS value for bouldering and climbing decreased from 5.25 (± 1.4) before to 2.4 (± 1.6) after the intervention (p < 0.001). Shoulder flexion increased from 167.5 (± 14.9) to 173.1 (± 7.7) after the intervention (p < 0.05), abduction from 172.5 (± 14.9) to 179.6 (± 5.9) (n. s.), external rotation from neutral zero position from 77.6 (± 16.8) to 86.3 ± (8.3) (p < 0.05). Feasibility and acceptance of the intervention were good. Ninety-five percent of the participants continued to exercise, and 100 percent recommended the program to others.

CONCLUSION

 The ACT led to an improvement in pain, activities of daily living, range of motion and strength in boulderers and climbers with overstrain symptoms of the shoulder. It is also classified as a realistically feasible workout. The extent to which this effect will continue, and whether or not the program can prevent injuries, remains to be seen. It can only be presumed that regular exercises prevent shoulder injuries in the climbing population.

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

BACKGROUND

Rock climbers are particularly susceptible to shoulder injuries due to repetitive upper-limb movements on vertical or overhanging terrain. However, the long-term effects of prolonged climbing on the shoulder joints are still unknown.

PURPOSE

The purpose of this study was to analyze the prevalence of pain and degenerative changes in the shoulder joints after high-level rock climbing over at least 25 years. We hypothesized that specific climber-associated patterns of degeneration would be found.

METHODS

Thirty-one adult male high-level rock climbers were compared to an age- and sex-matched control group of 31 nonclimbers. All participants underwent a detailed interview, standardized clinical examination, and bilateral (climbers) or unilateral (nonclimbers, dominant side) magnetic resonance imaging (MRI) scans. Clinical and MRI findings of the groups were compared.

RESULTS

The lifetime prevalence of shoulder pain in the rock climbers was 77%. The rock climbers had significantly more abnormalities in the labrum (82% vs. 52%; P = .002), long biceps tendon (53% vs. 23%; P = .006), and cartilage (28% vs. 3%; P = .005). These increased changes positively correlated with climbing intensity. There were no differences between the 2 groups with respect to rotator cuff tendon pathology (68% vs. 58%; P = .331) and acromioclavicular joint degeneration (88% vs. 90%; P = .713). Despite the increased degenerative changes in the rock climbers, their Constant score (CS) was still better than that of the nonclimbers (CS 94, interquartile range [IQR] 92-97, vs. CS 93, IQR 91-95; P = .019).

CONCLUSIONS

Prolonged high-level rock climbing leads to a high prevalence of shoulder pain and increased degenerative changes to the labrum, long biceps tendon, and cartilage. However, it is not related to any restriction in shoulder function.