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Müller M, Pedersen S, Mair O, Twardy V, Siebenlist S, Biberthaler P, Banke IJ. Mid- to long-term functional outcome and return to sport after elbow dislocation in bouldering: a clinical retrospective cohort study. Arch Orthop Trauma Surg 2024:10.1007/s00402-024-05397-0. [PMID: 38869659 DOI: 10.1007/s00402-024-05397-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/02/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Traumatic elbow dislocations are among the most common injuries in sport climbing. They occur most frequently in bouldering (a climbing discipline with strong upward trend often performed indoors) due to the typical low-height backward fall into crashpads. There is still no data about the functional outcome and return to sport of this typical bouldering injury. MATERIALS AND METHODS All Patients with elbow dislocations due to a bouldering associated fall between 2011 and 2020 were identified retrospectively in our level I trauma centre. Trauma mechanisms, injury types and therapies were obtained. Follow-up was performed with an online questionnaire including sports-related effects, return to sport and the Elbow Self-Assessment Score (ESAS). RESULTS 30 patients with elbow dislocations after bouldering accidents were identified. In 22 (73.3%) patients the injury was a simple dislocation. The questionnaire was completed by 20 patients. The leading mechanism was a low-height fall into crashpads. Surgical procedures were performed in every second patient. 18 patients (90%) reported return to bouldering after 4.7 ± 2.1 months. 12 patients (66.7%) regained their pre-injury level. Mid-/Long-term follow-up (mean 105 ± 37.5 months) showed excellent results in ESAS score (97.2 ± 3.9 points). Persistent limited range of motion or instability was reported by only 3 patients (15%). CONCLUSION Most athletes are able to return to bouldering but only two thirds regain their pre-injury performance level in this demanding upper-extremity sport. The unique low-height trauma mechanism may create a false sense of security. Specific awareness and safety features should be placed for climbing athletes to reduce elbow injuries.
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Affiliation(s)
- M Müller
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
| | - S Pedersen
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - O Mair
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - V Twardy
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - S Siebenlist
- Department of Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - P Biberthaler
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - I J Banke
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Eichler M, Lutter C, Morris PD, Schöffl V. "Run-and-jump failure": new injury patterns in indoor bouldering. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2024; 38:27-30. [PMID: 38049098 DOI: 10.1055/a-2197-6017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
In recent years, professional and non-professional bouldering have seen a fundamental change in movement patterns towards complex movement sequences. This is associated with increased demands on the musculoskeletal system, especially the lower extremities, which can lead to new injury patterns. In the course of our clinical work, we have already seen an increasing number of lower extremity injuries after run-and-jump sequences, with a severe one being highlighted in this case report.
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Affiliation(s)
- Mathis Eichler
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg Germany
| | - Christoph Lutter
- Universitätsmedizin Rostock, Universitatsmedizin Rostock, Orthopedics, Rostock, Germany
- School of Health, Leeds Becket University, UK
| | | | - Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg Germany
- Department of Orthopedic and Trauma Surgery, Friedrich Alexander Universität Erlangen-Nürnberg, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine at the University of Colorado School of Medicine, USA
- School of Health, Leeds Becket University, UK
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Quarmby A, Zhang M, Geisler M, Javorsky T, Mugele H, Cassel M, Lawley J. Risk factors and injury prevention strategies for overuse injuries in adult climbers: a systematic review. Front Sports Act Living 2023; 5:1269870. [PMID: 38162697 PMCID: PMC10756908 DOI: 10.3389/fspor.2023.1269870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/09/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Climbing is an increasingly popular activity and imposes specific physiological demands on the human body, which results in unique injury presentations. Of particular concern are overuse injuries (non-traumatic injuries). These injuries tend to present in the upper body and might be preventable with adequate knowledge of risk factors which could inform about injury prevention strategies. Research in this area has recently emerged but has yet to be synthesized comprehensively. Therefore, the aim of this study was to conduct a systematic review of the potential risk factors and injury prevention strategies for overuse injuries in adult climbers. Methods This systematic review was conducted in accordance with the PRISMA guidelines. Databases were searched systematically, and articles were deemed eligible based upon specific criteria. Research included was original and peer-reviewed, involving climbers, and published in English, German or Czech. Outcomes included overuse injury, and at least one or more variable indicating potential risk factors or injury prevention strategies. The methodological quality of the included studies was assessed with the Downs and Black Quality Index. Data were extracted from included studies and reported descriptively for population, climbing sport type, study design, injury definition and incidence/prevalence, risk factors, and injury prevention strategies. Results Out of 1,183 records, a total of 34 studies were included in the final analysis. Higher climbing intensity, bouldering, reduced grip/finger strength, use of a "crimp" grip, and previous injury were associated with an increased risk of overuse injury. Additionally, a strength training intervention prevented shoulder and elbow injuries. BMI/body weight, warm up/cool downs, stretching, taping and hydration were not associated with risk of overuse injury. The evidence for the risk factors of training volume, age/years of climbing experience, and sex was conflicting. Discussion This review presents several risk factors which appear to increase the risk of overuse injury in climbers. Strength and conditioning, load management, and climbing technique could be targeted in injury prevention programs, to enhance the health and wellbeing of climbing athletes. Further research is required to investigate the conflicting findings reported across included studies, and to investigate the effectiveness of injury prevention programs. Systematic Review Registration https://www.crd.york.ac.uk/, PROSPERO (CRD42023404031).
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Affiliation(s)
- Andrew Quarmby
- Sports Medicine & Sports Orthopaedics, University of Potsdam, University Outpatient Clinic, Potsdam, Germany
| | - Martin Zhang
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Moritz Geisler
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Tomas Javorsky
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Hendrik Mugele
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
| | - Michael Cassel
- Sports Medicine & Sports Orthopaedics, University of Potsdam, University Outpatient Clinic, Potsdam, Germany
| | - Justin Lawley
- Department of Sports Science, Division of Performance Physiology and Prevention, University of Innsbruck, Innsbruck, Austria
- EURAC Research, Institute for Mountain Emergency Medicine, Bolzano, Italy
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Schöffl V, von Schroeder H, Lisse J, El-Sheikh Y, Küpper T, Klinder A, Lutter C. Wrist Injuries in Climbers. Am J Sports Med 2023; 51:3416-3425. [PMID: 37800447 DOI: 10.1177/03635465231199671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
BACKGROUND Acute and chronic injuries to the wrist are among the most common sport-related complaints of climbing athletes but have not been extensively evaluated in this population. Therefore, it is important to categorize climbing injuries to the wrist, analyze risk factors, and assess treatment outcomes. PURPOSE To evaluate the distribution, outcomes, and influencing factors of wrist injuries in climbers. STUDY DESIGN Case series; Level of evidence, 4. METHODS Climbing athletes with wrist injuries who presented to our specialized sports medical center over the course of 4 years (2017-2020) were selected. All had prospectively completed questionnaires including their climbing-specific background (years of training, climbing level, training methods, etc). Injuries were analyzed (International Climbing and Mountaineering Federation [UIAA] grade and diagnosis), and treatment methods and outcomes were retrospectively assessed with a minimum follow-up of 2 years. Parameters included the climbing score, visual analog scale for pain score, Patient-Rated Wrist Evaluation (PRWE) score, and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score including the sport component (DASH-Sport) score before and after treatment as well as time to return to climbing. RESULTS A total of 69 patients (25 female, 44 male) with 78 wrist injuries were identified and analyzed. Of these, 7 injuries were bilateral, occurring at the same time, and 2 injuries were independent reinjuries to either the same or the contralateral side. In addition, 24 injuries (30.8%) were acute, while 54 (69.2%) were chronic. Overall, 2 injuries had a UIAA grade of 3; all others had a UIAA grade of 2. The most frequent injuries were synovitis of the ulnocarpal recess, ulnar impaction, bone marrow edema of the lunate, wrist sprains (joint capsular pain with stress, with no pathological finding on magnetic resonance imaging), and wrist ganglion cysts. Nonoperative treatment was performed for 61 of the injuries, while 17 were treated surgically. In 51 cases (65.4%), injuries healed without consequences; in 27 cases (34.6%), discomfort remained. The visual analog scale pain score decreased from 4.8 ± 1.9 before treatment to 0.7 ± 1.0 after treatment (P < .001), the PRWE score decreased from 53.6 ± 24.9 to 10.3 ± 13.1 (P < .001), the QuickDASH score improved from 53.0 ± 16.6 to 20.0 ± 20.2 (P < .001), and the DASH-Sport score improved from 82.0 ± 16.1 to 38.1 ± 23.5 (P < .001). The climbing score improved from 2.5 ± 1.1 to 4.3 ± 1.0 points (P < .001). The patient-reported number of days with pain was negatively correlated with changes in the PRWE score (r = -0.351; P < .001), QuickDASH score (r = -0.316; P = .007), and climbing score (r = -0.264; P = .025) as well as the number of days without climbing (r = -0.266; P = .025). The number of days without climbing was positively correlated with changes in the PRWE score (r = 0.369; P < .001). CONCLUSION Wrist injuries in climbers constituted a diverse set of diagnoses. Ulnar-sided injuries were most common, and many patients had >1 diagnosis. Outcomes for all treatment methods (surgery and nonoperative care) were favorable, but approximately one-third of climbers had persistent wrist discomfort after treatment, underscoring the need for accurate diagnoses and acute and expert care.
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Affiliation(s)
- Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany
- Department of Trauma Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- School of Health, Leeds Beckett University, Leeds, UK
| | - Herb von Schroeder
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Plastic, Reconstructive & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Hand Program, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
- Dovigi Orthopaedic Sports Medicine Clinic, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jens Lisse
- Department of Trauma Surgery, Klinikum Forchheim, Forchheim, Germany
| | - Yasser El-Sheikh
- Division of Plastic, Reconstructive & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, North York General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Küpper
- Institute for Occupational, Social & Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - Annett Klinder
- Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
| | - Christoph Lutter
- Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
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Grønhaug G, Joubert LM, Saeterbakken AH, Drum SN, Nelson MC. Top of the podium, at what cost? injuries in female international elite climbers. Front Sports Act Living 2023; 5:1121831. [PMID: 37398555 PMCID: PMC10312002 DOI: 10.3389/fspor.2023.1121831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/15/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives Competitive sport climbing has made its way to the Olympic stage. This prestige has brought about route setting and training alterations which presumably affect injury epidemiology. Most of the climbing injury literature contains male climbers and lacks high performing athletes. Studies with both female and male climbers, rarely included separate analyses for performance level or sex. Therefore, injury concerns for elite female competitive climbers are impossible to discern. A former study examined the prevalence of amenorrhea in elite international female climbers (n = 114) and reported that 53.5% had at least one injury in the past 12 months, but injury details were excluded. This study's aim was to report these injury details and their associations with BMI, menstrual status and eating disorders of the cohort. Methods Online survey was emailed to competitive female climbers recruited through the IFSC database between June and August 2021. Data was analyzed using Mann-Whitney U, χ2 and logistic regression. Results 229 registered IFSC climbers opened the questionnaire and 114 (49.7%) provided valid responses. Respondents (mean ± SD; age = 22.9 ± 5 year) represented 30 different countries and more than half (53.5%, n = 61) reported an injury in the prior 12 months with the majority in shoulders (37.7%, n = 23) and fingers (34.4%, n = 21). Injury prevalence in climbers with amenorrhea was 55.6% (n = 10). BMI was not a significant predictor of injury risk (OR = 1.082, 95% CI: 0.89, 1.3; p = 0.440) while accounting for current ED over the past 12 months. However, the odds ratio for having an injury was doubled for those with an ED (OR = 2.129, 95% CI: 0.905, 5.010; p = 0.08). Conclusion With over half reporting recent injuries (<12 months) mostly to shoulders and fingers, development of new strategies for injury prevention in competitive female climbers are warranted. In addition, climbers with disordered eating behaviors and/or menstrual disturbances might be more prone to injury. More research in this population is required. Suitable screening to prevent these health issues and proper monitoring of these athletes are paramount to long-term athlete success.
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Affiliation(s)
- G. Grønhaug
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus, Sogndal, SFC, United States
| | - L. M. Joubert
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
| | - A. H. Saeterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus, Sogndal, SFC, United States
| | - S. N. Drum
- Student-Athlete High Performance Center and Sims-Treharne Collaborative Research Laboratory; Department of Health Sciences, Northern Arizona University, Flagstaff, AZ,United States
| | - M. C. Nelson
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
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