Physiological responses to rock climbing in young climbers

Stress fractures of the hand and wrist in athletes

Stress fractures of the upper extremity are reported less often than their lower extremity counterpart. This review aims to provide a comprehensive overview of an important and often missed diagnosis in pediatric athletes: hand and wrist stress fractures.

Palmar Shift of the Proximal Interphalangeal Joint in Different Grip Positions as a Potential Risk Factor for Periphyseal Injuries in Adolescent Climbers

INTRODUCTION

The aim of this study was to evaluate different grip positions as a contributing factor for primary periphyseal stress injuries of the finger phalanges in climbing.

METHODS

Ultrasound imaging of the proximal interphalangeal joint was performed on 37 asymptomatic adolescent climbers. Longitudinal images were obtained of middle and ring fingers of both hands in different grip positions (open, half-open, and crimp), unloaded and loaded. The translation between the dorsal head of the proximal phalanx and the shaft of the middle phalanx was measured in an unloaded and loaded situation for all grip positions. The resulting difference was determined as the palmar shift.

RESULTS

The mean age of the study population was 13 y. Results showed a palmar shift of 0.57 mm in a loaded crimp grip position compared to 0.13 mm in an open position and 0.20 mm in a half-open grip position. With a P value of <0.001, this shift was significantly higher in a crimp grip position compared to open or half-open grip positions.

CONCLUSIONS

This leads to an increase in joint incongruity and much higher peak forces on the dorsal aspect of the epiphyseal-physeal-metaphyseal complex, which is particularly vulnerable during the adolescent growth spurt. Thus, climbing and training behavior should be adapted accordingly during this phase by avoiding the crimp grip position until epiphyseal fusion.

Wrist Injuries in Climbers

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.

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

Hillebrandt, David, Anil Gurtoo, Thomas Kupper, Paul Richards, Volker Schöffl, Pankaj Shah, Rianne van der Spek, Nikki Wallis, and Jim Milledge. UIAA Medical Commission recommendations for mountaineers, hillwalkers, trekkers, and rock and ice climbers with diabetes. High Alt Med Biol. 24: 110-126.-The object of this advice article is not only to give the diabetic mountaineer general guidance but also to inform his or her medical team of practical aspects of care that may not be standard for nonmountaineers. The guidelines are produced in seven sections. The first is an introduction to the guidelines, and the second is an introduction to this medical problem and is designed to be read and understood by diabetic patients and their companions. The third section is for use in an emergency in mountains. The fourth is for rock, ice, and competition climbers operating in a less remote environment. These initial sections are deliberately written in simple language. The fifth and sixth sections are written for clinicians and those with skills to read more technical information, and the seventh looks at modern technology and its pros and cons in diabetes management in a remote area. Sections One and Two could be laminated and carried when in the mountains, giving practical advice.

Low occurrence of MRI spinal changes in elite climbing athletes; a cross-sectional study

OBJECTIVES

To examine the occurrence of magnetic resonance imaging (MRI) changes in the thoracolumbar spine among elite climbing athletes.

METHODS

All climbers of the Swedish national sport climbing team (n = 8), and individuals having trained for selection to the national team (n = 11), were prospectively included. A control group, matched in age and sex, were recruited. All participants underwent a thoracolumbar MRI (1.5 T, T1- and T2-weighted imaging), evaluated according to Pfirrmann classification, modified Endplate defect score, Modic changes, apophyseal injuries and spondylolisthesis. Pfirrmann ≥ 3, Endplate defect score ≥ 2 and Modic ≥ 1 was defined as degenerative findings.

RESULTS

Fifteen individuals, 8 women, participated in both the climbing group (mean age 23.1, SD 3.2 years) and the control group respectively (mean age 24.3, SD 1.5 years). In the climbing group, 6.1% of the thoracic and 10.6% of the lumbar intervertebral discs showed signs of degeneration according to Pfirrmann. One disc with a grade above 3 was present. Modic changes in the thoracic/lumbar spine were prevalent in 1.7%/1.3% of the vertebrae. Degenerative endplate changes according to the Endplate defect score were found in 8.9% and 6.6% of the thoracic and lumbar spinal segments of the climbing group, respectively. Two apophyseal injuries were found, while no participants displayed signs of spondylolisthesis. There was no difference in point-prevalence of radiographic spinal changes between climbers and controls (0.07 < p < 1.0).

CONCLUSION

In this small cross-sectional study, only a low proportion of elite climbers displayed changes of the spinal endplates or intervertebral discs, as opposed to other sports with high spinal loads. Most observed abnormalities were low grade degenerative changes and did not differ statistically compared to controls.

Persistent Unilateral Force Production Deficits Following Hand Injury in Experienced Climbers: A Reliability and Retrospective Injury Study

INTRODUCTION

In climbing, research is needed to guide clinical and training advice regarding strength differences between hands. The objectives of this study were to establish test-retest reliability of a field-based apparatus measuring sport-specific unilateral isometric hand strength and to investigate whether these measures detect between-hand differences in climbers with and without a history of unilateral hand injury.

METHODS

A reliability and case-control injury study was carried out. Seventeen intermediate-advanced climbers without and 15 intermediate-advanced climbers with previous unilateral hand injury participated. Unilateral isometric fingertip flexor strength was assessed during maximal voluntary contraction (MVC) and peak rate of force development (RFD) tests in full-crimp overhead position. The magnitude of within-group between-hand differences was calculated using a generalized estimating equation to evaluate if prior injury was associated with lower MVC and RFD outcomes and whether hand dominance influenced the magnitude of these effects. The control group was assessed 1 wk later to determine intraclass correlation coefficients (ICCs) for all measures.

RESULTS

The MVC (ICC 0.91-0.93) and the RFD (ICC 0.92-0.83) tests demonstrated moderate-to-high reliability. When accounting for handedness, those with prior injury showed 7% (P=0.004) reduced MVC and 13% (P=0.008) reduced RFD in the injured hand. The nondominant hand was also significantly weaker in MVC (11%, P<0.001) and RFD (12%, P=0.02) outcomes. For uninjured climbers, MVC and RFD were not significantly higher in the dominant hand (differing by 4% and 5%, respectively).

CONCLUSIONS

Previous climbing injury was associated with persistent weakness in the injured limb and exacerbated handedness effects. Therefore, recommendations for rehabilitation should be considered.

The Risk Factors Associated with Grip Lock Injuries in Artistic Gymnasts: A Systematic Review

Artistic gymnastics (AG) is a sport that demands grace, strength, and flexibility, leading to a broad spectrum of injuries. The dowel grip (DG) is widely used by gymnasts to securely hold onto the high bar or uneven bars. However, incorrect usage of the DG can result in grip lock (GL) injuries. This systematic review aims to (1) identify studies that have investigated the risk factors related to GL injuries among gymnasts and (2) synthesize the key evidence. A comprehensive electronic search was conducted in the following databases: PubMed, ScienceDirect, Elsevier, SportDiscus, and Google Scholar, covering the period from their inception until November 2022. The data extraction and analysis were independently completed by two investigators. A total of 90 relevant studies were initially identified, out of which seven clinical trials met the eligibility criteria. For the quantitative synthesis, five studies were included. The details extracted from each article include: the sample characteristics (number, gender, age, and health status), the study design, the instrumentation or intervention used, and the final results. Our results revealed that the underlying causes of the risk factors of GL injuries were the irregular checking of the dowel grip and the mating surface of the bar, the tearing of the dowel of the leather strap, and the use of the dowel grip in different competition apparatuses. In addition, GL injuries may occur either as severe forearm fractures or mild injuries. Excessive flexion of the forearm and overpronation of the wrist during rotational movements, such as the swing or backward/forward giant circle, may increase the possibility of GL injury on the high bar. Future studies should focus on GL injury prevention strategy and rehabilitation protocol for GL injuries. Further high-quality research is required to establish the validity of these findings.

Sport-specific performances in elite youth sport climbers; gender, age, and maturity specifics

Study aim: The increase in the number of professional climbers led to the development of climbers since early age. Therefore, the average age of elite climbers has decreased over the last decade. Consequently, age and maturity specifics should be investigated with the influential factors in climbing. This research aimed to investigate the forearm muscle strength in youth sport climbers and determine the gender, age, and maturity status as factors of influence on forearm muscle performance in elite youth climbers.

Materials and methods: This research included 18 elite sport climbers (Croatian National team members), divided into two age groups: younger (aged 13–15 years) and older (aged 16–18 years). Variables included anthropometric indices (body mass, body height, body fat percentage, ape index), handgrip strength, and climbing-specific forearm strength.

Results: Climbers did not differ between age groups in the studied variables. Also, no significant correlations were found among anthropometric/body-built indices and forearm muscle performances, with age and maturity offset. However, when gender stratified, there were associations between forearm capacity in sitting position and maturity offset in girls (r = 0.73; p < 0.05) but not in boys.

Conclusion: Results could be explained by the assumption that each subsequent generation is better than the previous one. Also, the associations between performance variables and biological age in girls are probably related to girls’ earlier maturation and specificity of sports selection. Forearm muscle capacities are a crucial determinant of success in sports climbing, and a good assessment of these muscle groups could serve as a tool for sport-specific selection.

A Life Dedicated to Climbing and Its Sequelae in the Fingers-A Review of the Literature

Fingers of sport climbers are exposed to high mechanical loads. This work focuses on the fingers of a 52-year-old active elite climber who was the first in mankind to master 8B (V13), 8B+ (V14) and 8C (V15) graded boulders, bringing lifelong high-intensity loads to his hands. It is therefore hypothesized that he belongs to a small group of people with the highest accumulative loads to their fingers in the climbing scene. Fingers were analyzed by means of ultrasonography, X-rays and physical examination. Soft tissue and bone adaptations, as well as the onset of osteoarthritis and finger stiffness, were found, especially in digit III, the longest and therefore most loaded digit. Finally, this article aims to provide an overview of the current literature in this field. In conclusion, elite sport climbing results in soft tissue and bone adaptations in the fingers, and the literature provides evidence that these adaptations increase over one's career. However, at later stages, radiographic and clinical signs of osteoarthritis, especially in the middle finger, seem to occur, although they may not be symptomatic.

Primary Periphyseal Stress Injuries of the Fingers in Adolescent Climbers: A Critical Review

ABSTRACT

The worldwide rise in popularity of climbing and development of climbing as a competitive sport is reflected by its debut at the 2021 Summer Olympic Games in Tokyo. Digital primary periphyseal stress injuries in adolescent climbers may pose a significant risk to long-term skeletal health. The aim of this article is to critically review research on the diagnosis and management of primary periphyseal stress injuries of the fingers in adolescent climbers. We adopted a systematic approach to searching for relevant literature. Articles were identified after searches of the following electronic databases: Discover, Academic Search Complete, PubMed, Embase, SPORTDiscus, and ScienceDirect. Conclusive evidence suggests digital primary periphyseal stress injuries are a consequence of repetitive microtrauma. Pain reported by adolescent climbers on the dorsal aspect of the proximal interphalangeal joint should be investigated promptly to avoid serious negative consequences. Clinicians should be aware of the efficacy of imaging techniques to inform a clinical diagnosis. A conservative management approach is preferred but in rare cases surgical intervention may be necessary. A diagnostic and therapeutic algorithm for digital primary periphyseal stress injuries is presented.

Cognitive factors that predict on-sight and red-point performance in sport climbing at youth level

Introduction

The ascent of a route can be defined as being climbed on-sight or red-point. Climbing performance is measured by the grade of the personal best route that the athlete has ever climbed.

Methodology

The study examined 17 youth climbers (10 male and 7 female). The inclusion criteria were age (less than 20 years), a minimum of three sessions per week, a minimum 7a climbing grade and participation in national or international competitions. We used the Cognitrom battery and applied tests measuring spatial orientation and reactivity.

Results

Climbing experience explained 42.7% of the variance of on-sight performance, and 49.5% of the variance of red-point performance. Image generation has a negative on both on-sight and red-point performance, lowering the prediction with 0.5% for on-sight climbing and with 1.5% for red-point climbing.

Discussion

Experience can predict climbing performance with a better prediction for red-point performance than on-sight with almost 7%. A high level of image generation ability can lead to viewing more approaches for passing the crux, but in a moment of physical and mental breakdown, can lead to failure. Red-pointing is less demanding than on-sight from physiological and psychologycal points of view. On-sight climbing requires greater levels of cognitive skills, such as route intepretation strategies, spatial orientation, motric memory, problem-solving skills, but also greater levels of psychological skills such as stress management, risk management, coping anxiety.

Youth Judokas Competing in Higher Age Groups Leads to a Short-Term Success

Coaches of youth judo athletes might be under the influence of some extraordinary elite judo athletes that have won elite competitions at a relatively young age and might put youth athletes under pressure to gain as much fighting experience as fast as possible. The present study aims to present a 5-year competition structure, volume and age competition categories (ACC) range in which youth judokas competed with 10-year dropout status. Data from 46 judokas were collected (M = 24; F = 22) for four categorisation classes (National-NC; Perspective-PC; International-IC; World class-WC). Competitive structure, volume, performance and number of ACC were collected from 2009 to 2013 for all age groups from scores and standings records of the National Federation. Youth judokas competed in 8 (±2) competitions per year and also competed in 3 (±1) ACC. Abroad competitions affect the fighting experience and competitive success (CS). CS showed positive correlations with the number of ACC in the year 2009 (p = 0.01), 2010 (p = 0.01) and 2011 (p = 0.04). The final observed years’ CS 2012 (p = 0.009) and 2013 (p = 0.002) showed a negative association with the number of ACC. CS in the final observed year 2013 showed a positive association (p = 0.012) with the dropout status in 2018 and a negative one with the number of abroad competitions in 2013 (p = 0.029). In total, 52% dropout was noted in 10 years. This ‘’playing-up’’ approach was shown to be successful in creating youth medalists. However, just in the short term, if implemented for too long, it starts to affect competition success negatively and increases youth athletes’ dropout. Therefore, coaches should include more competitions abroad in competitors’ primary age group, while training sessions could be done with higher age groups which would allow for gathering additional experience in a more controlled environment in their yearly periodisation.

Pediatric Musculoskeletal Injuries

Musculoskeletal injuries are a common reason for emergency department and primary care visits in the pediatric population. The prevalence of these injuries is likely related to children and adolescents participating in sports activities, physical activity, and exercise that can lead to these injuries. It is important for health care professionals and practitioners to understand the assessment, evaluation, and treatment of musculoskeletal injuries, but also to understand when to refer for expert consultation. [Pediatr Ann. 2022;51(9):e330-337.].

Integrating Wearable Sensors and Video to Determine Microlocation-Specific Physiologic and Motion Biometrics-Method Development for Competitive Climbing

Competitive indoor climbing has increased in popularity at the youth, collegiate, and Olympic levels. A critical aspect for improving performance is characterizing the physiologic response to different climbing strategies (e.g., work/rest patterns, pacing) and techniques (e.g., body position and movement) relative to location on climbing wall with spatially varying characteristics (e.g., wall inclinations, position of foot/hand holds). However, this response is not well understood due to the limited capabilities of climbing-specific measurement and assessment tools. In this study, we developed a novel method to examine time-resolved sensor-based measurements of multiple personal biometrics at different microlocations (finely spaced positions; MLs) along a climbing route. For the ML-specific biometric system (MLBS), we integrated continuous data from wearable biometric sensors and smartphone-based video during climbing, with a customized visualization and analysis system to determine three physiologic parameters (heart rate, breathing rate, ventilation rate) and one body movement parameter (hip acceleration), which are automatically time-matched to the corresponding video frame to determine ML-specific biometrics. Key features include: (1) biometric sensors that are seamlessly embedded in the fabric of an athletic compression shirt, and do not interfere with climbing performance, (2) climbing video, and (3) an interactive graphical user interface to rapidly visualize and analyze the time-matched biometrics and climbing video, determine timing sequence between the biometrics at key events, and calculate summary statistics. To demonstrate the capabilities of MLBS, we examined the relationship between changes in ML-specific climbing characteristics and changes in the physiologic parameters. Our study demonstrates the ability of MLBS to determine multiple time-resolved biometrics at different MLs, in support of developing and assessing different climbing strategies and training methods to help improve performance.

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.

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

Background: Sport climbing places high mechanical loads on fingers. In 2012, our research group demonstrated adaptations of climbers’ cortical bones with the presence of osteophytes compared to non-climbing controls.

Objectives: 1) To investigate 10-year changes in cortical bone thickness, base osteophyte occurrence and radiological signs of osteoarthritis in the fingers of elite male sport climbers with more than 25 years of climbing history and 2) to compare cortical bone thickness, base osteophyte occurrence and radiological signs of osteoarthritis between male sport climbers and age-matched controls at the 10-year follow-up.

Methods: All 31 elite sport climbers who participated in both the baseline and 10-year follow-up assessments (follow-up rate 100%) were examined by means of X-rays. Cortical bone thickness, presence of osteophytes and signs of osteoarthritis according to Kellgren-Lawrence were obtained and compared to the baseline values 10 years earlier and to age-matched controls at the follow-up (n = 15).

Results: Significantly increased cortical bone thickness over the past 10 years was observed in climbers (mean absolute difference with 95% CI:0.98 mm (0.77 mm, 1.19 mm); p <0.001). Moreover, compared to age-matched controls, climbers had significantly thicker cortical bone at the 10-year follow-up (mean absolute difference with 95% CI:0.86 mm (0.61 mm, 1.12 mm); p <0.001). In climbers, osteophytes and clear signs of osteoarthritis were mainly seen in DIP joints. Signs of osteoarthritis according to Kellgren-Lawrence were more prevalent than 10 years before in most joints. In lateral radiographs, base osteophytes were not significantly more prevalent than 10 years before in most of the joints. The percentage of climbers who had osteophytes in any DIP (PIP) joint increased from 93.5% (67.7%) at baseline to 100% (74.2%) at the 10-year follow-up. The percentage of climbers who had clear signs of osteoarthritis according to Kellgren-Lawrence in any DIP (PIP) joint increased from 12.9% (9.7%) at baseline to 74.2% (64.5%) at 10-year follow-up. Only a few such degenerative changes were found in age-matched controls.

Conclusion: An accumulation of repetitive climbing-related stress to the fingers of elite sport climbers over the career may induce lifelong mechano-adaptation of the cortical bone thickness of all phalanges. At the 10-year follow-up, a further significant increase in radiographic signs of osteoarthritic changes was observed.

Early Sport Specialization and Past Injury in Competitive Youth Rock Climbers

INTRODUCTION

Sport specialization has been shown to have negative effects on athletes but has not been studied within rock climbing. This study seeks to evaluate the proportion and impact of specialization in pediatric climbers.

METHODS

Climbers (ages 8-18 y) were recruited from throughout the United States to complete a 1-time survey regarding climbing experience, training patterns, and injury history. The main outcome of proportion of climbers suffering an injury was assessed within the last 12 mo and within their entire climbing experience (defined as "lifetime" injury). Early specialization was defined as exclusive participation in climbing, with training for >8 mo‧y^-1, prior to age 12 y (late specialization if after age 12 y).

RESULTS

Participants (n=111, 14±3 y [mean±SD], 69 females) were high-level climbers. Fifty-five percent of participants specialized in climbing, and 69% of those specialized early. Hand and ankle injuries occurred most commonly. Seventy-eight percent of late specialized climbers had a lifetime injury. Late specialized climbers were 1.6 times (95% CI: 1.1-2.3) more likely than early specialized climbers to have had a lifetime injury and 1.8 times (95% CI: 1.1-2.8) more likely to have had an injury in the last 12 mo. No difference in overuse injuries was found between specialization groups.

CONCLUSIONS

Early specialization is common among youth climbers but was not associated with an increase in injuries. Late specialization was associated with a higher likelihood of having had a climbing injury in the last 12 mo and during an entire climbing career.

Does sport type matter? The effect of sport discipline on cognitive control strategies in preadolescents

This study aimed to test the effects of specific sport practices on cognitive sensory-motor performance and underlying brain functions in children. Behavioral performance and event-related potentials (ERP) were investigated during a cognitive visuomotor task in 64 preadolescent children practicing racket (Rack) sports, martial arts (Mart), indoor climbing (Clim), or not practicing any sport (controls, Cont). At the behavioral level, response speed and accuracy were studied. At the electrophysiological level, motor, cognitive and sensory-attentional readiness, and post-perceptual attentional functions were investigated. Behavioral results showed that Mart players had the fastest response time (RT). Rack players had the most consistent RT and committed the lowest omission errors. Clim athletes were the most accurate in terms of false alarms. ERP results showed that motor readiness was largest in Mart players. The Rack group had the largest cognitive preparation and the Clim one had the largest sensory-attentional readiness activity. Rack and Mart players had the largest activity associated with post-perceptual attentional processing. This result shows that practicing specific sports may allow differential benefits on cognitive processing. Racket sports seem to stimulate action speed consistency and improve accuracy for omissions, increasing cognitive preparation, and post-perceptual attentional processing. Mart practice may allow a more speed-oriented response behavior, probably due to large motor preparation and allocation of post-perceptual attentional resources, but only when response execution is required. Indoor climbing may favor response accuracy reducing unwanted responses as indexed by an increased sensory-attentional readiness. Overall, all the considered sports disciplines may improve cognitive processing, but each one is associated with different benefits on cognitive performance by possibly stimulating separate brain processing. This kind of information could be crucial to select the more appropriate sport depending on individual demands.

Acute Handgrip Fatigue and Forearm Girth in Recreational Sport Rock Climbers

Indoor sport rock climbing has been increasing in popularity both recreationally and competitively. Despite this increase in popularity, the physiological responses to sport climbing as an exercise to specific muscle groups are not well defined. The purpose of this study was to quantify the change in handgrip strength over a 30-minute bout of continuous climbing, specifically in intermediate-level sport climbers. Ten intermediate rock climbers (age = 27 ± 2 years; climbing experience: 7.3 ± 1.5 years) completed baseline handgrip strength and forearm girth measurements. Each participant ascended one of two 5.9 difficulty routes as many times as possible in 30 minutes. After each ascent, heart rate was obtained, and handgrip strength and forearm girth were measured. Data were analyzed using repeated-measures ANOVA with significance set at α < 0.05. Dominant arm handgrip strength decreased by 22%, and non-dominant handgrip strength reduced by 23%. Dominant and non-dominant forearm girth increased by 4.5% and 4.4%, respectively. Weak but significant negative correlations were observed between handgrip strength and forearm girth in dominant (r = -0.311, p = 0.001) and non-dominant limbs (r = -.491, p = 0.001). These results indicate a relationship between increased forearm girth and decreases in muscular strength. Since handgrip strength decreases substantially during a 30-min climb in intermediate rock climbers, this population would be advised to carefully monitor recovery time between bouts.

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

STUDY DESIGN

This is a case report.

BACKGROUND

A woman with hemiplegic cerebral palsy and limited right upper extremity motion, strength, and control was referred to hand therapy to enable participation in adaptive climbing.

PURPOSE

The purpose of this case is to describe the role of hand therapy in identifying and addressing barriers to participation in adaptive climbing. Description of the patient's wrist flexion/extension, grip strength, and functional use over the course of eleven months is also included.

METHODS

Activity analysis, iterative problem solving, activity simulation, activity modification, and targeted therapeutic exercises were used over the course of eleven sessions.

RESULTS

The patient conveyed successful participation in adaptive climbing with reported improvements in overall strength, motion, ability to shift weight, ability to manage digit spasticity, spontaneous right upper extremity use, and body awareness. Active right wrist flexion, wrist extension, and grip strength improved by 33 degrees, eight degrees, and 35 lbs, respectively.

CONCLUSIONS

This case highlights an unconventional treatment scenario where outpatient hand therapy was entirely focused on targeting and facilitating the patient's participation in a specific activity-adaptive climbing. Rehabilitation professionals, uniquely suited to helping individuals explore interests, determine "good fit", identify barriers, and navigate obstacles, can advance the promotion of participation in activities that are both meaningful and physically engaging.

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.

The Sagittal Integral Morphotype in Male and Female Rowers

The goal of this study was to describe the integrated spinal assessment of the sagittal morphotype in rowers to determine whether the intense practice of rowing causes a modification of the sagittal curvatures of the spine, its relationship with the rowing technique, and training background. The second goal was to analyse how the dorsal and lumbar curves behave in the three phases of the rowing gesture, and to determine which phases can be detrimental to the correct development of the spine during growth. We analysed the spine curvatures in the sagittal plane of 29 females and 82 males, which were measured with an inclinometer in standing, slump sitting, maximal trunk flexion and during rowing performance. The average value of thoracic kyphosis in the rowers was 30° (mean, 30 + 8.27°). Thoracic hyperkyphosis was found in only two rowers (1.8%). Lumbar lordosis was within normal range in 84.1% of the males (mean, 27 + 9.57°) and 75.9% of female rowers (mean, 33°). Functional thoracic hyperkyphosis was observed in 57.4% of the males and 17.1% of the females. Functional lumbar hyperkyphosis was observed in 28 of the 69 males (40.5%) and five of 22 females (17.2%). Rowing seems to provide adequate spine alignment in the sagittal plane on standing. The integrated spinal assessment of the sagittal morphotype showed that half or our rowers presented with functional thoracic hyperkyphosis, and 43.2% presented with functional lumbar hyperkyphosis. Spine behaviour during the rowing technique shows that the thoracic kyphosis (98.2%) and lumbar spine (91%) perform within normative ranges and could explain the adequate positioning of the spine in the sagittal plane on standing. Years of rowing training tend to reduce thoracic kyphosis in males.

Mechanical loading of primate fingers on vertical rock surfaces

Mechanical loading of finger bones (phalanges) can induce angular curvature, which benefits arboreal primates by dissipating forces and economising the recruitment of muscles during climbing. The recent discovery of extremely curved phalanges in a hominin, Homo naledi, is puzzling, for it suggests life in an arboreal milieu, or, alternatively, habitual climbing on vertical rock surfaces. The importance of climbing rock walls is attested by several populations of baboons, one of which uses a 7-m vertical surface to enter and exit Dronkvlei Cave, De Hoop Nature Reserve, South Africa. This rock surface is an attractive model for estimating the probability of extreme mechanical loading on the phalanges of rock-climbing primates. Here we use three-dimensional photogrammetry to show that 82–91% of the climbable surface would generate high forces on the flexor tendon pulley system and severely load the phalanges of baboons and H. naledi. If such proportions are representative of vertical rock surfaces elsewhere, it may be sufficient to induce stress-mitigating curvature in the phalanges of primates.

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

BACKGROUND

Sport climbing induces physiological changes in the body of high-level climbers. In 2012, our study group demonstrated adaptions of elite climbers' soft tissues with thicker A2/A4-pulleys, flexor tendons and palmar plates compared to non-climbers.

OBJECTIVES

To assess these adaptations over time we examined all 31 (follow up 100%) climbers that participated in that baseline study again using ultrasonography after a follow-up of 10 years.

MAIN FINDINGS

(1) In climbers, a significant increase in A2 and A4-pulley and flexor tendon thickness over the last 10 years was observed (p < 0.001), while PIP&DIP palmar plate thickness remained unchanged (p > 0.05); (2) at 10-years follow-up, all soft tissue thickness parameters (incl. palmar plates) were still significantly larger in climbers than in age-matched controls (p < 0.05); (3) as for the association with anthropometrics and climbing performance/experience, a significant association of the current climber's soft tissue thickness could only be found between palmar plate and reached climbing level(p = 0.032) as well as climber's body weight(p = 0.004).

CONCLUSION

An accumulation of repetitive climbing-related stress to the fingers of elite sport climbers over the career induces mechano-adaptation of the A2/A4-pulleys, flexor tendons and palmar plates. At later stages, there is a further significant increase in flexor tendon and pulley thickness, but not for palmar plate thickness.

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

BACKGROUND

The popularity of both indoor and outdoor rock climbing has dramatically increased over the last decade. The purpose of this study is to evaluate trends in United States climbing injury rates as well as assess specific injury characteristics, especially in the context of indoor and outdoor climbing.

METHODS

The National Electronic Injury Surveillance System database was queried (2010-2019) to compare national weighted injury estimates and compare various injury characteristics from climbers presenting to US emergency departments.

RESULTS

The annual national estimates of rock climbing-related injuries presenting to US emergency rooms increased significantly (p=0.030) from 2010 (N=2,381; CI 1,085-3,676) to 2019 (N= 4,596; CI 492-8,699). 58.7% of the injuries in this study that could be classified by location occurred climbing outdoors. Ankle injuries were 2.25 times more likely (CI 1.03-3.08) to occur indoors than outdoors. Outdoor climbers were 2.25 times more likely to sustain an injury via falling and 13.8 times more likely to be injured by being struck by an object than indoor climbers (CI 1.05-2.42, CI 10.67-17.78).

CONCLUSIONS

Indoor and outdoor rock climbing are associated with different injury characteristics and risks. Therefore proper safety precautions, equipment, and training specific to terrain should be observed by all climbers in order to help decrease the rising trend of rock climbing-related injuries in the United States.

Future-Oriented Coping with Weather Stress among Mountain Hikers: Temperamental Personality Predictors and Profiles

The aim of the study was to explore temperamental personality traits as predictors of fu-ture-oriented coping with weather stress in a group of Polish mountain hikers. The subjects were 209 young mountain hikers (M = 21.20; SD = 3.70) who took three temperament–personality questionnaires, i.e., FCZ-KT Temperament Questionnaire, Sensation Seeking Scale IV and NEO-FFI- Personality Inventory, alongside a recently constructed scale for diagnosing future-oriented coping with weather stress in outdoor context, Preventive and Proactive Coping with Bad Weather Scale in Outdoor Sports. The regression analysis indicated that preventive coping with weather stress in hiking was predicted by activity, emotional reactivity, briskness, sensory sensitivity, experience seeking, agreeableness and conscientiousness. In turn, proactive coping with bad weather in hiking was predicted by endurance, activity, thrill and adventure seeking and extraversion. In turn, the cluster analysis revealed three distinct clusters of hikers characterized by diverse re-sults on the scales of preventive and proactive dealing with adverse weather, namely, prudent hikers (high preventive coping/high proactive coping), reckless hikers (low pre-ventive coping/high proactive coping) and wary hikers (high preventive coping/low proactive coping). The hikers in these clusters differed in terms of temperamental per-sonality traits.

Returning to Climb after Epiphyseal Finger Stress Fracture

The number of youth participating in rock climbing has increased over the years. Finger stress epiphyseal fractures are the most common injury among youth climbers. These injuries tend to occur around puberty because this is when the physis is most vulnerable to injury. Additionally, it has been found that intensive finger training (campus boarding, a previously known risk factor for epiphyseal fractures) during adolescence can lead to early-onset osteoarthritis of the hand up to a decade later. There is currently a lack of a return-to-climb protocol for youth climbers following a repetitive stress epiphyseal fracture. Because of this gap in the literature, our purpose was to create a structured return-to-play protocol specific to youth climbers who sustained an epiphyseal fracture to the finger. By establishing these guidelines, medical professionals and coaches may be able to guide their athlete to gradually and safely return to sport.

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

Climbing as a competition sport has become increasingly popular in recent years, particularly the sub-discipline of bouldering. The sport will debut in the Tokyo Summer Olympic Games. National and international competitions have three disciplines: lead (climbing with rope protection), bouldering (climbing at lower heights with mattress floor protection) and speed (maximum speed climbing on a standardised route in 1-on-1 mode). There is also a 'combined mode' of all three disciplines (combined) which forms the Olympic competition format; all competition formats are held on artificial walls. Existing literature describes a predominantly low injury frequency and severity in elite climbing. In comparison to climbing on real rock, artificial climbing walls have recently been associated with higher injury rates. Finger injuries such as tenosynovitis, pulley lesions and growth plate injuries are the most common injuries. As finger injuries are sport-specific, medical supervision of climbing athletes requires specific medical knowledge for diagnosis and treatment. There is so far little evidence on effective injury prevention measures in top athletes, and antidoping measures, in general, requiring further work in this field. An improved data situation regarding high-performance climbing athletes is crucial to ensure that the sport continues to be largely safe and injury-free and to prevent doping cases as extensively as possible.

The Association of Finger Growth Plate Injury History and Speed Climbing in Youth Competition Climbers

INTRODUCTION

Finger growth plate injuries are the most common injury among youth climbers, and the association between these injuries and speed climbing, a mandatory discipline in the 2021 Olympics, has not been examined previously. Our primary purpose was to examine the demographic and training characteristics of adolescent competition climbers who reported a history of a finger growth plate injury compared to those who did not report a history of a finger growth plate injury. Our secondary purpose was to determine whether training characteristics differed between adolescent competition climbers who did and did not report speed climbing.

METHODS

Our study was a cross-sectional study design. We surveyed adolescent climbers who competed in the 2017 USA Climbing Sport and Speed Youth National Championships. Questions assessed climbing injury history and current rock-climbing training characteristics.

RESULTS

Two-hundred sixty-seven adolescent competition climbers, 14±3 (9-18) y of age (mean±SD with range), completed the survey. Those with a history of a finger growth plate injury reported greater approximate time spent speed climbing throughout the year (β=1.28, 95% CI 0.11-2.46, P=0.032) and training regularly on the International Federation of Sport Climbing speed wall (adjusted odds ratio=3.95, 95% CI 1.14-13.7, P=0.031).

CONCLUSIONS

Training regularly at practices on the speed wall was associated with a self-reported history of finger growth plate injuries among elite youth competition climbers. Speed climbing should be limited, especially during periods of rapid growth.

Comprehensive Review of Rock Climbing Injuries

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.

On-Sight and Red-Point Climbing: Changes in Performance and Route-Finding Ability in Male Advanced Climbers

AIM

In lead climbing, the ascent of the route can be defined as on-sight or red-point. On-sight is the more challenging style since it demands greater physiological and psychological commitment. The differences between the two modes in advanced climbers have not been studied much. Two essential skills needed to optimize performance, in both on-sight and in red-point climbing, are route interpretation (RI) ability and movements sequence recall. Therefore, this study aimed to compare performance between on-sight and red-point ascent in advanced climbers and evaluate how a climber's RI ability and movement sequences recall might change before and after on-sight and red-point climbing.

METHODS

Eighteen advanced male climbers (age 29.2 ± 4.7 years, body mass 67.8 ± 3.6 kg, stature 175.2 ± 2.4 cm, best red-point and on-sight grades 7b+/8a and 7a+/7b+, respectively) were video-recorded during the route ascent in on-sight and red-point modes to evaluate performance and to measure static and dynamic action times. RI ability and movement sequence recall were assessed before and after each climb. Level of anxiety was evaluated via a self-report questionnaire. Heart rate (f H), lactate concentration, ([La-]), and rating of perceived exertion (RPE) were detected during and after each climb.

RESULTS

Compared to on-sight, an improvement in performance was observed in a red-point climb: the ascent was faster (148.7 ± 13.6 s and 179.5 ± 12.5 s, respectively, P < 0.05), smoother (significant reduction in exploratory moves and in stops times, P < 0.05), less demanding physiologically (lower f H peak and [La-]peak, P < 0.05), and psychologically (lower RPE, cognitive and somatic anxiety and higher self-confidence, P < 0.05). The RI ability was improved in red-point versus on-sight and, in the same mode, between pre and post ascent.

CONCLUSION

Red-point climbing was found to be less demanding than on-sight, both physiologically and psychologically, under the conditions investigated by this study. Our findings suggest that RI is a trainable skill and underscore the importance of including specific techniques in training programs designed to improve interaction between perceptual, psychological, and physiological factors.

Joint Mobility Protection during the Developmental Age among Free Climbing Practitioners: A Pilot Study

Sport-climbing popularity increased intensely over the past years. Particularly, children's and adolescents' interest therein is constantly growing. Despite a large effort in preventing injuries and muscle overloads, a fine-tuned training for each sensitive phase of child development is still needed. The objective of the study was to evaluate an innovative training program aimed at the preservation of joint mobility during the developmental age. This article relies on the results of a steady training program allowing to retain joints integrity among the practice of sport climbing in children. Joint mobility changes have been monitored before and after a one-year training program in fifteen subjects aged between 8 and 18 years. Subjects were divided into three groups depending on age (Turgor Secundus, Proceritas Secunda and Turgor Tertius). The motor tests administered were the sit-and-reach test, coxo-femoral mobility test and scapula-humeral mobility test. Our results showed that one-year training improved joint mobility at each analyzed phase, suggesting that this training program could improve mobility and flexibility. Given the importance of joint mobility preservation for discipline-related injuries prevention and eventually recovering, it is essential to provide a specific training program as a route to approach sport climbing, and even more importantly, at an early age. This work represents a preliminary study in order to demonstrate both efficacy on the joint mobility and the requirement of our playful work to support the global sport-climbing workout.

Are Adolescent Climbers Aware of the Most Common Youth Climbing Injury and Safe Training Practices?

Finger growth plate injuries are the most common youth climbing injuries. The purpose of our study was to understand youth awareness of the most common youth climbing injury and safe training practices. We surveyed climbers, ages eight to 18 years old, at the 2017 USA Climbing Sport and Speed Youth National Championships. A total of 267 climbers completed the survey (mean age = 14 ± 2.7 years; 52% male). The A2 pulley injury was reported as the most common youth climbing injury by the largest portion of participants, 36%. The second most commonly identified injury was at the growth plate of the finger, 15% of participants, which was reported as significantly less than the A2 pulley injury, p < 0.001. Six percent of climbers reported the correct safe age to start double dyno campus board training. Roughly 18% of athletes identified growth plate injuries exclusively as a stress fracture, whereas 29.2% of those climbers self-reported as informed about finger growth plate injuries, but only 7.4% of climbers who self-reported as uninformed answered this question correctly. Misperceptions about skeletally-immature climbing injuries are prevalent amongst youth climbers. Education on the prevalence of finger growth plate injuries and the scarcity of A2 pulley injuries in youth climbers can increase diagnostic accuracy, improve care, and reduce long-term complications.

ANALYSIS OF THE PREVALENCE OF INJURIES AND ASSOCIATED FACTORS IN BRAZILIAN CLIMBERS

ABSTRACT Introduction Many Brazilians became climbing enthusiasts in the 20th century, and the activity was recently included as an Olympic sport at the Tokyo 2020 Olympic Games. With the increase in the number of climbers seeking to beat personal and/or competitive records, the number of injuries has also increased. Objectives To verify the prevalence of injuries in Brazilian climbers, as well as their association with sociodemographic characteristics and sport performance. Methods A cross-sectional, descriptive and analytic observational study was conducted from March 2018 to May 2018 with the application of a virtual questionnaire for 266 Brazilian climbers. The statistical analysis was performed subsequently. Results The prevalence of injuries in Brazilian climbers was 71.8%. The main characteristics of the injuries that merited special attention were musculotendinous site (50.8%), sport climbing (22.0%), upper limb (50.3%) and mechanism of abrupt movement (20.4%). The most popular treatment was medical in combination with physiotherapy (34.5%), and time off was generally more than 30 days (50.3%). There was a significant association (p <0.05) of the injuries with age, gender, region of the country, BMI, level of education and involvement in other sports, as well as athletic and recreational category, climbing time, basic course certificate, warming up, monthly rock climbing and weekly indoor climbing frequency, and the climbing grade. Conclusion Due to the increase in the popularity of the sport and the high prevalence of climbers with a history of injuries, multiprofessional follow-up is needed to procure risk reduction programs and to enhance climbers’ awareness of the factors associated with these injuries. Level of Evidence III; Study of nonconsecutive patients, without consistently applied ‘’gold’’ reference standard.

Identification of Parameters That Predict Sport Climbing Performance

In recent years, extreme sport-related pursuits including climbing have emerged not only as recreational activities but as competitive sports. Today, sport climbing is a rapidly developing, competitive sport included in the 2020 Olympic Games official program. Given recent developments, the understanding of which factors may influence actual climbing performance becomes critical. The present study aimed at identifying key performance parameters as perceived by experts in predicting actual lead sport climbing performance. Ten male (M_age = 28, SD = 6.6 years) expert climbers (7a+ to 8b on-sight French Rating Scale of Difficulty), who were also registered as climbing coaches, participated in semi-structured interviews. Participants’ responses were subjected to inductive-deductive content analysis. Several performance parameters were identified: passing cruxes, strength and conditioning aspects, interaction with the environment, possessing a good climbing movement repertoire, risk management, route management, mental balance, peer communication, and route preview. Route previewing emerged as critical when it comes to preparing and planning ascents, both cognitively and physically. That is, when optimizing decision making in relation to progressing on the route (ascent strategy forecasting) and when enhancing strategic management in relation to the effort exerted on the route (ascent effort forecasting). Participants described how such planning for the ascent allows them to: select an accurate and comprehensive movement repertoire relative to the specific demands of the route and reject ineffective movements; optimize effective movements; and link different movements upward. As the sport of climbing continues to develop, our findings provide a basis for further research that shall examine further how, each of these performance parameters identified, can most effectively be enhanced and optimized to influence performance positively. In addition, the present study provides a comprehensive view of parameters to consider when planning, designing and delivering holistic and coherent training programs aimed at enhancing climbing performance.

Effects of Rock Climbing Exercise on Physical Fitness among College Students: A Review Article and Meta-analysis

BACKGROUND

The aim of this study was to systematically determine the effects of rock climbing on College Students' physical fitness by means of Meta-analysis.

METHODS

Studies investigated the possible fitness benefits of rock climbing were identified through a computerized search of six electronic databases: China National Knowledge Infrastructure, China Science Periodical Database, PubMed, Web of Science, SPORTDiscus and PsycINFO. Effects of rock climbing exercise intervention trials ≥4 wk, published in English and Chinese between Jan 1996 and May 2016, including between subject and within subject designs, were reviewed. Nine studies were included in this meta-analysis. Ten selected variables in this meta-analysis were: Body fat percentage, VO₂max, Heart rate, Handgrip strength, Lower limb pedaling power, Vertical Jump, Push-Ups, Pull-Ups, Sit-Ups, and Sit-and-reach. The effect sizes of these ten variables were calculated (P<0.05) and forest plots along with effective sizes were presented.

RESULTS

Rock climbing can significantly improve Handgrip strength, Lower limb pedaling power, Vertical Jump, Push-Ups, Pull-Ups, Sit-Ups and Sit-and-reach (P<0.01), and significantly increase VO₂max (P<0.05), however, rock climbing did not show significant improvement on Heart rate and Body fat percentage.

CONCLUSION

As a newly popular physical exercise, rock climbing has a significantly positive impact on the physical fitness among college students. Rock climbing may be more effective if the college students engage in it for a longer term.

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

BACKGROUND

In the past few years, competition climbing has grown in popularity, and younger people are being drawn to the sport.

PURPOSE

While radiographic changes in long-term climbers are known, there are little data available on adolescent climbers. The question arises as to whether climbing at high levels at a young age leads to radiographic changes and possibly an early onset of osteoarthritis of the finger joints.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

A total of 19 members of the German Junior National Team (GJNT group) and 18 recreational climbers (RC group) were examined clinically and radiographically in 1999. In 2011, these climbers were re-examined (mean follow-up, 11.3 ± 1.2 years). Radiographs were evaluated using a standard protocol, searching for physiological adaptations such as cortical thickness of the middle phalanx and an increased adopted Barnett-Nordin index, as well as for early-onset osteoarthritic changes of the hand. In contrast to the Kellgren-Lawrence scale, subchondral sclerosis was added to the group of physiological, adaptive stress reactions and was not defined as osteoarthritis. Osteoarthritis was defined by a Kellgren-Lawrence grade ≥2.

RESULTS

Overall, 15 of 19 (follow-up rate, 78.9%) climbers in the GJNT group and 13 of 18 in the RC group (follow-up rate, 72.2%), with a mean age of 26.8 years, were examined at the 11-year follow-up. Five climbers (33%) in the GJNT group presented with a decreased range of motion for the finger joints, in contrast to only 1 climber (8%) in the RC group. Radiographic stress reactions of the hand were found in 80% of the GJNT group and 46% of the RC group, including cortical hypertrophy (GJNT: 73%; RC: 23%), subchondral sclerosis (GJNT: 80%; RC: 31%), a broadened proximal interphalangeal joint base (GJNT: 67%; RC: 38%), and a broadened distal interphalangeal joint base (GJNT: 53%; RC: 31%). Training intensity in 1999 and body weight in 1999 were significant for the development of radiographic stress reactions in 2011 (P < .05 for both). Signs of early-stage osteoarthritis were seen in 6 climbers: 4 (27%) in the GJNT group and 2 (15%) in the RC group. Significant statistical influences for the development of early-onset osteoarthritis were found for overall total training years (P = .024), use of campus board training in 1999 (P = .033), and climbing level (P = .030).

CONCLUSION

One-quarter of climbers who performed at a high level in their youth showed a "mild" form of osteoarthritis (Kellgren-Lawrence grade 2). In analyzing the training regimens of our climbers for longer than 10 years, we conclude that intensive finger training (eg, campus board training) can lead to early-onset osteoarthritis of the hand. We also demonstrate that a high Union Internationale des Associations d'Alpinisme (UIAA) climbing level correlates with the risk for early-onset osteoarthritis of the hand and therefore must be seen as a risk factor for developing early-onset osteoarthritis of the finger joints.

The effects of 8 weeks of two different training methods on on-sight lead climbing performance

BACKGROUND

Despite climbing being an increasingly popular sporting pursuit, there have been very few scientific evaluations of appropriate training methods for competitive climbers. The aim of this study was to investigate the effects of an 8-week climbing-specific muscular hypertrophy (MH) or muscular endurance (ME) resistance training program on the on-sight lead climbing performance in a similar setting to a World Cup.

METHODS

Twenty-three elite male and female climbers (age: 25.5±6.7 years; height: 1.72±0.08 m; body mass: 63.4±7.7 kg; measured on-sight level: 20.8±2.0 IRCRA [International Rock Climbing Research Association]) participated in 8 weeks' worth of MH (N.=11) or ME (N.=12) training. Before the training (FT1), after 8 weeks of training (FT2), and after a 2-week tapering period (FT3), the participants climbed an on-sight lead route in a similar setting to a world cup.

RESULTS

Climbers were able to perform significantly more moves (P=0.019; P<0.001) and climbed significantly harder (P=0.014; P<0.001) with FT2 and FT3 versus FT1. Climbing moves per unit time increased significantly when comparing FT2 to FT1 (P=0.007) and showed a tendency to increase when comparing FT3 to FT1 (P=0.061). However, there was no interaction effect between the groups.

CONCLUSIONS

Our findings demonstrated that climbing-specific ME, as well as MH resistance training, improved on-sight lead climbing performance in a similar setting to a world cup. For competing climbers and climbing coaches, we recommend inclusion of the same proportions of climbing-specific ME and MH resistance training in their training programs to enhance on-sight lead climbing performance.

Effects of Sport Climbing on Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune and neurodegenerative disease of the central nervous system (CNS) with different types of disease courses (relapsing-remitting, secondary-progressive, primary progressive) that leads to physical as well as mental disability. The symptoms comprise paresis or/and paralysis, ataxia, bladder dysfunction, visual problems as well as effects on cognition. There is limited data regarding the possible effects of sport climbing respectively therapeutic climbing on patients with MS. Sport climbing offers many potentially beneficial effects for patients with MS since there are effects on coordination, muscular strength, and cognition to name the most relevant ones. Also, disease models in rodents point toward such positive outcomes of climbing. Therefore, we assessed the currently available research literature on general effects of physical exercise, impact of climbing on body and mind and therapeutic climbing for prevention or therapy for the treatment of MS. The sparse published controlled trials that investigated this sport activity on different groups of patients with neurological or geriatric diseases grossly differ in study design and outcome parameters. Nevertheless, it appears that climbing offers the opportunity to improve some of the symptoms of patients with MS and can contribute to an enhanced quality of life.

Somatic Profile of the Elite Boulderers in Poland

Ozimek, M, Krawczyk, M, Zadarko, E, Barabasz, Z, Ambroży, T, Stanula, A, Mucha, DK, Jurczak, A, and Mucha, D. Somatic profile of the elite boulderers in Poland. J Strength Cond Res 31(4): 963-970, 2017-The study was designed to determine the values of selected somatic characteristics, body proportions, and the somatotype of elite bouldering climbers in Poland and to establish the relationships between the values of the somatic characteristics and climber's performance in bouldering. The study was conducted in a group of elite sport climbers (n = 10) who were ranked by the Polish Mountaineering Association in 2011, 2012, and 2013. The anthropometric measurements were made according to the relevant rules and standards. The results were used to calculate the values of somatic variables and body proportion indices for the climbers and to establish their somatotype. The results were compared with the data on untrained students (n = 165). The boulderers were found to differ significantly from the controls regarding body height (p < 0.01), body mass (p ≤ 0.05), body density (p < 0.01), fat mass percentage (FM%) (p < 0.01), fat mass (FMkg) (p < 0.01), lean body mass (p ≤ 0.05), arm span (p ≤ 0.05), and leg length (p < 0.01). Body proportions in the groups significantly differed in the arm length index (p < 0.01), arm-to-leg length ratio (p < 0.01), and in the indices of the forearm (p < 0.01), thigh (p < 0.01), and lower leg (p ≤ 0.05) muscles. With regard to the somatotypes of the analyzed groups, the biggest differences were observed for the levels of mesomorphy (NS) and endomorphy, the latter being statistically significant (p < 0.01). The strongest and significant correlations between the competitive level of the climbers and the values of their somatic characteristics were established for FM% (r = -0.81), fat mass (in kilograms) (r = -0.82), body density (r = 0.81), endomorphy (r = -0.74), arm length (r = 0.77), and the arm length index (r = 0.80). The results of linear regression showed that the competitive level of a bouldering climber was significantly explained (p < 0.01) by fat mass (in kilograms) and the value of the arm length index. A high level of performance in bouldering is related to small stature (an ecto-mesomorph somatotype) and a low body fat percentage (low endomorphy). Regarding body proportions, greater than average arm length to body height ratio and well-developed musculature of the limbs are required for a boulderer to perform on a competitive level. High arm length index and low body fat percentage represent the strongest determinants of performance in bouldering. It can be assumed that arm length index has a high diagnostic value for recruitment and selection of climbers.

The effect of cold ambient temperatures on climbing-specific finger flexor performance

Different ambient temperatures are known to affect muscular performance based on the type of contraction. The effect of cold (10°C) and thermoneutral (TN) (24°C) ambient temperatures on finger flexor performance was examined in 12 rock climbers. After 30 min of seated rest in the designated temperature condition, participants completed maximal voluntary contractions (MVC) on a climbing-specific finger flexor assessment device equipped with a crimp grip hold. Participants then completed an intermittent fatiguing task until failure. The fatiguing task consisted of 10-s contractions at 40% MVC followed by a 3-s of rest. MVC recovery was assessed immediately, 5, 10, and 15 min post-task failure. Estimated muscle temperature and subjective thermal ratings were significantly lower throughout testing in the cold condition (P < .001). Finger flexor MVC strength was similar between conditions at baseline and throughout recovery. Time to task failure was significantly longer (364 ± 135 vs. 251 ± 97 s, P = .003) and force time integral was greater (53,715 ± 19,988 vs. 40,243 ± 15,360 Ns, P = .001) during the cold condition. No significant differences were found between conditions for force variability or electromyography (EMG) at the start and end of the fatiguing task. However, the rate of increase in EMG for the TN condition was significantly faster (P = .03). These results suggest important implications for researchers when examining climbing performance, especially in outdoor settings where temperatures may vary from day to day. Inconsistencies in testing temperatures might significantly affect muscular endurance.

Rock Climbing for Promoting Physical Activity in Youth

Prevalence of overweight and obesity in youth has steadily increased over the last decade, although it appears to have currently stabilized. Physical inactivity is a major contributor to this obesity epidemic, and more than half of American youth do not meet physical activity recommendations. Rock climbing and bouldering require both aerobic and anaerobic fitness, with the metabolic cost comparable to moderate to vigorous physical activity in adults. Minimal data on youth climbers exist, yet climbing is extremely popular with youth, and thus the sport may be a viable option for decreasing the prevalence of obesity. Available data show that rock climbing can provide youth with muscular strength and endurance building exercise, and possibly improve flexibility. In addition, rock climbing has the potential to provide youth with moderate levels of physical activity according to recommended guidelines. Nine peer reviewed articles are included in this review, as these are the articles specifically associated with youth climbing and health-related fitness. Due to limited research in this area, no articles were excluded if they were related to health-related fitness and youth and rock climbing/bouldering. This review aims to systematically address the impact of rock climbing and bouldering on health-related fitness in youth.

PSYCHOPHYSICAL BENEFITS OF ROCK-CLIMBING ACTIVITY

The aim of the study was to compare the psychophysical effects of rock climbing with a supervised fitness training in adults. Thirty-three healthy participants (M age=32 yr., SD=7) participated in rock climbing or in fitness training. The participants' functional fitness, anxiety, and mood states were tested before and after 3 mo. of training. There was significant improvement of physical fitness in both groups after the intervention period. Anxiety significantly decreased after each single training session at the end of both courses. Differential effects in the rock-climbing group, as compared to the fitness group, emerged only on Vigor. Specifically, the rock-climbing group showed a decreasing trend in Vigor while the fitness group showed an increasing trend of Vigor after the intervention.

Determinant factors in climbing ability: Influence of strength, anthropometry, and neuromuscular fatigue

The goal of this study was to (i) assess the physical and anthropometric differences between three levels of climbers and (ii) predict climbing ability by using a multiple regression model. The participants were divided into novice (n = 15), skilled (n = 16), and elite (n = 10) climbers. Anthropometric characteristics such as height, weight, percentage of body fat and muscle, bi-acromial breath, arm span, and ape index were measured. General and specific strength were assessed through an arm jump test, a bench press test, and a hand and finger grip strength test in maximal and endurance conditions. All variables were combined into components via a principal component analysis (PCA) and the components used in a multiple regression analysis. The major finding of this study is that climbing ability is more related to specific rather than general strength. Only finger grip strength shows a higher level of initial strength between all samples while the arm jump test discriminates between climbers and non-climbers. The PCA reveals three components, labeled as training, muscle, and anthropometry, which together explain 64.22% of the variance. The regression model indicates that trainable variables explained 46% of the total variance in climbing ability, whereas anthropometry and muscle characteristics explain fewer than 4%.