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Pastor T, Schweizer A, Andronic O, Dietrich LG, Berk T, Gueorguiev B, Pastor T. A Life Dedicated to Climbing and Its Sequelae in the Fingers-A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17050. [PMID: 36554928 PMCID: PMC9778768 DOI: 10.3390/ijerph192417050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
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.
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Affiliation(s)
- Tatjana Pastor
- Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland
- AO Research Institute Davos, 7270 Davos, Switzerland
| | - Andreas Schweizer
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, 8006 Zurich, Switzerland
| | - Octavian Andronic
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, 8006 Zurich, Switzerland
| | - Léna G. Dietrich
- Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland
| | - Till Berk
- AO Research Institute Davos, 7270 Davos, Switzerland
- Department of Trauma, University Hospital Zurich, 8091 Zurich, Switzerland
| | | | - Torsten Pastor
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, 8006 Zurich, Switzerland
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, 6002 Lucerne, Switzerland
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Pastor T, Fröhlich S, Pastor T, Spörri J, Schweizer A. 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. Front Physiol 2022; 13:893369. [PMID: 35721555 PMCID: PMC9203125 DOI: 10.3389/fphys.2022.893369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Torsten Pastor
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- *Correspondence: Torsten Pastor,
| | - Stefan Fröhlich
- University Center for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University Zurich, Zurich, Switzerland
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Tatjana Pastor
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Jörg Spörri
- University Center for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University Zurich, Zurich, Switzerland
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Andreas Schweizer
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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Driban JB, Lo GH, Roberts MB, Harkey MS, Schaefer LF, Haugen IK, Smith SE, Duryea J, Lu B, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, McAlindon TE. Racket or Bat Sports: No Association With Thumb-Base Osteoarthritis. J Athl Train 2022; 57:341-351. [PMID: 35439314 PMCID: PMC9020592 DOI: 10.4085/1062-6050-0208.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Repetitive joint use is a risk factor for osteoarthritis, which is a leading cause of disability. Sports requiring a racket or bat to perform repetitive high-velocity impacts may increase the risk of thumb-base osteoarthritis. However, this hypothesis remains untested. OBJECTIVE To determine if a history of participation in racket or bat sports was associated with the prevalence of thumb-base osteoarthritis. DESIGN Descriptive epidemiologic study. SETTING Four US clinical sites associated with the Osteoarthritis Initiative. PATIENTS OR OTHER PARTICIPANTS We recruited 2309 men and women from the community. Eligible participants had dominant-hand radiographic readings, hand symptom assessments, and historical physical activity survey data. MAIN OUTCOME MEASURE(S) A history of exposure to racket or bat sports (badminton, baseball or softball, racketball or squash, table tennis [or ping pong], tennis [doubles], or tennis [singles]) was based on self-reported recall data covering 3 age ranges (12-18, 19-34, and 35-49 years). Prevalent radiographic thumb-base osteoarthritis was defined as Kellgren-Lawrence grade >2 in the first carpometacarpal joint or scaphotrapezoidal joint at the Osteoarthritis Initiative baseline visit. Symptomatic thumb-base osteoarthritis was defined as radiographic osteoarthritis and hand or finger symptoms. RESULTS Radiographic or symptomatic thumb-base osteoarthritis was present in 355 (34%) and 56 (5%), respectively, of men (total = 1049) and 535 (42%) and 170 (13%), respectively, of women (total = 1260). After adjusting for age, race, and education level, we found no significant associations between a history of any racket or bat sport participation and thumb-base osteoarthritis (radiographic or symptomatic; odds ratios ranged from 0.82 to 1.34). CONCLUSIONS In a community-based cohort, a self-reported history of participation in racket or bat sports was not associated with increased odds of having radiographic or symptomatic thumb-base osteoarthritis in the dominant hand.
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Affiliation(s)
- Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Mary B. Roberts
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | | | | | - Ida K. Haugen
- Department of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Stacy E. Smith
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey Duryea
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Bing Lu
- Department of
Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | - Marc C. Hochberg
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Rebecca D. Jackson
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Medical Center, Columbus
| | | | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
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Schöffl V, Schöffl I, Flohé S, El-Sheikh Y, Lutter C. Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers. Am J Sports Med 2022; 50:229-237. [PMID: 34817275 DOI: 10.1177/03635465211056956] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending. PURPOSE To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers. STUDY DESIGN Case series; Level of evidence, 4. METHODS On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d'Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score. RESULTS Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3. CONCLUSION The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.
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Affiliation(s)
- Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany
- School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
- Section of Wilderness Medicine, Department of Emergency Medicine, School of Medicine, University of Colorado, Denver, Colorado, USA
- Department of Orthopedic and Trauma Surgery, University Erlangen-Nuremberg, Erlangen, Germany
| | - Isabelle Schöffl
- School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
- Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany
| | - Sascha Flohé
- Department of Orthopedic and Trauma Surgery, Klinikum Solingen, Solingen, Germany
| | - Yasser El-Sheikh
- Department of Surgery, North York General Hospital, Toronto, Canada
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Christoph Lutter
- School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
- Department of Orthopedic Surgery, University Hospital Rostock, Rostock, Germany
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Long term evolution of soft tissue response in the fingers of high-level sport climbers: A cross-sectional 10 Year follow-up study. Phys Ther Sport 2021; 52:173-179. [PMID: 34547601 DOI: 10.1016/j.ptsp.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 01/03/2023]
Abstract
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.
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Pastor T, Schweizer A, Reissner L, Pastor T, Spörri J, Fröhlich S. Long-term evolution of cartilage abnormalities and osteophytes in the fingers of elite sport climbers: A cross-sectional 10-year follow-up study. Eur J Sport Sci 2021; 22:1452-1458. [PMID: 34121624 DOI: 10.1080/17461391.2021.1943716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The sequelae of high mechanical stress to the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints of the fingers in elite sport climbers and its contribution to the development of osteoarthritis are still relatively unknown. The purpose of this study was to investigate the evolution of cartilage abnormalities of the PIP and DIP joints, as well as the progress of osteophytes, in the fingers of elite sport climbers with a minimum of 25 years of climbing history over the time period of the last 10 years. Moreover, their actual cartilage abnormalities and osteophyte occurrence were compared to non-climbing age-matched controls. Thirty-one elite male sport climbers and 15 male non-climbers underwent a sonographic examination of the PIP and DIP joint cartilage and osteophyte thickness in the frontal and sagittal plane of digits II-V of both hands. The same cohort had already been measured with an identical protocol 10 years earlier (follow-up rate of 100%). Compared to the baseline assessment 10 years earlier, the cartilage thickness of sport climbers has significantly decreased; however, it was still greater than in age-matched controls. Moreover, sport climbers showed significantly higher relative frequencies of osteophyte occurrence than non-climbers (all fingers and joints). Nevertheless, despite a substantial (and compared to baseline a further increased) occurrence of osteophytes in elite sport climbers, there was no association between the radiological signs of osteoarthritis and pain within the last six months prior the follow-up investigation.Highlights Long-term elite climbers show thicker cartilage and occurrence of Osteophytes in their fingers (especially Digit III) compared to controls already early in their career.Later occurrence of osteophytes increases (especially Digit II and IV) and cartilage decreases but is still thicker compared to controls. No association between those findings and pain was found.
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Affiliation(s)
- Torsten Pastor
- Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Andreas Schweizer
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lisa Reissner
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Tatjana Pastor
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Fröhlich
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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McMullen CW, Mugleston BJ, Booker LN. Coaches' Attitudes Toward Campus Board Training in Adolescent Climbers in the United States. Wilderness Environ Med 2021; 32:168-175. [PMID: 33972161 DOI: 10.1016/j.wem.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 01/09/2021] [Accepted: 02/03/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Campus board training in adolescent climbers is controversial. Evidence, albeit limited, suggests this type of training may lead to the development of finger epiphyseal stress fractures. The purpose of the present study was to investigate coaches' attitudes toward campus board training in the United States. METHODS Surveys were sent to 116 coaches at gyms across the United States with affiliated adolescent climbing teams. Outcomes collected included demographic information, training time, campus board use prevalence, coaches' attitudes toward campus board use, and willingness to participate in future research. RESULTS Seventy-three coaches representing 3090 adolescent climbers completed the survey. Forty-six coaches (63%) reported using full weight (no foot contact) campus board training in some or all of their climbers. A variety of factors were cited by coaches when deciding which climbers should or should not use the campus board, including physical maturity, climbing ability, and age, among others. CONCLUSIONS Climbing coaches in the United States disagree on the use of campus board training in adolescent climbers. Some coaches avoid using this training modality entirely, whereas others believe certain climbers can use it safely. There is lack of consensus in determining who those certain climbers are.
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Affiliation(s)
- Christopher W McMullen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington.
| | - Brian J Mugleston
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Lyndsey N Booker
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington
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Lutter C, Tischer T, Schöffl VR. Olympic competition climbing: the beginning of a new era-a narrative review. Br J Sports Med 2020; 55:857-864. [PMID: 33036996 DOI: 10.1136/bjsports-2020-102035] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Christoph Lutter
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Thomas Tischer
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Volker Rainer Schöffl
- Section of Sports Medicine, Department of Trauma and Orthopedic Surgery, Klinikum Bamberg, Bamberg, Germany.,Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.,Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado, USA.,School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
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9
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Joint Mobility Protection during the Developmental Age among Free Climbing Practitioners: A Pilot Study. J Funct Morphol Kinesiol 2020; 5:jfmk5010014. [PMID: 33467230 PMCID: PMC7739414 DOI: 10.3390/jfmk5010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/03/2020] [Accepted: 02/10/2020] [Indexed: 11/17/2022] Open
Abstract
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.
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10
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Lutter C, Hotfiel T, Tischer T, Lenz R, Schöffl V. Evaluation of Rock Climbing Related Injuries in Older Athletes. Wilderness Environ Med 2019; 30:362-368. [PMID: 31668938 DOI: 10.1016/j.wem.2019.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/19/2019] [Accepted: 06/13/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION With the growing enthusiasm from people of all ages about rock climbing and bouldering, adaptions and medical conditions of the older athlete have become increasingly important. We aimed to analyze injury demographics, distribution, and severity for the older rock-climbing athlete. METHODS During a 3-y period, we performed a single-center injury surveillance in athletes ≥35 y of age presenting with rock climbing-related injuries or complaints. A standard questionnaire and examination protocol were conducted. RESULTS A total of 198 patients (age 44.2±7.1 [35-77] y) (mean±SD, with range) with 275 independent injuries were recorded. Ninety percent of all injuries affected the upper extremity, 6% the lower extremity, and 4% other body regions. The Union Internationale des Associations d'Alpinisme injury scores were 2.0±0.3 (1-4), and no fatalities occurred. Acute injuries were observed in 32% and overuse injuries in 68% of all injuries. Among the overuse injuries, 47% were classified as degenerative overuse conditions. Athlete age did not significantly correlate with the development of overuse injuries and UIAA injury score, but subgroup analysis showed a weak correlation of the climber age with the development of degenerative conditions (P<0.05). The leading diagnosis of degenerative conditions was subacromial impingement syndrome of the shoulder. CONCLUSIONS Compared to younger athletes, older rock climbers demonstrate a higher proportion of overuse injuries, especially degenerative conditions. Profound knowledge of climbing injuries patterns and conditions in older rock climbers is crucial to prevent injuries among all age groups and to decrease the number of degenerative injuries.
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Affiliation(s)
- Christoph Lutter
- Department of Orthopedics, University Medical Center, Rostock, Germany; Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Bamberg, Germany.
| | - Thilo Hotfiel
- Department of Orthopedics, Trauma and Hand Surgery, Klinikum Osnabrück, Osnabrück, Germany; Department of Orthopedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Thomas Tischer
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Robert Lenz
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Volker Schöffl
- Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Bamberg, Germany; Department of Trauma and Orthopedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; Department of Emergency Medicine, Section Wilderness Medicine, University of Colorado School of Medicine, Denver, CO
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11
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Jones ME, Davies MAM, Shah K, Kemp S, Peirce N, Leyland KM, Stokes KA, Judge AD, Newton JL, Furniss D, Arden NK. The prevalence of hand and wrist osteoarthritis in elite former cricket and rugby union players. J Sci Med Sport 2019; 22:871-875. [PMID: 30940442 PMCID: PMC6593259 DOI: 10.1016/j.jsams.2019.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/01/2019] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
Objectives This study aimed to determine the prevalence of hand and wrist osteoarthritis in former elite cricket and rugby union players, by sport and playing position, and to define the prevalence of severe hand injury, and its association with hand osteoarthritis. Design Cross-sectional. Methods Data from cross-sectional studies of former elite male cricket and rugby players were used to determine the prevalence of hand pain, physician-diagnosed osteoarthritis, and previous severe injury. Multivariable logistic regression was used to determine the association of previous injury with pain and osteoarthritis. Results Data from 200 cricketers and 229 rugby players were available. Complete case analysis resulted in 127 cricketers and 140 rugby players. Hand pain was more prevalent amongst cricketers (19.7%) than rugby players (10.0%). The prevalence did not differ between cricket and rugby players for hand osteoarthritis (2.4% and 3.6%), wrist osteoarthritis (1.6% and 2.1%), or previous severe hand injury (36.2% and 31.4%). No significant association between previous hand injury and pain or osteoarthritis was identified in either sport. Conclusions Former elite cricketers reported more hand pain than rugby players. No significant association was found between self-reported severe injury and hand osteoarthritis in either cohort, potentially indicating that risk factors aside from injury may be more prominent in the development of hand osteoarthritis.
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Affiliation(s)
- Mary E Jones
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK; Department of Primary Care and Population Health, University College London, UK.
| | - Madeleine A M Davies
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK; Department of Health, University of Bath, UK
| | - Karishma Shah
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK
| | | | - Nick Peirce
- England and Wales Cricket Board, National Cricket Performance Centre, UK
| | - Kirsten M Leyland
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK; Bristol Medical School, Population Health Sciences, University of Bristol, UK
| | - Keith A Stokes
- Rugby Football Union, UK; Department of Health, University of Bath, UK
| | - Andrew D Judge
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK; Bristol Medical School, Translational Health Sciences, University of Bristol, UK
| | - Julia L Newton
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK
| | - Dominic Furniss
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK
| | - Nigel K Arden
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, UK
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Pieber K. Klettertypische Hand‑/Fingerverletzungen und Überlastungen. MANUELLE MEDIZIN 2019. [DOI: 10.1007/s00337-018-0489-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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