1
|
Grønhaug G, Saeterbakken A, Casucci T. Painfully ignorant? Impact of gender and aim of training on injuries in climbing. BMJ Open Sport Exerc Med 2024; 10:e001972. [PMID: 39081465 PMCID: PMC11288151 DOI: 10.1136/bmjsem-2024-001972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Climbing has evolved from an obscure outdoor sport to a predominantly indoor sport with the rise of mainstream climbing on artificial walls. Reported climbing-related injuries were predominantly chronic and may be avoided with proper planning of training. All climbers, regardless of age and gender, are training on the same routes and perform similar movements; however, few studies have investigated gender-specific injuries in climbing. Objectives Assess the distribution of chronic climbing injuries in an international population with gender-specific analyses and assess the impact of the person's training focus or aim of training on those injuries. Methods A cross-sectional survey using a web-based item-driven questionnaire was created and promoted using social media and several climbing media stakeholders. All climbers engaged in either sport climbing, bouldering or traditional climbing were included. Results The survey received 1513 responses (877 men, 427 women and 9 not reporting gender), of which 50.3% (n=665; 51.4% men and 48.0% women) had experienced an injury in the past 12 months. There were significant differences in injuries in feet/ankle (p=0.014), neck (p=0.03), head (p=0.0001), shoulder (p=0.001), elbow (p=0.021) and fingers (p=0.003). Conclusion Over 50% of the climbers experienced an injury in the past 12 months. The most common injuries were to the shoulders (women) and fingers (men). There were significant differences between the genders regarding injury site and prevalence. The gender differences may be affected by the aim for training and the style of climbing.
Collapse
Affiliation(s)
- Gudmund Grønhaug
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences Faculty of Teacher Education and Sport, Sogndal, Norway
| | - Atle Saeterbakken
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences Faculty of Teacher Education and Sport, Sogndal, Norway
| | | |
Collapse
|
2
|
Eichler M, Lutter C, Morris PD, Schöffl V. "Run-and-jump failure": new injury patterns in indoor bouldering. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2024; 38:27-30. [PMID: 38049098 DOI: 10.1055/a-2197-6017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
In recent years, professional and non-professional bouldering have seen a fundamental change in movement patterns towards complex movement sequences. This is associated with increased demands on the musculoskeletal system, especially the lower extremities, which can lead to new injury patterns. In the course of our clinical work, we have already seen an increasing number of lower extremity injuries after run-and-jump sequences, with a severe one being highlighted in this case report.
Collapse
Affiliation(s)
- Mathis Eichler
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg Germany
| | - Christoph Lutter
- Universitätsmedizin Rostock, Universitatsmedizin Rostock, Orthopedics, Rostock, Germany
- School of Health, Leeds Becket University, UK
| | | | - Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg Germany
- Department of Orthopedic and Trauma Surgery, Friedrich Alexander Universität Erlangen-Nürnberg, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine at the University of Colorado School of Medicine, USA
- School of Health, Leeds Becket University, UK
| |
Collapse
|
3
|
Son S, Seo Y, Son J, Yun S, Lee DT. Comparison of finger flexion strength and muscular recovery of male lead sport climbers across climbing classes. Phys Ther Sport 2024; 65:122-129. [PMID: 38159445 DOI: 10.1016/j.ptsp.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND/OBJECTIVE The purpose of this study was to compare finger flexor strength (FS), finger flexor muscle recovery (FR), and forearm circumference (FC) across three different climbing classes in male lead sport climbers. METHODS A total of 37 male lead sport climbers were classified into low (LC), intermediate (IC), and advanced classes (AC) categories according to the International Rock Climbing Research Association (IRCRA) Scale. All participants measured FS three times for both open grip (OG) and crimp grip (CG). Following FS measurement, the FR was observed immediately after the all-out training. The FC was measured twice using an inelastic tape. RESULTS The FS differed significantly across climbing classes for both grip styles and hands, regardless of dominant hand, with the higher classes showing greater FS (all, p ≤ 0.001). FR was significantly higher in AC compared to IC and LC at 5 min (all, p ≤ 0.001), 10 min (all, p ≤ 0.005) and 15 min (all, p ≤ 0.005). The FC showed significant differences with climbing classes for both forearms. CONCLUSION Climbing classes are associated with differences in FS, with higher class corresponding to greater FS. Similarly, climbing classes are linked to FR and FC, with higher classes being associated with faster recovery and larger FC.
Collapse
Affiliation(s)
- Somang Son
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea
| | - Yongsuk Seo
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea
| | - Jungjun Son
- Son Jungjun Sport Climbing Institute, Republic of Korea
| | - Somi Yun
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea.
| | - Dae Taek Lee
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea.
| |
Collapse
|
4
|
von Essen D, Schöffl VR. Acute and Chronic Injury Patterns in Competitive Paraclimbing Sports. Am J Phys Med Rehabil 2023; 102:1122-1129. [PMID: 36728434 DOI: 10.1097/phm.0000000000002181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This is the first study to evaluate sport-related injuries in competitive Paraclimbing athletes with the aim of creating a medical database for future research on injury prevention. DESIGN This was a descriptive epidemiology study. Data collection took place in two parts. In the first part, an online survey ( n = 81) was conducted. The second part was undertaken during three competitions ( n = 273) of the 2021 International Federation of Sport Climbing Paraclimbing competitions. Injury severity grading was determined using the Climbing Injury Score of the International Federation of Sport Climbing. RESULTS In the online survey, 76 injuries were reported: 62% acute and 38% chronic injuries. Injury severity was as follows: 21 scored 1, 34 scored 2a, 19 scored 2b, and 2 scored 3. The most injured body regions were the upper extremity (66%) with shoulder injuries (29%) most common; 53% reported regular pain/discomfort during training/competition and 16% used nonsteroidal anti-inflammatory drugs regularly to prevent pain/discomfort when training. In the 2021 International Federation of Sport Climbing Paraclimbing competitions, eight injuries were recorded. Injury severity was as follows: seven scored 1 and one scored 2a. The most injured body region was the upper extremity (47%). Overall, the calculated climbing time was 975 hrs, and injury incidence risk was 8.21 per 1000 hrs. CONCLUSION Compared with nondisabled climbers, the injury pattern seems to be sport dependent but influenced by the unique impairments of the athletes. In Paraclimbing competitions, the injury severity is mostly mild, with an overall low injury incidence. A concern is the number of athletes with pain/discomfort during training/competition with regular nonsteroidal anti-inflammatory drug intake.
Collapse
Affiliation(s)
- Daniel von Essen
- From the Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (DvE); Medical and Anti-Doping Commission of the International Federation of Sport Climbing (IFSC), Turin, Italy (DvE, VRS); Department of Orthopedic and Trauma Surgery, Sports Medicine, Klinikum Bamberg, Bamberg, Germany (VRS); Department of Orthopedic and Trauma Surgery, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (VRS); Section of Wilderness Medicine, Department of Emergency Medicine, Colorado School of Medicine, Denver, Colorado (VRS); and School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK (VRS)
| | | |
Collapse
|
5
|
Grønhaug G, Joubert LM, Saeterbakken AH, Drum SN, Nelson MC. Top of the podium, at what cost? injuries in female international elite climbers. Front Sports Act Living 2023; 5:1121831. [PMID: 37398555 PMCID: PMC10312002 DOI: 10.3389/fspor.2023.1121831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/15/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives Competitive sport climbing has made its way to the Olympic stage. This prestige has brought about route setting and training alterations which presumably affect injury epidemiology. Most of the climbing injury literature contains male climbers and lacks high performing athletes. Studies with both female and male climbers, rarely included separate analyses for performance level or sex. Therefore, injury concerns for elite female competitive climbers are impossible to discern. A former study examined the prevalence of amenorrhea in elite international female climbers (n = 114) and reported that 53.5% had at least one injury in the past 12 months, but injury details were excluded. This study's aim was to report these injury details and their associations with BMI, menstrual status and eating disorders of the cohort. Methods Online survey was emailed to competitive female climbers recruited through the IFSC database between June and August 2021. Data was analyzed using Mann-Whitney U, χ2 and logistic regression. Results 229 registered IFSC climbers opened the questionnaire and 114 (49.7%) provided valid responses. Respondents (mean ± SD; age = 22.9 ± 5 year) represented 30 different countries and more than half (53.5%, n = 61) reported an injury in the prior 12 months with the majority in shoulders (37.7%, n = 23) and fingers (34.4%, n = 21). Injury prevalence in climbers with amenorrhea was 55.6% (n = 10). BMI was not a significant predictor of injury risk (OR = 1.082, 95% CI: 0.89, 1.3; p = 0.440) while accounting for current ED over the past 12 months. However, the odds ratio for having an injury was doubled for those with an ED (OR = 2.129, 95% CI: 0.905, 5.010; p = 0.08). Conclusion With over half reporting recent injuries (<12 months) mostly to shoulders and fingers, development of new strategies for injury prevention in competitive female climbers are warranted. In addition, climbers with disordered eating behaviors and/or menstrual disturbances might be more prone to injury. More research in this population is required. Suitable screening to prevent these health issues and proper monitoring of these athletes are paramount to long-term athlete success.
Collapse
Affiliation(s)
- G. Grønhaug
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus, Sogndal, SFC, United States
| | - L. M. Joubert
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
| | - A. H. Saeterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus, Sogndal, SFC, United States
| | - S. N. Drum
- Student-Athlete High Performance Center and Sims-Treharne Collaborative Research Laboratory; Department of Health Sciences, Northern Arizona University, Flagstaff, AZ,United States
| | - M. C. Nelson
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
| |
Collapse
|
6
|
Luiggi M, Lafaye P, Martha C. Epidemiology of sport climbing injuries caused by a climbing fall among climbers of the French Federation of Mountain and Climbing. J Sports Med Phys Fitness 2023; 63:452-460. [PMID: 36321816 DOI: 10.23736/s0022-4707.22.14388-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND Fall-related injuries (FRIs) are the most severe sport climbing injuries. The main objective of this study was to measure FRI prevalence and risk factors in a representative sample of climbers of the French Federation of Mountain and Climbing. The second objective was to explore FRI mechanisms. METHODS The study included 3919 climbers aged 16+. They were invited to fill out an online questionnaire where they reported sociodemographics, sport-related characteristics and whether they had sustained an FRI in the past 12 months (12-FRI), and over their entire career (ALL-FRI). The mechanisms of 12-FRI were asked for. Multivariable logistic regression analyses were performed to evaluate the association between sport-related characteristics and FRI. RESULTS Nine per cent of the participants reported a 12-FRI and 29% an ALL-FRI. No statistically significant effect of sex, context of climbing, or onsight level was observed on 12-FRI. Climbers with 0-3 years of experience (YE) were 1.7 (95% CI: 1.2-2.6) and 3.6 (95% CI: 2.2-6.3) times more likely to have sustained a 12-FRI compared with those with 5-8 YE and 14-23 YE, respectively. An interaction effect was found between YE and onsight level. Among climbers with 0-8 YE, those with a higher onsight level had a higher risk of 12-FRI. Natural falls, unexpected falls and static belaying were the most commonly reported 12-FRI mechanisms. CONCLUSIONS These results highlight that future FRI prevention programs should target priority-inexperienced climbers who have progressed rapidly. Climbers should be taught as a priority to stay focused while belaying even in the least difficult passage, and to belay dynamically.
Collapse
Affiliation(s)
| | - Pascal Lafaye
- Prevention and Security Correspondent, Ligue Occitanie, Fédération Française de la Montagne et de l'Escalade, Toulouse, France
| | - Cécile Martha
- Institut des Sciences du Mouvement (ISM), Aix-Marseille University CNRS, Marseille, France
| |
Collapse
|
7
|
Jones G, Johnson R, Schöffl V, Schöffl I, Lutter C, Johnson MI, Halsey T. Primary Periphyseal Stress Injuries of the Fingers in Adolescent Climbers: A Critical Review. Curr Sports Med Rep 2022; 21:436-442. [PMID: 36508599 DOI: 10.1249/jsr.0000000000001016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
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.
Collapse
Affiliation(s)
| | - Rowena Johnson
- Carnegie School of Sport, Leeds Beckett University, Leeds, UNITED KINGDOM
| | | | | | | | - Mark I Johnson
- Centre for Pain Research, Leeds Beckett University, Leeds, UNITED KINGDOM
| | | |
Collapse
|
8
|
Bosco F, Giustra F, Lusso A, Faccenda C, Artiaco S, Massè A. Closed flexor pulley injuries: A literature review and current practice. J Orthop 2022; 34:246-249. [PMID: 36131797 PMCID: PMC9483560 DOI: 10.1016/j.jor.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 11/22/2022] Open
Abstract
Background Closed flexor pulley injuries are a clinical entity of great interest in hand surgery, and these lesions could be observed mainly in rock-climbing athletes. Objective An extensive literature search of PubMed, SCOPUS, Cochrane Library, and Web of Sciences databases on closed finger pulley rupture, related treatments, and outcomes were performed. All relevant information was used in this literature review. Conclusions Many athletes are potentially exposed to these uncommon injuries. Therefore, these lesions require careful examination and a high index of suspicion to confirm the diagnosis and identify the degree of soft tissue injury, particularly in patients not involved in sporting activities. The data summarized in this literature review demonstrated that according to Schöffl's classification, conservative treatment should be indicated for low-grade injuries (grade 1 or 2), whereas surgical treatment should be performed in patients with more severe acute injuries (grade 4). Grade 3 flexor pulley injuries lie in a grey area where conservative and surgical treatment may give good clinical and return-to-sport patient results.
Collapse
Affiliation(s)
- Francesco Bosco
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Fortunato Giustra
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Alessandro Lusso
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Carlotta Faccenda
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Stefano Artiaco
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Alessandro Massè
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| |
Collapse
|
9
|
Chen DL, Meyers RN, Provance AJ, Zynda AJ, Wagner KJ, Siegel SR, Howell DR, Miller SM. Early Sport Specialization and Past Injury in Competitive Youth Rock Climbers. Wilderness Environ Med 2022; 33:179-186. [PMID: 35484015 DOI: 10.1016/j.wem.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/18/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
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.
Collapse
Affiliation(s)
- Daniel L Chen
- UT Southwestern Medical Center, Dallas, Texas; Texas Scottish Rite Hospital for Children, Frisco, Texas; Nationwide Children's Hospital, Columbus, Ohio.
| | - Rachel N Meyers
- Duke University School of Medicine, Doctor of Physical Therapy Division, Durham, North Carolina
| | - Aaron J Provance
- Children's Hospital Colorado, Aurora, Colorado; University of Colorado School of Medicine, Aurora, Colorado
| | | | | | | | - David R Howell
- Children's Hospital Colorado, Aurora, Colorado; University of Colorado School of Medicine, Aurora, Colorado
| | - Shane M Miller
- UT Southwestern Medical Center, Dallas, Texas; Texas Scottish Rite Hospital for Children, Frisco, Texas
| |
Collapse
|
10
|
Impact of 30 years' high-level rock climbing on the shoulder: an magnetic resonance imaging study of 31 climbers. J Shoulder Elbow Surg 2021; 30:2022-2031. [PMID: 33545338 DOI: 10.1016/j.jse.2020.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Rock climbers are particularly susceptible to shoulder injuries due to repetitive upper-limb movements on vertical or overhanging terrain. However, the long-term effects of prolonged climbing on the shoulder joints are still unknown. PURPOSE The purpose of this study was to analyze the prevalence of pain and degenerative changes in the shoulder joints after high-level rock climbing over at least 25 years. We hypothesized that specific climber-associated patterns of degeneration would be found. METHODS Thirty-one adult male high-level rock climbers were compared to an age- and sex-matched control group of 31 nonclimbers. All participants underwent a detailed interview, standardized clinical examination, and bilateral (climbers) or unilateral (nonclimbers, dominant side) magnetic resonance imaging (MRI) scans. Clinical and MRI findings of the groups were compared. RESULTS The lifetime prevalence of shoulder pain in the rock climbers was 77%. The rock climbers had significantly more abnormalities in the labrum (82% vs. 52%; P = .002), long biceps tendon (53% vs. 23%; P = .006), and cartilage (28% vs. 3%; P = .005). These increased changes positively correlated with climbing intensity. There were no differences between the 2 groups with respect to rotator cuff tendon pathology (68% vs. 58%; P = .331) and acromioclavicular joint degeneration (88% vs. 90%; P = .713). Despite the increased degenerative changes in the rock climbers, their Constant score (CS) was still better than that of the nonclimbers (CS 94, interquartile range [IQR] 92-97, vs. CS 93, IQR 91-95; P = .019). CONCLUSIONS Prolonged high-level rock climbing leads to a high prevalence of shoulder pain and increased degenerative changes to the labrum, long biceps tendon, and cartilage. However, it is not related to any restriction in shoulder function.
Collapse
|
11
|
Auer J, Schöffl VR, Achenbach L, Meffert RH, Fehske K. Indoor Bouldering-A Prospective Injury Evaluation. Wilderness Environ Med 2021; 32:160-167. [PMID: 33966976 DOI: 10.1016/j.wem.2021.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Bouldering has become a sport of growing interest, but little prospective evidence exists about injury proportions and patterns. The purpose of this study was to prospectively evaluate the cause of injuries sustained during indoor bouldering, proportion of affected body location, and injury severity. METHODS Proportions and patterns of injury among German-speaking indoor boulderers were evaluated prospectively in an explorative cohort study. Participants completed a baseline questionnaire assessing anthropometric data and sport-specific potential preventive and risk factors, followed by monthly injury questionnaires including injury location and injury severity over a period of 12 mo. RESULTS Out of 507 boulderers, 222 (44%) sustained 305 injuries. Of those, 78% (n=238) were classified as Union Internationale de Associations d'Alpinisme (UIAA) 1, 19% (n=57) as UIAA 2, and 3% (n=10) as UIAA 3. Injuries of the upper extremities accounted for 63% (n=191) of all injuries. Injuries of the lower extremities accounted for 23% (n=71) but were more often classified as UIAA≥2 (P=0.0071; odds ratio [OR] 2.23; 95% CI 1.23-4.04) and were more often caused by falling (P=0.0005; OR 2.92; 95% CI 1.57-5.42) and jumping off the wall (P<0.0001; OR 4.39; 95% CI 2.25-8.56) than injuries of other body locations. There was no statistically significant protective effect of the evaluated potential preventive measures. Participants who used heavily downturned climbing shoes had a higher risk of sustaining a UIAA ≥2 injury (P=0.0034; OR 2.58; 95% CI 1.34-4.95). CONCLUSIONS Injuries in indoor bouldering are common. Lower extremity injuries are associated with higher injury severity. Preventive measures need to be established to reduce bouldering injuries, especially during falls and landings.
Collapse
Affiliation(s)
- Jonas Auer
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Volker R Schöffl
- Department of Sports Medicine-Sports Orthopedics, Klinikum Bamberg, Bamberg, Germany
| | - Leonard Achenbach
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Rainer H Meffert
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Kai Fehske
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany.
| |
Collapse
|
12
|
Caso H, Vigouroux L, Valerio T, Goislard de Monsabert B, Jaloux C, Legré R. Unusual rupture of the middle finger flexor digitorum superficialis tendon in a climber: Biomechanical analysis. HAND SURGERY & REHABILITATION 2021; 40:643-649. [PMID: 33905942 DOI: 10.1016/j.hansur.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022]
Abstract
Sport climbing is increasingly popular and consultations by climbers in hand surgery departments are on the increase. The pathologies related to this sport concern essentially the pulley system, tendons being rarely affected. We report the case of a male climber who presented an atypical rupture of the flexor superficialis tendon in his left middle finger sustained when using an atypical climbing grip technique: the "hook grip". This consists in extension of the metacarpophalangeal joints and maximal flexion of the proximal interphalangeal joints with force exerted only on middle phalanx of the middle finger. A biomechanical analysis using finger musculoskeletal modeling was performed to compare the hook grip to other grips, and the patient's recovery performance was assessed. Adapted functional treatment with physiotherapy seems to have been a good option for the treatment of this atypical lesion since the patient recovered normal use of his finger in daily life. He recovered maximal force in climbing holds. The biomechanical analysis confirmed that the atypical "hook grip" was likely at the origin of the rupture, since flexor digitorum superficialis tendon force for this grip is greater than in other climbing grip techniques. The "hook grip" seems to be dangerous and should be used cautiously by climbers to prevent similar pathology. Additionally, the patient should henceforth be careful when climbing, since the biomechanical model showed that the remaining flexor digitorum profundus tendon was overused.
Collapse
Affiliation(s)
- H Caso
- Department of Hand and Reconstructive Surgery, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005 Marseille, France.
| | - L Vigouroux
- Aix-Marseille University, CNRS, ISM, 163 Avenue de Luminy, CP 910, 13288 Marseille Cedex 09, France
| | - T Valerio
- Aix-Marseille University, CNRS, ISM, 163 Avenue de Luminy, CP 910, 13288 Marseille Cedex 09, France
| | - B Goislard de Monsabert
- Aix-Marseille University, CNRS, ISM, 163 Avenue de Luminy, CP 910, 13288 Marseille Cedex 09, France
| | - C Jaloux
- Department of Hand and Reconstructive Surgery, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005 Marseille, France
| | - R Legré
- Department of Hand and Reconstructive Surgery, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005 Marseille, France
| |
Collapse
|
13
|
Abstract
INTRODUCTION Mountain running races have grown in popularity in the recent years. Nonetheless, there are few studies on injuries and injury rates. Moreover, these studies have focused on long-distance events such as ultramarathons (>42 km). Therefore, the aim of the present study was to examine the severity, type, and body location of musculoskeletal injuries during 20-42 km mountain running races. In addition, the injury rates in this type of races were examined. METHODS Data on injuries were collected during 36 mountain running races over 5 consecutive seasons from 2015 to 2019. The participants reported all musculoskeletal injuries on a standardized injury report form. The results were presented as the number of injuries per 1000 h exposure and per 1000 participants. RESULTS Twenty eight injuries were reported. Most injuries occurred in the ankle (32%) followed by the knee (14%) and foot/toe (11%). The number of injuries represented an overall injury rate of 1.6 injuries per 1000 h running and 5.9 injuries per 1000 runners. The case fatality rate was 0. CONCLUSIONS The incidence of musculoskeletal injuries during 20-42 km mountain running races is low. In addition, the majority of injuries experienced by runners are minor in nature and located in lower extremities, mainly the ankles.
Collapse
|
14
|
Ehiogu UD, Stephens G, Jones G, Schöffl V. Acute Hamstring Muscle Tears in Climbers-Current Rehabilitation Concepts. Wilderness Environ Med 2020; 31:441-453. [PMID: 33189522 DOI: 10.1016/j.wem.2020.07.002] [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: 08/23/2019] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
Acute hamstring injuries are often caused by the heel hook technique. This technique is unique to climbing and causes injury to muscular and inert tissues of the posterior thigh. The heel hook is used by climbers during strenuous ascent on overhanging walls and when crossing difficult terrain. The technique reduces the amount of upper body strength required during strenuous climbing because the climber's center of mass is retained within the base of support. The heel hook is stressful collectively for the hamstring muscle group and musculotendinous junction. Depending on injury severity, both conservative and surgical methods exist for the management of hamstring injuries. Contemporary approaches to rehabilitation primarily advocate the use of eccentric muscle strengthening strategies because of high rates of elongation stress associated with sprinting and team sports. However, there is reason to doubt whether this alone is sufficient to rehabilitate the climbing athlete in light of the high degree of concentric muscle strength required in the heel hook maneuver. This review examines the contemporary rehabilitation and strength and conditioning literature in relation to the management of acute hamstring musculotendinous injuries for the climbing athlete. The review provides a comprehensive approach for the rehabilitation and athletic preparation of the climbing athlete from the initial injury to full return to sports participation.
Collapse
Affiliation(s)
- Uzo Dimma Ehiogu
- Birmingham Royal Orthopaedic Hospital, Research and Training Department, Birmingham, United Kingdom; Birmingham Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom.
| | - Gareth Stephens
- Birmingham Royal Orthopaedic Hospital, Research and Training Department, Birmingham, United Kingdom
| | - Gareth Jones
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - Volker Schöffl
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom; Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany; Section of Sports Medicine, Department of Orthopedic Surgery, Klinikum Bamberg, Germany; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| |
Collapse
|
15
|
Simon M, Lutter C, Schöffl V. Rupture of the Short Head of the Biceps Brachii Muscle Belly Caused by a Rock-Climbing Accident. Wilderness Environ Med 2020; 31:327-331. [PMID: 32709490 DOI: 10.1016/j.wem.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 01/03/2023]
Abstract
The case of a 42-y-old rock climber who sustained a complete, isolated rupture of the short head of the biceps brachii muscle after falling onto his upper arm while bouldering is presented. This is the first description of this rare injury after a climbing accident. Moreover, there is no definitive consensus on whether and when surgical intervention is necessary in such a case. We performed a direct end-to-end suture of the muscle belly through an open surgical approach. Postoperatively, we performed a detailed follow-up, including clinical examinations and sonography and magnetic resonance imaging to check the integrity of the suture. After 6 mo, our patient had regained a full range of motion without functional complaints or pain. Concerning the sports-specific outcome, we only found a slight decrease in rock-climbing abilities (Union Internationale des Associations d'Alpinisme Scale of Difficulty grade VII+ postsurgery compared to VIII preinjury). In conclusion, we suggest that early surgical reapproximation of the muscle belly might be the best treatment option for this severe but rare injury in athletes.
Collapse
Affiliation(s)
- Michael Simon
- Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Bamburg, Germany; Department of Orthopedics and Traumatology, Klinikum Bamberg, Bamburg, Germany.
| | - Christoph Lutter
- Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Bamburg, Germany; Department of Orthopedics and Traumatology, Klinikum Bamberg, Bamburg, Germany
| | - Volker Schöffl
- Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Bamburg, Germany; Department of Orthopedics and Traumatology, Klinikum Bamberg, Bamburg, Germany; Department of Trauma and Orthopedic Surgery, Friedrich Alexander University, Erlangen-Nuremberg, Germany
| |
Collapse
|
16
|
Halsey T, Johnson MI, Jones G. Epiphyseal Stress Fractures of the Fingers in an Adolescent Climber: A Potential "Maslow's Hammer" in Terms of Clinical Reasoning. Curr Sports Med Rep 2020; 18:431-433. [PMID: 31834172 DOI: 10.1249/jsr.0000000000000658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Tim Halsey
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UNITED KINGDOM.,School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UNITED KINGDOM
| | - Mark I Johnson
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UNITED KINGDOM
| | - Gareth Jones
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UNITED KINGDOM
| |
Collapse
|
17
|
|
18
|
Efficacy of corticosteroid injection in rock climber's tenosynovitis. HAND SURGERY & REHABILITATION 2019; 38:317-322. [DOI: 10.1016/j.hansur.2019.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 01/03/2023]
|
19
|
Grønhaug G, Saeterbakken A. No pain no gain: a survey of use of healthcare and reasons not to seek healthcare by Norwegian climbers with chronic injuries. BMJ Open Sport Exerc Med 2019; 5:e000513. [PMID: 31191970 PMCID: PMC6539184 DOI: 10.1136/bmjsem-2019-000513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 01/17/2023] Open
Abstract
Objectives To assess the use of healthcare, and reasons not to seek healthcare, by climbers with a chronic injury. Method Retrospective survey. Setting Web-based questionnaire. Participants 667 active climbers (385 with chronic injuries). Outcome measure Use of healthcare (including reasons not to seek healthcare if the patient was not attended by health professionals), performance level in sport climbing, onset of a climbing-related injury, site of injury, preferred style of climbing and gender differences. Result Of the 667 respondents, 385 had experienced a chronic injury in the past 6 months. Climbers with a chronic injury are reluctant to seek healthcare, and male climbers are less likely to seek healthcare than female climbers. The two most frequent reasons not to seek healthcare were: (1) an assumption that the injury was not serious enough (70%) and (2) a belief that a health professional could not help (60%). Only one in five of the climbers with a finger injury sought healthcare. The more experienced climbers were less likely to seek healthcare than recreational climbers. Conclusion Use of healthcare among climbers with a chronic injury is limited and injured climbers self-assess the injury before seeking medical aid. Experience is a strong predictor for not seeking healthcare after an injury. These findings open up the possibility that some of those who do not seek healthcare after self-assessing the injury are underestimating the seriousness of the injury due to lack of confidence in the health professionals’ abilities to help treating chronic climbing related injuries.
Collapse
Affiliation(s)
- Gudmund Grønhaug
- Education, arts and sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Atle Saeterbakken
- Education, arts and sports, Western Norway University of Applied Sciences, Sogndal, Norway
| |
Collapse
|
20
|
Sanchez X, Torregrossa M, Woodman T, Jones G, Llewellyn DJ. Identification of Parameters That Predict Sport Climbing Performance. Front Psychol 2019; 10:1294. [PMID: 31214092 PMCID: PMC6554989 DOI: 10.3389/fpsyg.2019.01294] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 05/16/2019] [Indexed: 12/03/2022] Open
Abstract
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 (Mage = 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.
Collapse
Affiliation(s)
- Xavier Sanchez
- Department of Health and Sport, Halmstad University, Halmstad, Sweden
| | - M Torregrossa
- Department of Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - T Woodman
- School of Sport, Health and Exercise Sciences, Bangor University, Bangor, United Kingdom
| | - G Jones
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - D J Llewellyn
- Medial School, University of Exeter, Exeter, United Kingdom
| |
Collapse
|
21
|
|