Evaluation of Rock Climbing Related Injuries in Older Athletes

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.

Dietary Intake, Body Composition and Iron Status in Experienced and Elite Climbers

Climbing has developed into a popular recreational and elite sport, evidenced by a growing number of licenced competition athletes, and the acceptance into the Olympic calendar for Tokyo 2020. A nutritional assessment, including the evaluation of anthropometric and biochemical data, has not been previously reported in climbing athletes. Therefore, the aim of this study was to assess the dietary intake, body composition, and iron status in experienced climbers, across a range of performance levels. Forty climbers (n = 20 male, n = 20 female; 8.8 ± 6.6 years' experience; BMI 21.6 ± 1.7) aged 18–46 (30.3 ± 6.7 years) participated in the study. Dietary intake was recorded in a 3-days diet diary. Body composition was assessed using a skinfold profile and iron status via blood markers. Mean energy intake was 2154.6 ± 450 kcal·day⁻¹, with 30% of male climbers and 5% of female climbers failing to meet predicted resting metabolic rate. Furthermore, 77.5% of participants failed to meet a predicted energy requirement to support a “moderate” training programme. There were no significant correlations between daily energy intake and exercise volume. Mean intake of carbohydrate, protein and fat was 3.7 ± 0.9 g·kg⁻¹·day⁻¹, 1.6 ± 0.5 g·kg⁻¹·day⁻¹, and 1.4 ± 0.4 g·kg⁻¹·day⁻¹, respectively, with no significant difference between genders. Approximately 17% of males (n =3) and 45% of females (n = 9) had a sub-optimal iron status. Thirty percent of females met the classification criteria for iron deficiency. Mean serum ferritin was significantly greater in males, compared to females (102.7 ± 54.9 vs. 51.4 ± 24.2 μg·L⁻¹; p ≤ 0.01) and significantly lower in vegan/vegetarians vs. omnivores, in female climbers only (33.2 ± 14.8 vs. 57.5 ± 24 μg·L⁻¹; p = 0.05). No significant differences were observed between climbing ability groups (intermediate-advanced/elite-higher elite) for body composition, dietary intake, or iron status, for males or females. These findings suggest that experienced climbers are at risk of energy restriction and iron deficiency, therefore, routine assessment of nutritional status is warranted. Future research should consider iron status in relation to energy availability and investigate additional factors which may predispose this population to iron deficiency, as well as the risk of relative energy deficiency in sport (RED-S).

New Zealand blackcurrant extract enhances muscle oxygenation during repeated intermittent forearm muscle contractions in advanced and elite rock climbers

Anthocyanin-rich New Zealand blackcurrant (NZBC) may improve forearm muscle oxygenation and enhance performance in high-level rock climbers. As such, using a double-blind, randomised, cross-over design study, twelve participants performed an oxidative capacity assessment, and two successive exhaustive exercise trials (submaximal forearm muscle contractions at 60% of their maximal volitional contraction). Each visit was conducted following 7-days intake of 600 mg·day^-1 NZBC extract or placebo. Oxidative capacity was estimated by calculating the oxygen half time recovery using near infrared spectroscopy. Time to exhaustion (s), impulse (kg·s), and minimum tissue saturation index (min-TSI %) were assessed during both the exercise trials. Muscle oxidative capacity was greater with NZBC (mean difference [MD] = 5.3 s, 95% confidence intervals [95% CI] = 0.4-10.2 s; p = 0.036; Cohen's d = 0.94). During the exercise trials, there was an interaction for min-TSI % (time x condition, p = 0.046; ηp2= 0.372), which indicated a greater level of oxygen extraction during trial two with NZBC extract (MD = 9%, 95% CI = 2-15%) compared to the placebo (MD = 2%, 95% CI = 1-7%). There was a decrease in time to exhaustion (p <0.001, ηp2 = 0.693) and impulse (p = 0.001, ηp2 = 0.672) in exercise trial two, with no effect of NZBC extract. In high-level rock climbers 7-days NZBC extract improves forearm muscle oxygenation with no effect on isolated forearm muscle performance.

Anthropometry and performance characteristics of recreational advanced to elite female rock climbers

Despite climbing's popularity and an increasing number of female participants, there are limited anthropometric and performance data for this population. This study compares the characteristics of 55 experienced female climbers, divided into three categories (lower [ADV-L] and higher advanced [ADV-H] and elite [ELT]) based on self-reported ability. Data on climbing experience, body dimensions, body composition, flexibility, lower and upper-body power and finger strength were assessed. ELT climbers differed significantly from the ADV groups in age (Mean Difference [MD] = 8.8-9.8 yrs; despite smaller differences in years climbing MD = 1.6-2.4 yrs), greater climbing and hours training per week (MD = 3.0-3.7 h & MD = 0.9-1.6 h, respectively), and greater upper-body power (MD = 12.9-16.6 cm) and finger strength (MD = 51.6-65.4 N). Linear regression analysis showed finger strength and upper body power to be associated with ability, particularly when adjusting for descriptive and anthropometric variables (finger strength R² = 53% and 45%; upper-body power R² = 60% and 39% for boulder and sport, respectively). The findings support the importance of finger strength and upper-body power; changes in female anthropometric data over the last decade provide insight into the changing nature of the sport.

Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: A randomized controlled trial

OBJECTIVES

Bouldering has shown promising results in the treatment of various health problems. In previous research, bouldering psychotherapy (BPT) was shown to be superior to a waitlist control group and to physical exercise with regard to reducing symptoms of depression. The primary aim of this study was to compare group BPT with group cognitive behavioural psychotherapy (CBT) to test the hypothesis that BPT would be equally as effective as CBT.

DESIGN

We conducted a randomized, controlled, assessor-blinded non-inferiority trial in which 156 outpatients meeting the criteria of a depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were randomly assigned to one of the two intervention groups (CBT: N = 77, BPT: N = 79).

METHODS

Intervention groups were manualized and treated for 10 weeks with a maximum of 11 participants and two therapists. The primary outcome was depressive symptom severity assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Patient Health questionnaire (PHQ-9) at the beginning and end of the treatment phase as well as one year after the end of treatment.

RESULT

In both groups, depressive symptoms improved significantly by an average of one severity level, moving from moderate to mild depressive symptoms after therapy (MADRS difference scores: BPT -8.06, 95% CI [-10.85, -5.27], p < .001; CBT -5.99, 95% CI [-8.55, -3.44], p < .001). The non-inferiority of BPT in comparison with CBT was established on the basis of the lower bound of the 95% confidence interval falling above all of the predefined margins. BPT was found to be effective in both the short (d = 0.89) and long term (d = 1.15).

CONCLUSION

Group BPT was found to be equally as effective as group CBT. Positive effects were maintained until at least 12 months after the end of therapy. Thus, BPT is a promising approach for broadening the therapeutic field of therapies for depression.

PRACTITIONER POINTS

Physical activity is effective in the treatment of depression and current guidelines explicitly recommend it as a complementary method for the treatment of depression. Nevertheless, body-related interventions are still underrepresented in current treatments for depression. Bouldering psychotherapy (BPT) combines physical activity with psychotherapeutic content. Its concept relies on proven effective factors from CBT such as exposure training, problem solving and practicing new functional behaviours and is thus an enrichment and implementation of CBT methods on the bouldering wall. The positive effect of group bouldering psychotherapy (BPT) in reducing depressive symptoms in outpatients with depression is not inferior to the effect of group cognitive behavioural therapy (CBT). Additionally the 10-weeks BPT-programme significantly improved symptoms of anxiety and interpersonal sensitivity as well as health-related quality of life, coping, body image, self-efficacy, and global self-esteem.

Lean and mean? Associations of level of performance, chronic injuries and BMI in sport climbing

Objectives

To assess possible associations between performance level (achieved level of difficulty), chronic injuries and body mass index (BMI) in sport climbing.

Method

Retrospective survey.

Setting

Web-based questionnaire.

Participants

667 active climbers (385 reported having chronic injuries).

Outcome measure

BMI, performance level in sport climbing, onset of a climbing-related injury, preferred style of climbing, education, gender.

Statistics

Descriptive statistics and general linear model(GLM) performed with SPSS V.25 for windows.

Result

No associations were found between level of performance in sport climbing, onset of a climbing-related injury, preferred style of climbing, education, gender and BMI.

Conclusion

BMI is not associated with climbing-related chronic injury or level of performance in climbing. The average BMI of climbers up to the elite level is similar to that of a lower rate of performance.

Clinical relevance

The findings in this study suggest that there is no need for maintaining a low BMI to be able to reach elite levels in climbing.

Nutritional Considerations for Bouldering

Bouldering competitions are held up to International level and governed by the International Federation of Sport Climbing. Bouldering has been selected to feature at the 2020 Olympic Games in Tokyo, however, physiological qualities and nutritional requirements to optimize performance remain inadequately defined due to large gaps in the literature. The primary goals of training include optimizing the capacity of the anaerobic energy systems and developing sport-specific strength, with emphasis on the isometric function of the forearm flexors responsible for grip. Bouldering athletes typically possess a lean physique, similar to the characteristics of sport climbers with reported body fat values of 6-12%. Athletes strive for a low body weight to improve power to weight ratio and limit the load on the extremities. Specialized nutritional support is uncommon and poor nutritional practices such as chronic carbohydrate restriction are prevalent, compromising the health of the athletes. The high intensity nature of bouldering demands a focus on adequate carbohydrate availability. Protein intake and timing should be structured to maximize muscle protein synthesis and recovery, with the literature suggesting 0.25-0.3 g/kg in 3-4 hr intervals. Supplementing with creatine and b-alanine may provide some benefit by augmenting the capacity of the anaerobic systems. Boulderers are encouraged to seek advice from nutrition experts to enhance performance, particularly important when weight loss is the desired outcome. Further research is warranted across all nutritional aspects of bouldering which is summarized in this review.

The distribution of climbing chalk on climbed boulders and its impact on rock-dwelling fern and moss species

Rock climbing is popular, and the number of climbers rises worldwide. Numerous studies on the impact of climbing on rock-dwelling plants have reported negative effects, which were mainly attributed to mechanical disturbances such as trampling and removal of soil and vegetation. However, climbers also use climbing chalk (magnesium carbonate hydroxide) whose potential chemical effects on rock-dwelling species have not been assessed so far. Climbing chalk is expected to alter the pH and nutrient conditions on rocks, which may affect rock-dwelling organisms. We elucidated two fundamental aspects of climbing chalk. (a) Its distribution along nonoverhanging climbing routes was measured on regularly spaced raster points on gneiss boulders used for bouldering (ropeless climbing at low height). These measurements revealed elevated climbing chalk levels even on 65% of sampling points without any visual traces of climbing chalk. (b) The impact of climbing chalk on rock-dwelling plants was assessed with four fern and four moss species in an experimental setup in a climate chamber. The experiment showed significant negative, though varied effects of elevated climbing chalk concentrations on the germination and survival of both ferns and mosses. The study thus suggests that along climbing routes, elevated climbing chalk concentration can occur even were no chalk traces are visible and that climbing chalk can have negative impacts on rock-dwelling organisms.

The Effect of Magnesium Carbonate (Chalk) on Geometric Entropy, Force, and Electromyography During Rock Climbing

Rock climbers believe chalk dries the hands of sweat and improves the static coefficient of friction between the hands and the surface of the rock. The purpose of this study was to assess whether chalk affects geometric entropy or muscular activity during rock climbing. Nineteen experienced recreational rock climbers (13 males, 6 females; 173.5 ± 7.0 cm; 67.5 ± 3.4 kg) completed 2 climbing trails with and without chalk. The body position of the climber and muscular activity of the finger flexors was recorded throughout the trial. Following the movement sequence participants hung from a standard climbing hold until they slipped from the climbing structure, while the coefficient of friction and the ratio of the vertical forces on the hands and feet were determined. Although there were no differences in the coefficient of friction (P = .748), geometric entropy (P = .359), the ratio of the vertical forces between the hands and feet (P = .570), or muscular activity (P = .968), participants were able to hang longer after the use of chalk 62.9 ± 36.7 s and 49.3 ± 25.2 s (P = .046). This is advantageous because it may allow for prolonged rests, and more time to plan the next series of climbing moves.

Competitive performance predictors in speed climbing, bouldering, and lead climbing

The study modelled the influence of anthropometric components, climbing-specific power, strength and endurance parameters, flexibility, coordination, and motor planning skills on competitive climbing performance in speed, bouldering, and lead climbing. Sixty-one competitive climbers (26 women [18.1 ± 1.9y], 35 men [21.4 ± 6.1y]) participated. PCA and MRA were used for statistical analyses. Significant predictors for speed climbing performance (R2 = 44% and 35%) were lower (ß = .43 and .47) and upper body power and strength (ß = .40 and .37) for women and men, respectively. For women's bouldering performance (R2 = 39%), they were hip flexibility (ß = .42) and upper body power and strength (ß = .37), for the men's (R2 = 53%) lower (ß = .41) and upper body power (ß = .41) and body fat (ß = .37). For women's lead climbing (R2 = 58%) upper body power and strength (ß = .59) and finger endurance (ß = .48) predict performance, for the men's (R2 = 58%) lower (ß = .36) and upper body power (ß = .28), body fat (ß = .27) and motor planning skills (ß = .27). The multivariate models provide a framework for scientifically grounded climbing training by emphasizing the role of specific performance components.

Post-activation Potentiation Response of Climbers Performing the Upper Body Power Exercise

The purpose of this study was to determine a performance-enhancing effect of post-activation potentiation (PAP) stimulus on climbing-specific upper body power exercises, measured by the IRCRA Power Slap test on a campus board. Two groups of climbers performed the test under one of two conditions: without initial pre-loading (control group) or after 5RM (repetition maximum) pull-ups (PAP group). The test was performed at four time points: at baseline (PRE) and after 4 (POST4), 6 (POST6), and 8 (POST8) minutes of a PAP stimulus (PAP group) or after the same rest period lengths (control group). The results showed that post-baseline slap distances were significantly greater in the experimental group while no change was seen in the control group [repeated measures ANOVA: F _{( 3},_{42 )} = 6.26, p = 0.001]. Post hoc analysis revealed no significant difference between any of the post-baseline trials in both groups. The mean improvement in the first POST4 test in the experimental (PAP) group was +6.5 cm (6.8%). The results of the present study suggest that PAP might be beneficial for acute improvement of upper body power performance in climbers. Therefore we conclude that such stimuli might be advisable for climbers as a part of the warm-up before bouldering competitions and training as well. They might also offer a stronger stimulus for climbers working on power development.

Cardiorespiratory demands of competitive rock climbing

Rock climbing has become a mainstream sport, contested on the Olympic stage. The work/rest pattern of bouldering is unique among disciplines, and little is known about its physiological demands. This study characterised the cardiorespiratory responses to simulated competition. Eleven elite boulderers (7 male) volunteered to participate (age = 23.3 ± 4.5 years; mass = 68.2 ± 9.7 kg; stature = 1.73 ± 0.06 m; body fat = 10.4% ± 5%). Subjects completed incremental treadmill running to determine maximal capacities. On a separate day, they undertook a simulated Olympic-style climbing competition comprising 5 boulder problems, each separated by 5 min of rest. Pulmonary ventilation, gas exchange, and heart rate were assessed throughout. Total climbing time was 18.9 ± 2.7 min. Bouldering elicited a peak oxygen uptake of 35.8 ± 7.3 mL·kg^-1·min^-1 (∼75% of treadmill maximum) and a peak heart rate of 162 ± 14 beats·min^-1 (∼88% of maximum). Subjects spent 22.9% ± 8.6% of climbing time above the gas exchange threshold. At exercise cessation, there was an abrupt and significant increase in tidal volume (1.4 ± 0.4 vs. 1.8 ± 0.4 L; p = 0.006, d = 0.83) despite unchanged minute ventilation. Cardiorespiratory parameters returned to baseline within 4 min of the rest period. In conclusion, competitive bouldering elicits substantial cardiorespiratory demand and evidence of tidal volume constraint. Further studies are warranted to explore the effect of cardiorespiratory training on climbing performance. Novelty: Competitive bouldering evokes a high fraction of maximal oxygen uptake and prolonged periods above the gas exchange threshold. Climbing appears to impose a constraint on tidal volume expansion. Cardiorespiratory indices in elite climbers return to baseline within 2-4 min.

Physical performance testing in climbing-A systematic review

Due to the increasing popularity of climbing, the corresponding diagnostics are gaining in importance for both science and practice. This review aims to give an overview of the quality of different diagnostic testing- and measurement methods for performance, strength, endurance, and flexibility in climbing. A systematic literature search for studies including quantitative methods and tests for measuring different forms of strength, endurance, flexibility, or performance in climbing and bouldering was conducted on PubMed and SPORT Discus. Studies and abstracts were included if they a) worked with a representative sample of human boulderers and/or climbers, b) included detailed information on at least one test, and c) were randomized-controlled-, cohort-, cross-over-, intervention-, or case studies. 156 studies were included into the review. Data regarding subject characteristics, as well as the implementation and quality of all relevant tests were extracted from the studies. Tests with similar exercises were grouped and the information on a) measured value, b) unit, c) subject characteristics (sex and ability level), and d) quality criteria (objectivity, reliability, validity) were bundled and displayed in standardized tables. In total, 63 different tests were identified, of which some comprised different ways of implementation. This clearly shows that there are no uniform or standard procedures in climbing diagnostics, for tests on strength, endurance or flexibility. Furthermore, only few studies report data on test quality and detailed information on sample characteristics. This not only makes it difficult to compare test results, but at the same time makes it impossible to give precise test recommendations. Nevertheless, this overview of the current state of research contributes to the creation of more uniform test batteries in the future.

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.

Head Injuries in Rock Climbing: A Scoping Review

Rock climbing was recognized as a sport at the 2020 Tokyo Olympics. Despite its increasing participation, there is no knowledge synthesis of head injuries (HIs), defined as any injury to the head, associated with climbing, making it challenging for clinicians to provide evidence-based care. Our aim was to synthesize HI literature within rock climbing and identify knowledge gaps. Six databases (Medline, Embase, Sports Medicine & Education Index, SPORTDiscus, CINAHL, and Cochrane) were searched. Two reviewers screened 345 studies and 31 studies were selected for data abstraction. We found the quality of individual studies mainly "fair" to "good." Both HI and traumatic brain injury (TBI) had inconsistent definitions and categorization. The HIs represented between 0 to 36% of reported climbing injuries. Between 11 to 100% of HIs were TBIs, defined as an HI with permanent or temporary neurological sequelae. The most common causes of HIs were outdoor falls and falling objects. Climbing-specific factors associated with the causes were infrequently examined in the literature. Data sources of safety practices were incomplete. Overall, there was a lack of literature examining HIs, mechanisms of injury, and safety practices associated with climbing. To improve the tracking of HIs in climbing, we suggest the use of consistent reporting standards and the creation of a climbing injury surveillance system.

Corrigendum: Addressing grading bias in rock climbing: machine and deep learning approaches

[This corrects the article DOI: 10.3389/fspor.2024.1512010.].

Rock climbing confers distinct injury risk in pediatric versus adult populations: an analysis of twenty-year national trends

OBJECTIVES

The sport of rock climbing has recently gained in popularity due in part to its adoption by noncompetitive athletes as a physical activity with a level of intensity that can be self-regulated. However, the epidemiology of rock climbing injuries is poorly described at the national level.

METHODS

We report demographic and injury characteristics from 85,235 national weighted estimates of rock climbing injuries presenting to United States (US) emergency departments (EDs) between 2000 and 2019 in the National Electronic Injury Surveillance System, stratifying by whether patients were ≤18 years of age (A) or ≥19 years of age (B).

RESULTS

The national weighted estimate of patients presenting to US EDs with injuries associated with rock climbing rose significantly (p < 0.001) from 2000 (2,667, CI 1,777-3,557) to 2019 (7,087, CI 4,544-9,630). Patients ≤18 years of age were significantly less likely to be male (A: 56.3%, CI 52.0-60.6%; B: 64.7%; CI 60.4-69.0%; p = 0.003), sustain injuries on weekends (A: 29.8%, 24.5-35.1%; B: 64.7%, CI 60.4-69.0%; p = 0.002), or sustain injuries during summer seasons (A: 26.6%, CI 22.1-31.1%; B: 33.2%, CI 28.1-38.3%; p = 0.049). Multivariate logistic regression demonstrated that patients ≤18 years of age were significantly more likely to present to EDs with head and neck (OR: 1.52, CI 1.04-2.21; p = 0.032) or upper extremity (OR: 1.55; CI 1.24-1.93; p < 0.001) injuries associated with rock climbing.

CONCLUSION

We identified a significant increase in the annual estimated number of patients presenting to US EDs with rock climbing injuries compared to what has previously been reported. As the number of climbers continues to grow, standardized safety policies may be implemented that specifically target injury mechanisms and patterns unique to both adult and pediatric populations.

Nutritional Assessment, Body Composition, and Low Energy Availability in Sport Climbing Athletes of Different Genders and Categories: A Cross-Sectional Study

Climbing is an Olympic discipline in full development and multidisciplinary in nature, where the influences of body composition and nutritional status on performance have not yet been clarified despite the quest for a low weight in anti-gravity disciplines such as climbing. The present cross-sectional study aimed to conduct nutritional (3-day dietary diaries) and body composition (ISAK profile) assessments on sport climbing athletes by gender and climbing level during the months of February and March 2024. The t-test for independent samples and the Mann-Whitney U-test, as well as an ANOVA and the Kruskal-Wallis H-test, were used to compare the distributions of two or more groups, respectively, and Pearson's and Spearman's correlation coefficients were used to estimate the correlations between the different variables. The mean age of the 46 Spanish climbers (22 men and 24 women) was 30 years (SD: 9) with 7.66 years of experience (SD: 6.63). The mean somatotype of the athletes was classified as balanced mesomorph. Negative correlations were observed between fat mass variables and climbing level (p < 0.010), and positive correlations were observed with forearm circumference (p < 0.050). The mean energy availability (EA) was 33.01 kcal-kg FFM-1d-1 (SD: 9.02), with 55.6% of athletes having a suboptimal EA status and 35.6% having low energy availability (LEA). The carbohydrate and protein intakes were below the recommendations in 57.8% and 31.1% of athletes, respectively. There were deficient intakes of all micronutrients except phosphorus in males. These findings suggest that climbing athletes are at a high risk of developing low energy availability states and concomitant problems. Optimal nutritional monitoring may be advisable in this type of athlete to try to reduce the risk of LEA.

Nutrition knowledge, weight loss practices, and supplement use in senior competition climbers

Introduction

Sport climbing has gained increased scientific attention, including studies investigating the dietary habits and nutritional requirements of climbers; however, significant gaps in the literature remain. An assessment of nutritional knowledge, weight loss for competition, and supplement use has not been previously reported in senior competition climbing athletes.

Methods

Fifty climbers (26 male, 24 female; BMI 21.6 ± 1.9; 23.7 ± 5.2 years) participated in the study. Participants answered a 72-item questionnaire, comprised of demographic data and three main sections to assess general and sports nutrition knowledge, weight loss strategies, and supplement use.

Results

The mean nutrition knowledge score was 'average', with considerable individual variation (53.5 ± 11.1 %). There were no significant sex differences in the general (GNK) or sport (SNK) nutrition knowledge scores, or effect of age. Significantly higher knowledge was demonstrated by national vs. international athletes for the GNK scores (11.09 ± 1.58 vs. 9.58 ± 1.75; p = 0.028). Participants scored well in questions concerning protein, carbohydrates, alcohol, and supplements, and conversely, performed poorly in hydration and micronutrient related questions. Less than one-fifth of respondents had access to a dietitian. Forty-six percent of males and 38% of female climbers reported intentional weight loss for competition on at least one occasion. Of those, ~76% reported utilizing concerning practices, including methods that conform with disordered eating and/or eating disorders, dehydration, vomiting, and misuse of laxatives. Approximately 65% of athletes reported using at least one nutritional supplement in the previous 6 months, with 44% reporting multiple supplement use. There was no significant difference in supplement use between sexes or competition level.

Discussion

Due to the established importance of nutritional intake on athlete health and performance, educational support should be employed to improve knowledge in climbers and address shortcomings. Moreover, intentional weight loss for climbing competition is common, with most athletes achieving ~3-8% body weight loss over ≥2 weeks. It is crucial that professionals working with competitive climbers are vigilant in identifying athletes at risk of concerning weight management and establish referral pathways to the appropriate specialist services. High quality intervention trials to assess the efficacy of ergogenic aids in climbing remains inadequate.

Risk factors and injury prevention strategies for overuse injuries in adult climbers: a systematic review

Introduction

Climbing is an increasingly popular activity and imposes specific physiological demands on the human body, which results in unique injury presentations. Of particular concern are overuse injuries (non-traumatic injuries). These injuries tend to present in the upper body and might be preventable with adequate knowledge of risk factors which could inform about injury prevention strategies. Research in this area has recently emerged but has yet to be synthesized comprehensively. Therefore, the aim of this study was to conduct a systematic review of the potential risk factors and injury prevention strategies for overuse injuries in adult climbers.

Methods

This systematic review was conducted in accordance with the PRISMA guidelines. Databases were searched systematically, and articles were deemed eligible based upon specific criteria. Research included was original and peer-reviewed, involving climbers, and published in English, German or Czech. Outcomes included overuse injury, and at least one or more variable indicating potential risk factors or injury prevention strategies. The methodological quality of the included studies was assessed with the Downs and Black Quality Index. Data were extracted from included studies and reported descriptively for population, climbing sport type, study design, injury definition and incidence/prevalence, risk factors, and injury prevention strategies.

Results

Out of 1,183 records, a total of 34 studies were included in the final analysis. Higher climbing intensity, bouldering, reduced grip/finger strength, use of a "crimp" grip, and previous injury were associated with an increased risk of overuse injury. Additionally, a strength training intervention prevented shoulder and elbow injuries. BMI/body weight, warm up/cool downs, stretching, taping and hydration were not associated with risk of overuse injury. The evidence for the risk factors of training volume, age/years of climbing experience, and sex was conflicting.

Discussion

This review presents several risk factors which appear to increase the risk of overuse injury in climbers. Strength and conditioning, load management, and climbing technique could be targeted in injury prevention programs, to enhance the health and wellbeing of climbing athletes. Further research is required to investigate the conflicting findings reported across included studies, and to investigate the effectiveness of injury prevention programs.

Systematic Review Registration

https://www.crd.york.ac.uk/, PROSPERO (CRD42023404031).

Extensor Mechanism Disruption with Multiligamentous Knee Injury from Bouldering

Extensor mechanism injuries and multiligamentous knee injuries are rare and typically are caused by high-energy injury mechanisms. We present a case of an active-duty military service member who sustained a patellar tendon rupture with concomitant multiligamentous knee injury due to a fall while bouldering. This case report is the first to highlight this significant injury due to bouldering, in addition to the surgical steps taken to get the patient fit for full military duty. These injuries often go undiagnosed and are incredibly important to recognize given the importance of prompt evaluation and ultimate surgical care in these scenarios.

Treating depression in an outpatient setting: Predictors of patient response to bouldering psychotherapy, cognitive behavioural therapy or exercise alone

BACKGROUND

Bouldering psychotherapy (BPT) for depression has proven effective, but nothing is known about its potential predictors of response. This study should identify predictors of response to BPT, cognitive behavioural therapy (CBT) and an active control (home-based exercise programme; EP) using a literature-based model.

METHODS

In a multicentre randomised controlled trial, 233 outpatients were assigned to BPT, CBT or EP. Response (reduction of at least 46% on the Montgomery-Åsberg Depression Rating Scale [MADRS]) and remission (≤7 MADRS points) were defined as suggested by the literature. Predictors of response were identified twofold: (1) univariate analyses followed by logistic regression analyses in each group with all predictors yielding a univariate p-value <.20 and (2) a backward regression analysis with all potential predictors. Only variables that emerged as predictors in both types of analyses were interpreted.

RESULTS

There was a significantly greater proportion of responders (p = .035) in the BPT than in the EP. The chance of response in the BPT was higher for patients with a higher health-related quality of life. In the EP, response was higher for patients with lower interpersonal sensitivity, suffering from their first episode and living with a partner.

CONCLUSIONS

Response rates in BPT are similar to or even higher than in other outpatient psychotherapy group therapies. BPT and CBT are suitable for a wide range of patients, but patients with higher functionality could start with psychoeducation and exercise.

Handedness, Bilateral, and Interdigit Strength Asymmetries in Male Climbers

PURPOSE

To determine whether there are bilateral and interdigit differences in the maximal force production of experienced climbers and whether these differences are mediated by ability level or preferred style of climbing.

METHODS

Thirty-six male climbers (age 30 [9.4] y) took part in a single-session trial to test their maximal force production on both hands. The tests included a one-arm maximal isometric finger flexor strength test (MIFS) and a one-arm individual MIFS. Bilateral differences were analyzed by strongest hand (defined as the hand that produced the highest MIFS value) and dominance (defined as the writing hand).

RESULTS

A pairwise t test found that MIFS was significantly greater for the strongest hand (mean difference = 4.1%, 95% CI, -0.052 to 0.029, P < .001), with handedness explaining 89% of the variation. A 2-way mixed-model analysis of variance determined that there were no interactions between preferred style (bouldering or sport climbing) and MIFS or between ability level (advanced or elite) and MIFS.

CONCLUSIONS

Climbers have significant finger flexor strength bilateral asymmetries between their strongest and weakest hand. Moreover, when dominance is controlled, this difference in strength is present, with the dominant hand producing more force. Neither preferred style of climbing nor the ability level of the climbers could explain these asymmetries. As such, practitioners should consider regularly monitoring unilateral strength, aiming to minimize the likelihood of large bilateral asymmetry occurring.

Assessing climbing-specific strength: The impact of body position and elbow flexion on reliability and predictive validity

Finger strength is a key determinant of climbing performance, yet the optimal method for reliable assessment remains unsettled. This study evaluated the reliability and validity of finger strength assessments across four positions: seated and standing with bent and straight arms. Twenty-six intermediate-to-elite climbers completed a climbing-specific isometric pull-down test on two occasions, 48-96 hours apart. Average and peak force outputs from the mean of three attempts and the best single attempt were analyzed. Tests performed with bent arms showed slightly higher between-sessions reliability (intraclass correlation coefficient [ICC] = 0.983-0.991) compared to straight arms (ICC = 0.978-0.989). Seated positions yielded better within-session reliability (CV = 1.81-2.99%; ICC = 0.985-0.990) than standing (CV = 2.33-3.11%; ICC = 0.951-0.979). Between-sessions coefficient of variation (CV) ranged from 2.04% to 3.37%. Relative finger strength correlated more strongly with climbing performance (r = 0.425-0.767) than absolute strength (r = 0.422-0.741), with seated positions showing the strongest associations (r = 0.709-0.767). Absolute values demonstrated slightly higher test-retest reliability, but relative values were more predictive of climbing ability, particularly in sport climbing. All tested positions proved viable for assessing maximal finger strength, although seated with bent arms appears slightly more reliable and valid. Finally, averaging three attempts or using the best single attempt provided comparable reliability.

Five weeks of dynamic finger flexor strength training on bouldering performance and climbing-specific strength tests. A randomized controlled trial

The aim of the study was to examine the effects of a 5-week dynamic finger flexor strength training program on bouldering performance and climbing-specific strength tests. Advanced to elite level boulderers (n = 31) were randomized to a dynamic finger strength training group (DFS) or a control group (CON). The DFS training program consisted of 3 weekly sessions (3-5 sets, 4-10 repetitions per session). Both groups continued bouldering training as usual throughout the intervention period. Pre- and post-intervention measures included bouldering performance, maximal dynamic finger strength, isometric finger strength (peak and average force), and rate of force development (RFD). The DFS demonstrated greater improvement in dynamic finger strength (11.5%, 3.9 kg) than the CON (5.3%, 1.7 kg; p = 0.075, ES = 0.90), but there were no differences between the groups in 1RM (p = 0.075, ES = 0.67), bouldering performance (p = 0.39, ES = 0.35), isometric finger strength (p = 0.42-0.56, ES = 0.20-0.22) or RFD (p = 0.30, ES = 0.46). The DFS improved dynamic (p < 0.01, ES = 1.83) and isometric peak and average (p < 0.01, ES = 0.98, and p < 0.01, ES = 0.75, respectively) finger strength, while the CON only increased dynamic finger strength (p < 0.05, ES = 0.58). None of groups improved bouldering performance or RFD (p = 0.07-0.58). In conclusion, 5 weeks of DFS training improving dynamic strength to a greater extent than bouldering alone in addition to improving isometric finger strength among advanced boulderers. Isolated bouldering improved dynamic finger flexor strength, but importantly, increased finger strength (dynamic or isometric) did not improve bouldering performance.