Rock Climbing

Introduction

• Rock climbing popularity and access have opened the sport up to climbers of all ages.

  • Beginning with Tokyo 2020, sport climbing included in Summer Olympic Games

  • International Federation of Sports Climbing (IFSC) organizes senior and junior World Championships, World Cup, and international events

• Climbing requires strength, endurance, flexibility, agility, and courage

• Equipment advances have made climbing safer

• Overuse and climbing-specific injuries pose challenges to climbers and providers

  • Increase in adolescent overuse injury patterns

Epidemiology

• A 2015 systematic review in British Journal of Sports Medicine evaluated risk factors for injury:

  • Age, years of climbing experience, highest climbing grade achieved, high climbing intensity score, lead climbing, previous injury

  • No conclusive data regarding injury prevention

• Type of climb

  • Competition climbing: route climbing, speed climbing, bouldering

  • Indoor climbing is safer and more controlled, but adds risk for overuse, particularly to fingers.

  • Risk of death and serious injury greater in mountaineering ( Table 99.1 )

    Table 99.1

    Accidents And Injuries In North American Mountaineering And Rock Climbing

    Modified from Williamson JE. Accidents in North American Mountaineering . Golden: American Alpine Club, Inc.; 2006:97–98.

    Year	Accidents Reported	Injured	Fatalities
    2005	111 USA	85 USA	34 USA
    	19 Canada	14 Canada	7 Canada
    1951–2005	6111 USA	5158 USA	1373 USA
    	958 Canada	715 Canada	292 Canada

  • 3.1 injuries per 1000 climber hours in sport competitions ( Table 99.2 )

    Table 99.2

    2005 World Championships In Rock Climbing Injury Risk

    Modified from Schoffl VR, Kuepper T. Injuries at the 2005 World Championships in rock climbing. Wilderness Environ Med . 2006;1(3):187–190, used with permission.

    Year	2005
    Climbers	443
    Countries	55
    Climbing days	520
    Acute medical issues	18
    Serious medical issues	4 (zero deaths)
    Injury rate per 1000 climbing hours	3.1

• Equipment

  • Regular inspection and replacement of damaged or expired equipment

    • Follow manufacturer’s recommendation for soft and metal gear replacement

  • Proper use of protection

• Skill level

  • Elite climbers on more difficult climbs carry higher risk of overuse and exposed falls.

  • Most injuries occur at or below the climber’s usual level.

  • Greater risk in male climbers who climb harder routes, have been climbing more than 10 years, and lead climb more than top rope climb.

• Environmental

  • Falling rocks

  • Isolation, weather, heat, cold (see Chapter 21: “Exercise in the Heat and Heat Illness” and Chapter 22: “Exercise in the Cold and Cold Injuries”)

  • Altitude (see Chapter 23: “Altitude Training and Competition”)

  • Plants and animals/insects

General Principles