Head Injuries in Rock Climbing: A Scoping Review

Abstract

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.

Analyzing Injury Patterns in Climbing: A Comprehensive Study of Risk Factors

“…Belayers themselves can also be injured. In our case, belayers were most often injured by rope slippage in their hands and burns from the rope, or by falling rocks in accordance with the literature [ 32 , 55 ]. Unlike others [ 31 ], we did not record any instances of belayers being thrown against the rock.…”

“…According to our data, the phase during which the injury occurred does not significantly differ among the various climbing disciplines. In rope-secured climbing, the role of the belayer comes into play, who can be a cause of injury and can also be injured themselves (falling objects, impact against the wall when catching a fall, burns from the rope), as also stated in other studies [ 29 , 32 , 55 ]. In bouldering, although there is no belaying with a rope, injuries caused by improper landing on the crash pad, both on and off it, are more frequent, as confirmed by [ 19 , 21 , 30 , 56 ].…”

“…Particularly, we recorded head injuries, shoulder and collarbone injuries, hand and finger injuries, rib injuries, knee, shin, ankle, and toe injuries. Head injuries occur either from a climber’s fall or from falling objects (stones or items dropped by climbers) with only about 20% of climbers reportedly using helmets [ 28 , 55 , 63 ]. In the case of foot injuries in lead climbing, the most common are bruises, fractures of the talus and calcaneus, sprains, and ligament damage, as found in previous research [ 50 , 56 , 62 ].…”