The Epidemiology of Injury in Mountaineering, Rock and Ice Climbing

Abstract

Climbing and mountaineering sports are gaining more and more public interest. This chapter reviews scientific studies on injuries and accidents in climbing and mountaineering sports to evaluate the danger of these sports and their specific injuries and preventive measures. An initial PubMed query was performed using the key words 'rock climbing', 'sport climbing', 'mountaineering', 'alpine injuries' and 'climbing injuries'. More than 500 extracted papers were analyzed which gave information on injury, mortality/fatality, prevention and risk factors. Cross-references were also scanned according to the above given criteria. Also the data sources of the UIAA and IFSC Medical Commissions were analyzed. Overall, alpine (traditional) climbing has a higher injury risk than sport climbing, especially indoor climbing. Alpine and ice climbing have more objective dangers which can affect climber safety. Overall injury rates are low, nevertheless fatalities do occur in all climbing disciplines. Altitude-related illnesses/injuries also occur in mountaineering. Most injuries in sport climbing are overstrain injuries of the upper extremity. In alpine climbing, injuries mostly occur through falls which affect the lower extremity. Objective reporting of the injury site and severity varied in most studies according to the injury definition and methodology used. This creates differences in the injury and fatality results and conclusions, which in turn makes inter-study comparisons difficult. In future studies, the UIAA MedCom score for mountain injuries should be used to guarantee inter-study comparability. Evidence in preventive measures is low and further studies must be performed in this field.

Feet injuries in rock climbers

“…Neuhof et al [2] in contrast found a even injury distribution between the upper (42.6%) and lower extremities (41.3%) (Figure 1). In summary, most of the studies found that overuse injuries are mainly affecting the upper extremity, while acute traumatic injuries are more frequently located on the lower extremity [1,76] . Also, besides the acute lower limb injuries the incidence of chronic feet problems increases in the higher levels of sport climbing [23,25,75,77,78] .…”

“…The literature data on injury distribution between the upper and lower extremity is inconsistent [1] . Many scientific climbing papers only present case studies or common hand injuries [17,19,30,41,48,54,55,[60][61][62][63] and are there- Table 1 The ten most frequent localization of climbing specific diagnoses 1/98-12/01 [61] n (%) Schöffl …”

“…While alpine climbing has its inherent dangers, sport, indoor and competition climbing showed a minor injury risk [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] . Also, most of the injuries occurring are of minor severity and often due to overuse [1,3,16] . In rock climbing mostly only the hands and feet are used to be holding onto the rock or artificial climbing wall; thus placing extreme forces on the distal extremities [9,13, .…”

Wilderness medicine

“…[6] Retrospective surveys have shed light on the nature and frequency of traumatic injuries sustained while climbing. [37][38][39][40][41][42][43][44][45][46] Advances in cervical spine management and immobilization, opiate-based pain control, and invasive procedures are being discussed. [47][48][49][50][51] Advanced techniques such as shoulder reduction are being taught to lay providers.…”

Energy Expenditure and Fitness Response Following Once Weekly Hill Climbing at Low Altitude

“…Thus, understanding and accurately assessing the energy expenditure of diff erent types of physical activity is important for exercise prescription and for recommending the dose-dependent physical activity. While climbing and mountaineering sports are gaining more and more public interest [ 41 ] , most research concerning the energy cost of mountaineering has focused on high-altitude expeditions ( > 4 000 m) [ 30 ] , moderate altitude (2 500-3 800 m) [ 5 ] and rock climbing [ 14 ] . Low-intensity physical exercise in normobaric hypoxia (15 % O 2 , ≈ 2 500 m) leads to more weight loss in obese people than low-intensity physical exercise in normobaric sham hypoxia [ 33 ] .…”