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History of Rock Climbing
Indoor and outdoor bouldering has become a widespread popular sport, which deservedly has been recognised as a suitable sporting event for the upcoming 2020 Tokyo Olympic Games (Jones and Johnson, 2016). Indoor and outdoor bouldering is known now as a well-known sporting activity. The location of this sport usually are indoor climbing facilities with artificial holds, boulders, slabs, and volumes, where as outdoor bouldering uses the environment such as, rock surfaces, rock boulders, or even slabs (Jones and Johnson, 2016).
The objective of participating in rock climbing for participants is to complete a pre-designed route. If the participant falls or uses a different coloured boulder, then this would be classed as a failed attempt Jones and Johnson, 2016). There is a variety of colour coordinated climbing routes which are listed as grades . Each colour represents a varied type of difficulty to challenge the climbers ability. The movements associated with rock climbing may include descending, ascending, and climbing sideways (Jones and Johnson, 2016). However, traditional climbing focuses on equipment such as ropes, clips, and supporters who attached the rope and act as a counter weight for support in case the climber falls (Jones and Johnson, 2016). Sport climbing can take place in either indoor or outdoors. The objective is too complete the set route, along with being attached by a rope. The climber must connect their rope to each fixed anchor point of the wall during the ascent (Jones and Johnson, 2016).
Rock climbing has gained an enormous popularity, it was known more than several years ago, it was estimated that in 2003 1.27 million individuals participated in regular, rock climbing activity (British Mountaineering Council 2003). Fast forward 13 years forward and since 2016, there has been a huge development in the popularity of climbing with an increase 386 indoor climbing facilities, where as in 1988, there was only 40 climbing gyms in Britain (British Mountaineering Council 2016).
Different Types of Rock Climbing
However, within the rock-climbing industry, there is a competitive element. Professional rock-climbing athletes partake in indoor climbing, indoor speed climbing, indoor bouldering, and indoor para-climbing. From the list above, only indoor climbing has been accepted for the 2020 Tokyo Olympic Games (Jones and Johnson, 2016). With the increase of physical activity of rock climbing benefitting the welfare of the British citizens, the increase in participating in rock climbing can more than likely increase the percentage of climbing-related injuries meaning an increased percentage of using doctors, physicians, or the NHS for muscular skeletal injuries (Jones and Johnson, 2016).
Indoor bouldering is designed for the climber to participate in low level movements, achieved on a pre-determined route (Jones and Johnson, 2016). Both indoor/outdoor bouldering and soloing do not require as much equipment (ropes, clips, supporter), where-as traditional and lead climbing do. The brutality of the impact of an injury from falling when climbing can depend from the length of the fall and the positioning of the landing. However, no research is presentable to state in the injury incidence in any type of rock climbing (Jones and Johnson, 2016). Although, Campbell et al., (2015) provide statistical information that the likeliness of a climber injuring themselves when participating within indoor climbing ranges from 0.01-0.097 injuries over 1000 hours.
Percentages and Injuries Regarding Rock Climbing
Reported injuries occurring with rock climbing vary between 10% and 81%, where as the irrespective of causing an injury is between 10% to 50% of injuries (Jones, Asghar, & Llewellyn, 2008, (Josephsen et al., 2007, Neuhof et al., 2011, Woollings et al., 2015). Although, more statistical research from Paige, Fiore, & Houston (1998) suggest that between 28%-81% is the cause for self-inflicted trauma-based injuries and, 33%-44% of participants may inflicted chronic, overused injuries (Backe et al., 2009, Jones, Asghar, & Llewellyn, 2008, Woollings et al., 2015, Wright, Royle & Marshall, 2001).
Other injuries when climbing could include shoulder which account for 17% of all injuries and the elbow 8% (majority upper limbs) (Jones and Johnson, 2016), lower limb injuries such as the ankle or foot are usually obtained with falling and the impact from the ground (Jones and Johnson, 2016).
However, focus of this assignment is to study the most reoccurring injury through any variation of rock climbing, finger injuries. It is known that finger injuries are the most common injury within the rock-climbing community, averaging around 33%-52% of climbers sustained (Gerdes, Hafner & Aldag 2006, Rohrbough, Mudge & Schilling, 2000, Schöffl et al., 2015, van Middelkoop et al., 2015).
Finger injuries are usually caused with excessive strain from contractile and non-contractile tissue. This is usually obtained when a great amount of strain is applied when participating is a challenging movement (Jones and Johnson, 2016). Other movements which could inflict on going damage to the fingers is when a climber refuses too fall when their feet are no longer within contact of the wall and refuse to let go, resulting in the use of only the upper body limbs to hold their position. Participating in this manor may result in chronical overused injuries from exertion, repetition, and forceful movements on the fingers over numerous climbs (Jones and Johnson, 2016). If so, injuries such as mal-aligned healing and tissue damage located in the fingers and upper limbs (Jones and Johnson, 2016). Campbell et al., (2015) research also agrees with the previous statement due to presenting similar results from their research. It was reported the majority of injuries when rock climbing was 4.2% of injuries over 1000 hours, but 93% of the injuries was due to overuse.
An Impact on Finger Injuries from A Variety of Variables
The above statements suggest the most common injury for climbers who participate in any variation of climbing suffer from the same finger related injuries. With this being said, the hands/fingers are the most vital part of climbing. A climbers fingers are there to support, stabilise, and ascending when necessary. The previous journals regarding subject of damaging A1-4 pulleys when climbing, it shows the reader that further research on the subject of A1-5 pulleys is required and whether other variables contribute to the reoccurring injury i.e., weight, height, age, sex, or time.
When research related articles regarding finger injuries and whether or variables were to be accounted for the re-occurring injury, it was reports from Woollings, McKay, & Emery, (2015) that women are more likely to sustain sprains compared to be men, whereas males were recorded at a higher percentage than females to suffer from lacerations and fractures. Although, Woollings, McKay, & Emery, (2015) controversially contradict their previous statement by stating there was no evidence to suggest that there is a difference between sexes on the likelihood for injury.
Age was also thought to be a factor for an increase of reoccurring injuries. Furthermore, five studies informed Woollings, McKay, & Emery, (2015) stating there was no increased percentage of risk depending on age. Although, the systematic review showed an increased hand/finger injury within older climbers. Furthermore, one study showed within younger climbers, reinjury is more common with younger climbers, rather than older climbers (Woollings, McKay, & Emery, 2015). Furthermore, a systamtic review, conducted by Woollings et al., 2015 invesigated if the years of climbing aligned with an increase of injury. 3 papers were studied, and the results suggested that there was no significance between years and injury. Although, 4 other papers suggested that their injuries and years of climbing do have a significant injury risk factor. It was thought that after the 5-year period of participating in climbing will increase the chances of injury or re-occurring injuries (Woollings et al., 2015). It was also noted that climbers who participate climbing with the first year will have a higher increased percentage of sustaining an injury (Woollings, McKay, & Emery, 2015)
Woollings et al., (2015) also presented information regarding whether participating in climbing activities increased the risk factor for injury depending on the duration of the session. Results showed that there was no relative connection between an increased duration of time whilst climbing. Information was highlighted participating in any variation of climbing once per wee increased the risk of injury (Woollings et al., 2015).
Bodyweight was also reviewed by Lion et al., (2016) and Woollings, McKay, & Emery, (2015) regarding whether bodyweight had a significant impact on finger injuries when climbing. Results showed that there was no evidence to suggest that a difference in weight could potentially increase the risk factor of finger injury. Although, other resources researched whether a difference in weight could increase the percentage of injury (Lion et al., (2016, Woollings, McKay, & Emery, 2015).
The above research suggests that either there is not enough evidence to present any valuable rationale to discuss whether other variables would have an impact on finger injuries during climbing.
The most interesting results was presented from Woollings et al., (2015) and (Woollings, McKay, & Emery, (2015) regarding years and injuries. It shows that climbers who are relatively new (1st year climbing) and any climbers who exceed the 5-year mark are more likely to suffer finger injuries or reoccurring injuries. Jones & Johnson, (2016) state finger injuries sustain for 33-52% of all rock-climbing related injuries thus, leading to finger injuries being the most reoccurred injury with chronic overuse.
Why Fingers?
According to Jones & Johnson, (2016), the most overused fingers during climbing are the ring and middle fingers. These fingers are usually the centre piece of complicated holds to support the climbers bodyweight. There is a variety of different grip/hand techniques which apply substantial pressure and stress to the fingers. However, depending on the technique of the grip, evaluating the type of injury to the technique used could diagnose the injury more accurately (Jones & Johnson, 2016).
A climbers technique for grip could determine whether they have the ability to complete the coordinated route (Jones & Johnson, 2016). Depending on the grip, it depends on the designed route, whether this is big, medium, or small hold, but this depends on the climbers hands size and ability for this to be seen as a strength or weaknesses.
As previously mentioned, each climbing facility will design and coordinate the difficulty of each route and depending on the colour of the route suggests how difficult the route could potentially be. When a climber progresses further into their development of their climbing ability, they should be able to progress onto the next difficulty of routes. This is when more variations of grip techniques would be introduced such as the open crimp, hooked, crimp, pocket, pinch, and under cling (Jones & Johnson, 2016).
By introducing different grip techniques shows that the holds for the more challenging routes will incorporate smaller hand holds, resulting in the use of crimp grip. This is due too the amount of force and pressure that can be generated from this variation of a hand grip (Jones & Johnson, 2016). The crimp grip is known to be one of the favourited grips within rock climbing due to its volume of force it can generate from the middle and ring finger (Jones & Johnson, 2016). To use this technique, it requires the ring finger to control the revolving movement of the hand, running length ways across the axis.
The difference between the crimp grip and closed crimp grip is the different sized rocks used on. If the rock is small and hard to gain any contact with the hand, then using the closed crimp grip would be suitable.
All fingers are within contact with the finger board by the distal finger tips (index, middle, and ring fingers) and the palms of the hand with the thumb placed over the index finger. Both holds as described above are designed to aid the climbers performance. Depending on the type of hold is required, 2 different techniques are issued to generate the most power within a small hold. It is most commonly known for climbers to injure their fingers regularly from these holds due to falling or slipping whilst performing this technique (Kubiak, Klugman, and Bosco (2006).
A1-A5 Pulleys
There are 5 different types of pulleys, all located in each finger. A1 starting near the palm and ending at A5 at the end of the finger. With each pulley contributing to the open and closed crimp grips, each tendon is under immense stress. Schöffl et al., (2015) experimented within the sport of rock climbing, examining the most common injuries over 4 years. The results showed that the pulleys are the most common injury for rock climbers. It was also noted by Schöffl et al., (2015) that the A2-A4 are vitally important too climbers due to connecting to the underlining bone. It should also be noted that A1,3, and 5 are merely for support and A2-A4 can withstand pressure and exert power and strength.
Bollen, (1990) and Tropet et al., (1990) realised the potential with the A2-A4 pulleys, but also the dangers which may come with rupturing the pulleys. The positives of using the open and closed crimp grip is that the A2 can uphold up to 40kg. However, when participating in rock climbing, an average climber could be over exposing this weight in an excessive amount of force thus leading too damaging, tearing, or rupturing the pulleys (Klauser et al., 2002).
References
- Backe S, Ericson L, Janson S, Timpka T. Rock climbing injury rates and associated risk factors in a general climbing population. Scandinavian Journal of Medicine & Science in Sports. 2009;19(6):850-6.
- Bollen SR. Injury to the A2 pulley in rock climbers. Journal of Hand Surgery (Edinburgh, Lothian). 1990;15:268-70.
- British Mountaineering Council Web site [Internet]. Climbing Wall Directory; [cited 2016 January 5]. Available from: https://www.thebmc.co.uk/find-a-climbing-wall.
- British Mountaineering Council Web site [Internet]. Participation Statistics. 2003; [cited 2015 September 10]. Available from: https://www.thebmc.co.uk/bmcNews/media/u_content/File/press/factsheets/Participati onStats03.pdf.
- Campbell, A. D., Davis, C., Paterson, R., Cushing, T. A., Ng, P., Peterson, C. S., & McIntosh, S. E. (2015). Preparticipation evaluation for climbing sports. Wilderness & Environmental Medicine, 26(4), S40S46. doi:10.1016/j.wem.2015.09.014
- Gerdes EM, Hafner JW, Aldag JC. Injury patterns and safety practices of rock climbers. J Trauma 2006;61:151725.
- Josephsen, G., Shinneman, S., Tamayo-Sarver, J., Josephsen, K., Boulware, D., Hunt, M. and Pham, H. (2007). Injuries in Bouldering: A Prospective Study. Wilderness & Environmental Medicine, 18(4), pp.271-280.
- Jones G, Asghar A, Llewellyn DJ. The epidemiology of rock-climbing injuries. British Journal of Sports Medicine. 2008;42(9):773-8
- Jones, G. and Johnson, M. (2016). A Critical Review of the Incidence and Risk Factors for Finger Injuries in Rock Climbing. Current Sports Medicine Reports, 15(6), pp.400-409. doi:10.1249/JSR.0000000000000304
- ClimbingHauger O, Chung CB, Lektrakul N, Botte MJ, Trudell D, Boutin RD, Resnick D. Radiology. 2000 Oct;217(1):201-12. Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath
- Klauser, A., Frauscher, F., Bodner, G., Halpern, E., Schocke, M., Springer, P., Gabl, M., Judmaier, W. and zur Nedden, D. (2002). Finger Pulley Injuries in Extreme Rock Climbers: Depiction with Dynamic US. Radiology, 222(3), pp.755-761.
- Kubiak, E. N., Klugman, J. A. and Bosco, J. A. (2006) Hand injuries in rock climbers, Bulletin of the NYU Hospital for Joint Diseases. doi: 10.1016/j.mehy.2004.07.023.
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- Rohrbough JT, Mudge MK, Schilling RC. Overuse injuries in the elite rock climber. Med Sci Sports Exerc 2000;32:1369-72.
- Schöffl V, Popp D, Küpper T, Schöffl I. Injury Trends in Rock Climbers: Evaluation of a Case Series of 911 Injuries Between 2009 and 2012. Wilderness & Environmental Medicine. 2015;26(1):62-7.
- Schweizer A, Hudek R. Kinetics of Crimp and Slope Grip in Rock Climbing. Journal of Applied Biomechanics. 2011;27(2):116-21 6p.
- Tropet Y, Menez, D., Balmat, P, Pem, R., Vichard, P. Closed traumatic rupture of the ring finger flexor tendon pulley. The Journal of Hand Surgery. 1990;15:745-7.
- Woollings KY, McKay CD, Kang J, Meeuwisse WH, Emery CA. Incidence, mechanism and risk factors for injury in youth rock climbers. British Journal of Sports Medicine. 2015;49(1):44-50.
- Woollings, K. Y., McKay, C. D., & Emery, C. A. (2015). Risk factors for injury in sport climbing and bouldering: A systematic review of the literature. British Journal of Sports Medicine, 49(17), 10941099. doi:10.1136/bjsports-2014-094372
- Wright DM, Royle TJ, Marshall T. Indoor rock climbing: who gets injured? British Journal of Sports Medicine. 2001;35(3):181-5
- van Middelkoop, M., Bruens, M., Coert, J., Selles, R., Verhagen, E., Bierma-Zeinstra, S. and Koes, B. (2015). Incidence and Risk Factors for Upper Extremity Climbing Injuries in Indoor Climbers. International Journal of Sports Medicine, 36(10), pp.837-842.
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