Training for Climbing, 2nd: The Definitive Guide to Improving Your Performance (How To Climb Series)

seek professional treatment from a physician familiar with sports injuries (call around and ask this question straight out). Countless climbers have fallen into the trap of self-treatment and trying to climb through an injury—these approaches often make matters worse and can lead to unnecessarily long-term downtime. The bottom line: Read this chapter as an injury primer that encourages proactive, professional treatment of all injuries, and not as an absolute guide to the subject.

Overview of Climbing Injuries
     
    A wide variety of injuries can result from climbing and sport-specific training activities, and a survey of available literature yields a broad range of pathologies from tendinitis to broken bones. While acute trauma resulting from falls is a very real issue, this overview of climbing injuries focuses on the chronic overuse injuries that typically result from the process of climbing and training, instead of falling. For more comprehensive coverage of both acute and overuse climbing injuries I strongly recommend that you read the excellent book One Move Too Many (Hochholzer 2003).

Types of Injuries
     
    Injury surveillance data from several recent studies confirms that the majority of climbing injuries are not the result of falls. A well-designed British study revealed that three-quarters of climbing injuries were of the chronic overuse variety (Doran 1999). In this study 111 active climbers of all ages and abilities were questioned with regard to injuries incurred over the two previous years. One hundred forty overuse injuries from forty-nine climbers were reported—obviously some climbers in this sample experienced multiple or recurrent injuries during the twenty-four months of the study.
    A breakdown of these overuse injuries confirms what experienced climbers have known anecdotally for years: The fingers, shoulders, and elbows are the three most common sites of nonfall injuries (see figure 11.1). Of all the injuries revealed in the British study, 40 percent occurred in the fingers, 16 percent in the shoulders, and 12 percent in the elbows. Other common sites for injury, though much less prevalent, were the knees (5 percent), back (5 percent), and wrists (4 percent). These findings agree surprisingly well with a German study (Stelzle 2000) of 314 climbers of both sexes and all degrees of climbing ability, which identified the most common injuries as finger tendon (39 percent), elbow (11 percent), and knee (about 5 percent).

Contributing Factors
     
    An almost unanimous conclusion of the many injury studies is that occurrence of overuse injuries is directly proportionate to climbing ability and the perceived importance of climbing to the individual. Other cofactors include use of indoor climbing walls and use of campus boards and fingerboards in training for climbing.
    The British study depicts a dramatic increase in injury rates among 5.11 climbers versus 5.10 climbers (see figure 11.2). At the 5.12 level, nearly 88 percent of climbers surveyed had experienced overuse injuries in the prior two years. By comparison, only 20 percent of individuals climbing at levels below 5.9 incurred overuse injuries, the lowest relative frequency of all categories (Doran 1999).

     
    Figure 11.1 Sites of Nonfall Injuries
     

     
    Figure 11.2 Overuse Injuries
     

    At least two studies show a statistically significant relationship between perceived importance of climbing and incidence of injury. Doran (1999) says, “The frequency of injury occurrence was significantly higher in those who perceived climbing to be very important to those who rated it as not so important.” An important corollary to this relationship is that enthusiastic climbers are more likely to return to climbing before full rehabilitation has occurred, thus leading to a pattern of recurrence.
    Another British study of 295 climbers at a recent World Cup event found that those most at risk for overuse injuries were climbers with “the most ability and dedication to climbing.” The analysis showed a linear relation between lead-climbing grade and overuse injuries (Wright 2001).
    A number of other variables have been identified as cofactors in contributing to overuse injuries, including climbing preference and training practices.
    Consensus among experts in the field is that incidence of overuse injuries has increased since the advent of indoor walls and sport-climbing tactics. An article in Sports Medicine proposes that the preponderance of