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Review article: Biomedical intelligence

Vol. 142 No. 4142 (2012)

Sport climbing from a medical point of view

  • Andreas Schweizer
Cite this as:
Swiss Med Wkly. 2012;142:w13688


Rock climbing, sport climbing and bouldering are highly popular new sport disciplines. An increasing number of indoor climbing gyms throughout the country offer the possibility to perform the sport regularly independently from the weather. As a result a variety of new pathologies like the closed flexor tendon pulley rupture of the finger and syndromes caused by overuse mainly in the upper extremity have appeared and should be familiar to physicians and therapists working in the field of sports medicine. An overview of the most common and most specific climbing related injuries as well as their diagnosis and treatment options with a focus on the upper extremity are presented.


  1. Bollen SR. Injury to the A2 pulley in rock climbers. J Hand Surg. [Br] 1990;15:268–70.
  2. Tropet Y, Menez D, Balmat P, Pem R, Vichard P. Closed traumatic rupture of the ring finger flexor tendon pulley. J Hand Surg Am. 1990;15:745–7.
  3. Schweizer A. Lumbrical tears in rock climbers. J Hand Surg. [Br] 2003;28:187–9.
  4. Schoffl V, Winkelmann HP. Accident statistics at “indoor climbing walls”. Sportverletz Sportschaden. 1999;13:14–6.
  5. Neuhof A, Hennig FF, Schoffl I, Schoffl V. Injury risk evaluation in sport climbing. Int J Sports Med. 2011;32:794–800.
  6. Schussman LC, Lutz LJ, Shaw RR, Bohnn CR. The epidemiology of mountaineering and rock climbing accidents. Journal of Wilderness Medicine. 1990;1:235–48.
  7. Backe S, Ericson L, Janson S, Timpka T. Rock climbing injury rates and associated risk factors in a general climbing population. Scand J Med Sci Sports. 2009;19:850–6.
  8. Mannering FL, Grodsky LL. Statistical analysis of motorcyclist’ perceived accident risk. Accid Anal Prev. 1995;27:21–31.
  9. Junge A, Dvorak J. Soccer injuries: a review on incidence and prevention. Sports Med. 2004;34:929–38.
  10. Wedderkopp N, Kaltoft M, Lundgaard B, Rosendahl M, Froberg K. Injuries in young female players in European team handball. Scand J Med Sci Sports. 1997;7:342–7.
  11. Molsa J, Kujala U, Nasman O, Lehtipuu TP, Airaksinen O. Injury profile in ice hockey from the 1970s through the 1990s in Finland. Am J Sports Med. 2000;28:322–7.
  12. Gabbett TJ. Incidence of injury in amateur rugby league sevens. Br J Sports Med. 2002;36:23–6.
  13. Schoffl V, Hochholzer T, Winkelmann HP, Strecker W. Pulley injuries in rock climbers. Wilderness Environ Med. 2003;14:94–100.
  14. Josephsen G, Shinneman S, Tamayo-Sarver J, Josephsen K, Boulware D, Hunt M, et al. Injuries in bouldering: a prospective study. Wilderness Environ Med. 2007;18:271–80.
  15. Paige TE, Fiore DC, Houston JD. Injury in traditional and sport rock climbing. Wilderness Environ Med. 1998;9:2–7.
  16. Marco RA, Sharkey NA, Smith TS, Zissimos AG. Pathomechanics of closed rupture of the flexor tendon pulleys in rock climbers. J Bone Joint Surg Am. 1998;80:1012–9.
  17. Schweizer A. Biomechanical properties of the crimp grip position in rock climbers. J Biomech. 2001;34:217–23.
  18. Tan MA, Fuss FK, Niegl G. Dynamics of A2 finger pulley rupture. Journal of Mechanics in Biology and Medicine. 2007;7:75–87.
  19. Schoffl I, Oppelt K, Jungert J, Schweizer A, Bayer T, Neuhuber W, et al. The influence of concentric and eccentric loading on the finger pulley system. J Biomech. 2009;42:2124–8.
  20. Schoffl VR, Jungert J. Closed flexor pulley injuries in nonclimbing activities. J Hand Surg Am. 2006;31:806–10.
  21. Klauser A, Frauscher F, Bodner G, Cihak C, Gabl M, Schocke M, et al. Value of high-resolution ultrasound in the evaluation of finger injuries in extreme sport climbers. Ultraschall Med. 2000;21:73–8.
  22. Klauser A, Frauscher F, Bodner G, Halpern EJ, Schocke MF, Springer P, et al. Finger pulley injuries in extreme rock climbers: depiction with dynamic US. Radiology. 2002;222:755–61.
  23. Moutet F, Forli A, Voulliaume D. Pulley rupture and reconstruction in rock climbers. Tech Hand Up Extrem Surg. 2004;8:149–55.
  24. Schoffl VR, Einwag F, Strecker W, Schoffl I. Strength measurement and clinical outcome after pulley ruptures in climbers. Med Sci Sports Exerc. 2006;38:637–43.
  25. Arora R, Fritz D, Zimmermann R, Lutz M, Kamelger F, Klauser AS, et al. Reconstruction of the digital flexor pulley system: a retrospective comparison of two methods of treatment. J Hand Surg Eur Vol. 2007;32:60–6.
  26. Gabl M, Reinhart C, Lutz M, Bodner G, Angermann P, Pechlaner S. The use of a graft from the second extensor compartment to reconstruct the A2 flexor pulley in the long finger. J Hand Surg Br. 2000;25:98–101.
  27. Schweizer A. Biomechanical effectiveness of taping the A2 pulley in rock climbers. J Hand Surg. [Br] 2000;25:102–7.
  28. Warme WJ, Brooks D. The effect of circumferential taping on flexor tendon pulley failure in rock climbers. Am J Sports Med. 2000;28:674–8.
  29. Stener B. Displacement of the ruptured ulnar collateral ligamnet of the metacarpo-phalangal joint of the thumb. J Bone Joint Surg. 1962;44B:869–79.
  30. Watson HK, Ryu J. Evolution of arthritis of the wrist. Clin Orthop Relat Res. 1986:57–67.
  31. Bayer T, Schweizer A. Stress fracture of the hook of the hamate as a result of intensive climbing. J Hand Surg Eur Vol. 2009;34:276–7.
  32. Hahn F, Erschbaumer M, Allenspach P, Rufibach K, Schweizer A. Physiological Bone Responses in the Fingers After More Than 10 Years of High-Level Sport Climbing: Analysis of Cortical Parameters. Wilderness & Environtal Medicine 2012:in press.
  33. Bollen SR, Wright V. Radiographic changes in the hands of rock climbers. Br J Sports Med. 1994;28:185–6.
  34. Rohrbough JT, Mudge MK, Schilling RC, Jansen C. Radiographic osteoarthritis in the hands of rock climbers. Am J Orthop. 1998;27:734–8.
  35. Sylvester AD, Christensen AM, Kramer PA. Factors influencing osteological changes in the hands and fingers of rock climbers. J Anat. 2006;209:597–609.
  36. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494–502.
  37. Altman RD, Hochberg M, Murphy WA, Jr., Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995;(3 Suppl A):3–70.
  38. Allenspach P, Saupe N, Rufibach K, Schweizer A. Radiological changes and signs of osteoarthritis in the fingers of male performance sport climbers. J Sports Med Phys Fitness. 2011;51:497–505.
  39. Schoffl V, Hochholzer T, Schoffl I. Extensor hood syndrome – osteophytic irritation of digital extensor tendons in rock climbers. Wilderness Environ Med. 2010;21:253–6.
  40. Moor BK, Nagy L, Snedeker JG, Schweizer A. Friction between finger flexor tendons and the pulley system in the crimp grip position. Clin Biomech. (Bristol, Avon) 2009;24:20–5.
  41. Schweizer A, Moor BK, Nagy L, Snedeker JG. Static and dynamic human flexor tendon-pulley interaction. J Biomech. 2009;42:1856–61.
  42. Hochholzer T, Schoffl VR. Epiphyseal fractures of the finger middle joints in young sport climbers. Wilderness Environ Med. 2005;16:139–42.
  43. Pfeifer C, Messner K, Scherer R, Hochholzer T. Injury pattern and overuse stress syndrome in young sport climbers. Wien Klin Wochenschr. 2000;112:965–72.
  44. Peters P. Nerve compression syndromes in sport climbers. Int J Sports Med. 2001;22:611–7.
  45. Ghiggio P, Nobile G, Cogola L, Testoni R. Wrist and hand nervous distress syndromes in sports. J Sports Traumatol. 1991;13:54–2.
  46. Wolf JM, Ozer K, Scott F, Gordon MJ, Williams AE. Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study. J Hand Surg Am. 2011;36:1269–72.
  47. Peterson M, Butler S, Eriksson M, Svardsudd K. A randomized controlled trial of exercise versus wait-list in chronic tennis elbow (lateral epicondylosis). Ups J Med Sci. 2011;116:269–79.
  48. Schweizer A, Bircher HP. Reposition of a dislocated shoulder under use of cannabis. Wilderness Environ Med. 2009;20:301–2.
  49. Schoffl V, Popp D, Dickschass J, Kupper T. Superior labral anterior-posterior lesions in rock climbers-primary double tenodesis? Clin J Sport Med. 2011;21:261–3.
  50. Bircher H-P, Thuer C, Schweizer A, Bereiter H. Shoulder injuries in sportclimbers, presentation at the Congress of Swiss Orthopaedic and Trauma Society. 2007.
  51. Burtscher M, Jenny E. Häufigste trainingsbdingte Beschwerden und Verletzungen bei Sportkletterern. Praktische Sport- und Traumatologie und Sportmedizin 1987;2/87:15–21.