INJURIES AND MEDICAL INCIDENCES DURING THE IFSC 2012 CLIMBING WORLD CUP SERIES

Abstract

Objective: To prospectively evaluate the injury risk and injury severity of climbers competing in the climbing World Cup series. Methods: In 2012 the International Federation of Sport Climbing (IFSC) implied, on demand of their Medical Commission, a medical injury and incidence surveillance system for their international events. All injuries and incidences were recorded, analyzed and classified. Climbing time was collected and injury rate per 1000 hours of sports performance calculated. Results: In total there were 1362 days (3405 h) of lead climbing, 1083 days (2707.5 h) of bouldering and 255 days (637.5 h) of speed climbing. Five injuries/medical incidences took place. All were grade 2 injuries. The overall injury/medical incidence risk was 0.74/1000 h of competition climbing. Both genders combined had a 0.29/1000 h injury/medical incidence risk for lead climbing, 1.47/1000 h for bouldering and zero for speed climbing. Conclusion: Indoor Competition Climbing showed a minor injury rate and the few injuries which occurred were of minor severity.

Full text

Medicina Sportiva
Med Sport 17 (4): 168-170, 2013
DOI: 10.5604/17342260.1081272
Copyright © 2013 Medicina Sportiva
ORIGINAL RESEARCH
168
INJURIES AND MEDICAL INCIDENCES DURING THE
IFSC 2012 CLIMBING WORLD CUP SERIES
Volker Schöffl1,2,3 (A-F), Eugen Burtscher1 (A,B,D,E), Francesco Coscia1 (A,B,D,E)
1Medical Commission of the International Federation of Sport Climbing (IFSC)
2Department of Traumasurgery, Friedrich Alexander University Erlangen-Nuremberg, Nuremberg, Germany
3Department of Sportorthopedics – Sportsmedicine, Klinikum Bamberg, Bamberg, Germany
Abstract
Objective: To prospectively evaluate the injury risk and injury severity of climbers competing in the climbing World Cup
series.
Methods: In 2012 the International Federation of Sport Climbing (IFSC) implied, on demand of their Medical Commission,
a medical injury and incidence surveillance system for their international events. All injuries and incidences were recorded,
analyzed and classified. Climbing time was collected and injury rate per 1000 hours of sports performance calculated.
Results: In total there were 1362 days (3405 h) of lead climbing, 1083 days (2707.5 h) of bouldering and 255 days
(637.5 h) of speed climbing. Five injuries/medical incidences took place. All were grade 2 injuries. The overall injury/medical
incidence risk was 0.74/1000 h of competition climbing. Both genders combined had a 0.29/1000 h injury/medical incidence
risk for lead climbing, 1.47/1000 h for bouldering and zero for speed climbing.
Conclusion: Indoor Competition Climbing showed a minor injury rate and the few injuries which occurred were of minor
severity.
Key words: rock climbing, sport climbing, climbing injury, sports injury, world cup
Introduction
Since the first international sport climbing World Cup
1989 in Snowmass, CO (USA) and the first official World
Championships 1991 in Frankfurt (Germany) climbing
competitions are gaining fast in popularity [1]. The first
international event had only two disciplines, lead climb-
ing and speed climbing. Bouldering, as athird discipline,
started with its own World Cup in 1999. Organizing body
of these international climbing events is the International
Federation of Sport Climbing, which was founded in 2007
[1]. Sport climbing already was ademonstrating sport for
the Olympics in Albertville 1992.
For an objective analysis of the climbing sport´s risk
prospective studies are necessary [2]. Up to date most
analysis of rock climbing injuries are either retrospec-
tive or do not exactly differ between the various sub
disciplines performed (e.g. indoor climbing, alpine or
traditional climbing) [2,3]. Only three studies [4-6] fo-
cus purely on indoor climbing and one on competition
climbing [7]. Afurther analysis is necessary to evaluate
not only one single competition [7] but awhole World
Cup season and is presented in this short report.
Methods
To gather exact information about the involved
injury risk of competition climbing in the World Cup
an injury surveillance system was implied through the
IFSC Medical Commission in 2012. All international
competitions of the IFSC are included. The competition
doctor in charge needs to complete an injury report,
which is included into the Jury President report. For all
injuries or medical incidents an additional injury form
must be completed, with the full data for afurther fol-
low up of the patient (injury outcome). All reports are
evaluated through the MedCom IFSC. For the present
analysis all 2012 World Cup events and the 2012 World
Championships were included. There were 10 events for
lead climbing, 7 for bouldering and 5 for speed climbing.
The climbing time for all events was collected through
the official results from the IFSC (www.ifsc.org). From
the collected number of competition days the climb-
ing hours were calculated, estimating one competition
day as 2.5 hours of climbing time. This estimation was
already further explained and used in prior studies [7]
and is based on the UIAA MedCom recommendation
for injury classification [8]. The respective injury risk
(including the risk of medical incidences) per 1000 h
of sports performance was calculated and the injuries
classified according to the UIAA MedCom classification
[8]. Nevertheless, as some acute presenting conditions
during aclimbing competition are based on overstrain/
overuse rather than on areal trauma the UIAA score
was further extended and grade 2 injuries were dis-
tinguished into grade 2a: grade 2 injury based on an
overuse and grade 2b: acute injury (climbing injury
score, see below). Injury location was reported using the
OSICS (Orchard Sports Injury Classification System)
body area character [9].
IFSC Climbing Injury Score (extended UIAA Med-
Com score [8])
0 No injury or illness
1 Mild injury or illness, no medical intervention nec-
essary, self-therapy (e.g. bruises, contusions, strains)

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2a Moderate severe injury based on overuse/overstrain.
Conservative therapy or minor surgery, outpatient
therapy, heals without permanent damage (e.g.
tendonitis, epicondylitis, capsulitis, impingement
syndrome)
2b Moderate severe acute injury or illness, not life
threatening, prolonged conservative or minor sur-
gery, outpatient therapy, doctor attendance within
ashort time frame (days), injury related work ab-
sence, heals without permanent damage (e.g. undis-
placed fractures, tendon ruptures, pulley ruptures,
dislocations, meniscal tear, minor frostbite)
3 Major injury or illness, not life-threatening, hospi-
talization, surgical intervention necessary, immedi-
ate doctor attendance necessary, injury-related work
absence, heals with or without permanent damage
(e.g. dislocated joint, fractures, vertebral fractures,
cerebral injuries, frostbite with amputations)
4 Acute mortal danger, polytrauma, immediate pre-
hospital doctor or experienced trauma paramedic
attendance if possible, acute surgical intervention,
outcome: alive with permanent damage
5 Acute mortal danger, polytrauma, immediate pre-
hospital doctor or experienced trauma paramedic
attendance if possible, acute surgical intervention,
outcome: death
6 Immediate death
Results
Overall 22 World Cups events took place in 2012
(lead: 10, bouldering 7 and speed 5). In total there
were 1362 days (3405 h) of lead climbing, 1083 days
(2707.5 h) bouldering and 255 days (637.5 h) of speed
climbing. All disciplines together had 2700 climbing
days, which calculates to 6750 climbing hours. 5 inju-
ries/events took place, which were 4 injuries and one
medical incidence (see Table 1). It is noticeable that in
incidence no.1 the climber fell in the first qualification
round and hit the wall with his chin. He was treated
in ahospital and received stitches to his chin wound.
Afterwards he was able to continue the competition;
which he actually won.
The overall injury/medical incidence risk was
0.74/1000 h of competition climbing. It was 0.54 in
male and 0.97/1000 h in female climbers. Both genders
combined had a0.29/1000 h injury/medical incidence
risk for lead climbing, 1.47/1000 h for bouldering and
zero for speed climbing. No higher than grade 2b
injuries occurred.
Discussion
Climbing and mountaineering sports are gaining
more and more public interest [2]. While outdoor
climbing has its great number of athletes also indoor
climbing is aconstantly raising sport, with many climb-
ers never ever even climbing outdoors. Various previous
studies analyzed the injury risk for different climbing
activities [2,3,6,10-18]. Objective reporting of injury
site and severity varied in most studies according to the
injury definition and methodology used [2,3,8,10]. This
creates differences in the injury and fatality results and
conclusions, which in turn makes inter-study compari-
sons difficult. In 2011 the UIAA Medical Commission
published its injury score as aconsensus paper, which
will help to increase inter-study comparability [8]. The
new score was already used in the study of Neuhof et al.
[10] and Schöffl et al. [6] and is part of several other on-
going studies. To further differ between overuse injuries
and acute injuries this score was extended for the present
evaluation. While most climbing studies demonstrated
aminor injury risk for sport climbing in comparison to
alpine climbing, little research is presented on indoor,
and especially on competition climbing [2,3,6].
Wright et al. [14] evaluated the frequency of over-
use injury during the indoor 1999 World Climbing
Championship (n=295) where 44% of the respondents
had sustained an overuse injury, 19% at more than one
site. Wright [14] found an independent correlation to
increased injuries (P < 0.01) when: climbing harder
routes, bouldering or leading versus top rope climbing,
and climbing >10 years. Multivariate analysis removed
the effect of sex as an independent predictor. Jones et
al. [12] similarly found increased numbers of overuse
injuries or injuries caused by strenuous moves, and less
from fall related injuries than in traditional and outdoor
sport climbing [15,17,19,20]. Three large-scale studies
[4-6] analysed indoor climbing injuries. Limb’s survey
reported 55 accidents, from 1.021 million climbing wall
visits, and no fatalities [5]. Schöffl and Winkelmann
prospectively surveyed 25.163 registrants at ten climb-
Table 1. Injuries and medical incidences of the 2012 Sport Climbing World Cup
Number Gender Discipline Injury OSICS [9] IFSC Climbing
Injury Score
1 M Lead chin contusion, skin laceration H 2b
2 F Boulder ankle sprain A 2b
3 F Boulder dehydration X 2b
4 F Boulder suspected ACL tear K 2b
5 M Boulder ankle sprain A 2b
(M = male, F = female, ACL = anterior cruciate ligament)

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Schöffl V., Burtscher E., Coscia F. / Medicina Sportiva 17 (4): 168-170, 2013
Authors’ contribution
A – Study Design
B – Data Collection
C – Statistical Analysis
D – Data Interpretation
E – Manuscript Preparation
F – Literature Search
G – Funds Collection
ing walls [4]. Only four significant injuries (NACA 3)
were found and no fatalities; the injury-risk per visit was
0.016% or 0.079 injuries/1000 h of performance [4]. Jus t
recently Schöffl et al. published their data on aprospec-
tive analysis of 515.337 indoor climbing wall visits in
5 years [6]. Thirty climbing injuries were recorded, 22
were in male and 8 in female climbers with atotal mean
age of 27.5 (± 10.6) years. Injuries happened in 6 cases
while bouldering, in 16 cases while lead climbing, in 7
cases while top roping and in one case as athird per-
son (not climbing or belaying) while watching another
climber. Fifteen injuries were UIAA MedCom grade
2, 13 grade 3 and 2 grade 4 injuries. The overall injury
rate was 0.02 injuries per 1000 h of climbing activities.
In summary, these indoor climbing studies demon-
strated avery minor injury risk and severity in com-
parison to traditional climbing and various other sports
[2,3,6]. Overuse injuries were commonly reported in
upper limbs, with the finger most affected [2,3].
Only one study analysed competition climbing, but
only at one single event. Schöffl and Küpper recorded in-
juries and injury rates at the 2005 World Championships
[7]. They found an injury rate of 3.1/1000 h. Eighteen
acute medical problems were treated (including 13 cases
of skin bruising). They did not yet grade these injuries
yet according to the UIAA MedCom score, as this study
was prior to the scores publication. In analysing their
injury at this point of time all the 13 cases of skin bruises
are only UIAA grade 1 injuries. Grade 1 injuries are very
minor injuries, which are self treatable and are normally
not included in the evaluation of the significant injuries
[2-4,8,10]. Neglecting these there were only 4 injuries (all
UIAA grade 2b) and one medical incident (grade 2b).
These numbers are similar to the present evaluation of
the 2012 Climbing World Cup. Only one study reported
afatality rate, which was zero in 515.337 indoor climb-
ing wall visits in 5 years [6]. The present evaluation also
showed azero fatality rate, which is similar to the previous
years of World Cup Climbing Competitions (retrospec-
tive data, IFSC, www.ifsc.org). Nevertheless this study
is the first that evaluates awhole season of World Cup
competition climbing completely. Competition climbing
(World Cup) showed avery minor injury risk, with the
injury severity being also minor. Nevertheless the po-
tential risk of afatal injury always remains. These results
may not necessarily represent all competition climbing,
as safety standards may be lower in local or regional level
competitions. Further prospective analysis is necessary
and the monitoring of all Climbing World Cup events
through the IFSC Medical Commission will continue.
Declaration of interest
The authors report no conflicts of interest.
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Accepted: November 28, 2013
Published: December 20, 2013
Address for correspondence:
Volker Schöffl
Klinikum Bamberg, Bugerstr. 80,
96049 Bamberg, Germany
Volker.schoeffl@me.com
Tel. 004995150312241, fax 004995150312249
Eugen Burtscher: eugen.burtscher@vol.at
Francesco Coscia: f.coscia@email.it