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Over the last years concerns have been raised about the health effects particularly on young climbers due to the observation of short stature with low body weight and body fat in sports climbers. The aim of this study was to investigate anthropometric and hormonal data for climbers of the German Junior national team. 16 climbers were compared with 14-age matched nonclimbers with respect to several anthropometric variables, leptin level, and climbing characteristics. Height, weight and body mass index (BMI) standard deviation scores (SDS) for boys were not significantly different from the controls, whereas girls had significantly lower SDS-values for weight and BMI. In comparison with the control group boys and girls had a lower skinfold thickness. The leptin values were lower than the calculated leptin levels but only reached significance for the girls. The young athletes of the GJNT were neither of short stature nor thin when compared with a physically active control group. The low body fat in boys and girls was within expected limits. The lower leptin levels might be attributed to a decrease in total body fat.
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Pediatric Exercise Science, 2011, 23, 477-486
© 2011 Human Kinetics, Inc.
Correlations Between High Level
Sport-Climbing and the Development
of Adolescents
Isabelle Schöffl
Klinikum Bamberg
Volker Schöffl
J. Dötsch
University of Cologne
H.G. Dörr and J. Jüngert
Over the last years concerns have been raised about the health effects particulary
on young climbers due to the observation of short stature with low body weight
and body fat in sports climbers. The aim of this study was to investigate anthro-
pometric and hormonal data for climbers of the German Junior national team.
16 climbers were compared with 14—age matched nonclimbers with respect to
several anthropometric variables, leptin level, and climbing characteristics. Height,
weight and body mass index (BMI) standard deviation scores (SDS) for boys were
not signicantly different from the controls, whereas girls had signicantly lower
SDS-values for weight and BMI. In comparison with the control group boys and
girls had a lower skinfold thickness. The leptin values were lower than the calcu-
lated leptin levels but only reached signicance for the girls. The young athletes
of the GJNT were neither of short stature nor thin when compared with a physi-
cally active control group. The low body fat in boys and girls was within expected
limits. The lower leptin levels might be attributed to a decrease in total body fat.
Sport climbing has become more and more popular over the last 30 years
both as a recreational physical activity, but especially as a competitive sport. The
increasing number of indoor facilities, widespread popularity of this sport, and the
I. Schöf is with the Clinic for Children and Adolescents, Klinikum Bamberg, Bamberg, Germany. V.
Schöf is with the Dept. of Trauma Surgery, Friedrich-Alexander-University, Erlangen-Nuremberg,
Germany. Dötsch is with the Clinic for Children and Adolescents, University of Cologne, Cologne,
Germany. Dörr and Jüngert are with the Clinic for Children and Adolescents, Friedrich-Alexander-
University, Erlangen-Nuremberg, Germany.
478 Schöffl et al.
development of local, national, and international competitions have led to the study
of the physical characteristics that may be associated with high level performance.
Several studies found elite adult competitive climbers to be short in stature with
low body mass and very low fat percentages (3,17,22,23,25). Although relatively
high hand grip strength/body mass ratios have been reported in high level climbers
(7,25), the absolute handgrip strengths are moderate (25), suggesting that the high
strength/mass ratios are due to the effect of low body mass.
The association of high-level climbing performance with small stature and
low body fat percentage along with the possibility of improving strength/mass ratio
through body mass reduction, has raised concern about the potential health effects
on climbers (24). Sports climbing shares the trend of achieving extremely low body
weight with other sports in which physical performance is determined not only by
the motor abilities of the athletes but also to a large extent by a low body weight, i.e.,
ski jumping, road cycling, woman’s acrobatic gymnastics, rhythmic gymnastics, and
long-distance running (19). The concept of the reduction in body mass and/or the loss
in body fat mass based on performance and not on appearance or excessive concern
about body shape has lead to the introduction of the Anorexia athletica. Although
Anorexia atheltica resembles Anorexia nervosa with the high levels of exercise and the
disordered eating habits it is not classied as a clinical eating disorder but as abnormal
eating behavior (20). To reduce percentage of body fat, elite athletes often have diets
too low in energy and nutrients. This in turn leads to decits in micronutrients (19).
Other effects of Anorexia athletica are endocrine abnormalities (4) such as delayed
onset of puberty, menarche, menstrual irregularities and decreased bone formation
(also recognized as the Female Athlete Triad (2,10)), but also to a loss of hormones
related to fat mass, e.g., leptin, a hormone produced by the fat cells, which regu-
lates appetite and energy expenditure (12,26). Leptin and ghrelin are two hormones
that have been recognized to have a major inuence on energy balance. Leptin is
a mediator of long-term regulation of energy balance, suppressing food intake and
thereby inducing weight loss. Ghrelin, secreted by the stomach, on the other hand
is a fast-acting hormone, seemingly playing a role in meal initiation. Both originate
in the periphery and signal through different pathways to the brain, particularly to
the hypothalamus. In the hypothalamus, activation of the leptin or ghrelin receptor
initiates different signaling cascades leading to changes in food intake. Furthermore,
regulation of the effects of ghrelin on hypothalamic neurones (ghrelin blocks leptin’s
action through the activation of the hypothalamic NPY/Y1 receptor pathway) has
been suggested to be one of the important mechanisms by which leptin may control
food intake and body weight (11).
Although there is only anecdotal data on eating disorders and unrealistic weight
reduction practices in climbers, Austria has introduced a minimum BMI that has
to be met by the climbers to participate in competitions (16). Whether the selected
levels of limitation are justiable or reasonable for climbers is difcult to judge,
as there are few published anthropometrical data about competitive sport climbers.
Because the energy and nutritional inadequacies combined with the use of purging
methods can be found in young athletes, and restrictive eating behavior may become
the norm at a young age, special attention needs to be paid to adolescents. The aim
of this study was to evaluate anthropometry, developmental and
hormonal data for high-level climbers of the German Junior National Team
and to compare these data with an age matched group of physically active youth
not performing at a high level.
High Level Sport-Climbing and the Development of Adolescents 479
16 adolescents of the German Junior National Team (GJNT) were studied, 9 boys
with an average chronological age (CA) of 16.8 ± 2.3 (SD) years and 7 girls with
an average CA of 17.2 ± 2.8 years. As a control group we recruited 14 nonclimb-
ing adolescents, 8 boys with a mean CA of 15.9 ± 1.8 years and 6 girls with a
CA of 16.3 ± 2.5 years. The control group consisted of active adolescents who
did sports on a regular but noncompetitive basis. The study was approved by an
ethics committe, and subjects as well as their parents provided assent and written
permission, respectively. A questionnaire was employed to investigate the eating
habits (fat reduced, normal), pubertal development (time of menarche, pubarche)
and menstrual cycle. In another questionnaire the climbers were asked about their
training habits (number of training session per week, hours spent per training, type
of training) and climbing difculties (in UIAA—scale: Union Internationale des
Associations d’Alpinisme / International Mountaineering and Climbing Federation).
The body composition was measured using Bioelectrical impedance analysis
(BodyComp V7.0, MEDI CAL HealthCare, Karlsruhe, Germany) for extracellular
mass, body cell mass, fat free mass, fat mass, extracellular water, weight and other
Furthermore we measured body height and skinfold thickness using a caliper
(ccu-Measure, LLC, Greenwood Village, Co, Usa) at the scapula. Body height,
weight and BMI was then transferred in SDS (standard deviation score) values
using the LMS method (The distribution of a measurement as it changes accord-
ing to age is shown by the Reference centile curves. The changing distribution of
three curves representing the median (M), coefcient of variation (S) and skewness
(L) which is expressed as a Box-Cox power are summarized by the LMS method)
proposed by Cole and Green (5). We calculated the ape index of each individual
by dividing the length of each climber by the length of his arm span. A ratio of
more than one signies that the arm span is higher than the body height and leads
to a so called positive ape index.
Furthermore, we corrected height SDS (H-SDS) of each member of the GJNT
with target height SDS (TH-SDS) of the parents (mean of the parents height plus
6.5 cm for boys and minus 6.5 cm for girls) by the following formula: corrected
H-SDS = H-SDS minus TH-SDS. This correction for height is important as sport
climbers are described to be of smaller height (13,24) and the question arises whether
this is a consequence of dietary restrictions or of their anthropometric background.
Serum-Leptin level was measured by an in-house Radio–Immuno-Assay (RIA;
15) in the venous blood, serum-grehlin by a Radio-immuno-assay (RIA, R 90,
Mediagnost, Reutlingen-Germany). With regard to pubertal stage, all participants
were mature determined by clinical examination using the Tanner stages (21).
Statistical analysis was performed using Microsoft Excel 2000 for data col-
lection and SPSS 14.0 (SPSS Inc., Chicago, IL). All measured values are reported
as means and standard deviations. The Kologomorov-Smirnov test was used to
check for normal distribution. Homogeneity of variance was investigated using
Levine’s F-test. For normally distributed variables differences within and between
groups were assessed with paired and unpaired t tests, otherwise the Wilcoxon or
the Whitney-Mann-U tests were used. All tests were 2-tailed, a 5% probability
level was considered signicant (*). Pearson or Spearmen correlation coefcients
were used to investigate univariate correlation between independent variables and
480 Schöffl et al.
dependent climbing parameters for the members of the GJNT. As no signicant
correlations were found we did not undertake a stepwise multiple regression analysis
for determining the most important factor for explaining climbing ability.
There was no difference between the GJNT and their respective control groups
regarding eating habits or pubertal development. The mean CA of the GJNT and
their respective control groups was not signicantly different. The boys of the GJNT
climbed signicantly better (mean = 9.7 ± 0.45 in UIAA) than the girls (mean =
8.83 ± 0.50). Table 1 and 2 present means (SD) and minimum-maximum ranges
for parameters concerned with the climbing specialties of the girls and boys of the
GJNT respectively. Although the girls trained more often over the week the boys
spent more hours in training. The years of climbing were comparable. The arm span
of the girls was not signicantly different from their height, however the boys had a
signicantly higher arm span/height ratio, leading to a positive so-called ape index
of 1.03. However the ape index showed no correlation with climbing ability in any of
the tested groups (boys of the GJNT, girls of the GJNT, both genders taken together).
SDS values of the girls and the boys of the GJNT are shown in Figure 1. The
boys were not signicantly different with regard to height, weight or BMI from the
standard population. The girls had signicantly lower weight and BMI SDS values.
The differences between the means of the GJNT and their respective control
groups are shown in Table 3 for the girls and Table 4 for the boys (p < .05 is consid-
ered signicant). Although the girls were shorter, lighter and had a lower BMI than
their control group, only the weight proved to be signicant. The leptin values were
not signicantly different. The boys were also shorter, lighter, had a lower BMI and
lower leptin values than their control group, but none of the differences reached sig-
nicance. The serum-levels of ghrelin did not reach signicant differences between
the GJNT and their respective control groups. With respect to skinfold thickness the
Table 1 Climbing Parameters of the Girls of the GJNT
Parameter Mean (sd) Minimum Maximum
Climbing grade (UIAA) 8.8 (0.50) 8 9.3
Years of climbing (y) 6.9 (2.0) 4 10
Training sessions per week 5.4 (4.3) 3 15
Training hours 10.5 (4.2) 3.5 15
Table 2 Climbing Parameters of the Boys of the GJNT
Parameter Mean (
) Minimum Maximum
Climbing grade (UIAA) 9.7 (0.45) 9.3 10.5
Years of climbing (y) 6 (2.1) 3 8
Training sessions per week 3.4 (0.9) 2 4.5
Training hours 12.8 (4.7) 7 22
Figure 1 — SDS values (mean ± SD) for height, weight and BMI as well as DSDS (cor-
rected SDS values according to parental growth estimation) values (mean ± SD) for height
for the girls and boys of the German Junior National Team (GJNT). Signicant differences
are represented by *.
Table 3 Means and Standard Deviations Between the Girls of the
GJNT and Their Control Group and the p-Values of Their Differences
Girls of the
GJNT Female Control Significance (p-value)
Height (m) 161.6 (4.3) 167.5 (5.7) 0.05
Weight (kg) 50.3 (4.4) 56.5 (3.6) 0.02
BMI 19.3 (1.8) 20.1 (0.8) 0.32
Leptin (ng/ml) 2.9 (1.2) 5.3 (3.0) 0.08
Ghrelin (pg/ml) 1442.69 (562.49) 1035.42
Table 4 Means and Standard Deviations Between the Boys of the
GJNT and Their Control Group and the p-Values of Their Differences
Boys of the GJNT Male Control Significance (p-value)
Height (m) 174.9 (9.0) 177.3 (5.5) 0.50
Weight (kg) 61.3 (7.1) 69.7 (11.0) 0.08
BMI 20.1 (1.9) 22.2 (3.9) 0.15
Leptin (ng/ml) 0.5 (0.2) 1.9 (2.8) 0.16
Ghrelin (pg/ml) 1321.36 (464.09) 1097.11
boys and the girls were signicantly lower than their respective control group (s.
Figure 2). The mean differences of the fat mass between the GJNT and the control
group only reached signicance for the boys, girls showed a trend (p = 0,48) to be
lower (s. Figure 3). Leptin values were lower than the target values calculated using
the estimated Tanner stages (s. Figure 4), but the results were only signicantly lower
in the female group, the boys only showed a tendency (p = .159).
Figure 2 Mean ± SD for the skinfold thickness of the boys and girls of the GJNT in
comparison with their respective control group (signicant differences to the control group
represented by *).
Figure 3 — Mean ± SD for the fat mass for the boys and the girls of the GJNT with their
respective control group.
High Level Sport-Climbing and the Development of Adolescents 483
This study was intended to investigate the correlations between high-level sport
climbing and the development of adolescents. We studied girls and boys of the
German Junior National Team (GJNT) and compared them to a control group of
physically active adolescents of the same age group.
In a rst step we compared the climbing characteristics of girls and boys of
the GJNT with each other. The boys climbed signicantly better than the girls even
though they had been climbing for a comparable length of time and that they spent
about the same time for training per week. This nding is in accordance with the
literature (25). Many climbers believe that a positive ape index, i.e., a greater arm
span than body height, leads to a better climbing performance. However no study
could objectify this believe (9,13). Watts et al. (24) suggest that an increased arms
span to height measurement, called a positive ape index, in elite climbers may be
a selective trait. The boys of the GJNT in this study did show a positive ape index
but there was no correlation between ape index and climbing grade achieved.
High-level sports climbers are signicantly shorter (13,25) than nonclimbers.
This is believed to be a consequence of better performances with better biome-
chanical proportions and lower weight. The recorded heights in this study (girls:
161.4 cm, boys: 174.9 cm) are comparable to other studies on adults (13,25), but
they were higher than in the study by Watts et al. (24), who investigated young
climbers not having reached their nal height yet. We therefore took a closer look
at the SDS values to quantify the heights in relation to the normal collective. The
SDS-values recorded in this study were not different from the standard population.
Therefore we did not nd our climbers to be exceptionally small in stature but rather
of normal height. With regard to the question whether high-level sports climbing
has negative effects on the growth of the adolescents, as observed in gymnastics
Figure 4 — Mean ± SD for the Leptin levels (in ng/ml) for the boys and the girls of the
GJNT with their respective control group.
484 Schöffl et al.
(8,12,26), we can state that this does not apply to this group, as the DSDS values of
the boys and girls of the GJNT were not signicantly different from zero, meaning
that they were growing as predicted by the height of their parents.
Another characteristic of sports climbers is their low body weight (24,25). The
concern that young climbers may manipulate body mass to extremes to perform
at a higher level has led the Austrian organization for climbing to adopt a set of
minimum BMI standards for competitive climbers (16). Our collective was com-
parable to adults studied by Watts et al. (25), and had comparable BMI values to
the adolescents studied by Watts et al. (24), the higher values recorded for weight
in our study are therefore explainable by the difference in height. Concerning the
SDS values, the group of the GJNT in this study the girls had signicantly lower
values for weight as well as for BMI. When compared with their control group
the girls of the GJNT were signicantly lighter but this did not show in the BMI,
as they were also smaller than the control group. Therefore when compared with
another physically active group, the girls were not exceptionally thin. In our opinion,
a comparison of athletic children with the general population may be inappropriate
and adapted SDS values need to be considered for better evaluation of physically
active children. The boys were lighter and had a lower BMI with respect to their
SDS values. However, none of the parameters reached signicance. All the BMI
values recorded in this study were well above the limits envisioned by the ÖSK and
therefore it remains questionable whether such limits are even necessary.
It is interesting to note, that although the boys of the GJNT were not signi-
cantly different from their control group with respect to height, weight and BMI,
they had a signicantly lower fat mass determined by skinfold thickness (GJNT:
5.4 ± 1.1, control: 8.4 ± 2.8), as well as by body impedance (GJNT: .7 ± 3.9,
control: 12.8 ± 6.4). The girls also had signicantly lower skinfold thickness than
their control group (GJNT: 7.0 ± 1.4, control: 9 ± 1.7), however the difference in
fat mass, albeit lower than in the control group, did not reach signicance (GJNT:
13.4 ± 5.2, control: 18.3 ± 3.2). These ndings are comparable to the data from
Watts et al. (24) even though the different measuring techniques make a direct
comparison impossible. It also needs to be stressed that the skinfold thickness was
only measured over the scapula which is a limitation in itself. There is a widespread
believe among climbers that reduced body fat improves performance, even though
this has never been shown (18). Still many elite climbers often have low levels of
body fat (14,17,24,25,27). The estimated minimum amount of body fat in adults
compatible with good health is 5% in males and 12% in females (1). The adoles-
cents in this study had higher fat percentages than these minimum requirements.
However, there are no reference tables available for the minimum fat percentages
in growing young athletes.
We also studied leptin levels as mediator of long-term regulation of energy
balance in both groups especially regarding the correlation to the physical develop-
ment and constitution of the high level sport climbers. Leptin levels did not differ
signicantly from the control group. However, when calculating leptin levels in
SDS, we found signicantly lower leptin levels in girls and not in boys. This nd-
ing goes in line with the reduction of total fat mass in girls. Thus, we suggest that
leptin levels should be adjusted for athletic children. The serum-level of ghrelin as
a fast-acting hormone did not reach any signicant difference in both groups. The
subjects did not report any abnormal eating habits or caloric restrictions. A study
High Level Sport-Climbing and the Development of Adolescents 485
by Courteix et al. (6) report that hypoleptinaemia in rhythmic gymnasts might be
related to direct osteogenic effects and indirect hormonal mechanisms including
preservation of normal IGF and cortisol levels.
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abnormalities with regards to leptin and development.
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... Considering that competitions in sport climbing are held from <10 years old, it is clear that there is a need to determine fitness profiles for younger age categories. Finally, there are few studies that examine gender differences, with contradictory findings (Philippe et al., 2012;Schoffl et al., 2011). This purpose of this study was to determine the gender-specific fitness profile of elite youth sport climbers (13-18 years old). ...
... Males are taller and have lower body fat compared to females. These results are logical and have been confirmed in numerous previous studies on the non-trained population and athletes (Watts & Jensen, 2003;Schoffl et al., 2011). This is primarily due to the secretion of sex hormones and genetic imprint (puberty is manifested by an increased secretion of testosterone in boys, followed by the development of muscle mass and the lower accumulation of fat tissue) (Karastergiou et al., 2012). ...
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Sport climbers should possess specific anthropometric characteristics and conditioning capacities to reach a top level in this sport. PURPOSE: The purpose of this study was to determine gender differences in the fitness status of the top-level youth sport climbers. METHODS: The study was conducted on 20 elite Croatian youth sport climbers (all members of the national team, ten females; 13-18 years of age). The variables included anthropometric status (mass, height, arm span, and body fat percentage), generic-(countermovement-and squat-jump, grip strength), and specific-fitness tests (power slap test and Draga foot lift). RESULTS: Boys were taller than girls (t-test=2.51, p=0.02, moderate effect size (ES)), and had lower body fat percentage (t=-5.66, p=0.001, very large ES). Boys achieved better results in countermovement-(t=5.39, p=0.001, very large ES) and squat-jump (t=2.19, p=0.04, moderate ES), while there were no gender differences in the specific fitness tests. CONCLUSION: Gender differences were observed in generic but not in specific fitness, which may indicate that climbing is a specific sport that requires and develops specific abilities in a similar way in boys and girls.
... However, such facts as that climbing is generally performed upwards, includes movement forms that differ from the ones utilized in daily life, and utilizes 10mm-wide strings or other thin metal materials are all risk factors for climbers. The sportsperson tries to adapt to the changing conditions of the environment and gains a dynamic posture by keeping up with climbing (4,5). Good posture is the placement of spinal segments and every part of the body in the optimal position in proportion to the segments adjacent to them and the whole body. ...
... This evidence was previously confirmed in rock climbers, a category of athletes that should control the body weight strictly. 21 one year training for rowing for a season did not modify resting basal leptin levels but it attenuated the post exercise-induced reduction in leptin. 22 not only leptin was found to lower immediately after an intense exercise in rowers, but also the rate of decrease was found to be associated with the distance rowed. ...
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Leptin is a multifunctional hormone (adipocytokine) involves in several biological processes. From brain metabolism, to signalling, in sexual development, inflammation, fat metabolism, as an ergogenic aid for sport and in the regulation of food intake and body weight. However, recent studies investigated some new aspects of leptin, elucidating the genetics mechanisms of production, relationships with starvation and environmental variables, and even some methodological issues in leptin measurement. Some interesting new studies deals with aerospace medicine, investigating effect of space flights on leptin. Relationships with rare disease such as HIV and with psychiatric disorders are also among the recent development of leptin studies. Physical activity remain the most important factor associate with leptin metabolism, and recent studies shows how the leptin levels are influenced by exercise in extreme sport, such ultramarathon. Relationships between leptin levels and amount of exercise is well known, but still exist some controversial point about what is the shape of the relationships (if linear or polynomial) between leptin and moderate and heavy exercise. It is emerging the need for multifactorial studies which take into account phenotype, environmental variables, nutritional status, as well as cultural aspects influencing nutrition, and controlled timing in leptin measurements.
... Because climbing is dependent on a high strength-to-bodyweight ratio, low bodyweight has always been an important factor within the sport (5,6). Various substances, such as appetite suppressants, diuretics, and others, were used in the past and are most likely still used in climbing today (7). ...
... n that during growth spurts, testosterone levels rise, decreasing the mechanical strength of the physis Kurock & Sennerich, 1986), and making it more prone to fracture. The risk of growth plate fatigue fractures thus correlates with puberty, which most often will occur at an age of 13-15 years (Hochholzer & Schöffl, 2005;I. Schöffl & Schöffl, 2018;I. Schöffl, Schöffl, Dötsch, Dörr, & Jüngert, 2011), but again could differ greatly from this number. I. Schöffl and Schöffl (2018) found that distinguishing between adolescents above and below 15 years of age was important, as the mean age of junior climbers with epiphyseal fractures was 14.1 years, and all were within one year of their peak growth velocity (I. Schöffl & Schöffl, 2018). ...
Rock climbing is a fast-growing sport performed by athletes in all age groups, especially youths. While epidemiological data are available for injuries in adults, these data are lacking for young climbers. The current literature shows it being a comparably safe activity, mostly in indoor and sport climbing. Age related self-responsibility is necessary under guided supervision by an adult. Injuries are mostly related to a fall (e.g. alpine environment) or overstrain. Epiphyseal stress fractures of the fingers are a major concern, especially during the pubertal growth spurt. A critical evaluation of finger pain in young climbers as well as a neglect of certain training exercises is crucial. Suggestions for injury prevention and further research are provided.
Background Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending. Purpose To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers. Study Design Case series; Level of evidence, 4. Methods On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d’Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score. Results Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3. Conclusion The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.
Im Rahmen der Professionalisierung des Sports und der erstmaligen Aufnahme in das Programm der Olympischen Spiele wächst das Risiko für Verletzungen und Überlastungsschäden im Leistungssport, sowohl im Erwachsenenalter als auch im Kindes- und Jugendalter (Lutter et al. 2019b). Dabei sollte insbesondere der Trainings- und Wettkampfbetrieb im Kindes- und Jugendalter mehr Aufmerksamkeit erfahren und auf spezifische anatomische Gegebenheiten und Risikokonstellationen eingegangen werden. Mit dem wachsenden Leistungsdruck im professionellen Wettkampfsport wird zukünftig auch die Antidopingarbeit an Bedeutung gewinnen und die ersten bekannten Dopingfälle die Sportart erreichen. Auch wenn bisher wenig Evidenz zu dieser Thematik vorliegt, so ist ein verstärktes Bewusstsein aller Akteure (Sportler, Betreuer, Fans, etc.) hinsichtlich der Thematik Antidoping vonnöten. Eine suffiziente Antidopingarbeit, intensivierte Dopingkontrollen, sowohl im Training als auch im Wettkampf, sowie eine enge sportmedizinische Anbindung sind unumgänglich. Das weltweite Interesse wird im Rahmen der Olympischen Spiele erstmals im großen Stile auf die Sportart gerichtet sein. Umso wichtiger ist es daher, das Bewusstsein für die Grundsätze und Umsetzung der Dopingbekämpfung innerhalb des Sports zu erhöhen und zudem verletzungsarme, spannende Kletterwettkämpfe auszurichten.
Klettern gehört zu den Sportarten, bei denen ein niedriges Körpergewicht von Vorteil ist. Dies führt dazu, dass viele Sportler auf zumindest eine ungesunde Art und Weise ihr Gewicht kontrollieren. Die Folgen sind Mangelernährung mit teils klassischen Symptomen und Langzeitfolgen: Karies, Osteoporose, Nierenerkrankungen, Anämie, etc. Aber auch psychische Erkrankungen können sich entwickeln. Vor allem Anorexie und Depression resultieren als Folge der krankhaften Überzeugung, sein Gewicht niedrig halten zu müssen. Bei vielen Athleten sind diese Überzeugungen so fest verankert, dass sie ihr ganzes Leben unter den mentalen Folgen leiden. Ein frühzeitiges Erkennen möglicher Warnzeichen und die Unterstützung der Athleten sind daher von oberster Priorität, um Langzeitschäden zu vermeiden.
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To report the physiological responses of indoor rock climbing. Fourteen experienced climbers (nine men, five women) performed three climbing trials on an indoor climbing wall. Subjects performed three trials of increasing difficulty: (a) an easy 90 degrees vertical wall, (b) a moderately difficult negatively angled wall (106 degrees), and (c) a difficult horizontal overhang (151 degrees). At least 15 minutes separated each trial. Expired air was collected in a Douglas bag after four minutes of climbing and heart rate (HR) was recorded continuously using a telemetry unit. Arterialised blood samples were obtained from a hyperaemised ear lobe at rest and one or two minutes after each trial for measurement of blood lactate. Significant differences were found between trials for HR, lactate, oxygen consumption (VO2), and energy expenditure, but not for respiratory exchange ratio. Analysis of the HR and VO2 responses indicated that rock climbing does not elicit the traditional linear HR-VO2 relationship characteristic of treadmill and cycle ergometry exercise. During the three trials, HR increased to 74-85% of predicted maximal values and energy expenditure was similar to that reported for running at a moderate pace (8-11 minutes per mile). These data indicate that indoor rock climbing is a good activity to increase cardiorespiratory fitness and muscular endurance. In addition, the traditional HR-VO2 relationship should not be used in the analysis of this sport, or for prescribing exercise intensity for climbing.
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To assess oxygen uptake (VO2), blood lactate concentration ([La(b)]), and heart rate (HR) response during indoor and outdoor sport climbing. Seven climbers aged 25 (SE 1) years, with a personal best ascent without preview or fall (on sight) ranging from 6b to 7a were assessed using an indoor vertical treadmill with artificial rock hand/foot holds and a discontinuous protocol with climbing velocity incremented until voluntary fatigue. On a separate occasion the subjects performed a 23.4 m outdoor rock climb graded 5c and taking 7 min 36 s (SE 33 s) to complete. Cardiorespiratory parameters were measured using a telemetry system and [La(b)] collected at rest and after climbing. Indoor climbing elicited a peak oxygen uptake (VO2climb-peak) and peak HR (HRpeak) of 43.8 (SE 2.2) ml/kg/min and 190 (SE 4) bpm, respectively and increased blood lactate concentration [La(b)] from 1.4 (0.1) to 10.2 (0.6) mmol/l (p < 0.05). During outdoor climbing VO2 and HR increased to about 75% and 83% of VO2climb-peak and HRpeak, respectively. [La(b)] increased from 1.3 (0.1) at rest to 4.5 mmol/l (p < 0.05) at 2 min 32 s (8 s) after completion of the climb. The results suggest that for elite climbers outdoor sport rock climbs of five to 10 minutes' duration and moderate difficulty require a significant portion of the VO2climb-peak. The higher HR and VO2 for outdoor climbing and the increased [La(b)] could be the result of repeated isometric contractions, particularly from the arm and forearm muscles.
Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age. The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power. Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom. The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in U.S.A. girls.
Athletes engage in a number of dietary and weight control practices which may influence metabolism, health, and performance. This paper reviews the literature on these factors with special emphasis on athletes who show large, frequent, and rapid fluctuations in weight (wrestlers) and athletes who maintain low weight and low percent body fat (e.g., distance runners, gymnasts, and figure skaters). A theory is presented which relates these weight patterns and the accompanying dietary habits to changes in body composition, metabolism, metabolic activity of adipose tissue, and the distribution of body fat. Changes in these physiological variables may be manifested in enhanced food efficiency (weight as a function of caloric intake) as the body seeks to protect and replenish its energy stores. This may explain the surprisingly low caloric intakes of some athletes. The health status of the athlete is a concern in this regard because there may be changes in fat distribution, risk factors for cardiovascular disease, and hormonal factors associated with reproductive functioning in both females and males. Amenorrhea in female athletes may be mediated at least in part by regional fat distribution; depletion of femoral fat depots (lactational energy reserves) may be the stimulus for cessation or disruption of menses.
The performance of competition climbers in laboratory-based tests of pinch and whole hand grip strength and endurance was compared to that of non-climbers of the same age, sex and physique. Climbers performed significantly better, indicating higher stresses acting in the flexor mechanism, possibly predisposing injury. Attempts were made to correlate the performance in the tests to climbing achievement, measured by current technical climbing standards. Although pinch grip strength increased with the length of climbing experience, there was no evidence that strength in the hands alone guarantees success in competition climbing.
Over the past few years, competitive rock climbing--for a long time a popular sport in Europe--has increased in popularity in North America. An annual international World Cup competition circuit was started in 1988 which has shown growing success and a definite elite group of athletes has emerged. Descriptive anthropometric profiles of elite climbers have been unavailable. In order to fill this information void, 39 world-class climbers (21 males, 18 females) were assessed immediately prior to competition at an international World Cup sport climbing championship. All of the subjects tested were competition semi-finalists and, among these, seven males and six females advanced to the finals. The variables measured included age, years of climbing experience, height, body mass, height-weight ratio, sum of seven skinfolds, % body fat, fat-free mass, hand and arm volumes via plethysmography, average of right and left grip strengths, grip strength to body mass ratio (SMR), and climbing ability defined as the most difficult route climbed on lead. The results indicated that elite sport climbers are of small to moderate stature and exhibit very low % fat, moderate grip strength and high SMR when compared with other athletic groups. Values for the height-weight ratio and sum of seven skinfolds in the female finalists were very near those of the male finalists, which may indicate that reduction of body mass and % fat are primary adaptations in these female athletes. Climbing ability was predictable from SMR and % fat, though the R2 was low.
Modern rock climbers stress the importance of hand-to-rock contact strength as a factor for success in competitive sport climbing events, however, the degree of handgrip fatigue that occurs during difficult climbing and the time course of recovery from fatigue have not been previously described. The purpose of this study was to characterize the nature of handgrip fatigue that results from difficult continuous climbing until a fall occurs. Eleven expert-level rock climbers (age = 28.7 +/- 4.5 years) volunteered to climb continuous laps over a pre-set competition-type route on an indoor modular climbing wall until a fall occurred. The route difficulty (YDS rating of 5.12 a) was near the limit of each subject's "on-sight" lead climbing ability and placed an emphasis on physically difficult movements. "On-sight" refers to a climbing style where the climber ascends the route on the first try without falls and without prior viewing or information about the route. Practice was allowed to enable each subject to master the individual technical movements of the route. Fingertip blood samples were obtained 10 min pre-climb, at post-climb, and at 5-, 10-, and 20-min recovery and analyzed for lactate. Maximum handgrip force in Newtons was determined via dynamometry for each hand and averaged for pre-climb, post-climb, and 5-, 10-, and 20-min recovery periods. Right handgrip endurance, defined as the time that the dominant hand handgrip force could be sustained above 70 percent of handgrip strength, was determined pre-climb, post-climb, and at 20-min recovery. Mean climbing time during testing was 12.9 +/- 8.5 min for 2.8 +/- 2.2 laps over the route. Data among measurement times were analyzed using a repeated measures ANOVA with Newman-Keuls post hoc tests. Handgrip strength decreased by 22 percent and handgrip endurance decreased by 57 percent from pre-climb to post-climb and both remained depressed after 20 minutes of resting recovery. The pre-climb blood lactate of 1.4 +/- 0.8 mmol.l-1 significantly increased to 6.1 +/- 1.4 mmol.l-1 at post-climb and remained elevated (2.3 +/- 0.8 mmol.l-1) at 20-min recovery. Percent decreases in handgrip strength were significantly correlated with climbing time (R = 0.70), number of laps completed (R = 0.70), and blood lactate (R = 0.76). Percent decreases in handgrip endurance were significantly correlated with climbing time (R = 0.70) and number of laps completed (R = 0.80), but not with blood lactate (R = 0.56). It was concluded that handgrip strength and handgrip endurance decrease with continuous difficult rock climbing and remain depressed after 20 minutes of resting recovery. It also appears that handgrip strength recovers at a faster rate than handgrip endurance.
Leptin, the product of the ob-gene, is specifically released by adipocytes. In addition to its metabolic function it seems to affect the feedback-mechanisms of the hypothalamic-pituitary-gonadal-axis. We studied 13 female juvenile elite gymnasts with anorexia athletica (AA) and 9 female patients with anorexia nervosa (AN) regarding the relation between leptin, fat stores, and the reproductive hormone levels. Leptin levels in females with anorexia nervosa (Tanner stage B4 [median]; mean age: 17.8 +/- 1.7 years) were low (2.9 +/- 2.7 microg/L), and were related to body mass index (BMI) (r = 0.71; p = 0.03) and percentage body fat mass (r = 0.78; p = 0.01). Leptin levels of the elite gymnasts were even more decreased (1.2 +/- 0.8 microg/L) caused by the low amount of fat stores. Leptin correlated with BMI (r= 0.77; p = 0.004) and the percentage body fat mass (r = 0.6; p = 0.04). In elite gymnasts leptin levels correlated with CA showing an age-dependent increase (r= 0.59; p = 0.04). Oestradiol was secreted at a low level in both groups (AN: 25.6 +/- 17.4 microg/L; AA: 24.4 +/- 13.5 microg/L). A delay in menarche and a retarded bone maturation occurred in AA. Our results clearly show that leptin levels are low in restrained eaters. Leptin levels represent the fat stores in the body and play a permissive role for female pubertal development. There is evidence that the mechanisms leading to a dysregulation of the reproductive-axis in patients with AN are comparable with those leading to delayed puberty in juvenile elite gymnasts with AA. This implies that AN and AA are overlapping groups and AA can lead to the development of AN.
Background: Elite gymnasts favour low body fat mass as the current aesthetic ideal required for complex movements in this sports discipline. Pubertal development and growth are retarded in juvenile gymnasts. Leptin, the protein product of the ob-gene, is secreted by fat cells. Besides its role in regulation of body weight, leptin also stimulates the reproductive axis. We investigated various serum hormones including leptin, body composition and nutrition in cohorts of female and male elite gymnasts to elucidate if there is a relationship between leptin levels and delayed puberty in elite gymnasts. Materials and methods: Twenty-two female and 18 male elite gymnasts were enrolled in this study. Pubertal stage, various hormonal levels and body composition were determined and nutritional intake was assessed. Leptin was analysed using a specific RIA. Results: Pubertal development and growth were delayed in the study group, especially in girls. The percentage of body fat was reduced as compared to a normal age-matched population: 14.4% versus 21.9% in girls and 10.4% versus 15.1% in boys. Serum leptin levels were decreased, especially in pubertal girls, and did not show the normal developmental pattern with a steady increase in girls and a peak in boys of pubertal stage 2. In all gymnasts leptin levels correlated with the amount of fat mass (r = 0.6, P = 0.005 in girls; r = 0.44, P = 0.038 in boys). When leptin levels were transformed into standard deviation scores (SDS) it became obvious that the gymnasts, especially pubertal females, had significantly lower values than normal controls of the same sex, pubertal stage and body mass index (BMI): leptin SDS (BMI) = -1.21 and -3.99 in prepubertal and pubertal girls, - 0.94 and -0.91 in prepubertal and pubertal boys, respectively. When leptin SDS were based on % body fat instead of BMI, mean values were still significantly decreased compared to normal controls: -1.05 in girls (P < 0.001) and -0.60 in boys (P = 0. 025). Conclusions: Adjustment of serum leptin levels in elite gymnasts for gender, pubertal stage and BMI or % body fat reveals inappropriately low values. The reason for this hypoleptinemia is most probably insufficient caloric intake. The data suggest that hypoleptinemia in turn causes delayed puberty and growth in this particular group of athletes.