Rock Climbing Injuries Treated in Emergency Departments in the U.S., 1990–2007

  • Nicolas G. Nelson
    Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
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  • Lara B. McKenzie
    Address correspondence and reprint requests to: Lara B. McKenzie, MA, PhD, Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus OH 43205
    Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio

    Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
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      Rock climbing is an increasingly popular sport in the U.S., with approximately nine million participants annually. The sport holds an inherent risk of falls and stress-related injuries. As indoor climbing facilities become more common, more people are participating in the sport.


      The objective of this study is to describe the prevalence, characteristics, and trends of rock climbing–related injuries treated in U.S. emergency departments from 1990 through 2007.


      A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission for all ages from 1990 through 2007. Sample weights provided by NEISS were used to calculate national estimates of rock climbing–related injuries. Trend significance of the number of rock climbing–related injuries over time was analyzed using linear regression. Analysis was conducted in 2008.


      An estimated 40,282 patients were treated in emergency departments for rock climbing–related injuries in the U.S. over the 18-year period. Patients aged 20–39 years accounted for more than half of all injuries. Fractures, sprains, and strains accounted for the largest portion of injuries (29.0% and 28.6%, respectively). The lower extremities were the most frequently injured body part, accounting for 46.3% of all injuries; ankle injuries accounted for 19.2%. Men were more likely to sustain lacerations (OR=1.65; 95% CI=1.03, 2.67) and fractures (OR=1.54; 95% CI=1.10, 2.17), whereas women were more likely to sustain a sprain or strain (OR=1.68; 95% CI=1.13, 2.51). Overexertion injuries were more likely to occur to the upper extremities (OR=5.32; 95% CI=1.99, 14.23). Falls were responsible for three quarters of all injuries (77.5%). Overall, 11.3% of patients were hospitalized.


      Our results indicate that the most common rock climbing–related injuries are to the lower extremities and are fractures, sprains, and strains. More research is needed to determine how rock-climbers' characteristics, climbing setting, style of climbing, and use of safety equipment and training may affect their risk for certain injury patterns.
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      1. The superstudy of sports participation: outdoor sports participation trends (1990–2007).
        American Sports Data, Inc, Cortlandt Manor NY2007
        • Outdoor Industry Foundation
        2005 Outdoor Recreation Participation Study.
        Outdoor Industry Foundation, Boulder CO2006
        • Jones G.
        • Asghar A.
        • Llewellyn D.J.
        The epidemiology of rock-climbing injuries.
        Br J Sports Med. 2008; 42: 773-778
        • Gerdes E.M.
        • Hafner J.W.
        • Aldag J.C.
        Injury patterns and safety practices of rock climbers.
        J Trauma. 2006; 61: 1517-1525
        • Rooks M.D.
        • Johnston 3rd, R.B.
        • Ensor C.D.
        • McIntosh B.
        • James S.
        Injury patterns in recreational rock climbers.
        Am J Sports Med. 1995; 23: 683-685
        • Josephsen G.
        • Shinneman S.
        • Tamayo-Sarver J.
        • et al.
        Injuries in bouldering: a prospective study.
        Wilderness Environ Med. 2007; 18: 271-280
        • Limb D.
        Injuries on British climbing walls.
        Br J Sports Med. 1995; 29: 168-170
        • Paige T.E.
        • Fiore D.C.
        • Houston J.D.
        Injury in traditional and sport rock climbing.
        Wilderness Environ Med. 1998; 9: 2-7
        • Bowie W.S.
        • Hunt T.K.
        • Allen Jr, H.A.
        Rock-climbing injuries in Yosemite National Park.
        West J Med. 1988; 149: 172-177
        • Bollen S.R.
        Injury to the A2 pulley in rock climbers.
        J Hand Surg [Br]. 1990; 15: 268-270
        • Bollen S.R.
        Soft tissue injury in extreme rock climbers.
        Br J Sports Med. 1988; 22: 145-147
        • Bollen S.R.
        Upper limb injuries in elite rock climbers.
        J R Coll Surg Edinb. 1990; 35: S18-S20
        • Bollen S.R.
        • Gunson C.K.
        Hand injuries in competition climbers.
        Br J Sports Med. 1990; 24: 16-18
        • Rohrbough J.T.
        • Mudge M.K.
        • Schilling R.C.
        Overuse injuries in the elite rock climber.
        Med Sci Sports Exerc. 2000; 32: 1369-1372
        • Logan A.J.
        • Makwana N.
        • Mason G.
        • Dias J.
        Acute hand and wrist injuries in experienced rock climbers.
        Br J Sports Med. 2004; 38: 545-548
        • Schoffl V.
        • Hochholzer T.
        • Winkelmann H.P.
        • Strecker W.
        Pulley injuries in rock climbers.
        Wilderness Environ Med. 2003; 14: 94-100
        • Killian R.B.
        • Nishimoto G.S.
        • Page J.C.
        Foot and ankle injuries related to rock climbing.
        J Am Podiatr Med Assoc. 1998; 88: 365-374
        • Wright D.M.
        • Royle T.J.
        • Marshall T.
        Indoor rock climbing: who gets injured?.
        Br J Sports Med. 2001; 35: 181-185
        • Wyatt J.P.
        • McNaughton G.W.
        • Grant P.T.
        A prospective study of rock climbing injuries.
        Br J Sports Med. 1996; 30: 148-150
        • Schroeder T.
        • Ault K.
        The NEISS sample (design and implementation), 1997 to present.
        U.S. Consumer Product Safety Commission, Division of Hazard and Injury Data Systems, Washington DC2001 June
        • NEISS
        The National Electronic Injury Surveillance System: a tool for researchers.
        U.S. Consumer Product Safety Commission, Bethesda MD2000
        • Locker T.
        • Chan D.
        • Cross S.
        Factors predicting serious injury in rock-climbing and non-rock-climbing falls.
        J Trauma. 2004; 57: 1321-1323
        • Hohlrieder M.
        • Lutz M.
        • Schubert H.
        • Eschertzhuber S.
        • Mair P.
        Pattern of injury after rock-climbing falls is not determined by harness type.
        Wilderness Environ Med. 2007; 18: 30-35
        • Gotsch K.
        • Annest J.L.
        • Holmgreen P.
        Nonfatal sports- and recreation-related injuries treated in emergency departments—United States, July 2000–June 2001.
        MMWR Morb Mortal Wkly Rep. 2002; 51: 736-740