As more gyms along American highways offer faux rock-climbing experiences to would-be adventurers, more climbing injuries are turning up in American emergency rooms, researchers say.
The most common injuries are fractures, sprains, and strains that occur in the lower extremities -- particularly the foot and ankle -- according to Dr. Lara McKenzie, of the Center for Research Injury and Policy at Nationwide Children's Hospital in Columbus, Ohio.
She and colleagues reported their findings online in the American Journal of Preventive Medicine.
Most of the injuries were caused by falls, McKenzie said, indicating that patients, who are typically restrained by a harness or who go bouldering (meaning to climb a little ways without a harness) land feet-first when they miss a climbing hold.
Although rock climbing was once regarded as an extreme sport, that perception is changing.
"There are a lot of people who are participating in rock climbing, and it's evolved from an extreme sport reserved for adrenaline junkies, to people who … are doing it recreationally," she observed.
In fact, indoor climbing facilities are becoming more common, and climbing walls are nearly ubiquitous on college campuses. About 9 million people go rock climbing every year, she said, even though the sport carries an inherent risk of falls and stress-related injuries.
To track changes in the number of injuries from the sport, the researchers conducted a retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS) for all ages from 1990 through 2007.
They found that 40,282 patients were treated in emergency departments for climbing-related injuries over the 18-year period. That amounts to 2,237 injuries annually – but the total increased by 63 percent over the study period.
Men were much more likely than women to get hurt, sustaining 72 percent of all injuries, while climbers of both sexes between 20 and 39 accounted for more than half of the injuries.
The most common injury involved the ankle (19.2 percent), with about two thirds of those being sprains and strains.
Climbing a Risk to Your Feet
Foot injuries were most likely to be fractures, the researchers said.
After fractures, sprains, and strains, the common injuries were lacerations (17.1 percent), soft tissue injuries (16.9 percent), and dislocations (4.3 percent).
The head and legs were five times more likely to sustain cuts than than any other kind of injury, while the upper extremities were more likely to be dislocated.
"We rarely saw concussions and head injuries," Dr. McKenzie said, most likely because climbers wear a helmet and harness that causes them to fall feet-first.
Indeed, falling was the most common cause of injury (77.5 percent). Hitting an object accounted for 7.1 percent of injuries, followed by being struck by an object (6.4 percent).
While most climbers fell from 20 feet or less, about 34 percent fell from a height of greater than 20 feet. More than half of those who fell from such a height were hospitalized.
About 11 percent of patients required hospitalization, researchers said – a relatively high percentage compared with other sports and recreational injuries.
There were also gender differences. Men were more likely to have cuts and broken bones, while women were more likely to have sprains and strains.
Dr. Chris McStay, a wilderness and sports medicine expert at the NYU/Bellevue Department of Emergency Medicine, said that anecdotally, most of the patients he treats for rock climbing injuries are young males who've been hurt only minimally.
He predicted that the real danger could stalk faux rock-wall climbers who want to apply their skills in the wild.
The elements add an extra level of danger to climbing, with a need for attention to risk of sunburn, heat exhaustion, and storms, he said.
Outdoor climbing also requires much more instruction and equipment, Dr. McStay said.
"Their level of skill and talent should dictate what type of climbing they do," he added.
The researchers aid their study may have been limited because NEISS captures only injuries treated in emergency departments.
Dr. McKenzie said that more research is needed on the role of personal safety equipment and environmental protection in order to prevent future injuries.
The researchers reported no conflicts of interest.