Climbing Medicine: A Practical Guide

Preface
Disclaimer
Contents
Contributors
English Language Editing
1: Introduction
1.1 History
1.2 Terminology
1.3 Grading
1.4 Equipment
1.5 Competition Climbing
1.6 Disciplines
1.7 Lead Climbing (On-Sight)
1.8 Bouldering
1.9 Speed
References
Part I: Basics
2: Injury Statistics
2.1 Introduction
2.2 Injury Grading and Scoring
2.3 Analysis of the Climbing Subdisciplines
2.3.1 Alpine Climbing, Sport Climbing, and Bouldering
2.3.2 Indoor and Competition Climbing
2.3.3 Ice Climbing
2.4 Is Climbing a High-Risk Sport?
2.5 Conclusion
References
3: Anatomy and Biomechanics of the Hand
3.1 Anatomy
3.1.1 The Extensor Tendons
3.1.2 The Flexor Tendons and Their Functional System with the Pulleys and Tendon Sheath
3.1.3 The Physis (Growth Plate)
3.2 Tendon Healing
3.3 Biomechanics
3.3.1 Pulleys
3.3.2 The Growth Plate
3.4 Conclusion
References
4: Historical Development of a Physiological Model for Rock Climbing Performance
4.1 Background
4.2 Physiological Study of Climbers and Climbing
4.2.1 Anthropometry and Body Composition
4.2.2 Bioenergetic Power
4.2.3 Muscular Strength, Endurance, and Power
4.3 Prediction of Climber Performance Via Physiological Characteristics
References
5: Imaging of Climbing Injuries
5.1 X-ray
5.1.1 X-ray Procedures for the Diagnosis of Climbing Injuries
5.1.2 Tips for X-ray Procedures
5.1.3 Fundamentals of X-rays
5.2 Sonography
5.2.1 Sonography for the Diagnosis of Climbing Injuries
5.2.2 Tips for Sonography
5.2.3 Fundamentals of Sonography
5.3 Magnetic Resonance Imaging (MRI)
5.3.1 MRI for the Diagnosis of Climbing Injuries
5.3.2 Tips for MRI
5.3.3 Basics of MRI
5.4 Typical Differential Diagnosis of Climbing Injuries
5.4.1 Pulley Rupture
5.4.2 Stress Fracture of the Growth Plate
5.4.3 Lumbrical Shift Syndrome
5.4.4 Trabecular Microfracture of the Scaphoid
5.4.5 MR Arthrography for Diagnosing Labrum Tear
References
Part II: Orthopedics of the Upper Extremity
6: Hand and Fingers
6.1 Clinical Examination of the Hand
6.2 Diagnostic Imaging
6.2.1 Normal Findings
6.2.2 Distribution of Finger Injuries
6.3 Finger Injuries
6.3.1 Pulley Injuries
6.3.1.1 Clinical Presentation
6.3.1.2 Diagnostic
6.3.1.3 Treatment
6.3.1.4 Outcome
6.3.1.5 Prevention
6.3.2 Finger Flexor Tenosynovitis
6.3.3 Clinical Presentation and Diagnostic
6.3.4 Therapy
6.3.5 Joint Capsule Damage and Collateral Ligament Injury
6.3.5.1 Therapy
6.3.6 Chronic Capsulitis (Intra-Articular Synovitis)
6.3.7 Osteoarthritis
6.3.8 Extensor Hood Syndrome
6.3.9 Flexor Tendon Strains and Tears
6.3.10 Ganglion Cysts
6.3.11 Epiphyseal Growth Plate Fractures in Adolescent Climbers
6.3.11.1 Diagnosis
6.3.11.2 Therapy
6.3.11.3 Results
6.3.12 Lumbrical Shift Syndrome and Lumbrical Muscle Tears
6.3.12.1 Diagnosis
6.3.12.2 Therapy and Outcome
6.3.13 Cellulitis and Other Soft Tissue Infections
6.3.14 Irritations of Finger Nerves
6.3.15 Dupuytren Contracture
6.3.16 Rope-Tangling Injuries, Avulsion Amputations
6.3.17 Fractures
6.3.18 Cartilage Compression Injury
6.4 Conclusion
References
7: Wrist Injuries
7.1 Overview (Statistics)
7.2 Diagnosis
7.3 Bone Edema
7.4 Hamate Fractures
7.5 Dupuytren’s Contracture
7.6 Ulnocarpal Pain Syndromes
7.7 Conclusion
References
8: Elbow and Forearm
8.1 Overview
8.2 Lateral and Medial Epicondylitis
8.3 Tendinopathies of the Biceps, Triceps, and Brachialis Muscles
8.4 Functional Compartment Syndrome of the Forearm Muscles
8.5 Elbow Dislocation (with Vascular Injury)
8.5.1 Elbow Dislocation with Injury to the Brachial Artery
8.6 Muscle Injuries
8.7 Rupture of the Short Head of the Biceps Brachii Muscle Belly
8.8 Distal Biceps Tendon Rupture
8.9 Conclusion
References
9: Shoulder Injuries
9.1 Overview
9.2 Impingement Syndrome
9.3 SLAP Lesions
9.4 Pathologies of the Rotator Cuff
9.5 Shoulder Dislocation
9.6 Rupture of the Long Head of the Biceps Tendon
9.7 Thrombosis of the Subclavian Vein (Paget-Schroetter Syndrome)
9.8 Conclusion
References
Part III: Orthopedics of the Lower Extremity
10: Foot and Ankle
10.1 Introduction
10.2 Modern Climbing Shoes
10.3 Chronic Foot Conditions From Climbing Shoes
10.4 Traumatic Feet Injuries
10.5 Peroneal Tendon Dislocations
10.6 Conclusion
References
11: Hip and Knee Injuries
11.1 Overview (Statistics)
11.2 Diagnosis
11.3 Femoroacetabular Impingement
11.4 Heel Hook Injuries
11.5 Knee Injuries
11.6 Conclusion
References
Part IV: Orthopedics of the Trunk
12: The Spine
12.1 Traumatic Spine Injuries
12.1.1 Back Strain
12.1.2 Fractures of the Spinous or Transverse Process
12.1.3 Hyperextension Fractures and Injuries
12.1.4 Compression and Burst Fractures
12.2 Chronic and Degenerative Back Diseases
12.2.1 Myalgia and Myogelosis
12.2.2 Lumbago
12.2.3 Blocking of Facet Joints and Rip Joints
12.2.4 Herniated Disc or Nucleus Pulposus Prolapsus
12.2.5 Spondylolisthesis/Spondylolysis
12.2.6 Thoracic Outlet Syndrome
12.2.7 Climber’s Back
12.2.8 “Belayer’s Neck” and Cervical Spine Syndrome
References
Part V: Climbing and Age
13: Long-Term Effects of Intensive Rock Climbing to the Hand and Fingers
13.1 Introduction
13.1.1 Clinical Findings
13.2 Adaptive Osseous Reactions
13.3 Long-Term Damage
13.4 Exemplary Cases
13.5 Causes and Therapy
13.6 Summary
References
14: Pediatric Aspects in Young Rock Climbers
14.1 Significance of Climbing for the Early Child Development
14.2 Specifics of Climbing with Children
14.3 Training with Children and Adolescents
14.4 Conclusion
References
15: Climbing in Older Athletes
15.1 Introduction
15.2 Acute and Overuse Injuries
15.3 Degenerative Conditions
15.4 Conclusions
References
Part VI: General Medical Considerations
16: Anorexia Athletica and Relative Energy Deficiency
16.1 Introduction
16.2 RED-S (Relative Energy Deficiency in Sport)
16.3 RED-S in Climbing
16.3.1 Energy and Nutrient Supply in Sport Climbers
16.3.2 Correlations Between Climbing Performance and BMI/Body Fat
16.3.3 Eating Disorders in Climbers
16.4 Definition RED-S CAT and Its Implementation
16.4.1 Red Light
16.4.2 Yellow Light
16.4.3 Green Light
16.4.4 Treatment
16.5 Conclusion
References
17: Sport Climbing with Pre-existing Medical Conditions
17.1 Physiology of Sport Climbing Seen with the Eyes of Exercise Physiology
17.2 Acute Infections
17.3 Sport Climbing with Diabetes Mellitus
17.4 Sport Climbing with Cardiovascular Disease
17.4.1 Hypertension
17.4.2 Coronary Heart Disease (CHD)
17.4.3 Arrhythmia
17.4.4 Cardiac Insufficiency and Valvular defects
17.5 Pulmonary Diseases
17.6 Renal Insufficiency
17.7 Seizures
17.8 Conclusion
References
18: Sport Climbing During Pregnancy
18.1 Synopsis
18.2 Conclusion
References
19: Sports-Medical Supervision of Competition Climbers and Climbing Competitions
19.1 Introduction
19.2 Climbing Team Examinations
19.2.1 Orthopedic Aspects
19.2.2 Pediatric and Medical Aspects
19.2.3 Cardiac Aspects
19.3 Climbing Competition Care
19.4 Conclusion
References
Part VII: Rehabilitation and Prevention
20: Climbing Injury Rehabilitation
20.1 Introduction
20.2 Rehabilitation and Physical Preparation
20.3 Principles of Management
20.3.1 Early Stage
20.3.2 Middle–Late Stage
20.4 Other Professionals Allied to Performance
20.5 Exercise and Mechanical Loading
20.6 Blood Flow Restriction
20.7 Electrophysical Therapy and Other Therapeutic Adjuncts
20.7.1 Electrophysical Therapy
20.7.2 Extracorporeal Shockwave Therapy
20.7.3 Manual Therapies
20.7.4 Joint Mobilisation and Manipulation
20.7.5 Evidence for Clinical Efficacy
20.7.6 Summary
20.8 Specific Conditions
20.8.1 Lower Limb
20.8.1.1 Acute Hamstring Injury
20.8.1.2 Initial Management
20.8.1.3 Definitive Managment
20.8.2 Ankle Sprains
20.8.2.1 Initial Management
20.8.2.2 Definitive Management
20.8.3 Upper Limb
20.8.3.1 The Painful Wrist
20.8.3.2 Definitive Management
20.8.3.3 Local Assessment
20.8.3.4 Global Assessment
20.8.3.5 Rehabilitation
20.8.4 Closed Traumatic Flexor Tendon Pulley Rupture
20.8.4.1 Initial Management
20.8.4.2 Definitive Management
20.9 Shoulder
20.9.1 Chronic Subacromial Pain Syndromes
20.10 Traumatic Anterior Glenohumeral Dislocation
20.11 Elbow
20.11.1 Tendinopathy
References
21: Injury Prevention
21.1 Introduction
21.1.1 Evaluating Injury Terminology
21.1.2 Evaluating Study Design and Data Collection Procedures
21.1.3 Evaluating Data Processing
21.1.4 Summary
21.2 Monitoring Athletic Load
21.2.1 Introduction
21.2.2 Session Rating of Perceived Exertion (Session-RPE)
21.2.3 Acute Chronic Workload Ratios
21.2.4 Summary
21.3 Contemporary Strategies Used to Develop Soft Tissue Robustness and Fatigue Management
21.3.1 Physical Preparation and Athletic Development
21.3.2 Strategies to Increase the Ultimate Load Profile of Tissues to Mechanical Stress
21.3.3 Strategies to Decrease the Acute and Chronic Stress Imposed upon Tissues
21.3.4 Strategies to Increase the Metabolic Capacity of the Athlete to Encourage Fatigue Resistance
21.3.5 Strategies to Management Fatigue Without Affecting Performance
21.3.6 Summary
References
22: Taping
22.1 Basics
22.2 Pulley Taping (Pulley Injury, Tenosynovitis) (H-taping)
22.3 Finger Middle Joint (PIP Joint)
22.4 Finger Middle Joint Collateral Ligament Injury
22.5 Finger End Joint (DIP Joint)
22.6 Finger Base Joint (MCP Joint)
22.7 Buddy-Taping
22.8 Lumbrical Tape
22.9 Wrist
22.9.1 Taping Technique
22.10 Base Joint of the Thumb
22.11 Hand Taping in Crack Climbing
22.12 Elbow Taping
22.13 Taping of the Ankle
22.14 Conclusion
References
Part VIII: Future Perspectives
23: Future Aspects: Climbing in the Olympics
23.1 Competitive Sport Climbing
23.2 Anti-Doping
23.3 Newbie Syndrome
23.3.1 Conclusion
References