Rock Climber Research Articles

Revision Pulley Reconstruction in a Rock Climber for Phalanx Bone Resorption With Extensor Retinaculum Slip: A Case Report and Technique Review

Revision Pulley Reconstruction in a Rock Climber for Phalanx Bone Resorption With Extensor Retinaculum Slip: A Case Report and Technique Review

Clinical management of finger joint capsulitis/synovitis in a rock climber.

This case study presents a 23-year-old male recreational rock climber, who climbed an average of 3-4 times per week and presented with finger joint capsulitis/synovitis after increasing his climbing intensity and training from moderate to high over 6 months, which led up to injury. During the exam, the diagnosis was ruled in with clinical orthopedic testing. Additional movement analyses revealed improper gripping mechanics contributing to asymmetric finger loading. A comprehensive rehabilitation program was developed based on the concept of a progressive framework that included unloading of the affected tissues, increasing mobility, improving muscle performance, and correcting suboptimal climbing movements. After 6 weeks, the climber's pain 24 h after climbing, which was rated on a visual analog pain scale (VAS), decreased from 5.5/10 to 1.5/10 and 0/10 at the 12-month follow-up. His patient-specific functional scale improved from 0% at the initial evaluation to 43% after 6 weeks and to 98% after 12 months. His sports-specific disabilities of the arm, shoulder, and hand improved from 69% to 34% to 6% during the initial evaluation, 6-week follow-up, and 12-month discharge. He made a full recovery to his previous grade of V8 bouldering. This is the first case study of its kind to provide a rehabilitation framework for the management of finger joint capsulitis/synovitis in a rock climber.

Editorial

Editorial

Successful Glenohumeral Shoulder Reduction With Combined Suprascapular and Axillary Nerve Block

BackgroundAnterior glenohumeral dislocation is a common injury seen in the emergency department (ED) that sometimes requires procedural sedation for manual reduction. When compared with procedural sedation for dislocation reductions, peripheral nerve blocks provide similar patient satisfaction scores but have shorter ED length of stays. In this case report, we describe the first addition of an ultrasound-guided axillary nerve block to a suprascapular nerve block for reduction of an anterior shoulder dislocation in the ED. Case ReportA 34-year-old man presented to the ED with an acute left shoulder dislocation. The patient was a fit rock climber with developed muscular build and tone. An attempt to reduce the shoulder with peripheral analgesia was unsuccessful. A combined suprascapular and axillary nerve block was performed with 0.5% bupivacaine, allowing appropriate relaxation of the patient's musculature while providing excellent pain control. The shoulder was then successfully reduced without procedural sedation. Why Should an Emergency Physician Be Aware of This?Procedural sedation for reduction of anterior shoulder dislocations is time consuming, resource intensive, and can be risky in some populations. The addition of an axillary nerve block to a suprascapular nerve block allows for more complete muscle relaxation to successfully reduce a shoulder dislocation without procedural sedation.

John Graham Ramsay. 17 June 1931—12 January 2021

John Ramsay was a scientific polymath, the finest structural geologist of his generation, with superb field mapping skills and a solid grasp of mathematics and engineering. He was also accomplished as a cellist, painter in oils, runner, cyclist, linguist, poet, cook, skier and rock climber. He was a gifted scientist and aesthete who saw beauty in the natural world and sought it in all his work. His fundamental contributions, in 94 papers and four books, modernized structural geology, enabling us to understand the deformation of rocks in completely new ways. He was ‘Father’ of modern structural geology, great scientist and renaissance man.

Multiple Flexor Tendon Pulleys Injury in Korean Rock Climber

Multiple Flexor Tendon Pulleys Injury in Korean Rock Climber

Multiple Flexor Tendon Pulleys Injury in Korean Rock Climber

Multiple Flexor Tendon Pulleys Injury in Korean Rock Climber

Don't Panic: Remaining El Capitan While Navigating Unpreparedness in Response to Extreme Events

Company leaders are frequently confronted with highly uncertain and risky situations for which they are often ill-prepared, and consequently, in which they often panic. Based on an exploratory case study of extreme rock climber Alexander Honnold, we have developed propositions that help decision-makers to learn to avoid panic in crises. Our findings suggest that gradual exposure to incrementally more challenging tasks by adjusting individual learning goals allows decision-makers to leverage existing skills, and to develop their physical, mental and emotional states simultaneously. Deliberate confrontation with the challenges that may trigger panic through real-life simulation and imagination helps decision-makers to retrain and transform triggers for panic responses, and to build systemic confidence. This organic and holistic growth provides decision-makers with the simultaneous preparation and mastery of their physical, mental, and emotional states to ensure the lightness and calmness necessary not to panic when facing a crisis.

Macro- and microhabitat use patterns of holothurians in Buena Vista, Nggela, Solomon Islands: rock climber and bottom crawler species

Densities and habitat use patterns of holothurians, including nocturnal species, were assessed in Buena Vista, Nggela, Solomon Islands, for community-based resource management. Nighttime snorkeling surveys were conducted along transects (maximum 1.6 km) with 3 to 5 searchers in nearshore, channel, and outer reef macrohabitats. Only the population in the seagrass macrohabitat was separately assessed in 30 m line transects during the daytime. Microhabitats were clearly separated between species living on 3-dimensional structures (e.g. surfaces of knolls and reef slopes; rock climber group) and those on flat bottoms (bottom crawler group), although they coexisted at macrohabitat scales. Potential shelters adjacent to each individual differed between the 2 groups. Among bottom crawler species, Bohadschia koellikeri, which was recently taxonomically divided from B. vitiensis, occupied macrohabitats intermediately ranging between those of B. argus in the channel and outer reef macrohabitats and those of B. vitiensis and B. marmorata in the nearshore and seagrass macrohabitats. The high-density population was observed in the seagrass macrohabitat, mainly composed of Holothuria scabra, B. marmorata, and H. fuscogilva, although most individuals of these species were smaller than the national legal size limits. Moreover, the body lengths of H. atra and H. fuscogilva increased from the seagrass macrohabitat to the outer reef macrohabitat, implying their migration during growth and the roles of seagrass areas as nurseries. These results revealed diversity of macro- and microhabitat use patterns among species and their growth stages and highlight the importance of considering these factors for conserving diverse species by areal-based protection measures.

DEVELOPMENT OF CLIMBING CLOTHES USING COMPUTERIZED 3D CLOTHING SIMULATION

The purpose. This paper aims to explore the applicability of computerized 3D virtual clothing simulation programs for the development of patterns for men’s rock climbing pants. Methodology. The experiment involved comparative methods of virtual wearing, as well as pressure points, perspective map and appearance evaluations. The theoretical and methodological basis of the research are scientific works presenting data from 3D virtual fitting software. Results. The study selected three designs of climbing pants to compare the layout of patterns and to analyze the appearance through virtual garment fit maps. First, the 2D-to-3D was applied to develop garment patterns of a rock climber’s pants. The patterns were developed directly in the 3D software. The flat patterns can be visualized in the sewing/assembly stage of the prototype. Then, 3D animation technology was used in simulation. The results throughout the study were: 1) 3D simulation of three different types of pants design. 2) Evaluating the fit and comfort of the clothing using garment fitting maps. 3) Identifying the most discomforting parts of the patterns, thigh, hip, waist, pants hem and knee girth. 4) Modify and adjust the clothing according to the evaluation situation. Scientific novelty consists in providing a systematic methodology of utilizing 3D simulation for a specific category of wearers, such as rock climbers. Practical significance. The considered research directions of 3D clothing simulation can be used by designers and patternmakers in the creative and experimental process of designing clothes expanding the possibilities of software to transform functional design in the industry and research.

Comparisons of Some Selected Physiological and Physical Aspects of Snow Skaters and Rock Climbers of Jammu and Kashmir

Researchers have shown their interest in taking up this issue to assess and compare several physical and physiological variables between snow skaters and rock climbers JAMMU and KASHMIR. The investigators limited their studies to physical and physiological variables: flexibility, BMI, tidal volume, and cardiovascular endurance. The study was conducted on 60 players, all subjects were from JAMMU and KASHMIR, and the sampling technique adopted for topic selection from both groups was carried out through the random sampling method. Data for comparing various physical and physiological variables is collected through standardized and scientifically approved testing devices. The standard deviation calculated from the snow-skaters' four variables and rock-climbing JAMMU and KASHMIR, namely the mean and standard deviation of the rock climber's tidal volume, is (455.74 ± 78.94), and the mean and standard deviation of the tidal volume of the snow rate. Skaters were (497.3 ± 82.07), with a mean difference of 42.56. The mean and standard deviation of rock climbers' BMI were (20.76 ± 1.04) and snowboarding (23.54 ± 1.89), respectively, with a mean difference of 2.77. The mean and standard deviation of rock climber flexibility is (24.65 ± 4.3) and snow skater sane is (21.74 ± 4.01) with a mean difference of 2.91, mean and standard deviation of vo2 Max snow skater is (58.24 ± 3.68) and the mean and standard deviation of vo2max calculated from the rock climber is (70.4 ± 4.03) with a mean difference of 11.8. Therefore rock climbers were excellent at all BMI, lung tidal volume, and endurance but lower in flexibility than snow skaters. The practical implications of this study show that rock climbing is better for overall health than snowboarding. Not much effort is required for snowboarding as it is necessary for rock climbing, which may cause better physical and physiological development of the rock climbing profile.

Assessment of myofascial stiffness of flexor digitorum superficialis muscles in rock climbers

Myofascial stiffness is the biomechanical property that can be considered as a modifiable risk factor injury of athletes. Moreover, the level of muscle stiffness can be crucial to assessment muscle adaptation to exercise. However, stiffness of flexor muscles in rock climbers has never been investigated. The purpose of this study was to evaluate the myofascial stiffness of the flexor digitorum superficialis (FDS) in the rock climbers. The group of rock climbers (n = 16) has been compared to the non-climbers group (n = 16), matched in terms of anthropometric measures and an average level of physical fitness. Moreover, the impact of the one-time rock climbing training on FDS stiffness was assessed in the rock climbers group. The measurement of myotonometric myofascial stiffness of FDS muscles was performed, when the elbow was flexed and fully extended. In both positions, the measurements were taken with the hand open and closed. It has been shown that rock climber's FDS muscle stiffness before training was significantly higher (from 15 to 20%) compared to non-climbers group. Moreover, after climbing myofascial stiffness of FDS muscles increased significantly from 25 to 40%. Rock climbers have significantly higher stiffness of FDS muscles after rock climbing training. Moreover, the increased stiffness in the FDS differentiates rock climbers from the active and healthy control group. Results may indicate that decrease of muscle stiffness of FDS can be an important factor for the improvement of the climbing effectiveness and prevention of overload in the forearm flexor muscles and their recovery.

Virtual Reality Body Image Training for Chronic Low Back Pain: A Single Case Report

Background: Virtual reality (VR) allows people to embody avatars that are different from themselves in appearance and ability. These experiences provide opportunities to challenge bodily perceptions. We devised a novel VR Body Image Training (VR-BIT) approach to target self-perceptions and pain in people with persistent pain. Methods: A 45-year old male with a 5-year history of disabling chronic low back pain participated in a 4-week VR-BIT intervention. Pain began following a fall from a first-floor deck. Pain was central and on the right side of his lower back, radiating to his right buttock and thigh. Pain was constant and varying at a 5/10 average intensity. The 4-week intervention consistent of three face-to-face sessions 1-week apart, followed by 1-week of in-home VR-BIT. During the first face-to-face session, the participant embodied three athletic avatars: a superhero (Incredible Hulk), a boxer, and a rock climber. Since the participant strongly identified with the boxer, only boxing experiences were subsequently used. Primary outcomes relating to body image (self-perceived strength, vulnerability, agility, and confidence with activity) and pain intensity were assessed using numerical rating scales (0–10 NRS). Disability, kinesiophobia, overall change, and self-efficacy were assessed as secondary outcomes. Outcomes were assessed during each face-to-face session, and at 1-week and 3-month follow-up. Results: The participant reported a high degree of engagement. Positive changes were noted during and after VR for all body image and pain assessments. Improvements were retained at 3-months for body image ratings (mean change: 4.5/10 NRS) and average pain intensity (change: 2/10 NRS). Improvements in disability (45% improvement); self-efficacy (pre: 2/12; post: 10/12); and overall change (“Very much improved”) were noted at 3-month follow-up. No change in kinesiophobia was detected. No adverse advents were recorded. Conclusion: The participant engaged strongly with the intervention and showed clinically meaningful changes in body image, pain, disability, and self-efficacy. Despite his long history of pain and rapid improvements, reported changes may be due to non-treatment effects. Nonetheless, VR-BIT clearly warrants further investigation as a potential addition to usual care.

The public loneliness of endurance athletes: Creating ambient affiliation through involvement strategies on Twitter

The accessibility and interactivity of Twitter both facilitate athlete-fan interaction and contribute to the time/space compression between sporting events and communication about them. While numerous studies investigate real-time participatory engagement of fans on Twitter, athletes’ use of Twitter during competition remains underexplored. Using a case study approach, this study brings together computer-mediated discourse analysis and prior work on involvement in discourse to examine tweets posted during competitive events by two endurance athletes (an experienced amateur marathon runner and an elite rock climber). Specifically, it explores how athletes mobilize various linguistic strategies to create relations of connectedness, or ambient affiliation (Zappavigna, 2011), with their respective audiences who are distanced spatially and often temporally. It also demonstrates how the affordances and limitations of technology, and the constraints of the athletic events themselves, shape ambient involvement. In this way, this work adds to our understanding of how ambient affiliation is constructed in a particular context – a competitive athletic event of an endurance athlete practicing a solitary sport – while also shedding light on how involvement is created and maintained with a largely unknown online audience.

The closed traumatic rupture of long finger flexor tendon pulley in rock climber: A case report

The closed traumatic rupture of long finger flexor tendon pulley in rock climber: A case report

Traitement par suture directe des ruptures de poulies chez le grimpeur de haut niveau avec rééducation active postopératoire

Closed traumatic rupture of the finger flexor tendon pulleys is rare among the general population but is seen much more commonly in rock climbers. There is no evidence-based published guidelines on the surgical treatment of these on closed traumatic ruptures of finger flexor pulleys which still presents difficult challenges. Different surgical repair options exist based on the use of grafted material to replace the ruptured pulley or pulleys, but direct repair has never been presented as an option. In this study, we retrospectively reviewed 8 cases of closed traumatic rupture of the flexor tendon pulley with simple repair and active re-education postoperative in high level rock climbers. Eight high level rock climbers were operated on between July 2015 and July 2018 for complete flexor tendon pulley ruptures. Postoperative improvement was evaluated by rock climber level, compared to the initial level. We performed a direct repair of the injured pulley with 4/0 absorbable separated sutures. An ultrasound examination of the sutured pulley was performed for 3 patients after 3 years postoperative. The average time of surgery was 16 minutes on average (range: 13–25 minutes). According to the Buck-Gramcko score, all injured fingers showed an excellent result. Finger diameter, Functional gene and JAMAR have been evaluated. They regained their climbing level after 5.8 months on average (range: 3–8 months). The ultrasound found 3 patients with pulley continuity and solid during their movements. Simple suturing of flexor tendon pulley in high level rock climbing and active re-education postoperative seems to be an alternative surgical treatment in acute situation.

Custom-made total talonavicular replacement in a professional rock climber: functional evaluation with gait analysis and 3D video-fluoroscopy

Custom-made total talonavicular replacement in a professional rock climber: functional evaluation with gait analysis and 3D video-fluoroscopy

Efficacy of corticosteroid injection in rock climber's tenosynovitis

While many finger conditions in climbers have been studied extensively, no data exist on the treatment of rock climber's finger flexor tenosynovitis. The purpose of this study was to evaluate the outcomes after corticosteroid injection. The study included rock climbing athletes suffering from chronic (longer than 6 weeks) finger flexor tenosynovitis who were seen at our clinic in 2017. All 42 patients received two corticosteroid injections within a 7–10 day period. Thirty-one climbers (73.8%) were pain free after the second injection and a mean of 20.9±23.1 days. The climbers reported an 84.2% decrease in pain level and no complications. The positive outcome after corticosteroid injection therapy and the absence of complications justifies this invasive approach in rock climbing athletes.

WITHDRAWN: Custom-made total talonavicular replacement in a professional rock climber: Functional evaluation with gait analysis and 3D video-fluoroscopy

WITHDRAWN: Custom-made total talonavicular replacement in a professional rock climber: Functional evaluation with gait analysis and 3D video-fluoroscopy

Rock Climber Self-Rescue Skills

Rock climbing involves some inherent danger, and rock climbers should be able to carry out basic rescue techniques for their own safety. This study seeks to assess such abilities by examining self-rescue skills in a cohort of rock climbers. Climbers who participate in multipitch sport or traditional climbing styles were recruited via posters at a local climbing gym and on social media. Participants completed a survey assessing climbing history and confidence in their rescue skills and then were evaluated on 3 rescue scenarios in an indoor, standardized setting. Scenario pass rates were calculated and compared with rescue skill confidence on the survey. Twenty-five climbers participated in the study. Mean confidence in rescue skills varied from 4 to 4.5 (on a 7-point scale). The pass rates for the 3 scenarios were 28%, 68%, and 52%. Only 24% of climbers passed all 3 scenarios. Surveyed confidence in rescue skills and pass rate statistically correlated in only 1 scenario. Self-rescue skills were generally lacking in our study population. Climber confidence, experience, training, and climbing frequency did not appear to be associated with a higher level of rescue skills. Self-rescue skills should be emphasized in climbing instruction and courses to increase overall safety.