My name is Oliver Rivera and I am a physical therapist at UIC. You may have seen me at the Uptown or Block 37 locations last March and April trying to recruit FA members to participate in my research study.
For a little background on me, I am a suburban Chicago native who finished up physical therapy school in June of 2017 in Las Vegas. It was in Nevada at Red Rock Canyon where I developed my passion for climbing. Recently, I completed a 13 month orthopedic physical therapy residency at the University of Illinois at Chicago where I was required to create a research project on something related to my field. From what I saw, there currently is a gap in research related to rock climbing, so I thought it would be the perfect opportunity to combine some of my passions.
As a climber who has experienced a few wrist and hand injuries, I was very interested in whether there were any specific characteristics of the wrist or hand that could predict injuries in rock climbers. I spoke with my climbing friends, fellow physical therapists at UIC, and a few climbing specific physical therapists across the country to identify characteristics that would be interesting to look at in terms of possible correlations with wrist and hand injuries. We identified a variety of factors worth investigating, including climbing experience, climbing frequency, climbing ability, grip strength, wrist flexor and extensor strength, wrist flexor/extensor strength ratio, wing span, ape index, digit length and width, and digit length/width ratio. Climbers frequently discuss many of the factors regarding strength as areas to possibly focus on during their training, so this study has the potential to better inform the climbing community on areas that they should or shouldn’t be concerned about in their training, as well as what matters or not in regards to body type.
For the study, we used a survey based design to obtain questions about climbing specific information such as ability, frequency, and injury history, and then took measurements of all the strength and anthropometric characteristics that interested us. In total, 98 climbers participated in the study. Prior to running the analysis, I hypothesized that wrist flexor/extensor strength ratio and digit length/width ratio would demonstrate the strongest correlation with wrist or hand injury in climbers. Specifically, I believed that someone with an “imbalanced” wrist flexor/extensor strength ratio, and someone with narrower and longer fingers would be at a greater risk of sustaining an injury.
With the help of a statistician, we ran an analysis of the whole data set to look for significant interactions between all of the variables we recorded. Unfortunately, no significant interactions were found between any of the objective measurements we took. These findings were disappointing, as the goal of the study was to find some type of objective measure that could possibly predict wrist or hand injury in climbers. However, the positive takeaway from these findings is that none of the objective variables mattered in terms of influencing injury risk; there may not be a specific body characteristic or strength measurement that increases injury risk.
After the analysis, we did find two significant interactions within our survey data. A significant correlation was present between the following: wrist/hand injury and self reported climbing experience, and wrist/hand injury and self reported climbing ability.
At first glance, these findings make sense, since the longer you participate and the higher difficulties you encounter in climbing, the longer your exposure and the higher the risk you have sustaining any type of injury. What I also interpret from these findings is that what the climbing community may believe to be important for injury prevention may not be as vital as knowledge of tissue adaptation and a solid training program progression.
From my research, I learned an interesting fact about the climbing community. For a majority of injuries, climbers do not seek medical attention. A primary reason is that the majority of injuries climbers endure are minor (strains, sprains, and contusions) and heal in a short amount of time. However, another reason found in the literature was that climbers do not trust medical professionals with their knowledge of climbing and climbing related injuries. As a physical therapist, I can say that PTs spend their education learning about tissue injury, healing, adaptation, and rehabilitation. Our profession is now at a doctoral level, and with direct access to physical therapy recently passed as Illinois law, PT’s are more qualified than ever to assist the climbing community directly with the education and rehabilitation of climbing related injuries. For athletes, understanding tissue adaptation and being smart about training progressions can play a pivotal role in injury prevention and rehabilitation.
If you are looking for guidance with injury prevention or rehabilitation, any physical therapist can provide helpful insight, and seeking a PT with a climbing background or orthopedic/sports training can also help. Look for credentials such as OCS, SCS, or FAAOMPT: therapists with these credentials often go through additional education to become specialists in their field.
First Ascent will also run Finger Injury Prevention workshops at all locations over the next couple of months with fellow FA member Dr. James Lee – be sure to sign up for one to go into even more depth about injury prevention.
I recently underwent ACL surgery 2 months ago from a soccer injury so climbing has been on hold for me. However I hope to be back in at First Ascent in the next 2-3 months, so if you see me around, feel free to say hi and ask any questions. You can also reach me at firstname.lastname@example.org.
By Oliver Rivera, a Chicago-based climber and physical therapist.