Risk Factors and Injury Prevention Among Female Rock Climbers

BACKGROUND: Female climbers are underrepresented in the literature on rock climbing injuries despite their increasing participation in the sport and higher risk for certain health conditions, especially those related to menstrual dysfunction and bone mineral density. We aimed to investigate potential risk factors for injury as well as possible protective behaviors among recreational female climbers. METHODS: We designed and distributed a 31-question survey on health and demographic characteristics, rock-climbing experience, training behaviors, and injury in the past 12 months. The survey was distributed via 6 online rock-climbing forums and 2 physical locations at rock-climbing gyms in Baltimore County, MD. Female climbers >18 years were invited to participate. Analyses were conducted to compare basic demographic characteristics of climbers with and without injury in the past year as well as to investigate associations between injury and potential risk factors. RESULTS: Nine hundred ninety-seven female climbers completed the survey. In bivariate analysis, warming up with activities other than climbing was significantly associated with injury in the past year compared to warming up with climbing only. After adjusting for hours per week climbing and relevant health conditions and training behaviors, climbers who participated in bouldering were more likely to have experienced injury in the past year (odds ratio [OR] = 1.69; 95% confidence interval [CI] 1.10–2.64; p = 0.018), whereas climbers who regularly participated in other sports were less likely to have experienced injury (OR = 0.65; 95% CI 0.48–0.87; p = 0.005). History of an eating disorder was associated with injury when adjusting for age, diagnosis of amenorrhea, and diagnosis of another physical health condition (OR = 1.53; 95% CI 1.02–2.33; p = 0.043). CONCLUSION: Cross-training and climbing-specific warm-up routines may be protective against injury among female climbers, but bouldering may have a higher risk of injury compared to other climbing disciplines. Clinicians should be aware that climbers with eating disorders may be at particularly high injury risk. Continued investigation into safe training practices is essential to ensure the long-term health and performance of recreational female climbers.