Fingers & Fears:
injury & the role of self-efficacy in
rock climbing
Presented by Gareth Jones
Introduction

Rock climbing is an increasingly
popular recreational activity
despite the obvious inherent risks

Psychological variables have been
shown to be crucial to successful
climbing performance

Psychological factors may play a
key role in the antecedents of
some athletic injuries
Major Influences on Climbing!!
Types of Climbing Behaviour
Bouldering
Traditional Leading
Sport Climbing
Competitive Disciplines
Soloing
Top Roping
Climbing Injuries
Climbers are susceptible to overuse injuries of the upper
limb: Studies consistently report a high prevalence of
finger related injuries (Jones et al, 2008; Shoffl et al, 2003)
 Disruption of the annular pulley system (particularly A2)
 Rotator cuff and shoulder impingement syndromes which
are associated with prolonged and repeated reaching
overhead (Peters, 2001)
 Tendonopathies
Why are the fingers susceptible ?

During the crimp grip wrist
extension increases the mechanical
advantage of the finger flexors and
reduces active insufficiency
(Lockwood, 1998)

Paradoxically this hand position
may increase the pre-disposition of
the climber to injury (Joel et al, 2000)
Why the 3rd & 4th fingers ?

Flexion of the remaining fingers when
holding a one finger pocket may
increase the maximum holding force
up to 48% (Shweizer, 2001)

Lumbrical tears to the third or fourth
lumbrical may occur if the finger is
dynamically loaded (Shweizer 2003)
What is already known on this
topic

Rock climbing is increasingly popular worldwide
 Chronic overuse injuries to the upper extremities,
particularly the fingers, are common in climbers
ascending difficult indoor routes frequently
 Misdiagnosis and delays in treatment occur due to
unfamiliarity with climbing injuries
In consideration of the current literature an
epidemiological study was conducted
Risk Factors for Injury

Only outdoor sport lead grade predicted fall related
injuries (odds ratio (OR) 1.47; 95% confidence
interval (CI) 1.47 to 2.09)
 The frequency and difficulty of all forms of climbing
behaviour were associated with overuse injuries,
with the exception of soloing grade and traditional
lead frequency
 Bouldering grade was the sole predictor of injuries
relating to strenuous moves (odds ratio (OR) 1.24;
95% confidence interval (CI) (1.02 to 1.50)
Jones, Asghar & Llewellyn (2008)
What our study adds

Dedicated climbers operating outdoors at the
highest levels are also at risk of overuse injury,
particularly finger and shoulder overuse injuries

Fall-related injuries are comparatively infrequent,
although often serious and all climbers may incur
them

Physiotherapists, other climbers and physicians
are the key sources of treatment or advice.
Jones, Asghar & Llewellyn (2008)
What of psychological factors
and occurence of injury?
Stress–Athletic Injury Model
Adapted from Andersen and Williams (1998)
Balance of evidence for the model





Personality-injury evidence has produced mixed
results
Empirical support for negative life event stress
Daily hassles has been shown to be a factor one
week prior to injury
Previous injury, fear of re-injury may heighten
anxiety
Most relevant to acute injuries does not explain
overuse
What other factors may be important?
What of overuse injuries?
The role of Self-Efficacy
“belief in one’s capability to organise and execute the
courses of action required to produce attainments”
(Bandura, 1997, p.3)
How are Self-Efficacy beliefs
formed?

Enactive mastery experiences
 Social modelling
 Verbal persuasion
 Physiological arousal
Key point: self-efficacy is reciprically determinate
The games climbers play!!






Pre-inspection
Pre-practice of route
Information from others ‘Beta’
Pre-place strategic runners
‘Head-point’
‘Red-point’
What of ethics?
Self-efficacy research

Associated with the frequency and difficulty of a
wide range of medium and high risk climbing
behaviours
 Key determinate when taking calculated risks in
climbing and shown to be predictive of
performance
(Llewellyn, Sanchez, Ashgar & Jones, 2008)

Does not appear to predict climbing injuries
(Jones, Llewellyn & Ashgar 2007)
Time for a short film
Presenters Research

Jones, G. Llewellyn, D.J. & Asghar, A. (2007) Risk factors
in rock climbing. Proceedings of the 2007 World
Conference of Physical Therapy. Vancouver, Canada.
 Jones G., Asghar A., & Llewellyn DJ. (2008) The
epidemiology of rock climbing injuries. British Journal of
Sports Medicine: 42: 773-778.
 Llewellyn DJ, Sanchez X., Ashghar A., Jones G. (2008)
Self-efficacy, risk taking and performance in rock
climbing. Personality & Individual Differences : 45: 75-81.
 Sanchez X, Lambert PH, Jones G, Llewellyn DJ. (2010)
Efficacy of pre-ascent climbing route visual inspection in
indoor sport climbing. Scandinavian Journal of Medicine
and Science in Sports