Risk profiles in two different alpine rock climbing styles

The aim of this study is to evaluate the injury risk profile of the two different styles of rock climbing, alpine climbing with minor route protection (AC) and alpine sport climbing on well-protected routes (SC), in order to develop preventive strategies for risk management.  PATIENTS AND METHODS : 18 SC and 12 AC rock climbing accidents were evaluated retrospectively with a focus on climbers` demographics (age, experience, training intensity, performance level), accident demographics (unforeseen events preceding the injury, ascending or descending, fall height), injury patterns (injury severity, pathologies, pathomechanism) and environmental conditions (rock characteristics, route frequency, route grade, weather).  RESULTS : Injuries were mainly sustained by male lead climbers during ascent (80%). The lower extremity was injured in 46%, the upper extremity in 40%, the pelvis in 6% and the head, chest and spine in 3%. Climbers were significantly older (43 vs. 31 years; p=0.03) and more experienced (21.5 vs. 5.7 climbing years) in AC. Falling height was significantly greater in AC (14.8 vs. 4.7m). Unforeseen events preceding the injury differed significantly between both groups. Slipping off and letting go preceded the fall in 78% in SC, while rock dislodging occurred only in AC. There was a tendency that climbers in SC climbed near or above their performance level, while climbers in AC climbed below their level. SC climbers tended to show more ankle fractures while AC climbers tended to present more cases with multiple injuries.

AC and SC climbers differ in their risk profiles. Poorer route protection in AC resulted in more severe injuries. Yet in SC routes, good protection alone was not enough to avoid severe injuries. For prevention, climbers should be aware of the specific risks in AC and SC routes and should adjust their behaviour accordingly. Athletic skills were overestimated in SC, while alpine demands were underestimated in AC. A higher focus on visual and haptic grip control may help to prevent loss of hold. A careful lining of the rope into solid rock can reduce rockfalls for the seconder. Continuous attention is mandatory in rope handling and belaying. Applying more mobile pros is recommended in AC because they may shorten fall heights.