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 3 rd & 4 th 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: 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:  Llewellyn DJ, Sanchez X., Ashghar A., Jones G. (2008) Self-efficacy, risk taking and performance in rock climbing. Personality & Individual Differences : 45:  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