Research Article| Volume 53, ISSUE 4, P1394-1400, April 2022

Characteristics of bouldering injuries based on 430 patients presented to an urban emergency department

Published:February 05, 2022DOI:


      • The five most commonly injured anatomical regions in acute bouldering accidents are the ankle, knee, elbow, spine and shoulder.
      • Especially unexperienced athletes and patients with more severe injuries often quit bouldering after an acute bouldering injury.
      • Injuries to the lower extremity are common among the acute injuries of our population wherease chronic injuries typically affect the upper extremity more often.



      Bouldering is a climbing sport that has been attracting a greater number of recreational and professional athletes over recent decades, which has led to an increase in sport-related injuries. The aim of this study was to determine the characteristics and the types of acute injuries caused by bouldering. Further athlete-specific factors and covariates for the trauma types were investigated.

      Materials and methods

      In this retrospective analysis, all patients presented to the level 1 trauma center at the hospital of the Technical University of Munich after an acute trauma related to bouldering were identified via the hospital documentation system. The period of observation was ten years, from 2010 until 2020. Epidemiological and injury-specific information as well as the initial treatment were registered. In a second step, the affected patients were invited to participate in an online survey in order to collect information about their skills, experience, and details about the trauma.


      A total of 430 patients with 447 acute injuries were identified. There were 244 injuries among female and 203 injuries among male patients. The most common anatomical region affected was ankle (36.7%), knee (16.8%), elbow (12.3%), spine (7.2%) and shoulder (6.3%). The majority of 273 (61.1%) injuries were located at the lower extremities. The most frequent types of injury were sprains (53.0%), fractures (22.8%) or joint dislocations (11.9%). Surgical treatment was necessary for 89 (19.9%) patients. A return to bouldering was more likely in male patients 50 (75.8%) than in females 47 (59.5%) (p = 0.038). Subjectively, inexperienced boulderers were also less likely to return to the sport than advanced boulderers with greater experience (p = 0.001)


      The incidence of bouldering injuries is rising. Typical bouldering injuries could be identified and quantified at least for those patients who were presented to a hospital emergency department. Injuries in this setting do differ from the injury types known from rock climbing injuries as they are located on the lower extremity more often. Injuries of the fingers and hand, which are common climbing injuries, have been barely encountered in the emergency center.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Schöffl V.
        Rock and Ice-Climbing Medicine.
        in: Feletti F Extreme Sports Medicine. Springer International Publishing, Cham2017: 109-121
        • Josephsen G.
        • Shinneman S.
        • Tamayo-Sarver J.
        • Josephsen K.
        • Boulware D.
        • Hunt M.
        • et al.
        Injuries in bouldering: a prospective study.
        Wilderness Environ Med. 2007; 18 (2007/12/01/): 271-280
      1. German-Alpine-Club. 2021.

        • Nelson N.G.
        • McKenzie L.B.
        Rock climbing injuries treated in emergency departments in the U.S., 1990-2007.
        Am J Prev Med. 2009; 37: 195-200
        • Buzzacott P.
        • Schoffl I.
        • Chimiak J.
        • Schoffl V.
        Rock climbing injuries treated in US emergency departments, 2008-2016.
        Wilderness Environ Med. 2019; 30: 121-128
        • Schöffl V.
        • Lutter C.
        • Popp D.
        The "Heel Hook"-A climbing-specific technique to injure the leg.
        Wilderness Environ Med. 2016; 27: 294-301
        • Backe S.
        • Ericson L.
        • Janson S.
        • Timpka T.
        Rock climbing injury rates and associated risk factors in a general climbing population.
        Scand J Med Sci Sports. 2009; 19: 850-856
        • Paige T.E.
        • Fiore D.C.
        • Houston J.D.
        Injury in traditional and sport rock climbing.
        Wilderness Environ Med. 1998; 9: 2-7
        • Schöffl V.
        • Morrison A.
        • Schoffl I.
        • Kupper T.
        The epidemiology of injury in mountaineering, rock and ice climbing.
        Med Sport Sci. 2012; 58: 17-43
        • Schöffl V.R.
        • Hoffmann G.
        • Küpper T.
        Acute injury risk and severity in indoor climbing—a prospective analysis of 515,337 indoor climbing wall visits in 5 years.
        Wilderness Environ Med. 2013; 24 (2013/09/01/): 187-194
        • Pierpoint L.
        • Klein M.
        • Comstock R.D.
        Epidemiology of rock climbing injuries treated in united states emergency departments, 2006–2015.
        Br J Sports Med. 2017; 51: 374
        • Woollings K.Y.
        • McKay C.D.
        • Kang J.
        • Meeuwisse W.H.
        • Emery C.A.
        Incidence, mechanism and risk factors for injury in youth rock climbers.
        Br J Sports Med. 2015; 49: 44-50
        • Schöffl V.
        • Popp D.
        • Küpper T.
        • Schöffl I.
        Injury trends in rock climbers: evaluation of a case series of 911 injuries between 2009 and 2012.
        Wilderness Environ Med. 2015; 26: 62-67
        • Schöffl V.
        • Lutter C.
        • Woollings K.
        • Schöffl I.
        Pediatric and adolescent injury in rock climbing.
        Res Sports Med. 2018; 26: 91-113
        • Grønhaug G.
        • Norberg M.
        First overview on chronic injuries in sport climbing: proposal for a change in reporting of injuries in climbing.
        BMJ Open Sport Exerc Med. 2016; 2e000083
        • Schöffl V.
        • Burtscher E.
        • Coscia F.
        Injuries and medical incidences during the IFSC 2012 climbing world cup series.
        Med Sport. 2013; 17 (12/20): 168-170
        • Morrison A.B.
        • Schöffl V.R.
        Physiological responses to rock climbing in young climbers.
        Br J Sports Med. 2007; 41: 852-861
        • Schoeffl V.
        • Hochholzer T.
        • Lightner S.
        One move too many...: how to understand the injuries and overuse syndromes of rock climbing.
        Sharp End Publishing, 2016
        • Rae K.
        • Orchard J.
        The orchard sports injury classification system (OSICS) version 10.
        Clin J Sport Med. 2007; 17: 201-204
        • Schöffl V.
        • Morrison A.
        • Hefti U.
        • Ullrich S.
        • Küpper T.
        The UIAA medical commission injury classification for mountaineering and climbing sports.
        Wilderness Environ Med. 2011; 22 (2011/03/01/): 46-51
        • Jones G.
        • Asghar A.
        • Llewellyn D.J.
        The epidemiology of rock-climbing injuries.
        Br J Sports Med. 2008; 42: 773-778
        • Lum Z.C.
        • Park L.
        Rock climbing injuries and time to return to sport in the recreational climber.
        J Orthop. 2019; 16 (Jul-Aug): 361-363
        • McDonald J.W.
        • Henrie A.M.
        • Teramoto M.
        • Medina E.
        • Willick S.E.
        Descriptive epidemiology, medical evaluation, and outcomes of rock climbing injuries.
        Wilderness Environ Med. 2017; 28: 185-196
        • Neuhof A.
        • Hennig F.F.
        • Schöffl I.
        • Schöffl V.
        Injury risk evaluation in sport climbing.
        Int J Sports Med. 2011; 32 (//26.09.2011): 794-800
        • Pieber K.
        • Angelmaier L.
        • Csapo R.
        • Herceg M.
        Acute injuries and overuse syndromes in sport climbing and bouldering in Austria: a descriptive epidemiological study.
        Wien Klin Wochenschr. 2012; 124 (2012/06/01): 357-362
        • Kubiak E.N.
        • Klugman J.A.
        • Bosco J.A.
        Hand injuries in rock climbers.
        Bull NYU Hosp Jt Dis. 2006; 64: 172-177
        • Lutter C.
        • Schweizer A.
        • Hochholzer T.
        • Bayer T.
        • Schöffl V.
        Pulling harder than the hamate tolerates: evaluation of hamate injuries in rock climbing and bouldering.
        Wilderness Environ Med. 2016; 27 (Dec): 492-499
        • Lutter C.
        • Tischer T.
        • Cooper C.
        • Frank L.
        • Hotfiel T.
        • Lenz R.
        • et al.
        Mechanisms of acute knee injuries in bouldering and rock climbing athletes.
        Am J Sports Med. 2020; 48: 730-738
        • Orbach H.
        • Rubin G.
        • Wolovelsky A.
        • Rinott M.
        • Giwnewer U.
        • Rozen N.
        [Hand injuries in rock climbers].
        Harefuah. 2016; 155: 407-409
        • Sandmann G.H.
        • Siebenlist S.
        • Lenich A.
        • Neumaier M.
        • Ahrens P.
        • Kirchhoff C.
        • et al.
        [Traumatic elbow dislocations in bouldering].
        Unfallchirurg. 2014; 117 (2014/03//): 274-280
        • Schöffl V.
        • Simon M.
        • Lutter C
        [Finger and shoulder injuries in rock climbing].
        Orthopade. 2019; 48: 1005-1012
        • Lutter C.
        • Hotfiel T.
        • Tischer T.
        • Lenz R.
        • Schöffl V.
        Evaluation of rock climbing related injuries in older athletes.
        Wilderness Environ Med. 2019; 30: 362-368
        • Folkl A.K.
        Characterizing the consequences of chronic climbing-related injury in sport climbers and boulderers.
        Wilderness Environ Med. 2013; 24: 153-158
        • Grønhaug G.
        Self-reported chronic injuries in climbing: who gets injured when?.
        BMJ Open Sport Exerc Med. 2018; 4e000406
        • Grønhaug G.
        Lean and mean? Associations of level of performance, chronic injuries and BMI in sport climbing.
        BMJ Open Sport Exerc Med. 2019; 5 (01/03)e000437
        • Jones G.
        • Llewellyn D.
        • Johnson M.I.
        Previous injury as a risk factor for reinjury in rock climbing: a secondary analysis of data from a retrospective cross-sectional cohort survey of active rock climbers.
        BMJ Open Sport Exerc Med. 2015; 1
        • Wright D.M.
        • Royle T.J.
        • Marshall T.
        Indoor rock climbing: who gets injured?.
        Br J Sports Med. 2001; 35: 181-185
        • Auer J.
        • Schoffl V.R.
        • Achenbach L.
        • Meffert R.H.
        • Fehske K.
        Indoor bouldering-a prospective injury evaluation.
        Wilderness Environ Med. 2021; (May 6)
        • Debieux P.
        • Wajnsztejn A.
        • Mansur N.S.B.
        Epidemiology of injuries due to ankle sprain diagnosed in an orthopedic emergency room.
        Einstein (Sao Paulo). 2020; 18: eAO4739
        • Schöffl V.
        • Lutter C.
        The “Newbie” syndrome.
        Wilderness Environ Med. 2017; 28 (2017/12/01/): 377-380