An Investigation into the prevention of injuries in climbing (dissertation) by Tristan Brown

AN INVESTIGATION INTO PREVENTING INJURIES IN CLIMBING. RESEARCH DISSERTATION Tristan Brown / 14-01-2020 / Student ID: 160224397

TRISTAN BROWN TABLE OF CONTENTS INTRODUCTION & ABSTRACT Abstract Introduction

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LITERATURE REVIEW Outlining and grading the risks involved with climbing Outlining how common climbing injuries are; what they are and the causes of them Describing present risk prevention methods Showing the growth and gaps in the climbing market

6 7 9 9

METHODOLOGY Draft Questionnaires Questionnaires

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RESULTS & DICSUSSION Questionnaire results

CONCLUSION & IMPROVEMENTS Conclusion

BIBLIOGRAPHY & REFERENCES References Secondary Data Questionnaires Results

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INTRODUCTION

AN INVESTIGATION INTO THE PREVENTION OF INJURIES IN CLIMBING WHAT DOES THIS ENTAIL? Introduction and Abstract

Abstract This investigation aims to find methods of preventing injury in climbing, in order to do this research into the types of injuries experienced and causes of such needed to be conducted. The data collected a study of 52 climbers, showed that over the course of their climbing lifetime 71.7% have had at least one injury. The investigation found out that the most common injury amongst climbers was an over-use injury to a person tendon in the hand, wrist or fingers, accounting for 40.5% in the study. The most common cause of injury was research and found to be poor technique. There is little data out there on the long-term effects of preventative measures to injury, however the opinion of the participants of the survey believed warming up to the best preventative measure.

Introduction The sport of climbing has progressed a lot in recent years, particularly with a growing trend in indoor climbing. According to an article by the Association of British Climbers (ABC) [1] there were around 1,000,000 independent indoor climbers in the UK in 2017, 100,000 of these climbing regularly. The same article also stated that numbers seems to be growing by 15-20% each year. Given the rise in popularity of climbing it’s likely to increase the number of new climbers trying the sport for the first time. This could result in lower levels of experience and knowledge on safe practises. Especially when considering bouldering which requires little to know training before taking part in. This could lend itself to an increased chance of injuries. Over the course of this investigation, research will be undertaken to find the most common injuries and causes of such. Focus will be put on this data and connections to demographics. Current preventative measures will also be looked out to find room for improvement or completely new measures. The aims of these studies will be to establish a niche problem within the sport of climbing that hasn’t been focused on. In order to effectively summarize a vast sport with literally hundreds of medical documents relating to climbing and health, this dissertation was organised into a specific structure. Initially a literature review would be 4

conducted using pre-assigned objectives and key words to narrow down searches. Following this primary data would be planned and conducted to elaborate on the findings of the previous section or fill in absences needed to answer crucial research objectives. Once the data was collected the findings of both secondary and primary research would be discussed to produce insights on injuries and prevention methods within climbing. Ultimately these insights would be evaluated and combined or eliminated to one primary problem that could be focused on in following sections. Some tertiary, problems might also follow through to the design specification stage, so that the product could potentially solve more than one issue.

LITERATURE REVIEW

so that contradicting points of view can be analysed to produce a more thorough summary. Primary research would aim to fill any necessary data missing.

Outlining and grading the risks involved with climbing.

LITERATURE REVIEW

The outline of this dissertation is to investigate how

Climbing is considered an adventure sport and inherently comes with risks, some more severe than others. However, severity shouldn’t be the only factor in deciding a risk’s value. The frequency of which it occurred; ease of prevention and how credible the article stating it was, should all be factors in the assessment. In this section articles were found that outlined the most common risks involved with climbing, they were then graded on value through the factors discussed earlier.

1. Outlining and grading the risks involved with climbing 2. Outlining how common climbing injuries are; what they are and the causes of them. 3. Describing present risk prevention methods 4. Showing the growth and gaps in the climbing market

A review that was particularly useful in this section was ‘Risk factors for injury in climbing and bouldering’ by Woolings, K.Y. [3]. 149 Abstracts were reviewed, from those 49 full articles were read and from that 19 articles were perceived relevant to the investigation. The relevant studies were then put through a methodical quality assessment, using the Downs and Black Quality Index [2] to grade them out of a possible 32 points. The Downs and Black criteria are a common grading method, which measures an articles quality based on multiple factors. This quality rating was referred back to at multiple point in this review to compare articles and how reliable their data was.

SECONDARY RESEARCH

DATE: 13-12-2019

to prevent injuries within climbing. A critical way of approaching this is through the analysis of secondary research. However, to help sort through the vast amounts of data out there relevant to climbing, objectives are needed to narrow down useful literature. Four objectives have been developed to focus the search for material as well as evaluate its relevance. The objectives are as follows:

When searching for secondary data articles with larger sample sizes were preferred with the hopes that it led to a more accurate representation of the market. However, sample demographic mattered equally. The aim was to find a sample that consisted only of climbers with a wide spread of abilities, ages, experience, types of climbing conducted and fitness levels. To focus the searching of research key words were used, such as ‘injury’, ‘injury prevention’, ‘climbing’, ‘growth’ and ‘risk’. Combinations of these were used in article search systems (most frequently Aston Library Services) always revolving around the word ‘climbing’. Once relevant articles had been found, notes were taken on information that matched the objectives. These notes were analysed against each other to establish the validity of points, as arguments confirmed by two separate sources a more reliable. The structure of this literature review was broken down into each objective. Multiple papers were analysed and relevant points to each objective noted. The aim was to roughly have two to three different studies per objective, 6

Woolings, K.Y. listed the main risk factors for climbing are years of experience, higher difficulty in climbing and lead climbing. It also stated there are several other potential risk factors, that should be investigated further to cement their accuracy. These being BMI as an increasing factor on risk and tapping of wrists and fingers; muscle training and stretching to decrease risk, thus being preventative measures. The article made some interesting finds that seemed to go against logic for instance years of experience. Three articles, which ranked high on Downs and Black Quality Index stated that climbers with 5+ and 10+ years of experience have a higher chance of risk. This may be explained by a find later in the study where 8 articles found links between higher difficulty levels a climber can climb and an increase in risk of injury. A significant trend when considering only three studies contradicted this pattern. There is potential correlation between these two points, usually as experience in a sport grows so too does your skill level, which in climbing is directly linked to the difficulty you climb at. This suggest that more experienced climbers climb harder grades, which lead to a higher

chance of injury. This can be down to higher graded climbs placing more stress on the body, as more force is placed into smaller holds. In turn, isolating and applying more pressure to certain parts of the body particularly fingers, which can lead to overuse injuries. Though not conclusive, primary research on this area could lead to a more definite conclusion. A more detailed investigation into the risk of lead climbing is needed as four articles stated it as a significant risk factor for injury. However, one articles by Schöffl et al [4] stated injuries as part of lead were significantly lower than bouldering. At 0.29 injuries per 1000 hours of climbing to 1.47 injuries. Neither of these articles mentioned whether the lead climbing was based outdoors, so links between this and safety of indoor climbing can’t easily be made. Primary research as to which aspect of climbing is the riskiest could lead to narrowing down the causes of injuries within the sport. An article outside of the Woolings, K.Y. study by Nicita, L. [5] called ‘Valuing the benefits of rock climbing and the welfare gains from decreasing injury risk’ found that lead climbing had the greatest risk. It states that in lead climbing the quantity and quality of bolting has a direct impact on risk. As there is increased chance of ‘Runouts’ (Long stretches on a wall between bolts), therefore increasing the length of falls. Longer falls increase the chance of flipping upside down, a position where the faller is less in control and far more likely to hit their head. It was worth nothing that run-out are predominately present in outdoor climbing as the bolting isn’t pre-made into the wall so tends to be spaced every 4 to 5 meters in comparison to indoor climbing’s average of 2 meters. Nicita, L. highlighted the primary risk involved in sport climbing to be the quality and quantity of bolts, however data was collected from a limited source i.e. a few climbers in Sicily. This affects the reliability of the source due to its small representation. The fact that BMI is listed as a contributor to risk of injury isn’t surprising when comparing it to other articles like Bache S. [6]. The Bache. S. article observed that overweight people and one’s who practised bouldering are more at risk of injury. The correlation between these two articles agreeing on BMI and overweight people being more at risk is compelling. However, the risk of being overweight’s relevance to this study is questionable as with most sports having a reasonable fitness level is expected and its reduction on injury is well known. In addition, there are plenty of devices or apps that aim to help people with getting into shape, the market is over-saturated. To summarize when comparing all the studies analysed in

Woolings, K.Y. and the Nicita, L. paper it’s clear that certain risks are far more prevalent than others. Grading the risk using the factors mentioned prior, it’s clear that the level of difficulty whilst climbing showed the most significant trend relating it to an increased risk of injury. Secondary to that would be lead climbing. This source is graded high due to it coming up in 4 articles within Woolings, K.Y. and one external article, increasing the reliability of the statement, as findings to back it up occurred more frequently. These two points received further validation in the following injury section of the literature review. However, due to Bache, S. study finding bouldering to be of higher risk, further primary research would be advisable. Finally, the literature stating that being overweight or having a higher BMI increases risks isn’t significant enough and doesn’t show enough opportunity for a viable product solution for it to be acknowledged later in the project.

Outlining how common climbing injuries are; what they are and the causes of them. An article conducted by Schöffl, V.R. [4] on the ‘acute injury risk and severity in indoor climbing’ conducted a large investigation into several indoor climbing centres in Germany over a 5-year period, gathering a large sample of 515,337 participants. The study found climbing to be relatively safe sport with low chances of injury. Using a measure judging the number of injuries over a 1000 hours of partaking in the activity, found climbing lower than several other major sports. Against Rugby which has 91 injuries per 1000 hours climbing only had 0.02. In addition to this climbing ranked lower than other adventure sports, like surfing at 13/1000. Disagreeing with this data is the Bache, S. [6] study which chose a random sample of 606 climbers from the members of the Swedish Climbing Association (a relatively small sample size in comparison). This group were not specific to any particular area within climbing. There was a 63% response rate. The question’s asked were around climbing history, safety practices and retrospective accounts of injury events, within the last 1.5 years. The study like the previous used statistical methods to work out the chance of general injury over 1000 hours of climbing, the data showed on average during this time 4.2 injuries were sustained. The report data showed that overuse injuries accounted for 93% of all injuries. Inflammatory tissue damage to the wrist and fingers being the most prevalent. This data implies that climbing hours and loads should be gradually increased and early symptoms of overuse should be monitored more closely. The study also made a few more observations in that overweight people that practise bouldering are more at risk of injury; males have a higher re-injury rate and older 7

LITERATURE REVIEW

climbers have a lower re-injury rate. The study does go onto to explain that these specific observations weren’t as clear as previous ones and should require further studies to validate these claims Interestingly similar statistics to Bache, S. study were found in Grzegorz, Z.’s [7] study ‘Determining the index of injuries requiring specialist treatment during boulder climbing on an artificial climbing wall’. The survey here, was conducted over the course of 10 months in a climbing centre in Poland, it looked into the specifics of injuries requiring specialist treatment, caused during bouldering only. The data showed two main points of note. Firstly, when comparing the frequency of injuries requiring specialist treatment (hospitalization, calls to an emergency medical team and surgical sewing) to less severe injuries the data found that more severe injuries occur significantly less, at 1.66 injuries per 1000 hours of climbing compared to 4.2 for all injuries. Secondly the study also stated that the cause of almost all of the severe injuries in the study were due to falling from a great height. The exact heights weren’t listed, however the tallest walls at the centre were 4.5 metres. Due the first points data sets having such a significant difference, a point could be made that a device that focused on preventing less serious injuries would be more useful and therefore widely accepted. However, this assumption does not take into the account the relatability of the data sets. The study focusing just on bouldering rather than all forms of climbing, limit’s the sample size and application. In addition, more severe injuries are less desirable so the value people place on preventing them could be equal if not higher than more common injuries. To resolve this, primary research could look into what climbers’ value as a more pressing risk, across all fields of the sport. In addition, the Schöffl, V.R. study found that over the course of their experiment 30 injuries happened; 6 cases whilst bouldering; 7 top roping; 16 whilst lead climbing and one ‘on-looker’ injury. This outcome matches that off Nicita, L. and Woolings, K.Y.’s findings of lead climbing to have an increased risk of injury. Furthermore, it noted the types, cause and severity of said injuries, noted in the table below [appendix, figure 1]. The data showed some interesting findings, the most likely injury being ankle or foot involved with 10 injuries (33.3%), interestingly though these weren’t mainly cause by falling or in bouldering, which is usually to be expected due to not having ropes. Instead 9 out of the 10 foot/ankle injuries were in lead climbing, the most common cause being a belay mistake accounting for 55.5% of such. A reason behind this correlation between ankle injuries and lead climbing, is shown by the fact the 8

cause is most significantly a belay mistake. In lead climbing if the belayer was to make a mistake it increases the slack or amount of rope that goes through the belay device before the climbers stops, thus how much they full. This severely effects the forces the climber experiences when impacting either the floor or the wall. All of these injuries were listed as 2 to 3 (out of 5) on the UIAA MedCom grade [appendix, figure 2] showing severity, this means the injuries at worst were major injuries, requiring hospitalisation but not life threatening and 7 out of the 9 times non-permanent. The second most likely injury was Shoulder dislocations representing 10% of the injuries, the cause of which were all listed as accidents. Overall, the most common cause of injuries were belay mistakes accounting for 33% of the data, the majority of these were on lead due to its more complex belaying. The severity of injuries varied a bit, but usually were between 2 or 3 on the UIAA grade, being at 50% and 43% of injuries respectively. There were two grade 4 injuries and no fatalities fortunately. Worth noting was the other strong data trends in the table, which provide demographic information. These were 53% of injures happened to intermediate skilled climbers. Disagreeing to some degree with Woolings, K.Y. previous statement that experience is a major factor in risk. The data also showed the average age for people who got injuries as 27; 73% were male (which is partially explained by 63.6% of the overall study being male) and the average time at the centre per session was 2 hours and 47 minutes. Finally, it’s worth noting that 66.6 % of bouldering injuries were caused by falling onto the mat, all the others the others listed as accidents. The final piece of literature looked at was Woolings, K.Y. [3] which stated that ‘Previous research, involving primarily adult populations, suggested that upper extremity overuse injuries and acute flexor tendon pulley strains of the fingers are the most common injuries sustained by rock climbers in varying disciplines, though ankle injuries are also common due to falls’ this previous research being Jones, G. [8] and Logan, AJ [9]. To summarise this secondary data, the amount of injuries suffered in climbing is debatable. Two respected sources Bache, S. and Grzegorz, Z. had matching data that injuries occurred 4.2 times per 1000 hours of climbing. Despite this, due to the number of participants in the Schöffl, V.R. study at 515,337 compared to the next closest at 606 climbers, the correlation isn’t significant enough. Though, all data is significantly lower than all the other sports listed in the Schöffl, V.R. study. Potentially weakening the representativeness of nay findings was the fact that two out of the three sources collected data from only indoor climbing centres. For outdoor data the Bache, S. study was the only one collecting, however this wasn’t a factor on

which information was collected exclusively on. In terms of which injury was the most common the data analysed showed two main trends. Firstly, the Schöffl, V.R. study listed ankle and foot injuries from ‘Lead’ climbing as the most common injury. Due to its statistical significance over the next most frequent injury in that survey accounting for only 10% and the diverse representation of the survey, this insight is highly reliable. Secondly, the data reviewed showed in Bache, S. and Woolings, K.Y. studies that overuse injuries were another common occurrence, specifically inflammatory tissue damage in the wrist and fingers. This matches data from the previous objective, that more difficult climbs come with a greater risk, as the difficulty of a climb is often represented in the size of holds and force a person puts through them. Thus, isolating stress on certain parts of the body like the fingers, creating injuries. An issue with this conclusion is that lack of detailed data, which could be solved through primary research. Finally, in terms of causes of injury the data in this section clearly show’s belay mistakes to be a significant trend accounting for 33.3% of all causes in the Schöffl, V.R. study. However, these injuries are most likely caused by large falls as a result of belay mistakes. This is backed up by falls on the mat being the third most frequent cause in that study and in addition listed as a cause in the Grzegorz, Z article.

Describing present risk prevention methods At that moment there was several risk prevention methods in climbing and general sport to mitigate the chance of injury. Most of risk preventative methods were at indoor centres as they had the ability to more closely control their environment and enforce safe practise. Outdoors risk prevention was firmly in the place of what the climber deemed necessary and could afford and carry, in terms of safety equipment. Furthermore, safety equipment for climbing has been developed for years due to necessity, which has created a huge amount of competition in the market, progressing the development of many forms of equipment. Making competing directly very difficult, as in terms of utility and function most existing items have been development to perfection. The aim of this objective was to examine the current preventative methods and look for areas in safety which have been overlooked. A review that had relevant data to this objective was Woolings, K.Y. [3] study on ‘Risk factors for injury in climbing and bouldering’. Within the review a study by Josephsen et al [10] found tapping of the wrists and weight training to have a significant association with decreasing risk of injury. Stretching though amongst three articles showed no significant impact on preventing injury. The article, however, suggests further research in this area

as a lot of factors in the study could be changed for more relevant results. The review also states previous injuries as a significant predictor to subsequent injuries. Blaming lack of research in the area, contributing to insufficient treatment and understanding of present injuries. Particularly amongst, the sufferers who lack understanding of when to seek medical attention. Better understanding and a more open environment surrounding injury could lead to more collaboration in order to tailor people’s therapy and climbing style to pre-existing injuries. An example being Tommy Caldwell a professional climber who lost a finger in an accident. However, went on to change his climbing style to remain and improve within the sport. Completing his most challenging climb of ‘The Dawn Wall’ in Yosemite post injury. Schöffl, V.R. [4] study on a group of climbing walls in Germany found the most frequent cause of injury to be belayer mistakes. The author reports that many of these injuries were preventable as the belayer incorrectly tied knots or failed to pay attention at all times. This comes down to lack of practise and understanding and can usually be fixed quickly with teaching. This study also listed ankle and foot injuries as the most occurring, especially whilst lead climbing. Though there are methods to reduce a climbers fall on a route, a lot are out of the climber’s or belayer’s control. For instance, run-outs, rope stretch and the type of ground all can help prevent injury. Finally, Bache, S. [6] states that preventative measure for over-use injuries should be a gradual increase of climbing hours and load, as well as monitoring over-use more closely. Though data wasn’t conducted on this in the study, it was just an opinion by the author, so it’s credibility is lessened. To conclude the most common and feasible preventive method from this section is tapping and a weight training. Though the Woolings, K.Y. see this trend in only 8 articles. Teaching and skill are seen as effective preventative methods in the Schöffl, V.R. and Bache, S. studies. Both with similar findings, that better knowledge on when to rest and how to climb reduced the chance of injury.

Showing the growth and gaps in the climbing market The Nicita, L. [5] article contributes the increase in climbing in recent years down to a growth in indoor climbing centres. Stating that indoor centres; have a wider appeal to all skill levels; less of a steep learning curve; provide all season training space and theoretically safer climbing. An article by Berry, N. [11] on ‘Social Climbers – the evolving 9

LITERATURE REVIEW

indoor climbing industry’ talks about a study done by the Association of British Climbers [1]. During 2017 1 million people climbed independently indoors in the UK, including about 100,000 regulars. Of these, 59% are estimated to climb exclusively indoors. This number was predicted to grow by 15-20% each year. The article chalks part of it up to a change in achieving fitness. Most people were looking to go from the very transactional repetitive gym sessions to something alternative and more fun. In 2015, Bloomberg observed that in the USA, ‘Indoor rockclimbing is a quietly expanding exercise industry ripe for a CrossFit-like explosion’. Women, in particular, say they find the wall more welcoming than the gym, with often has macho mentality. In addition to the physical health benefits of climbing a study at Arizona University [13] linked climbing to mental health benefits. In a study group of 50 participants an average improvement of 1.4 after 8 weeks of regular climbing on the Beck’s depression scale was seen. Individually the greatest improvement being 6.27 points. The study stated this to be a significant correlation and deemed the study a success. Further detail from the Berry, N. study linked the growth in climbing to a push by Sports-England to get younger people involved, after the 2020 Tokyo Olympics announcement, the climbing would be included as a sport. This growth can be seen by data from the ABC showing that 400,000 under-18s are currently climbing under supervision. A final thing to note from the study was that 78% of major UK climbing walls are solely or predominantly boulder facilities, this data correlates with the previous statement about people looking for an alternative to gyms, but don’t want to commit to the training or gear involved with other forms of rope climbing. Though not conclusive this could be a link to injury amongst beginners. In summary these articles showed the rapid growth of climbing in recent years, particularly indoor climbing. This being mostly due to a recent uptake in adventure, health and well-being sports. Predominately this data comes from one source the BMC, which affects reliability. However as of 2017 it had 85,00 members. In addition, the growth in climbing is confirmed by the Nicita, L. paper. For the primary research a more in-depth study in gaps in the market is needed, in order to establish a niche for a product.

METHODOLGY

PRIMARY RESEARCH

DATE: 13-12-2019

To source relevant primary data to the investigation topic, the target group for research was isolated to participants that play sports. A focus was put on to prioritise responses from climbers, as their data would provide the most applicable answers. Recruitment was done through online questionnaires (Google Forms), this approach handed itself to being easily spread, especially via social networks, ensuring a wider coverage. The online questionnaires also didn’t require any raw materials and collated the data instantaneously, making analysis far easier.

Draft Questionnaires: Initially, three draft questionnaires were created and tested on a small group of fellow students, that data gathered from it will not be included in the analysis stages. The data and feedback gathered however was crucial in improving the format and questions asked. The first questionnaire produced bore the title “Study into the use and effectiveness of warm-ups”. After gathering feedback, it was concluded that questionnaire limited responses only around warm-ups creating a lack of information, especially as the majority of respondents didn’t warm up. The questionnaire also wasn’t tailored to any particular sport, which increased the sample size dramatically whilst ensuring less relevant data on climbing was gathered as not specifically related questions could be asked. After this stage in development, the decision to make two questionnaires was made. One focusing on climbing and another on general sports. Both of the following questionnaires would also expand questions, to include more on safety problems and injury causes. The second round of questionnaires consisted of two drafts, tested amongst an equally small group of five participants. Feedback from these questionnaires was improved, however the inclusion of too many open answer boxes was noted. Whereby people wrote down whatever they thought was an appropriate answer. In later

questionnaires, where possible these boxes were changed to multiple choice options. An ‘other’ box was added, as well if participants didn’t like the provided responses. This adaptation helped immensely in analysis as the data could be represented more quantitively, lending itself to easier comparisons. Another issue brought up was, the focus still around warm-ups as the primary cause of injury. In the later questionnaires, the number of warm-up related questions were reduced and replaced with questions around the causes of injuries and safety problems within the sport. Not all warm-up questions were removed, as the value and need for them were established in the literature review.

Questionnaires:

There were two questionnaires that were sent out as the first phase of primary research. The first focusing specifically on climbing [appendix, figure 3] was placed on two university climbing club Facebook groups, Aston and Warwick Universities. This method ensured a high response rate and a wide variety of experience levels, however limited responses to a tighter age band, the majority being eighteen to twenty-four. To combat this the climbing related questionnaire was placed on two climbing forums found on Reddit and a Discord server. These forums more consistently came up with higher experienced climbers, which was both good and bad for the study. Due to secondary data revealing higher experienced climbers to have more injuries and thus more to talk about, this correlation is explored more during the data analysis section. In total fifty-one responses were gathered from these sources. The second questionnaire [appendix, figure 4] was tailored so it could be answered from a number of different sports perspectives. This was shared, amongst Facebook friends due to fast response rates; Aston Kayak club’s Facebook group and an adventure sports forum on reddit. There was a conscious effort to focus research on adventure sport participants as the risks presented in such, aligned more with climbing. However, this was not exclusive as other more casual sports were included in question 3. In total twenty-two responses were gathered. The layout of the questionnaires were relatively similar, with a few more specific questions in the climbing one. They were designed to partly fill in gaps from the literature review. In addition, fulfil research objectives outlined in the initial viva and literature review. Sticking to these objectives ensures questions don’t go off topic and gather sufficient information to answer the brief of this dissertation. The questionnaires were broken down into four groups 11

METHODOLOGY

of questions. The initial ones establishing a bio focusing on age, fitness levels and gender (the same in each questionnaire). Like with previous studies such as Bache S. this data could be correlated with findings to create insights. To measure fitness levels, the study asked people to evaluate themselves on a one to ten scale, therefore the accuracy of this is lessened in comparison to hands on testing. In future a bleep test would provide more robust data, however gaining the number of participants would be harder. In the second group of questions, the two questionnaires diverted. The more generalised sport one, asking participants to select sports from a pre-ordained list, done to limit responses into easier to analyse categories. After that, questions were the same in each asking people to write the frequency they conducted their sport as well as trained in. These questions were a non-subjective way of establishing skill, however making the assumption that the more you do a sport the better you are at it. The hope of these questions was that during the evaluation stage links between skill level and injury rate could be created to test Woolings, K.Y. hypothesis, that higher skill levels result in an increase in risk of injury. The third group of questions in both studies, sought to show the risk involved with the sport and the frequency, types and causes of injuries that occurred. Through the use of listing injuries and causes; what people believed were the most common injuries and safety gaps in their sport. The climbing specific questionnaire chose to go into more detail over what people believed to be the main contributors to injuries. Getting participants to rank a list of five common contributors and list any missing in a later question. The aim of such questions was to fill in missing injury data from the secondary research as in Bache, S. and summarized in Woolings, K.Y. a lack of variety of injuries came up and detail on their causes. Instead much of the literature focused on risk, not directly linking specific injuries to their process and how might they be avoided. Greater detail would allow more definitive and specific preventative measures to be drawn out. The final group of questions in both the climbing and generalised sport questionnaire focused on warmups. As discussed in Woolings, K.Y.’s literature review greater research is needed in warmups and their effects. Given to the time constraints of data collection period, long term warmup and injury studies couldn’t have been run. Instead choosing to settle with an initial question gathering how much people warmed up on a scale of frequency. Then subjective questions on why they didn’t warm up if applicable and their value on warming up. The questions here aimed to gather data that would help evaluate the importance of warming and whether it leads to a reduction in injury, as Woolings, K.Y. hypothesised there was no significant correlation. It also would provide insight into the market on why people don’t presently warmup.

RESULTS + DICUSSION

RESULTS AND DISCUSSION PRIMARY DATA

DATE: 13-12-2019

This section analysed the primary data gathered and where possible represented it in graphs. The data shown was from the two main questionnaires. For qualitative data the points brought up will be evaluated in a similar style to the literature review and correlations that come up between respondents’ answers, will be seen as a more significant point. The results will be split into the major groups of questions, such ones to do with demographics. It worth noting, that the respondent for the climbing and general sports questionnaires were 51 and 22, respectively. This creates some issue with how representative the data would be, due to the relatively small sample size in comparison to the secondary data. However, if this data is used to supplement secondary data it can be of more use. Once the data was analysed any findings were evaluated against secondary data, to produce correlations, these would go on to form the key insights of this investigation in the conclusion.

Demographics

Figure 1 (left) shows ages of climbers, Figure 2 (right) shows ages of general sport participants

Figure 3 (left) shows gender of climbers, Figure 4 (right) shows gender of general sport participants 14

The demographics separating respondents in the climbing questionnaire and general sports questionnaire were age and gender. Data shows that the majority of respondents from both questionnaires were male (figures 3 and 4) ranging between the age of 18 and 24 (figures 1 and 2). In this climbing survey age and gender were significantly greater than other options representing 73.1% and 71.2% respectively. In the general sport survey, a similar trend was seen though it had a more diverse and even spread of females at 34%, yet 81% were still between the ages of 18 and 24. In both studies 25 to 35 was the next largest age representation. When analysing these insights against the literature review, similar findings with age were found. Berry, N. study on ‘Social climbers’ stated that 400,000 people under 18 climbed in 2017, representing 40% of the total climbing visits that year. This strongly matched this climbing’s survey that 73.1% of participants were young between the age of 18 and 24. These correlations suggest that the majority of climbers are in teenage to young adult bracket. The Berry, N.’s and Schöffl, V.R. study also found male climbers to be more prevalent, at 63.6%. A significantly higher percentage of male climbers could support the Bache, S. statement that male climbers are at higher risk of re-injury.

Type of sport, attendance and training At this stage the two primary surveys differ. On the climbing one, it’s assumed that all participants take part in climbing. So the frequency for which they climb is asked (figure 5). This data is far more even than other sets varying by a few percent. However, the top response was 3 times a week. This result isn’t surprising as a lot of respondents were sourced from university clubs, which typically operate activities this frequently. Regardless, when comparing this to the next two most common responses of ‘twice weekly’ and ‘once a week’, which were 21.2% and 19.2% respectively, the experience of the climbers can be speculated. Though not definitive as this doesn’t take into account overall time spent in the sport, it still gives a good idea as to the participant’s commitment. This should mean more in depth findings later on in the study, as most respondents are familiar with the sport. Contradictory to this is the data from the fourth question on training (figure 6). This data most significant finding is that no training is done, with 23.4% of respondents answering like this. The next most significant findings were once a week and monthly or less, at 17% each. This data potentially shows two things, one that participants aren’t committed to the sport or that training isn’t regarded highly amongst the climbing community.

Figure 5

Figure 6

For the other questionnaire on general sport the initial question was to do with preferred sport (figure 7), this overwhelmingly being kayaking at 31.8%, next to that was climbing at 18.2%. The reliability of this finding is somewhat tainted by the sample size and method of data collection, as this survey was spread via social media through friends, so would be more likely to group respondents than a random survey. After this, similar questions on training and attendance were asked. A similar mix of responses came back with two points of note. Firstly, the ‘frequency of attendance’ question’s (figure 8) most common response was twice weekly, with a significant representation of 31.8% of respondents. Secondly, the amount of training done (figure 9) showed a correlation to the other survey with 28.6% of respondents answering monthly or less. This correlation is interesting, as it could show a general lack of interest in training across all sports. This data on amount of climbing done specifically could be linked to the average age of respondents to approximate skill level and total climbing experience. Given the more you participate in a sport the better one tends to get. Given the average age of respondents is 18 to 24 and most frequent participation amount being 3 times a week, it could be assumed the majority of participants are above beginners and are likely predominantly intermediates. This is further backed up by the next section, stating the most common fitness level at 7. A likely, response to someone committed and at the middle to up levels of a sport.

Fitness level Figure 7

Figure 8

Figure 9

This question was included so that correlations between injury and fitness could be tested in order to test previous hypotheses, that being overweight or unfit increases the risk of injury. The data from both surveys (figures 10 & 11) showed the most common response at level 7 out of 10 (10 being high). This suggest a high level of fitness from most participants. However, the climbing survey was more mixed in responses with level 7 fitness being matched by level 6, both at 26.9%. However, when comparing this to the data from that question as a hole a significant trend can be found, whereby 76.9% of responses were between the level 6 and 8, strongly signifying that most respondents believed themselves to have a high level of fitness. In part this could be down to the majority being 18 to 24 years of age.

Figure 10

RESULTS + DICUSSION

tendon injuries to be the most common issues. Coming in second was shoulder injuries at 13.7%. This back-up the previous question results, making the conclusion that hand related injuries are the most common even more reliable.

Figure 11

Injury For this section the data from the general sport questionnaire was excluded as it was deemed irrelevant to the investigation. Due to the varied motions in other sport’s making it very difficult to create parallels between them and climbing. In the climbing questionnaire qualitative data was collected. In order to make analysis and correlation easier data was banded into 7 groups, predominately based on parts of the body. These being foot and ankle injuries; knees and legs; shoulder; cuts, scrapes and blisters; elbow; hands and wrists (specifically pulley and tendon damage) and finally any other injuries. Once the data had been banded some significant trends formed. From the first question, asking users to list their previous personal injuries the most common occurring injury was to do with the hands and wrists. Out of the 37 injuries listed 15 were in this band, the majority being strained tendons and pulley injuries. This accounts for a significant amount of total injuries at 40.5%. This correlates with previous findings in the literature review, listing over-use injuries as most common. The second and third most frequent injuries were shoulders at 19% and cuts at 19%. The data also made interesting insight in terms of number of injuries, which when you factor against the total number of respondents shows that over the course of everyone’s climbing lifetime 71.1% of people have had at least one injury. Though not in a direct comparable format to data from the literature review, it seemed to signify a significant difference between it and the Schöffl, V.R. study, which had the risk of injury far lower. A future change to this study would be to include a question on total years of climbing. This also can be linked to the previous section on fitness. As high levels of injuries are present amongst a majority of healthy fit people, this contradicts Woolings, K.Y. findings that overweight people are more at risk of injury. The secondary question asked participants to list what they believed to be the most common injury. Out of 51 responses, the data showed 60.7% listed hand, finger and 16

It's worth noting that when analysing this data on injuries, particularly the fact about most climbers having a 71.7% chance of receiving an injury over their climbing career, against previous questions correlations can be made. For instance, when comparing it to the statement made earlier about the majority of people being at intermediate skill levels, the high injury rate makes sense. Firstly, as this would agree with the Schöffl, V.R. finding that 52% of injuries are to intermediate climbers. Secondly the, intermediate skill range tends to be when climbers push there grade up to ones where small holds and crimps are more frequently introduced. When analysing this against the literature review, it agrees that small holders tend to focus pressure on specific parts of the boy, causing more overuse injuries around the hands. This injury consistently being the most frequent injury found across this study and many secondary studies. Finally, these two questions asked for responses from uses over the cause of injuries, which unfortunately was limited. However, the data present showed the most common cause was over-use of a certain part of the body having 6 respondents reporting this. Following that was lack of stretching with 5 responses; then too much pressure through holds with 3; falling during bouldering with 2 and lead falls and poor technique with 1 response each. This data gives some idea as to how to prevent injuries, however, is addressed in more detail in the next question. The next question asked people to rank 5 contributors to climbing injuries (figure 12) in order of most common cause. The data showed some interesting statistics. When participants were limited to a set list of causes, the most frequently listed was poor technique, juxtaposing the previous questions findings. To ensure the most reliable response all the data was averaged out to find that poor techniques was still listed as most common, followed by

Figure 12

failure to warm up; then pushing too hard; then falling and finally environmental factors. Though the data looks like it disagreed with the previous results actually correlations can be made. Over-use and poor technique are to some degree similar, as in climbing with good technique people should be applying less pressure on isolated parts of the body, instead spreading it more evenly, thus reducing injury. Secondly, the data’s second most common contributor was lack of warming-up, which mated the previous sections results. This significantly suggest that the most common contributors to injury in climbing is poor technique, lack of warming up and to a lesser degree pushing too hard and falling. The final question in this section of the study was to establish any missing contributors to injury, however no significant trends were found in the data. All results were one off anomalies.

Safety problems in climbing The question on safety problems in the sport was included in the general sports questionnaire. It was not relevant to this investigation though, as responses were very specific to each sport. Unlikely to relate on any degree to climbing. From the climbing responses though, three trends were uncovered. Most significant of which was bravado or recklessness and lack of knowledge. Each of these responses appeared six times out of the 52 total responses. Both of these responses agree with a statement made earlier in the analysis of the Schöffl, V.R. whereby belay mistakes caused 33% of the injuries. The reason behind these being most likely due to lack of practise and knowledge as easily fixable mistakes were made. This suggest the most appropriate action for combating these safety issues would be teaching and that this would significantly reduce the risks involved with climbing. The third trend to note, was the lack of warmups and knowledge around them, which validates to some degree the previous sections findings. In that many healthcare professionals state a lack of warmups mostly leads to over-use injuries, due to imbalanced use in joints. The abundance of this injury further supporting this fact.

though this was the same result as occasionally warming up. Though, given the next most common response being frequently warming up at 21.2% the data still implies a similar point. This being that participants warm up frequently to some level. When analysing this against previous finding that state lack of warming up to be a key contributor, this suggest that it might not be the lack of warming up however the extent to which it done and how it’s undertaken. Suggesting mistakes in peoples form. The next two questions were qualitative data and asked users why they don’t warm up and whether they believe it to be a necessary precursor to their sports. The findings for both of these surveys have been combined as results were similar and both relevant to the investigation. The findings from the first questions showed that the most common reason for a lack of warming up to be impatience, with a total of 8 responses within this topic. The second most common response was casual participation with 4 and then laziness with 3. This data shows two main insights, one being that present warmups take too long. The other that people believe the level they play a sport at as typically insufficient to justify a warmup, this was particularly applicable to climbing, as most responses came from that survey. This could be a potentially dangerous opinion to hold, as at these lower levels of climbing poor technique is more likely, which earlier was found to be a key contributor to injury. The third question in this section was on ‘whether people believed it to be necessary to warm-up’. To aid in analysis the responses were grouped into yes and no, so they could be analysed as quantitative data. From the climbing survey 75.8% of people responded that it was a necessary precursor. This was almost identical to the generalised sports data showing 76.8% marking it as necessary. This data definitively shows that the majority of people believe it to be necessary to warm up. This interesting as Woolings, K.Y. findings state that warm-ups don’t have any significant effect on risk and chance of injury, however people believe they do. This is beneficial to any future products. Figure 13

Warming up The final section of the survey was focused around warms up, in both surveys (figures 13 & 14). Responses differed between the two surveys in the first question. Where the frequency at which people warmed up was asked. For general sports a significant trend was found stating that 54.5% of respondents warmed up before every session. This data was partially matched in the climbing survey, as 30.8% of respondents warmed up before every session,

Figure 14

CONCLUSION

CONCLUSION AND IMPROVEMENTS

To conclude its worth analysing some of the issues with the primary data, in order to establish its reliability. The first of which was that it didn’t specifically ask about total duration of climbing done over a participant’s lifetime and what they believed their skill level to be. This was a missed opportunity, as this data would of lead to being able to more confidently test the multiple literature articles conclusion that experience level has an adverse effect on risk. However, the data from the primary study attempted to do this by combining fitness level, average attendance over a week and average age of participants, to some degree of success. Another issue is a failure to gather enough data on preventative measure, as all data collected was from people opinions. Not hardcore evidence was produced to back these statements, in order to do this a more robust study around all the preventative measure would need to be taken. Whereby some participants take part in a preventative measure and others don’t and the number of injuries seen over an extended period of time is compared. Overall, the data from this investigation lead to many insights crucial in designing a climbing product that reduces injury. The key insights gathered from all sections of the investigation, are as follows: - -

- -

The largest risk in climbing is the level of difficulty at which a person climbs. Overuse injuries are the most common injury in climbing. In the form of wrist of finger injuries, usually in the tendons. Second to this is ankle injuries, most frequently caused by falling on ‘lead climbs’ The major cause of injury in climbing is primarily due to poor technique, followed by the over-use of specific parts of the body, then a lack of or ineffective warm-ups. Warm-ups aren’t conducted to a proper level in climbing due to lack of knowledge and time. There is a growing number of beginners in climbing specifically in bouldering, who are participating mainly for health benefits.

These insights will go on to produce the design specification, which will be used a guiding tool for later stages in the final project.

BIBLIOGRPAHY AND APPENDICES

Bibliography

1. Association of British Climbing Walls. (2014). About the ABC - Association of British Climbing Walls. [online] Available at: https://www.abcwalls.co.uk/about/ [Accessed 20 Nov. 2019].

2. Anon, N.D. Downs and Black Qualtiy Index. [online] Available at: https://journals.plos. org/plosone/article/file?type=supplementary&id=info:doi/10.1371/journal.pone.0192903. s002 [Accessed 20 Dec. 2019]. 3. Woollings, K.Y., McKay, C.D. and Emery, C.A. (2015). Risk factors for injury in sport climbing and bouldering: a systematic review of the literature. British Journal of Sports Medicine, 49(17), pp.1094–1099. 4. ‌Schöffl, V.R., Hoffmann, G. and Küpper, T. (2013). Acute Injury Risk and Severity in Indoor Climbing—A Prospective Analysis of 515,337 Indoor Climbing Wall Visits in 5 Years. Wilderness & Environmental Medicine, [online] 24(3), pp.187–194. Available at: https:// www.wemjournal.org/article/S1080-6032(13)00087-2/fulltext [Accessed 20 Jan. 2020]. 5. Nicita, L., Shaw W, D. and Signorella, G. (2018). Valuing the Benefits of Rock Climbing and the Welfare Gains from Decreasing...: Journal articles, journal titles and books**. [online] Ebscohost.com. Available at: http://eds.a.ebscohost.com/eds/detail/ detail?vid=2&sid=03fe3c9e-cc7e-443f-9ec1-395deaf6ded8%40sdc-v-sessmgr01&bdata=Jn NpdGU9ZWRzLWxpdmU%3d#db=bth&AN=132873016 [Accessed 8 Jan. 2020]. 6. Backe, S., Ericson, L., Janson, S. and Timpka, T. (2009). Rock climbing injury rates and associated risk factors in a general climbing population. Scandinavian Journal of Medicine & Science in Sports, 19(6), pp.850–856. 7. Grzegorz Zieliński, Estera Zięba and Michał Ginszt (2019). Determining the index of injuries requiring specialist treatment during boulder climbing on an artificial climbing wall. Journal of Education, Health and Sport, [online] 9(9), pp.90–93. Available at: http:// www.ojs.ukw.edu.pl/index.php/johs/article/view/7368/9045 [Accessed 9 Jan. 2020]. 8. Jones G, Asghar A, Llewellyn DJ. The epidemiology of rock-climbing injuries. Br J Sports Med 2008 9. ‌Logan AJ, Makwana N, Mason G, et al. Acute hand and wrist injuries in experienced rock climbers. Br J Sports Med 2004‌ 10. ‌Josephsen G, Shinneman S, Tamayo-Sarver J, et al. Injuries in bouldering: a prospective study. Wilderness Environ Med 2007 11. ‌Berry, N. (2018). FEATURE: Social Climbers - The Evolving Indoor Climbing Industry. [online] Ukclimbing.com. Available at: https://www.ukclimbing.com/articles/features/ social_climbers_-_the_evolving_indoor_climbing_industry-10953 [Accessed 21 Dec. 2019]. 12. Bouldering Envisioned as New Treatment for Depression (2017). Bouldering Envisioned as New Treatment for Depression. [online] UANews. Available at: https://uanews.arizona. edu/story/bouldering-envisioned-new-treatment-depression [Accessed 21 Dec. 2019].

APPENDICES

Appendices

Figure 1: Schoffl, V.R. injury report table [4]

22/01/2020

Table 3: Injury events

Close Window

Table 3 Injury events Table 3 Injury events Climbing Climbing Case Date Climbing Injury Age Sex experience experience No. (month/year) style cause climber belayer

UIAA Belay MedCom device grade used

Bilateral calcaneus and ankle fractures Munter Contusion hitch calcaneus Dental Unknown injuries and jaw fracture Shoulder Unknown dislocation Mid foot — fracture Belayer Munter injured, hitch severe rope burns

Permanent disability

01/2007

34 M Expert

Belay mistake

02/2007

17 M Intermediate Intermediate L

Belay mistake

05/2007

11 M Intermediate Expert

Climbing 2 mistake

04/2007

21 M Intermediate Intermediate L

Accidental 2

03/2008

38 F

Fall onto mat

03/2008

— M Professional Expert

Belay mistake

06/2008

11 M Intermediate Expert

Climbing 2 mistake

ATC

Back sprain

Tying wrong knot

Munter hitch

Polytraumatic (multiple fractures, Yes abdominal injuries)

ATC

Contusions

Beginner

Professional —a

07/2008

22 M Intermediate Beginner

10/2008

31 M Intermediate Expert

11/2008

25 M Expert

12/2008

43 M Intermediate Professional T

01/2009

52 M Professional Intermediate L

03/2009

30 M Intermediate Beginner

04/2009

29 F

—a

07/2009

24 M Intermediate —a

07/2009

28 F

01/2010

15 M Beginner

05/2010

22 F

07/2010

29 M Intermediate Intermediate T

Accidental 3

07/2010

16 F

Accidental 2

Beginner

Expert

Intermediate L

Belay 2 mistake Undeﬁned 3 Climbing mistake, 3 sequela of failure Belay mistake Belay mistake Fall onto mat Fall onto mat

3 3 3 3

Professional L

Undeﬁned 2

Beginner

Belay mistake

Fall onto mat

Intermediate —a

Intermediate Expert

https://www.wemjournal.org/action/showFullTableImage?isHtml=true&tableId=t0015&pii=S1080603213000872 20

Injury

GriGri®

GriGri® Ankle fracture Vertebral fractures, tibia ATC fracture, lacerations Calcaneus fractures, ATC cerebral concussion Munter Vertebral hitch fractures Elbow — fracture Vertebral — fracture Foot ATC contusion Munter Multiple hitch contusions Anterior cruciate and — collateral ligament tears knee Munter Arm fracture hitch Shoulder ATC dislocation

Yes No No No No Yes No

No No Yes

Yes No No No No No Probable No No 1/2

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Table 3: Injury events

09/2010

30 M Intermediate Intermediate T

Accidental 2

unknown

11/2010

27 F

Beginner

Climbing 2 mistake

Munter hitch

01/2011

28 F

Expert

—a

05/2011

25 M Beginner

Beginner

06/2011

51 M Intermediate Intermediate L

06/2011

23 M Beginner

07/2011

12 F

09/2011

Expert

Intermediate —a

33 M Expert

36 M Expert

Fall onto mat Belay mistake Belay mistake

ATC

Smart®

Foot fracture No

Munter hitch —

Patella dislocation Neck sprain

Accidental 2 Tying wrong 3 knot

10/2011

Intermediate O

11/2011/11/2011 — M Intermediate Intermediate L

—

Accidental 2

Intermediate L

Shoulder dislocation Ankle sprain with ligament injury Elbow fracture Calcaneus fracture

Yes No

No No

ankle fracture GriGri® Probable (complex)

Complex sequela of 4 failure

ATC

Belay mistake

Polytraumatic, multiple vertebral Yes fractures, abdominal injuries

ATC

Back sprain

T, top rope; L, lead; B, bouldering; O, others. aClimbing experience belayer is not considered in boulder accidents, the “Munter hitch” belay technique is also known as the “Italian hitch” or “crossing hitch” or “HMS”.

Figure 22/01/2020

[4] 2: Schoffl, V.R. & UIAA Table MedCom 2: Injury andReport Illness Severity Classiﬁcation (IIC)—UIAA MedCom Score11

Table 2

Close Window

Injury and Illness Severity Classification (IIC)—UIAA MedCom Score 11 x 11 Schöffl, V., Morrison, A., Hefti, U., Schwarz, U., and Küpper, T. The UIAA Medical Commission injury classification for mountaineering and climbing sports. Wilderness Environ Med. 2011; 22: 46–51 See all References Table 2 Injury and Illness Severity Classification (IIC)—UIAA MedCom Score 11 x 11 Schöffl, V., Morrison, A., Hefti, U., Schwarz, U., and Küpper, T. The UIAA Medical Commission injury classification for mountaineering and climbing sports. Wilderness Environ Med. 2011; 22: 46–51 See all References 0 No injury or illness 1 Mild injury or illness, no medical intervention necessary, self-therapy (eg, bruises, contusions, strains) Moderately severe injury or illness, not life-threatening, prolonged conservative or minor surgery, outpatient therapy, doctor attendance within a short time frame (days), injury-related work absence, heals 2 without permanent damage (eg, undisplaced fractures, tendon ruptures, pulley ruptures, dislocations, meniscal tear, minor frostbite) Major injury or illness, not life-threatening, hospitalization, surgical intervention necessary, immediate 3 doctor attendance necessary, injury-related work absence, heals with or without permanent damage (eg, dislocated joint, fractures, vertebral fractures, cerebral injuries, frostbite with amputations) https://www.wemjournal.org/action/showFullTableImage?isHtml=true&tableId=t0015&pii=S1080603213000872 Acute mortal danger, polytrauma, immediate prehospital doctor or experienced trauma paramedic 4 attendance if possible, acute surgical intervention, outcome: alive with permanent damage Acute mortal danger, polytrauma, immediate prehospital doctor or experienced trauma paramedic 5 attendance if possible, acute surgical intervention, outcome: death 6 Immediate death

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APPENDICES

Figure 3: Climbing Questionnaire

22/01/2020

An investigation into preventing injuries in climbing

22/01/2020

An investigation into preventing injuries in climbing

5. What would you say your fitness level is? (1 being low, 10 being high) Mark only one oval.

An investigation into preventing injuries in climbing

1 2

Participating in this form will aid in research aiming to reduce the number of climbing related injuries

3 4

1. Age Mark only one oval.

5 6

0 - 17

18 - 24

25 - 35

36 - 49

50 - 65 65 +

6. Have you every been injured whilst climbing? If so, list your injuries and believed causes of them.

2. Gender Mark only one oval. Female Male Prefer not to say Other: 7. In your personal experience, what do you believe is the most common climbing related injury?

3. How frequently do you climb? Mark only one oval. 4+ times a week 3 times a week Twice weekly Once a week Fortnightly

8. Rank from 1 to 5 (1 being most common) these contributors to climbing injuries. Check all that apply.

Monthly or Less 4. If you train for climbing, how often do you? (exclude any training that is climbing itself) Mark only one oval.

Environmental factors Falling Failure to warm up Pushing too hard Poor technique

4 + times a week 3 times a week Twice weekly Once a week

9. If there is a key contributor to climbing injuries you think is missing please list below

Fortnightly Monthly or Less Never

22/01/2020

An investigation into preventing injuries in climbing

10. Do you believe there is a current safety problem in climbing, if so what do you believe it to https://docs.google.com/forms/d/1rWowqTGGvj9YR0WD5xOXPRnXej2PyYBddtB5Je791vk/edit

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be?

11. How frequently do you warm-up before climbing? Mark only one oval. Never Occasionally Frequently Before every session Throughout every session 12. If you warm up infrequently, why do you?

13. Do you perceive warming up as a necessary precursor to climbing?

14. Any comments or ideas list below, please.

https://docs.google.com/forms/d/1rWowqTGGvj9YR0WD5xOXPRnXej2PyYBddtB5Je791vk/edit

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https://docs.google.com/forms/d/1rWowqTGGvj9YR0WD5xOXPRnXej2PyYBddtB5Je791vk/edit

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Figure 4: General Sport's Questionnaire 22/01/2020

An investigation into preventing injuries in sport

22/01/2020

An investigation into preventing injuries in sport

5. If you train for your sport, how often do you? (exclude any training that is just doing the sport itself) Mark only one oval.

Participating in this form will aid in research aiming to reduce the number of sport related injuries

4 + times a week 1. Age Mark only one oval.

3 times a week Twice weekly

0 - 17

Once a week

18 - 24

Fortnightly

25 - 35

Monthly or Less

36 - 49

Never

50 - 65

6. What would you say your fitness level is? (1 being low, 10 being high) Mark only one oval.

65 + 2. Gender Mark only one oval.

1 2

Female

Male

Prefer not to say

Other:

6 7

3. What is your preferred sport? Mark only one oval.

8 9

Football

Rugby Hockey

7. Have you every been injured whilst doing you preferred sport? If so, list your injuries and believed causes of them.

Swimming Kayaking Climbing Hiking Cricket Tennis Other:

8. In your personal experience, what do you believe is the most common injury in your sport and what causes it?

4. How frequently do you take part in your preferred sport? Mark only one oval. 4+ times a week 3 times a week Twice weekly Once a week Fortnightly Monthly or Less https://docs.google.com/forms/d/1xKpPnAMgwNzqnR0YttbwB4Cfx5cMYvd_nKYf3FwvGnI/edit

22/01/2020

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An investigation into preventing injuries in sport

9. Do you believe there is a current safety problem in your sport, if so what do you believe it to be? https://docs.google.com/forms/d/1xKpPnAMgwNzqnR0YttbwB4Cfx5cMYvd_nKYf3FwvGnI/edit

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10. How frequently do you warm-up before doing your preferred sport? Mark only one oval. Never Occasionally Frequently Before every session Throughout every session 11. If you warm up infrequently, why do you?

12. Do you perceive warming up as a necessary precursor to your sport?

13. Any comment or ideas list below, please.

https://docs.google.com/forms/d/1xKpPnAMgwNzqnR0YttbwB4Cfx5cMYvd_nKYf3FwvGnI/edit

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APPENDICES

Figure 5: Climbing Questionnaire's Raw Data Timestamp

Age

12/6/2019 14:22:32 18 - 24 12/6/2019 14:30:18 18 - 24 12/6/2019 14:39:00 18 - 24

Gender Male Female Female

How frequently do you climb? If you train for climbing, how What often would do you? you (exclude say your any Have fitness training you level every that is? (1 been is climbing being injured low, Initself) your whilst 10 being personal climbing? high)experience, If so, list Rank your what from injuries do 1you to and 5believe (1 believed being is the most Rank causes most common) from common of1 them. to these 5 (1 climbing being contributors most Rank related common) from to injury? climbing 1 to these 5 (1injuries. being contributors most Rank [Environmental common) from to climbing 1 to these 5 factors] (1injuries. being contributors most Rank [Falling common) from to] climbing 1 to these 5 (1injuries. being contributors most If [Failure there common) is toto aclimbing key warm these contributor up] injuries. contributors Do to [Pushing climbing you to believe climbing too injuries hard there injuries. ]you is athink current How [Poor isfrequently missing safety technique problem please do] youlist inwarm-up climbing, below If you warm before if so up what climbing? infrequently, do you believe Dowhy youdo itperceive toyou? be? warming up Anyascomments a necessary or ideas precursor list below, to climbing? please. 3 times a week Once a week

Once a week

8 Nope

Once a week

Pulling a tendon

6 Patella dislocation - weak knee Dislocations & bad angle

3 times a week

5 4

8 Knee injury - badly carriedTendonitis out falls training....... Knee impacted with a hold 3

4 4 2

2 2 1

1 5 1

3 Not paying attention

Bravado, it's a sport that pushes Occasionally you to take a risk i.e.I'm climb outdoors aboveand your there grade. aren't Yes, Especially thegiven rightin how routes. trad, many which Mypeople indoor has Theroutes Igrade know idea of that is have pushing low, reinjured actually so warm your themselves graded limits ups would I think as because un be will safe dull always but as they they tobe haven't bewould aseen battling be as a so factor good easy. against climbersafety. you are The encouraged sport I believe to dohas the done riskierasones. muchAlso as itnot can wearing do to improve a helmetupon is common this but and the people in somewill circles always seen push as past cool. it, its in the nature of the sport.

Before every session

Male

Monthly or Less

5 No

Tendon damage

Never

Male

Monthly or Less

8 No

Dislocated shoulders

Occasionally

12/6/2019 15:03:33 18 - 24

Male

Once a week

Tendon damage/decking from falling

Occasionally

12/6/2019 15:07:20 18 - 24

Male

Fortnightly

3 times a week

8 No

Pulled muscles

Before every session

A2 pulley tear

No time for full recovery 3 Overtraining and not allowing

12/6/2019 16:11:34 18 - 24 12/6/2019 16:16:50 18 - 24

Male Male

4+ times a week

Twice weekly

Twice weekly Monthly or Less

Rotator cuff tear Bursitis Pulley tendon tears Hamstring tear Wrist problems Cartilage tear in knees

7 Yes. Nothing serious, just several Grazes small grazes and bumps. All caused by falling 5 from the wall and colliding 1 with the wall/holds on 2the way down 8 No

Shoulder injuries

Yes

Ignorance to the risk of notThroughout wearing a helmet every session (outdoors in particular) even someYes, instructors not onlydon't to avoid haveinjury their but students to improve wearing climbing them. ability. Risk of rocks falling outdoors is high but people don't seem to care, I guess because so many people don't wear one it's just become trend.

12/6/2019 14:41:11 18 - 24 12/6/2019 15:02:48 18 - 24

I’m a rookie

Yes

Before every session

Yes completely

3 N/A

Unknown

2 Equipment failure

Climbing comes with lots ofFrequently risks but that is something you just accept when you Yes do it, you mitigate them as much as possible but climbing can never be fully safe

Before every session

Female

Monthly or Less

Male

Once a week

6 Injured shoulder from slipping whilst bracing against a wall

2 Nope

Only that due to the popularity Occasionally and media of people like Laziness Alex Honnold, and keenness more people to yes get on areand climbing climb beyond their n/a limits and breaking saftey rules

Reckless people, lack of knowledge Occasionally on what to do in Icertain don't climb dangerous hard enough situations routes Probably to have a good to idea warm up Sweets on completion of survey please :)

12/6/2019 17:22:26 25 - 35

Female

4+ times a week

4 + times a week

Minor finger injuries 2 severely stretched ligaments and 1 tendon in my right ankle. 6 Caused by me being a twatPulleys in fingers 5 cold, not wearing proper 4 shoes and stretching too 1 far. and trying to beat Joelles traverse record, I was also

12/6/2019 17:31:51 18 - 24

Female

Fortnightly

Monthly or Less

12/6/2019 17:36:53 18 - 24 12/6/2019 17:39:14 18 - 24 12/6/2019 17:48:26 18 - 24

Female Male Male

Monthly or Less

6 No more than little, negligible tendon scrapes based? not sure

Once a week 3 times a week

cuts on fingers and hands

6 Mild tendonitis Never

Tendon damage

4 4 5

1 2 3

2 3 1

5 2

Before every session

Yes. I didn’t originally but caused myself nerve pain in my arms. Now I warm up before every session

12/6/2019 16:37:59 18 - 24 12/6/2019 16:38:06 18 - 24

Occasionally

N’A

Yes

N/A

Usually not something I actively I thinkthink it's probably about (other betterthan to as just opposed doing easier to not routes to warm-up)

Throughout every session

Definitely

7 No

Tendon Injury

Not in the grand scheme Frequently

Yes

12/6/2019 17:51:23 18 - 24

Male

Twice weekly

Monthly or Less

6 no

Pulled muscles

yes

12/6/2019 17:53:57 18 - 24

Female

Monthly or Less

2 Broken ankle, whoops (bouldering Sprains and tall) breaks

People are not taught to warm Occasionally up or improve technique lack of time or space

12/6/2019 17:55:16 18 - 24

Male

4+ times a week

3 times a week

8 Assorted pulley injuries, rotator Disregard cuff, assortment to a proper warm of pulled up muscles, bursitis, general 3 cuts, lots of abrasion 2 damage, more pulley injuries, 5 broken(?) Toe

Poor route setting ie large Before holds below everypoor session feet where Because a fall would I am impatient result in you and 100% hitting foolish vital the hold unexpectedly often with a straight leg, also parkour style boulders

12/6/2019 17:57:43 18 - 24

Male

Twice weekly

Never

Cut finger open 6 screwed up left shoulder PTSD - almost got crushed by a rock

12/6/2019 18:01:51 18 - 24

Female

Once a week

Twice weekly

3 Not injured

4 + times a week

Both shoulder impingement lumbrical r-ring, A2, A3 Both middle fingers Tennis Elbow Gold Elbow Right knee stopped (tendon inflammation) Bruised calf 7 lower back Damage to ego, Probably something in your shoulder 5 or leg

12/6/2019 18:30:02 18 - 24 12/6/2019 21:33:00 25 - 35

Male Male

4+ times a week 3 times a week

Once a week

Holly's ankle lol. Finger sprains

8 Left elbow nerve strain. Overuse Finger of related left arm injuries. climbing.

Throughout every session

No idiots, maybe?

People aren't always taught Occasionally correct technique

4 1

1 1

3 1

Occasionally

Yes

12/6/2019 21:43:12 18 - 24

Male

Monthly or Less

Never

3 Never

Blisters

12/6/2019 22:20:37 18 - 24

Female

Monthly or Less

Never

4 Minor cuts

Broken bones

5 N/a

Occasionally

Rarely climb so when I do No it’s more a fun activity

12/6/2019 23:48:03 18 - 24

Male

3 times a week

7 no

pulley injuries

1 lack of technique

I don't know

Before every session

laziness

yes

12/7/2019 2:20:09 25 - 35

Male

4+ times a week

Twice weekly

8 Yes, fractured scaphoid, ganglion pulley sprain cyst.....hard press move against the wrist. 5

don't feel the need

12/7/2019 5:35:08 0 - 17

Male

3 times a week

Fortnightly

7 Nothing serious, a few tendon Possibly strains, tornmuscle muscles overusage, or tendons very minor injuries.4Couple week maximum recovery. 2

12/7/2019 15:31:36 18 - 24 12/7/2019 23:32:05 25 - 35

Male Male

3 times a week Once a week

Sprained ankle - falling mTBI - decking 6 Golfers/tennis elbow - overuse Finger injury

Fortnightly Twice weekly

Never

Before every session

2 Incorrect use of equipment

Before every session

Male

3 times a week

5 Climbing finger

Climbing finger

Frequently

Male

Once a week

3 times a week

5 Yes, tendon injury. No injury Finger management, and tendon prolong problems delay of treatment

12/9/2019 4:07:10 18 - 24

Female

Twice weekly

Once a week

6 Sprained finger during leadTendon fall, further injuries injured wrist from climbing on it for months 4 (needs surgery)

3 times a week

6 no

finger strains.

4 full crimping before you're no ready to do so

Occasionally

Once a week

Never

Poor technique

Frequently

12/9/2019 17:14:22 18 - 24

Male

Once a week

7 No

Strained/sore tendons

1 No

Male

Monthly or Less

Twice weekly

Monthly or Less

Never

Yes, even if it's active climbs a few grades below your limit Yes yes

Occasionally

Male Female

Female

Not at my age, I definitely think I could get on my projects as soon as I walk in, but as I age I do think it will get much more important.

99% of time is human error/problems Before every session

12/9/2019 15:00:28 0 - 17 12/9/2019 17:13:45 18 - 24

12/9/2019 18:37:03 25 - 35

To feel more limber

Excess of un-validatiable information Throughout(did-information). every session Particularly in regards toAbsolutely rope/gear techniques

12/8/2019 9:48:14 0 - 17 12/9/2019 2:50:38 25 - 35

12/9/2019 20:24:27 18 - 24

Half roping

Yes, because I'm an old man Watch whoand is falling prepare apart to cradle your partners head

Before every session Occasionally

Do a group warm up before climbing

No - I've not hurt myself yet Group warm up session

Yes, but thats what makesBefore it interesting, every session unless you are a muppet

5 Not knowing when to stop.Overdoing climbing.

yes

Not really Laziness

Frequently

Yes, gotta get those muscles nice and warm for less injuries just want to climb

somewhat Yes as it can prevent injuries

N/A

Yes it does.

N/A

Definitely In any sports activity warming up is the key to preventing muscle and joint injuries.

2 No

Wrist and knee injuries

8 No

Finger injuries

4 No

Sometimes when rope climbing Occasionally it has been very busyI don’t and people do hard have climbs stood andon No if the I plan butrope I on can whilst doing see Ithat hard wasitclimbs belaying would Ibe do and beneficial theletting easiera toones person do so. asdown a warm from up.the wall.

12/9/2019 20:46:26 18 - 24

Female

Twice weekly

Never

6 No

Ankles

Frequently

Yes

12/9/2019 21:03:30 18 - 24

Male

Twice weekly

Fortnightly

7 Tendonitis - Cold weather,Rolled lack ofankle warm up

Before every session

Yes

12/10/2019 10:41:52 18 - 24

Male

3 times a week

Before every session

6 A2 partial rupture, crimpingTwisted ankles or finger injuries

Not enough emphasis on warmups Frequently

12/10/2019 17:08:10 18 - 24

Male

Twice weekly

Once a week

8 No

2 N/A

Lack of knowledge in safety Frequently

12/11/2019 7:27:56 0 - 17

Male

3 times a week

7 Tendon strain. Not warming Allup kinds properly/doing of finger injuries. certain climbs at the end of tiring 4 sessions.

I think if you know what your Throughout doing andevery you are session careful Towith prevent yourinjuries/sore safety/gear, muscles. then Defiantly you will be all fine. However some people simply forget about some stuff which causes injuries (sometimes severe injuries)

12/11/2019 14:23:23 18 - 24

Male

3 times a week

Fortnightly

Twisted Knee and Ankle when dropping from top of bouldering wall. 8 Overtrained Fingers caused Overtrained or damaged joint and tendon pain. tendons.

2 Climbing too often, not enough Not really recovery time.

Occasionally

Warming up isn't the fun part Yesofifclimbing climbing for training.N.a. Not as important if climbing socially.

Frequently

so i dont pull or strain something pretty much

People new to climbing that Frequently are uneducated in fitness, fail to understand that tendons Yes, just and asligaments any sport grow you should substantially be warming slowerup than to reduce muscle,the push chance to hard of injury. and cause injury especially in their fingers. Especially early on, your grip strength will improve rapidly, but your tendons and ligaments in your fingers won't improve as quickly and if they start full

Rope Burn

12/11/2019 19:50:45 18 - 24

Male

Twice weekly

Never

7 n/a

12/16/2019 1:57:50 25 - 35

Male

4+ times a week

3 times a week

7 Elbow: Overuse, not enough Finger supplemental or Elbow pushing training.

12/23/2019 23:45:33 0 - 17

Male

4+ times a week

4 + times a week

not warming up/stretching

7 Rotator cuff tendinitis, overuse Finger with pulley bad tears form

4+ times a week

Monthly or Less

Broken or dislocated joints from poor falling, 3 times in 1 year at my gym. 7 A1 injury left ring finger. Slight tear are whilst warming uptoo. on a juggy route (perhaps 2 second climb of the day), 5 followed by testing hand 3 with a campus and realising 2 what I have done. flappers very common

Male

Twice weekly

Once a week

6 Subluxated both shoulders,I think unsure it would why. be either finger injuries or shoulder 4injuries

Male

Twice weekly

Never

Small cuts on fingers - coming of holds quickly 7 Elbow sprain - falling off bouldering Sprains and overuse injuries handson arm at an odd angle andfor landing

3 Poor landing technique when Poor bouldering techniqueand andjumping lack ofOccasionally knowledge down

1/15/2020 21:48:14 25 - 35

Female

Once a week

Never

6 Yes I've hurt my wrist, holding Finger to aand hold tendon too hard problems

2 Cockiness

1/18/2020 16:19:28 25 - 35

Female

Twice weekly

Never

3 twisted my ankle

3 4, 5

shoulder pain

Yes

Throughout every session

Male

1/3/2020 1:55:07 18 - 24 1/15/2020 21:44:27 18 - 24

12/28/2019 15:46:08 18 - 24

Yes N/A

No.

N/A

Yes

Frequently

Pulse raisers and dynamic stretching followed by warm up routes.

Before every session

For sure, I can't climb without warming up. I just like to get on with climbing It should so usually be do lower grade stuff first

Bravado surrounding doingNever run out or potentially dangerous I warm up routes by climbing easyNot stuff, really, but depends I never really how climb hard you too hard climb, anything above a 5b probably Before every session

Figure 6: General Sports Questionnaire's Raw Data Timestamp

Gender

What is your preferred sport? How frequently do you takeIf part you train in your forpreferred your sport, sport? how Whatoften would do you? you say (exclude your Have fitness any training you level every is? that (1 been isbeing just injured doing low, In your whilst 10 thebeing personal sport doing high) itself) you experience, preferred Dowhat sport? you believe doIfyou so, there believe list your is is ainjuries current the How most frequently and safety common believed problem doinjury you causes inwarm-up inyour Ifyour ofyou them. sport, sport warm before ifand so up doing what what infrequently, your do causes you preferred Do believe why it?youdo perceive sport? ityou? to be?warming up Anyascomment a necessary or ideas precursor list below, to your please. sport?

12/6/2019 15:51:10 18 - 24

Male

Hiking

Monthly or Less

5 No

Sprains

12/6/2019 16:29:00 18 - 24

Age

Male

Kayaking

Fortnightly

Twice weekly

Shoulder dislocation, through improper training and warm Before upevery session

12/6/2019 16:31:43 18 - 24

Female

Kayaking

Monthly or Less

8 No

Various shoulder injuries due Notto problem the impact as much and getting as known, Before caught unavoidable every on various session danger obstacles, N’A etc.

12/6/2019 16:31:55 18 - 24

Male

Kayaking

Twice weekly

Fortnightly

6 I've injured my shoulder previously Shouldernot injuries realted andtoathe lack The kayaking of biggest warming, butsafety the badaggravated technique problemFrequently inand that kayaking bad injuryfortune when is the Ihuman have Na paddled factor since due to a combination Yes if doing of it still to a being serious weak level, from notthe so injury much and for anot pool warming sessionup unless properly you have a specific requirement

12/6/2019 16:50:22 18 - 24

Male

Kayaking

Twice weekly

Dislocated joints

12/6/2019 18:06:45 18 - 24

Female

Climbing

3 times a week

Monthly or Less

6 No

Pulled muscle, not warming People up properly bitting ropes then falling Throughout every session Busy

12/6/2019 18:08:45 18 - 24

Female

Climbing

3 times a week

Monthly or Less

Yes Tendon Injury Sprains 8 Dynamic move from pocketAwkward Movements

12/6/2019 18:11:09 18 - 24

Female

Taekwondo

Twice weekly

Sprained ankle Ankle injury 7 during practise a girl landed Before every session ason many my ankle sports are mobileno therefore higher risk of hurting each other feat/ ankles

12/6/2019 18:13:44 18 - 24

Male

Climbing

Monthly or Less

Never

7 Carpal tunnel - overtrainingTendonitis the fingers- doing causing toonerve much Becoming damage too fast or complacent overtraining andBefore losing every focus session

12/6/2019 18:20:35 18 - 24

Male

Climbing

4+ times a week

4 + times a week

7 Both shoulders, tennis elbow, Damage golf elbow to your ego, probably Yes but something thats what in your makes shoulder Before it interesting, orevery leg session unless you're a muppet

12/6/2019 18:22:34 18 - 24

Male

Hiking

Fortnightly

3 times a week

8 Yes crazed ankle, unawareLeg of surroundings injury / foot injury and coldAwareness feet of surroundingsOccasionally

12/6/2019 18:24:46 18 - 24

Male

Football

3 times a week

Once a week

7 Yes pulled hamstring, overQuadricep use injury injury - over extension Opponents overfoul useplay

Before every session

12/7/2019 19:25:34 18 - 24

Male

Kayaking

Once a week

Monthly or Less

5 2x shoulder dislocation caused Shoulder by joint dislocation hypermobility caused Noby hyperextension

Frequently

12/8/2019 16:31:42 18 - 24

Male

Kayaking

Once a week

Monthly or Less

7 Flipped going down a rapidShoulder and hit my dislocation head on or a rock damage resulting due to in bad a 3 or paddle so inch placement Frequently cut in head.

N/A

Never

Bad habbit

Not really Yes, to prevent injury

Before every session

N/A

Yes

Sometimes Beforemisjudging every session Incompetent climbers/ belayers their abilities

yes

To perform well yes yes Yes definitely Yes, because I'm an old man keep who an is eye falling on your apartpartner, cradle the head

Time, unaware of what warm No up to perform yes Lack of time.

Yes

If I don't warm it's becauseNot I forget necessary or I want buttoit flirt should on the be water done as soon as possible

1/15/2020 18:24:16 18 - 24

Male

Rugby

3 times a week

Sprained knee, due to impact on the joint bending the knee backwards. The knee swelled and required rest and icing for 2 weeks before playing again. Bruises, from powerful impacts. 8 Fractured finger, stamped Fractured The sport is dangerous, Occasionally of it.of I weeks. don't think I believe safety gear is up needed whileNo you American play is thefootball, best method, maybeusually only scrum we have caps. a drills To combat or a practise it bettergame refereeing but there is needed not really to combat warm ups dirty play. damaged fingers, as these areand delicate parts of the body that canmore easily be warming damaged during alike ruck. on by bootorduring a ruck, required tapping restthats for a part couple

1/15/2020 18:31:40 25 - 35

Female

Hockey

Once a week

Grazes, playing on astro turf, when ever you full over your gonna get some scrapes. These are usually small and you can play through them. Lots of grazes, mainly on hands and knees 6 Bruises of shins Yes short penalties around the D.every a fowl happens or theatball within Yes, the aD lap these oroccasionally two happen. is just Defenders part of the wait in aren't the it gets goal you withloose the keeper and makes and have you feel to run ready at the attacker with the ball they are allowed to hit it in the air, b Being hit with a stick is secondly most likely, there is Before always aIf lot ofsession sticks swinging thatgoes leveloffside and they can get you where yousession pads there.

1/15/2020 18:37:17 0 - 17

Male

Hockey

Twice weekly

7 Bruises on the arms, bodyAs andgoalie thighs. I play goalie for Yes, my short team. corners. When defenders Before linesession upyour in the D,We they are are forced finally togiven run two head Yes, masks before it gets but the you nothing session in the covers mood or training the for rest athose even game, of their starts, canbody be it assures fun or throat. with everyones other Inoften. that people situation fitness and they isare on around are a similar almost a lotcause level. inasgame likely anyways to get hit as me. pads were I'd feel nothing. bruises, how good your pads are depends on howevery much of body they cover. I had gaps inlaps my upper thigh and arms, I used areas to block balls The ballssit hard and bruises a lot. Where

1/15/2020 18:40:57 36 - 49

Female

Running

Twice weekly

Never

5 Nope, just a little weesey Twisted ankle probably, but Lack I runofon specific roads running so it hasn't paths Occasionally happened specifically to me in cities. I live I count in Birmingham running slow notatnear theYes, start a park ifas you so warming run do italong more up, the but seriously canal. occasionally, than It's good meI'llIbut can stretch cause seeaitlittle. of ascrime, a necessary I'd onlything do it during to get you the limber day. These places need to be lit better.

1/15/2020 21:15:17 25 - 35

Male

Tennis

Once a week

7 Grazed knee

Sprained ankle - stop start game, makes it jarring Sprained wrist - dito knee injuries - dito Grazes - Play on astro Nope

Before every session

1/15/2020 21:17:51 18 - 24

Male

Football

Twice weekly

Never

8 No

Sprain or shin injury

Never

Outside of goalie grazes, people get em most games, cause a lot of people trip people with sticks.

1/15/2020 21:22:34

Female

Kayaking

Fortnightly

1/15/2020 21:31:36 18 - 24

Female

Swimming

Twice weekly

Yes, especially if the sport is stop start high intensity I play casually, so don't exert No myself that much

Cut to the head Dislocated shoulder Bruises 5 ^^ all hitting rocks

Bruises and cuts - If you invert going down aIt's river, a dangerous you are likely sport, to its hitalways Occasionally your head gonna firsthave on rocks safety issues. I only warm Potentially up a bitsome before sort Ifgoing your of more gonna down breathable an dointense something front bit or protected intense if particularly yeah mask.hung But itover has to be easy to take off and not effect you while swimming. The sport as a whole if done correc

7 No

Overuse injury

Before every session

Stretch and do a slow lap Yes

An Investigation into the prevention of injuries in climbing (dissertation)

Articles inside

An Investigation into the prevention of injuries in climbing