Int J Sports Med 2009; 30(6): 395-402
DOI: 10.1055/s-0028-1112143
Review

© Georg Thieme Verlag KG Stuttgart · New York

Sport Climbing with Pre-existing Cardio-pulmonary Medical Conditions

T. Kuepper 1 , 2 , A. Morrison 2 , U. Gieseler 2 , 3 , V. Schoeffl 2 , 4
  • 1Department of Occupational & Social Medicine, University of Aachen, Aachen, Germany
  • 2Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA), Bern, Switzerland
  • 3Department of Internal Medicine, Diakonissenkrankenhaus, Speyer, Germany
  • 4Department of Trauma and Orthopaedic Surgery, Klinikum Bamberg, Bamberg, Germany
Further Information

Publication History

accepted after revision November 10, 2008

Publication Date:
06 February 2009 (online)

Abstract

Over the past 25 years sport climbing has developed from an elite extreme sport subculture pursued by few into a mainstream recreational sport enjoyed globally by climbers of all ages, climbing abilities, and with pre-existing health conditions. As the demands and grades of climbing difficulty have increased over this period, most scientific literature on sport climbing focused on acute injuries and overuse syndromes, or performance physiology in healthy adult males. The physiological response to sport climbing is more similar to that of resistance training (i.e., body building) rather than a predominantly aerobic sport (i.e., running, cycling), so that heart rate and blood pressure during a climb will be disproportionately high relative to the ‘exercise’ of climbing, and breathing may be irregular. Therefore this review sought evidence-based recommendations for recreational sport climbing participation by those individuals with pre-existing cardiopulmonary medical conditions including coronary heart disease, chronic heart failure, cardiac dysrhythmia, pulmonary diseases (i.e., asthma) or hypertension. This review defines the criteria that must be fulfilled for safe sport climbing by those with pre-existing cardiopulmonary conditions or those with hypertension.

References

  • 1 Allegra L, Cogo A, Legnani D, Diano PL, Fasano V, Negretto GG. High altitude exposure reduces bronchial responsiveness to hypo-osmolar aerosol in lowland asthmatics.  Eur Respir J. 1995;  8 1842-1846
  • 2 Arora R, Fritz D, Zimmermann R, Lutz M, Kamelger F, Klauser AS, Gabl M. Reconstruction of the digital flexor pulley system: a retrospective comparison of two methods of treatment.  J Hand Surg [Br]. 2007;  32 60-66
  • 3 Becque MD, Huber L. Exertional intensity and energy expenditure of sport rock climbing.  Med Sci Sports Exerc. 1996;  8 209
  • 4 Billat V, Palleja P, Charlaix T, Rizzardo P, Janel N. Energy specificity of rock climbing and aerobic capacity in competitive sport rock climbers.  J Sports Med Phys Fitness. 1995;  35 20-24
  • 5 Bollen SR. Upper limb injuries in elite rock climbers.  J R Coll Surg Edinb. 1990;  35 S18-S20
  • 6 Bollen SR, Gunson CK. Hand injuries in competition climbers.  Br J Sports Med. 1990;  24 16-18
  • 7 Booth J, Marino F, Hill C, Gwinn T. Energy cost of sport rock climbing in elite performers.  Br J Sports Med. 1999;  33 14-18
  • 8 Carmeli E, Wertheim M. [Hand injuries in young and old wall climbers] Handverletzungen bei jugendlichen und erwachsenen Sportkletterern.  D Z Sportmed. 2001;  52 285-288
  • 9 Coats AJS. Review exercise training in heart failure.  Curr Control Trials Cardiovasc Med. 2000;  1 155-160
  • 10 Cornett JA, Herr MD, Gray KS, Smith MB, Yang QX, Sinoway LI. Ischemic exercise and the muscle metaboreflex.  J Appl Physiol. 2000;  89 1432-1436
  • 11 Delise P, Guiducci U, Zeppilli P, D’Andrea L, Proto C, Bettini R. Cardiological guidelines for competitive sports eligibility.  Ital Heart J. 2005;  6 661-702
  • 12 Durand F, Kippelen P, Ceugniet F, Gomez VR, Desnot P, Poulain M, Prefaut C. Undiagnosed exercise-induced bronchoconstriction in ski-mountaineers.  Int J Sports Med. 2005;  26 233-237
  • 13 Ferguson RA, Brown MD. Arterial blood pressure and forearm vascular conductance responses to sustained and rhythmic isometric exercise and arterial occlusion in trained rock climbers and untrained sedentary subjects.  Eur J Appl Physiol. 1997;  76 174-180
  • 14 Forster R, Penka G, Bosl T, Schoffl VR. Climber's back – form and mobility of the thoracolumbar spine leading to postural adaptations in male high ability rock climbers.  Int J Sports Med. 2008;  30 57-59
  • 15 Franklin BA. ACSM's guidelines for graded exercise testing and prescription. 6 ed. Baltimore: Williams & Wilkins 2000: 749-768
  • 16 Haas JC, Meyers MC. Rock climbing injuries.  Sports Med. 1995;  20 199-205
  • 17 Hartsock LA, Feagin  Jr  JA, Ogilvie BC. Climbing and the older athlete.  Clin Sports Med. 1991;  10 257-267
  • 18 Hochholzer T, Schöffl V. One move too many. 2nd ed. Ebenhausen: Lochner Verlag 2006
  • 19 Hochholzer T, Schöffl VR. Epiphyseal fractures of the finger middle joints in young sport climbers.  Wilderness Environ Med. 2005;  16 139-142
  • 20 Hollmann W, Hettinger T, Strüder KH. Sportmedizin – Grundlagen für Arbeit, Training und Präventivmedizin. 4 ed. Suttgart: Schattauer 2000: 576-578
  • 21 Holtzhausen LM, Noakes TD. Elbow, forearm, wrist, and hand injuries among sport rock climbers.  Clin J Sport Med. 1996;  6 196-203
  • 22 Houston CS. Trekking at high altitudes. How safe is it for your patients?.  Postgrad Med. 1990;  88 56-58 , 61–53, 67–58 passim
  • 23 Kannus P, Liu-Ambrose T. Exercise Prescription for Health. In: Bruckner P, Khan K, eds. Clinical Sports Medicine. 3rd ed. Australia: McGraw Hill Medical 2007: 912-934
  • 24 Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: A meta-analysis of randomized controlled trials.  Hypertension. 2000;  35 838-843
  • 25 Kupper T. Non-traumatic aspects of sport climbing.  Wien Med Wochenschr. 2005;  155 163-170
  • 26 Largiader U, Oelz O. An analysis of overstrain injuries in rock climbing.  Schweiz Z Sportmed. 1993;  41 107-114
  • 27 Lauren PB, Jenkins DG. The scientific basis for high-intensity interval training – optimising training programmes and maximising performance in high trained endurance athletes.  Sport Med. 2002;  32 59-79
  • 28 Limb D. Injuries on British climbing walls.  Br J Sports Med. 1995;  29 168-170
  • 29 Logan AJ, Makwana N, Mason G, Dias J. Acute hand and wrist injuries in experienced rock climbers.  Br J Sports Med. 2004;  38 545-548
  • 30 MacDougall JD, MacKelvie SM, Moroz JR, Sale DG, MacCartney N, Buick F. Factors affecting blood pressure during heavy weight lifting and static contractions.  J Appl Physiol. 1992;  73 1590-1597
  • 31 MacDougall JD, Tuxen D, Sale DG, Moroz JR, Sutton JR. Arterial blood pressure response to heavy resistance exercise.  J Appl Physiol. 1985;  58 785-790
  • 32 Medicine ACoS .ACSM’S guidlines for exercise testing and prescription. 7 ed. Lippincott Williams & Wilkins 2005
  • 33 Michailov M. Evolvement and experimentation of a new interval method for strength endurance development. In: Moritz EF, Haake S, eds. The engineering of Sport 6. New York: Springer Science and Business Media 2006: 291-296
  • 34 Michikami D, Kamiya A, Fu Q, Niimi Y, Iwase S, Mano T, Suzumura A. Forearm elevation augments sympathetic activation during handgrip exercise in humans.  Clin Sci. 2002;  103 295-301
  • 35 Morgan J. The patient with CHD at altitude.  Wilderness Environ Med. 1990;  1 147-153
  • 36 Morrison AB. Application of intermittent hypoxication exposure (IHE) to improve rock climbing performance – A pilot study. In. London: Westminster University (Thesis) 2006
  • 37 Morrison AB, Schoffl VR. Review of the physiological responses to rock climbing in young climbers.  Br J Sports Med. 2007;  41 852-861
  • 38 Noe F, Quaine F, Martin L. Influence of steep gradient supporting walls in rock climbing: biomechanical analysis.  Gait Posture. 2001;  13 86-94
  • 39 Piacentini GL, Martinati L, Fornari A, Comis A, Carcereri L, Boccagni P, Boner AL. Antigen avoidance in a mountain environment: influence on basophil releasability in children with allergic asthma.  J Allergy Clin Immunol. 1993;  92 644-650
  • 40 Piepoli MF, Flather M, Coats AJ. Overview of studies of exercise training in chronic heart failure: the need for a prospective randomized multicentre European trial.  Eur Heart J. 1998;  19 830-841
  • 41 Quaine F, Vigouroux L, Martin L. Effect of simulated rock climbing finger postures on force sharing among the fingers.  Clin Biomech. 2003;  18 385-388
  • 42 Rohrbough JT, Mudge MK, Schilling RC. Overuse injuries in the elite rock climber.  Med Sci Sports Exerc. 2000;  32 1369-1372
  • 43 Roloff I, Schöffl VR, Vigouroux L, Quaine F. Biomechanical model for the determination of the forces acting on the finger pulley system.  J Biomech. 2006;  39 915-923
  • 44 Rooks MD. Rock climbing injuries.  Sports Med. 1997;  23 261-270
  • 45 Schaffert W. Planned sojourn at high elevations – what the primary care physician should know.  MMW Fortschr Med. 2005;  147 33-34 36-37
  • 46 Schöffl I, Einwag F, Strecker W, Hennig F, Schöffl V. Impact of taping after finger flexor tendon pulley ruptures in rock climbers.  J Appl Biomech. 2007;  23 52-62
  • 47 Schöffl V. Handverletzungen beim Klettern.  D Z Sportmed. 2008;  59 85-90
  • 48 Schöffl V, Einwag F, Strecker W, Schöffl I. Strength measurement after conservatively treated pulley ruptures in climbers.  Med Sci Sports Exerc. 2006;  38 637-643
  • 49 Schöffl V, Hochholzer T. Sportklettern – Aktuelle sportmedizinische Aspekte. Ebenhausen: Lochner Verlag 2004: 205
  • 50 Schöffl V, Hochholzer T, Imhoff A. Radiographic changes in the hands and fingers of young, high-level climbers.  Am J Sports Med. 2004;  32 1688-1694
  • 51 Schöffl V, Hochholzer T, Winkelmann HP. Management der geschlossenen Ringbandruptur bei Sportkletterern.  Sport Ortho Trauma. 2002;  18 79-85
  • 52 Schöffl V, Hochholzer T, Winkelmann HP, Roloff I, Strecker W. Verletzungen des Ringbandapparates bei Sportkletterern.  Handchir Mikrochir Plast Chir. 2004;  36 224-230
  • 53 Schöffl V, Hochholzer T, Winkelmann HP, Strecker W. Differentialdiagnose von Fingerschmerzen bei Sportkletterern.  D Z Sportmed. 2003;  54 38-43
  • 54 Schöffl V, Hochholzer T, Winkelmann HP, Strecker W. Pulley injuries in rock climbers.  Wilderness Environ Med. 2003;  14 94-100
  • 55 Schöffl V, Hochholzer T, Winkelmann HP, Strecker W. Verletzungen bei Sportkletterern.  Alpinmed Rundbrief. 2004;  30 6-7
  • 56 Schöffl V, Klee S, Strecker W. Evaluation of physiological standard pressures of the forearm flexor muscles during sport specific ergometry in sport climbers.  Br J Sports Med. 2004;  38 422-425
  • 57 Schöffl V, Küpper T. Injuries at the 2005 World Championships in rock climbing.  Wilderness Environ Med. 2006;  17 187-190
  • 58 Schöffl V, Möckel F, Köstermeyer G. Entwicklung einer sportartspezifischen Leistungsdiagnostik der laktaziden Kraftausdauer der Unterarmbeugemuskulatur im Sportklettern.  Ö J Sportmed. 1997;  1 30-38
  • 59 Schöffl V, Möckel F, Köstermeyer G. Development of a performance diagnosis of the anaerobic strength endurance of the forearm flexor muscles in sport climbing.  Ö J Sportmed. 1999;  3 31-32
  • 60 Schöffl V, Möckel F, Köstermeyer G, Roloff I, Küpper T. Development of a performance diagnosis of the anaerobic strength endurance of the forearm flexor muscles in sport climbing.  Int J Sports Med. 2006;  27 205-211
  • 61 Schöffl V, Schöffl I. Injuries to the finger flexor pulley system in rock climbers - current concepts.  J Hand Surg [Am]. 2006;  31 647-654
  • 62 Schöffl V, Winkelmann HP. Unfallstatistik an Indoor-Kletteranlagen“.  Sportverletz Sportschaden. 1999;  13 14-16
  • 63 Schöffl VR, Hochholzer T, Imhoff AB, Schoffl I. Radiographic adaptations to the stress of high-level rock climbing in junior athletes: a 5-year longitudinal study of the German junior national team and a group of recreational climbers.  Am J Sports Med. 2007;  35 86-92
  • 64 Schöffl VR, Schoffl I. Finger pain in rock climbers: reaching the right differential diagnosis and therapy.  J Sports Med Phys Fitness. 2007;  47 70-78
  • 65 Sheel AW. Physiology of sport rock climbing.  Br J Sports Med. 2004;  38 355-359
  • 66 Sheel WA, Seddon N, Knight A, MacKenzie DC, Warburton DER. Physiological responses to indoor rock-climbing and their relationship to maximal cycle ergometry.  Med Sci Sports Exerc. 2003;  35 1225-1231
  • 67 Sinoway L, Shenberger J, Leaman G, Zelis R, Gray K, Bailey R, Leuenberger U. Forearm training attentuates sympathetic responses to prolonged rhythmic forearm exercise.  J Appl Physiol. 1996;  81 1778-1784
  • 68 Vigouroux L, Quaine F. Fingertip force and electromyography of finger flexor muscles during a prolonged intermittent exercise in elite climbers and sedentary individuals.  J Sports Sci. 2006;  24 181-186
  • 69 Washburn RA, Seals DR. Peak oxygen uptake during arm cranking for men and women.  J Appl Physiol. 1984;  56 954-957
  • 70 Watts P, Newbury V, Sulentic J. Acute changes in handgrip strength, endurance, and blood lactate with sustained sport rock climbing.  J Sports Med Phys Fitness. 1996;  36 255-260
  • 71 Watts PB. Physiology of difficult rock climbing.  Eur J Appl Physiol. 2004;  91 361-372
  • 72 Watts PB, Daggett M, Gallagher P, Wilkins B. Metabolic response during sport rock climbing and the effects of active versus passive recovery.  Int J Sports Med. 2000;  21 185-190
  • 73 Watts PB, Drobish KM. Physiological responses to simulated rock climbing at different angles.  Med Sci Sports Exerc. 1998;  30 1118-1122
  • 74 Wekesa M, Langhof H, Sack P. The asthma six-minute provocation test and mountain climbing in children.  East Afr Med J. 1994;  71 51-54
  • 75 Williams ES, Taggart P, Carruthers M. Rock climbing: observations on heart rate and plasma catecholamine concentrations and the influence of oxprenolol.  Br J Sports Med. 1978;  12 125-128

Correspondence

T. KuepperAss. Prof. 

Department of Occupational & Social Medicine

University of Aachen

Pauwelsstr. 30

52074 Aachen

Germany

Phone: +49/1520/182 02 56

Fax: +49/211/164 91 11

Email: TKuepper@ukaachen.de

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