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Fingers & Fears:injury & the role of self-efficacy in rock climbing Presented by Gareth Jones
Introduction • Rock climbing is an increasingly popular recreational activity despite the obvious inherent risks • Psychological variables have been shown to be crucial to successful climbing performance • Psychological factors may play a key role in the antecedents of some athletic injuries
Traditional Leading Bouldering
Soloing Top Roping
Climbing Injuries Climbers are susceptible to overuse injuries of the upper limb: Studies consistently report a high prevalence of finger related injuries (Jones et al, 2008; Shoffl et al, 2003) • Disruption of the annular pulley system (particularly A2) • Rotator cuff and shoulder impingement syndromes which are associated with prolonged and repeated reaching overhead(Peters, 2001) • Tendonopathies
Why are the fingers susceptible ? • During the crimp grip wrist extension increases the mechanical advantage of the finger flexors and reduces active insufficiency (Lockwood, 1998) • Paradoxically this hand position may increase the pre-disposition of the climber to injury(Joel et al, 2000)
Why the 3rd & 4th fingers ? • Flexion of the remaining fingers when holding a one finger pocket may increase the maximum holding force up to 48% (Shweizer, 2001) • Lumbrical tears to the third or fourth lumbrical may occur if the finger is dynamically loaded (Shweizer 2003)
What is already known on this topic • Rock climbing is increasingly popular worldwide • Chronic overuse injuries to the upper extremities, particularly the fingers, are common in climbers ascending difficult indoor routes frequently • Misdiagnosis and delays in treatment occur due to unfamiliarity with climbing injuries In consideration of the current literature an epidemiological study was conducted
Risk Factors for Injury • Only outdoor sport lead grade predicted fall related injuries (odds ratio (OR) 1.47; 95% confidence interval (CI) 1.47 to 2.09) • The frequency and difficulty of all forms of climbing behaviour were associated with overuse injuries, with the exception of soloing grade and traditional lead frequency • Bouldering grade was the sole predictor of injuries relating to strenuous moves (odds ratio (OR) 1.24; 95% confidence interval (CI) (1.02 to 1.50) Jones, Asghar & Llewellyn (2008)
What our study adds • Dedicated climbers operating outdoors at the highest levels are also at risk of overuse injury, particularly finger and shoulder overuse injuries • Fall-related injuries are comparatively infrequent, although often serious and all climbers may incur them • Physiotherapists, other climbers and physicians are the key sources of treatment or advice. Jones, Asghar & Llewellyn (2008)
Stress–Athletic Injury Model Adapted from Andersen and Williams (1998)
Balance of evidence for the model • Personality-injury evidence has produced mixed results • Empirical support for negative life event stress • Daily hassles has been shown to be a factor one week prior to injury • Previous injury, fear of re-injury may heighten anxiety • Most relevant to acute injuries does not explain overuse What other factors may be important? What of overuse injuries?
The role of Self-Efficacy “belief in one’s capability to organise and execute the courses of action required to produce attainments” (Bandura, 1997, p.3)
How are Self-Efficacy beliefs formed? • Enactive mastery experiences • Social modelling • Verbal persuasion • Physiological arousal Key point: self-efficacy is reciprically determinate
The games climbers play!! • Pre-inspection • Pre-practice of route • Information from others ‘Beta’ • Pre-place strategic runners • ‘Head-point’ • ‘Red-point’ What of ethics?
Self-efficacy research • Associated with the frequency and difficulty of a wide range of medium and high risk climbing behaviours • Key determinate when taking calculated risks in climbing and shown to be predictive of performance (Llewellyn, Sanchez, Ashgar & Jones, 2008) • Does not appear to predict climbing injuries (Jones, Llewellyn & Ashgar 2007)
Presenters Research • Jones, G. Llewellyn, D.J. & Asghar, A. (2007) Risk factors in rock climbing. Proceedings of the 2007 World Conference of Physical Therapy. Vancouver, Canada. • Jones G., Asghar A., & Llewellyn DJ. (2008) The epidemiology of rock climbing injuries. British Journal of Sports Medicine: 42: 773-778. • Llewellyn DJ, Sanchez X., Ashghar A., Jones G. (2008) Self-efficacy, risk taking and performance in rock climbing. Personality & Individual Differences : 45: 75-81. • Sanchez X, Lambert PH, Jones G, Llewellyn DJ. (2010) Efficacy of pre-ascent climbing route visual inspection in indoor sport climbing. Scandinavian Journal of Medicine and Science in Sports