Fingers & Fears:Fingers & Fears:injury & the role of self-efficacy in injury & the role of self-efficacy in

rock climbingrock climbing

Presented by Gareth JonesPresented by Gareth Jones

IntroductionIntroduction

Rock climbing is an increasingly popular recreational activity despite the obvious inherent risks

Psychological variables have been shown to be crucial to successful climbing performance

Psychological factors may play a key role in the antecedents of some athletic injuries

Major Influences on Climbing!!Major Influences on Climbing!!

Types of Climbing BehaviourTypes of Climbing Behaviour

BoulderingBouldering Traditional LeadingTraditional Leading

Sport ClimbingSport Climbing

Competitive DisciplinesCompetitive Disciplines

SoloingSoloing Top RopingTop Roping

Climbing InjuriesClimbing 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 ?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 3Why the 3rdrd & 4 & 4thth fingers ? 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 What is already known on this topictopic

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 InjuryRisk 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 addsWhat our study adds Dedicated climbers operating outdoors at the

highest levels are also at risk of overuse injury, particularly finger and shoulder overuse injuries

Fall-related injuries are comparatively infrequent, although often serious and all climbers may incur them

Physiotherapists, other climbers and physicians are the key sources of treatment or advice.

Jones, Asghar & Llewellyn (2008)

What of psychological factors What of psychological factors and occurence of injury?and occurence of injury?

Stress–Athletic Injury ModelStress–Athletic Injury Model

Adapted from Andersen and Williams (1998)

Balance of evidence for the modelBalance 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 other factors may be important?

What of overuse injuries?What of overuse injuries?

The role of Self-EfficacyThe 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 How are Self-Efficacy beliefs formed?formed?

Enactive mastery experiences Social modelling Verbal persuasion Physiological arousal

Key point: Key point: self-efficacy is reciprically determinate

The games climbers play!!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?What of ethics?

Self-efficacy researchSelf-efficacy research Associated with the frequency and difficulty of a

wide range of medium and high risk climbing behaviours

Key determinate when taking calculated risks in climbing and shown to be predictive of performance

(Llewellyn, Sanchez, Ashgar & Jones, 2008)

Does not appear to predict climbing injuries (Jones, Llewellyn & Ashgar 2007)

Time for a short filmTime for a short film

Presenters ResearchPresenters 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