Climbing injuries, as the medical studies name them.

How often climbers are injured

A 2023 systematic review by Quarmby, Zhang, Geisler, Javorsky, Mugele, Cassel and Lawley (Frontiers in Sports and Active Living), covering 34 studies, cites earlier work putting climbing injury incidence at around 4.2 injuries per 1,000 hours of climbing, with a point prevalence of 22.8 percent and a one-year prevalence of about 50 percent. Other figures vary widely. An indoor study with a strict definition reports a far lower rate: the gym study on the gym safety page found 0.02 per 1,000 hours counting only injuries for which a medic was called. A search summary of several reviews gives ranges from about 1 to 4.24 per 1,000 hours overall and lower indoor figures than outdoor ones, a spread put down to different methods and populations; those ranges are unconfirmed.

Overuse injuries

Quarmby and colleagues (2023) report that most overuse injuries affect the upper body, and that one cited study classed up to 93 percent of climbing injuries as overuse. The factors they found associated with higher overuse risk were higher climbing intensity, bouldering, lower grip or finger strength, use of a crimp grip, and previous injury. Evidence on training volume, age or experience, and sex was conflicting.

An earlier systematic review by Woollings, McKay and Emery (British Journal of Sports Medicine, 2015) of 19 studies listed age, years of climbing, highest grade achieved, a high climbing intensity score and lead climbing as potential risk factors. It found the evidence on prevention inconclusive and the data less robust than in established sports.

Finger pulley injuries

Miro, vanSonnenberg, Sabb and Schoeffl (Wilderness and Environmental Medicine, 2021) describe finger flexor pulley injuries as the most common overuse injury in rock climbers and rare outside the sport. They name the A2, A3 and A4 pulleys as those at highest risk, particularly under eccentric loading. Quarmby and colleagues give a pulley rupture while pulling hard in a crimp grip as an example of an injury from overstraining in a single move. The literature commonly refers to a grading system for pulley injuries attributed to Schoeffl, though sources describe its grades slightly differently; this is from a search summary and unconfirmed.

Injuries from falls

US emergency departments

McKenzie and colleagues at the Center for Injury Research and Policy, Nationwide Children's Hospital (American Journal of Preventive Medicine, 2009), used national emergency department data and found more than 40,000 people treated for rock climbing injuries in the US from 1990 to 2007, a 63 percent rise over the period. Fractures and sprains or strains were each 29 percent of injuries. The lower limbs were the most injured region (46 percent) and the ankle the most injured single part (19 percent). Falls caused over three quarters of injuries. Climbers who fell more than 20 feet were 10 times as likely to be hospitalised as those who fell less, and such falls made up 70 percent of hospitalised patients.

Madsen, Pezzullo, Nixon, Vincent and Vincent (Frontiers in Sports and Active Living, 2025) used the same national data for 2013 to 2022, covering 1,372 climbers, 42.2 percent of them female. The limbs were the most injured sites. Fractures were 29.7 percent of injuries and sprains or strains 19.9 percent; 84.6 percent of patients were treated and released and 12.3 percent admitted. Most injuries in every age and sex group happened outdoors on rock or mountains, but half of injuries to under-18s happened on climbing walls. Women and under-18s were more often hurt in short indoor falls, and men and 18 to 50 year olds in longer outdoor falls. Citing earlier work, they say emergency bouldering injuries rose about fivefold from 2010 to 2020, and that a German hospital series by Mueller and colleagues of 430 bouldering patients found mostly lower-limb injuries: sprains 53 percent, fractures 22.8 percent and dislocations 11.9 percent, with 19.9 percent admitted.

The Austrian registry

Rugg, Tiefenthaler, Rauch, Gatterer, Paal and Stroehle (International Journal of Environmental Research and Public Health, 2020) studied 2,992 rock climbing incidents in the Austrian National Registry of Mountain Accidents from 2005 to 2018.

The authors found older age, a longer fall, climbing in the morning, and climbing without a helmet or rope associated with severe or fatal outcomes.

Mountain rescue records

Across UK mountain rescues from 2002 to 2006, Mort and Godden (Emergency Medicine Journal, 2010) found 77.2 percent of casualties injured and 10.4 percent ill. Fracture was the most reported injury (58.6 percent) and the lower limb the most injured area (53 percent). These figures cover all mountain activities, mostly hillwalking. Scottish Mountain Rescue's 2024 report records an injury for 128 people (27 percent) assisted in mountaineering incidents, with fracture the most common type (71) and the ankle (30 percent), lower leg (25 percent) and head (10 percent) the most common sites.

Other conditions in mountain data

Not every case is an injury. Curran-Sills and Karahalios (2015) found hypothermia, exhaustion, frostbite and dehydration were the main non-traumatic conditions in Alpine Club of Canada rescue records from 1970 to 2005. Scottish Mountain Rescue's 2024 report lists hypothermia (11), illness (8), seizure (3), heart conditions (2) and hyperthermia (2) among its recorded types. Illness at altitude is covered on the altitude illness page.

How injuries are classified

The UIAA Medical Commission published an injury classification for mountaineering and climbing sports (Standard No. 17, by Schoeffl, Morrison, Hefti, Schwarz and Kuepper), intended for doctors and scientists. It was written because earlier studies used inconsistent definitions and scores that made them hard to compare. It adapts the NACA score and records the location and class of injury and the risk of death. The UIAA document is dated 2010, with its text approved on 10 May 2010; a Bern emergency department study says the classification was introduced in 2011 (from a search summary). The gym study on the gym safety page reports its severity grades on the UIAA scale.