Health and performance among Swedish climbers: Exploring the challenges affecting mental well-being, injury, and athletic Development

Abstract

Climbing has, in the recent decades developed rapidly both as a recreational activity and a competitive sport. The rapid growth of the number of participants, increased media attention, and the sport’s inclusion in the Olympic Games in 2020 has facilitated this expansion. As the sport of climbing matures, there is a growing awareness of health issues associated with the sport. As the transformation of climbing into a mainstream activity and an athletic discipline is in its early stages, scientific research on climbing-related health conditions is still limited. The overall aim of this thesis was to investigate sports-related health issues, previously identified in more established sports, within the context of climbing. Study I is a cross-sectional study, investigating the prevalence of radiographic spinal changes in climbers using Magnetic Resonance Imaging (MRI). The occurrence of spinal changes was compared with a non-climbing control group. No significant differences between the groups could be displayed in terms of spinal changes. The overall occurrence and the severity of spinal changes were low in both groups. Study II is a systematic review examining current practices in MRI classification systems used when examining spinal changes in athletes. The results showed that the use of established classification systems was limited and lacked consistency when examining spinal changes in general athlete cohorts. Study III is a cross-sectional survey-based study examining depressive symptoms, sleep quality, stress, anxiety, and overuse injuries in advanced and elite climbers, compared with non-climbing controls. The results displayed substantial symptoms of mental health problems as well as poor sleep quality in climbers and controls. No significant differences were however found between climbers and controls, nor between advanced and elite rock climbers. Fingers and hands were the most common injury location, with 16.5% of the climbing participants currently experiencing substantial problems. 4 ABSTRACT Study IV is a cross-sectional study examining disordered eating, body dissatisfaction, and climbers’ perceptions of the importance of leanness and low body weight in relation to climbing performance. The climbing group was compared with non-climbing controls. Non-climbers reported significantly higher levels of body dissatisfaction compared with the climbing group. No significant difference was recorded in terms of eating disorders between climbers and non-climbers. Study V is a validation-study of methods for examining maximal finger strength testing, a key indicator of bouldering performance. The study examined six commonly used grip positions among male climbers in the climbing discipline of bouldering. Strength in the half-crimp position was demonstrated the most important performance indicator in the sample, explaining 57% of the variance in bouldering performance. Together, this grip position and the position Front three drag accounted for 66% of the variance in performance. The study provides a dependable and easily reproduceable method for measuring maximum finger strength among bouldering athletes. In summary, climbing athletes experience symptoms of mental ill-health at a high prevalence, but seemingly at a similar level as non-climbers. Widespread ideas of the importance of low body weight for performance are prevalent and alarming. Degenerative changes of the spine were not more prevalent in climbing athletes, but the study was limited by sample size. Given that most observed abnormalities in climbers were minor, climbing does not seem to pose a major risk for the development of these changes. Established classification systems for spinal changes, along with the development of quantitative classification methods are needed to further advance research in this field. Finger strength is a key factor in climbing performance, and the method for assessing finger strength presented in this thesis is applicable for evaluating and improving performance of athletes in the sport.