Climbing is a great time but accidents and injuries happen occasionally. Before you climb, read up on prevention and first-aid management of common climbing injuries. Look out and care for one another while out in the wilderness. Happy climbing!

Rope burn

Grab hold of a fast-moving rope and you put yourself at risk of rope burn. It commonly occurs to the belayer when their climber takes an unexpected fall and you have to make a quick correction. Rope burn is painful and can put you out of climbing action while it heals.

Prevention

As a belayer, pay attention to your climber and avoid unexpected falls. Lower the climber through controlled decent. For more protection use a pair of belay gloves.

Treatment

• Wash well with saline solution
• Use topical iodine, antiseptic and antibacterial cream or ointments liberally to discourage infection
• Cover with gauze or adhesive bandage and keep clean and dry
• Check again after 24 hours – if it has begun to scab it will heal better uncovered

Seek medical attention if the burn is deeper than the epidermis (outer layer of skin).

Cuts & abrasions

Cuts and abrasions are common while climbing and commonly involve the hands (especially when crack climbing), elbows, knees and other extremities.

Prevention

Proper climbing technique should limit your cuts and abrasions. Map out your moves up the wall as you go to prevent banging into the walls. While crack climbing, consider making a tape glove to protect your hands from abrasion. Strapping tape is useful to protect existing cuts and grazes. As long as it’s not too slippery it should not inhibit your ability to climb.

Treatment

• Apply pressure to the area to cease bleeding
• Wash with saline solution
• Disinfect with iodine or another antiseptic
• Antibacterial creams are good to prevent infections and promote healing
• Cover with gauze or adhesive bandage
• Change the dressing every 24 hours
• Deep lacerations require extensive irrigation and sutures. If you do not have appropriate training, seek medical help.

Blisters

Repetative rubbing on a single pressure point will cause blistering. Poorly fitting climbing shoes are a common cause of blisters over the heel and Achilles tendon insertion. Blistering is common over the metacarpal or middle phalangeal heads on the palmer aspect of the hand.

Prevention

Well-fitted shoes will help to prevent blistering on the feet. Good outdoors stores (like Bogong) will fit your shoes prior to purchase. Put tape over any areas that you know or feel are rubbing. For the fingers and palms, make a tape glove however, a glove will impair your feel on the rock. Over-time the skin over pressure points will callus – a physiological barrier to blistering.

Treatment

• Wash with saline solution
• Cover the blister with non-adhesive gauze and secure with tape.
• Avoid puncturing the blister (tempting) as this may introduce infection.
• Seek medical assistance if the area is not healing or becomes irritated, red, warm, with increasing pain.

Head injury

Head injuries in climbing are most likely to result from objects falling from above. More serious head injuries may result from a big fall but are unlikely if the person has been trained to take falls correctly.

Prevention

If climbing outdoors always wear a helmet. Put it just before you enter the crag and don’t take it off until you leave. Some other simple measures to ensure you avoid a head injury:

• Be aware of what is going on above you.
• Don’t walk below someone who is climbing above.
• If a rock (or something else) falls from your wall, call “Rock!” repeatedly.
• If someone calls “Rock!” do not look up. You might get hit in the face.

While bouldering, climb sensibly, not too high, not for too long. Look out for your friends. Use a crash pad and ensure that it is positioned appropriately under the climber. Spot others from behind while they climb and communicate with them frequently. Ensure they know you are there and give you warning before they let go of the wall.

Treatment

Note: head injuries can be life threatening, if unsure about your own medical abilities or the status of the patient make sure to seek help from a medical professional by dialling 000.

Mild head injuries with no loss of consciousness, confusion or disorientation and mild scalp bleeding, treat like any other laceration. Head injuries will often bleed more so you will need to apply pressure for a while to stop the bleeding.

If any of the following occur always call emergency services:

• Loss of consciousness, even if consciousness is regained
• Confusion, disorientation or lethargy following the injury.
• Nausea and vomiting
• Skull deformities
• Clear fluid from ears or nose
• Black eyes or bruising behind the ears
• Visions changes – fixed dilated pupil
• Any memory loss

Unconscious climber – DRS ABCD

Treatment or an unconscious patient follows DRSABCD

• Danger – check for any surrounding danger. E.g. more falling rocks
• Response – is the patient responsive. Call their name. If there is no response, squeeze their hand or forearm. Can they open their eyes? Can they respond with their voice? Do they move their fingers and toes, arms and legs?
• Send for help – if you have seen the injury you can do this straight away.
• Airways – check that nothing is obstructing their airways. If the person is talking or crying out their airway is clear.
• Breathing – are they still breathing. Is their chest rising and falling.
• CPR – if they are not breathing commence CPR. Aim for 100 compressions per minute. Do 30 compressions and then two breaths.
• Defibrillation – if you have a defibrillator make sure to use it. Defibrillators should be attached as early as possible.
• Avoid moving an unconscious patient unless they are in immediate danger. Unnecessary movement may worsen any sustained spinal injuries.

Finger pulley injury

This injury is almost exclusive to climbing. The finger flexor tendons run through sheaths along the ventral aspect of the metacarpal and phalanx bones. The sheaths cross perpendicularly, anchoring the tendons to the bone and prevent them pulling away as the fingers bend. It is possible to rupture the tendon sheath when climbing with the fingers fully flexed or crimped. Dynamic moves onto a small crimp are often the culprit. You may hear a pop and feel significant pain near the base of your fingers. YIKES!

Prevention

To prevent finger pulley injuries make sure you are properly warmed up. Static stretching of your flexor muscles really helps. Building up your climbing slowly and steadily will prevent your chance of injury. Don’t be a hero and go for that impressive dyno to crimp when you haven’t been climbing for 6 months. It’s not likely to end well.

Treatment

Immediate management is pain control and basic first aid. Unfortunately there is not much else to do. Don’t just push through the pain, it may make the injury worse. Once home seek professional medical advice.

Specific treatment depends on the severity of the injury:

• Grade 1 – a partial tear of a single pulley
  • Gentle finger stretching, stretch the finger until it feels tight and hold for a few seconds
• Grade 2 – partial tear of multiple pulleys
  • Immobilise the finger with a finger splint for 1-2 weeks.
  • Gentle movement exercises
  • H-taping for three months while climbing
• Grade 3 – full rupture of single pulley
  • as for Grad 2 tears
• Grade 4 – full rupture of multiple pulleys and damage to surrounding lumbricals
  • often required surgery

Subluxation and dislocation

Subluxation or dislocations in climbing usually occur in the upper limbs, either shoulder, elbow or finger. Shoulder is the most common and can occur during dynamic moves due to forces on the joint in full extension. Previous or predisposing injuries may increase your risk of dislocation at the shoulder or fingers.

Prevention

Build up your climbing experience and strength over time to prevent injury. Don’t go too big, too early. Warm up prior to climbing and avoid dynamic moves that put your joints at risk (dangling off a single arm). Prevention of sublaxation and dislocation is very important as recurrence is very common after your initial injury.

Treatment

DO NOT try and relocate a dislocated joint unless you have the medical training to do so. Improper relocation can cause damage to the surrounding soft tissue, nerves and vasculature.

• Check the proximal limb for any signs of vascular or neural damage (if present call 000)
  • Check for pallor of the limb
  • Check capillary refill
  • Check for any loss of sensation
  • Check for any tingling
• Use padding and bandages to support the limb in the position most comfortable
• Apply ice
• If comfortable support the limb in a sling
• Seek medical attention as soon as possible