Background Rock-climbing participation has grown globally in recent years, and the sport was officially recognised by the International Olympic Committee in 2010. The epidemiology of climbing injuries in adults has been examined, but few studies have investigated injury in youth climbers.

Objective To examine the incidence, mechanisms and risk factors for injury in recreational and elite sport climbers and boulderers aged 11–19 years.

Study design Cross-sectional.

Methods Youth (n=116) were recruited from climbing facilities across Alberta, Canada. Participants completed an anonymous questionnaire from October 2012 to March 2013. Climbing injury incidence proportions and incidence rates (IR) were calculated. ORs with corresponding 95% CIs were estimated for possible risk factors.

Results The injury IR was 4.44 injuries/1000 climbing hours (95% CI 3.74 to 5.23). Sprains (27%) and strains (26%) were the predominant injury types, and repetitive overuse was the primary mechanism of injury (42%). Hands and fingers were the most commonly injured locations (21%). Exploratory analyses showed three risk factors for injury: older age (15–19 vs 11–14 years; OR=11.30, 95% CI 2.33 to 54.85), injury in a sport other than climbing (OR=6.46, 95% CI 1.62 to 25.68) and preventive taping (OR=5.09, 95% CI 1.44 to 18.02).

Conclusions Injury risk is high in youth climbers. Findings are consistent with the reported rates, types and mechanisms in adults. Modifiable risk factors warrant further investigation to inform the development of injury prevention strategies, targeting high-risk climbers including adolescents and those with previous injury.