Background Rock climbing, an increasingly popular sport internationally, has become more accessible to broader populations with increasing numbers of climbing gyms and clubs. Even more participation should result from competitive climbing's inclusion in the 2020 Tokyo Olympics. Describing injury patterns among broad populations of climbers is a first step in developing recommendations for increasing the safety of both recreational and competitive climbers.

Objective Describe incidence, characteristics, and trends of rock climbing injuries presenting to United States (US) emergency departments (EDs) from 2006–2015.

Design Retrospective descriptive epidemiology.

Setting US EDs.

Patients Patients presenting with climbing injuries.

Assessment of Risk Factors Case reports were obtained from a large national hospital surveillance system that included sample weighting factors enabling calculation of national estimates.

Main Outcome Measurements Injury incidence and characteristics.

Results An estimated 39,285 climbing injuries were treated in US EDs from 2006–2015; incidence increased by 36% during that period. The majority of injured climbers were male (70.0%) and aged 20–39 years (57.5%). Ankles (21.7%) and lower legs (16.0%) were the most commonly injured body parts. Fractures (28.4%) and sprains/strains (27.3%) were the most common diagnoses. Most common mechanisms included falls (73.0%) and acute non-contact (13.0%). Overall, 12.1% of injuries treated in the ED resulted in hospitalization. Males (OR=1.91, 95% CI=1.11–3.30) and climbers who fell >20ft (OR=7.46, 95% CI=4.01–13.71) were more likely to be hospitalized than other injured climbers. Hospitalization was most frequent for fractures (66.6%) and head injuries (19.8%).

Conclusions Climbing injury incidence increased over the past decade with young males most commonly injured. While lower limb injuries were the most commonly treated, head injuries accounted for nearly 20% of all hospitalizations. Such basic descriptive epidemiology studies characterizing injuries among broad populations of climbers can inform health care coverage decisions at competitions and drive future injury prevention efforts.