Mountaineering is a dynamic activity which places very high demands on the body. It involves considerable risk, taking into account the terrain, altitude, and unpredictable weather conditions.1 One of the major risks of mountaineering is musculoskeletal injuries. The climber is exposed to a wide spectrum of musculoskeletal injuries when on an expedition which could have occurred because of rock climbing, ice climbing, loss of balance while walking on an uneven surface, etc. Insufficient mountaineering skills and/or preparation, and overestimation of their own capabilities were considered major reasons for injuries in mountaineers.2
The most commonly seen musculoskeletal problems in mountaineering include:

1. Ankle Sprain 

 Forms the biggest chunk of injuries in trekkers and mountaineers.3 An ankle sprain by itself may not be a concerning problem in the general population. However, for trekkers and mountaineers who rely on their foot and ankle joints for feedback to be able to walk on uneven surfaces, it is a matter of concern. Acute sprain if not treated and rehabilitated properly can lead to chronic ankle instability affecting the proprioception and balance of the individual which further increases the risk of falls.

2. Knee Pain 

Pain due to overuse injury of the structures around the knee especially when descending or going downhill is another commonly seen problem in trekkers and mountaineers. BMI>30kg/m2, improper technique while descending along with poor control and muscular imbalance around the knee are the main causes of knee pain in the mountaineering population.

3. Finger Injuries

 These injuries occur during rock climbing or due to excessive force on the fingers of which A2 pulley, tendon, and ligament strains are the most common finger injuries in climbers.4 Can be an acute injury or a chronic injury due to repeated micro-injuries to the soft tissue around the finger joints.

4. Shoulder Impingements

Impingement of the muscles around the shoulder complex either inside the shoulder joint or at the end of the collar bone causes pain in the shoulder. Usually occurs gradually over time with repeated ice and rock climbing. Poor climbing technique and muscle stabilization of the shoulder blade and the shoulder joint are the main predisposing factors for shoulder impingement injuries.

5. Low Back Pain

A sudden jerk to the back while trying to lift the backpack off the ground or consistently climbing with a backpack heavier than your body’s ability to withstand load without using chest and waist straps are the main causes of low back pain. It may be an acute episode or low-intensity long-standing pain depending on the extent of the injury. Reducing the load along with the use of a rucksack with good strapping goes a long way in preventing back pain on treks and expeditions.
A majority of the injuries that happen during treks or expeditions can be prevented by proper conditioning and preparation before the expedition/trek. Assessment and treatment of any pre-existing injuries, aches, and pains before going ahead with the climb ensures a safe expedition and minimizes the chances of re-injury. .

Author – Dr. Dhvani Nirmal (PT)
References:
Nirmal D, Ghodge S. Awareness about the Role Of Physiotherapy in Mountaineering Among Indian Mountaineers. International journal of physiotherapy and research. 2023 Jun 11;11(3):4531–6.

Burtscher M, Niedermeier M, Gatterer H. Editorial on the Special Issue on “Mountain Sports Activities: Injuries and Prevention.” International Journal of Environmental Research and Public Health. 2021 Feb 3;18(4):1405.

Paul John Braybrook, Hideo Tohira, Birnie T, Brink D, Finn J, Buzzacott P. Types and anatomical locations of injuries among mountain bikers and hikers: A systematic review. PLOS ONE. 2023 Aug 30;18(8):e0285614–4.

Schöffl V, Morrison A, Schöffl I, Küpper T. The Epidemiology of Injury in Mountaineering, Rock and Ice Climbing. Medicine and Sport Science. 2012;17–43.