Impact of 30 years high-level rock climbing on the shoulder - an MRI study of 31 climbers.

BACKGROUND: Rock climbers are particularly susceptible to shoulder injuries due to repetitive upper-limb movements on vertical or overhanging terrain. However, the long-term effects of prolonged climbing on the shoulder joints are still unknown.

PURPOSE: The purpose of this study was to analyze the prevalence of pain and degenerative changes in the shoulder joints after high-level rock climbing over at least 25 years. We hypothesized that specific climber-associated patterns of degeneration would be found.

METHODS: Thirty-one adult male high-level rock climbers were compared to an age- and sex-matched control group of 31 nonclimbers. All participants underwent a detailed interview, standardized clinical examination, and bilateral (climbers) or unilateral (nonclimbers, dominant side) magnetic resonance imaging (MRI) scans. Clinical and MRI findings of the groups were compared.

RESULTS: The lifetime prevalence of shoulder pain in the rock climbers was 77%. The rock climbers had significantly more abnormalities in the labrum (82% vs. 52%; p = 0.002), long biceps tendon (53% vs. 23%; p = 0.006), and cartilage (28% vs. 3%; p = 0.005). These increased changes positively correlated with climbing intensity. There were no differences between the two groups with respect to rotator cuff tendon pathology (68% vs. 58%; p = 0.331) and acromioclavicular (AC) joint degeneration (88% vs. 90%; p = 0.713). Despite the increased degenerative changes in the rock climbers, their Constant score (CS) was still better than that of the nonclimbers (CS 94, IQR [92,97] vs. CS 93, IQR [91,95]; p = 0.019).

CONCLUSIONS: Prolonged high-level rock climbing leads to a high prevalence of shoulder pain and increased degenerative changes to the labrum, long biceps tendon, and cartilage. However, it is not related to any restriction in shoulder function.

LEVEL OF EVIDENCE: Level III; Case-Control Design; Epidemiology Study.