Paper Method Subjects Described injuries. Questionnaire. Sent to members of the national climbing federation (RR 51%)

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AJ Logan, N Makwana, G Mason, J Dias. Acute injuries in the hand and Wrist Br J of Sports Med 2004;38:545-548[5] Sent to members of the national federation (RR 51%) 545 Subjects, Age 23-93, average 50, British M-E6 Finger joints 33% (non specific 25%, A2 pulley rupture 8%), lacerations 15% AJ Logan, N Makwana, G Mason, J Dias. Can rock lead to Dupuytren s disease? Br J of Sports Med 2005;39:639-644[6] Sent to members of the national federation (RR 51%) 545 Subjects, Age 23-93, average 50.Climbing level: British M- E6 Dupuytren s disease (19,5%) Jones G, Asghar A, Llewellyn DJ. The epidemiology of rock injuries Br J Sports med 2008;42:773-778[7] Handed out to potential respondents on facilities indoors and outdoors 201 Subjects, Age 35,2 (SD10, 7) Years of 13.9(SD11.8) Acute/Chronic 33% chronic injuries; Fingers 35%, shoulders 20%, elbow 17% Wrist 7%, forearm >5% other locations 15% Hochholzer T, Schøffl VR Epiphyseal fractures of the finger middle joints in young sport climbers. Wilderness and environmental medicine 2005; 16:139-142[8] 24 Subjects, Age 14,5 (SD0, 9). Climbing level 7a (6a-8a) Epiphyseal fractures Schøffl V, Hochholzer T, Schoffl I.Extensor hood syndromeosteophytic irritation 13 Subjects, Age 33,8 (17-55). Climbing level: German Extensor hood syndrome

of digital extensor tendons in rock climbers. Wildernes and environmental medicin 2010;21:253-256[9] 10,2, years of 19 (5-30) El.Sheik Y, Wong I, Farrokhayar F, Thoma A. Diagnoses of Finger flexor pulley injury in rock climbers: a systematic review. Can J Plast Surg 2006;14(4):227-231[10] Literature search 29 articles about flexor tendon injuries Review of finger flexor injuries Wright DM, Royle TJ, Marshall T Indoor rock : who gets injured? Br J sports med. 2001;35(3):181-185[11] Semisupervised questionnaire. Handed out to the audience of a world cup in 1999 Subjects 295. French 4-7b Chronic injuries 44%, 19% had more than one site of injury. Fingers most common 32% Roseborrough A, Lebec M Differences in static scapular position between rock climbers and a non-rock climber population. NA J O Sport PH T 2007;2(1):44-50[12] Subjects 61 (21 climbers, 40 healthy controls). Age 25,8 (SD6,8) Larger ratio of Glenohumeral/Scapular thoracic rotation among climbers than healthy controls Schweizer A Sport from a Review. No method A2-A4 ruptures, secondary

medical point of view. Swiss med wkly 2012;142:w13688[13] mentioned osteoarthritis in fingers and hip, carpal tunnel syndrome, tenosynovitis, ganglion cyst of A1 and A2. Epitrochleitis, biceps tendonitis (SLAP), outlet impingement, rupture of RC, acromioclavicular degeneration, rare glenohumoral degeneration, rupture of the meniscus in the knee, collateral ligamental laxation and rupture in the knee, maybe foot problems, low back pain, unspecific neck pain Bayer T, Schweizer A Stress fracture of the hook of the hamate as a result of intensive. J Hand Surg Eur 2009 34;276[3] Case report 1 subject. Age 31. Climbing level: high level Stress fracture of the hook of hamate Förster R, Penka G, Bösl T, Schöffl VR Climbers back- form and mobility of the thoracolumbar spine leading to postural adaptions in male high ability rock climbers. Int J Sports med 2009;30:53-59[14] Subjects 80. Age 31,2 (SD 6,75). Climbing level: At least French 7c, 3 years in row Climbers back

Peters P Nerve compression syndromes in sport climbers. Int J Sports Med 2001;22:611-617[15] Clinical examination of climbers with painful arms Subjects 83. Age 32,4 (19-48). Climbing level: French 6a-8a 25,3% nerve compression syndromes (16,9% upper extremity, 8,4% under extremity). Carpal tunnel syndrome 4, Ulnar nerve compression in the canal de Guyon 2, supinator syndrome 1, Pronator syndrome 1, unspecific hand pain 6, forefoot neuritis 5, compression of the superficial nerve of the dorsum of the foot 2 Pieber K, Angelmaier L, Csapo R, Herceg M Acute injuries and overuse syndromes in sport and bouldering in Austria: a descriptive epidemiological study. Wien Klin Wochenschr 2012;124:357-362 16] Published on websites and walls Subjects 193. Age 30,4 (SD8,1). Climbing Intensity Score 1671.4 (SD1916.4) Ligamental ruptures of the fingers 30,7%, Epicondylitis of the elbow 13,1%, chronic arthropaties of the fingers 7,5%, Rotator cuff lesions, SLAP, Bankart, bursitis and subluxations of the shoulders 6,4%, back pain (incl 2 fractures) 5,3% Rohrbough JT, Mudge MK, Schilling RC Overuse injuries in the elite rock climber. Med sci sports exerc 2000;32(8):1369-1372 17] Questionnaire and clinical evaluation of contestants in the national championship in USA 1995 Subjects 42. Age 25 (13-40). French 8a (7b- 8b+) Collateral ligament injury in fingers 40,5%, shoulder pain 33,3%, bowstring 26,2%, flexor tendon pain 26,2%, A2 pulley pain 23,8%, nodules of the tendon 23,8%, medial epicondylitis 21,4%, lateral epicondylitis 9,5%, painful muscle joint connection 7,1%,

wrist undercling injury 7,1%, carpal tunel syndrome 7,1% Thompson RN, Hanratty B, Corry IS heel hook rock maneuver: a specific pattern of knee injury Clin J Sport Med 2011;21:365-368[18] Single case report 1 subject, age 24. Climbing level: experienced Rupture of anterolateral bundle, partial rupture of posteromedial bundle of PCL Schweizer A Lumbrical tears in rock climbers. J Hand surg 2003;23B(2):187-189 4] Description of diagnosis Subjects 3. Age 25-29. Climbing level: French 7b+-8b+ Rupture of musculi lumbricalis (4 lumbrical) Buda R, Di Caprio F, Bedetti L, Mosca M, Giannini S Foot overuse diseases in rock an epidemiologic study J Of am pod med asc; 2013 103(2): 113-120 19] Clinical examination of athletes Subjects 144. Age 31,7 (16-60). Climbing level: 4-8 (Scale unknown) 86% chronic injuries in the foot. Nails 65,3%, ankle sprains (27,8%), retrocalcaneal bursitis 19,4%, achilles tendinitis 12,5%, metatarsalgia 12,5%, plantar facitis 5,6% Supplementary Table : Included papers