Background: Rock climbing participation in the United States has grown markedly, yet recent epidemiologic data are limited. This study characterizes national trends, injury patterns, and risk factors for severe injuries among climbers treated in US emergency departments from 2014 to 2023. Methods: Rock climbing-related injuries were identified in the National Electronic Injury Surveillance System database. Injuries were analyzed by type, body region, mechanism, and demographic group. Weighted logistic regression assessed fracture and hospitalization risk by age and fall height. Results: From 2014 to 2023, an estimated 47,251 injuries occurred. Fractures (26.8%) were most common, followed by sprains/strains (20.4%), soft tissue (10.2%), and lacerations (8.0%). Lower extremities were most frequently injured (50.6%), followed by upper extremities (26.7%) and torso (14.9%). Falls (58.8%) were the leading mechanism; falls >20 ft carried 52% higher fracture risk (odds ratio = 1.52, 1.41-1.63). Adults 21 to 45 years accounted for 63.1% of cases. Climbers >45 years had 45% higher fracture odds compared with those 7 to 20 years. Hospitalization occurred in 9% of cases. Conclusion: Fractures and lower extremity injuries are the most common presentations in US rock climbing Emergency Department visits. Older age and higher fall height were associated with increased severity of the injury. Level of Evidence: Level III . See Instructions for Authors for a complete description of levels of evidence.
Lin et al. (2026) studied this question.