Climber's Hand Care: Bone Marrow Edema

Climber's Hand Care: Bone Marrow Edema

A German study recently published in the Clinical Journal of Sports Medicine has followed up previous findings of bone marrow edema (BME) of the hand in climbing athletes. Between 2009 and 2015 MRI scans were performed on high-level climbers (climbing between 23-33 Ewbanks) that complained of non-specific pain in the hand, fingers and/or lower forearm. Only climbers suffering load-dependent pain, unable to climb were included in the study. 94% of climbers presented with BME (see below for examples). BME is the build-up of fluid in the bones. For climbers, this typically occurs in the bones of the hand (see image below) and can be excruciatingly painful at times. If ignored and high-intensity training continues, fractures can often eventuate. Climbers who increase their training intensity dramatically within a short time are especially at risk of developing BME.

High-frequency training and high-load exercise were attributed to BME of the wrist. Consequently, all climbers were advised against any extensive training. However it was recommended they incorporate light sports to compensate until full recovery. Not surprisingly delayed healing was seen in climbers who restarted climbing and training too soon. To recover, this study suggests BME must no longer be visible on MRI and/or the symptoms must have ceased prior to restarting full-load training. This usually requires up to 6 months or more.

Distribution of BME: (A) metacarpal bones, (B) carpal bones 74.2% , and (C) forearm.  Image source:Volker Schöffl@ResearchGate

Distribution of BME: (A) metacarpal bones, (B) carpal bones 74.2% , and (C) forearm. 
Image source:Volker Schöffl@ResearchGate

Bone marrow edema of the hand in 3 different rock climbing athletes (A: 16-year-old rock climber, B: 31-year-old athlete, and C: 24-year-old patient).  Image source: Volker Schöffl@ResearchGate

Bone marrow edema of the hand in 3 different rock climbing athletes (A: 16-year-old rock climber, B: 31-year-old athlete, and C: 24-year-old patient). 
Image source: Volker Schöffl@ResearchGate

 
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