title: Radiographic adaptations to the stress of high-level rock climbing in junior athletes: a 5-year longitudinal study of the German Junior National Team and a group of recreational climbers.
abstract: BACKGROUND
  Radiographic adaptations and changes in adult climbers are a well-known fact, but few data are available for young climbers.
  
  
  OBJECTIVE
  Radiographic adaptations have been shown for highly active young climbers. The question arises whether these adaptations may lead to an early onset of osteoarthrosis in the fingers.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  Ten members of the German Junior National Team (GJNT; 21.0 +/- 1.6 years) and 10 recreational climbers (RC; 19.9 +/- 1.9 years) were examined using a standard questionnaire and radiographs of the hand. For comparison, radiographs of 12 young nonclimbers (control group [CG]) were evaluated.
  
  
  RESULTS
  The climbing level of GJNT increased significantly during the 5-year evaluation period (P < .01) and was significantly higher than that of the RC (1999: P < .01, 2004: P < .01). There was no increase in finger contractures or finger joint capsular width during the 5 years. Stress reactions were found in 8 of 10 of GJNT (1999 and 2004) and increased in RC from 2 of 10 (1999) to 3 of 10 (2004). No osteoarthrotic changes were found in 2004. There was no significant difference for the Barnett-Nordin Index between GJNT, RC, and CG. Years of climbing (P < .01), participation in climbing competitions (P < .01), hours of training per week (P < .01), number of training units per week (P < .05), and climbing level (2004) (P < .01) were significant factors for development of radiographic stress reaction in all athletes (GJNT and RC).
  
  
  CONCLUSIONS
  Intensive training and climbing leads to adaptive reactions such as cortical hypertrophy and broadened joint bases in the fingers. Nevertheless, osteoarthrotic changes are rare in young climbers. A longer follow-up is necessary to evaluate whether these adaptive stress reactions may lead to an early onset of osteoarthritis.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Klinikum Bamberg, Bugerstr. 80, Germany 96049. volker.schoeffl@t-online.de
authors.forename: Volker Rainer
authors.initials: VR
authors.lastname: Schöffl
authors.forename: Thomas
authors.initials: T
authors.lastname: Hochholzer
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schöffl
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging* / Q000473:pathology; D005858:Germany; D006225:Hand / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D006984:Hypertrophy; D008137:Longitudinal Studies; D008297:Male; D009051:Mountaineering / Q000502:physiology*; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D018709:Statistics, Nonparametric