title: Foot overuse diseases in rock climbing: an epidemiologic study.
abstract: BACKGROUND
  Literature examining the incidence of foot diseases in rock climbing is limited to traumatic injuries. We examined a large sample of climbers, assessed the chronic diseases of the foot, and correlated them with foot morphology, shoe type, and type of climbing practiced.
  
  
  METHODS
  Between May 1 and September 30, 2009, 144 climbers (mean age, 31.7 years) were examined to analyze the effect of rock climbing on the various foot diseases found at the time of the evaluation.
  
  
  RESULTS
  Eighty-six percent of the climbers were affected by a pathologic condition. Nail disease was found in 65.3% of patients, followed by recurrent ankle sprains (27.8%), retrocalcaneal bursitis (19.4%), Achilles tendinitis (12.5%), metatarsalgia (12.5%), and plantar fasciitis (5.6%). Male sex, the use of high-type shoes, the high degree of climbing difficulty, and the competitive level were often related to the onset of foot diseases. Climbing shoes are usually smaller than common footwear. This "shoe-size reduction" averaged 2.3 sizes, forcing the foot into a supinated and cavus posture that favors lateral instability. The posterior edge of the shoe aperture produces increased pressure on the heel, with retrocalcaneal bursitis.
  
  
  CONCLUSIONS
  Overuse foot diseases related to rock climbing are particularly frequent and debilitating. Detailed knowledge of these diseases and their predisposing factors may help us implement effective preventive or therapeutic measures, including changes in the type of climbing, correction of body weight, degree of difficulty, footwear, orthoses, and measures that maximize the support of the foot to the ground.
authors.affiliation: Rizzoli Orthopedic Institute-II Orthopedic Clinic, Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Buda
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Caprio
authors.forename: Letizia
authors.initials: L
authors.lastname: Bedetti
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mosca
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D012090:Cumulative Trauma Disorders / Q000453:epidemiology*; D016021:Epidemiologic Studies; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005534:Foot Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012775:Shoes; D055815:Young Adult