Statistics on injuries resulting from ice lead falls

Derek Doucet wrote: The main difference between falling on ice and the drytoolers you mention above is the angle of the terrain they're generally climbing on. The vast majority of pure ice routes are at most vertical. Most modern drytooling is on overhanging ground.

There are a lot of techy vertical and off-vertical drytool routes and many overhanging mushroomy, curtainy ice climbs around here. I would just rather fall on bomber bolts that are 4-5 feet apart in solid rock with no icicles hanging around.

Derek Doucet wrote: Sadly, the lesson they seemed to have learned (increased confidence in the strength of ice pro) misses the point entirely.

Exactly my point: increased confidence in modern pro and the "ice climbing is easy" nowadays common belief arm people with false security to jump on sharp end well before they are ready, IMO.

Here is a rant by Will Gadd on the above posted video: gravsports.blogspot.com/201…

And here is Will Mayo's rant on how ice climbing is not trivial: willmayo.us/new-routes-in-v…

I know of at least 9 (edited) ice climbing falls. Maybe these are the ones that stuck in my memory.

1) fall on runout thin ice. Broken scapula.
2) fall on ice transitioning into rock. MI2 position fall. Broken thumb.
3) fall on steep ice. Probably broken pelvis. Unclear if medical condition precipitated the fall. Climber died.
4) fall steep pillar when it collapsed. Climber survived with minimal injuries.
5) advanced climber on steep ice, major lower leg injuries, long recovery.
6) infrequent ice climber on more remote climb, only 1/2 rope clipped, fell, comminuted lower extremity fractures, long crawl out. Long rehab.
7) big ice pillar collapsed on climber. Climber died from massive trauma.
8) climber goes simul-solo on low angle ice while nursing a shoulder injury. Climber fails to drive pick adequately, bounces down ice, catches self, hematomas, finally gets attention for shoulder.
9) climber on hero steep ice in remote location, falls, nasty lower extremity fractures, long extraction. Climber loses lower leg.

Try not to fall on ice.

Doglio wrote: "Here is a rant by Will Gadd on the above posted video: gravsports.blogspot.com/2011/03/ice-climbing-is-not-rock-cli">>>

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Video clip spoiler: the guy lives.

I was going to post this video link to another post going on re: dealing with a cool head while leading on steep ice but everyone is so upbeat in supporting the first commenter and subsequently everyone else that I didn't want to add such a sobering clip.

I probably eventually would have though. I saw this within weeks when it first came out along with the caveat from a Conway friend who said it was "difficult to watch" (meaning, the guy gets slammed, but also difficult in how many & which kinds of mistakes were made, ESP by the belayer (who I think should be banned from ice climbing if not all forms of climbing - sorry for the strong feelings).

He sez on camera: "It's common to fall on ice, it's to be expected"). Not.

In my lexicon, the word "rant" does not connote a positive tone. Even Gadd, at the beginning asks everyone (the bloggers) to (paraphrasing Will) "dial down the dialogue & make it constructive" yet he makes his own feelings known. If anyone gets to "rant" about anything related to ice climbing, it's Will Gadd.

Besides watching the clip numerous times, I recommend reading the bloggers' comments. They caught mistakes in the video that Gadd missed and he admits it. Many commenters make very good points, hence, the lesson is not only the video but reading the responses. The point is that such a series of disastrous mistakes are difficult to fully dissect.

gravsports.blogspot.com/201…

For those following the forum "lost my lead climbing head" [something like that], think about what is to be learned in the clip and DO NOT imagine YOU doing what these guys did because if you imagine yourself doing it, it ups the chance that you will.

Lead on.

There ARE statistics re: ice climbing falls:

There IS an academic study of ice climbing injuries published by (I think) the American College of Orthopedic Surgeons (or a professional group such as this -there are several such organizations).

The last one I remember was about 4- 5(?) years ago and I recall they published it rather regularly (every 2-3 years ????); could be wrong...might have been a one-off.

I will both search the net and look for my hard copy. I've looked online the last 3 or so years and have not found find it. My orthopedic surgeon is an uber climber; will ask him.

One statistic from the study has always stuck with me (and makes sense but sobering nonetheless): If an ice climber falls [just] 3', they have [based on their studies] a 90% chance of sustaining some sort of ankle injury, even it if it's a slight sprain. I think their conclusion is the most likely culprit is catching the crampons' front points. Of course.

Others in this dialogue and elsewhere have experienced or seen different results. Of course.

So I concluded that if you take a 100' whipper on a bungy cord, you'll be OK.

Will try to find the study and post.

If anyone else finds it, please post but I am certain that such a study was done.

Adam Maxwell wrote:Took a 30+ footer last week and gratefully walked away unscathed despite pitching back and falling most the way upside down. On looking at the screw that held found 3 fractures all at 120 degrees. I have heard horizontal fractures are more typical but havent seen any photos of affected ice. Stoked the ice held, but obviously was stressed. Not sure how close this threshold was taken to failure but gives me confidence for future dire moments!

How long was the screw? Was your placement at a positive or negative angle? Did you carefully inspect the screw for structural failure such as a bend, however so slight?

Looking for a study I hear, this one has potential?
link.springer.com/article/1…

NATE'S ACCIDENT AND AN OVERVIEW OF ICE CLIMBING FALL TRAUMA

Re: Video clip accident on Dracula (New Hampshire)

Am a bit bewildered by several in this string using these words "....the leader survived UNSCATHED.....".

He was not 'unscathed'.

- Fractured fibula;

- Fractured right little finger;

- Skull fracture of 'frontal lobe' (the term Nate uses. The "lobe" is the brain, the bone is the frontal BONE....that's what he means; this is not a critical comment - just clarifying);

- Orbital eye fracture. (This could be either/both the, i.e., the "superior orbital rim" (underneath the eyebrow), AND/OR the "inferior orbital rim" (bottom of the eye socket).

(The hole in his forehead is more than curiously identical to the diameter of an ice screw. While his screws held, he had others on his harness. I and other physicians believe it was an ice screw wound; however, it all happened fast...and it's extremely difficult to tell from the video exactly what happened).

No doubt he is lucky and a fantastic guy; I've had the pleasure of meeting him. As someone correctly pointed out, a fall like this is not typical (nor was Jack Robert's tragic fall and subsequent death on Bridalveil).

I do NOT agree that Nate was "unscathed" nor the impression that word may give to the uninformed re: ice climbing; however, he is unlikely to have long term problems (with the possible exception of his eye socket & longer term eye pathology should the broken bone(s) influence that in some fashion). The frontal lobe fracture means he possibly (probably) sustained a concussion; that could have long terms effects, especially if he experiences additional head trauma events.

We'll be optimistic here and say he will have no long term problems. After all, as he says, he gets to go home to his family.

A commenter said: "The lessons they SHOULD have learned appear to have been missed entirely". In my opinion, you are absolutely correct; however, I think this applies more to the belayer.....his comments that "falls happen all the time and are to be expected" gives uninformed viewers a grossly distorted impression of ice climbing. I and others in different venues, including health professional's conferences have openly objected to his comments on numerous occasions).

Many in this string have emphasized that serious injuries can result from minor falls or "slips". It is this very thing that should be emphasized versus something like Nate's fall that can result in being "unscathed".

I think there is too much belief in the notion that "if the ice screw held, (by extension of that logic), then it's OK to fall". This is perilous thinking.

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THE EMERGENCY ROOM

The trauma (inc. non-fall injuries) we see in our ER (a major hospital) as a result of ice climbing accidents is as follows, generally in this order (many of you may know much or all of this but for those who don't):

1. ANKLE SPRAINS, DISLOCATIONS & FRACTURES

Note: we & others believe ankle injuries are under reported to ERs and other health professionals because those we see usually have potentially and/or perceived serious damage while lesser ankle 'sprains' that ice climbers may sustain...or believe are limited to such... are an issue that they think (often incorrectly) can be managed on their own.

Those whose ankle problems substantially worsen in the ensuing days typically do not visit an ER, rather, they will see their own physician (who may or may not be an orthopedist) or be referred to one. Many will not seek any medical care; indeed, many will not need professional evaluation. Thus, we are very unlikely to see them, thus the paucity of solid data in studies of ice climbing accidents with regard to ankle injuries in particular.

Simply put, it is certain that there are more serious ankle injuries from ice climbing falls - even very short ones (excluding very mild ankle injuries which climber patients can successfully manage on their own) than is reported. Fellow climbers should encourage such victims to visit an ER immediately rather than "tough it out, put an ice cube on it and see how it goes".

2. CUTS, PUNCTURES AND ABRASIONS FROM SHARP OBJECTS

All know that a falling ice climber is an open box of razor blades, even if the distance is very short. Wounds to the head can bleed profusely and appear worse than they are; however, the climber may have sustained other, more serious cuts and/or punctures such as a crampon catching and rotating inwards (toward the other leg) and severing the femoral artery. All know that this is a life threatening situation. Unfortunately, we have experience with these rare accidents.

Because head wounds are not that uncommon (as Nate experienced), those immediately involved in providing care and evaluation (to the extent of their expertise) should take care not to dismiss the possibility of other wounds and/or broken bones that may be more serious and that need priority attention. We are programmed to see and pay priority attention to the color "red"; don't let it fool you.

An ice screw doesn't need to go far in penetrating skin to do significant damage, including eventual infection and the odd shape and pattern of just the teeth of a screw cut is.....odd. In other words, to some, a very shallow incision may be dismissed (and most likely should be in the very short run unless it has punctured a major blood vessel). Some wounds of this nature tend to not bleed much at first but they should not be ignored. A deeper ice screw wound is an entirely different, obvious beast.

Harnesses that have ice clippers too far forward are not the best design. If you put your harness on and clip ice screws (1 or 10 -- doesn't matter) on the forward-most part of your harness and squat down, the screw(s) should not be sitting further than the middle of your thigh (at best; they shouldn't even be laying on your thigh). If they move into your crotch area, well....don't say we didn't warn you.

It is interesting to note that some manufacturers market certain harnesses as "ice climbing harnesses" yet the front clipper area (say, sewn for that purpose) is way too far forward for safety reasons. Another problem is that some climbers will attach ice clippers too far forward on whatever type of harness they have. Screw location and hang direction should always be considered when using and/or modifying any harness used for ice climbing.

3. KNEE JOINT DISLOCATIONS/LOWER LIMB ROTATION, INCLUDING TENDON AND MUSCLE DAMAGE

4. SHOULDER DISLOCATIONS AND/OR ROTATOR CUFF DAMAGE

These are likely the result of ice tools (attached by leashes when leashes are worn) catching ice and or rock features, placed protection and ropes during a fall. (Note: tools attached to tethers (as opposed to leashes) are not a common presenting problem in the ER due to the typical slack in the system; the trauma is typically secondary to something else. Unforgiving 'home made' leashes constructed from static webbing is a problem we have seen.

5. HEAD CONCUSSIONS

The most serious concussions are the result of the climber patient falling backwards, hitting the occipital (rear) part of the skull. Climbing helmets are designed and tested for protection (however limited) from falling objects from above and not from behind nor a side impact. It is well known in many sports that helmet protection is the subject of increased research and design; the climbing helmet industry is no exception - considerable research is underway.

All ice climbers know that falling ice is perilous; it is hardly worth mentioning because it is attendant to the activity, however, we have seen serious concussions as a result of ice impact. If the force really "rings your bell", cracks your helmet or knocks you off a stance, it's probably time to visit an ER.

When ice (or rock) falls from above and the climber(s) know it is coming (either visually or from a shout above), the natural reaction for humans is to turn their head away (sideways) and somewhat hunch their shoulders. This reaction is precisely the movement to avoid because it exposes the person to being hit on the side of the head (and no helmet on the market.... except the little known and difficult to find Italian KASK)...will prevent side impact injury) and/or neck or even collar bones. For a lead climber, it increases the chance of him/her being knocked off the stance or position, not only because of potential force but more often imbalance, even slight on steep terrain.

The body movement that increases a margin of safety is to quickly thrust your HELMETED head straightforward and slightly down against the ice, hunch your shoulders up high and tight and "flatten" your body (as much as possible) against the ice. If you are wearing even a small pack, that may help lessen the impact either by direct absorption or in supporting the neck. The idea is obvious: be less of a target. Be streamlined.

Because the above response/reaction is not at all natural in humans (turning away is), I recommend it be practiced (moving head first into the ice), however silly it may look to others or feel for you - get over it! "Practice" does not mean throwing ice down on each other! The body movement can be done at the bottom of a climb in a protected area or even on the route itself at a belay stance but obviously under controlled conditions and situations. (Practicing at home isn't recommended for various reasons, not the least of which is you really aren't near ice and your brain is smarter than that; do it on the "real thing"). You need not feel nor act like a NFL player, i.e., don't slam your head against the ice nor do it repeatedly. The goal is to at least get an idea of the action and position because many will likely not have done so until it's too late. We know this because we occasionally see the results.

(A related note to this injury category: That Nate's belayer lowered him head first and unconscious was obviously the wrong thing to do, especially with an ER physician on the scene who would have immediately evaluated him at a higher spot where he initially stopped. If he had sustained spinal injury, his lowering could have had disastrous consequences. That said, a situation such as Nate's happens fast and keeping a cool head about it all is asking a lot. In their case, many people were shouting "do this, no, do that". Difficult to tune that out).

Surprisingly, we've never seen a broken neck as a result of an ice climbing fall or objective danger such as large ice chunks striking a climber but such accidents have occurred elsewhere.

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Not surprisingly, we see a range of other unique, ice climbing injuries such as dropped tools & equipment onto belayers...or others below, however, I would not place them in 'major' categories. The exception may be lower back injuries, the likely result of being torqued in unspecified, unpredictable, and various actions of the harness and body (fulcrum-ish) movement during the fall (the mere wearing of the harness is obviously not the problem).

Just as some serious ankle injuries are not immediately reported to the ER, lower back injuries often take the same course, i.e., become a chronic problem not necessarily associated by the climber patient with an ice climbing fall that happened much earlier (weeks, months, years) but in fact was.

It is not unusual to see ice climber patients in late evening, even (or especially) at night. This is because climbers, in the winter days of less light, can be caught (through no fault of their own or poor judgement) on a route and/or descending a route with an injury and the darkness itself has been a contributing (or causal) factor in worsening the situation because of a number of factors. (Of course headlamps should always be taken but they do not obviate all potential hazards, in particular, extreme cold).

Interestingly, cold weather can mask less serious injuries such as minor cuts and even sprains because the body is more interested in keeping its core warm than in paying attention to less threatening problems. In other words, your body is feeling (and maybe fighting) the cold but not paying much attention to trauma that is best dealt with by trained medical staff.

It is notable that face shields (such as Petzl's) are much more common in Europe than in the U.S. The difference in face trauma (of various kinds and severity) is also notable and statistically verified.

A FINAL IMPORTANT NOTE: The above accidents as described do not consider nor take into account the grade nor intermittent slope degree of the climb; however, some correlations can and have been made in informal studies. It is beyond the intent of this post to discuss this complicated but interesting matter. The "safe" assumption is that all of the above can happen at any grade. Mixed climbing has other issues unique to itself, however, all of the above apply. Those that argue overhung mixed climbing is safer than it looks are correct. This particular risk issue has been studied by others.

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I have indicated in another post that a statistical study of ice climbing accidents was done within approximately the last five years by a medical association and while I've looked for this before (both my hard copy and online), I've yet to find it. When I do, I'll post up (link or hard copy) to anyone interested.

Just above this post, Andy P (thanks) provides an academic reference asking if the link he provided was to the study I am referring. No, it is not...that is a German study and curiously, the abstract says: “Rock climbing originated as a skill practice for difficult sections of a mountaineering ascent in the 1960’s and was practiced by a small group of dedicated climbers.”

They may be off by 200 years +/-.

Andy, I know of this 2010 study but had not read it; I also know one of the authors....will have to tease him about the above comment. But the group is trying very hard to provide evaluative formulae that addresses many types of sports injuries....hard to do but I think they are about to publish their results. This should be watched because they have singled out ice climbing as a particularly risky sport (of course) and to their credit, they are after hard stats on it in particular.

Andy P. wrote:Looking for a study I hear, this one has potential? link.springer.com/article/1…

Andy P, thanks much for this. I've addressed this study --- and credited you -- in my too-long post above this one (re: trauma of ice climbing falls).

In response to Warbonnet:

First, thanks for the information. Much appreciated.

Second, my apologies for the poor choice of words with the term "unscathed". While I still might argue that "relatively unscathed" given the severity of the fall is a fair assessment, the fact is that I hadn't viewed the video since it was first released. I recalled the leader speaking to the camera and upright the day after the fall, but didn't recall his injuries and did not intend to trivialize them. That said, I'm still astonished that they weren't much, much worse. That could have very easily been a fatal fall.

I also stand by my contention that the sharp, pointy things we have on our feet (and elsewhere as you noted), combined with the relatively low angle of most ice climbs (even sustained 5+ is rarely beyond vertical, it just feels that way) are the main issues. Ice pro itself has gotten much better than when I began, and perhaps most importantly, so easy to place, that it has dramatically reduced the length and frequency of the huge runouts once so typical of leading steep ice. In good ice, modern screws themselves are reasonably reliable. But I'll say it again: falling is still a TERRIBLE idea. Even if the screws hold, the chances of significant damage are just too high.

I highly recommend to all aspiring ice leaders that they think through in advance how they will react when facing a building pump or weird ice. Do they know how to clip in to their tools in a desperate situation? Do their fancy tools even have a place to clip to? Have they put in the mileage on TR and as a second to climb in real control? Can they down climb out of trouble if need be? All this stuff and much more needs to be thought through and dialed before stepping off the ground. Ice is no place to blindly go for it.

Derek Doucet wrote:In response to Warbonnet: First, thanks for the information. Much appreciated. Second, my apologies for the poor choice of words with the term "unscathed". While I still might argue that "relatively unscathed" given the severity of the fall is a fair assessment, the fact is that I hadn't viewed the video since it was first released.

Derek, not to worry and no apologies necessary. I've was working on and editing my long post re: ice climbing trauma from the view point of an ice climber ER dude. Just as your post came in, I was changing reference to your name and comment to make it more general because you were not the only one who used the word "unscathed". So, apologies from me to you. So sorry. Other readers will not see that nor other things I've edited & re-edited. So, moot point.

Agree with the words "relatively unscathed". I absolutely do not believe in miracles...except his. As I said in my long post, I've met Nate and am familiar with some of his specific trauma from a medical professional viewpoint. He is spectacularly, unbelievably lucky.

My respect for Nate has nothing to do with him as an ice climber, rather, it's that he was so willing to get in front of a camera and be so candid, real and excuse-free, accepting all that happened and appreciative of what he has. He is a fine human being.

None of us want anyone to get the impression that it's OK to fall or that properly placed pro will prevent injury. I see it on my rotations and it's usually not pretty. I'm not supposed to take it personally but I just do; one of my many short comings.

Your follow-up note that just came in reinforces a number of issues -- thanks for your reply. Apologies again Derek.

P.S. I do take issue with your comment "....combined with the relatively low angle of most ice climbs....are the main issues." Perhaps counter-intuitively, studies have shown (and my experience is) that "low slope angle" does not necessarily lessen severe trauma. In fact, depending on the type, low angle terrain exacerbates certain kinds of ice climbing fall injuries. Sometimes it's better (theoretically) to take a whipper off the uber classic Sea of Vapors when it's in at WI 7. But not really of course. The point is that NO FALL on ice of any angle is the best and only kind of fall. I know you agree with that.

You make good points in your last paragraph re: "what if's". There is another good string going on in MT re: a climber "losing his lead head" and what to do about it. The dialogue is great and in line with your "what if" questions you pose. Weigh in on the other string; you have something to offer.

I'll just shorten via this diagram my way too long post re: what ER docs see with ice climbing injuries. It's just a metaphor.....

This is just a metaphor......

Le Fort fractures are my favorite!

Warbonnet wrote: Derek, not to worry and no apologies necessary. I've was working on and editing my long post re: ice climbing trauma from the view point of an ice climber ER dude. Just as your post came in, I was changing reference to your name and comment to make it more general because you were not the only one who used the word "unscathed". So, apologies from me to you. So sorry. Other readers will not see that nor other things I've edited & re-edited. So, moot point. Agree with the words "relatively unscathed". I absolutely do not believe in miracles...except his. As I said in my long post, I've met Nate and am familiar with some of his specific trauma from a medical professional viewpoint. He is spectacularly, unbelievably lucky. My respect for Nate has nothing to do with him as an ice climber, rather, it's that he was so willing to get in front of a camera and be so candid, real and excuse-free, accepting all that happened and appreciative of what he has. He is a fine human being. None of us want anyone to get the impression that it's OK to fall or that properly placed pro will prevent injury. I see it on my rotations and it's usually not pretty. I'm not supposed to take it personally but I just do; one of my many short comings. Your follow-up note that just came in reinforces a number of issues -- thanks for your reply. Apologies again Derek. P.S. I do take issue with your comment "....combined with the relatively low angle of most ice climbs....are the main issues." Perhaps counter-intuitively, studies have shown (and my experience is) that "low slope angle" does not necessarily lessen severe trauma. In fact, depending on the type, low angle terrain exacerbates certain kinds of ice climbing fall injuries. Sometimes it's better (theoretically) to take a whipper off the uber classic Sea of Vapors when it's in at WI 7. But not really of course. The point is that NO FALL on ice of any angle is the best and only kind of fall. I know you agree with that. You make good points in your last paragraph re: "what if's". There is another good string going on in MT re: a climber "losing his lead head" and what to do about it. The dialogue is great and in line with your "what if" questions you pose. Weigh in on the other string; you have something to offer.

Hi Warbonnet,

One point of clarification, since I was apparently unclear: My contention is that low angle terrain (and almost all pure ice climbing takes place on relatively low angle terrain, which I define loosely as anything less than sustained vertical), is much, much worse to fall off of then truly steep terrain.

I think we agree completely. First, don't fall off leading ice. Second, don't fall off leading ice. Third, if you blow it on points 1 & 2, it's much better to be on a very steep pitch then some grade 3 ledge-fest.

The video itself reinforces this point. Dracula Right is fairly steep by moderate ice standards. 4+ or 5- is pretty fair in typical conditions. Even so, Nate bounces several times. As for his courage in exposing himself to the virtual peanut gallery, we agree on that as well. That speaks volumes about who he must be as a person.

RE: the video

What did the belayer do wrong? Other than his attitude about falls being normal. If anything, that attitude is good for a belayer to have. It means they expect something to happen at any point.

Andy P. wrote:Looking for a study I hear, this one has potential? link.springer.com/article/1…

Looks like an interesting study but it's answering a different question. LawHous was asking about the incidence of lead falls where people didn't get hurt. The problem, of course, is that hardly anyone ever reports that kind of incident. The incidents that get reported are mainly those with bad outcomes. It's a bit like trying to collect statistics on dogs that don't bark.

Russ Keane wrote:RE: the video What did the belayer do wrong? Other than his attitude about falls being normal. If anything, that attitude is good for a belayer to have. It means they expect something to happen at any point.

Read Will Gadd's commentary

I'm sorry, who's Will Gadd? I have tried to read everything but I am missing the belayer's mistakes here.

Russ Keane wrote:RE: the video What did the belayer do wrong? Other than his attitude about falls being normal. If anything, that attitude is good for a belayer to have. It means they expect something to happen at any point.

For starters, he's using a device known as a GiGi (not Gri Gri). GiGis are a fantastic tool, but only for belaying a second or seconds directly off the anchor. While they can be used to belay a leader, it's awkward at best and requires a specialized rigging the belayer does not use. He also seems ridiculously complacent about being in the path of falling ice. There is no excuse for positioning an ice belay in the line of fire,especially when it's ON THE GROUND. There's ample room at the base of Dracula to get out of the bomb zone.Instead he anchors himself essentially directly below the line of ascent to a three screw anchor. The positioning demonstrates either a lack of respect for or awareness of the ice fall hazard. The three screw anchor is indicative of a fundamental misunderstanding of the system and the hazards he's trying to mitigate.

Hmm... All good points. Although I fail to see how these oversights factored into the fall or the injuries. He caught the fall, he was watching, he had the correct amount of slack, he was anchored in, he seemed not to have contributed negatively to the event.

My apologies if I am missing something obvious. Also- I didn't see the Gigi in the video (never heard of it), but it looked like it worked.

Hmm, found the "rant" .... I defer to the experience of the writer Will Gadd, and many of his points, especially:

"The climber should have stopped way, way before he fell... It is NOT ok to climb super-pumped on ice, the consequences of a fall are simply too high."

The lead climber in this video was to blame. I disagree that the belayer was at fault. Maybe it's true that he should not be in the direct line of ice fall, and maybe his device sucked, but neither had anything to do with this fall. He did his job, I don't get it beyond that.