Breaking the Myth that Indoor Rock Climbing does not Cause Knee Ligament Injuries – A Case Report

Introduction: Indoor rock climbing (IRC) is considered to be a safe sport, without risk of severe injury. We present here a case of a professional athlete who injured his lateral and posterolateral knee corner while training IRC.

Patient and Method: A 28 years old, male, rock climbing coach, who, while training and trying to push himself up the wall, made an internal rotation of his hip, while his knee in varus position. As a result he felt a click, followed by sensitivity and swelling over the postero-lateral aspect of the knee. He felt instability of the knee while walking and limitation of knee flexion compared to the contralateral knee.

Physical examination: Three days post injury, the patient walks with a limp of the right leg; ROM hip joints – normal, no pain. Knees: slight varus position. Spine – normal SLR. Right knee: no fluid palpated; slight tenderness on the medial joint line, but more on the lateral joint line, and fibular head; No tenderness over the patella; Tenderness over the belly muscle of the hamstring. Knee ROM: 0-135 on the right and 135 on the left. Stability: slight lateral opening in 30 degrees flexion, normal in extension. Lachman, anterior drawer test, and posterior drawer test - negative. Dial test - positive on the right, negative on the left; weakness of the hamstring on the right, as compared to the left side. X-ray: normal. MRI shows partial tear of the LCL and bone edema on MFC and on the popliteus, lateral to the biceps tendon.

Conclusion: Varus internal rotation of the knee when pushing oneself up is unusual maneuver that exists only in IR and may cause severe injury. The physician to misdiagnose the injury as insignificant if one does not look more deeply into the mechanism and conduct a careful physical examination.