A “Normal” Sport Climbing Fall Ended in a Traumatic Thumb Amputation. What Happened?

The morning of Monday, November 24 started out as a normal day for Mylee Lorenz. The 24-year-old woke up in Red Lodge, Montana, a tiny ski town where she’d just moved to join ski patrol for the upcoming winter. But the ski season hadn’t started yet, and the weather was perfect for climbing—a brisk 50 degrees and sunny.

At 9:30 a.m., Lorenz and her four friends left the Palisades parking area, hiking up the steep path to the limestone cliff that crowned the hill. The Palace was aptly named, with glassy slabs that rose 50 feet up beyond the treetops and offered a luxurious view of Red Lodge’s golden valley.

By about 12:15 p.m., Lorenz was tying in for her second attempt of DJ Quiet (5.10d). She climbed smoothly through the first two bolts, then faced off against a powerful crux sequence of side pulls and slick feet. Here, she was at risk of a ground fall, a few feet above the second bolt and a dozen above the ground. With her right hand, she pulled up a loop of slack and reached up toward the third draw. Just before she made the clip, her foot slipped.

Lorenz’s friends Leyton Steen and Dustin Kisner watched her plummet past the second bolt. The rope caught her as she hit the ground, and Lorenz slowed into a soft deck, her feet tapping the dirt. A loud pop spit through the air. She dropped an inch lower, the rope caught between her legs. Then she started screaming.

“Call 911!” she yelled. “My thumb is gone!”

She held up a bloody right hand. A few feet away, her missing digit rested neatly on a twist of blue rope.

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Her friends took a second to process what was happening. Then they burst into action.

Steen called 911. Ayla McNeilley freed Lorenz from the belay, cut a strip of fabric from her own Red Lodge Ski Patrol sun hoodie, and wrapped it tight around Lorenz’s hand to stop the bleeding. Kisner picked up the thumb from the ground and placed it carefully in a plastic bag. The paramedics asked if the team could self rescue. Lorenz was nauseous and in shock, but she decided she could make the hike down.

Two hours later, she sat with her mom in a hospital in Billings. Finally, a doctor came in. “They said, ‘You’re losing your thumb. We’re sorry,’” said Lorenz. But her mom refused to accept that. They strapped Lorenz down in a gurney, loaded her into a helicopter, and flew her to the University of Utah Hospital in Salt Lake City for emergency surgery.

The next morning, she woke up and looked down to see that her thumb was re-attached.

Relief poured in. “I was like, ‘I’ll be back to normal in no time. It’s just going to be a few months, and I’m still going to be able to write and do everything normally, hopefully. It felt like a success because Billings told us, ‘No way.’”

Soon the relief cooled into a nervous anticipation. The thumb still had to regain blood flow. For another six days, Lorenz stayed hospitalized in Salt Lake City, waiting for more updates on her thumb, which was still pink and warm. Then, on day seven, she noticed that it was a bit purple, but still had a pulse.

Finally, on the eighth day, Lorenz heard the news that would change her life forever.

“They couldn’t find a pulse,” she said, her voice pinched. “It hit me really hard. I was like, ‘Call another doctor.’ Someone has to find a pulse.” But they couldn’t, and on December 11, Lorenz got her thumb re-amputated.

When she returned to Billings, phantom pain kept her constantly occupied. “It feels like someone pulled off my [thumb] nail and is digging into my nail bed. It feels like your thumb’s there,” she said at the time. Regarding her treatment, she insists that she needs to be assured that she has really good grip strength. “I’m going to be compensating for a lot without a thumb.”

Three months later, her friends are still shaken and scarred from the accident. Steen, who did a two-week climbing trip with Lorenz in October, hasn’t climbed since. “I’m not too stoked about any of this,” he says. “It’s just fucked up.”

All three of them, including Lorenz herself, agree that she must have gotten the rope wrapped around her thumb as she fell, but they can’t explain what exactly caused the rope to trap her hand. “Maybe when she fell, she grabbed the rope, securing it around her thumb, but that’s all just speculation,” says Kisner. “She was really close to actually clipping the bolt.”

They conclude that it was a freak accident—unrepeatable, unavoidable.

But was it?

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For most people, the idea that a climbing rope can amputate your finger is totally foreign. Far more common are the fears of degloving, frostbite, or getting a digit stuck in a finger crack.

But despite being a rare fear, there are a few cases of finger amputation via ropes that match Lorenz’s scenario. Nine years ago, the American Alpine Journal reported the story of a 29-year-old man who lost a thumb after taking a 20-foot fall in the New River Gorge. Even though he was clipping with his right hand, it was his left thumb that got encircled by the rope and broke off entirely. Surgeons were later able to re-attach it. The man concluded that he must have grabbed the rope with his left hand while falling, although he did not remember doing so.

Four months later, a similar accident occurred for a different climber, Austin Martin, who was also in West Virginia. While lead climbing at the gym, just above the second bolt, Martin took an unexpected fall and found the rope wrapped around his right index finger. It snapped off, and surgeons re-attached it, but they ended up re-amputating the finger when it did not regain blood flow. Another case was reported in 2006 in Wilderness & Environmental Medicine, in which a man fell about 16 feet in the gym, grabbed the rope, and lost his index finger.

Finger amputations from rope loops have shown up in several other sports, from rodeo roping to hydrofoiling. But as the authors of the 2006 study showed, there is one key element to a rope-inflicted amputation in climbing: The rope will not simply wrap around the finger in a coil, rather a loop of rope will capture the finger.

To help re-create the conditions for Lorenz’s accident, I recruited Jeff Jaramillo—a gear expert, self-described “trad dad,” and seasoned expert of anything made with aluminum, nylon, or dyneema. Jaramillo is the Head of Gear Education and Outreach at WeighMyRack, where he writes blog posts about niche topics like rope sheath slippage. Back in May, I consulted him to learn why a properly clipped rope can just pop out of a draw and was impressed with his knowledge of odd gear behavior.

Jaramillo set up a simple replica of the route DJ Quiet in his home gym—not the moves, just the second and third draws. No video exists of the accident, but from the detailed accounts of Lorenz, McNeilly, Steen, and Kisner, we know a few important pieces of information:

1. When Lorenz fell, she was to the climber’s left of the third bolt.
2. She was reaching up and right, with her right hand, to clip the quickdraw.
3. The quickdraw’s lower gate was pointed left, toward her.

Using this information, Jaramillo replicated Lorenz’s process of reaching for and initiating the clip, but not completing it, then falling to the next draw, in order to create a possible loop for trapping the thumb. He tested two different clipping techniques, the popular “thumb” method and the old-school “pinch” method, and also tested the quickdraw’s gates facing both directions. Each combination of settings was attempted multiple times.

His results were clear: There was only one clipping position that could consistently trap the thumb in a loop: using the thumb method, with the quickdraw’s gate pointing left. Importantly, this only occurred only in a position prime for back-clipping. In every other scenario, the rope loop slid off like a ribbon from Jaramillo’s thumb when he “fell.”

“I think the thing that is absolutely the most likely is that the rope was grabbed in an untwisted orientation with a twisted wrist,” said Jaramillo, “and then the wrist was twisted as it was going up. That created that opportunity for the rope to wrap from the outside in…which is what captures the rope. In my finding, I don’t think it’s possible, if the rope is in the correct orientation for clipping, for this to happen.”

Steen, who watched Lorenz fall, originally described her clipping position to Climbing like this: “She was clipping as if you’re going to put your pointer finger in the carabiner on the draw, then put the rope through the draw with your thumb.” He added that the rope was positioned “from the Grigri going up, over her thumb, and back to her harness” with her “fingers pointed at the sky.” This description is a potential match for either a standard thumb clip (Figure B) or thumb back-clip (Figures A and C).

As a reminder, back-clipping occurs when the rope is clipped in the wrong direction, meaning that the belay strand of the rope goes through the carabiner, while the climber strand is caught between the carabiner and the wall. This can cause the rope to unclip itself during a fall from above. Every belay test in a U.S. gym includes a requirement to avoid back clips, but it’s still a common mistake that even the most seasoned climbers must constantly take care to avoid.

Until this accident, however, simply reaching up in the position to back-clip has not been considered dangerous. “This is now going to be added to my list of reasons why you should be looking out for back-clipping,” said Jaramillo.

While we’ll never know with 100% certainty what exactly happened on November 24, it’s likely that Lorenz had been reaching up to back-clip, positioning her thumb in a loop that later flipped and tightened. (She does not remember doing this, but acknowledges that it might have been possible). It is almost certain that she grabbed the rope as she fell—an understandable instinct, especially when she was facing a potential deck off a scary slab. “Without the rope in hand, there’s no tension to keep the rope in place,” said Jaramillo.

When I replicated the back-clipping (position C above) myself, with a single quickdraw and (unweighted) spare rope, I had some difficulty landing my thumb in the “captured” loop that Jaramillo showed me—unless I kept hold of the clipping strand while I was “falling.” Then I trapped it every time.

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Back in December, Lorenz told me she hoped to be climbing again by March. By January 21, however, she had already toproped a 5.9 slab. “I didn’t lead it,” she qualified, but added that she had been going to the climbing gym twice a week. Moving forward, she plans to learn how to crack climb this year, and wonders out loud if hand jamming might not depend as much on using her upper thumb as crimping does.

“The fact that she still has love for this sport and that [the accident] hasn’t taken that desire away… makes a big difference on how I view it,” said McNeilley, who added that belaying Lorenz on her fall has reminded her to always be diligent and prepared for the worst. “It’s easy to think it’s always going to happen to somebody else, and not to you. Until it does happen to you.”