Volume , Issue

Note: Neither the author, nor the WMS, has a connection to any of manufacturers linked in this article and no compensation has been provided for use or recommendation of these products. The brands mentioned are the ones the author has found most useful after many days in the field. Many comparable products exist. Your mileage may vary.

This article will explore strategies for freezing and non-freezing cold injury prevention (frostbite, hypothermia, and related concerns) in montane environments (mountaineering, rock climbing, ice climbing, backcountry skiing, etc.) outside of water immersion. I do not presume to offer particularly novel or innovative techniques to the large literature on the subject, which includes a number of methods for layering, field rewarming, etc. However, I hope that thousands of days in the mountains as a guide, climber, skier, and search and rescue team leader with Raynaud's disease might offer a useful nugget, small tip, or new insight to the experienced practitioner to help them start and stay warm and functional, so they can provide the best possible care for their patients.

Before Leaving the House

- Use a boot dryer, glove dryer, and/or fans and hang gear to dry as soon as possible following the previous day's outing.

- I'm diligent with lotion, ointment, and bandages to prevent and heal cracked skin that plagues hands and feet in winter to keep them ready for the next day's outing.

- I use liquid skin instead of bandages and tape before heading out the door to prevent constricting digits in the field.

- On gusty days, I may prophylactically apply KT tape to my nose and/or cheeks when a mask does not cooperate with googles or glasses.

- On the way out the door, my first pair of gloves goes against my belly in my base layer/jacket.

- In the vehicle, boots go under the floor vent in the cab where they get even more warm air.

- Put boots on while still in the vehicle instead of booting up by the tailgate.

- I ensure all my equipment is ready to go right out of the vehicle, instead of shivering while putting skins on skis or buckling ice tools to a pack.

- When I'm working and waiting on students, clients, etc., I use a “car puffy” as an extra outer layer that I strip off and leave in the vehicle as we walk away from the trailhead.

- Supplements and medications might help keep extremities warm, ranging from garlic and grapefruit to niacin and tadalafil. These have their proponents for a variety of applications, whether work in the polar regions, high altitude climbing, or Raynaud's. Regardless, they should first be discussed with one's primary care provider.

A poor tape job of my cheeks that still managed to prevent frostbite on a very windy day.

Dress Appropriately

In general…

- Don't wear anything constricting, and ensure footwear and socks both fit well and are paired well together to prevent constriction.

- I don't wear jewelry and keep my watch on my harness, belt, or pack strap.

- Synthetics, wool, or down are the materials of choice for layering.

- Consider if a three-layer semi-permeable membrane (such as Gore-Tex) is appropriate or not. Using such a layer as a go-to creates sweat, and damp clothing makes it harder to stay warm. If high precipitation intensity truly dictates the tool, moderate pace to prevent -significant sweating.

- Plan for an “action suit” and a “standing suit”. I wear the minimum necessary when moving, but the moment I stop I layer up, saving all the heat I just worked so hard to generate. This also helps dry out base layers. Will Gadd talks about this concept in some detail on his Instagram.

- To help prevent exposed skin while moving about, I find an integrated hood, thumb loops in the sleeves, and long waist tunnels to be great tools to prevent cold air working its way under my layers. The Patagonia R1 Hoody is my favorite option for this (though there are many similar products available), or a sun hoody of similar design for not-quite-so cold weather. Powder skirts, powder cuffs, bibs, or salopettes are also great for extreme conditions or significant snow wallowing.

- If moving consistently—think backcountry skiing or standard mountaineering routes—I'll often take an ultralight windbreaker (the Patagonia Houdini is perhaps the classic offering, though these days options abound). This is paired with an active-insulation layer such as an Arc'teryx Proton. These two layers are versatile enough to allow regulation in a wide range of temperatures, wind conditions, and sun exposure.

- If travel is stop-and-go, such as multipitch ice climbing, or I simply don't want to destroy a puffy while cool weather rock climbing, I'll wear a soft shell atop my hoody, and put something lightly insulating and puffy beneath the soft shell if it's burly cold.

- There's always an oversized belay parka in my pack to throw on over the whole mess any time I'm stopped.

Azissa Singh putting her Gore-Tex to good use on an early season mixed climb

Don't neglect the legs…

- I wear some kind of softshell pant in nearly all conditions year-round, selecting the weight of the pant accordingly.

- I wear heavier pants for winter conditions, but prefer to layer long underwear beneath as opposed to seeking a heavily insulated pant so I can dial in the needed warmth.

- If there will be particularly long stops (such as digging a snowpit) or conditions might deteriorate due to weather or itinerary, full side zip puffy pants end up in the bottom of my pack.

- Lately, I've been making much more regular use of super gaiters and have not regretted it. The Outdoor Research X-Gaiter even fits on my alpine touring boots. (I prefer carrying the weight of the gaiters instead of heated sock options given the relatively short battery life and failure potential of those products.)

Have a plan for head, hands, and feet…

- Thoughtfully select a headwear system that integrates with a helmet and eyewear as needed.

- I typically use a mid-layer with balaclava hood, a hooded shell, a hooded puffy jacket, plus a buff and ball cap. This manages everything from full over-the-nose face coverage to keeping the sun off on spring afternoons.

- When wind and cold demand full face coverage, goggles are often a good idea. I've found the most success preventing fogging using goggles with Julbo SuperFlow technology.

- Mittens are typically in the bottom of my pack. In technical environments, fully functional hands are crucial to negotiating the terrain, and mittens provide cheap insurance.

- Use lighter gloves to sweat into for stop-and-go activities plus a heavier pair when stopped. For sustained output, a couple mid-weight pairs do the trick.

- There's always a pair of gloves warming inside my layers. Even if they're already damp, warm and wet is better than cold and wet.

- Similar tactics can work for footwear, particularly rock climbing shoes. In cold conditions, my rock shoes live inside my puffy jacket or a pair of oversized booties that I slip on at belay stances.

There's rock somewhere beneath all that snow. These are good conditions for multiple pairs of gloves.

Nutrition & Hydration

- Avoid alcohol and excessive caffeine.

- For breakfast (you do eat breakfast before heading out into the sub-zero temps, don't you?), bundle relatively high fat with complex carbohydrates to promote short- and long-term thermogenesis.

- Hot drinks don't have a huge effect on body temperature on their own, but they are more palatable in the cold and encourage good hydration status.

- Keep water warm and handy, and consider alternatives for taste, calorie content, or electrolytes: tea, cocoa, miso soup, warm Gatorade, or vegetable broth.

- Hydration hoses are unreliable even with insulation sleeves; use bottles instead. Store them insulated (inside a puffy works well) and upside down (so the opening doesn't freeze) and tightly closed.

- Instead of having meals, keep snacks in pockets and eat continuously; plan accordingly.

Travel Plan

- Match the weather forecast to the actual travel location. A point forecast such as those available from the National Weather Service can be quite helpful. Pay particular attention to the forecast elevation, freezing line, wind speed and direction, and humidity.

- Take advantage of geographic features. If it's cold, take a break in the sun. If getting overwarm in a sunny spot, a break in the shade might prevent the need to doff and don a layer. If traveling to a saddle, ridgeline, or summit, stop a hundred vertical feet or so below to dress for the wind, cold, and moisture likely to be encountered higher (and subsequently slow the pace to avoid sweating before arrival).

- When possible, match the objective and travel mode to the conditions. Bouldering or dry tooling might be better than cold multipitch rock climbing. Use short pitches or lead in blocks to maintain consistent warmth. Dial back technical difficulty if needed, which could allow for simul-climbing, scrambling, or soloing. Backcountry skiing or snowshoeing allow for more consistent pacing (and therefore warmth).

A stoic Vlad Pascu makes his way to the summit along the north ridge of the Pfeifferhorn in full winter conditions. Short pitching was quite helpful to keep both of us mobile and warm.

I'll close by saying that the seemingly small habit of making fists and curling toes with each step has helped me many times in keeping my extremities perfused and functional when conditions were uncooperative. Hopefully one of the above suggestions does the same for others.

You Might Also Be Interested in


Climbing Anchors

Elaine Yu, DO, MS, FAWM9/9/2022

The Good, the Bad, and the Ugly


Cold Montane Environments

Derek DeBruin, WFR1/7/2022

Tips to Stay Warm and Dry (and Injury-Free)


Rock Climbing Accidents

Elaine Yu, DO, FAWM11/1/2021

2021 Year in Review


Accidents in North American Climbing (ANAC)

Corey Winstead, PA-S2, W/AEMT, FAWM, SPI5/10/2021

Accidents in North American Climbing