Abstract
According to the risk compensation hypothesis, the use of a ski helmet might provide a false sense of security, resulting in a riskier behavior by skiing faster or more aggressively, which might lead to an increased injury risk. Injury of the anterior cruciate ligament (ACL) is a common diagnosis in downhill skiers. Thus, the aim of the study was to evaluate the potential impact of risk-taking and ski helmet use on ACL injury risk in recreational skiing. Eighty-two ACL injured and 446 uninjured skiers with a mean age of 37.3 ± 11.9 years (52% females) were surveyed during the winter season 2018/19 about age, sex, self-reported risk-taking behavior, self-reported skill level, perceived speed, and ski helmet use. Multiple regression analysis revealed that older age (OR: 1.3, 95% CI: 1.2–1.4), riskier behavior (OR: 5.4, 95% CI: 2.8–10.5), and lower skill level (OR: 6.7, 95% CI: 3.4–13.3) were found to be factors associated with ACL injury, while ski helmet use was not. In conclusion, no support for the risk compensation hypothesis was found with regard to ACL injuries. Therefore, we doubt that ski helmet use increases the risk for ACL injury and recommend wearing a ski helmet due to reported protective effects.
Highlights
Recreational alpine skiing is one of the most popular winter sports annually enjoyed by several hundred million skiers worldwide [1]
Injury is a common diagnosis in injured recreational alpine skiers [3,4], the primary aim of this study was to evaluate whether risk-taking behavior and ski helmet use are associated with an anterior cruciate ligament (ACL) injury in recreational skiers
Multiple regression analysis revealed that an older age, a riskier behavior, and lower skill level were found to be significant risk factors associated with ACL injury, while ski helmet use was not
Summary
Recreational alpine skiing is one of the most popular winter sports annually enjoyed by several hundred million skiers worldwide [1]. One of the most frequent diagnosis in injured recreational alpine skiers is a rupture of the anterior cruciate ligament (ACL) with 15–21% of all injuries [3,4]. Up to 20% of all injuries on ski slopes are head injuries [1]. Can be significantly diminished by wearing a ski helmet [1,5]. Et al [5] found in a study from the winter seasons 1995/1996 to 2011/2012 a reduced incidence of any head injury and of potentially severe head injuries by 62% and by 67%, respectively, while helmet usage rate increased over the same time from 8 to 84%. The usage of a ski helmet might have additional, more subtle, effects on skiers
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