Preventing Injuries in Extreme Sports Athletes

Abstract

Designing an injury prevention plan for extreme sports participation is a multifaceted task. Essential to any plan is for the participant to possess or otherwise develop the capacity to objectively assess themselves on a number of key physiological, psychological, and behavioral factors as they relate to unique features of the specific extreme sport that they perform. For example, in addition to having endurant grip strength for rock or mountain climbing [1–5], the climber needs to possess a high strength/mass ratio and have sufficient joint flexibility to enable their whole-body center of mass to be positioned close to the climbing surface as forces are applied (Fig. 16.1). This simple characteristic decreases the resistance moment arms developed through their upper and lower extremities, thereby reducing neuromuscular activation demands. Having a sufficient power/weight ratio is similarly important in mountain biking [6]. In addition to evaluating their inherent physical characteristics (including the influence of their current and past medical or injury histories), the extreme sports athlete needs to be able to honestly appraise their actual versus perceived skill level and risk-taking tendencies, the influence of central and peripheral fatigue on activity performance and cognitive decision-making capability [7], and have a thorough understanding of the most likely injury risk factors associated with their sport [8]. For example hang gliding, base jumping, and paragliding are associated with a high frequency of back and lower extremity injuries (often resulting in vertebral fracture and/or spinal cord injury) due to improper landing techniques [9–12]. In contrast, whitewater kayaking is more likely to predispose the extreme sports athlete to glenohumeral joint injuries, particularly anterior-inferior labral and rotator cuff injuries, both from chronic and acute injury mechanisms. Downhill skiing on the other hand often results in knee injuries through sudden improper postural alignment when landing on one lower extremity, peripheral and/or central fatigue that compromises lower extremity neuromuscular shock absorption system function, poor decision-making, or any combination of these factors. Because of the influence of anxiety [13–15], fatigue, and other stressors on performance capability, the extreme sports athlete is advised to always underestimate their skill and expertise levels prior to participation. All too often, the spur-of-the-moment “thrill factor” which can occur at anytime during extreme sports participation supersedes sound judgment resulting in serious injury or death [16–18]. The extreme sports athlete is challenged with avoiding the seduction or rapture of the event, never letting it override sound judgment.