Alpine Skiing Injuries Research Articles

Mechanisms and Prevention Strategies of Anterior Cruciate Ligament Injuries in Alpine Skiers

Alpine skiing is a sport enjoyed by more than 50 million people across the world every year. However, despite advancements in safety practices and technology, anterior cruciate ligament (ACL) injuries remain a significant concern. This narrative review investigates the prevalence and mechanisms of ACL injuries in alpine skiing and differentiates between intrinsic (e.g., age, sex, and skill level) and extrinsic factors (e.g., equipment design and environmental conditions) that contribute to the risk of ACL injuries. This article outlines 4 primary mechanisms through which ACL injuries occur, highlighting the complex physical demands of skiing and the role of skier behavior and environmental interactions in injury occurrence. Based on these findings, this article advocates for neuromuscular training (NMT) as a possible effective prevention strategy. NMT enhances muscular coordination and strength, balance, and agility through exercises that mimic skiing movements, potentially lowering the risk of ACL injuries. By providing a detailed analysis of ACL injury risk factors and prevention strategies in the sport, this review offers valuable insights for reducing injury rates and underscores the importance of NMT to mitigate the high incidence of ACL injuries in alpine skiing.

Managing Alpine Skiing Injuries: Focus on Anterior Cruciate Ligament (ACL) Tear Prevention in Adolescent Athletes.

The Article Abstract is not available.

Knee ligament injuries in alpine skiing - the mechanism of injury and the possibilities of using modern knowledge and technology to prevent injuries in skiing

Introduction: Over the years, advances in alpine ski equipment such as helmets, bindings, skis and boots have resulted in risk reduction, remodelling of injury patterns and mechanisms. Skiers’ injuries are currently about 1 to 5 per 1000 days spent in the snow per athlete. The most common area of the injury is the knee, especially ACL and MCL. Purpose of the work: The purpose of the work is analysis of literature on mechanism of knee ligaments injury and potential prevention intervention in alpine skiing. Methods and materials: The present study was based on available data collected in the PubMed and Google Scholar database. The study was conducted by reviewing keywords such as: “alpine skiing”, “ski bindings”, “alpine skiing injuries”, “ACL”. Results: Taking into consideration less advanced skiers, we can distinguish three types of injury mechanism: valgus-external rotation sequence, boot-induced anterior drawer mechanism and phantom-foot mechanism. Three mechanisms have been described for professional skiers: slip-catch, landing back-weighted and dynamic snowplow. Female skiers have a higher risk of ACl injury than male skiers. Conclusion: Most of the described injury mechanisms are linked with no releasing of bindings. The future injury prevention should concentrate on injury mechanisms using electronic sensors placed at skiers equipment. New micro-electronic technologies can help create mechatronic ski bindings.

Fractures of tibial shaft and tibial head in winter sports

Injuries in alpine skiing often affect the lower extremities, in particular the knee joint and lower leg. In addition to conventional radiological diagnostics, CT and, in the case of fractures of the knee joint area, MRI also play an important role. In the case of tibial head fractures, especially if there has been adislocation mechanism, there is an increased risk of vascular and nerve injuries. Lower leg fractures are predestined for the development of acompartment syndrome. For these reasons, an exact survey of the vascular-nerve status and amonitoring of the soft tissues should be carried out. In the further therapy, whether conservative or surgical, the soft tissue situation must also be included in the planning. In the case of tibial head fractures in particular, the choice of the right approach is essential for agood result in surgical therapy. Angle-stable plate osteosynthesis and screw osteosynthesis play the most important role as osteosynthesis methods in the knee joint area. In the case of fractures in the shaft area, medullary nail osteosynthesis or angle-stable plate systems are primarily used. In the case of severely compromised soft tissue or unstable situations, it may be necessary to apply an external fixator first. The initiated therapy should enable functional follow-up treatment as early as possible. Good physical fitness, driving-specific training, but also good core stabilization have apreventative effect against injuries. In addition, the correct material coordination between ski boot, binding and ski is important for accident prevention.

Imaging Review of Alpine Ski Injuries.

Skiing is a continuously evolving winter sport, responsible for a considerable number of musculoskeletal injuries. Specific injury patterns and mechanisms in the upper and lower extremities, head, and spine are influenced by skier expertise and skill, position during injury, and environmental conditions. Predilection for certain joints and injury patterns have changed over time, largely due to technological advancements in equipment, increased awareness campaigns, and preventive protocols. Knowledge and understanding of these trends and developments can aid the radiologist to reach a timely and accurate diagnosis, thereby guiding clinical management and potentially reducing the overall incidence of debilitation and death.

Approaching the Mechanism of Alpine Ski Injuries—How to Overcome the Current Issues—

Approaching the Mechanism of Alpine Ski Injuries—How to Overcome the Current Issues—

Editorial: Youth and Winter Sports

3. This congress was multidisciplinary with key notes and parallel sections on both life sciences and social sciences. We received communications about physical preparation, physiology, biomechanics, sport medicine, rehabilitation as well as history, sociology, management, psychology, teaching.The following world-class experts gave six key notes presentations:• Milena Parent (Canada) -Governance and legacy of the YOG.• Hans-Christer Holmberg (Sweden) -Biomechanics and physiology in nordic skiing.• Andrew Denning (USA) -History of the human-environment relationships in the Alps through the sport of skiing.• Erich E. Muller (Austria) -Biomechanics and prevention of injuries in alpine Skiing.• Oyvind Sandbakk (Norway) -Norwegian success in winter sports. Despite that the research topic was multidisciplinary in line with the content of the congress, only articles in exercise physiology, biomechanics and nutrition are published. years old -physiological characteristic (i.e., high total haemoglobin mass expressed in g/kg) is a relevant predictor of success at senior level in endurance sports as cross-country ski or triathlon.Finally, this research topic includes three reviews (compression garments, injuries and nutritional considerations) relevant to all winter sports:

Medical services and injury management in Alpine skiing during the Winter Youth Olympic Games 2020 in Lausanne

Purpose: The Youth Olympic Games (YOG) are an elite sporting event for young athletes aged 15-18 years from all over the world. In the third Youth Olympic Winter Games, held in Lausanne in 2020, there were 16 disciplines and 81 events. In previous reports regarding YOG, injury risk was highest in the skiing events and alpine ski had a high rate, 14% in 2012 and 12.9% in 2016. The purpose of this report is to discuss the rescue organization, investigate the incidence of alpine ski injury during YOG 2020 and compare to previous reports. Methods: During the YOG 2020, we reviewed all alpine skiing injuries from 1 official training and 9 events. 77 men racers from 57 countries and 78 women racers from 54 countries have participated. We calculated injury incidence as the number of injuries in competition, training or in total during the game period divided by the respective number of participating athletes; with incidence values presented as injuries per 100 athletes. The injury rates per a game duration were compared among the each YOG games (2012, 2016, 2020) with use of the chi-square test. The injury rate between men and women was compared using the chi-square test as well.

A multibody simulation study of alpine ski vibrations caused by random slope roughness

In alpine skiing an athlete's performance or injury mechanisms are strongly influenced by ski vibrations. Ski vibrations are mainly caused by irregularities of the ski-snow interaction (e.g. ripplets and disturbances of the slope, friction between ski and snow). With respect to the ski-snow interaction ski vibrations were not yet considered in computer simulation studies. During this study a planar multibody simulation model of a mono-skier has been developed to investigate transversal vibrations of unedged skis during schussing in the fall line over rough (random) ski slopes. The skis are modelled as dynamic Euler-Bernoulli beams and are incorporated as flexible beams into a multibody skier model. The interaction between skis and snow is modelled by a Kelvin-Voigt constitutive equation for the snow penetration force. The random ripplets and disturbances of the slope are described by random fields, which are generated based on real data obtained from measuring a public ski slope surface with a high resolution laser scanner. By the Monte Carlo simulation method a sequence of runs over random slope surfaces is performed and the ski vibrations of the ski shovel are analysed. The results show that the irregularities on a ski slope contribute considerably to the vibration of a ski and the performance of a skier. Thus, they have to be considered in multibody simulation models of alpine skiing. The developed simulation model will support the understanding of ski vibrations and their causes to improve the run time and to prevent injuries in alpine skiing. The presented simulation model can also be applied to find optimal material parameters to reduce ski vibrations during schussing. This work combines a flexible multibody simulation model and random fields. The implementation of random fields in multibody simulation models admits a more realistic investigation of the mechanical behaviour of complex systems due to random spatial uncertainties in input parameters.

Evaluation of Alpine Skiing Injuries in Terms of Personal Precautions: Erciyes Sample

Evaluation of Alpine Skiing Injuries in Terms of Personal Precautions: Erciyes Sample

Management of youth athletic injuries in alpine skiing

The popularity of alpine skiing is growing among young athletes. However, this development also carries the risk of early health problems such as traumatic and overuse injuries. To support a long-term beneficial effect of an early sport specialization, the amount of appropriate volume and intensity of training need to be investigated. As a basis for a prospective and reliable data collection, we developed a training and injury database to repeatedly record the occurrence of traumatic injuries and overuse injuries. Study participants were 82 young talented alpine skiers aged between 9 and 14 years. We found a relatively high rate of 0,86 traumatic injuries per 1000 hours of training. In contrast a low occurence of overuse injuries were recorded (0,28/1000 hours of training). Further research is required on sport specific, age- and development-related risk factors and the appropriate amount of training to guarantee long-term health benefits of youth elite athletes.

Personality Traits in Swedish High School Alpine Skiers – A Comparison between Injured and Uninjured Skiers

Objective: Prevention of alpine ski injuries is less studied when it comes to psychological aspects. The aim of the present investigation was to study if there were any relationships between some p ...

Wie häufig und warum stürzen Skifahrer und Snowboarder?

Injuries in alpine skiing and snowboarding are mainly caused by falls. In 2002, a study was conducted to gain insight into the risk factors for falls when skiing or snowboarding. Since then, the evolution of skiing, snowboarding and safety equipment, as well as slope preparation, may have altered the frequency of falls while skiing or snowboarding. In total, 1436 male and female skiers and snowboarders from all age groups were interviewed from February until April 2012, in 6 Tyrolean ski resorts. The questionnaire was nearly identical to that used in 2002. It contained questions concerning personal characteristics, falls, equipment and risk taking behaviour. The incidence of falls among skiers was 0.076 ± 0.21 per hour and that among snowboarders was 0.429 ± 0.70 per hour. Age (OR: 0.96; CI:0.95 - 0.97), soft snow conditions (OR: 4.1; CI:1.9 - 8.8) and poor skiing skills (beginners and intermediates) (OR: 2.6; CI: 1.2 - 8.1) were predictive for falls during skiing. Poor snowboarding skills (beginners and intermediates) (OR: 8.3; CI:3.1 - 27.4), wearing a helmet (OR: 2.3; CI: 1.2 - 4.6) and alcohol consumption (OR: 2.1; CI: 1.2 - 3.9) were predictive for falls during snowboarding. The incidence of falls among skiers and snowboarders was substantially lower when compared to that in 2002. Improvements in skiing and snowboarding equipment as well as slope preparation may have contributed to this favourable development. We strongly assume that the lowering in fall incidence may positively affect the injury incidence.

Alpine skiing injuries in Finland – a two-year retrospective study based on a questionnaire among Ski racers

BackgroundAlpine skiing is one of the most popular winter sports in the world. Nevertheless, it has always been associated with a high risk of injury. There are however, only a few studies that have examined the risk of injury of competitive skiers, especially of the junior ski racers.MethodsThe inclusion criterion was an injury in alpine skiing resulting in a pause in training longer than one week. Athletes of all ages were included. The study period was from the start of the season of 2008–2009 to end of the season of 2009–2010 (two years).ResultsThe average annual number of ski racers in Finland was 661. There were 61 injuries (36 males with a median age of 14 years, 25 females with a median age of 14) fulfilling the inclusion criteria. Ligamentous knee injury was the most frequent (17) and lower leg fracture the second common (16) injury, respectively. There was a female dominance in the ACL injuries. Only one major abdominal injury and no major head injuries were observed. The overall training pause was 26 weeks after the ACL injury and 17 weeks after the lower leg fracture, respectively.ConclusionThe most common and most disabling injuries affect the knee and the lower leg. The high number of lower leg and ACL injuries is alarming. A continuous and careful monitoring of injuries needs to be established to assess this trend. A systematic review of injuries is the appropriate way to monitor the effects of changes made in terms of safety. The present retrospective two-year pilot study forms a base for a continuous alpine ski injury survey in Finland.

Special issue on winter sports

In all forms of winter sports the equipment is of central importance. The equipment is needed to protect the athlete from adverse environmental conditions and to provide safety and comfort. Moreover, in a majority of winter sports the equipment facilitates a specific form of locomotion: gliding on the snow or ice. Gliding allows for much higher speeds than other, more typical forms of human locomotion, such as walking or running. It is thus the equipment that makes most forms of winter sport the highly dynamic sports that are so appealing to many of us. Much research has been and continues to be carried out in improving the safety and performance of winter sports athletes through better designed equipment. It is, therefore, perhaps not a surprise that our call for papers for a special issue on winter sports in the journal Sports Engineering resulted in an overwhelming response. Nineteen manuscripts were submitted of which 11 were found suitable for the journal. Eight of these could be included in this special edition, and others were distributed throughout volume 17. This editorial provides a brief overview of all accepted papers. Protection against injury has always been a primary field of interest for researchers and engineers working on winter sports. Two papers submitted for this special issue specifically address injury prevention. A white paper by Michel and colleagues presents current concepts for wrist protectors in snowboarding and discusses the need for an industry standard. This paper represents a position statement of the International Task Force on Wrist Protectors in Snowboarding of the International Society for Skiing Safety (ISSS). Another review paper by Senner et al. focuses on knee injuries in recreational alpine skiing and discusses what modifications of the ski-binding-boot system might offer an opportunity for reducing the risk of injury. The authors specifically consider the implications that the development of mechatronic bindings may have for injury prevention in skiing discussing three different types. Speed is an important determinant for athlete performance, which places a premium on optimising gliding friction and air drag. Several studies included in this special issue address friction phenomena. Puukilainen et al. used a variety of measurement devices that are currently used in the industry to characterise the surface properties of skis. They document changes in the topography, crystallinity and wettability of the skis’ running surface and in the skis’ sliding properties due to ski use, waxing and stone grinding. Bardal and Reid investigated how air drag depends on the permeability of alpine skiing apparel. Contrary to common belief, they found a weak dependence implying that increasing apparel permeability may have only a marginal effect on the speed of alpine skiers. Lozowski and colleagues investigated the friction between speed skate blades and ice by developing a sophisticated model that incorporates various interaction processes. To the best of our knowledge, this is the first model for speed skate-ice interaction that considers inclined skate blades. The studies by Swaren et al. and Petrone et al. investigated the deformation properties of cross country ski poles and alpine ski boots, respectively. Both of these topics are important for the performance and the comfort of the athletes participating in these sports. P. Federolf (&) Norwegian School of Sport Sciences, P.O. Box 4014, Ulleval Stadion, 0806 Oslo, Norway e-mail: peter.federolf@nih.no

Technical possibilities for optimising the ski-binding-boot functional unit to reduce knee injuries in recreational alpine skiing

This review study focuses on knee injuries in recreational alpine skiing. The objectives of this study were (1) to provide selected knowledge derived from current and past knee injury epidemiology; (2) to outline the most important knee injury mechanisms; and (3) to review and discuss how modifications of the skiing equipment might alleviate the risk of knee injuries. This review represents the essence of a comprehensive research report and considers the content of more than 230 scientific papers, further “grey literature”, patents, international standards and other publications. Knee injuries are the most frequent injuries in alpine skiing and their incidence rate remained high despite a decline of the incidence of other skiing injuries in recent years. Women have a higher knee injury risk, but age and tiredness appear not to be significant factors. Apart from the commonly described injury mechanisms “phantom foot” and “boot-induced anterior drawer” other more sophisticated injury categorisations are given. The ski radius, the ski length and the standing height on the ski may be relevant ski parameters. For the binding, the release mechanisms in different mechanical degrees of freedom, the impact tolerance and the maintenance frequency are discussed. In the ski boot, the height of the upper, the boot liner, the shaft stiffness, and the position on the ski may play a role. The biggest challenge, but probably also the biggest opportunity for a reduction of knee injury rates seems to be the development of a mechatronic binding. The current strategies to develop these types of bindings are explained and illustrated by one example. Some of the possible parameters which may be essential for the necessary control algorithms are described. Finally, considerations regarding the strategic and operational implication of the analysed technical measures are given.

Risk factors for injuries in alpine skiing, telemark skiing and snowboarding – case-control study

BackgroundAlpine skiing and snowboarding have a substantial risk of injuries, but precise risk factor estimates are limited.ObjectiveTo determine the risk factors among skiers and snowboarders.Study designCase-control study.MethodsSki patrols reported cases...

Mechanisms of Anterior Cruciate Ligament Injury in World Cup Alpine Skiing

Background: There is limited insight into the mechanisms of anterior cruciate ligament injuries in alpine skiing, particularly among professional ski racers. Purpose: This study was undertaken to qualitatively describe the mechanisms of anterior cruciate ligament injury in World Cup alpine skiing. Study Design: Case series; Level of evidence, 4. Methods: Twenty cases of anterior cruciate ligament injuries reported through the International Ski Federation Injury Surveillance System for 3 consecutive World Cup seasons (2006-2009) were obtained on video. Seven international experts in the field of skiing biomechanics and sports medicine related to alpine skiing performed visual analyses of each case to describe the injury mechanisms in detail (skiing situation, skier behavior, biomechanical characteristics). Results: Three main categories of injury mechanisms were identified: slip-catch, landing back-weighted, and dynamic snowplow. The slip-catch mechanism accounted for half of the cases (n = 10), and all these injuries occurred during turning, without or before falling. The skier lost pressure on the outer ski, and while extending the outer knee to regain grip, the inside edge of the outer ski caught abruptly in the snow, forcing the knee into internal rotation and valgus. The same loading pattern was observed for the dynamic snowplow (n = 3). The landing back-weighted category included cases (n = 4) where the skier was out of balance backward in flight after a jump and landed on the ski tails with nearly extended knees. The suggested loading mechanism was a combination of tibiofemoral compression, boot-induced anterior drawer, and quadriceps anterior drawer. Conclusion: Based on this video analysis of 20 injury situations, the main mechanism of anterior cruciate ligament injury in World Cup alpine skiing appeared to be a slip-catch situation where the outer ski catches the inside edge, forcing the outer knee into internal rotation and valgus. A similar loading pattern was observed for the dynamic snowplow. Injury prevention efforts should focus on the slip-catch mechanism and the dynamic snowplow.

Kinematics of a slip-catch mechanism for anterior cruciate ligament injury in world cup alpine skiing

BackgroundWe have identified that a slip-catch situation is the main mechanism for anterior cruciate ligament (ACL) injuries in World Cup alpine skiing by simple visual inspection of injury videos. This...

Mechanisms of anterior cruciate ligament injury in world cup alpine skiing: a systematic video analysis of 20 cases

BackgroundWe have limited insight into the mechanisms of anterior cruciate ligament (ACL) injuries in alpine skiing, particularly among professional ski racers.ObjectiveTo describe the mechanisms of ACL injury in World Cup...