Ski Injuries Research Articles

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

The Article Abstract is not available.

An Epidemiologic Comparison of Injuries to Skiers and Snowboarders Treated at United States Emergency Departments, 2000-2019.

Skiing and snowboarding are popular competitive and recreational sports that can be associated with significant injury. Previous studies of skiing and snowboarding injuries have been conducted, but studies evaluating injury types and patterns over long periods of time are needed to drive effective injury prevention efforts. We hypothesized that injury patterns would differ among snowboarders and skiers and that the number of injuries remained constant over time. This is a retrospective study of patients presenting with skiing or snowboarding injuries to the United States emergency departments from 2000 to 2019. A total of 34,720 injured skiers (48.0%) and snowboarders (52.0%) presented to US emergency departments over a 20-year period, representing an estimated 1,620,576 injuries nationwide. There is a decreasing trend of the number of injuries over the study period (p=0.012). Males represented the majority (65.7%) of injuries. Skiers were older than snowboarders (mean 30.1 vs. 20.0 years; p<0.001) and patients aged<18 represented more snowboarding (57.0%) than skiing (43.0%) injuries (p<0.001). Common diagnoses included fractures (33.0%) and sprains/strains (26.9%). Snowboarders primarily presented with upper extremity injuries, meanwhile, skiers primarily presented with lower extremity injuries. Most patients (93.2%), were treated and discharged from the emergency departments. Understanding the epidemiology of injuries presenting to emergency departments can help guide prehospital care and medical coverage allocation for resorts and event organizers, as well as identifying areas for targeted injury prevention efforts.

Surgical Treatment of an Unusual Ski Injury: Combined Tibial Fracture With Anterior Cruciate Ligament Avulsion and Segond Lesion

Background: Alpine skiing is considered to be a high-risk sport due to frequent knee injuries and lower limb fractures. The most common lower limb fracture is tibial shaft fracture, while the most common ligament injuries include anterior cruciate ligament (ACL) or medial collateral ligament tears. An injury rarely described in the literature is the association of a bony leg fracture with an ACL injury and Segond fracture. Indications: While the tibial fracture can be managed with intermedullary nailing and proximal ACL tears can be managed with primary repair, the combination of treatments including fixation of the Segond fracture is uncommon. Technique Description: We report combination treatment with nailing for the tibial fracture, primary repair for the ACL avulsion, and primary fixation of Segond fracture. Results: Simultaneous reduction and fixation of the fracture and stabilization of the knee with ACL and anterolateral ligament repair in a single stage resulted in an excellent outcome with complete healing of tibial fracture, ACL repair, and Segond fixation at final follow-up. Discussion/Conclusion: Even if combined leg fracture associated with ipsilateral ACL tear and Segond fracture is a very rare injury, the described technique based on 1-stage fixation of the 3 injuries is a viable option. This surgical technique can be considered a reparative treatment, with the goal of preserving the joint. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Ski and snowboard injury patterns in the United States from 2010 to 2020 in pediatric patients

BackgroundChildren and adolescents are at higher risk of injuries from winter sports like skiing and snowboarding which can cause severe lifelong debilitation and death. PurposeThe objective of this study is to perform a nationwide analysis of pediatric skiing and snowboarding injuries to identify patterns regarding patient demographics, type of injuries, outcomes, and admission rates. Study DesignDescriptive Epidemiological Study. MethodsThis was a retrospective cohort study of publicly available data. Cases were sourced from the National Electronic Injury Surveillance System (NEISS) from 2010 to 2020 and included 6421 incidents. ResultsEven when the highest percentage of injuries was the head at 19.30%; the diagnosis of concussion was placed third while fractures were the most common diagnosis at 38.20%. The proportion of pediatric incidents by hospital type is changing with children's hospitals currently managing the majority of cases. ConclusionsThese findings can assist clinicians in the ED across different hospital types in understanding the patterns of injury to be better prepared for new cases.

Effectiveness of an injury prevention video on risky behaviours in youth snow sports: A randomized controlled trial.

Ski and snowboard-related injuries are common among Canadian youth. Analyzing the role of risky behaviours that contribute to injury risk is essential for gaining an understanding of injury prevention opportunities. The objective was to determine if rates of risky behaviour seen at the ski hill were lower for children and adolescents exposed to an educational injury prevention video. This single-blinded cluster randomized controlled trial included students (ages 7-16) from 18 Calgary schools who were enrolled in novice levelled school-sanctioned ski and snowboard programs. Consenting schools were randomly assigned to the intervention or control. The control group followed standard preparation including watching a general ski hill orientation video that was created by the ski hill. The intervention group viewed the intervention video focussed on injury prevention. The Risky Behaviour and Actions Assessment Tool was used by blinded research assistants to observe and record students' risky behaviours at an Alberta ski hill. In total, 407 observations estimated the rate of risky behaviour. The overall rate of risky behaviour was 23.31/100 person runs in the control group and 22.95/100 person runs in the intervention group. The most commonly observed risky behaviours in both groups were skiing too close to other skiers/snowboarders and near collision with an object/person. Both groups showed similar rates of risky behaviour and demonstrated the same most common type of behaviour. Practical applications: future work should focus on mitigating common risky behaviours.

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.

Psychological readiness to return to the slopes following serious injury among competitive skiers and snowboarders

IntroductionDespite the traditional focus on assessment of athletes’ physical readiness to return to sport, mounting evidence suggests that consideration of psychological readiness is critically important in ensuring that individuals safely and effectively resume competitive activities. ObjectivesThe primary aims of this article are to: (1) evaluate existing measures assessing psychological readiness; among skiers and snowboarders (the focus of this special issue); (3) discuss biopsychosocial factors that facilitate or undermine psychological readiness; and (4) highlight implications of psychological readiness for return to sport outcomes and articulate future research directions. MethodsA literature search was performed in Scopus, PsycInfo, and PubMed using the keywords “psychological readiness,” “ski injuries,” “snowboard injuries,” “return to sport,” and “concussions.” ResultsExisting measures of psychological readiness are limited by conceptual ambiguities and measurement shortcomings. Limited research with skiers and snowboarders suggests that cognitive, affective, and behavioral elements of psychological readiness outlined in past work is apparent among skiers. Physical (issue healing and body system recovery), psychological (personality, recovery motivation), and social (social support, trust in rehabilitation providers) factors can facilitate or undermine psychological readiness. Psychological readiness predicts salient postinjury outcomes, such as the likelihood of returning to sport, reinjury, as well as the quality of postinjury performance. ConclusionsFuture research is needed to further delineate the nature of psychological readiness among skiers and snowboarders. Existing evidence, however, suggests a variety of biopsychosocial factors contribute to athletes’ psychological readiness which may be a key predictor of salient postinjury outcomes.

Extracting decision models for ski injury prediction from data

AbstractCreating decision models for risk assessment of ski injuries is a challenging task. Ski injuries are rare events, but they carry a high cost, that is, can cause working or movement disabilities. Usually, ski risk assessment is performed on small‐scale, case‐controlled studies where the effect of a single factor is evaluated. Recently, data mining and machine learning algorithms are being employed for ski risk assessment and injury prediction. However, these models do not generally satisfy the need for interpretation of the decision model, do not provide explanations for the predictions, and in general do not ensure the completeness and consistency of decision rules. To make data mining and machine learning models useful, one needs to implement the aforementioned properties. Decision support systems are expected to have these properties; however, the process of building such decision support systems is still tedious: it has to consider human biases, assumptions, and subjective values, as well as focus on the decision problem being solved. We propose a method for extraction of decision models from data at hand. Our method DIDEX, Data Induced DEcision eXpert, builds models that have desirable properties for inclusion in decision support systems. The proposed method is used to build a decision model for ski injury prediction based on data from Mt. Kopaonik ski resort, Serbia. The results show that DIDEX generates up to a five times simpler model compared to the existing domain expert DEX models while having a 6% better predictive accuracy. Additionally, its predictive accuracy is comparable to similar machine learning algorithms, such as decision tree classifiers, random forest, and logistic regression.

LESÃO MUSCULAR E GERENCIAMENTO DA REABILITAÇÃO ESPORTIVA NO TREINAMENTO DE RESISTÊNCIA DIRECIONADO AOS ESPORTES DE INVERNO

ABSTRACT Introduction: Muscle injury in ski sports training has gradually increased, greatly impairing performance in ice and snow sports competitions. Objective: To study muscle injury and muscle movement during ice and snow sports training and the rehabilitation of muscle injuries. Methods: Thirty skiers with knee muscle injuries were selected as subjects and underwent rehabilitation training for six weeks, and the indicators were statistically evaluated. Results: The ski injuries were mainly muscle strain, muscle or ligament strain, and ligament rupture. The indices after treatment were significantly different from those before treatment (P &lt; 0.05); compared with the three rehabilitation programs, the improvement of each index in group C was significantly different from that in the other two groups (P &lt; 0.05), while there was no significant difference in the improvement of each index between the multi-angle isometric training treatment in group A and the proprioceptive neuromuscular stimulation technique in group B (P&gt;0.05). Conclusion: The influence of recovery training technology on knee muscle re-education was proposed, and a rehabilitation plan for skiing was presented. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

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.

A study on ski groups size and their relationship to the risk of injury

This paper addresses a novel topic in ski injury research - how a ski group size indicates the risk of ski injury. There is evidence in research literature that people ski in groups. However, the relationship between group size and the risk of injury has remained unexplored. Based on ski lift entrance data, we use the density-based clustering algorithm OPTICS to identify groups of skiers and discuss the advantages of using this algorithm. We show that the ski group size can be used to improve the identification of skiers who experience ski injury. The results of the identification of ski groups at Mt. Kopaonik Ski Resort in Serbia show that skiing alone is most susceptible to ski injury, while skiing in couples or in bigger groups reduces the risk of injury by 46%. In addition, it is confirmed that ski injuries are an early failure event phenomena. Based on the CHAID decision tree analysis, spending a small amount of time at the ski resort and skiing alone are associated with the: 6 times greater ski injury risk than the average ski injury risk.

Musculoskeletal Injuries in Cross-Country Skiing.

Cross-country skiing, one of the oldest forms of skiing, is enjoyed widely as a recreational activity and as a competitive sport. It is practiced in regions with snow-covered landscapes, particularly in the Nordic countries and with increasing popularity in non-Nordic countries of Europe as well as in the United States, Canada, Australia, and New Zealand, among others. Cross-country skiing is a fairly safe activity, and historically the risk of injury has been relatively low. However, advances in equipment development, together with increasing speeds, more demanding trails, and growing numbers of participants, have all contributed to a larger report of injuries, although still comparatively low versus other skiing modalities. Injuries in cross-country skiing can occur either after a single traumatic event or in the setting of chronic repetitive microtrauma (i.e., overuse injuries).

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—

A machine learning approach for learning temporal point process

Despite a vast application of temporal point processes in infectious disease diffusion forecasting, ecommerce, traffic prediction, preventive maintenance, etc, there is no significant development in improving the simulation and prediction of temporal point processes in real-world environments. With this problem at hand, we propose a novel methodology for learning temporal point processes based on one-dimensional numerical integration techniques. These techniques are used for linearising the negative maximum likelihood (neML) function and enabling backpropagation of the neML derivatives. Our approach is tested on two real-life datasets. Firstly, on high frequency point process data, (prediction of highway traffic) and secondly, on a very low frequency point processes dataset, (prediction of ski injuries in ski resorts). Four different point process baseline models were compared: second-order Polynomial inhomogeneous process, Hawkes process with exponential kernel, Gaussian process, and Poisson process. The results show the ability of the proposed methodology to generalize on different datasets and illustrate how different numerical integration techniques and mathematical models influence the quality of the obtained models. The presented methodology is not limited to these datasets and can be further used to optimize and predict other processes that are based on temporal point processes.

The effect of a ski and snowboard injury prevention video on safety knowledge in children and adolescents

It is believed youth snow-sports injuries are preventable through adequate safety education. This study evaluated the effectiveness of a ski and snowboard injury prevention video on youth safety knowledge. A cluster randomized controlled trial was conducted among grade 2-9 students participating in a ski-snowboard school program. The intervention group watched a new injury prevention video. The control group watched the general ski-area orientation video. Students completed a 15-question ski-snowboard safety test before, immediately after, and one month after viewing. Within-subject difference between the pre- and post-questionnaire scores was calculated. Linear mixed-effects model assessed difference in knowledge change scores. 1034 students (seven intervention; 10 control schools) were enrolled. Pre- to-post-test knowledge increased by an average of 1.91 in the intervention (n = 388) and 0.10 points in the control (n = 646). The difference between the immediate and one-month post-test was 0.17 for the intervention (n = 122) and 0.60 for the control (n = 130). The mean change score for the immediate post-test was greater in the intervention (1.77; 95% CI: 1.52-2.03). The mean change score between the immediate and one-month post-test was lower (−0.55; 95% CI: −1.07 to 0.02) for the intervention compared with the control. The findings showed a ski-snowboard safety video can increase knowledge immediately after viewing within a school-aged population.

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:

Water Ski Injuries and Chronic Pain in Collegiate Athletes.

This study examined the rate of injuries and chronic pain in collegiate water-ski athletes as a preliminary study. We also compared the mechanics and cause of injuries by the level of water-skiing experiences. A total number of 96 collegiate water-ski athletes, aged 21.4 ± 2.23 years, participated in the study. An off-line questionnaire was distributed at the collegiate tournaments in the United States. The questionnaire consisted of 20 questions, including demographic information, body region and type of injuries, mechanics and cause of injuries, chronic pain and pain management. A Chi-squared test was used to examine the differences in injury rates by sex and the level of experiences (beginner: <5 years, intermediate: 5–10 years, advanced: <10 years). The significance level was set at ≤0.05. A total of 336 water skiing-related injuries were observed from 96 participants. The ankle/feet, knee, and head/neck regions were the most common body regions injured, representing 26.5, 16.7, and 15.8%, respectively. Female athletes were more likely to have nerve injuries than male athletes (p = 0.039). The intermediate athletes were more likely to have trunk (p = 0.047) and upper extremity (p = 0.042) injuries than beginner athletes, and the beginner athletes had less joint/ligament (p = 0.001) and bone injury (p = 0.010) compared to the advanced athletes. Torsion/twisting (32.8%) and deceleration (26.9%) were the most common mechanism of injury. Beginner athletes experienced injuries more due to insufficient skill (p = 0.03), while the advanced athletes were likely to have more injuries by the loss of control (p = 0.01). Collegiate athletes had higher rates of chronic pain in the trunk (42.7%) and skeletal muscle (43.8%), and they participated in stretching/exercise (40.8%) and massage/form rolling (29.6%) to manage their chronic pain. The present study revealed that injury rates in males and females were 49.7% and 50.2%, respectively. Female athletes were more likely to have a nerve injury than male athletes. The mechanics and cause of injuries were different by the level of experiences where different training approaches may be required to minimize the injuries. Additionally, the strength and conditioning program that is systematically designed for core strength is needed to eliminate chronic trunk pain in collegiate water-skiing athletes.

Epidemiologia das Lesões Musculoesqueléticas de Desportos de Inverno

Promoting and protecting an athlete’s health is an important task for any sports organization. The most common ski injuries are sprains of the medial collateral ligament of the knee, of the anterior cruciate ligament, of the cubital collateral ligament of the first finger metacarpophalangeal and injuries of the rotator cuff. Although the number of recreational snowboarders is relatively lower than that of alpine ski sports, the probability of acute injury on snowboarders is higher than that of the skier. Associated with snowboarding, injuries often involve the anatomical region of the wrist, shoulder and ankle. Alpine skiing and snowboarding put winter athletes at risk for a variety of injuries. It is important to recognize and treat them properly in order to minimize future sequelae and a return to previous physical activity.

Analysis of the mass skiers' injury in a large ski resort in Chongli, China

Objective To make a retrospective analysis of the injuries of skiing population in a large ski resort in Chongli, China and provide a basis for predicting the rapidly increasing medical needs for ski injuries in the context of the 2022 Winter Olympic Games. Methods The basic data of all injured skiers who were treated in a medical station of a large ski resort in Chongli during the snow season from November 2017 to March 2018 and from November 2018 to March 2019 were collected. The number of skiers, the number of injuries, the causes of injuries, the types of injuries and the locations of injuries were compared. Results A total of 753 skiers were injured in two snow seasons, and the estimated average incidence of injury was 4.53 and 4.46 per 1 000 skier days at the resort respectively. The average daily injury rate per 1 000 skiers in November of the two snow seasons was relatively low, with 2.20 and 1.38 cases respectively. The difference of injury rate in different months might have little to do with snowfall and more to do with passenger flow. In both the snow seasons, men accounted for more injuries than women, and injured skiers aged between 21 and 30 accounted for the largest proportion, reaching 36.8%. The main causes of injuries were falls (76.6%). The highest rate of injury was in the head and neck (17.9%), followed by the knee (17.4%) and wrist and fingers (13.3%). The most common types of injuries were contusion and trauma (29.5%) and joint and/or ligament injuries (22.2%). Children (2-12 years old) accounted for 12.7% of all the injured skiers. The rate of moderate to severe injuries (including fractures, concussions, etc.) was 34.8% among the injured patients over 50 years of age. Conclusion The snow resort should focus on injuries to children and elderly skiers and carry out targeted guidance and rescue work. In order to better ensure the medical safety of skiers, the ski resort medical station and nearby treatment hospitals should be equipped with a corresponding number of medical personnel and equipment, and the ski resort should further improve its safety management and rescue system.