Background: Although the importance of physical fitness for injury prevention is recognized in sports medicine and rehabilitation, few studies have investigated this factor among recreational alpine skiers. Objective: To determine the effect of lower extremity fitness on the risk and severity of injury among recreational alpine skiers. Method: This prospective cohort study involved 117 recreational skiers at two alpine resorts during the 2021–2022 winter season. Anthropometric characteristics, skiing skills, and lower extremity agility (hexagon test), balance (Y-Balance Test), and endurance (60-s squat test) were assessed before the winter season. All of the participants were divided into an injured group and an uninjured group, based on whether an injury was recorded throughout the season. Results: In binary logistic regression, the hexagon test duration and composite Y-Balance Test score were significant injury risk factors (p < 0.05). Ordinal polytomous logistic regression revealed no significant factors for injury severity (p > 0.05). Conclusions: Recreational alpine skiers with inferior lower extremity agility or balance may have a higher injury risk and this must be considered when assessing individual risk. In the context of injury prevention, regular neuromuscular training and testing, including agility and balance aspects should be recommended to skiers.

Peripheral nerve injury leads to severe neuropathic pain. Previous studies have highlighted the beneficial effects of physical exercise on alleviating neuropathic pain. Exercise regulating transforming growth factor-β1 (TGF-β1) can improve several diseases and relieve neuropathic pain induced by peripheral nerve injury. Here, we investigated whether exercise could alleviate neuropathic pain by modulating TGF-β1 expression. We assessed mechanical and cold pain behavior and conducted molecular evaluation of the spinal cord. We found that spared nerve injury (SNI) led to mechanical and cold allodynia in the hind paw, elevated the expression of latency-associated peptide- (LAP-) TGF-β1, and activated astroglial in the spinal cord. Exercise decreases allodynia, astroglial activation, and LAP-TGF-β1 in SNI mice. Intrathecal injection of a TGF-type I receptor inhibitor attenuated exercise analgesia and enhanced astroglial activation. These findings demonstrate that exercise induces analgesia by promoting TGF-β1 activation and inhibiting astrogliosis. Our study reveals a new underlying mechanism for exercise-attenuated neuropathic pain in the maintenance stage of neuropathic pain after nerve injury.