Update on Injury Trends in Alpine Skiing

Abstract

Over the past 26 years, the authors have given many reports at ASTM Conferences on injury trends in Alpine skiing. These reports have generally taken two forms: a cursory report on a broad range of injury groups or an in-depth look at a specific injury group or sub-group of the general population. In the current study, the authors provide an update on two large injury groups that have been the subject of many earlier reports, fractures and sprains of the lower leg and sprains of the anterior cruciate ligament of the knee. Examples of the lower leg injury common to Alpine skiing are tibia fractures, ankle sprains and fractures, tibia plateau fractures, heel cord injuries, and knee sprains. Between December 1972 and April 1998 the authors evaluated prospectively 15 526 injuires reported to the injury clinic operated in the base lodge of a moderate size northern Vermont ski area. During that time approximately 5 298 600 skier-visits (days) occurred at the area. Over that period the overall injury rate decreased by 46%. However, the change for the two target groups can not be expressed in such simple terms. Historically, the authors have described injury trends in mean days between injury (MDBI), fitting each year's MDBI to an exponential curve by regression analysis. In this study the authors explain why this technique can no longer be used for these two groups and propose new methods, which could lead to a better understanding of the trends identified by this study.

Injury Trends in Recreational Skiers and Boarders in the 16-Year Period 1996–2012

“…6), as reported previously [21,22]. The risk for lower leg fracture in alpine skiers decreased significantly in the 1970 and 1980, probably due to better boots and release bindings, and better binding setting and adjustment in the ski shops, levelling out to a lower plateau from the 1990 [6]. This has not been observed to the same degree in children where the prevalence of lower leg fracture decreased from 20% in the 1996/1998 seasons reaching a plateau of 12-13% from the 2006/2008 seasons.…”

“…But skiing and boarding are not without risk, and it is important to perform epidemiological studies to identify risk factors. Most of the studies have been short-term covering 1-2 seasons [2][3][4][5], but several good long-term studies have been published from the USA and France [6][7][8][9].…”

Effect of Ski Binding Parameters on Knee Biomechanics: A Three-Dimensional Computational Study

“…The overall injury rate was estimated to be between 1 and 6 per 1000 skier-days in different studies from the 1970s to the 1990s (5,16,20,27,28). However, most authors agree that the incidence of injury has declined by approximately 40 -50% over the years (5,17,18).…”

“…In fact, lower-extremity injuries, which account for 40 -60% of all injuries (16,20), have been decreasing over the last 20 yr at Sugarbush, Vermont (16 -18). Whereas tibia and ankle injuries have been decreasing by about 70 -90% (5,17), severe knee sprains usually involving the anterior cruciate ligament (ACL) have been increasing by as much as 170 -280% from the 1970s to the 1990s (5,17,18). In the late 1980s, ACL rupture was found to represent 2.4% of all injuries (20).…”

Self-Release of Ski-Binding

“…Up to the beginning of the 1990s LEER injuries declined significantly, which primarily was due to better functioning modern bindings [18]. Ski bindings should be set according to appropriate tables (BfU, ISO, IAS or ASTM standards) and functionally tested using release calibrators.…”