Ski and Snowboarding Injuries

With skiing and snowboarding in full swing in the Pacific Northwest, it is important to review what can be done to reduce the risk of injury and make the season as enjoyable as possible.  In the United States, approximately 20 million people participate in skiing and snowboarding every year.  In my clinic, skiing and snowboarding injuries are common.  Snowboarding has been shown to have a three fold higher rate of injuries compared to skiing.  With the increasing popularity of snowboarding, we are also seeing an increase in overall injuries.  There are several injury prevention techniques, however, that can be easily implemented to help reduce your chance of a serious injury.

Helmets:

Forcite Alpine helmet

In the past several years, helmet use has increased significantly; however, approximately 40% of people still elect to not use a helmet (1).  There is overwhelming evidence to support the use of helmets to reduce the risk and severity of head injuries with both skiing and snowboarding.  I highly recommend the use of helmets with both of these activities.

Wrist guards:

Wrist injuries are very common with skiing, but especially with snowboarding.  Evidence shows that the use of wrist guards with snowboarders substantially reduces the risk of wrist injury, sprain, and fracture (2).

Knee bracing and ACL injury prevention:

The use of knee braces to prevent ACL injuries is still a very controversial topic.  It is known that knee braces do help patients who have ACL-deficient knees or who have had prior ACL reconstruction surgery, however, additional studies are needed to evaluate the effectiveness of bracing in preventing ACL injuries in knees with normal ACLs (3,4).

In addition to bracing, there is a focus of research on modifiable risk factors to prevent knee injuries with skiing and snowboarding.  It has been shown that decreased core strength and decreased quadriceps and hamstrings power can lead to a higher rate of knee injuries (5).  This demonstrates the need to focus on resistance training for any athlete who wants to participate in skiing and snowboarding.  I recommend this workout.

Ski bindings:

Modern ski boots are designed to provide excellent control and support.  The failure of a ski binding to release is substantially associated with ACL ruptures.  In a study done, bindings failed to release in 78% of cases of ACL rupture (6).  It is very important to have your ski bindings inspected every year to check for proper calibration of the heel and toe pieces.

Bindings and boots:

As many of you know, there are three different types of snowboarding boots: soft, hybrid, and hard.  Hard snow more boots place snowboarders at risk of fracture of the fibula and tibia at the top of the boot.  This is known as a boot top fracture.  Telemark ski boots, which contain an open heel, can effectively prevent these fractures in a forward fall (7).  Hard snowboard boots have been shown to place snowboarders at approximately 2 times the risk of knee injury compared with soft boots.  Soft boots, however, place these athletes at approximately two times the risk of ankle injuries compared with hard snowboard boots (8).  Boot selection is a very personal choice and I don’t think that one can make that choice solely on the risk of injury, however, it is an important consideration.

Boot top fracture

Skiing and snowboarding are among the most popular winter sports worldwide.  This is especially true in the Pacific Northwest.  Recent developments in equipment and prevention measures have helped reduce the incidence of injuries related to skiing and snowboarding.    I personally recommend the use of helmets, wrist guards, and core and lower extremity strengthening so that you can enjoy your ski season without injury. 

If you are suffering from a nagging injury that is preventing you from enjoying your winter or have a new injury, then come and see me.  I hope to see you all in the lodge safe and sound!

References

1.            Milan M, Jhajj S, Stewart C, Pyle L, Moulton S: Helmet use and injury severity among pediatric skiers and snowboarders in Colorado. J Pediatr Surg 2017;52(2):349–353.

2.            Russell K, Hagel B, Francescutti LH: The effect of wrist guards on wrist and arm injuries among snowboarders: A systematic review. Clin J Sport Med 2007;17(2):145–150.

3.            Sterett WI, Briggs KK, Farley T, Steadman JR: Effect of functional bracing on knee injury in skiers with anterior cruciate ligament reconstruction: A prospective cohort study. Am J Sports Med 2006;34(10):1581–1585.

4.            Kocher MS, Sterett WI, Briggs KK, Zurakowski D, Steadman JR: Effect of functional bracing on subsequent knee injury in ACL-deficient professional skiers. J Knee Surg 2003;16(2):87–92.

5.            Jordan MJ, Aagaard P, Herzog W: Rapid hamstrings/quadriceps strength in ACL-reconstructed elite Alpine ski racers. Med Sci Sports Exerc 2015;47(1):109–119.

6.            Ruedl G, Helle K, Tecklenburg K, Schranz A, Fink C, Burtscher M: Factors associated with self-reported failure of binding release among ACL injured male and female recreational skiers: A catalyst to change ISO binding standards? Br J Sports Med 2016;50(1):37–40.

7.            Tuggy ML, Ong R: Injury risk factors among telemark skiers. Am J Sports Med 2000;28(1):83–89.

8.            Young CC, Niedfeldt MW: Snowboarding injuries. Am Fam Physician 1999;59(1):131–136, 141.