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Skiing Injuries

Skiing & Snowboarding Injuries

Ahh...the feel of powder as it swooshes beneath your skis or snowboard. The speed, the exhilaration, the beauty. All these are wonderful things, but, if you're like us, you also always have a nagging thought in the back of your head: the risk of injury.

No doubt, skiing and snowboarding can have their risks, but properly addressed, each can be an extraordinary experience. Injuries from skiing and snowboarding can include:

  • Head injuries

  • Knee injuries

  • Fractures (clavicle, ankle, tibia, femur, spine)

  • Dislocations (especially shoulder)

Head injuries

This has raised the most interest in the past few years with the deaths of Sonny Bono and Michael Kennedy, and has stirred a debate on mandatory use of helmets. Only 10-15% of all ski injuries are related to head injuries with over 43% occurring in younger children. Most of the fatal head injuries occur in younger, more aggressive skiers who are skiing out of control, on un-groomed trails, at high speeds (usually greater than 30 mph) and striking a solid, fixed object. Helmets are recommended by the AMA and AOA as methods to help reduce the incidence of head injury, but a helmet provides little protection at high speeds. So, your best protection against a head injury is to ski skillfully, on groomed trails, at lower speeds. It is highly recommended that you use a helmet. This is extremely important for the younger skiers who are at the highest risk of head injury and by the virtue of physics, can benefit the most from head protection. When choosing a helmet, look for the ASTM Logo which means the helmet has met a set of minimum manufacturing standards.

Knee injuries

Knee injuries are quite frequent in skiers because of the simple mechanics of the sport: the body is propelled at high speed. Your feet and ankles are relatively locked into your skis. In a situation where your ski is torqued, but does not release, the joint that sustains the most force is the knee.

Knee injuries can range from simple meniscus tears, to more severe injuries such as ACL tears or even complete dislocations.

By far, knee injury is the most common disabling injury for skiers and boarders. It accounts for 25% of all ski injuries and occurs in approximately 1.33 per 1,000 skier days. The two most common knee injuries are to the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL).

Medial collateral ligament (MCL) injuries occur most frequently in beginning and intermediate skiers. This is due to the fact that beginning skiers use a snowplow type of stance to stop and turn which places a tremendous amount of stress on the inside portion of the knee. This stress or force is multiplied by the mass of the skier and the acceleration of gravity and results in a physics disaster (F= M * A). Fortunately, a majority of these injuries can be treated without surgery. A brace, physical therapy and the tincture of time usually takes care of these injuries. In rare cases, surgical reconstruction is undertaken to treat these injuries.

Anterior Cruciate Ligament (ACL) injuries tend to occur in more advanced skiers and can be attributed to specific falling patterns. Despite wonderful engineering advances in skiing and snowboarding equipment which have reduced the rate of lower extremity fractures, these advances have failed to reduce the incidence of ACL injuries. In fact, there is an alarming increase in ACL injuries (almost a 240% increase) with some interesting theories for this increase. Specific suggestions to prevent knee injuries include:

  • Keep your knees flexed, and don't try to straighten them during a fall since a straight leg provides a longer lever force against the knee.

  • When you're down, stay down; don't try to stop the fall. You can not predict which way your leg is going to twist.

  • Fall forward. Don't land on your hands backward. Keep your arms up and forward. Falling backwards places abnormal forces across the ACL.

  • Don't jump unless you know where and how to land. Land on both skis and keep your knees flexed

    (reference: Ettlinger CF, Johnson RJ and Shealy JE, American Journal of Sports Medicine 1995; 23(5): 531-537)

DonJoy Armor Action eXtreme Brace

DonJoy eXtreme
Armor Action

Finally, you may be asking yourself if a knee brace is something you need to prevent a knee injury. Since we are a brace company, our nature would be to say "absolutely yes". However, you may be shocked to know that we want to be as honest as possible when answering this question. The following page offers some research indicating that a DonJoy Legend Knee Brace or similar type such as the DonJoy eXtreme Armor Action Knee Brace has provided protection of the ACL. We want you to be the skeptic and research this yourself: learn more about research on the DonJoy Legend. Also, be sure to consider the Ossur CTi OTS Pro Sport knee brace.

Fractures (clavicle, wrist, ankle, tibia, femur, spine)

Luckily, modern engineering advances in ski equipment has reduced the incidence of lower extremity fractures. However, the popularity of snowboarding has caused a slight increase in upper extremity fractures. Most of the lower extremity injuries (usually the tibia or leg) are due to a twisting injury of the leg and a failure of the binding to release. Proper settings for your bindings and frequent inspection of your equipment by a professional will help prevent these injuries. Upper extremity injuries are more common with snowboarders falling forward onto an outstretched wrist or directly onto the shoulder. Staying within your limits of skill and using wrist guards may help prevent these injuries. The most common injury of the upper extremity for downhill skiers occurs at the thumb and is sometimes referred to as "skier's thumb". This injury is caused by a force applied directly to the inside (ulnar) portion of the thumb. The force can cause the ligament to rupture and cause disabling pain when attempting to grip or lift items. This can be a serious injury if not recognized early and treated appropriately. With previous and personal experience with this injury, it is highly suggested that stress x-rays be taken of your thumb if you suspect this injury. Prevention of skier's thumb has been theorized to occur from improper grasping of the pole strap. It is suggested not to wrap your straps around your wrist or to use a clip on type of strap to the glove to prevent this injury.

Go Speed Racer!

Finally, general guidelines to have a safe and enjoyable ski vacation include:

  • Don't ski when you're tired. We can't tell you how often we see skiers get injured on the "last run of the day". The mountain will still be there tomorrow, next month, or next year.

  • Keep an eye on the terrain. Look out for grass, rocks, ice, or different density snow.

  • Keep an eye on the other skiers/snowboarders. Often, the out-of-control skier beside you can cause you more harm than can the slope you're descending.

  • Know your limitations. Make sure you are able to master lesser slopes before trying that black diamond. Consider getting lessons to be sure. Don't let your friends "persuade" you into something you do not feel comfortable doing.

  • Think twice about drinking alcohol when you ski. Your reflexes will be slowed, and your muscles will fatigue more easily.

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