You can also visit my FAQ pages specific to alpine skiing, snowboarding and skiboarding. I am in the process of writing a page specifically relating to pre-existing medical conditions and participation in skiing/snowboarding. This will include information on skiing or snowboarding when pregnant and I hope to have it online by February 2012.
1. How dangerous are snow sports in general?
I don't personally regard snow sports in general as "dangerous sports" at all and I don't think you should either - I hope once you have read through this website you will agree! For a start, the overall injury risk combining all the snow sports is about 0.2-0.4%. In simple terms, this means that for every 1000 people skiing or snowboarding in a day, on average between 2 and 4 will require medical attention. This is really very low and a tribute to the work of many people in the ski injury field including researchers, equipment manufacturers, ski instructors and staff at the ski areas themselves. If you're still not convinced, think of an average game of football (soccer) - usually 2 or 3 players end up with an injury at the end of the game (which only lasts 90 mins!) - i.e. 3/22 or 14% compared to 0.4% for snow sports. So if you think snow sports are dangerous then according to the statistics football must be positively suicidal!!
2. What sport has the lowest risk of injury?
The current on-piste snow sport injury rates (taken from our latest Scottish injury study season 2009/10) in ascending order of injury risk are:
|Snow sport||On piste injury rate
|On piste injury rate
|1. Telemark skiing||1.13||889|
| 2. Skiboarding
| 3. Alpine skiing
|All sports combined||2.59||386|
IPTSD = Injuries per 1000 skier days - the average number of people who will be injured for every 1000 people skiing, snowboarding or skiboarding at a ski area on any given day
MDBI = Mean days between injury = the number of days you would have to participate in a particular snow sport before being injured - so the higher the number, the lower the risk. If you're confused, both concepts are fully explained here
These figures only relate to on-piste injuries - injuries will obviously occur (especially telemark & snowboarding) off-piste but these are not recorded in our study to date.
3. Are injury rates on the way up, down or static?
Short answer - The overall injury rate for all snow sports has been stable for the last 5 years or so. In some countries, there has actually been a small reduction in the injury risk. Looking at individual snow sports, the rate for alpine skiing has been decreasing steadily for the last 5 years, snowboarding rates have bounced up and down a bit from year to year and the rate for skiboarding was on a steady increase but has reduced in the last couple of years. Telemark ski injury rates have remained static - although the overall risk of injury from this sport is very low.
Long answer - From the 1970's to the early 1990's the absolute injury rate for alpine skiing has decreased by about 50%, mainly due to the development of release bindings and ski brakes. These lead to big reductions in the incidence of lower leg fractures and lacerations respectively. In the same time frame however, there was a 240% increase in the rate of serious knee sprains - mainly anterior crucriate ligament (ACL) tears. The ACL injury rate then remained static for 10 seasons at about one injury per 2200 days skiing. In the last four years there appears to have been a decrease in ACL injury rates. It's too early to be sure, but it's possible that the shorter tail on new carving skis are helping to reduce the incidence of ACL injuries and in fact many researchers believe that the widespread use of carving skis also explains the downward trend in alpine ski injuries in the last five years. More details on my knee and latest research pages. The injury rate for snowboarding is at worst stable and in fact in some countries, most notably France, the risk of injury from snowboarding has actually reduced below that of alpine skiing. France is the only country to have reported this change which they explain is due to a reduction in the number of beginner snowboarders on French slopes. Telemark ski injury rates appear to have remained static for the last few seasons. Initially, skiboarding seemed to pose no greater overall risk of injury than alpine skiing but from 2000-2004 the stats seemed to show that in fact the risk of injury from skiboarding is the highest of all the snow sports. Added to which, if you are injured on skiboards there is a 40% chance that the injury you sustain will be a fracture (broken bone). The latest stats available up until 2010 show that the risk from this sport has reduced. This seem to be related more to the fact that the total number of skiboarders has reduced rather than the recent availability of release bindings for skiboards. More on the skiboard page.
4. What is the risk of dying whilst skiing or snowboarding?
Extremely low unless you're a complete numpty. The traumatic death rate for skiing is 0.7 deaths per million skier visits. For snowboarding the figure is 35% lower at 0.46 deaths per million snowboarder visits. These rates exclude deaths from medical causes (e.g. cardiac arrests, asthma attacks etc). Skiers are more likely than snowboarders to die as the result of an impact injury whereas snowboarders are more likely to die from jumping or a tree well (NARSID) accident. On average, about 35-40 skiers and snowboarders die every year in the USA as a result of a traumatic accident. Excess speed and/or jump heights are usually involved in most traumatic deaths on the slopes.
5. How do the injury rates for skiing and snowboarding compare to other sports?
Follow this link from the NSAA to find out........ click here
6. What are the commonest causes of snow sports injuries?
The vast majority of snow sports injuries occur as the direct result of an isolated fall, by which I simply mean something goes wrong and the person falls over. In turn the majority of these occur because of user error. Most of the time the injured person has lost control, often travelling too fast for the prevailing conditions and/or on a slope inappropriate to their ability level. About 10% of accidents result from a collision with another person or object, 10% are lift related and 5% occur as the result of equipment failure (such as the bindings releasing inadvertently). Secondary factors are of course important - for example impact with solid snow or ice. It should be remembered that most of these figures rely on an accurate report of what happened from the injured individual - not something that you can always rely on!
7. Should I be wearing a helmet?
To cut a long story short, the current evidence strongly suggests that helmets may prevent or reduce the severity of many head injuries. Nevertheless, even the best currently available helmet cannot protect you against all potential impacts. Sadly, in too many accidents, the forces involved are simply too great. This is especially so in accidents involving collisions (for example with other people, trees or pylons) Nevertheless, it seems clear that wearing a helmet will often reduce the risk of head injuries and I therefore strongly recommend their use and I personally wear one. Remember though, that wearing a helmet does not make you invincible and should be considered the second line of defence after skiing and boarding responsibly. If you are unlucky enough to hit a tree or other static object when travelling at the speed of an average intermediate skier or snowboarder, the forces involved are much bigger than you might imagine and often exceed the protective capabilities of any helmet. This is borne out by the fact that many of those killed on the slopes whilst skiing and snowboarding were wearing a helmet at the time of their accident.
If you do buy a helmet make sure it fits properly (don't just accept hand-me-down helmets for your children), that it is designed for snow sports and meets one or more of the following standards - ASTM F2040, Snell RS98 or CEN 1077. A helmet that has sustained a significant impact should be replaced. For more information on this important topic visit my head injury and helmet pages.
8. Should helmet use be mandatory?
This is a different question. Whilst I strongly recommend that everyone on the slopes wears a helmet, I also respect the right of an individual to choose for themselves. For a start, it has to be remembered that the absolute risk of a serious head injury on the slopes is extremely small (one occurs on average about once every 25,000 days skiing). Whilst the risk is slightly higher for children (whose capacity to recognise and react to danger is often reduced) its still pretty small. To my mind, and that of many snow sports injury experts (including the International Society for Skiing Safety, the International Society for Winter Sports Traumatology and Medicine, the International Ski Patrol Federation and the International Ski Instructors Association amongst others) the absolute risks are so small that there is no need to force everyone on the slopes to wear a helmet. Everybody's situation is different of course, and may vary from day to day depending on snow and weather conditions, individual plans etc etc.
Whilst I do not think helmet use should be mandatory for everyone on the slopes, I respect those who disagree with this, especially those who have either sustained an injury themselves or families of those who have died as a result. Many ski areas and ski schools do now insist that all children wear helmets - a smaller % insist on helmets for all on the slopes. Nevertheless, from an evidence-based medicine perspective, the risks are very small and for now my position remains unchanged.
9. Which sport is the kindest on the knees?
Short answer - Either snowboarding or telemark skiing.
Long answer - Alpine skiing and skiboarding have the highest incidence of knee injuries, which account for 33% and 37% of all injuries respectively in these sports. Snowboarding is generally kinder on the knees, as long as you're not planning lots of wicked jumps with heavy impacts. The main reason for the difference is that on skis and skiboards, each leg is able to twist independent of the other and thus cause injury to the knee. For the most time on a snowboard, both legs are fixed to the same board and therefore it is not easy for the knees to twist independent of the other. However, when a snowboarder is using a lift, most resorts require the rear boot to be out of the binding (so that boarders can use this foot to push themselves clear of the lift on dismount). This means that, whilst one boot is out of the binding, the boarder in effect has a large ski on and is vulnerable to twisting knee injuries. So take care when one foot is out of your binding. Fitting a stomp/slip pad (a friction plate) between the two bindings gives the free boot somewhere to grip, making things less slippy. Snowboarder's knees also get injured (especially in the beginner phase) from repeated forward falls onto the front of the knees. Most of these injuries are minor bruises and as a doctor I don't see many of them that are bad enough to need my attention. A pair of impact pads for the knees cost about £15 and are worth considering. If you really can't give up skiing, then telemark skiing has a low absolute rate of knee injuries - but make sure you fit release bindings to your skis or else don't dial your cable bindings up too tight!
If you've sustained a bad ligamentous injury (ACL, MCL, PCL or combined injury) then you may want to consider a functional bracing system - you can buy these off the shelf but a better (and admittedly more expensive) option is a custom-fitted hinged brace. You'll find more information on my pages dedicated to knee injuries and knee braces. An alternative may be the ski mojo - a spring loaded assistance system for skier's legs - see www.skiallday.co.uk