ALPINE SKIING FAQs
1. What are the commonest injuries sustained by alpine skiers?

2. What about carving skis?
There were some initial concerns that carving skis might be associated with an increased risk of injury. It would now seem that this risk has disappeared - probably because the majority of people have now changed over to this type of ski and the "learning" phase has passed. As carving skis are the norm now, beginner skiers have never experienced anything else. In fact, the very latest figures that we have from Scotland indicate that wearing carving skis may result in a marginal protective effect against injury.
3. Why don't modern bindings protect against all lower leg injuries?
Whilst modern alpine ski bindings have come on a long way in the last twenty years, they are still not perfect. If you think about it, bindings have to perform a difficult balancing act. On the one hand, we want them to hold onto our boots as we apply a multitude of different forces across them skiing at different speeds down a variety of pistes. On the other hand, we expect them to be able to recognise in a millisecond the application of an abnormal force when we lose control and release our boot before the forces become so great that an injury occurs! No easy task. There is a perception amongst many ski injury researchers that the current ISO binding settings are too high - especially for women and children - and the fact that the collateral ligaments of the knee remain the commonest site of injury in alpine skiers would tend to support this. Any reduction in binding settings has to be balanced against increasing the risk of injury from an "inadvertent release", when the binding releases when the skier doesn't want it to. In 2000, France boldly introduced a new (generally lower) setting system - so far the results are promising - a reduction in injury rates without an increase in inadvertent release injuries. The possible development of "learning bindings" may also be a step in the right direction. A new and exciting ski binding system that should protect the ACL in the event of a backwards fall will be released in time for the 2008/09 season - see answer 5 below. For details of a simple procedure that all skiers should be encouraged to do before they start skiing, click here.
4. How do ACL injuries occur and why all the fuss about them?
The injury rate to the ACL has until very recently been static for the last seven years at one injury for about every 2200 days skied. There are three main accepted mechanisms responsible for injury to the ACL whilst alpine skiing:-
- Phantom Foot - the tail of the ski acts as a lever when a skier falls off balance to the rear
- Boot Induced - after landing off balance from a jump, the boot pushes on the calf leading to injury
- The classic mechanism - This mechanism is thought to occur when the skier moves forwards relative to the ski (such as when catching an edge at high speed), a severe anterior bending movement is applied as a result and the forces generated rupture the ACL.
These injuries are important - not only can they easily end a professional ski career, but for the recreational skier an ACL injury will mean many months away from the slopes and most likely a knee that will never give the same level of support as before. Surgery, intensive physio, time off work and considerable expense may all be encountered! More details on my knee page.
5. What about skiers in terrain parks?
More and more skiers are now venturing into terrain parks - traditionally the domain of snowboarders. Short, twin type carving skis are ideal for performing acrobatic tricks on rails and in pipes. We now have some data from three countries - France, the USA and Canada - which unfortunately (but perhaps not surprisingly) all show similar findings - that compared to on slope injuries, injuries in terrain parks tend to be more serious (especially affecting the head and spine). You can find full details on this page - click the terrain park link.
6. Any new developments on the horizon?
Yes! Probably the most important innovation in recent times is due to become available next season (2008/09). This is a new alpine binding designed to protect against the commonest cause of ACL injury - the so called Phantom Foot scenario (explained in detail on both my knee page and new KneeBindingTM page). Featuring lateral heel release below the elastic limit of the ACL, this binding has been many years in development. Whilst in theory it should protect the knee, it does not seem to lead to an increase in inadvertent (i.e. accidental) release compared to any other binding. For more details, visit my page describing this binding or go to the manufacturers page at www.kneebinding.com
In addition, snow sports manufacturers in general have been in overdrive on the development front for the last few years! Ski design has altered radically and now we have twin tips, split skis, amazing sidecuts and even Intellifibres in Head skis. These piezoelectric fibres generate an electrical charge when flexed and react to the voltage by growing stiffer. This means that as you ski harder, the ski edge bites harder which is a great feature on icy slopes or hardpacked terrain. As with the Skibo Edge system featured elsewhere, they have yet to be proven to improve safety. On one front it might seem logical that they will, as they should offer better grip but the flip side is that by skiing harder the risk of injury might be increased - we simply don't know at this point in time. Expect other manufacturers to follow with their own designs in the near future. Soft ski boots are becoming increasingly popular too - on the face of it a pretty decent compromise between performance and comfort. Again, little is known about any potential safety issues with these boots as yet.


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