Injury Prevention

For those of us who love snow sports, one of the worst things is being unable to ski or board. Whilst we can't do much about some of the reasons for this (such as a lack of snow), we can do lots to prevent ourselves being injured. That is the prime aim of this website - to prevent injuries occurring in the first place whilst also emphasising that snow sports are in fact relatively safe. So, first and foremost don't get paranoid - contrary to what you might think or have heard, the risks of an injury whilst skiing or snowboarding are much much lower than most people believe. For every one thousand people on the slopes per day, statistically between 2-4 only will sustain an injury that requires medical attention - in percentage terms that's a risk of only 0.2-0.4%. So, although the overall risk is less than 1%, if it happens to be you it may not only bring your eagerly awaited holiday to an abrupt end, but could also prove to be very expensive in terms of medical treatment and time off work. Snow-sports deaths, whilst often making front page news, are in fact very rare - there only being one death on the slopes every 1.5 million skier days. In fact stats from America demonstrate that overall ten times more people drown in a bath-tub than die on the slopes every year.

Other individuals sustain avoidable minor soft tissue injuries which can nevertheless interfere with the enjoyment of their holiday. Here are a few simple tips that can help to significantly reduce your risk of injury without spoiling the enjoyment of your time on the slopes.

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General Advice For Everyone on the Slopes

For my full injury prevention advice sheet (as a pdf file) updated for 2008- click here.

• Follow the F.I.S. code on piste safety (see later). In today's litigatious world the chances are that you may face a civil charge of negligence if you ignore the code and cause an accident/injury to someone/thing else and have to pay damages (and substantial legal fees). In addition, criminal charges may also be applied - in a highly publicised case after a fatal skier-skier collision, Nathan Hall was convicted of criminally negligent homicide in Colorado and was sentenced to ninety days in jail, 240 hours of community service, and three years’ probation - not to mention any ensuing claim for financial compensation - sobering stuff.....other similar cases have since been reported and doubtless more will follow.

• Don’t be tempted to skip professional instruction - injuries are commoner in beginners and bad habits learnt early on are difficult to resolve later. This may lead to you hitting a brick wall at the 'intermediate stage' when you want to progress that wee bit further...Be aware though, that early on if you take instruction not to ruin everything by trying to do too much too soon. Our research indicates that those on their very first day who take instruction are in fact more likely to be injured than those who do not!

• Have your own equipment checked regularly or use a reputable equipment hire company as advised by your rep. Don’t be tempted to overstate your level of skill – longer skis are more difficult to turn and bindings set too high for your ability are more likely to cause injury. Boots should fit snugly without your ankle moving around inside. If your skis, board, boots or bindings don’t feel right, don’t be afraid to go back to the hire shop. Staff at hire facilities should take time to fit your equipment properly - if they don't ask you any questions about your height/weight/ability then seriously consider going somewhere else to hire your gear - even if it is a bit more expensive and a bit of a hassle. Believe me, sorting out a broken leg whilst abroad is a lot more hassle....

• Whatever you do, don't borrow kit off your friends. This increases your risk of injury by a massive 800%!

• Warm up and down properly – spend a few minutes gently stretching your hamstrings, thigh muscles, hips and calves before and after going on the slopes. Hold each stretch gently for 30 seconds. It shouldn't hurt!

• Recognise when you need a rest – most injuries occur after lunchtime when tiredness sets in.

• Hard though it is, try and avoid being persuaded to attempt slopes or speeds beyond the level of your ability. Our injury data suggests that you are more likely to be injured if you try and keep up with more experienced friends

• Wear adequate clothing, preferably in layers. Don’t forget good quality sunglasses, goggles and sunscreen.

• Consider wearing a protective helmet. Whilst some consider them “untrendy” there is nothing cool about sustaining a head injury.  Ideally, any helmet should comply with one of the American standards (Snell RS98 or ASTM F2040) or the European standard EN1077. This indicates that it has passed certain standards. No helmet will protect the foolhardy who ski too fast and/or out of control and then slam into a tree or other static object - see my helmet page for some sobering stats....

• Never ski or board off-piste alone. Be aware of the prevailing avalanche risk and, if in doubt, consult a local guide or the ski patrol before setting out. Carry all the appropriate gear including an avalanche transceiver and know how to use it.

• Be aware of the risk posed by tree wells. Its a horrible way to die and largely preventable. Click this link to read more if, like the vast majority of skiers and snowboarders, you've never heard of tree wells.

• Never attempt to ski or board down a closed piste. Not only do you run the risk of serious injury, but you could be prosecuted and be held liable for the costs of any rescue. Ski patrollers are not killjoys - pistes are only closed for good reason, even if those reasons are not immediately apparent to you.

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  Avalanche Advice

  Every year, a handful of skiers and snowboarders die as a result of avalanches. The risk is highest in the backcountry but slides can occur very near to ski areas. Even in Scotland, avalanches can pose serious dangers to those foolhardy enough to ignore the warnings. Whilst no amount of advice, experience, planning or equipment will ever provide 100% protection against either triggering or being caught in an avalanche, the following resource is a useful reference source on all aspects of avalanches - including a six point checklist of how to avoid them and what to do if you or a colleague are caught in a slide.

  Sport Scotland Avalanche Information Service

   

  Specific advice for alpine skiers

  The commonest injuries are knee sprains, thumb sprains and shoulder injuries.

  (a) The commonest single injury to an alpine skier is a grade I-II sprain of the medial collateral ligament on the inside of the knee. Usually these result from a twisting fall when the lower leg bends outwards relative to the thigh. An additional factor may be a failure of the ski binding to release. These injuries also result from a 'snowplough gone wrong', especially when the skier has a wide,  unstable stance (as in the picture on the right). Although no releasable ski binding currently available could ever claim to protect the skier against all such injuries, correct functioning of the boot-binding interface maximises the chances of correct binding release occurring and consequently reduces the risk of this injury. To keep your boot-binding interface in top condition, I recommend the following:

  Have your bindings serviced at least once a year - bindings are mechanical devices that require cleaning, lubrication, and re-setting. Think of all that salt, dirt, rust etc playing havoc with the internal springs..... Studies have shown that un-serviced bindings are less likely to release because (for example) although they may be set at say 6, in fact the springs have become a bit stiffer through lack of care and as a result they actually act as if they were set at 8.

  Avoid walking too much whilst wearing your ski boots. The sole of the boot is designed to fit snugly into the binding plate and if it becomes worn down the efficiency of the boot-binding interface will be compromised

  If you are hiring your gear, always go to a reputable facility and, if the staff or equipment don't inspire confidence, go elsewhere. Carving skis should be the norm now and its worth paying a bit more for good quality kit

  Never borrow someone else's skis unless either you or they know what you're doing and can properly readjust bindings to the correct settings! As already mentioned, our research indicates that those who borrow gear are 8 x (yes, eight times!) more likely to be injured than others.

  Finally - and most importantly, get into the habit of performing a self-test on your binding everyday. This simple procedure ensures that your bindings are set correctly for your needs, has been demonstrated to reduce the risk of injury and is endorsed by experts from the International Society for Skiing Safety.

  (b) Certain situations increase the risk of a serious knee sprain (anterior cruciate ligament tear). The commonest mechanism of ACL injury is the so-called 'Phantom Foot' which classically occurs in three situations....

          1. Attempting to get up whilst still moving after a fall
          2. Leaning right back on your skis or attempting to sit down after losing control
          3. Attempting to recover from an inevitable fall
  
  To avoid such injuries –
           In a fall, keep your arms forward and your hands over your skis if possible
           Don’t fully straighten your legs when you fall - try and keep them bent
           After a fall, don’t try to get up until you have stopped moving
   

  Recent ACL friendly developments included Lange's rear release boot system. This seemed to be a positive step towards reducing the incidence of ACL injuries - but has not proven to be a commercial success. More info here. New binding developments seem to offer a new ray of hope in the fight to reduce ACL injuries from alpine skiing. For more detailed information on knee injuries in alpine skiing, click here or for my latest research news page (with information on new bindings research) click here.

  
  (c) Try and avoid skiing with your hands inside the ski pole straps. This locks your hand to the pole in a fall, the pole then acts as a lever on the thumb and this greatly increases the risk of injury to the thumb joint. (An exception would be when skiing in deep powder snow on piste though where the loss of a pole could be a major problem).
  
  (d) Contrary to popular belief, it has been proven in several studies that skiers are more likely to collide with and injure fellow skiers than are snowboarders. Keep a close eye on everyone else on the piste! It is the responsibility of the uphill skier or snowboarder to avoid collisions with those below them (just as in a car accident, the rear car is usually held responsible in a front/back collision).

  (e) If you have already sustained an ACL injury and/or undergone reconstructive surgery, consider wearing a hinged knee brace. More information here.

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  Specific advice for snowboarders

  The commonest injuries are to the wrist, shoulder and head. The risk of sustaining a fracture is at least twice that of skiers.
  
  (a) The main concern for snowboarders (especially beginners) is the risk of a wrist fracture. It is estimated that 95,000 wrist fractures occur world-wide every season amongst snowboarders, although (again) the absolute risk of an injury is still very low with one wrist fracture for every 1200 days snowboarding. The problem is that the natural reaction to falling having lost balance on a snowboard is to land on an outstretched hand. The forces of the fall are absorbed by the wrist joint and injury results. Beginners, being more likely to lose balance (and fall) are at the highest risk of injury of all.