Injuries amongst elite skiers and snowboarders - introduction

Until recently, there has been very little data available concerning the risks of injury to elite (i.e. World Cup standard) skiers and snowboarders. Previous small scale studies had revealed the following injury rates for various sports:

Alpine skiing : 1-4 injuries per 1000 runs (Ekeland et al 1985, Bergstrom et al 2001)
Snowboarding: 1.3-4 injuries per 100- runs (Torjussen et al 2005/2006)
Freestyle skiing: 1.6 injuries per 1000 runs (Heir et al 1995)
Ski jumping: 1.2 injuries per 1000 skier days (Wright et al 1986)

As you will read shortly, in the last 3 years we have been learning more about the up to date risks faced by elite skiers and snowboarders. The challenge (as with recreational riders) is to come up with workable and acceptable solutions that keep those risks as low as possible. No easy task.

FIS Injury Surveillance System

In 2006, the FIS (International Ski Federation) in colloboration with the Oslo Sports Trauma Research Centre and financially supported by DJO, set up the FIS Injury Surveillance System. Since the 2006/07 season, this has collated all injuries requiring medical attention that have been sustained by elite skiers and snowboarders during the world cup season. A standardised form is used for data collection and this is completed either by the athlete themselves or their coach/physio/doctor. The injury may have occured during competition or training to be included in the database.

Results to date

The latest results from the study were presented at the ISSS 2009 meeting by Tonje Florenes from the Oslo Sports Trauma Research Centre and have now been published in a series of articles in the British Journal of Sports Medicine and the Scandinavian Journal of Medicine and Science in Sports (see references at the bottom of this page). I have included some of the slides from her presentations on this page. So far, during the two seasons 2006/07 and 2007/08 a total of 705 injuries have been recorded amongst 2121 athletes. This means that one in three elite skiers/snowboarders sustains an injury! 49% of these injuries occur during world cup events. The table below gives a breakdown of these statistics.

	n of athletes	n of injuries
Alpine	521	191
Freestyle	416	160
Snowboard	421	237
Ski jumping	213	45
Nordic combined	120	23
Cross country	430	49
TOTAL	2121	705

Injury severity was classified according to the amount of time lost from training/competition as a result of the injury. Severe injuries were classified as those requiring more than 28 days absence and accounted for almost 1 in 3 of all injuries sustained (see below).

Of the 196 severe injuries, the highest rates were seen amongst freestyle skiers and snowboarders.

The knee was by far the commonest area of injury followed by the back, head and shoulder joint (see table below).

The following shows a more detailed breakdown of injury type by location. Ligament injuries not surprisingly dominated amongst knee injuries and concussions amongst those with head injuries.

Preliminary results from season 2008/09

Some preliminary data was also presented from the 2009/09 season just finished which basically shows that the high risks of injury amongst elite skiers and snowboarders is continuing (see below)

In conclusion

In a nutshell, the injury rates seen amongst elite skiers and snowboarders are extremely concerning. Every season on average, 1 in 3 athletes sustains an injury. Almost one third of these injuries are severe enough to cause them to cease activities for more than 28 days.

Moving forwards

Now that the current scale of the problem has begun to be identified, the medical committee of the FIS are urgently seeking ways to reduce the incidence of injuries amongst their elite athletes. Part of the ISSS 2009 meeting was a joint FIS/ISSS symposium on elite injuries and its clear that there are no easy quick fixes. Skiers for example are likely to continue to dial their bindings up as tight as possible, worried as ever by the possibility of inadvertent binding release but often ending up the victim of binding retention! There are, however, some potential ideas that might help. Watch this space!

References

1 Florenes TW, Nordsletten L, Heir S, Bahr R. Recording injuries among World Cup skiers and snowboarders: a methodological study. Scand J Med Sci Sports 2009.

2 Florenes TW, Bere T, Nordsletten L, Heir S, Bahr R. Injuries among male and female World Cup alpine skiers. Br J Sports Med 2009; 43(13):973-978.

3 Florenes TW, Heir S, Nordsletten L, Bahr R. Injuries among World Cup freestyle skiers. Br J Sports Med 2010; 44(11):803-808.

4 Florenes TW, Nordsletten L, Heir S, Bahr R. Injuries among World Cup ski and snowboard athletes. Scand J Med Sci Sports 2010.