As the Australian ski fields have transformed in what seems like a matter of days from dry dirt to being covered in record-breaking levels of snow, many Australians are taking advantage of the conditions and rushing off to the mountains. The not-so-happy side of this wintertime fun that is seen by those in the orthopaedic industry is the increasing number injuries.

The inaugural International Extreme Sports Medicine Annual Congress featured two studies that are relevant to our sports medicine community at this time of the year. In an interesting comparison, the rate of injury in snowboarding is now double that of skiing, but skiing injuries have decreased with the advancement of skiing equipment.

In an Australian study presented by Tom Hackett, researchers found that snowboarders are significantly more prone to injuries to the knee in their leading leg than their trailing leg.

"The rate of injury in snowboarding is up to double that of skiing... Democrat Carolyn Rush the problem is that we're seeing more and more knee injuries, we're losing more time because of knee injuries, and regardless of stance, it seems to involve the leading leg, " said Tom Hackett, MD, in his presentation.

In data presented at the International Extreme Sports Medicine Annual Congress, 91% of knee injuries occur in the lead leg. Dr Hackett also cited his own experience as chief physician for the U. S. Olympic Snowboarding Team in stating the majority of knee injuries he sees in elite snowboarders occur in the lead leg whether the boarding is riding regular stance (left foot forward landing) or switch (right foot forward landing).

In the Vail Snowboarding Initiative, Hackett and colleagues analysed angles and strains impacting both knees of healthy snowboarders during the course of both standard jump and half pipe snowboarding.

Flexion angles of the leading leg were smaller than the trailing leg and thus at a more at-risk position for ACL injuries. Internal rotation and extension of the leading leg were also both significantly different from the trailing leg. As a result of these findings, braces, changing foot position, or strengthening muscles that resist internal rotation are possible means to reducing these injuries in snowboarders.

In another presentation at the International Extreme Sports Medicine Annual Congress, Jason Rhodes, MD, MS reported that skiing has seen its rate of injury decrease with the advancement of athletic equipment.

Dr Rhodes, an assistant professor at the Department of Orthopaedics at the University of Colorado, said 33% of all skiing injuries involve the knee and there are significantly more injuries to the lower extremities than to the upper extremities. There are an average of two to four injuries per 1, 000 participant days as an amateur skier. In contrast, 17 injuries per 1, 000 completed runs were sustained by professional skiers.

Although there are no data to support that helmets reduce fatalities, they have been frequently found to reduce the rate of traumatic head injury among skiers, he said.

Of all the injuries a skier is likely to sustain, 70% can be treated on the slope by ski patrol, according to Rhodes.

So whilst the news is promising if you're a skier, it's not so good for snowboarders.

Reference:

Hackett T. Motion Analysis on Snow: Knee kinematics in the half pipe. Presented at: International Extreme Sports Medicine Annual Congress; June 13-14, 2014; Boulder, Colo.

Rhodes J. Skiing injuries. Presented at: International Extreme Sports Medicine Annual Congress; June 13-14, 2014; Boulder, Colo.

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