Recording injuries only during winter competitive season underestimates injury incidence in elite alpine skiers.

Current epidemiological studies in elite alpine skiers are mostly limited to retrospective surveys on in-season injury. The aim of this study was to determine the risk and pattern of injury in elite alpine skiers during the winter competitive season (WCS) and the summer off-season (SOS). European Cup skiers were prospectively followed during 5 complete years. A total of 133 skier-seasons (79 males and 54 females) completed the study. All acute and overuse injuries that required medical attention were registered, representing a total of 166 injuries. Absolute injury incidence was 124.8 (95% CI [106-145]) injuries per 100 athletes per complete season and was higher during the WCS compared with the SOS, albeit in a smaller magnitude than expected (relative risk ratio (RR) 1.44 [1.06-1.96]). The absolute incidence of severe injuries (ie, time-loss >28 days) was twofold higher during WCS compared with SOS (RR 2.19 [1.21-3.95]). Most common injuries during the 2013-2015 seasons were knee followed by back (absolute incidences 56 [38-80] and 20 [10-36], respectively; RR 2.82 [1.42-5.61]), but this difference disappeared after 2015 (absolute incidences 25.6 [15.7-39.6] and 23.1 [13.7-36.5], respectively; RR 1.11 [0.59-2.10]). In summary, we found that 98 (59%) injuries occurred during WCS and 68 (41%) during SOS over 5 years. These results demonstrate the necessity to record injuries during the entire year to avoid a significant underestimation of the injury incidence. In addition, the current data showed an evolution of injury pattern over time and since previous reports, with back injuries being the main concern along knee joint injuries.

Features of Chronic Exertional Compartmental Syndrome of the Leg in Elite Nordic Skiers.

This study aimed to assess prevalence and incidence of chronic exertional compartmental syndrome as well as functional outcomes after surgery in elite Nordic skiers. An exhaustive list of 294 elite Nordic skiers from the French national teams between 1994 and 2014 was analyzed through their individual medical files in order to identify cases of chronic exertional compartmental syndrome. Eighteen athletes had confirmed diagnosis and performed a structured interview to identify factors associated with chronic exertional compartmental syndrome and surgery outcomes. The prevalence was 6.1% and the incidence 13 per 1000 skier-years. Biathletes had a higher prevalence than cross-country skiers (OR=0.40, p=0.08). Free-technique skiing and roller-skiing were the main conditions inducing symptoms. All injured athletes had bilateral surgery and 94% of them reported no more or sporadic leg pain after. Almost 90% resumed competition at the same or higher level than prior surgery. Compare to previous studies, the incidence rate of chronic exertional compartmental syndrome is higher in French elite Nordic skiers. The higher prevalence in biathletes and the trigger during free-technique skiing suggest a contribution of this technique to this disease. This study also confirmed that surgery was an efficient therapeutic solution without compromising athletes' career.

Return to Sport Among French Alpine Skiers After an Anterior Cruciate Ligament Rupture: Results From 1980 to 2013.

BACKGROUND: There is little known about return to sport and performance after anterior cruciate ligament (ACL) tear in high-level alpine skiers. PURPOSE: To analyze the parameters that influence the return to sport and performance after an ACL tear in French alpine skiers from 1980 to 2013. STUDY DESIGN: Descriptive epidemiology study. METHODS: The study population included 239 male and 238 female skiers who competed on the national French alpine ski team for at least 1 season between 1980 and 2013 in the speed (downhill and super-G) and technical disciplines (giant slalom and slalom). Two groups were formed: group 1 (G1) included athletes who had sustained an ACL rupture, and group 2 (G2) included athletes who had never sustained an ACL rupture. Three performance indicators were selected: International Ski Federation (FIS) points calculation, FIS ranking, and podium finishes in the World Cup, World Championships, and Olympic Games. RESULTS: The first-decile FIS points and international FIS ranking showed that G1 skiers obtained better performance than did G2 skiers. The mean ± SD career length of G1 skiers (men, 7.9 ± 4.7 years; women, 7.1 ± 4.1 years) was longer than that of G2 skiers (men, 4.5 ± 3.3 years; women, 4.2 ± 3.5 years). In addition, 12.8% (61 of 477) of the skiers achieved at least a podium finish during their careers: 23.0% (34 of 148) in G1 and 8.3% (27 of 329) in G2. The mean age at ACL rupture was 22.6 ± 4.1 years for men and 19.9 ± 3.5 years for women. In G1, 55 podiums were achieved before ACL rupture and 176 after in all competitions. Skiers who improved their performances after ACL rupture were significantly younger (men, 22.2 ± 3.0 years; women, 18.7 ± 2.2 years; P < .0001) at the time of injury than those showing a performance deterioration after ACL rupture (men, 25.3 ± 4.2 years; women, 22.4 ± 4.0 years). All skiers who had ACL tears continued their competitive careers after the injury. CONCLUSION: The overall results showed that it is possible to return to preinjury or even higher levels of performance after an ACL rupture and that age is the main element that guides postsurgical recovery.

Eighty percent of French sport winners in Olympic, World and Europeans competitions have mutations in the hemochromatosis HFE gene.

The HFE gene encodes a protein involved in iron homeostasis; individuals with mutations in both alleles develop hemochromatosis. 27% of the French population is heterozygous for mutations in this gene. We found that 80% of the French athletes who won international competitions in rowing, Nordic skiing and judo display mutations in one allele of HFE, thus demonstrating the existence of a favourable phenotype linked to this heterozygosity.