Examining ski area padding for head and neck injury mitigation.

OBJECTIVES: The injury mitigation capabilities of foam, ski-area padding was examined for headfirst impacts. DESIGN AND METHODS: A custom-made pendulum impactor system was constructed using an instrumented, partial 50th-percentile-male Hybrid-III anthropomorphic testing device (ATD). For each test, the ATD was raised 1.0m, released, and swung into a 20-cm diameter wooden pole. Test trials were conducted with the wooden pole covered by ski area padding (five conditions of various foam types and thicknesses) or unpadded. Linear (linear acceleration and HIC15) and angular (angular velocity, angular acceleration, and BrIC) kinematics were examined and used to estimate the likelihood of severe brain injury. Cervical spine loads were compared to the injury assessment reference values for serious injury. Further tests were conducted to examine the changes produced by the addition of a snowsport helmet. RESULTS: 38 test trials were recorded with a mean (±sd) impact speed of 4.2 (±0.03) m/s. Head, resultant linear acceleration, HIC15, and associated injury likelihoods were tempered by ski area padding at the impact speed tested. Ski area padding did not reduce brain injury likelihood from rotational kinematics (p>0.05 for all comparisons) or reduce the cervical spine compression below injury assessment reference values. The addition of a helmet did not reduce significantly the likelihoods of brain or cervical spine injury. CONCLUSIONS: At the impact speed tested, ski area padding provided limited impact protection for the head (for linear kinematics) but did not protect against severe brain injuries due to rotational kinematics or serious cervical spine injuries.

Alpine Skiing Injuries.

CONTEXT:: Alpine skiing is a popular sport worldwide but has significant risk for injury. The epidemiology of skiing-related injuries has been described, which has led to the identification of risk factors for specific types of injuries. EVIDENCE ACQUISITION:: Pertinent literature from peer-reviewed publications was reviewed. STUDY DESIGN:: Clinical review. LEVEL OF EVIDENCE:: Level 5. RESULTS:: The adoption of international standards for ski-boot-binding systems has changed the profile of skiing-related injuries over time, as has the widespread use of helmets. An understanding of mechanisms of injury, risk factors, and preventative measures may decrease the incidence of skiing-related injuries. CONCLUSION:: Advances in standards for skiing equipment have been effective at decreasing both the frequency and severity of skiing-related injuries, but additional efforts are required to improve the safety of the sport.

Snowboarding injuries: trends over time and comparisons with alpine skiing injuries.

BACKGROUND: Participation in snowboarding as a winter sport is comparable to alpine skiing concerning the demographics of the participants, risk of injury, and variation in types of injuries sustained. PURPOSE: To examine the types of snowboarding injuries and changes in injury patterns over time. We also sought to highlight important differences in injury patterns between snowboarders and alpine skiers as affected by age, experience, and sex. STUDY DESIGN: Case control; Level of evidence, 3. METHODS: Data were collected on injured snowboarders and skiers in a base-lodge clinic of a ski resort in Vermont over 18 seasons (1988-2006) and included extensive information about injury patterns, demographics, and experience. Control data were also obtained during this time period to provide information about the population at risk. RESULTS: The injury rates were assessed as mean days between injuries (MDBI). The average MDBI for all injuries among snowboarders was 345 as compared with 400 for skiers (the lower the number, the higher the injury rate). The most common type of injury for snowboarders was a wrist injury (MDBI, 1258), while for skiers, it was an anterior cruciate ligament (ACL) sprain (MDBI, 2332). Wrist injuries accounted for 27.6% of all snowboard injuries and 2.8% of skiing injuries, and ACL injuries composed 1.7% of all snowboard injuries and 17.2% of skiing injuries. Among snowboarders, more wrist injuries, shoulder soft tissue injuries, ankle injuries, concussions, and clavicle fractures were seen, while skiers had more ACL sprains, medial collateral ligament (MCL) sprains of the knee, lateral collateral ligament (LCL) sprains of the knee, lower extremity contusions, and tibia fractures. The trend analysis revealed an increased incidence of clavicle fractures (P < .01) and a decrease in MCL injuries (P < .01) and ankle injuries (P < .025) among snowboarders over time. Skiers had a decrease in thumb metacarpophalangeal-ulnar collateral ligament (MCP-UCL) injuries (P < .001) and MCL injuries of the knee (P < .001) over time. We found the highest rate of injury among young, inexperienced, female snowboarders. When examining the location of injury, 21.8% of snowboard injuries occurred in the terrain park compared with 6.5% of ski injuries. CONCLUSION: Injury rates in snowboarders have fluctuated over time but currently remain higher than in skiers. Wrist, shoulder, and ankle injuries are more common among snowboarders, while knee ligament injuries are more common in skiers. Injured snowboarders were significantly younger, less experienced, and more likely to be female than injured skiers or snowboard control participants. We did not find any evidence that those who spend time in terrain parks are overrepresented in the injury population.

Myths concerning alpine skiing injuries.

There are many commonly discussed myths about ski safety that are propagated by industry, physicians, and skiers. Through a review of the literature concerning 12 such topics, this article demonstrates that the following are untrue: (1) Broken legs have been traded for blown-out knees. (2) If you know your DIN (a slang term for release indicator value), you can adjust your own bindings. (3) Toe and heel piece settings must be the same to function properly. (4) Formal ski instruction will make you safer. (5) Very short skis do not need release bindings. (6) Spending a lot of money on children's equipment is not worth the cost. (7) Children need plenty of room in ski boots for their growing feet. (8) If you think you are going to fall, just relax. (9) Exercise can prevent skiing injuries. (10) Lower release settings can reduce the risk of anterior cruciate ligament injury. (11) Buying new ski equipment is safer than renting. (12) Skiing is among the most dangerous of activities. It is important for the skiing public, physicians, and all those interested in improving skiing safety to verify the measures they advocate. The statements analyzed here are simply untrue and have the potential to cause harm if taken as fact by those exposed to these unsupported opinions.