09:14pm Sunday 19 January 2020

Johnson Paper Refutes Ski Injury Myths

The team, including Carl Ettlinger, M.S., adjunct assistant professor of orthopaedics and rehabiliation, and Jasper Shealy, Ph.D., professor emeritus at Rochester Institute of Technology, has published extensively on a variety of ski injury-related topics and recently co-authored an article titled “Myths Concerning Alpine Skiing Injuries” in the November/December 2009 issue of the journal Sports Health.

In the article, the researchers note the importance of understanding that in order to improve skiing safety, the skiing public, physicians, and others must verify the measures they advocate, listing 12 skiing injury myths that they found to be untrue based on a literature review they conducted for the article. Below are a sample of the myths proved false in the study:

MYTH 1: Skiing is among the most dangerous of activities.
According to the researchers, “in terms of deaths per million hours of exposure, it is no more dangerous than riding in a car or on a bicycle.” Their review found that the overall ski injury rate dropped 55 percent over a 34-year period ending in 2006 and that ACL sprains — reported to be the most common skiing-related injury — reduced 42 percent between 1992 and 2006.

MYTH 2: Broken legs have been traded for blown-out knees — a bad bargain.
While fractures and sprains below the knee decreased more than 80 percent between the early 1970s and the late 1980s, the risk of suffering a severe knee sprain increased 240 percent between the late 1970s and early 1990s. Anterior Cruciate Ligament (ACL) sprains, which remain the most common ski-related injury, are not linked to ski binding function or dysfunction. Bindings were designed to protect the lower leg bone (tibia), according to the researchers. “Now that the incidence of lower leg injuries and ACL sprains is improving, the challenge for researchers is to identify the factors most responsible and to accelerate these positive trends,” state the study authors.

MYTH 5: Formal ski instruction will make you safer.
“In the majority of studies done in North America and Europe, skiing lessons did not decrease the risk of personal injury,” conclude the research team. Most ski instruction, say the authors, “focused on rapid skill acquisition” instead of safety. The group cites an experimental ACL awareness training program that stressed a kinesthetic learning process and viewing video footage of real ACL injury events followed by the development of strategies to avoid ACL injury. Among the 4000 study participants, ski patrollers (the highest risk group among ski area employees), experienced a 76 percent reduction in incidence of severe knee sprains.

MYTH 8: When buying boots for children, leave plenty of room for their fast-growing feet.
In fact, say Johnson and colleagues, research shows that poor boot fit is a major contributor to lower leg fractures and sprains, especially among children. “If the foot can easily move within the boot, then the binding release function is compromised,” say the study authors, who advise ensuring that children get the best-fitting equipment.

MYTH 9: If you think you are going to fall, just relax and let it happen.
Based on UVM’s broad research on falls, the team strongly advocates for skiers to practice a plan. They recommend: keeping every joint in the body flexed moderately; keeping feet together; keeping chin against chest; do not land on a hand, but keep arms up and forward and be prepared to use the arms to protect face and head. “Do not relax, but strongly contract the limb and trunk muscles during the fall,” says Johnson, who adds that this process stiffens and protects the bones and joints. They groups also recommends that skiers not get up from a fall until they are no longer moving/sliding.

MYTH 10: Exercise is the best way to avoid skiing-related injuries.
The team found that fatigue, moreso than conditioning, played more of a role in one’s risk for injury. “Increased muscle strength alone cannot reduce the risk of several lower extremity injuries, such as ACL injuries and tibia fractures,” Johnson says. He and the other researchers maintain that “with no downside to overall good physical condition, common sense would support conditioning to improve the enjoyment of alpine skiing,” adding that “well-prepared skiers will probably get in more runs with less fatigue and will probably be better prepared for the rare emergency requiring strength or endurance.”

Several articles regarding Johnson’s study have appeared in U.S. and Canadian publications, including The Montreal Gazette3, Anchorage Daily News4, and The Province5 (Vancouver, British Columbia, Canada).

Author: Jennifer Nachbur1
Email: Jennifer.Nachbur@uvm.edu2
Phone: 802/656-7875 Fax: 802-656-3961

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