Coping with Winter Injuries

W. Steven Pray, PhD, DPh


US Pharmacist. 2007;32(12):12-15. 

In This Article


Strains, sprains, and other musculoskeletal problems are extremely common. Summer is a peak time for these injuries, as people have more time to engage in recreational pursuits. However, winter carries its own unique risks for injury. Snow-shoveling, icy conditions leading to falls, and sports such as ice-skating, skiing, and snowboarding all can produce musculoskeletal and tendon injury.

The number of U.S. citizens engaging in skiing or snowboarding is estimated at 13 million, with 13% to 27% of skiers being children.[1,2] The number of snowboarders, who make up more than 40% of this group, has risen rapidly in the last two decades.[1,3] Ski resorts report growing attendance over the past decade, boosting the overall number of injuries.[4] The aggregate number of ski-resort visits is 57 to 60 million.[1,5] The rate of skiing-related injury is estimated to be 3 to 4 injuries per 1,000 skier-days.[6] Half of all injuries suffered at ski resorts are due to snowboarding.[6] The rate of injury among elite snowboarders is estimated at 0.8 per 1,000 snowboarding hours.7 An estimated 100,000 to 140,000 nonfatal skiing and snowboarding accidents require emergency-room treatment each year.[1,5]

Several epidemiological trends help predict who is more likely to be injured during winter sports and which type of injury is most likely to occur. Novice snowboarders are the most likely to be injured.[8] The initial three hours are the most injury-prone period for snowboarding. Injuries in beginners are more commonly fractures; more experienced snowboarders suffer more hand, elbow, and shoulder injuries, and their injuries are more severe.[8,9] In one study of skiing and snowboarding injuries, gender was predictive of injury.[10] Males suffered 81% of skiing injuries and 86% of snowboarding injuries; this makes sense, as males predominate among snowboarders.[11] Children under 16 years of age suffer more than 180,000 skiing injuries yearly, at an injury rate of 3.92 to 9.1 per 1,000 ski days.[2]

Skiers on open slopes can attain speeds of 25 to 30 miles per hour. Alpine skiers are prone to lower-limb injuries, the knee being the major target.[6,12] At least 35% of all injuries are knee-related.[6] The most common type of knee injury is medial collateral ligamentous damage.[6]

The number of snowboarders has grown rapidly as the sport has gained in popularity.[7] This rapid growth has meant a greater number of novice snowboarders and a consequent rise in the injuries common in newcomers to most high-risk sports. Compared with skiers, snowboarders are at greater risk for upper-limb injuries.[8] Injuries in novices are far more likely than in skiers. When compared with a group of skiers without regard to skill level, first-time snowboarders had a three- to fourfold greater likelihood of experiencing fractures, concussions with loss of consciousness, dislocations, and loss of teeth.[7,8] Knee injuries account for an additional 3% to 23% of snowboarding injuries, and back and chest injuries constitute 2% to 16%.7 Twenty percent of injuries involve the wrist, an injury particularly common among beginners.[7]


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