Comprehensive Review of Skiing and Snowboarding Injuries

Brett D. Owens, MD; Christopher Nacca, MD; Andrew P. Harris, MD; Ross J. Feller, MD

Disclosures

J Am Acad Orthop Surg. 2018;26(1):e1-e10. 

In This Article

Abstract and Introduction

Abstract

Skiing and snowboarding have increased in popularity since the 1960s. Both sports are responsible for a substantial number of musculoskeletal injuries treated annually by orthopaedic surgeons. Specific injury patterns and mechanisms associated with skiing and snowboarding have been identified. No anatomic location is exempt from injury, including the head, spine, pelvis, and upper and lower extremities. In these sports, characteristic injury mechanisms often are related to the position of the limbs during injury, the athlete's expertise level, and equipment design. Controversy exists about the effectiveness of knee bracing and wrist guards in reducing the incidence of these injuries. Understanding these injury patterns, proper training, and the use of injury prevention measures, such as protective equipment, may reduce the overall incidence of these potentially debilitating injuries.

Introduction

In 2010, an estimated 11.5 million people in the United States participated in skiing, and 8.2 million engaged in snowboarding.[1] Snowboarding has experienced a considerable increase in popularity since its inception in the 1970s.[2] Given the increased popularity of the sport and the emergence of terrain parks, the incidence of snowboarding injuries has increased more than the incidence of skiing injuries. Made and Elmqvist[3] found a threefold higher injury rate in snowboarders than in skiers. The authors found that from 1989 to 1999, the incidence of snowboarding injury as a component of all snow sport–related injuries increased from 4% to 56%.

Kim et al[1] demonstrated that the most common injuries in snowboarders were wrist injuries, whereas the most common skiing injuries involved the lower extremity, predominately affecting the anterior cruciate ligament (ACL). However, no anatomic location is exempt from the potential for injury (Table 1). Compared with the incidence of snow sport–related injury to the upper extremities, the incidence of injury to the lower extremities has decreased substantially since the early 1970s.[1] Improved equipment, such as newly developed bindings, may account in part for this considerable reduction in lower leg injuries.[4] Some evidence suggests that wrist guards can successfully reduce serious upper extremity injury.[5] Specific focus has been placed on the prevention of ACL injuries, resulting in injury prevention training programs and knee bracing.[6]

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