Alpine ski racing is known to be a sport with a high risk of injury and a high proportion of time-loss injuries. In recent years, substantial research efforts with regard to injury epidemiology, injury etiology, potential prevention measures, and measures’ evaluation have been undertaken. Therefore, the aims of this review of the literature were (i) to provide a comprehensive overview of what is known about the aforementioned four steps of injury prevention research in the context of alpine ski racing; and (ii) to derive potential perspectives for future research. In total, 38 injury risk factors were previously reported in literature; however, a direct relation to injury risk was proven for only five factors: insufficient core strength/core strength imbalance, sex (depending on type of injury), high skill level, unfavorable genetic predisposition, and the combination of highly shaped, short and wide skis. Moreover, only one prevention measure (i.e. the combination of less-shaped and longer skis with reduced profile width) has demonstrated a positive impact on injury risk. Thus, current knowledge deficits are mainly related to verifying the evidence of widely discussed injury risk factors and assessing the effectiveness of reasonable prevention ideas. Nevertheless, the existing knowledge should be proactively communicated and systematically implemented by sport federations and sport practitioners.

BackgroundThere is limited knowledge about key injury risk factors in alpine ski racing, particularly for World Cup (WC) athletes.ObjectiveThis study was undertaken to compile and explore perceived intrinsic and extrinsic risk factors for severe injuries in WC alpine ski racing.MethodsQualitative study. Interviews were conducted with 61 expert stakeholders of the WC ski racing community. Experts’ statements were collected, paraphrased and loaded into a database with inductively derived risk factor categories (Risk Factor Analysis). At the end of the interviews, experts were asked to name those risk factors they believed to have a high potential impact on injury risk and to rank them according to their priority of impact (Risk Factor Rating).ResultsIn total, 32 perceived risk factors categories were derived from the interviews within the basic categories Athlete, Course, Equipment and Snow. Regarding their perceived impact on injury risk, the experts’ top five categories were: system ski, binding, plate and boot; changing snow conditions; physical aspects of the athletes; speed and course setting aspects and speed in general.ConclusionsSevere injuries in WC alpine ski racing can have various causes. This study compiled a list of perceived intrinsic and extrinsic risk factors and explored those factors with the highest believed impact on injury risk. Hence, by using more detailed hypotheses derived from this explorative study, further studies should verify the plausibility of these factors as true risk factors for severe injuries in WC alpine ski racing.

Recently, four concepts explaining time differences in alpine ski racing have been suggested. Since the demands on a “well performed” turn are contradicting among these concepts, it is unclear which turn characteristics a skier should aim for in a specific giant slalom situation. During a video-based 3D-kinematic field measurement, single repetitive runs of a world class athlete were compared regarding section times over one turn and variables explaining time differences. None of the existing concepts was able to entirely explain time differences between different performed turns. However, it was found that the skier's line and timing played an important role for time over short sections. Hence, for both science and coaching, there is a need for more comprehensive approaches that include all variables influencing performance in one concept. In coaching, one such approach could be the training of implicit adaptation mechanisms in terms of situation-dependent line and/or timing strategies.

To cite: Gilgien M, Spörri J, Kröll J, et al. Br J Sports Med 2014;48:742-747.

BackgroundCourse setting has often been discussed as a potential preventative measure in the World Cup ski-racing community. However, there is limited understanding of how it is related to injury risk.ObjectiveThis study was undertaken to investigate the effect of increased horizontal gate distance on energy-related and injury mechanism-related variables.MethodsDuring a video-based three-dimensional (3D)-kinematic field measurement, a top world-class racer performed giant slalom runs at two course settings with different horizontal gate distances. A full-body segment model was reconstructed in 3D and selected biomechanical parameters were calculated.ResultsFor the analysed turn, no significant differences were found in turn speed for increased horizontal gate distance. However, a large effect size was observed for speed reduction towards the end of the turn. Turn forces were by tendency higher at the beginning and significantly higher towards the end of the turn. Additionally, significant differences were found in higher inward leaning, and large effect sizes were observed for a decreased fore/aft position after gate passage.ConclusionsOn the basis of the data of this study, no final conclusion can be made about whether, for a section of consecutive turns, increasing horizontal gate distance is an effective tool for speed reduction. However, this study pointed out two major drawbacks of this course setting modification: (1) it may increase fatigue as a consequence of loading forces acting over a longer duration; (2) it may increase the risk of out-of-balance situations by forcing the athlete to exhaust his backward and inward leaning spectrum.

Prevention measures should aim to control and/or reduce the magnitude of frontal bending, lateral bending, and torsion in the trunk, as well as the peak loads, while skiing.

In alpine ski racing the relationships between skier kinetics and kinematics and their effect on performance and injury-related aspects are not well understood. There is currently no validated system to determine all external forces simultaneously acting on skiers, particularly under race conditions and throughout entire races. To address the problem, this study proposes and assesses a method for determining skier kinetics with a single lightweight differential global navigation satellite system (dGNSS). The dGNSS kinetic method was compared to a reference system for six skiers and two turns each. The pattern differences obtained between the measurement systems (offset ± SD) were −26 ± 152 N for the ground reaction force, 1 ± 96 N for ski friction and −6 ± 6 N for the air drag force. The differences between turn means were small. The error pattern within the dGNSS kinetic method was highly repeatable and precision was therefore good (SD within system: 63 N ground reaction force, 42 N friction force and 7 N air drag force) allowing instantaneous relative comparisons and identification of discriminative meaningful changes. The method is therefore highly valid in assessing relative differences between skiers in the same turn, as well as turn means between different turns. The system is suitable to measure large capture volumes under race conditions.

Inertial sensor drift is usually corrected on a single-sensor unit level. When multiple sensor units are used, mutual information from different units can be exploited for drift correction. This study introduces a method for a drift-reduced estimation of three dimensional (3-D) segment orientations and joint angles for motion capture of highly dynamic movements as present in many sports. 3-D acceleration measured on two adjacent segments is mapped to the connecting joint. Drift is estimated and reduced based on the mapped accelerations' vector orientation differences in the global frame. Algorithm validity is assessed on the example of alpine ski racing. Shank, thigh, and trunk inclination as well as knee and hip flexion were compared to a multicamera-based reference system. For specific leg angles and trunk segment inclination mean accuracy and precision were below 3.9° and 6.0°, respectively. The errors were similar to errors reported in other studies for lower dynamic movements. Drift increased axis misalignment and mainly affected joint and segment angles of highly flexed joints such as the knee or hip during a ski turn.