Recording injuries only during winter competitive season underestimates injury incidence in elite alpine skiers

Abstract

Current epidemiological studies in elite alpine skiers are mostly limited to retrospective surveys on in‐season injury. The aim of this study was to determine the risk and pattern of injury in elite alpine skiers during the winter competitive season (WCS) and the summer off‐season (SOS). European Cup skiers were prospectively followed during 5 complete years. A total of 133 skier‐seasons (79 males and 54 females) completed the study. All acute and overuse injuries that required medical attention were registered, representing a total of 166 injuries. Absolute injury incidence was 124.8 (95% CI [106‐145]) injuries per 100 athletes per complete season and was higher during the WCS compared with the SOS, albeit in a smaller magnitude than expected (relative risk ratio (RR) 1.44 [1.06‐1.96]). The absolute incidence of severe injuries (ie, time‐loss >28 days) was twofold higher during WCS compared with SOS (RR 2.19 [1.21‐3.95]). Most common injuries during the 2013‐2015 seasons were knee followed by back (absolute incidences 56 [38‐80] and 20 [10‐36], respectively; RR 2.82 [1.42‐5.61]), but this difference disappeared after 2015 (absolute incidences 25.6 [15.7‐39.6] and 23.1 [13.7‐36.5], respectively; RR 1.11 [0.59‐2.10]). In summary, we found that 98 (59%) injuries occurred during WCS and 68 (41%) during SOS over 5 years. These results demonstrate the necessity to record injuries during the entire year to avoid a significant underestimation of the injury incidence. In addition, the current data showed an evolution of injury pattern over time and since previous reports, with back injuries being the main concern along knee joint injuries.

Lower Back Complaints in Adolescent Competitive Alpine Skiers: A Cross-Sectional Study

“…Despite these plausible sports-related adverse loading patterns, only a few studies, however, have investigated the occurrence of lower back complaints in competitive alpine skiers. Moreover, due to focusing on a different age group and reporting other time prevalence measures or absolute injury rates, most of them are not directly comparable to the results of the current study [3,4,6,8,11]. The only study directly comparable to our investigation reported similar magnitudes of current low back pain (67.0%) in ski high school athletes aged 15-19 years [30].…”

“…Competitive alpine skiing is a popular yet high-risk sport. At all competition levels, health problems are frequent [1][2][3][4][5][6][7]. In particular, lower back has been reported to be one of the most affected body regions for overuse complaints [8].…”

Overuse injuries in the knee, back and hip of top elite female alpine skiers during the off-season preparation period: prevalence, severity and their association with traumatic preinjuries and training load

“…High prevalence of overuse-related injuries during the offseason preparation period Overall, our data further highlight the remarkably frequent occurrence of overuse injuries in alpine skiers during the off-season preparation period, and the necessity to record injuries during the entire year to avoid a significant underestimation of the actual injury extent. 9 During this particular period, intensive physical conditioning combined with extensive amounts of on-snow training are typical. 12 In contrast, during the competition period, training intensities are much lower (physical preservation training) and skiing is more quality than quantity orientated (only 2-3 runs a day).…”

“…The anatomical regions particularly prone to overuse injuries in skiers are the knee, the hip and the back. [9][10][11] For such patterns, an accumulation of heavy mechanical loads on the musculoskeletal system during intense/ extensive training periods, such as during the aforementioned off-season preparation period, may play an important role. So far lacking, however, is knowledge about the association of overuse injuries and the total training hours, as an estimator of the accumulated overall load caused by off-snow and on-snow training.…”

“…8 The few studies dealing with overuse injuries, however, revealed remarkably high rates, particularly during the off-season preparation period (ie, summer training). [9][10][11] This period starts with the first joint on-snow team training beginning of July on the glaciers and ends with the qualification runs in the forefront of the World Cup season opening beginning of October. During that time, intensive physical conditioning combined with extensive amounts of on-snow training are typical (approximately 10-14 training sessions for a total of 14-21 hour per week with major emphasis on aerobic capacity (intervals), maximal/explosive strength training and volume-orientated ski training), 12 and skiers' risk for overuse injuries is the highest of the entire year.…”