A Review of Injury Countermeasures and Their Effectiveness for Alpine Skiing

Alpine skiing is a popular sport that requires specific equipment. The technological aspects of this equipment and the associated injury patterns have changed over time. Skiing is also physically demanding and requires strength, flexibility, endurance, good anticipation and reflexes. Skiing is undertaken in conditions and an environment that change throughout the day and from one day to the next. The skier, ski equipment and the environment all play a role both in the occurrence of injuries and their prevention. The most commonly injured body regions are the upper extremity, thumb, knee, and ankle and lacerations are common. The objective of this report is to present a critical review of the extent to which countermeasures for preventing alpine skiing injuries have been formally evaluated and demonstrated to be effective. In particular, the results of these evaluations and the level of supporting evidence were considered. The review has found that the evidence for countermeasure effectiveness is generally based on a combination of epidemiological studies, biomechanical evidence or testing of equipment, and informed opinion or anecdotal evidence. Very little evidence is based on controlled trials or the actual evaluation of countermeasures ‘in the field’. The review also highlights areas that need more formal evaluation, those that warrant more immediate attention and action and those in which recommendations for progress in injury reduction could be made now on the basis of existing evidence. Finally, recommendations for further action in injury prevention research and practice are given. Recommendations for further countermeasure research, development and implementation are presented for each countermeasure separately and include the need to conduct further biomechanical and epidemiological research to determine injury mechanisms, continued monitoring of injury trends over time, further development and testing of equipment, the need to conduct controlled evaluations with representative skier populations, assessing the effectiveness of ski lessons and other forms of skier eduction, and ongoing injury surveillance, etc. This report also recognises the initiatives already undertaken by individuals and ski organisations, the available research and its findings and limitations, the improvements that can be made, and the opportunities for further research into and development of injury countermeasures. In doing so, it provides a basis for further action in injury prevention research and practice in the sport of alpine skiing.