Injury Patterns In The High-risk Sport Of Elite Youth Alpine Ski Racing

OBJECTIVES: Understanding injury patterns and their prevalence in young athletes is important to implement prevention programs and mitigate potential risk to injury. Studies reporting injuries in an elite adolescent alpine skiing population are uncommon, with most studies focusing on World Cup level athletes. The purpose of this study was to describe the injuries sustained at a youth elite ski organization over one season. METHODS: Injury data was collected prospectively at a national elite youth ski organization for all alpine ski racers. After IRB approval, de-identified data was obtained for the 2016-2017 ski season and retrospectively reviewed. All injuries and injury mechanisms are normally documented as part of standard of care by the ski club organization’s athletic trainers. Data collected included: age, sex, level, type of injury, snow conditions, race or training injury, alpine skiing event, time, mechanism of injury (MOI), injury treatment, and time to return to sport. Injuries were categorized as lower extremity (LE), upper extremity (UE), back, and/or head. MOI was categorized as overuse, impact, fall, axial force, or compression. Levels of skiers were grouped by age: U12, U14, U16, and FIS (or over 16). Alpine events included slalom, giant slalom, super g, downhill, and freeskiing. Treatments consisted of rest, physical therapy, immobilization, and surgery. RESULTS: In the 2016/17 ski season a total of 66 injuries occurred out of approximately 400 athletes enrolled in the program. 43 girls and 19 boys were injured with a mean age of 14 years (range 10 to 20 years). Of those who had injuries, there were 15 skiers in U12, 16 skiers in U14, 19 skiers in U16, and there were 16 skiers in the FIS age group. LE was the most common body part injured, with 48.5% (32/66), followed by head with 28.8% (19/66). 84% (16/19) of the total head injuries were a concussion. Impact with the snow, a gate, or the safety net was the most common mechanism of injury (54.8%), followed by overuse injury at 16%, backseat fall at 11.3%, and axial force fall at 11.2%. Snow conditions were documented as hard-packed in 57% of the injuries. 62% of injuries occurred during training runs and 65% happened before noon. There were 6 season ending injuries: 1 concussion, 3 fractures, 1 ACL, and 1 lumbar spine DJD. All season ending injuries required surgery aside from the concussion. Apart from the season ending injuries, mean time to return to sport was 12.6 days (0-48 days). Average day off skis for a concussion was 16 days (range 7-43 days). Most injuries occurred during Giant Slalom (28.8%) and slalom (18.2%), where the lower extremity and the head were injured the most (42.1% LE, 31.6% head). CONCLUSION: This study highlights baseline injury characteristics in an elite adolescent alpine ski organization. The highest injury rates were in GS and occurred in the lower extremity. Most injuries occurred during training runs on hard-packed snow where the skier impacted the snow or gate.