Int J Sports Med 2011; 32(10): 801-806
DOI: 10.1055/s-0031-1279719
Clinical Sciences

© Georg Thieme Verlag KG Stuttgart · New York

ACL Injury Mechanisms and Related Factors in Male and Female Carving Skiers: A Retrospective Study

G. Ruedl1 , M. Webhofer2 , I. Linortner2 , A. Schranz2 , C. Fink3 , C. Patterson1 , W. Nachbauer1 , M. Burtscher1
  • 1University Innsbruck, Sport Science, Innsbruck, Austria
  • 2Sportclinic medalp soelden-imst, Imst, Austria
  • 3Sportsclinic Austria, Innsbruck, Austria
Further Information

Publication History

accepted after revision April 26, 2011

Publication Date:
21 June 2011 (online)

Abstract

In recreational alpine skiing, ACL injury risk is 3 times greater in females. However, since the introduction of carving skis ACL injury risk seems to have decreased. No study has yet investigated the distribution of ACL injury mechanisms in male and female carving skiers. Therefore, the aim of the study was to investigate potential gender specific differences of ACL injury mechanisms and related factors among carving skiers. In total, 220 recreational carving skiers (59 males and 161 females) suffering from an ACL injury volunteered for this study. Demographic data, skiing ability, equipment related and environmental factors, circumstances and causes for the fall, and type of fall (injury mechanisms) were collected by questionnaire. The forward twisting fall is the most reported ACL injury mechanism in both gender (p=0.672) accounting for 54% of all injuries, although male and female skiers differed significantly with regard to circumstances of fall (p=0.001) and actions when ACL injury occurred (p=0.04). Bindings not releasing at the time point of accident occurred 2.6 times more with females than with males (p=0.005). The forward twisting fall seems to have become the dominant ACL injury mechanism both in male and female recreational skiers since the introduction of carving skis.

References

  • 1 Beynnon BD, Ettlinger CF, Johnson RJ. Epidemiology and mechanisms of ACL injury in alpine skiing. In: Hewett TE, Shultz SJ, Griffin LY (eds). Understanding and preventing noncontact ACL injuries.. American Orthopaedic Society for Sports Medicine, Human Kinetics 2007: 183-188
  • 2 Burtscher M, Gatterer H, Flatz M, Sommersacher R, Woldrich T, Ruedl G, Hotter B, Lee A, Nachbauer W. Effects of modern ski equipment on the overall injury rate and the pattern of injury location in Alpine skiing.  Clin J Sport Med. 2008;  18 355-357
  • 3 Burtscher M, Pühringer R, Werner I, Sommersacher R, Nachbauer W. Predictors of falls in downhill skiing and snow boarding. In: Müller E, Lindinger S, Stöggl T, (eds).Science and Skiing IV, Meyer & Meyer Sport (UK), 2009: 183-187
  • 4 Burtscher M, Sommersacher R, Ruedl G, Nachbauer W. Potential risk factors for knee injuries in alpine skiers.  J ASTM Int. 2009;  6 1-4
  • 5 Demirag B, Oncan T, Durak K. An evaluation of knee ligament injuries encountered in skiers at the Uludag Ski Center.  Acta Orthop Traumatol Turc. 2004;  38 313-316
  • 6 Ekeland A, Sulheim S, Rodven A. Injuries in Norwegian ski resorts 2000–2002.  Abstractbook of the 15th International Congress on Skiing Trauma and Skiing Safety, St. Moritz/Pontressina, Switzerland, 2003: E1–E3
  • 7 Ettlinger CF, Johnson RJ, Shealy JE. Functional and release characteristics of alpine ski equipment.  Abstracts of the Sixteenth International Symposium on Ski Trauma and Skiing Safety, Arai Mountain, Niigata, Japan, 17–23 April, 2005. Knee Surg Sports Traumatol Arthrosc. 2006;  14 97-104
  • 8 Flørenes TW, Bere T, Nordsletten L, Heir S, Bahr R. Injuries among male and female World Cup alpine skiers.  Br J Sports Med. 2009;  43 973-978
  • 9 Greenwald RM, Toelcke T. Gender differences in alpine skiing injuries: a profile of the knee-injured skier. In: Johnson RJ, Mote CD, Ekeland E (eds). Skiing Trauma and Safety: 11th Vol, ASTM, 1997, Baltimore: 111-121
  • 10 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sports and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
  • 11 Hintermeister RA. What do we know about super-side skis?.  Sportverletz Sportschad. 2007;  11 137-139
  • 12 Hull ML. Analysis of skiing accidents involving combined injuries to the medial collateral and anterior cruciate ligaments.  Am J Sports Med. 1997;  25 35-40
  • 13 International Organization for Standardization .Assembly, adjustment and inspection of an alpine ski/binding/boot (S-B-B) system ISO 11088.. Geneva, Switzerland; 2004
  • 14 Järvinen M, Natri A, Laurila S, Kannus P. Mechanisms of anterior cruciate ligament ruptures in skiing.  Knee Surg Sports Traumatol Arthrosc. 1994;  2 224-228
  • 15 Johnson RJ, Ettlinger CF, Shealy JF, Meader C. Impact of super sidecut skis on the epidemiology of skiing injuries.  Sportverletz Sportschaden. 1997;  11 150-152
  • 16 Johnson RJ, Ettlinger CF, Shealy JF. 2000 ACL injuries.  Abstracts of the 13th International Symposium on Ski Trauma and Skiing Safety, Cervinia, Italy, May 1999. Knee Surg Sports Traumatol Arthrosc. 1999;  7 389
  • 17 Johnson RJ, Ettlinger CF, Shealy JF. Injury trends and risk factors involving ACL injuries in alpine skiing.  Abstracts of the Sixteenth International Symposium on Ski Trauma and Skiing Safety, Arai Mountain, Niigata, Japan, 17–23 April, 2005. Knee Surg Sports Traumatol Arthrosc. 2006;  14 101
  • 18 Johnson RJ, Ettlinger CF, Shealy JF. Lower extremity injuries involving traditional alpine skis versus short skis with non-release bindings. In: Johnson RJ, Lamont MK, Shealy JE, (eds). Skiing Trauma and Safety: Fourteenth Volume. ASTM, West Conshohocken, PA; 2003: 105-112
  • 19 Kimura Y, Ishibashi Y, Tsuda E, Yamamoto Y, Tsukada H, Toh S. Mechanisms for anterior cruciate ligament injuries in badminton.  Br J Sports Med. 2010 Sep 28;  [Epub ahead of print]
  • 20 Köhne G, Kusche H, Schaller C, Gutsfeld P. Ski accidents-changes since introduction of carving ski.  Sportorthopädie Sporttraumatologie. 2007;  23 63-67 (in German)
  • 21 Koshida S, Deguchi T, Miyashita K, Iwai K, Urabe Y. The common mechanisms of anterior cruciate ligament injuries in judo: a retrospective analysis.  Br J Sports Med. 2010;  44 856-861
  • 22 LaPorte JD, Binet MH, Fenet N, Constans D. Ski bindings and lower leg injuries: a two year case-control study in Avoriaz.  Abstracts of the Sixteenth International Symposium on Ski Trauma and Skiing Safety, Arai Mountain, Niigata, Japan, 17.–23. April 2005. Knee Surg Sports Traumatol Arthrosc. 2006;  14 100-101
  • 23 Merkur A, Whelan KM, Kuah E, Choo P. The effect of ski shape on injury occurrence in downhill skiing.. Skiing Trauma and Safety: Fourteenth Volume, Johnson RJ, Lamont MK, Shealy JE (eds). ASTM, Saline, MI; 2003: 129-139
  • 24 Nachbauer W, Hoser C, Fink C. Injury mechanisms of anterior cruciate ligament tears in alpine ski racing.  Knee Surg Sports Traumatol Arthrosc. 2004;  176
  • 25 Natri A, Beynnon BD, Ettlinger CF, Johnson RJ, Shealy JE. Alpine ski bindings and injuries.  Current findings. Sports Med. 1999;  28 35-48
  • 26 Olsen OE, Myklebust G, Engebretsen L, Bahr R. Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis.  Am J Sports Med. 2004;  32 1002-1012
  • 27 Pressman A, Johnson DH. A review of ski injuries resulting in combined injury to the anterior cruciate ligament and medial collateral ligaments.  Arthroscopy. 2003;  19 194-202
  • 28 Rossi MJ, Lubowitz JH, Guttmann D. The skier's knee.  Arthroscopy. 2003;  19 75-84
  • 29 Ruedl G, Linortner I, Schranz A, Fink C, Schindelwig K, Nachbauer W, Burtscher M. Distribution of injury mechanisms and related factors in ACL-injured female carving skiers.  Knee Surg Sports Traumatol Arthrosc. 2009;  17 1393-1398
  • 30 Ruedl G, Pocecco E, Sommersacher R, Gatterer H, Kopp M, Nachbauer W, Burtscher M. Factors associated with self reported risk taking behaviour on ski slopes.  Br J Sports Med. 2010;  44 204-206
  • 31 Shimokochi Y, Shultz SJ. Mechanisms of noncontact anterior cruciate ligament injury.  J Athl Training. 2008;  43 396-408
  • 32 Sinning WE. Body composition and athletic performance. In: Clarke DH, Eckert HM (eds). Limits of Human Performance. The Academy Papers. Champaign; 1985: 45-56
  • 33 Stevenson H, Webster J, Johnson RJ, Beynnon B. Gender differences in knee injury epidemiology among competitive alpine ski racers.  Iowa Orthop J. 1998;  18 64-66
  • 34 Sulheim S, Ekeland A, Bahr R. Self-estimation of ability among skiers and snowboarders in alpine skiing resorts.  Knee Surg Sports Traumatol Arthrosc. 2007;  15 665-670
  • 35 Urabe Y, Ochi M, Onari K, Ikuta Y. Anterior cruciate ligament injury in recreational alpine skiers: analysis of mechanisms and strategy for prevention.  J Orthop Sci. 2002;  7 1-5
  • 36 Werner S, Willis K. Self-release of ski-binding.  Int J Sports Med. 2002;  23 530-535

Correspondence

Dr. Gerhard Ruedl

University Innsbruck

Sport Science

Fürstenweg 185

6020 Innsbruck

Austria

Phone: + 43/512/507 44 51

Fax: + 43/512/507 28 38

Email: Gerhard.Ruedl@uibk.ac.at

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