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Hou W, Li X, Wen Y, Du X. Global research trends in skiing from 1974 to 2023: A bibliometric analysis. Heliyon 2024; 10:e35471. [PMID: 39170295 PMCID: PMC11336741 DOI: 10.1016/j.heliyon.2024.e35471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
This study analyzes 1643 documents related to skiing from 1974 to 2023 using the Web of Science Core Collection database, employing CiteSpace and VOSviewer for quantitative analysis. Findings reveal a growing literature output, with the past five years contributing to 36.2 % of publications. Norway leads in total publications and collaboration intensity, with the University of Salzburg and the Norwegian University of Science and Technology as prominent institutions. The research spans a wide range of disciplines such as Sport Sciences, Physiology, etc., and interdisciplinary intersections with engineering, computer science, etc. have become a future research trend. The research focuses on the analysis of skiers' sports performance, the analysis of skiing-induced sports injuries, the biomechanical analysis of skiers' postures, and the analysis of skiing-induced respiratory diseases. The study highlights the evolution of research focus from skiing injuries to injury prevention and sports performance enhancement. This comprehensive overview aids scholars in understanding skiing research hotspots and future trends efficiently.
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Affiliation(s)
- Wenlong Hou
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
| | - Xiaoliang Li
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
| | - Yan Wen
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
| | - Xincheng Du
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
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2
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Bonell Monsonís O, Spörri J, Warsen M, Bolling C, Gouttebarge V, Verhagen E. We know a lot about little and little about a lot: A contextualized scoping review on injury prevention in alpine ski racing. Scand J Med Sci Sports 2024; 34:e14533. [PMID: 37955281 DOI: 10.1111/sms.14533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/19/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Our goal was to summarize and contextualize the available literature on alpine ski racing injury epidemiology, injury etiology, injury prevention measures, injury prevention context, and implementation issues. MATERIALS AND METHODS We searched four electronic databases using predetermined search terms. We included original studies that assessed injury, injury risk factors, and injury mechanisms, and assessed and reported the effect of an injury prevention measure in alpine ski racing. Two authors independently conducted title-abstract screening, and one performed the full-text review. For data synthesis and categorization, we used the Translating Research into the Injury Prevention Practice framework and a modified and adapted version of the Haddon matrix. RESULTS Of the 157 included studies, most corresponded to injury epidemiology and etiology, whereas few studies encompassed injury prevention measure development, implementation and evaluation. Preventive interventions targeting equipment, rules and regulations, course design and snow preparation were the most prevalent in the literature. Furthermore, various contextual factors in the current literature have been found, including gender, competition level, countries and federations, and time periods within a season. CONCLUSIONS We provided an in-depth and comprehensive overview of the current state-of-the-art in the alpine ski racing context. We know a lot about little and little about a lot across all the areas associated with injury prevention in such context. The limitations in the literature yield a road map for designing future injury prevention studies to address the key gaps identified. A more comprehensive context-driven approach throughout all stages of injury prevention would benefit the ultimate implementation of effective preventive strategies.
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Affiliation(s)
- Oriol Bonell Monsonís
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health and Sports, Amsterdam, The Netherlands
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Marit Warsen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caroline Bolling
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC Location University of Amsterdam, Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam Movement Sciences, Musculoskeletal Health and Sports, Amsterdam, The Netherlands
- Amsterdam UMC Location University of Amsterdam, Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health and Sports, Amsterdam, The Netherlands
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Wu Y, Dai R, Yan W, Ren S, Ao Y. Characteristics of Sports Injuries in Athletes During the Winter Olympics: A Systematic Review and Meta-analysis. Orthop J Sports Med 2023; 11:23259671231209286. [PMID: 38107844 PMCID: PMC10722932 DOI: 10.1177/23259671231209286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/02/2023] [Indexed: 12/19/2023] Open
Abstract
Background Athletes in the Winter Olympic Games are subject to high injury rates given the physical demands of sports. Comprehensive data regarding injury characteristics in these athletes are limited. Purpose To summarize and analyze data regarding the incidence and characteristics of sports injuries occurring in the Winter Olympic Games. Study Design Scoping review; Level of evidence, 4. Methods A systematic review of the PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure databases was conducted. Included were studies reporting the incidence of sports injuries during the Winter Olympics Games from 1995 through 2021. From 168 studies initially retrieved, 4 studies (8824 athletes, 1057 injured athletes) were included. A single-group meta-analysis of sports injury characteristics was performed, with subgroup analysis performed according to the different sports, injury locations, and injury types. Injury severity (time lost from sport) and mechanism were also assessed. Result The overall injury incidence rate (IIR) during the Winter Olympic Games was 9.6% (95% CI, 4.1%-19.8%). Snow sports were associated with the highest IIR (11.3%), with the top 3 events being the snowboard cross event in snowboarding (31.4%), the aerials event in freestyle skiing (28.6%), and the slopestyle event in snowboarding (27.7%). The most common injury locations were the knee (IIR = 20.0%; 95% CI 17.9%-22.0%), head (IIR = 10.6%; 95% CI, 9.4%-11.9%), and ankle (IIR = 8.2%; 95% CI 7.8%-8.7%). The most common injury types were contusion/hematoma/bruise (IIR = 29.9%; 95% CI 29.7%-30.0%), sprain (dislocation, subluxation, instability, ligamentous, rupture) (IIR = 21.9%; 95% CI 21.4%-22.3%), and strain (muscle rupture, tear, tendon rupture) (IIR = 11.3%; 95% CI 11.0%-11.6%). Regarding injury severity, most athletes had no time lost from sport (64.5%); 24.0% lost fewer than 7 days, and 11.5% lost more than 7 days. The most common injury mechanism was noncontact-related injury (63.3%). Conclusion In Winter Olympics sports, snow-sport injuries were more common than those associated with other sports, and the most common injury location was the knee. Most injuries did not require time loss, and the most were noncontact-related injuries.
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Affiliation(s)
- Yue Wu
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise and Health, Tianjin University of Sport, Tianjin, China
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Beijing, China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Ruilan Dai
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise and Health, Tianjin University of Sport, Tianjin, China
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Beijing, China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Wenqiang Yan
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Beijing, China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Shuang Ren
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Beijing, China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Yingfang Ao
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise and Health, Tianjin University of Sport, Tianjin, China
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Beijing, China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
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Zang W, Fang M, Zhang X, Xiao N, Wang S, Mu L. Exploring the Epidemiology of Injuries in Athletes of the Olympic Winter Games: A Systematic Review and Meta-Analysis. J Sports Sci Med 2023; 22:748-759. [PMID: 38045742 PMCID: PMC10690501 DOI: 10.52082/jssm.2023.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023]
Abstract
This study sought to provide a comprehensive assessment of the incidence of sports injuries among athletes participating in the Olympic Winter Games and to investigate contributing factors. We gathered injury data from athletes participating in the recent four Olympic Winter Games, incorporating details on the sports event, sex, injury location, and type. Through a meta-analysis, we calculated the injury incidence rates for each sport and examined the influence of sex and the type of sport on these incidence rates. Out of 11,197 registered athletes, we documented 1,304 sports injuries. The sports events with the highest injury rates were freestyle skiing, snowboarding, alpine skiing, bobsleigh, and ice hockey, with the most frequent injury locations being the knees, thoracic/lumbar/back regions, and the wrist/hand/fingers. Contusions, hematomas, and bruises were the most prevalent injuries, followed by strains (including muscle rupture, tearing, or tendon rupture) and sprains (covering dislocations, subluxations, and ligament ruptures). In the Olympic Winter Games, events such as freestyle skiing, snowboarding, alpine skiing, bobsleigh, and ice hockey pose a particularly high risk. Predominant injury sites include the knee, spine/back, and wrist and hand, with injuries ranging from contusions and hematomas to strains and sprains. For effective injury prevention, it is crucial to emphasize proper medical resource allocation, specialized training for medical personnel, and meticulous venue maintenance.
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Affiliation(s)
- Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Mingqing Fang
- Xiangya Hospital, Central South University, Changsha, China
| | - Xianzuo Zhang
- Department of orthopedics, the first affiliated hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Ningkun Xiao
- Institute of Chemical Engineering, Department of Immunochemistry, Ural Federal University, Yekaterinburg, Russia
| | - Su Wang
- Department of Sports Science, University of Harbin Sport, Harbin, China
| | - Liang Mu
- Postdoctoral Research Station, Harbin sport University, Harbin, China
- Winter Olympic College, Harbin sport University, Harbin, China
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5
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Wang Y, Chen M, Gao Y, He K, Yang Z, Li Y, Zhang S, Zhao L. Effect of one-time high load exercise on skeletal muscle injury in rats of different genders: oxidative stress and mitochondrial responses. Acta Cir Bras 2022; 37:e370805. [PMID: 36515323 DOI: 10.1590/acb370805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/10/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the impact of one-time high load exercise on skeletal muscle injury and analysis its mechanism in different genders. METHODS Twenty-four male and 24 female rats were divided randomly into four groups respectively: control, 0 h, 6 h, and 24 h after exercise. The activities of creatine kinase (CK), lactate dehydrogenase (LDH), and myohemoglobin (MYO) in serum, the expression level of oxidative stress markers, mitochondrial respiratory chain complex enzyme, and the apoptosis related protein in quadriceps were detected. RESULTS The results showed that the activities of CK, LDH and MYO in serum increased immediately after exercise and restored faster in female rats. More obvious structural disorder and apoptosis in male rats were showed. Malondialdehyde (MDA) and superoxide dismutase (SOD) were increased while catalase (CAT) and glutathione (GSH) were decreased in male rats. SOD, CAT and GSH were increased in female rats. Mitochondrial complex enzyme activity was decreased in males and increased in females. CONCLUSIONS The skeletal muscle injury in both genders of rat could be induced by one-time high load exercise due to the mitochondrial respiratory enzyme dysfunction and oxidative stress, which was relatively mild and recovered quicker in female rats.
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Affiliation(s)
- Yuan Wang
- Master. Jilin University - School of Nursing - Department of Rehabilitation - Professional Master's Program - Changchun, China
| | - Mengmeng Chen
- Master. Jilin University - School of Nursing - Department of Rehabilitation - Professional Master's Program - Changchun, China
| | - Yan Gao
- Master. Jilin University - School of Nursing - Department of Rehabilitation - Professional Master's Program - Changchun, China
| | - Kang He
- Master. Jilin University - School of Nursing - Department of Rehabilitation - Professional Master's Program - Changchun, China
| | - Zhaoyun Yang
- Bachelor. Jilin University - School of Nursing - Department of Rehabilitation - Professional Bachelor's Program - Changchun, China
| | - Yuewei Li
- PhD, Associate Professor. Jilin University - School of Nursing - Department of Rehabilitation - Changchun, China
| | - Shuang Zhang
- PhD, Associate Professor. Jilin University - School of Nursing - Department of Rehabilitation - Changchun, China
| | - Lijing Zhao
- PhD, Associate Professor. Jilin University - School of Nursing - Department of Rehabilitation - Changchun, China
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Barth M, Platzer HP, Forstinger CA, Innerhofer G, Giger A, Schröcksnadel P, Nachbauer W. In-Competition Severe Injury Events in Elite Alpine Ski Racing from 1997 to 2020: The Case of the Austrian Ski Team. SPORTS MEDICINE - OPEN 2022; 8:4. [PMID: 35022852 PMCID: PMC8755864 DOI: 10.1186/s40798-021-00384-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To increase safety in elite alpine ski racing Injury Surveillance Systems were implemented and preventive measures introduced. However, studies analysing the change in athletes’ injury risk by controlling for their exposure are still scarce.
Objectives
This study aimed to describe and analyse the risk of in-competition severe injury events (SIEcomp) in elite alpine ski racing.
Methods
Data recorded in the Austrian Ski Federation’s Injury Surveillance System were used to analyse the SIEcomp incidence. Information on athletes’ competition exposure was obtained from the official website of the International Ski Federation. In 23 seasons, 2333 skier seasons were recorded for the Austrian Ski Team. Within a total of 114,531 runs 169 SIEcomp occurred. Generalised Estimating Equation for Poisson Regressions were applied.
Results
The SIEcomp incidence per 1000 runs was 1.48 [95% confidence interval (CI) 1.26–1.73] for elite alpine ski racers and 2.21 (95% CI 1.79–2.75) for the subgroup of World Cup racers. A significant sex difference was detected for the subgroup of junior racers with a higher risk for female athletes [risk ratio (RR): 2.97, 95% CI 1.46–6.05]. Between the seasons of 1997 and 2020, the seasonal SIEcomp incidence increased by a factor of 2.67 for elite alpine ski racers and 3.53 for World Cup racers. Downhill (2.75, 95% CI 2.18–3.47) had the highest SIEcomp incidence, followed by super-G (1.94, 95% CI 1.30–2.88), giant slalom (1.40, 95% CI 1.06–1.85), and slalom (0.64, 95% CI 0.43–0.96).
Conclusion
Although many preventive measures have been implemented in elite alpine ski racing, the risk of SIEcomp has increased over the last two decades.
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Kiers K, Ellenberger L, Jermann J, Oberle F, Frey WO, Spörri J. Prospective Study on Dynamic Postural Stability in Youth Competitive Alpine Skiers: Test-Retest Reliability and Reference Values as a Function of Sex, Age and Biological Maturation. Front Physiol 2022; 13:804165. [PMID: 35480039 PMCID: PMC9035548 DOI: 10.3389/fphys.2022.804165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
This study aimed 1) to assess the test-retest reliability of dynamic postural stability index (DPSI) assessments using a ski-specific jump protocol that consists of single-leg landings on a three-dimensional force plate after forward-performed double-leg drop jumps from a box over a hurdle (DJSLLs), 2) to provide reference values for female and male youth competitive alpine skiers; 3) to explore their changes in DPSI over 3 years during adolescence; and 4) to investigate potential associations of DPSI with age and biological maturation. Using three-dimensional force plates, 16 healthy subjects were tested on the same day (test-retest reliability experiment; five test-retest assessments of right leg landings), and 76 youth skiers aged 13–15 years were tested 3 times within 2 years (main experiment; average of two trials per leg each time). The test-retest reliability experiment revealed an ICC(3,1) and 95% CI of 0.86 [0.74, 0.94] for absolute DPSI assessment. The within-subject SEM of absolute DPSI was 16.30 N [13.66 N, 20.65 N], and the standardized typical error was moderate (0.39 [0.33, 0.50]). Both absolute and relative DPSI values were comparable between male and female youth competitive alpine skiers. The mean absolute DPSI in year 1 (195.7 ± 40.9 N), year 2 (196.5 ± 38.9 N) and year 3 (211.5 ± 41.3 N) continuously increased (i.e., worsened) (p < 0.001). Mean relative, i.e. body weight force normalized, DPSI values significantly decreased, i.e., improved, from year 1 to 2 (0.42 ± 0.01 vs. 0.36 ± 0.004; p < 0.001) and year 1 to 3 (0.42 ± 0.01 vs. 0.36 ± 0.01; p < 0.001). Absolute DPSI correlated with age and biological maturation, while no such correlations were found for relative DPSI values. Our findings suggest that DPSI is a reliable and sensitive measure of dynamic postural control during DJSLLs and that relative DPSI improves annually in competitive youth skiers when accounting for body weight. Future work should consider biological maturation testing during the growth spurt, and normalizing to body weight force could be a possible solution.
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Affiliation(s)
- Kirsten Kiers
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lynn Ellenberger
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Julia Jermann
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Felix Oberle
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Walter O. Frey
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- *Correspondence: Jörg Spörri,
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Jordan MJ, Morris N, Nimphius S, Aagaard P, Herzog W. Attenuated Lower Limb Stretch-Shorten-Cycle Capacity in ACL Injured vs. Non-Injured Female Alpine Ski Racers: Not Just a Matter of Between-Limb Asymmetry. Front Sports Act Living 2022; 4:853701. [PMID: 35434617 PMCID: PMC9008592 DOI: 10.3389/fspor.2022.853701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/03/2022] [Indexed: 11/24/2022] Open
Abstract
A retrospective analysis of routine countermovement jump (CMJ) testing, a coupled eccentric-concentric (stretch-shorten-cycle: SSC) movement, was performed in female elite alpine skiers with anterior cruciate ligament (ACL) reconstruction (ACLR) and without ACLR. A total of 567 tests obtained from the daily training environment were analyzed in 41 elite female athletes (non-injured control: n = 30, ACLR: n = 17), including n = 6 athletes with pre-injury data, between 16 and 32 years of age from alpine ski racing (n = 32) and skier cross (n = 9). Bilateral CMJ testing was conducted on a dual force plate system, and the limb-specific vertical ground reaction force (Fz) was analyzed to obtain the net eccentric deceleration impulse (Ecc), lower limb stiffness (Stiff), maximal vertical jump height (JH), peak external mechanical power (PP) exerted on the body center of mass (BCM), modified-reactive-strength-index (RSImod), and the loss in BCM velocity during the final phase of the takeoff Δ(Vmax-Vtakeoff). Eccentric and concentric phase-specific between-limb asymmetry indexes (AIs) were also calculated. Additive mixed effects models (AMMs) were used to compare the age-dependent and post-injury time course change between groups. The mean values for non-injured controls >25 years of age were used as a comparative benchmark for recovery given the absence of pre-injury data. Net eccentric deceleration impulse increased and Δ(Vmax-Vtakeoff) decreased with age for the non-injured control group (p < 0.001) while between-limb AI (mean ± SD) fell between 1 ± 5% for the concentric phase and 3 ± 7% for the eccentric deceleration phase. Between-limb asymmetry became smaller in ACLR skiers with time-from-surgery to reach non-injured control values by 2 years, but SSC function, such as JH and PP, remained depressed up to 5 years post-surgery (p < 0.01), indicating impairments in SSC function. This highlights the importance of evaluating SSC performance capacity alongside vertical jump force-time asymmetries in female ACLR alpine skiers.
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Affiliation(s)
- Matthew J. Jordan
- Canadian Sport Institute Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
- School of Medical and Health Science, Centre for Human Performance, Edith Cowan University, Joondalup, WA, Australia
| | | | - Sophia Nimphius
- School of Medical and Health Science, Centre for Human Performance, Edith Cowan University, Joondalup, WA, Australia
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Walter Herzog
- Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
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Schoeb T, Fröhlich S, Frey WO, Verhagen E, Farshad M, Spörri J. The ISPA Int Injury Prevention Programme for Youth Competitive Alpine Skiers: A Controlled 12-Month Experimental Study in a Real-World Training Setting. Front Physiol 2022; 13:826212. [PMID: 35309082 PMCID: PMC8929391 DOI: 10.3389/fphys.2022.826212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/28/2022] [Indexed: 01/14/2023] Open
Abstract
Evidence-based injury prevention programmes for youth competitive alpine skiers are widely absent. The aims of this controlled 12-month experimental study were to introduce a novel injury prevention programme targeted to the injury patterns of youth skiers, called ISPAInt, and to compare the differences in injury occurrence between an intervention group (IG) additionally performing the ISPAInt programme and an independent, historical control group (CG) following their regular training routines. None of the skiers of the CG were part of the IG and vice versa. The study was directly conducted within the real-world youth development structures of skiers competing at the under 16 years (U16) level in Switzerland. Seventy-one skiers (aged 14.4 ± 0.3 years) assigned to the IG were compared to 58 age- and gender-matched controls. The IG was offered the ISPAInt programme with the recommendation to perform it at least once per week. Skiers’ adherence to this recommendation was surveyed but not enforced. Injuries were recorded using the Oslo Sports Trauma Research Centre Questionnaire. Primary outcomes were the absolute injury rates (number of injuries/100 athletes per season) and epidemiological incidence proportion (number of injured athletes/100 athletes per season). The secondary outcome was the average 2-weekly prevalence of traumatic knee, knee overuse, and lower back overuse injuries. There were lower absolute rates of all traumatic injuries [rate/risk difference, RD: −57.1 (−98.1, −16.0); rate/risk ratio, RR: 0.665 (0.485, 0.884)] and overuse injuries [RD: −35.9 (−71.0, −0.7); RR: 0.699 (0.493, 0.989)] in the IG than in the CG. Likewise, the epidemiological incidence proportion for all overuse injuries was smaller in the IG [RD: −28.4 (−44.8, −12.0); RR: 0.598 (0.435, 0.822)], while the proportion of skiers suffering from traumatic injuries did not significantly differ between the groups. Notably, the IG particularity differed from the CG in the average 2-weekly prevalence of knee trauma, knee overuse, and lower back overuse complaints, three of the major injury-related hot spots in youth skiers. Based on these promising results, the ISPAInt programme may have great potential to prevent injuries in youth competitive alpine skiers, and the underlying exercises should be considered complementary training content at the U16 level.
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Affiliation(s)
- Thierry Schoeb
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Stefan Fröhlich
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Walter O Frey
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Mazda Farshad
- Spine Surgery, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Spine Centre, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
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10
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Spörri J, Müller E, Kröll J. "When you're down, stay down": A lesson for all competitive alpine skiers supported by an ACL rupture measured in vivo. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:14-20. [PMID: 34852295 PMCID: PMC8847912 DOI: 10.1016/j.jshs.2021.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/02/2021] [Accepted: 11/16/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND During an experiment, a ski racer equipped with various measurement devices suffered an anterior cruciate ligament (ACL) rupture in his right knee. The aim of this study was to describe the underlying injury mechanism from a functional perspective. METHODS Eight giant slalom turns (i.e., 4 left turns), followed by 1 left turn at which the ACL injury occurred, were recorded by 2 video cameras, electromyography of 4 relevant muscle groups, inertial measurement units to measure knee and hip angles, and pressure insoles to determine ground reaction forces. RESULTS Due to a loss of balance, the ski racer began to slide sideways at the apex of a left turn. During sliding, his right (outside) leg was actively abducted upward without touching the ground. The ski racer then attempted to stand up again by dropping his leg back towards the snow surface. The end of this dropping was accompanied by a decrease in electromyographic activity in the knee stabilizing muscles. Once the inside edge of the outer ski caught the snow surface, a rapidly increasing peak force, knee flexion, and an aggressive sudden activation of the vastus medialis muscle were observed, while biceps femoris and rectus femoris further decreased their activation levels. This likely resulted in excessive anterior translation of the tibia relative to the femur, causing damage to the ACL. CONCLUSION Our example emphasizes that ski racers should not get up until they stop sliding. Remember: "When you're down, stay down."
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Affiliation(s)
- Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich 8008, Switzerland; University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich 8008, Switzerland.
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Ri 5400, Austria
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Ri 5400, Austria
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11
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Fu XL, Du L, Song YP, Chen HL, Shen WQ. Incidence of injuries in professional snow sports: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:6-13. [PMID: 33130094 PMCID: PMC8847944 DOI: 10.1016/j.jshs.2020.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/11/2020] [Accepted: 08/24/2020] [Indexed: 06/01/2023]
Abstract
PURPOSE The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders. METHODS We systematically searched PubMed, Web of Science, and MEDLINE for studies on injury incidence published from inception to April 2020. Injury data were extracted, alongside information on injury location, severity, type, cause, and sport discipline. Incidence of injuries was presented per 1000 athlete-days, with 95% confidence intervals (95%CIs). RESULTS The search identified 462 articles, and 22 were included in our review. The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days (95%CI: 2.97-4.01). Lower extremity had the highest injury incidence (1.54 per 1000 athlete-days, 95%CI: 1.24-1.84). Incidence rates of slight, mild, moderate, and severe injuries were 0.26, 0.31, 0.57, and 0.59 per 1000 athlete-days, respectively. Contusion had the highest incidence rate (1.82 per 1000 athlete-days, 95%CI: 1.01-2.63). The most common cause of injury was contact trauma (3.20 per 1000 athlete-days, 95%CI: 1.32-5.08). Freestyle skiing had the highest incidence rate (6.83 per 1000 athlete-days, 95%CI: 4.00-9.66), and Nordic skiing had the lowest rate (2.70 per 1000 athlete-days, 95%CI: 1.94-3.46). CONCLUSION Professional skiers and snowboarders have a substantial risk of sustaining injuries. Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.
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Affiliation(s)
- Xue-Lei Fu
- School of Medicine, Nantong University, Nantong 226001, China
| | - Lin Du
- School of Medicine, Nantong University, Nantong 226001, China
| | - Yi-Ping Song
- School of Medicine, Nantong University, Nantong 226001, China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong 226019, China.
| | - Wang-Qin Shen
- School of Medicine, Nantong University, Nantong 226001, China.
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12
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Stenseth OMR, Barli SF, Martin RK, Engebretsen L. Injuries in elite women's ski jumping: a cohort study following three International Ski Federation (FIS) World Cup seasons from 2017-2018 to 2019-2020. Br J Sports Med 2021; 56:35-40. [PMID: 34893472 DOI: 10.1136/bjsports-2021-104198] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To define incidence and injury patterns of International Ski Federation (FIS) World Cup (WC) women ski jumpers over three seasons. METHODS Ski jump athletes competing in the Women's FIS WC were recruited for prospective injury surveillance from 2017-2018 to 2019-2020. Team representatives recruited the athletes annually and prospectively recorded all injuries requiring medical attention. Retrospective end-of-season interviews corroborated injury surveillance. Medical doctors collected and processed the data. The 4-month competitive season was used to calculate the annual incidence of injuries per 100 athletes per season. Injury type, location, severity and aetiology were reported. RESULTS Athletes from 19 nations were enrolled equalling 205 athlete-seasons. Mean age was 21.2 years (SD=3.8). Thirty-nine injury events resulted in 54 total injuries (26.3 injuries/100 athletes/season). Injuries were mostly acute (83%) and occurred on the ski jump hill (78%). The most common injury location was the knee (n=18, 33%). Crash landings were the most common cause of injury events (70%). Nearly half of the acute ski jump injury events occurred in snowy, windy or cloudy conditions (44%) and/or during telemark landings (46%), and most jumps (96%) were shorter than hill size. One third of the injuries were severe, and 78% of severe injuries involved the knee. CONCLUSION Acute injury events occur relatively frequently in elite women ski jumpers, most resulting in time-loss from sport and a significant proportion involving serious knee injuries. Crash landing was the leading cause of injury. This baseline information can be used to guide and evaluate future efforts at injury prevention.
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Affiliation(s)
- Oleane Marthea Rebne Stenseth
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway .,The Norwegian School of Sports Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
| | - Sindre Fløtlien Barli
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,The Norwegian School of Sports Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
| | - R Kyle Martin
- Department of Orthopaedic Surgery and Sports Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lars Engebretsen
- The Norwegian School of Sports Sciences, Oslo Sports Trauma Research Center, Oslo, Norway.,University of Oslo, Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
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13
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杨 渝, 孔 思, 邓 佳, 蒋 艳, 敖 英. [Comparison of acute sports injury between recreational skiers and skiers]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:838-842. [PMID: 34650282 PMCID: PMC8517660 DOI: 10.19723/j.issn.1671-167x.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers. METHODS The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared. RESULTS A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen. CONCLUSION In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.
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Affiliation(s)
- 渝平 杨
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
- 北京大学第三医院崇礼院区运动医学科,河北张家口 076350Department of Sports Medicine, Chongli Hospital, Peking University Third Hospital, Zhangjiakou 076350, Hebei, China
| | - 思敏 孔
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 佳良 邓
- 北京冬奥组委运动会服务部医疗卫生处,北京 076350Medical and Health Department, Games Service Department, Beijing 076350, China
| | - 艳芳 蒋
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 英芳 敖
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
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14
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Csapo R, Runer A, Hoser C, Fink C. Contralateral ACL tears strongly contribute to high rates of secondary ACL injuries in professional ski racers. Knee Surg Sports Traumatol Arthrosc 2021; 29:1805-1812. [PMID: 32804249 DOI: 10.1007/s00167-020-06234-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/10/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE To analyse the effects of graft selection, sex, injury complexity and time to return to competition on the odds to suffer secondary ACL injury (either re-rupture or contralateral ACL tear) in professional alpine skiers. METHODS The database of a specialised joint surgery clinic was screened for professional alpine skiers who had participated in competitions at the FIS race, European Cup and World Cup level prior to having to undergo a primary ACL reconstruction, and who had returned to the same competitional level at least one year prior to the end of the observation period. The rates of secondary ACL injuries were statistically compared between athletes with hamstring and quadriceps tendon autografts, men and women, simple and complex (involvement of menisci or cartilage) primary ACL injuries, and between early (≤ 300 days after primary reconstruction) and late (> 300 days) returners to competition. RESULTS Fourteen out of the 30 athletes included (46.7%) suffered secondary ACL injuries on average 29.4 ± 22.5 months after primary reconstruction. The secondary injuries comprised five re-ruptures (16.7%) and nine contralateral ACL tears (30.0%). The odds to suffer contralateral ACL tears were non-significantly higher in patients with hamstring tendon autografts (OR 5.69, n.s.) and in those whose primary injuries were classified as simple ACL tears (OR 5.31, n.s.). None of the factors assessed was associated with the odds of graft failure. CONCLUSION The odds of ACL-injured professional alpine ski racers to suffer secondary ACL tears are nearly 50%, with subsequent contralateral ACL injuries being more common than graft failures. While statistical significance could not be established due to a lack of power, greater odds of contralateral ACL tears were observed in athletes with hamstring tendon grafts as well as those with simple primary ACL injuries. No factors potentially predisposing athletes for graft failure could be identified. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Robert Csapo
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG, UMIT Tirol, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
| | - Armin Runer
- Department of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Hoser
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG, UMIT Tirol, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.,Gelenkpunkt Sports and Joint Surgery, Innsbruck, Austria
| | - Christian Fink
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG, UMIT Tirol, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.,Gelenkpunkt Sports and Joint Surgery, Innsbruck, Austria
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15
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Fröhlich S, Helbling M, Fucentese SF, Karlen W, Frey WO, Spörri J. Injury risks among elite competitive alpine skiers are underestimated if not registered prospectively, over the entire season and regardless of whether requiring medical attention. Knee Surg Sports Traumatol Arthrosc 2021; 29:1635-1643. [PMID: 32556431 DOI: 10.1007/s00167-020-06110-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/11/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE Prospective studies assessing the injuries occurring in elite competitive alpine skiers are lacking, and a full picture of all injuries, including those not requiring medical attention, is absent. Likewise, little is known about the sex-specific injury risks and patterns of elite skiers throughout an entire season (i.e. an off-season preparation period and a competition period). Accordingly, this study investigated the injuries of a national team cohort with respect to season period and sex. METHODS Over an entire season, all injuries occurring in 44 Swiss National Ski Team members (25 females and 19 males) were registered, regardless of whether they required medical attention. Skiers were prospectively monitored by the Oslo Sports Trauma Research Centre (OSTRC) questionnaire and by continuously updated team medical records. Finally, these data were used as a reference for supplemental interviews, in which the correctness and completeness of the prospective data were verified. RESULTS The risk of suffering at least one injury during an entire season was 75.0% with a 95% confidence interval (73.1%, 76.9%) for traumatic injuries, and 52.3% (50.0%, 54.5%) for overuse injuries. Traumatic injuries concerned the head, lower leg and knee, while overuse injuries affected the lumbar spine, knee and hip. During the competition period, skiers were more prone to traumatic injuries, while during the off-season preparation period, skiers' risk was higher for overuse injuries. Over an entire season, there were no sex differences. However, females were more vulnerable to traumatic injuries during the preparation period and overuse injuries during the competition period, while males had a higher risk for overuse injuries during the preparation period. CONCLUSIONS When prospectively registering injuries among elite competitive alpine skiers over an entire season, regardless of whether the injuries required medical attention, the injury risks were alarmingly high and substantially larger than those previously reported. Moreover, since injury risks and patterns are season period and sex dependent, it is strongly recommended that (1) injury registration focuses on both the off-season preparation period and the competition period and (2) prevention efforts are specifically tailored to the sex of the athletes. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Stefan Fröhlich
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Lengghalde 5, Zurich, 8008, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Moritz Helbling
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Lengghalde 5, Zurich, 8008, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Sandro F Fucentese
- Knee Surgery, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Walter Karlen
- Mobile Health Systems Lab, Institute for Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Walter O Frey
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Lengghalde 5, Zurich, 8008, Switzerland.
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
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16
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Injury prevention in Super-G alpine ski racing through course design. Sci Rep 2021; 11:3637. [PMID: 33574431 PMCID: PMC7878813 DOI: 10.1038/s41598-021-83133-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/11/2021] [Indexed: 11/08/2022] Open
Abstract
In Super-G alpine ski racing mean speed is nearly as high as in Downhill. Hence, the energy dissipated in typical impact accidents is similar. However, unlike Downhill, on Super-G courses no training runs are performed. Accordingly, speed control through course design is a challenging but important task to ensure safety in Super-G. In four male World Cup alpine Super-G races, terrain shape, course setting and the mechanics of a high-level athlete skiing the course were measured with differential global navigation satellite systems (dGNSS). The effects of course setting on skier mechanics were analysed using a linear mixed effects model. To reduce speed by 0.5 m/s throughout a turn, the gate offset needs to be increased by + 51%. This change simultaneously leads to a decrease in minimal turn radius (− 19%), an increase in impulse (+ 27%) and an increase in maximal ground reaction force (+ 6%). In contrast, the same reduction in speed can also be achieved by a − 13% change in vertical gate distance, which also leads to a small reduction in minimal turn radius (− 4%) impulse (− 2%), and no change in maximal ground reaction force; i.e. fewer adverse side effects in terms of safety. It appears that shortening the vertical gate distance is a better and safer way to reduce speed in Super-G than increasing the gate offset.
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17
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Xu Y, Yang C, Yang Y, Zhang X, Zhang S, Zhang M, Liu L, Fu W. A Narrative Review of Injury Incidence, Location, and Injury Factor of Elite Athletes in Snowsport Events. Front Physiol 2021; 11:589983. [PMID: 33488394 PMCID: PMC7820716 DOI: 10.3389/fphys.2020.589983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
Snowsport athletes face a high injury risk both during training and in competitions. Reducing injury incidence is crucial for athletes to achieve breakthroughs. This narrative review aimed to summarize and analyze injury data of elite athletes in snowsports and provide references for injury prevention and health security for these athletes and their coaches. A total of 39 studies that investigated snowsport injury were analyzed in the present study. On the basis of injury data of elite athletes in snowsports events, this narrative review focused on four aspects, namely, injury incidence, severity, location and causes. The findings of this review were as follows. (1) The highest injury incidence was recorded in freestyle skiing, followed by alpine skiing and snowboarding, the majority of which were moderate and severe injuries. (2) The proportion of injury in competitions and during training was similar. However, more injuries occurred in official training during the Winter Olympic Games; by contrast, injury proportion was higher in competitions during World Cup/World Championships. (3) The most commonly and severely injured body parts were the knees (29.9%), head and face (12.1%), shoulders and clavicula (10.5%), and lower back (8.9%). The most common injury types were joint and ligament injury (41.5%), fracture and bone stress (24.4%), concussion (11.1%), and muscle/tendon injury (10.7%). (4) The main causes of snowsport injury were collisions, falls, and non-contact injuries. Snowsport injury was also influenced by the skill level of the athletes, gender, course setup and equipment. Future studies should further explore the influence of event characteristics and intrinsic and extrinsic risk factors on snowsport injury. An injury or trauma reconstruction may be developed to predict athletic injuries and provide effective prevention strategies.
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Affiliation(s)
- Yongxin Xu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Chenhao Yang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yang Yang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xini Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Shen Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Mingwen Zhang
- Beijing Institute of Fashion Technology, Beijing, China.,Institute for Frontier Materials, Deakin University, Geelong, VIC, Australia
| | - Li Liu
- Beijing Institute of Fashion Technology, Beijing, China
| | - Weijie Fu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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18
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Ineichen J, Connert T, Kühl S, Filippi A. Dental trauma and tongue injuries in professional alpine ski racing-A worldwide survey. Dent Traumatol 2020; 37:414-418. [PMID: 33377302 DOI: 10.1111/edt.12643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Skiing is a sport with a medium risk of injuries, and injuries are increasingly common among professional alpine skiers. Examples of other medium-risk sports are for example handball, basketball, and karate. The aim of this study was to assess the frequency of dental trauma in professional alpine skiing and to determine whether the frequency of dental injuries is associated with a skier's performance level, alpine skiing discipline, and/or years of skiing experience. MATERIAL AND METHODS A questionnaire consisting of 17 questions was distributed to professional male ski racers to gather information about their skiing discipline (category), performance level, and injuries, particularly dental trauma. RESULTS A total of 161 out of 190 skiers returned the survey, with a response rate of 84.2%. Of these, 134 (83.2%) had suffered alpine ski racing-related injuries during their career and 38 (23.6%) reported skiing-related dental trauma-most commonly crown fractures (65.8%, n = 25), which mainly involved the maxillary or mandibular incisors (76.0%, n = 28). Ski racers with higher performance levels were more likely to experience dental injuries, but the difference in the frequency of dental trauma between participants in the speed versus technical category was not significant. Likewise, the number of years of ski racing experience did not impact the frequency of dental injuries. The participants rarely wore custom-made mouthguards (6.8%, n = 11). None of those who reported dental injuries were wearing a custom-made mouthguard when the injury occured. They preferred to wear chin guards, over-the-counter mouthguards, or no mouthguards. CONCLUSION Professional alpine ski racing has a medium risk of dental trauma, which further increases with skier performance level. The participating skiers rarely wore custom-made mouthguards.
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Affiliation(s)
- Jasmin Ineichen
- Department of Oral Surgery, Center of Dental Traumatology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, Center of Dental Traumatology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, Center of Dental Traumatology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Andreas Filippi
- Department of Oral Surgery, Center of Dental Traumatology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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19
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Fröhlich S, Pazeller S, Cherati AS, Müller E, Frey WO, Spörri J. 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. BMJ Open Sport Exerc Med 2020; 6:e000892. [PMID: 33408876 PMCID: PMC7768963 DOI: 10.1136/bmjsem-2020-000892] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 01/18/2023] Open
Abstract
Objectives To investigate knee, back and hip overuse injuries in top female elite alpine skiers during the off-season preparation, which has so far received little attention, and to assess their relationship with traumatic preinjuries and overall training load. Methods A cohort of 26 females of the Swiss Alpine Ski-Team were prospectively surveyed by the use of the Oslo Sports Trauma Research Centre questionnaire. Along with the surveys also total training loads were monitored. Data on preinjuries were assessed retrospectively by baseline questionnaires and were verified by team medical records. Results 57.7% of the female skiers suffered from at least one severe traumatic knee injury during their preceding career. The average 2-weekly prevalence of overuse injuries was highest for the knee, followed by the back and hip. Technique specialists (major giant slalom and slalom) were more prone to back overuse injuries than speed specialists (major super-G and downhill). The occurrence of knee overuse complaints was directly associated to previous severe traumatic knee injuries and athletes' total training hours. Conclusion In top female elite alpine skiers, knee, back and hip overuse injuries are relatively frequent. Moreover, discipline preferences, previous traumatic injuries and the overall training load may play an important role for their manifestation.
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Affiliation(s)
- Stefan Fröhlich
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Seraina Pazeller
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Afsaneh Safar Cherati
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Walter O Frey
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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20
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Jordan MJ, Morris N, Lane M, Barnert J, MacGregor K, Heard M, Robinson S, Herzog W. Monitoring the Return to Sport Transition After ACL Injury: An Alpine Ski Racing Case Study. Front Sports Act Living 2020; 2:12. [PMID: 33345007 PMCID: PMC7739580 DOI: 10.3389/fspor.2020.00012] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/28/2020] [Indexed: 11/29/2022] Open
Abstract
Alpine ski racing is an extreme sport and ski racers are at high risk for ACL injury. ACL injury impairs neuromuscular function and psychological readiness putting alpine skiers with ACL injury at high risk for ACL reinjury. Consequently, return to sport training and testing protocols are recommended to safeguard ACL injured athletes against reinjury. The aim of this paper was to present a real-world example of a return to sport training plan for a female elite alpine ski racer who sustained an ACL injury that was supported by an interdisciplinary performance team (IPT) alongside neuromuscular testing and athlete monitoring. A multi-faceted return to sport training plan was developed by the IPT shortly after the injury event that accounted for the logistics, healing, psychological readiness, functional milestones, work capacity and progression to support the return to sport/return to performance transition. Neuromuscular testing was conducted at several timepoints post-injury. Importantly, numerous pre-injury tests provided a baseline for comparison throughout the recovery process. Movement competencies and neuromuscular function were assessed, including an evaluation of muscle properties (e.g., the force-velocity and force-length relationships) to assist the IPT in pinpointing trainable deficits and managing the complexities of the return to sport transition. While the athlete returned to snow 7 months post-injury, presenting with interlimb asymmetries below 10%, functional and strength deficits persisted up to 18 months post-injury. More research is required to establish a valid return to sport protocol for alpine ski racers with ACL injury to safeguard against the high risk for ACL reinjury.
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Affiliation(s)
- Matthew J Jordan
- Canadian Sport Institute Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
| | - Nathaniel Morris
- Canadian Sport Institute Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
| | - Mike Lane
- Canadian Sport Institute Calgary, Calgary, AB, Canada
| | | | | | - Mark Heard
- Banff Sports Medicine Centre, Banff, AB, Canada
| | | | - Walter Herzog
- Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
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21
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Shi H, Jiang Y, Ren S, Hu X, Huang H, Ao Y. Sex differences in the knee orthopaedic injury patterns among recreational alpine skiers. BMC Sports Sci Med Rehabil 2020; 12:74. [PMID: 33292435 PMCID: PMC7718676 DOI: 10.1186/s13102-020-00224-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/29/2020] [Indexed: 11/10/2022]
Abstract
Background Although studies have reported the sex differences in injury patterns among recreational skiers, the findings are still conflicting. This study aims to analyse the sex differences of orthopaedic knee injuries that occurred during alpine skiing. Methods A total of 306 recreational alpine skiers (125 females and 181 males) who sustained knee surgeries between June 2016 and December 2018 participated in this study. Age, height, weight, and physical activity level of the patients were recorded. The orthopaedic knee injury patterns were analysed based on the diagnosis given by the physicians. Results Male skiers (17.13%) had a higher proportion of multiple knee ligament injuries than females (6.40%). The combined anterior cruciate ligament (ACL) and medial collateral ligament injury were the most common injury types in both females and males, with ACL injury being more prevalent for females (79.20%) than that in males (56.35%). The proportion of female skiers (17.6%) with vigorous-intensity activity level was significantly lower than that of males (30.9%). Female skiers had lower body height, body weight, and body mass index than male skiers (P < 0.001). Conclusions ACL injury is the most common orthopaedic injury among both female and male knee-injured recreational skiers. The proportion of females with an ACL injury is higher than that of males, but the proportion of multiple knee ligament injuries is lower than that of males. More male recreational skiers have vigorous-intensity activity level habits in daily life than females.
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Affiliation(s)
- Huijuan Shi
- Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China.,School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Yanfang Jiang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China
| | - Shuang Ren
- Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China
| | - Xiaoqing Hu
- Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China
| | - Hongshi Huang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China
| | - Yingfang Ao
- Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China.
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22
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Csapo R, Juras V, Heinzle B, Trattnig S, Fink C. Compositional MRI of the anterior cruciate ligament of professional alpine ski racers: preliminary report on seasonal changes and load sensitivity. Eur Radiol Exp 2020; 4:64. [PMID: 33230703 PMCID: PMC7683641 DOI: 10.1186/s41747-020-00191-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to investigate potential changes in the anterior cruciate ligament (ACL) structure of alpine ski racers over the course of an entire season using quantitative magnetic resonance imaging (T2* mapping). The dominant legs of three alpine ski racers were examined on a 3-T MR scanner four times at 3-month intervals. Multi-echo sequences for T2* maps, which were coregistered with high-resolution morphological sequences for reproducible definition of ACL regions of interest, were acquired. Means and standard deviations of T2* values from the central and femoral portion of the ACL were extracted and presented in a descriptive manner. T2* values were subject to seasonal changes, which were most pronounced in the ligament central region. Substantial increases (+ 41%) occurred between the measurements taken in January and April. A partial recovery of T2* (-19%) was observed in the July follow-up. The increased T2* times may reflect decreased stress tolerance and increased susceptibility for fatigue tears at the end of the competitive season. Further research in larger samples is required. The likeliness of ACL tears may depend on the precedent history of mechanical loading and vary in professional athletes over the course of the competitive season.
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Affiliation(s)
- Robert Csapo
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG, University for Health Sciences, Medical Informatics and Technology, Hall, A-6060, Austria
| | - Vladimir Juras
- Highfield MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.
| | | | - Siegfried Trattnig
- Highfield MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.,CD Laboratory for Molecular Clinical MR Imaging, Vienna, Austria
| | - Christian Fink
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG, University for Health Sciences, Medical Informatics and Technology, Hall, A-6060, Austria.,Gelenkpunkt Sports and Joint Surgery, Innsbruck, A-6020, Austria
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23
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Mountjoy M, Moran J, Ahmed H, Bermon S, Bigard X, Doerr D, Lacoste A, Miller S, Weber A, Foster J, Budgett R, Engebretsen L, Burke LM, Gouttebarge V, Grant ME, McCloskey B, Piccininni P, Racinais S, Stuart M, Zideman D. Athlete health and safety at large sporting events: the development of consensus-driven guidelines. Br J Sports Med 2020; 55:191-197. [PMID: 33184113 DOI: 10.1136/bjsports-2020-102771] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 11/04/2022]
Abstract
All sport events have inherent injury and illness risks for participants. Healthcare services for sport events should be planned and delivered to mitigate these risks which is the ethical responsibility of all sport event organisers. The objective of this paper was to develop consensus-driven guidelines describing the basic standards of services necessary to protect athlete health and safety during large sporting events. By using the Knowledge Translation Scheme Framework, a gap in International Federation healthcare programming for sport events was identified. Event healthcare content areas were determined through a narrative review of the scientific literature. Content experts were systematically identified. Following a literature search, an iterative consensus process was undertaken. The outcome document was written by the knowledge translation expert writing group, with the assistance of a focus group consisting of a cohort of International Federation Medical Chairpersons. Athletes were recruited to review and provide comment. The Healthcare Guidelines for International Federation Events document was developed including content-related to (i) pre-event planning (eg, sport medical risk assessment, public health requirements, environmental considerations), (ii) event safety (eg, venue medical services, emergency action plan, emergency transport, safety and security) and (iii) additional considerations (eg, event health research, spectator medical services). We developed a generic standardised template guide to facilitate the planning and delivery of medical services at international sport events. The organisers of medical services should adapt, evaluate and modify this guide to meet the sport-specific local context.
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Affiliation(s)
- Margo Mountjoy
- Bureau-Sport Medicine Liaison, McMaster University Michael G DeGroote School of Medicine, Hamilton, Ontario, Canada .,Medical and Scientific Commission-Games Group-Sport Medicine, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Jane Moran
- Medical and Scientific Commission-Games Group-Sport Medicine, International Olympic Committee, Lausanne, Vaud, Switzerland.,Medical Commission, International Skating Union, Victoria, British Columbia, Canada
| | - Hosny Ahmed
- ADU, International Handball Federation, Basel, Switzerland
| | | | - Xavier Bigard
- Sport Medicine, Union Cycliste Internationale, Aigle, Vaud, Switzerland
| | - Dominik Doerr
- International Weightlifting Federation (IWF), Budapest, Hungary
| | - Alain Lacoste
- Sports Medicine, World Rowing, Lausanne, Vaud, Switzerland
| | - Stuart Miller
- Science & Technical Department, International Tennis Federation, Roehampton, UK
| | | | - Jeremy Foster
- Association of Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Louise M Burke
- Nutrition Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Vincent Gouttebarge
- Mental Health Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Marie-Elaine Grant
- Medical and Scientific Commission Games Group-Physiotherapy, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Brian McCloskey
- Medical and Scientific Commission-Games Group-Public Health, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Paul Piccininni
- Medical and Scientific Commission-Dental, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Sebastien Racinais
- Medical and Scientific Commission-Games Group Sport Science: adverse weather impact, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Mark Stuart
- Medical and Scientific Commission Games Group-Pharmacy, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - David Zideman
- Medical and Scientific Commission-Games Group Anaesthesiologist and Emergency Pre-Hospital Care Consultant, International Olympic Committee, Lausanne, Vaud, Switzerland
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24
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Barth M, Platzer HP, Giger A, Nachbauer W, Schröcksnadel P. Acute on-snow severe injury events in elite alpine ski racing from 1997 to 2019: the Injury Surveillance System of the Austrian Ski Federation. Br J Sports Med 2020; 55:bjsports-2020-102752. [PMID: 33023882 DOI: 10.1136/bjsports-2020-102752] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The study aimed to (1) determine the incidence and gender-specific risk ratio of acute on-snow severe injury events (SIE) in elite alpine ski racing, (2) examine the development of SIE over 22 seasons, and (3) analyse SIE with respect to the severely injured body parts and structures. METHODS Data recorded in the Austrian Ski Federation's Injury Surveillance System over 22 seasons were analysed. The Austrian Ski Team consists of four groups: Team National (n=477), Team A (n=444), Team B (n=696) and Team C (n=608). Team National and Team A comprised World Cup, Team B European Cup and Team C junior alpine ski racers. Simple and multiple Poisson regressions were calculated. RESULTS The SIE incidence was 15.7 (95% CI 14.2 to 17.5) per 100 skier seasons. ACL injury events accounted for 70.8% of severe knee injury events and 48.6% of SIE. The incidence of severe ACL injury events was 7.6 (95% CI 6.6 to 8.9). Female World Cup alpine ski racers had a 1.65 times (95% CI 1.02 to 2.69) higher risk of severe ACL injury events than their male counterparts. CONCLUSION The incidence of acute on-snow SIE in World Cup alpine ski racing was higher than previously reported. Despite various prevention efforts, the average seasonal incidence of SIE in World and European Cup alpine ski racers has grown from approximately 11 in 1997 to 23 in 2019; thus with roughly one more injured athlete every second season.
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Affiliation(s)
- Michael Barth
- Department of Sport Science, University of Innsbruck, Innsbruck, Tyrol, Austria
- Department of Business & Society, University of Applied Sciences Kufstein Tirol-FH Kufstein, Kufstein, Tyrol, Austria
- Department of Sports Science, Saarland University, Saarbrücken, Saarland, Germany
| | - Hans-Peter Platzer
- Department of Sport Science, University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Anton Giger
- Austrian Ski Federation, Innsbruck, Tyrol, Austria
| | - Werner Nachbauer
- Department of Sport Science, University of Innsbruck, Innsbruck, Tyrol, Austria
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25
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Platzer HP, Barth M, Giger A, Schröcksnadel P, Nachbauer W. Did injury incidence in alpine ski racing change after equipment regulations? An evaluation based on the injury surveillance system of the Austrian Ski Federation. J Sci Med Sport 2020; 24:1044-1048. [PMID: 32807655 DOI: 10.1016/j.jsams.2020.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 06/25/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To assess the effects of alpine competition equipment regulations from 2003, 2007 and 2012 on severe injury incidence. DESIGN Case study METHOD: Data originated from records of the injury surveillance system of the Austrian Ski Federation. Injuries from the seasons 2001-2017 were divided in four periods between the equipment regulations. For comparison of consecutive periods, risk ratios (RR = later period / preceding period) with 95% CI were calculated. Total severe injury events, events with severe knee injuries, and events with severe ACL injuries were separately investigated. RESULTS A significant increase of total severe injury incidence was found after the equipment regulation in 2003 (RR1.52, 95% CI 1.00-2.31). None of the other comparisons revealed significance (p<0.05) or statistical trends (p<0.1). Only the minority (40%) of the RR showed a reduction in the injury incidence of the Austrian Ski Team (lowest RR 0.78). 60% of the RR increased after the regulations (highest RR 1.63). CONCLUSIONS Even though statistical uncertainties remain, our findings allow the conclusion, that the implemented equipment regulations did not cause a noticeable reduction of injuries. The three analysed equipment regulations were not appropriate or were counteracted by other factors.
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Affiliation(s)
- Hans-Peter Platzer
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria; Research Center Snow, Ski, and Alpine Sport, Fürstenweg 185, 6020 Innsbruck, Austria.
| | - Michael Barth
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Anton Giger
- Austrian Ski Federation, Olympiastraße 10, 6020 Innsbruck, Austria
| | | | - Werner Nachbauer
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria; Research Center Snow, Ski, and Alpine Sport, Fürstenweg 185, 6020 Innsbruck, Austria
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26
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Abstract
OBJECTIVE To develop and implement a prospective varsity athlete surveillance system to identify injury and illness trends in a multisport varsity-level university setting. DESIGN Longitudinal prospective surveillance study. SETTING Varsity-level sport program at the University of Guelph, Guelph, ON, Canada. PARTICIPANTS Athletic therapists (ATs) (n = 35) from 17 varsity sports provided injury and illness information on 624 varsity-level athletes (381 men and 243 women) during the 2016/2017 competitive season. INTERVENTIONS Team ATs reported athlete health complaints weekly. Athletes reported additional details on the injury or illness that was reported. MAIN OUTCOME MEASURES The outcome measurements included when the injury or illness occurred, anatomical location, diagnosis, cause, perceived severity, treatment, estimated athlete exposure (AE) to training and competition, and time loss from sport. Measures were recorded from the teams' first competition through to the end the season and/or playoffs. RESULTS Twenty-nine of 30 varsity sports teams participated in this injury and illness surveillance protocol. The compliance of team ATs and varsity athletes was 89% (men: 94%, women: 82%). The overall injury and illness rates were 5.5 injuries and 1.7 illnesses per 1000 AEs, respectively. Men's injury rates were greater than women's, and injury rates of contact sports were greater than noncontact sports. CONCLUSIONS The utilization of a prospective injury and illness surveillance protocol in the Canadian University sport system is feasible with good athlete, AT, and coach acceptance. The surveillance data should inform future injury and illness prevention strategies.
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27
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Schoeb T, Peterhans L, Fröhlich S, Frey WO, Gerber C, Spörri J. Health problems in youth competitive alpine skiing: A 12‐month observation of 155 athletes around the growth spurt. Scand J Med Sci Sports 2020; 30:1758-1768. [DOI: 10.1111/sms.13740] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 03/02/2020] [Accepted: 05/25/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Thierry Schoeb
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Loris Peterhans
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Stefan Fröhlich
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
- University Centre for Prevention and Sports MedicineDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Walter O. Frey
- University Centre for Prevention and Sports MedicineDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Christian Gerber
- Team Shoulder & ElbowDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Jörg Spörri
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
- University Centre for Prevention and Sports MedicineDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
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28
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Fröhlich S, Peterhans L, Stern C, Frey WO, Sutter R, Spörri J. Remarkably high prevalence of overuse-related knee complaints and MRI abnormalities in youth competitive alpine skiers: a descriptive investigation in 108 athletes aged 13-15 years. BMJ Open Sport Exerc Med 2020; 6:e000738. [PMID: 32537242 PMCID: PMC7264838 DOI: 10.1136/bmjsem-2020-000738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2020] [Indexed: 12/13/2022] Open
Abstract
Background/aim Competitive alpine skiing is known to be associated with a high risk of traumatic knee injuries. However, little is known about the exact prevalence of knee overuse injuries and their associations with structural changes, particularly in youth skiers. Accordingly, the aim of the present study was to describe the overuse-related knee complaints and MRI abnormalities in a cohort of youth skiers around the growth spurt. Methods 108 youth competitive alpine skiers aged 13–15 years were examined using an MRI of both knees, an interview on existing knee complaints and a physical examination. As a common baseline for these assessments, skiers were prospectively monitored by the use of the Oslo Sports Trauma Research Centre questionnaire on health problems over a period of 12 months preceding the major investigations. Results 88.0% of the youth skiers showed at least one MRI abnormality in the knees. The most frequent findings were distal femoral cortical irregularities (63%), focal periphyseal oedema (FOPE) zones (25.0%) and cartilage lesions (18.5%). 47.2% of all skiers suffered from at least one overuse-related knee complaint during the 12 months preceding the MRI examination, mostly at the distal and proximal patellar tendon. However, despite a certain association with corresponding MRI abnormalities, the sensitivity of an MRI-based detection of such complaints was strongly limited. Conclusion Youth competitive alpine skiers suffer from a remarkably large number of knee overuse injuries. Accordingly, an effective prevention strategy should include a systematic screening of clinical complaints, ideally already starting around the growth spurt.
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Affiliation(s)
- Stefan Fröhlich
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Loris Peterhans
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Christoph Stern
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Walter O Frey
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Reto Sutter
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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29
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Gilgien M, Crivelli P, Kröll J, Luteberget LS, Müller E, Spörri J. Preventing injuries in alpine skiing giant slalom by shortening the vertical distance between the gates rather than increasing the horizontal gate offset to control speed. Br J Sports Med 2020; 54:1042-1046. [PMID: 32341022 DOI: 10.1136/bjsports-2019-101692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIM To set a safe giant slalom course, speed needs to be controlled in certain sections. Speed may be reduced by adjusting how the gates are set on a course. We studied the effect of elements of course-setting, entrance speed and terrain incline on the mechanics of turning (ie, turn speed, turn radius, and ground reaction force and impulse). METHODS During seven World Cup alpine giant slalom competitions, the course and terrain characteristics of the official racetracks and the mechanics of a professional-level athlete skiing the course immediately prior to competition were analysed with differential global navigation satellite system technology. Data were analysed using a linear mixed-effects model. RESULTS Course-setting geometry (vertical gate distance and horizontal gate offset), entrance speed and terrain incline modulated the injury-relevant factor turn speed. Depending on the terrain, the speed throughout a turn can be reduced by 0.5 m/s either by shortening the vertical gate distance by 4.9-6.9 m (from -20% to -29%) or by increasing the horizontal gate offset by 2.8-3.2 m (from +33% to +55%). However, increasing the horizontal gate offset causes the skier to turn with a smaller minimal turn radius, increase maximal ground reaction force and also increase impulse. DISCUSSION To reduce speed, we recommend decreasing the vertical gate distance rather than increasing the horizontal gate offset. Increasing horizontal gate offset would require the skiers to sharpen and prolong their turns (reducing turn radius), and this increases the acting ground reaction force and impulse and thus the athlete's fatigue.
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Affiliation(s)
- Matthias Gilgien
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway .,Center of Alpine Sports Biomechanics, St Moritz Health and Innovation Foundation, Samedan, Switzerland
| | - Philip Crivelli
- Group for Snowsports, WSL Institute for Snow and Avalanche Research SLF, Davos, Switzerland
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Rif, Austria
| | - Live S Luteberget
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Rif, Austria
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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30
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Westin M, Harringe ML, Engström B, Alricsson M, Werner S. Prevention of Anterior Cruciate Ligament Injuries in Competitive Adolescent Alpine Skiers. Front Sports Act Living 2020; 2:11. [PMID: 33345006 PMCID: PMC7739649 DOI: 10.3389/fspor.2020.00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 01/27/2020] [Indexed: 11/30/2022] Open
Abstract
Anterior cruciate ligament (ACL) injury is one of the most serious injuries among Swedish alpine ski high school students. An ACL injury forces the skier to stop skiing for several months, and some skiers even have to give up their skiing career. Therefore, an ACL injury prevention program might play an important role for alpine skiers. In the present study ski high school students have been followed in terms of ACL injuries during 1-2 ski seasons between 2006/2007 and 2012/2013. Alpine skiers studying at the Swedish ski high schools during the ski seasons 2011/2012 and 2012/2013 received a specific ACL injury prevention program (n = 305), while alpine skiers who attended a Swedish ski high school between the ski seasons 2006/2007 and 2010/2011 served as controls (n = 431). The prevention program was based on earlier studies and included indoor and outdoor exercises on snow focusing on core stability and neuromuscular control. Alpine skiing is an equilateral sport. Therefore, the goal of the prevention was to encourage the skiers to practice these exercises in order to perform equally good on both legs. The outcome measure consisted of the number and incidence of ACL injuries. The 2 years of prevention resulted in 12 ACL injuries (3.9%) compared with 35 ACL injuries during the control period (8.1%). The absolute risk rate showed a decreased incidence rate of -0.216 [CI -0.001-(-0.432)]/100 months attending a ski high school in favor of the intervention group. A prevention program focusing on the skier's ability to perform neuromuscular exercises equally good on both legs led to a reduction of ACL injuries.
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Affiliation(s)
- Maria Westin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm Sports Trauma Research Center, Stockholm, Sweden
| | - Marita Löfgren Harringe
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm Sports Trauma Research Center, Stockholm, Sweden
| | - Björn Engström
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm Sports Trauma Research Center, Stockholm, Sweden
| | - Marie Alricsson
- Department of Sports Science, Linnaeus University, Kalmar, Sweden
| | - Suzanne Werner
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm Sports Trauma Research Center, Stockholm, Sweden
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31
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Steidl-Müller L, Hildebrandt C, Müller E, Raschner C. Relationship of Changes in Physical Fitness and Anthropometric Characteristics over One Season, Biological Maturity Status and Injury Risk in Elite Youth Ski Racers: A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E364. [PMID: 31948103 PMCID: PMC6982196 DOI: 10.3390/ijerph17010364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022]
Abstract
Alpine ski racing is a sport with a high risk of injuries. In order to contribute to the longitudinal career development of young athletes, prevention measures should be elaborated. Therefore, the aim of the present study was to investigate prospectively the role of biological maturity status, and changes in anthropometric characteristics and physical fitness parameters over one season in elite youth ski racers younger than 15 years. Eighty-nine elite youth ski racers (39 females, 50 males), aged 10-14 years (mean age: 12.1 ± 1.3), were investigated. Anthropometric characteristics and physical fitness parameters were assessed prior and after the winter season; traumatic and overuse injuries were recorded over the 32 weeks. Binary logistic regression analyses (R² = 0.202-0.188) revealed that the biological maturity (Wald = 4.818; p = 0.028), and changes over the season in the jump agility test (Wald = 4.692; p = 0.03), in body height (Wald = 6.229; p = 0.013), and in leg length (Wald = 4.321; p = 0.038) represented significant injury risk factors. Athletes who could improve their jump agility performance more, had smaller changes in the anthropometric characteristics and who were closer to their peak height velocity were at a lower injury risk. In the context of injury prevention, regular neuromuscular training should be incorporated, and phases of rapid growth have to be considered.
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Affiliation(s)
- Lisa Steidl-Müller
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (C.H.); (C.R.)
| | - Carolin Hildebrandt
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (C.H.); (C.R.)
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, 5020 Salzburg, Austria;
| | - Christian Raschner
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (C.H.); (C.R.)
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Stenseth OMR, Barli SF, Martin RK, Engebretsen L. Injuries in elite women's ski jumping: surveillance through the 2017-18 FIS World Cup season. Br J Sports Med 2019; 54:44-48. [PMID: 31527043 PMCID: PMC6923946 DOI: 10.1136/bjsports-2019-100799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To describe the incidence, type, aetiology and severity of injuries sustained by the International Ski Federation World Cup level female ski jumpers during the 2017-18 season. DESIGN Prospective cohort study. METHODS Sixty-seven female ski jump athletes from 16 countries were followed throughout the 17-week winter season. Preseason baseline demographic data and injury history were recorded via questionnaire. Prospective biweekly reports and retrospective end-of-season interviews provided data on all injuries requiring medical attention. RESULTS Seventeen injuries were recorded, corresponding to an incidence of 25.4 injuries/100 athletes/season. The incidence of time-loss and severe injuries were found to be 17.9 and 4.5, respectively. The knee was the most common site of injury (4/17; 23.5%). Fourteen injuries occurred on the ski jump hill and crash-landing was the most common mechanism of injury (10/14; 71%). Eighty-five per cent of all moderate and severe injuries occurred in snow or windy conditions. Length of jumps resulting in injury averaged 83.7% (95% CI 72.9% to 94.4%) of hill size. Moderate injuries causing 8-28 days absence from training activities were most common (7/17; 41%) and there were three severe injuries necessitating >4 weeks absence. CONCLUSION Injuries among elite female ski jumpers are common and the majority are acute, resulting in time loss from training and competition. The knee was the most common site of injury and poor weather conditions may be a risk factor. Future studies are needed to identify risk factors for injury and to guide injury prevention initiatives.
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Affiliation(s)
- Oleane Marthea Rebne Stenseth
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway .,Oslo Sports Trauma Research Center, The Norwegian School of Sports Sciences, Oslo, Norway
| | - Sindre Fløtlien Barli
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Oslo Sports Trauma Research Center, The Norwegian School of Sports Sciences, Oslo, Norway
| | - Richard Kyle Martin
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Lars Engebretsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Oslo Sports Trauma Research Center, The Norwegian School of Sports Sciences, Oslo, Norway.,Orthopaedic Clinic, Oslo University Hospital and University of Oslo, Oslo, Norway
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Csapo R, Hoser C, Gföller P, Raschner C, Fink C. Fitness, knee function and competition performance in professional alpine skiers after ACL injury. J Sci Med Sport 2019; 22 Suppl 1:S39-S43. [DOI: 10.1016/j.jsams.2018.06.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/08/2018] [Accepted: 06/21/2018] [Indexed: 01/10/2023]
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Soligard T, Palmer D, Steffen K, Lopes AD, Grant ME, Kim D, Lee SY, Salmina N, Toresdahl BG, Chang JY, Budgett R, Engebretsen L. Sports injury and illness incidence in the PyeongChang 2018 Olympic Winter Games: a prospective study of 2914 athletes from 92 countries. Br J Sports Med 2019; 53:1085-1092. [DOI: 10.1136/bjsports-2018-100236] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2019] [Indexed: 11/03/2022]
Abstract
ObjectiveTo describe the incidence of injuries and illnesses sustained during the XXIII Olympic Winter Games, hosted by PyeongChang on 9–25 February 2018.MethodsWe recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the PyeongChang 2018 medical staff.ResultsIn total, 2914 athletes (1210 women, 42%; 1704 men, 58%) from 92 NOCs were observed for occurrence of injury and illness. NOC and PyeongChang 2018 medical staff reported 376 injuries and 279 illnesses, equalling 12.6 injuries and 9.4 illnesses per 100 athletes over the 17-day period. Altogether, 12% of the athletes incurred at least one injury and 9% at least one illness. The injury incidence was highest in ski halfpipe (28%), snowboard cross (26%), ski cross (25%), snowboard slopestyle (21%) and aerials (20%), and lowest in Nordic combined, biathlon, snowboard slalom, moguls and cross-country skiing (2%–6%). Of the 376 injuries recorded, 33% and 13% were estimated to lead to ≥1 day and >7 days of absence from sport, respectively. The highest incidences of illness were recorded in biathlon (15%), curling (14%), bobsleigh (14%) and snowboard slalom (13%). Thirty per cent of the illnesses were expected to result in time loss, and 70% affected the respiratory system. Women suffered 61% more illnesses than men.ConclusionOverall, 12% of the athletes incurred at least one injury during the Games and 9% an illness, incidences that are similar to the Olympic Winter Games of 2010 and 2014.
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Sexual dimorphism in the anatomy of the ulnar collateral thumb ligament. Wien Klin Wochenschr 2019; 131:216-220. [PMID: 30937541 DOI: 10.1007/s00508-019-1483-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/13/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Treatment of ruptured ulnar collateral thumb metacarpophalangeal (MCP) joint ligaments (UCL) necessitate a profound anatomic knowledge for optimal surgical repair in order to preserve range of motion and ensure postoperative joint stability. Therefore, knowledge of the angle between the UCL and the longitudinal axis of the first metacarpal bone could be useful. METHODS In this study 46 ulnar collateral thumb MCP joint ligaments in 15 male and 15 female embalmed anatomic specimens were dissected and the angles between the longitudinal axis of the first metacarpal bone and the proper (PUCL) as well as the accessory ulnar collateral thumb MCP ligament (AUCL) were measured. RESULTS In male specimens the angle for the PUCL measured on average 133.5° (±2.35°) and 122.75° (±3.8°) for the AUCL. A significantly different angle was measured for female specimens which showed on average 137.88° (±3.51°) for the PUCL and 128.65° (±4.14°) for the AUCL. CONCLUSIONS Optimal surgical repair or reconstruction of torn ulnar collateral thumb MCP joint ligaments should aim for an angle of approximately 135° in PUCL and 126° in AUCL in relation to the longitudinal axis of the metacarpal bone. Differences in men and women should be considered if possible. LEVEL OF EVIDENCE IV (anatomic study).
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Franchi MV, Ellenberger L, Javet M, Bruhin B, Romann M, Frey WO, Spörri J. Maximal Eccentric Hamstrings Strength in Competitive Alpine Skiers: Cross-Sectional Observations From Youth to Elite Level. Front Physiol 2019; 10:88. [PMID: 30833902 PMCID: PMC6388545 DOI: 10.3389/fphys.2019.00088] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/24/2019] [Indexed: 01/25/2023] Open
Abstract
Competitive alpine skiers are subject to substantial risks of injury, especially concerning the anterior cruciate ligament (ACL). During “landing back weighted” episodes, hamstrings may partially counteract the anterior shear force acting on the tibia by eccentrically resisting the boot-induced drawer of the tibia relative to the femur. The aim of the present study was to provide novel descriptive data and sport-specific reference values on maximal eccentric hamstrings strength (MEHS) in competitive alpine skiers from youth to elite level, and to explore potential relationships with sex, age and biological maturation. 170 competitive alpine skiers were investigated: 139 youth athletes (51 females, 88 males; age: 13.8 ± 0.59 years) and 31 elite athletes (19 females, 12 males; age: 21.7 ± 2.8 years). MEHS was assessed by the (Vald Performance, Newstead, Australia). U15 female skiers presented lower MEHS compared to female elite skiers for both limbs (R = 210 ± 44 N vs. 340 ± 48 N, respectively, p < 0.001, and L = 207 ± 46 N vs. 303 ± 35 N, respectively, p < 0.001). Similarly, lower MEHS was observed in U15 male skiers compared to male elite skiers for both limbs (R = 259 ± 51 N vs. 486 ± 62 N, respectively, p < 0.001, and L = 258 ± 57 N vs. 427 ± 54 N, respectively, p < 0.001). Correlations between MEHS and chronological age were modestly significant only for the U15 group (r = 0.37 and p < 0.001). When the correlations for the U15 group were performed between MHES and maturity offset (obtained from the calculation of biological age, i.e., age at peak height velocity), statistical significance was reached by all the correlations run for 3 variables (Males < 0: r = 0.59, p < 0.0001; Males > 0: r = 0.70, p < 0.0001; and Females > 0: r = 0.46, p < 0.0001, start of maturity offset = 0). This cross-sectional description of MEHS in alpine skiers from youth to elite level highlights the importance of biological maturation for MEHS values in youth athletes and presents novel data that may offer insights into new approaches for injury prevention.
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Affiliation(s)
- Martino V Franchi
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Laboratory for Muscle Plasticity, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lynn Ellenberger
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Marie Javet
- Section for Elite Sport, Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland.,Swiss-Ski, Muri bei Bern, Switzerland
| | - Björn Bruhin
- Section for Elite Sport, Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland.,Swiss-Ski, Muri bei Bern, Switzerland
| | - Michael Romann
- Section for Elite Sport, Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland
| | - Walter O Frey
- Balgrist Move>Med, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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Tarka MC, Davey A, Lonza GC, O'Brien CM, Delaney JP, Endres NK. Alpine Ski Racing Injuries. Sports Health 2019; 11:265-271. [PMID: 30689522 DOI: 10.1177/1941738119825842] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CONTEXT This article reviews the epidemiology of alpine ski racing-related injuries, risk factors, mechanisms of injury, and injury prevention strategies. EVIDENCE ACQUISITION Pertinent literature from peer-reviewed publications from 1976 through 2018. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 5. RESULTS The rate of injury in alpine ski racing is high. In general, knee injuries are the most common, with anterior cruciate ligament (ACL) disruptions being the most significant in terms of time loss from sport. Three specific mechanisms of ACL injury in alpine ski racers have recently been described (slip-catch, dynamic snowplow, and landing back-weighted). In contrast to other sports, female ski racers are not clearly at greater risk for ACL injury, especially at the highest level of competition. A high percentage of ski racers are able to return to their previous level of competition after ACL injury. Risk factors for injury and methods of injury prevention have been proposed; however, the rate of injury, particularly ACL injuries, has not decreased significantly. CONCLUSION Alpine ski racing has a high injury rate. ACL injuries in particular remain problematic. Further study is needed to identify modifiable risk factors and implementation of injury prevention strategies.
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Affiliation(s)
- Mitchell C Tarka
- Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont
| | - Annabelle Davey
- Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Geordie C Lonza
- Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Casey M O'Brien
- Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - John P Delaney
- Cleveland Clinic Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
| | - Nathan K Endres
- Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont
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Steidl-Müller L, Hildebrandt C, Raschner C, Müller E. Challenges of talent development in alpine ski racing: a narrative review. J Sports Sci 2019; 37:601-612. [PMID: 30676888 DOI: 10.1080/02640414.2018.1513355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Alpine ski racing is one of the most popular sports in many countries; nevertheless, selection disadvantages and severe injuries result in high dropout rates. In this review we summarize existing knowledge about the specific challenges associated with selection bias and injuries, and their effects on talent development in ski racing. The relative age effect (RAE) appears in all age categories of national Austrian and international alpine ski racing. Relatively younger athletes seem to only have a chance for selection if they are early maturing. Talent selection processes should consider both the biological maturity status as well as the relative age; additionally, a competition system based on a rotating cut-off date might contribute to a reduction of RAE. Youth and adolescent ski racers report lower injury rates compared to World Cup athletes. The knee was the most affected body part in relation to traumatic injuries. The most frequently reported overuse injuries were knee pain (youth) and low back pain (adolescent level). Athlete-related modifiable risk factors were core strength, neuromuscular control, leg extension strength and limb asymmetries. Based on these findings, prevention measures should be expanded to contribute to long-term injury prevention. In future research more multi-disciplinary, longitudinal studies should be performed.
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Affiliation(s)
- Lisa Steidl-Müller
- a Department of Sport Science , University of Innsbruck , Innsbruck , Austria
| | - Carolin Hildebrandt
- a Department of Sport Science , University of Innsbruck , Innsbruck , Austria
| | - Christian Raschner
- a Department of Sport Science , University of Innsbruck , Innsbruck , Austria
| | - Erich Müller
- a Department of Sport Science , University of Innsbruck , Innsbruck , Austria
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Steidl-Müller L, Hildebrandt C, Müller E, Fink C, Raschner C. Limb symmetry index in competitive alpine ski racers: Reference values and injury risk identification according to age-related performance levels. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:405-415. [PMID: 30450248 PMCID: PMC6230217 DOI: 10.1016/j.jshs.2018.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 04/23/2018] [Accepted: 05/10/2018] [Indexed: 05/27/2023]
Abstract
PURPOSE The aims of this study were to assess differences of limb symmetry index (LSI) in strength- and coordination-related tasks between high-level, competitive, noninjured ski racers of different age-related performance levels and to prospectively assess limb differences as a possible risk factor for traumatic and overuse injury in youth ski racers. METHODS The study (Study 1) included 285 high-level competitive ski racers (125 females, 160 males) of 3 age-related performance levels and based on the school system: 95 youth (10-14 years, secondary modern school), 107 adolescent (15-19 years, grammar school), and 83 elite athletes (20-34 years). To investigate the second aim (Study 2), 67 of the 95 youth athletes were included and any traumatic or overuse injuries were prospectively recorded over 2 seasons. All athletes performed 4 unilateral tests (strength related: one-leg counter movement jump (OL-CMJ) and one-leg isometric/isokinetic press strength test (OL-ILS); coordination related: one-leg stability test (OL-ST) and one-leg speedy jump test (OL-SJ)). The LSI was calculated by dividing the dominant leg by the nondominant leg and multiplying by 100. Kruskal-Wallis H tests and binary logistic regression analyses were conducted. RESULTS There were significant differences between the LSI of the 3 age-related performance-level groups only in the strength-related tests: the OL-CMJ (χ²(2, 285) = 9.09; p = 0.01) and the OL-ILS (χ²(2, 285) = 14.79; p < 0.01). The LSI for OL-ILS was found to be a significant risk factor for traumatic injury in youth ski racers (Wald = 7.08; p < 0.01). No significant risk factors were found for overuse injuries. CONCLUSION Younger athletes display slightly greater LSI values only in the strength-related tests. The cut-off value of limb differences of <10% for return to sport decisions seems to be appropriate for elite athletes, but for youth and adolescent athletes it has to be critically discussed. It seems to be necessary to define thresholds based on specific performance tasks (strength vs. coordination related) rather than on generalizations, and age-related performance levels must be considered. Limb differences in unilateral leg extension strength represent a significant injury risk factor in youth ski racers.
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Affiliation(s)
- Lisa Steidl-Müller
- Department of Sport Science, University of Innsbruck, Innsbruck 6020, Austria
| | - Carolin Hildebrandt
- Department of Sport Science, University of Innsbruck, Innsbruck 6020, Austria
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg 5400, Austria
| | - Christian Fink
- Research Unit for Orthopedic Sports Medicine and Injury Prevention, Institute of Psychology (ISAG), The Health & Life Sciences University (UMIT), Innsbruck 6020, Austria
- Gelenkpunkt – Sports and Joint Surgery, Innsbruck 6020, Austria
| | - Christian Raschner
- Department of Sport Science, University of Innsbruck, Innsbruck 6020, Austria
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Jordan MJ, Aagaard P, Herzog W. A comparison of lower limb stiffness and mechanical muscle function in ACL-reconstructed, elite, and adolescent alpine ski racers/ski cross athletes. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:416-424. [PMID: 30450249 PMCID: PMC6226549 DOI: 10.1016/j.jshs.2018.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE The aim of this study was to compare mechanical muscle function in the eccentric/concentric phases of vertical bilateral jumping in anterior cruciate ligament-reconstructed (ACLR), elite (ELITE), and adolescent (ADOL) alpine ski racers and ski cross athletes. METHODS Alpine ski racers/ski crossers (ACLR: n = 12, age = 26.7 ± 3.8 years; ELITE: n = 12, age = 23.9 ± 3.0 years; ADOL: n = 12, age = 17.8 ± 0.7 years; females: n = 6 per group, males: n = 6 per group) performed 5 maximal countermovement jumps (CMJs) and 5 squat jumps. The ground reaction forces for each limb were analyzed using dual force plate recording to obtain body center of mass (BCM) velocity, displacement, and power. The eccentric deceleration (ECC) and concentric phases were determined from BCM velocity. CMJ net concentric and ECC impulses were calculated (body mass normalized) along with the peak and mean BCM power and maximal vertical jump height. CMJ lower limb stiffness (LLS) was determined by the slope of the ground reaction forces vs. the BCM displacement curve over the ECC phase. Concentric and ECC asymmetry indices were calculated for each leg, and the left vs. right LLS was compared. Outcome measures (reported as mean ± SD) calculated as a 5-jump mean were normalized to body mass and compared using an analysis of variance. RESULTS No between-group differences were found for peak and mean power or jump heights. There were no group differences for LLS or net concentric phase impulse, but the net ECC impulse was lower in the ADOL group compared with ELITE skiers (ADOL: 1.33 ± 0.32 Ns/kg; ELITE: 1.59 ± 0.16 Ns/kg; p < 0.05). Although no group differences were found for ECC asymmetry indices, a group × limb interaction was found for LLS (p < 0.01), which was systematically higher in the right vs. the left limb of ADOL skiers (right: 54.1 ± 17.9 N/m/kg; left: 48.7 ± 15.7 N/m/kg; p < 0.01). CONCLUSION ADOL skiers demonstrated decreased ECC impulse and systematic right limb dominance in LLS compared with ACLR and ELITE skiers. The implication of these findings for injury and performance are unknown, but further investigation into these potential relationships is warranted.
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Affiliation(s)
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, SDU Muscle Research Cluster, University of Southern Denmark, Odense M5230, Denmark
| | - Walter Herzog
- Human Performance Laboratory, University of Calgary, Calgary AB T2N 1N4, Canada
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Müller E. Performance and safety in elite skiing sports: A big challenge on specificity, individuality, and complexity. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:379-380. [PMID: 30450245 PMCID: PMC6234022 DOI: 10.1016/j.jshs.2018.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 08/01/2018] [Indexed: 06/09/2023]
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Heinrich D, van den Bogert AJ, Nachbauer W. Peak ACL force during jump landing in downhill skiing is less sensitive to landing height than landing position. Br J Sports Med 2018; 52:1086-1090. [DOI: 10.1136/bjsports-2017-098964] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 11/03/2022]
Abstract
BackgroundCompetitive skiers face a high risk of sustaining an ACL injury during jump landing in downhill skiing. There is a lack of knowledge on how landing height affects this risk.ObjectivesTo evaluate the effect of varied landing height on peak ACL force during jump landing and to compare the effect of the landing height with the effect of the landing position varied by the trunk lean of the skier.MethodsA 25-degree-of-freedom sagittal plane musculoskeletal model of an alpine skier, accompanied by a dynamic optimisation framework, was used to simulate jump landing manoeuvres in downhill skiing. First, a reference simulation was computed tracking experimental data of competitive downhill skier performing a jump landing manoeuvre. Second, sensitivity studies were performed computing 441 landing manoeuvres with perturbed landing height and trunk lean of the skier, and the corresponding effects on peak ACL force were determined.ResultsThe sensitivity studies revealed that peak ACL force increased with jump height and backward lean of the skier as expected. However, peak ACL was about eight times more sensitive to the trunk lean of the skier compared with landing height. The decreased sensitivity of the landing height was based on the lower effects on the knee muscle forces and the shear component of the knee joint reaction force.ConclusionPreventive measures are suggested to focus primarily on avoiding trunk backward lean of the skier, and consequently on proper jump preparation and technique, and secondarily on strategies to reduce landing height during jumps.
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Abstract
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.
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Westin M, Harringe ML, Engström B, Alricsson M, Werner S. Risk Factors for Anterior Cruciate Ligament Injury in Competitive Adolescent Alpine Skiers. Orthop J Sports Med 2018; 6:2325967118766830. [PMID: 29780835 PMCID: PMC5954346 DOI: 10.1177/2325967118766830] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: There is a high risk for anterior cruciate ligament (ACL) injuries in alpine skiers. To reduce or try to prevent these injuries, intrinsic and extrinsic risk factors need to be identified. Purpose: To identify possible intrinsic and extrinsic ACL injury risk factors among competitive adolescent alpine skiers. Study Design: Case-control study; Level of evidence, 3. Methods: Between 2006 and 2009, a cohort of 339 alpine ski students (176 male, 163 female) from Swedish ski high schools were prospectively observed in terms of ACL injuries. First-time ACL injuries were recorded. In September, prior to each ski season, the skiers were clinically examined according to a specific knee protocol. Results: Overall, 11 male and 14 female skiers sustained a total of 25 first-episode ACL injuries. The majority of injuries occurred in the left knee (P < .05). Skiers who had participated in alpine skiing for >13 years (hazard ratio, 0.83; 95% CI, 0.68-1.00; P < .05) had a reduced risk of sustaining an ACL injury. Eighteen ACL injuries occurred during training, 12 in the technical discipline of giant slalom, and 8 in slalom. Fourteen skiers reported not to be fatigued at all at the time of injury, and 8 skiers reported that they were somewhat fatigued. Conclusion: ACL injuries occurred more often in the left knee than the right. This should be taken into consideration in the design of ACL injury prevention programs. Those who reported a higher number of active years in alpine skiing showed a reduced risk of sustaining an ACL injury. No other factor among those studied could be identified as an independent risk factor for ACL injury.
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Affiliation(s)
- Maria Westin
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Maria Westin, PhD, Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Box 5605, SE-114 27 Stockholm, Sweden ()
| | - Marita L. Harringe
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Björn Engström
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Marie Alricsson
- Department of Sport Science, Linnaeus University, Kalmar, Sweden
| | - Suzanne Werner
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Steenstrup SE, Mok KM, McIntosh AS, Bahr R, Krosshaug T. Reconstruction of head impacts in FIS World Cup alpine skiing. Br J Sports Med 2017; 52:709-715. [PMID: 29175825 DOI: 10.1136/bjsports-2017-098050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Prior to the 2013/2014 season, the International Ski Federation (FIS) increased the helmet testing speed from 5.4 to 6.8 m/s for alpine downhill, super-G and giant slalom. Whether this increased testing speed reflects head impact velocities in real head injury situations on snow is unclear. We therefore investigated the injury mechanisms and gross head impact biomechanics in seven real head injury situations among World Cup (WC) alpine skiers. METHODS We analysed nine head impacts from seven head injury videos from the FIS Injury Surveillance System, throughout nine WC seasons (2006-2015) in detail. We used commercial video-based motion analysis software to estimate head impact kinematics in two dimensions, including directly preimpact and postimpact, from broadcast video. The sagittal plane angular movement of the head was also measured using angle measurement software. RESULTS In seven of nine head impacts, the estimated normal to slope preimpact velocity was higher than the current FIS helmet rule of 6.8 m/s (mean 8.1 (±SD 0.6) m/s, range 1.9±0.8 to 12.1±0.4 m/s). The nine head impacts had a mean normal to slope velocity change of 9.3±1.0 m/s, range 5.2±1.1 to 13.5±1.3 m/s. There was a large change in sagittal plane angular velocity (mean 43.3±2.9 rad/s (range 21.2±1.5 to 64.2±3.0 rad/s)) during impact. CONCLUSION The estimated normal to slope preimpact velocity was higher than the current FIS helmet rule of 6.8 m/s in seven of nine head impacts.
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Affiliation(s)
- Sophie Elspeth Steenstrup
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kam-Ming Mok
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Andrew S McIntosh
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Tron Krosshaug
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Steenstrup SE, Bakken A, Bere T, Patton DA, Bahr R. Head injury mechanisms in FIS World Cup alpine and freestyle skiers and snowboarders. Br J Sports Med 2017; 52:61-69. [DOI: 10.1136/bjsports-2017-098240] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2017] [Indexed: 01/12/2023]
Abstract
IntroductionHead injuries represent a concern in skiing and snowboarding, with traumatic brain injuries being the most common cause of death.AimTo describe the mechanisms of head and face injuries among World Cup alpine and freestyle skiers and snowboarders.MethodsWe performed a qualitative analysis of videos obtained of head and face injuries reported through the International Ski Federation Injury Surveillance System during 10 World Cup seasons (2006–2016). We analysed 57 head impact injury videos (alpine n=29, snowboard n=13, freestyle n=15), first independently and subsequently in a consensus meeting.ResultsDuring the crash sequence, most athletes (84%) impacted the snow with the skis or board first, followed by the upper or lower extremities, buttocks/pelvis, back and, finally, the head. Alpine skiers had sideways (45%) and backwards pitching falls (35%), with impacts to the rear (38%) and side (35%) of the helmet. Freestyle skiers and snowboarders had backwards pitching falls (snowboard 77%, freestyle 53%), mainly with impacts to the rear of the helmet (snowboard 69%, freestyle 40%). There were three helmet ejections among alpine skiers (10% of cases), and 41% of alpine skiing injuries occurred due to inappropriate gate contact prior to falling. Athletes had one (47%) or two (28%) head impacts, and the first impact was the most severe (71%). Head impacts were mainly on snow (83%) on a downward slope (63%).ConclusionThis study has identified several characteristics of the mechanisms of head injuries, which may be addressed to reduce risk.
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Edouard P, Steffen K, Junge A, Leglise M, Soligard T, Engebretsen L. Gymnastics injury incidence during the 2008, 2012 and 2016 Olympic Games: analysis of prospectively collected surveillance data from 963 registered gymnasts during Olympic Games. Br J Sports Med 2017; 52:475-481. [PMID: 29032364 DOI: 10.1136/bjsports-2017-097972] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the incidence and characteristics of injuries in female and male gymnastics disciplines (artistic, rhythmic and trampoline) during three Olympic Games with a view to ultimately improving injury prevention. METHODS The National Olympic Committee's head physicians and the medical teams of the Local Organising Committee of the Olympic Games reported daily the occurrence (or non-occurrence) of newly sustained injuries in artistic, rhythmic and trampoline gymnastics on a standardised report form during the 2008, 2012 and 2016 Summer Olympic Games. RESULTS During the three Olympic Games, 81 injuries were reported in a total of 963 registered gymnasts, corresponding to an incidence of 84 injuries (95% CI 67 to 102) per 1000 registered gymnasts, with no difference in injury incidence between female and male gymnasts. Thirty-eight per cent of injuries led to time-loss from sport. The most frequent injury location and injury type were the ankle (22%) and sprain (35%), respectively. The most common diagnosis was ankle sprain (14% of all injuries and 23% of time-loss injuries). The injury incidence was highest in female (107±35) and male artistic gymnastics (83±32), followed by female rhythmic gymnastics (73±30), and lower in male (63±69) and female (43±43) trampoline gymnastics. CONCLUSIONS Research should focus on preventing injuries in artistic gymnastics and of the condition of ankle sprain. Injury surveillance studies should be continued during major championships and throughout the entire competitive season as the Olympic Games provides only a snapshot (although an important one).
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Affiliation(s)
- Pascal Edouard
- Inter-university Laboratory of Human Movement Science, University of Lyon, University Jean Monnet, Saint Etienne, France.,Department of Clinical and Exercise Physiology, Sports Medicine Unit, Faculty of Medicine, University Hospitalof Saint-Etienne, Saint-Etienne, France
| | - Kathrin Steffen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Centre, Oslo, Norway.,Department of Medical and Scientific, International Olympic Committee, Lausanne, Switzerland
| | - Astrid Junge
- Medical School Hamburg, Hamburg, Germany.,Swiss Concussion Centre, Schulthess clinik, Zurich, Switzerland
| | - Michel Leglise
- International Gymnastics Federation (FIG), Lausanne, Switzerland
| | - Torbjørn Soligard
- Department of Medical and Scientific, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Centre, Oslo, Norway.,Department of Medical and Scientific, International Olympic Committee, Lausanne, Switzerland.,Department of Orthopaedic Surgery, Faculty of Medicine, University of Oslo, Oslo, Norway
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Müller L, Hildebrandt C, Müller E, Fink C, Raschner C. Long-Term Athletic Development in Youth Alpine Ski Racing: The Effect of Physical Fitness, Ski Racing Technique, Anthropometrics and Biological Maturity Status on Injuries. Front Physiol 2017; 8:656. [PMID: 28912731 PMCID: PMC5583226 DOI: 10.3389/fphys.2017.00656] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/17/2017] [Indexed: 11/13/2022] Open
Abstract
Alpine ski racing is known to be a sport with a high risk of injuries. Because most studies have focused mainly on top-level athletes and on traumatic injuries, limited research exists about injury risk factors among youth ski racers. The aim of this study was to determine the intrinsic risk factors (anthropometrics, biological maturity, physical fitness, racing technique) for injury among youth alpine ski racers. Study participants were 81 youth ski racers attending a ski boarding school (50 males, 31 females; 9–14 years). A prospective longitudinal cohort design was used to monitor sports-related risk factors over two seasons and traumatic (TI) and overuse injuries (OI). At the beginning of the study, anthropometric characteristics (body height, body weight, sitting height, body mass index); biological maturity [status age at peak height velocity (APHV)]; physical performance parameters related to jump coordination, maximal leg and core strength, explosive and reactive strength, balance and endurance; and ski racing technique were assessed. Z score transformations normalized the age groups. Multivariate binary logistic regression (dependent variable: injury yes/no) and multivariate linear regression analyses (dependent variable: injury severity in total days of absence from training) were calculated. T-tests and multivariate analyses of variance were used to reveal differences between injured and non-injured athletes and between injury severity groups. The level of significance was set to p < 0.05. Relatively low rates of injuries were reported for both traumatic (0.63 TI/athlete) and overuse injuries (0.21 OI/athlete). Athletes with higher body weight, body height, and sitting height; lower APHV values; better core flexion strength; smaller core flexion:extension strength ratio; shorter drop jump contact time; and higher drop jump reactive strength index were at a lower injury risk or more vulnerable for fewer days of absence from training. However, significant differences between injured and non-injured athletes were only observed with respect to the drop jump reactive strength index. Regular documentation of anthropometric characteristics, biological maturity and physical fitness parameters is crucial to help to prevent injury in youth ski racing. The present findings suggest that neuromuscular training should be incorporated into the training regimen of youth ski racers to prevent injuries.
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Affiliation(s)
- Lisa Müller
- Department of Sport Science, University of InnsbruckInnsbruck, Austria
| | | | - Erich Müller
- Department of Sport Science and Kinesiology, University of SalzburgSalzburg, Austria
| | - Christian Fink
- Research Unit for Orthopedic Sports Medicine and Injury Prevention, Institute of Psychology (ISAG), The Health & Life Sciences University (UMIT)Hall, Austria.,Gelenkpunkt - Sports and Joint SurgeryInnsbruck, Austria
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Boesmueller S, Huf W, Rettl G, Dahm F, Meznik A, Muschitz G, Kitzinger H, Bukaty A, Fialka C, Vierhapper M. The influence of sex and trauma impact on the rupture site of the ulnar collateral ligament of the thumb. PLoS One 2017; 12:e0181754. [PMID: 28738083 PMCID: PMC5524296 DOI: 10.1371/journal.pone.0181754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 07/06/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE AND HYPOTHESIS Although sex- and gender-specific analyses have been gaining more attention during the last years they have rarely been performed in orthopaedic literature. The primary purpose of this study was to investigate whether for injuries of the UCL the specific location of the rupture is influenced by sex. A secondary study question addressed the sex-independent effect of trauma intensity on the rupture site of the UCL. METHODS This study is a retrospective analysis of all patients with either a proximal or distal bony avulsion or with a mid-substance tear or ligament avulsion of the UCL treated surgically between 1992 and 2015 at two level-I trauma centres. Trauma mechanisms leading to the UCL injury were classified into the following categories: (1) blunt trauma (i.e., strains), (2) low-velocity injuries (e.g., fall from standing height, assaults), and (3) high-velocity injuries (e.g., sports injuries, motor vehicle accidents). After reviewing the surgical records, patients were divided into three groups, depending upon the ligament rupture site: (1) mid-substance tears, (2) proximal ligament or bony avulsions and (3) distal ligament or bony avulsions. Dependencies between the specific rupture site and the explanatory variables (sex, age, and trauma intensity) were evaluated using χ2 test and logistic regression analysis. RESULTS In total, 1582 patients (1094 males, 488 females) met the inclusion criteria. Mean age was 41 years (range: 9-90 years). Taking into account the effects of sex on trauma intensity (p<0.001) and of trauma intensity on rupture site (p<0.001), mid-substance tears occurred more frequently in women, whereas men were more prone to distal ligament or bony avulsions (p<0.001). In other words, sex and rupture site correlated due to the effects of sex on trauma intensity and of trauma intensity on rupture site, but taking into account those effects there still was a significant effect of sex on rupture site. CONCLUSIONS The results of this study demonstrate that with regression analysis both sex and trauma intensity allow to predict rupture site in UCL injuries.
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Affiliation(s)
| | - Wolfgang Huf
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Gregor Rettl
- Medical University of Vienna, Department of Trauma Surgery, Vienna, Austria
| | - Falko Dahm
- AUVA Trauma Center Meidling, Vienna, Austria
| | | | - Gabriela Muschitz
- Medical University of Vienna, Department of Plastic and Reconstructive Surgery, Vienna, Austria
| | - Hugo Kitzinger
- Medical University of Vienna, Department of Plastic and Reconstructive Surgery, Vienna, Austria
| | - Adam Bukaty
- Medical University of Vienna, Division of General Anaesthesia and Intensive Care Medicine, Vienna, Austria
| | - Christian Fialka
- AUVA Trauma Center Meidling, Vienna, Austria
- Sigmund Freud University Vienna, Department of Trauma, Vienna, Austria
| | - Martin Vierhapper
- Medical University of Vienna, Department of Plastic and Reconstructive Surgery, Vienna, Austria
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Spörri J, Kröll J, Fasel B, Aminian K, Müller E. The Use of Body Worn Sensors for Detecting the Vibrations Acting on the Lower Back in Alpine Ski Racing. Front Physiol 2017; 8:522. [PMID: 28775695 PMCID: PMC5517454 DOI: 10.3389/fphys.2017.00522] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/06/2017] [Indexed: 01/09/2023] Open
Abstract
This study explored the use of body worn sensors to evaluate the vibrations that act on the human body in alpine ski racing from a general and a back overuse injury prevention perspective. In the course of a biomechanical field experiment, six male European Cup-level athletes each performed two runs on a typical giant slalom (GS) and slalom (SL) course, resulting in a total of 192 analyzed turns. Three-dimensional accelerations were measured by six inertial measurement units placed on the right and left shanks, right and left thighs, sacrum, and sternum. Based on these data, power spectral density (PSD; i.e., the signal's power distribution over frequency) was determined for all segments analyzed. Additionally, as a measure expressing the severity of vibration exposure, root-mean-square (RMS) acceleration acting on the lower back was calculated based on the inertial acceleration along the sacrum's longitudinal axis. In both GS and SL skiing, the PSD values of the vibrations acting at the shank were found to be largest for frequencies below 30 Hz. While being transmitted through the body, these vibrations were successively attenuated by the knee and hip joint. At the lower back (i.e., sacrum sensor), PSD values were especially pronounced for frequencies between 4 and 10 Hz, whereas a corresponding comparison between GS and SL revealed higher PSD values and larger RMS values for GS. Because vibrations in this particular range (i.e., 4 to 10 Hz) include the spine's resonant frequency and are known to increase the risk of structural deteriorations/abnormalities of the spine, they may be considered potential components of mechanisms leading to overuse injuries of the back in alpine ski racing. Accordingly, any measure to control and/or reduce such skiing-related vibrations to a minimum should be recognized and applied. In this connection, wearable sensor technologies might help to better monitor and manage the overall back overuse-relevant vibration exposure of athletes in regular training and or competition settings in the near future.
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Affiliation(s)
- Jörg Spörri
- Department of Sport Science and Kinesiology, University of SalzburgHallein-Rif, Austria.,Department of Orthopedics, Balgrist University Hospital, Zurich, University of ZurichZurich, Switzerland
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of SalzburgHallein-Rif, Austria
| | - Benedikt Fasel
- Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de LausanneLausanne, Switzerland
| | - Kamiar Aminian
- Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de LausanneLausanne, Switzerland
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of SalzburgHallein-Rif, Austria
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