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Posch M, Ruedl G, Greier K, Faulhaber M, Tecklenburg K, Schranz A, Schliernzauer B, Burtscher M. Impact of Environmental Factors on the ACL Injury Risk in Recreational Alpine Skiing. Int J Sports Med 2023; 44:1003-1008. [PMID: 37739010 PMCID: PMC10695699 DOI: 10.1055/a-2134-3908] [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: 10/03/2022] [Accepted: 07/11/2023] [Indexed: 09/24/2023]
Abstract
In recreational alpine skiing, an ACL injury represents the most common injury. Skiing is a complex activity where the skier interacts with the environment, such as weather, snow conditions, temperature, etc. Thus, the aim of this study was to evaluate the potential impact of environmental factors on ACL injury risk in recreational alpine skiers. Among a cohort of 392 ACL-injured skiers and 392 uninjured controls matched for sex and skiing skill, environmental factors were collected by questionnaire. Factors included weather conditions, snow conditions, perceived temperature, and slope difficulty at the time-point of the accident (ACL-injured skiers) or of questioning during the ski day (uninjured controls).Multiple logistic regression revealed that in addition to age, five environmental factors were significantly predictive of an ACL injury: fresh snow (OR 10.5), grippy snow (OR 7.8), icy slope condition (OR 12.4), very cold/cold perceived temperature (OR 1.6), and skiing on easy slopes (OR 6.9). In conclusion, besides age, environmental factors such as fresh and grippy snow, icy slope conditions, low temperatures, and flat slopes are associated with an increased ACL injury risk in recreational alpine skiing. Those factors are at least partly modifiable and should be taken into consideration for preventive strategies.
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Affiliation(s)
- Markus Posch
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck,
Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck,
Austria
| | - Klaus Greier
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck,
Austria
- University College of Education (KPH) Stams, A-6422 Stams,
Austria
| | - Martin Faulhaber
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck,
Austria
| | | | | | | | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck,
Austria
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Grønhaug G, Joubert LM, Saeterbakken AH, Drum SN, Nelson MC. Top of the podium, at what cost? injuries in female international elite climbers. Front Sports Act Living 2023; 5:1121831. [PMID: 37398555 PMCID: PMC10312002 DOI: 10.3389/fspor.2023.1121831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/15/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives Competitive sport climbing has made its way to the Olympic stage. This prestige has brought about route setting and training alterations which presumably affect injury epidemiology. Most of the climbing injury literature contains male climbers and lacks high performing athletes. Studies with both female and male climbers, rarely included separate analyses for performance level or sex. Therefore, injury concerns for elite female competitive climbers are impossible to discern. A former study examined the prevalence of amenorrhea in elite international female climbers (n = 114) and reported that 53.5% had at least one injury in the past 12 months, but injury details were excluded. This study's aim was to report these injury details and their associations with BMI, menstrual status and eating disorders of the cohort. Methods Online survey was emailed to competitive female climbers recruited through the IFSC database between June and August 2021. Data was analyzed using Mann-Whitney U, χ2 and logistic regression. Results 229 registered IFSC climbers opened the questionnaire and 114 (49.7%) provided valid responses. Respondents (mean ± SD; age = 22.9 ± 5 year) represented 30 different countries and more than half (53.5%, n = 61) reported an injury in the prior 12 months with the majority in shoulders (37.7%, n = 23) and fingers (34.4%, n = 21). Injury prevalence in climbers with amenorrhea was 55.6% (n = 10). BMI was not a significant predictor of injury risk (OR = 1.082, 95% CI: 0.89, 1.3; p = 0.440) while accounting for current ED over the past 12 months. However, the odds ratio for having an injury was doubled for those with an ED (OR = 2.129, 95% CI: 0.905, 5.010; p = 0.08). Conclusion With over half reporting recent injuries (<12 months) mostly to shoulders and fingers, development of new strategies for injury prevention in competitive female climbers are warranted. In addition, climbers with disordered eating behaviors and/or menstrual disturbances might be more prone to injury. More research in this population is required. Suitable screening to prevent these health issues and proper monitoring of these athletes are paramount to long-term athlete success.
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Affiliation(s)
- G. Grønhaug
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus, Sogndal, SFC, United States
| | - L. M. Joubert
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
| | - A. H. Saeterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus, Sogndal, SFC, United States
| | - S. N. Drum
- Student-Athlete High Performance Center and Sims-Treharne Collaborative Research Laboratory; Department of Health Sciences, Northern Arizona University, Flagstaff, AZ,United States
| | - M. C. Nelson
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
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Ruedl G, Posch M, Pocecco E, Tecklenburg K, Schliernzauer B, Kennedy MD, Faulhaber M, Burtscher M. Association of personal and equipment-related factors on ACL injury risk in alpine skiers with cautious or risk-taking behaviour: A case-control study. AIMS Public Health 2023; 10:348-359. [PMID: 37304585 PMCID: PMC10251046 DOI: 10.3934/publichealth.2023026] [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: 10/28/2022] [Revised: 04/17/2023] [Accepted: 04/12/2023] [Indexed: 06/13/2023] Open
Abstract
Background In recreational alpine skiing ACL injury risk depends on the interaction of individual characteristics and behaviours as well as on equipment-related factors. Aim to evaluate if and to what extent personal characteristics and equipment-related parameters are associated with ACL injury risk in cautious and risk-taking recreational alpine skiers. Methods A retrospective questionnaire-based, case-control study of ACL-injured and uninjured in a cohort of cautious as well as risk-taking recreational skiers was conducted. Participants self-reported their demographics, skiing skill level, and risk-taking behaviour. Ski length, side-cut radius, widths of the tip, waist, and tail were recorded from each participant's skis. Standing heights at the front and rear components of the ski binding were measured with a digital sliding caliper, and a standing height ratio between the front and rear components was calculated. Ski boot sole abrasion at the toe and heel pieces was also measured with the digital sliding caliper. Results In total, 1068 recreational skiers (50.8% females) with a mean age of 37.8 ± 12.3 years participated, of whom 193 (22.0%) sustained an ACL injury, and 330 (30.9%) participants reported a risk-taking behaviour. Results of the multiple logistic regression analyses revealed that a higher age, a lower skill level, a higher standing height ratio, and greater ski boot sole abrasion at the toe as well as heel pieces were independently associated with an increased ACL injury risk in both the cautious and the risk-taking group. Among cautious skiers, a longer ski length was an additional significant risk factor for sustaining an ACL injury. In conclusion, the same personal and equipment related characteristics contribute to an increase in the ACL injury risk regardless of risk-taking behaviour, with the only difference that longer skis represent an additional risk factor in cautious skiers.
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Affiliation(s)
- Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Markus Posch
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Elena Pocecco
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | | | - Michael D. Kennedy
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Van Vliet Ctr, Edmonton, Alberta, T6G 2H9, Canada
| | - Martin Faulhaber
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Hermann A, Christl V, Hastreiter V, Carqueville P, Ellenberger L, Senner V. Muscular Fatigue and Quadriceps-to-Hamstring Ratio in Alpine Skiing in Women over 40 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085486. [PMID: 37107769 PMCID: PMC10138889 DOI: 10.3390/ijerph20085486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 05/11/2023]
Abstract
(1) Background: In alpine skiing, senior athletes and especially women have a high risk of knee injury. This may also be related to muscular fatigue (MF) of the knee-stabilizing thigh muscles. This study investigates both the evolution of muscle activity (MA) and of MF of the thighs throughout an entire skiing day. (2) Methods: n = 38 female recreational skiers over 40 years of age performed four specific skiing tasks (plough turns, V-steps uphill, turns with short, and middle radii) at specific times, while freely skiing the rest of the day. Surface EMG of the thigh muscle groups (quadriceps and hamstrings) was measured using special wearables (EMG pants). Apart from standard muscle activity parameters, the EMG data were also processed in the frequency domain to calculate the mean frequency and its shift over the day as a metric of muscle fatigue. (3) Results: The EMG pants showed reliable signal quality over the entire day, with BMI not impacting this. MF increased during skiing before and for both muscle groups significantly (p < 0.006) during lunch. MF, however, was not reflected in the quadriceps-hamstrings ratio. The plough manoeuvre seems to require significantly (p < 0.003) more muscle dynamics than the three other tasks. (4) Conclusion: MF may be quantified over an entire skiing day and thus fatigue information could be given to the skier. This is of major importance for skiers at the beginner level dominantly performing plough turns. Crucial for all skiers: There is no regenerative effect of a 45-min lunch break.
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Affiliation(s)
- Aljoscha Hermann
- Professorship of Sport Equipment and Materials, TUM School of Engineering and Design, Technical University of Munich, 85748 Garching, Germany; (V.C.); (V.H.); (V.S.)
- Correspondence:
| | - Vera Christl
- Professorship of Sport Equipment and Materials, TUM School of Engineering and Design, Technical University of Munich, 85748 Garching, Germany; (V.C.); (V.H.); (V.S.)
| | - Valentin Hastreiter
- Professorship of Sport Equipment and Materials, TUM School of Engineering and Design, Technical University of Munich, 85748 Garching, Germany; (V.C.); (V.H.); (V.S.)
- Institute of Sports Science, Faculty of Economics and Social Sciences, Eberhard Karls Universität Tübingen, 72074 Tübingen, Germany
| | - Patrick Carqueville
- Professorship of Sport Equipment and Materials, TUM School of Engineering and Design, Technical University of Munich, 85748 Garching, Germany; (V.C.); (V.H.); (V.S.)
| | - Lynn Ellenberger
- Swiss Council for Accident Prevention BFU, Hodlerstrasse 5A, 3001 Bern, Switzerland;
| | - Veit Senner
- Professorship of Sport Equipment and Materials, TUM School of Engineering and Design, Technical University of Munich, 85748 Garching, Germany; (V.C.); (V.H.); (V.S.)
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Ruedl G, Posch M, Tecklenburg K, Schranz A, Faulhaber M, Burtscher M. Skill-Specific Differences in Equipment-Related Risk Factors for ACL Injury in Male and Female Recreational Skiers. Orthop J Sports Med 2023; 11:23259671231155841. [PMID: 36896096 PMCID: PMC9989403 DOI: 10.1177/23259671231155841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/08/2022] [Indexed: 03/11/2023] Open
Abstract
Background In recreational alpine skiing, the anterior cruciate ligament (ACL) is affected in approximately 50% of serious knee injuries. There are established sex-based and skill-based differences in ACL injury risk, but the potential impact of equipment used (eg, skis, bindings, and boots) has not been evaluated. Purpose To evaluate individual and equipment-related risk factors for an ACL injury depending on sex and skill level. Study Design Case-control study; Level of evidence, 3. Methods This was a retrospective questionnaire-based, case-control study of female and male skiers with and without ACL injuries during 6 winter seasons (from 2014-2015 to 2019-2020). Demographic data, skill level, equipment specifications, risk-taking behavior, and ownership of ski equipment were recorded. Ski geometry (ski length; sidecut radius; and widths of the tip, waist, and tail) was taken from each participant's ski. The standing heights of the front and back part of the ski binding were measured using a digital sliding caliper, and the standing height ratio was calculated. Abrasion of the ski boot sole was also measured at the toe and heel. Participants were divided by sex into less and more skilled skiers. Results A total of 1817 recreational skiers participated in this study, of whom 392 (21.6%) sustained an ACL injury. A greater standing height ratio and more abrasion at the toe of the boot sole were associated with increased ACL injury risk in both sexes, independent of the skill level. Riskier behavior increased the injury risk only in male skiers, independent of the skill level, and longer skis increased the injury risk only in less skilled female skiers. Older age, the use of rented/borrowed skis, and more abrasion at the heel of the boot sole were independent risk factors for ACL injury in the more skilled skiers of both sexes. Conclusion Individual and equipment-related risk factors for an ACL injury partly differed according to skill level and sex. Consideration of the demonstrated equipment-related factors should be implemented in order to reduce ACL injuries in recreational skiers.
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Affiliation(s)
- Gerhard Ruedl
- Department of Sport Science, Universität Innsbruck, Innsbruck, Austria
| | - Markus Posch
- Department of Sport Science, Universität Innsbruck, Innsbruck, Austria
| | | | | | - Martin Faulhaber
- Department of Sport Science, Universität Innsbruck, Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, Universität Innsbruck, Innsbruck, Austria
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Rauch A. [Knee injuries in winter sports]. ORTHOPADIE (HEIDELBERG, GERMANY) 2022; 51:870-881. [PMID: 36239771 PMCID: PMC9663366 DOI: 10.1007/s00132-022-04317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/05/2022]
Abstract
Winter sports represent a relevant entity for knee injuries due to their great popularity. In alpine skiing and snowboarding, knee joint injuries are the most common affected body regions, while in ice hockey they are in third place. Various accident mechanisms lead to different injury types and severities. In addition to medial collateral ligament injuries, anterior cruciate ligament injuries are of particular importance. In professional sports, severe combination injuries are more common. Therapy is exemplified using the anterior cruciate ligament rupture. The gold standard is replacement ligament surgery. The return-to-sport rate of 80% for skiing and snowboarding is comparable to summer sports such as football, basketball or baseball. For ice hockey, it is even better. Prevention is possible by targeted training programs, but also by optimizing the equipment and its adjustment.
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Affiliation(s)
- Alexander Rauch
- ECOM - Praxis für Orthopädie, Sportmedizin & Unfallchirurgie, Arabellastraße 17, 81925, München, Deutschland.
- Sporttraumatologie und Kniechirurgie, ATOS-Klinik München, Effnerstraße 38, 81925, München, Deutschland.
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Ruedl G, Posch M, Tecklenburg K, Schranz A, Faulhaber M, Pocecco E, Burtscher M. A Comparison of ACL Injury Risk, Ski Geometry and Standing Height Parameters between Skiers with Rented and with Owned Skis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711124. [PMID: 36078844 PMCID: PMC9518475 DOI: 10.3390/ijerph191711124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/03/2022] [Accepted: 09/04/2022] [Indexed: 05/13/2023]
Abstract
to evaluate if ACL injuries are associated with recreational skiers using rented skis and whether individual factors, ski geometry parameters and standing heights differ between skiers who rented or owned skis. A retrospective questionnaire-based, case-control study of ACL-injured and uninjured recreational skiers was conducted during six winter seasons. Age, sex, body height, body weight, nationality, ownership of skis, skill level, risk-taking behavior, ski length, side-cut radius, widths of the tip, waist, and tail, and the standing heights at the front and rear components of the ski binding were assessed. Additionally, ratios between ski widths and a standing height ratio were calculated. Altogether, 1780 skiers (48.9% females) with a mean age of 39.2 ± 13.0 years participated, of whom 22.0% sustained an ACL injury and 32.3% rented skis. ACL injury risk was significantly associated with rented skis (OR 3.2, 95% CI 2.5-4.0). Compared to skiers using own skis, participants who rented skis were more likely female, smaller and lighter, tourists, less skilled and more cautious. In comparison to owned skis, rented skis showed significantly lower mean values in ski length, side-cut radius, ski widths, and for the three ski widths ratios. Additionally, standing heights were significantly lower while standing height ratio was higher for rented skis. Beside individual factors, equipment-related factors should be considered when renting skis in order to reduce ACL injury risk.
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Affiliation(s)
- Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
- Correspondence: ; Tel.: +43-512-507-45861
| | - Markus Posch
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
| | | | | | - Martin Faulhaber
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
| | - Elena Pocecco
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
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