[Show abstract][Hide abstract]ABSTRACT: Background: Female recreational skiers have twice the rate of knee injuries and three time the rate of ACL injuries compared with their male counterparts. Female skiers suffering from a knee injury reported a significantly higher proportion of failure of binding release than knee injured male skiers.
Purpose: To evaluate factors associated with failure of binding release among ACL injured male and female recreational skiers.
Study design: Cohort study.
Methods: Among a cohort of 498 recreational skiers (68% females) suffering from an ACL injury (complete rupture or partial rupture), age, sex, height, weight, self-reported skill level and self-reported risk taking behaviour, gear origin, ski length, date of last binding adjustment, perceived speed at the moment of injury, type of fall, and failure of binding release of the ski of the injured knee, were collected by questionnaire.
Results: Failure of binding release was reported within 78% of cases and was significantly higher for females compared to males (83 vs 66%, p<0.001) with an adjusted OR of 2.7 (95% CI 1.7 to 4.4). A higher perceived speed at the moment of injury was significantly associated with a decreasing proportion of failure of binding release. A slow perceived speed was independently associated with failure of binding release (adjusted OR 2.0; 95% CI 1.2 to 3.5). There was a significantly higher proportion of failure of binding release during backward falling compared to forward falling (87 vs 72%, p=0.002); similarly, a higher proportion of failure of binding release occurred in cases of complete rupture compared with a partial tear of the ACL (81 vs 64%, p=0.001), respectively.
Conclusions: Among this cohort of ACL-injured skiers, failure of binding release was significantly associated with female sex, a slow perceived speed at the moment of injury and complete rupture of the ACL.
No preview · Article · Dec 2015 · British Journal of Sports Medicine
[Show abstract][Hide abstract]ABSTRACT: Zusammenfassung
Hintergrund: Im alpinen Freizeit-Skilauf betrifft rund ein Drittel aller Verletzungen das Kniegelenk und die häufigste Diagnose bei erwachsenen Skifahrern beider Geschlechter ist eine Verletzung des Vorderen Kreuzbandes (VKB) mit 15-21% aller Verletzungen. Generelle präventive Empfehlungen zur Reduzierung des Risikos einer Skiverletzung beinhalten das Vermeiden von Ermüdung. Allerdings ist unklar, in welchem Ausmaß die Ermüdung bei männlichen und weiblichen Skifahrern mit einer VKB-Verletzung eine Rolle spielt.
Methoden: In der vorliegende Studie wurden prospektiv VKB-verletzte Skifahrer während 5 Wintersaisonen von 2009/10 bis 2013/14 in zwei Österreichischen Skikliniken befragt. Gesamt wurden 588 Personen (67,9% weiblich) mit einem durchschnittlichen Alter von 42,1±10,9 Jahren hinsichtlich demographischer Daten, Skikönnen, Risikoverhalten, aktueller Fitness, zum Tag und Uhrzeit des Unfalles sowie zur Skidauer und zur subjektiven Ermüdung in den Beinen zum Unfallzeitpunkt befragt.
Ergebnisse: VKB-verletzte Männer schätzten ihr Skikönnen und ihren Fitnesszustand signifikant höher ein als VKB-verletzte Frauen und der Anteil an einem eher riskanten Verhalten war bei Männern signifikant höher als bei Frauen. Ungefähr ein Drittel der Männer und Frauen verletzten sich am ersten Tag des Skiurlaubes und rund 57% während der ersten beiden Tage. Allerdings zogen sich Frauen signifikant häufiger eine VKB-Verletzung während der ersten Stunde auf der Skipiste (28 vs. 17%) sowie während der ersten beiden Stunden Skifahren (52 vs. 44%) zu als Männer. Geschlechtsunabhängig verspürten zum Zeitpunkt des Unfalls rund 81% der Männer und Frauen keine oder nur eine sehr geringe Ermüdung in den Beinen.
Schlussfolgerung: Basierend auf den Ergebnissen dieser Studie zeigt sich, dass die Ermüdung weder bei männlichen noch weiblichen Skifahrern ein wesentlicher Risikofaktor für eine VKB-Verletzung darzustellen scheint.
Introduction: In recreational alpine skiing, the knee joint is the most common anatomical location of an injury with about one third of all injuries sustained by male and female skiers and the most common diagnosis is a tear of the anterior cruciate ligament (ACL) with 15-21% of all injuries in adult skiers of both sexes. Generally, preventive recommendations to reduce the incidence of ski injuries include avoiding fatigue. However, it seems unclear to which extent ACL injuries in male and female recreational skiers are related to perceived fatigue.
Methods: This study was conducted as a prospective questionnaire based investigation during the five winter seasons between 2009/2010 and 2013/2014 in two Austrian ski injury clinics. In total, 588 skiers (67.9% females) with a mean age of 42.1±10.9 years were interviewed about demographics, skiing ability, skiing behavior, fitness, as well as about day and time of accident, skiing duration and perceived fatigue at the moment of accident.
Results: ACL injured males reported a significantly higher skiing ability and fitness level as well as a more risky behaviour on ski slopes compared to females. About one third of males and females injured their ACL within the first day of the ski trip and about 57% within the first two days, with no sex differences. Female skiers suffered significantly more often from an ACL injury during the first hour of skiing (28 vs. 17%) as well as during the first two hours of skiing compared to males (52 vs. 44%). About 81% of males and females felt no fatigue or a trace of fatigue in their legs at the time of accident, with no sex differences.
Conclusion: Based on the findings of this study, fatigue seems not to be a major risk factor for an ACL injury among male and female recreational skiers.
No preview · Article · Dec 2015 · Sportverletzung · Sportschaden
[Show abstract][Hide abstract]ABSTRACT: In recreational alpine skiing, the knee joint accounts for about one third of all injuries in male and female skiers. However, female recreational skiers have twice the knee injury incidence of male skiers, and the anterior cruciate ligament (ACL) injury risk is 3 times greater in female skiers.
To evaluate whether leg dominance is a risk factor for noncontact ACL injuries in female recreational skiers.
Cohort study; Level of evidence, 3.
The relationships between leg dominance, side of knee injury, and gender were analyzed in 65 male and 128 female skiers suffering from a noncontact ACL rupture.
Anterior cruciate ligament ruptures of the left knee occurred more frequently in female than in male recreational skiers (68% vs 48%, P = .006). For both genders, in 90%, the right leg was the preferred kicking leg. With regard to leg dominance, female skiers suffered more often from ACL ruptures of their nondominant leg than male skiers (63% vs 45%, P = .020). An adjusted odds ratio of 2.0 (95% confidence interval, 1.0-3.8) was calculated.
Female skiers showed a 2-fold higher risk of suffering from an ACL rupture on their nondominant leg. Therefore, leg dominance seems to be a risk factor for noncontact ACL injuries in female recreational skiers.
No preview · Article · Mar 2012 · The American Journal of Sports Medicine
[Show abstract][Hide abstract]ABSTRACT: In recreational alpine skiing, ACL injury risk is 3 times greater in females. However, since the introduction of carving skis ACL injury risk seems to have decreased. No study has yet investigated the distribution of ACL injury mechanisms in male and female carving skiers. Therefore, the aim of the study was to investigate potential gender specific differences of ACL injury mechanisms and related factors among carving skiers. In total, 220 recreational carving skiers (59 males and 161 females) suffering from an ACL injury volunteered for this study. Demographic data, skiing ability, equipment related and environmental factors, circumstances and causes for the fall, and type of fall (injury mechanisms) were collected by questionnaire. The forward twisting fall is the most reported ACL injury mechanism in both gender (p=0.672) accounting for 54% of all injuries, although male and female skiers differed significantly with regard to circumstances of fall (p=0.001) and actions when ACL injury occurred (p=0.04). Bindings not releasing at the time point of accident occurred 2.6 times more with females than with males (p=0.005). The forward twisting fall seems to have become the dominant ACL injury mechanism both in male and female recreational skiers since the introduction of carving skis.
No preview · Article · Jun 2011 · International Journal of Sports Medicine
[Show abstract][Hide abstract]ABSTRACT: The aim of this study was to investigate the interaction of potential intrinsic and extrinsic risk factors in ACL injured recreational female skiers. 93 female recreational skiers who had suffered a non-contact ACL injury and 93 age-matched controls completed a self-reported questionnaire relating to intrinsic risk factors (menstrual history, BMI, previous knee injuries, self reported weekly sports participation) and extrinsic risk factors (type of ski used, time of last binding adjustment, snow condition, weather and slope difficulty). A logistic regression model revealed the following independent ACL injury risk factors for female recreational skiers: icy snow conditions (odds ratio, 24.33; 95% confidence interval, 6.8-86.5, P<0.001), skiing during snowfall (odds ratio, 16.63; 95% confidence interval, 1.8-152.1, P=0.013), use of traditional skis (odds ratio, 10.49; 95% confidence interval, 2.0-54.5, P=0.005), and preovulatory phase of menstrual cycle (odds ratio, 2.59; 95% confidence interval, 1.2-5.5, P=0.013). In conclusion, ACL injuries in female recreational skiers are the result of a complex interaction of intrinsic and extrinsic risk factors.
No preview · Article · May 2011 · International Journal of Sports Medicine
[Show abstract][Hide abstract]ABSTRACT: In alpine skiing, the knee represents the dominant injury location with marked gender differences. Snow, slope and weather conditions as well as altitude and low temperatures are thought to influence the prevalence of knee injuries. Therefore, ski patrol injury reports were used to compare gender-specific prevalence of knee injuries with regard to several environmental factors including the actual air temperatures. A total of 1039 non-contact knee injuries were reported with a corresponding prevalence of knee injuries of 44.4% (males: 30.1%; females: 57.4%). Temperature quartiles of all recorded injuries were calculated to compare gender-specific prevalence of knee injury with regard to temperatures. Comparing the first quartile (mean temperature -11°C) with the fourth quartile (mean temperature +3°C), the prevalence of knee injury in female skiers was higher at low ambient temperatures (61% vs 50%, odds ratio: 1.60, 95% confidence interval: 1.16-2.22; P=0.005) while no such association was found for male skiers. Additionally, knee-injured females showed a twofold prevalence when skiing during snowfall compared with females with other injuries (15.4% vs 8.6%; P=0.001). No other environmental factor showed a significant association with the gender-specific prevalence of knee injury. In conclusion, low ambient temperature and snowfall are important environmental risk factors for knee injuries in female skiers.
No preview · Article · Apr 2011 · Scandinavian Journal of Medicine and Science in Sports
[Show abstract][Hide abstract]ABSTRACT: In alpine skiing, knee injuries show marked sex differences, as female recreational skiers have a 2-fold greater incidence of knee injuries and a 3-fold higher ACL injury risk than male skiers. General preventive recommendations to reduce the incidence of ski injuries include avoiding fatigue. However, no study has yet examined to which extent ACL injuries in female recreational skiers are related to perceived fatigue. Therefore, 68 ACL injured female skiers and 136 matched controls were interviewed about skiing time and perception of fatigue in legs and the whole body at the time point of accident and questioning, respectively. In addition, skiing ability, self estimated fitness level, quantity and quality of breaks per run, sleeping quality, and group skiing and skill level of group members have been recorded. Patients and controls differ significantly regarding the duration of skiing as about 81% of ACL injuries occurred within the first 3 hours (odds ratio = 4.4; P < 0.001). In patients about 71% and in controls about 27% felt no fatigue or a trace of fatigue in their legs at the time of injury and questioning, respectively (P < 0.001). No other factors showed a significant difference. Therefore, fatigue seems no major risk factor for an ACL injury in female recreational skiing.
No preview · Article · Mar 2010 · Journal of ASTM International
[Show abstract][Hide abstract]ABSTRACT: While ACL injury mechanisms in skiers using traditional skis are well studied, no study has yet investigated the distribution of injury mechanisms in carving skiers. In traditional skiers, the backward twisting fall seems to be the dominant injury mechanism, especially in female skiers. Female recreational skiers have a threefold higher risk to sustain an ACL injury than male skiers; therefore, it is important to determine if carving skis influence the distribution of injury mechanisms and the related frequencies of ACL injuries in female skiers. We investigated the frequencies of injury mechanisms and related factors in 65 ACL-injured female carving skiers by questionnaire. The forward twisting fall was the most reported ACL injury mechanism with about 51%, followed by the backward twisting fall within 29% of cases. Catching an edge of the ski (59 vs. 24%, P = 0.03) when executing turns (69 vs. 41%, P = 0.053) was a more frequent cause for forward twisting falls than for the other types of falling. While 29% of bindings released during a forward twisting fall, only 3.1% released during the remaining mechanisms. In contrast to traditional skiers, the forward twisting fall was the dominant injury mechanism in female carving skiers with ACL injury.
No preview · Article · Aug 2009 · Knee Surgery Sports Traumatology Arthroscopy
[Show abstract][Hide abstract]ABSTRACT: Oral contraceptive use and menstrual cycle phase are suggested to influence the risk of anterior cruciate ligament (ACL) injuries in female athletes. However, only few data are available for recreational sports. Therefore, female recreational skiers with a non-contact ACL injury and age-matched controls completed a self-reported questionnaire relating to menstrual history, oral contraceptive use and previous knee injuries. Menstrual history data were used to group subjects into either preovulatory or postovulatory phases of menstrual cycle. Our findings suggest that oral contraceptive use did not show any protective effect against ACL injuries nor did self-reported previous knee injuries show any association with ACL injury rate in recreational alpine skiing. Analysis of menstrual history data revealed that recreational skiers in the preovulatory phase were significantly more likely to sustain an ACL injury than were skiers in the postovulatory phase.
No preview · Article · Apr 2009 · Knee Surgery Sports Traumatology Arthroscopy
[Show abstract][Hide abstract]ABSTRACT: Alpine skiing is one of the most popular recreational winter sports. About 8 million downhill skiers and snow boarders alone visit the Austrian Alps annually and complete more than 500 million ski lift transports. With the high interest in alpine skiing by locals and tourists, there is a natural increase in the number of ski-related injuries. However, the average injury rate is relatively low (< 2.0 injured persons per 1000 skier days). In alpine skiing the knee represents the dominant anatomical location of injuries. Epidemiological data demonstrate that knee injuries account for one third of all injuries in adult skiers. Approximately 50% of serious knee injuries in alpine skiing affect the anterior cruciate ligament (ACL). However, female recreational skiers have a 3-fold higher risk to sustain an ACL injury than male skiers. This difference may be related to external and internal risk factors, e.g. age, menstrual cycle phase, and fitness. Studies indicate higher age and the preovulatory phase to put female skiers at an increased risk for ACL injury. Additionally, the fitness level of female skiers with knee injury seems to be lower when compared to females suffering from other injuries. External risk factors are related to skiing equipment and environmental factors. Using a not newly adjusted binding, icy slope conditions, and bad weather conditions increase the risk of knee injury in female skiers. Therefore, preventive recommendations have to consider both, internal and external risk factors.
No preview · Article · Jan 2009 · Deutsche Zeitschrift für Sportmedizin