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Injuries about the shoulder in skiing and snowboarding.

Br J Sports Med. 2009 Dec;43(13):987-92

Authors: McCall D, Safran MR

There has been a decrease in the overall injury rate, particularly the rate of lower-extremity injuries, for alpine skiing, with a resultant increase in the ratio of upper-extremity to lower-extremity injuries. The upper extremity is injured nearly twice as often during snowboarding than alpine skiing, with approximately half of all snowboarding injuries involving the upper extremity. Shoulder injuries are likely under-reported, as many patients seek evaluation for minor shoulder injuries with their local physicians, and not at the ski medical clinic, where most epidemiology studies obtain their data. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper-extremity injuries. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper-extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are rotator cuff strains, glenohumeral dislocations, acromioclavicular separations and clavicle fractures. It is still unclear, when comparing snowboarding and skiing injury data, which sport has the higher incidence of shoulder injuries. Stratifying shoulder injuries by type allows better delineation as to which sport has an increased incidence of certain injury patterns. The differing mechanisms of injury combined with distinct equipment for each sport plays a role in the type and frequency of shoulder injuries seen in these two subgroups. With the increased ratio of upper- to lower-extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries are seen with increasing frequency by those who care for alpine sport injuries. According to recent epidemiological data, only clavicle and humerus fractures have shown increased rates of incidence among alpine skiers. Over the past 30 years, there has been a general decrease in both upper- and lower-extremity injuries which can be attributed to improved designs of protective equipment, increased awareness of injury patterns and emphasis on prevention. In the future, physicians and therapists who treat this population must be comfortable and confident in their treatment algorithms to help keep skiers and snowboarders conditioned and ready for the slopes and develop strategies for the prevention of upper-extremity injuries associated with these activities.

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– Injuries about the shoulder in skiing and snowboarding.

Factors associated with self-reported risk-taking behaviour on ski slopes.

Br J Sports Med. 2010 Feb;44(3):204-6

Authors: Ruedl G, Pocecco E, Sommersacher R, Gatterer H, Kopp M, Nachbauer W, Burtscher M

BACKGROUND: In recent years, discussions have arisen about the potential influence of wearing a ski helmet on an increasing level of risk taking and higher speeds on ski slopes. OBJECTIVE: To evaluate factors associated with self-reported risk-taking behaviour in recreational skiers and snowboarders. METHODS: Speeds of skiers and snowboarders were measured with a radar speed gun and sex, age, nationality, height, weight and helmet use, used type of gear, self-estimated skill level and self-estimated fitness level were recorded. In addition, participants were asked if they considered themselves as cautious or risk-taking skier or snowboarder. RESULTS: In total, 453 skiers (39.6 (14.8) years) and 74 snowboarders (26.4 (9.6) years) have been interviewed. A stepwise forward logistic regression model revealed five independent factors for a risk-taking behaviour on slopes. Adjusted OR and their 95% CI showed that risk takers were <40 years (OR 2.4, 95% CI 1.51 to 3.80), had a higher skill level (OR 2.1, 95% CI 1.25 to 3.50), were more likely males (OR 2.0, 95% CI 1.22 to 3.26), had a lower body mass index (22.8 vs 24.2) and skied with higher speeds (on average 53 vs 45 km/h) compared to cautious skiers. CONCLUSION: Risk-taking behaviour on ski slopes is associated with younger age, higher skiing ability, male sex, lower body mass index and on average higher speeds. Helmet use is not associated with riskier behaviour on slopes. In addition, helmet use has to be recommended because helmet use reduces the risk of head injuries among skiers and snowboarders.

20231601

– Factors associated with self-reported risk-taking behaviour on ski slopes.

The effectiveness of helmet wear in skiers and snowboarders: a systematic review.

Br J Sports Med. 2010 May 29;

Authors: Cusimano MD, Kwok J

Objective To summarise the best available evidence to determine the impact of helmet use on head injuries, neck injuries and cervical spine injuries in skiers and snowboarders. Data sources Relevant publications were identified through electronic searches of MEDLINE, PubMed, EMBASE, CINAHL and the Cochrane Library databases (1966-2009) in addition to manual reference checks of all included articles. Review methods 45 articles were identified through our systematic literature search. Of these, 10 studies met the inclusion criteria after two levels of screening. Two independent reviewers critically appraised the studies. Data were extracted on the primary outcomes of interest: head injury, neck injury and cervical spine injury. Studies were assessed for quality by the criteria of Downs and Black. Results Studies reviewed indicate that helmet wear reduces the risk of head injuries in skiing and snowboarding. Four case-control studies reported a reduction in the risk of head injury with helmet use ranging from 15% to 60%. Another cohort study found a significantly lower incidence of head injuries involving loss of consciousness in helmet users (p<0.05). The five remaining studies suggested a major protective effect of helmets by indicating that none or few of the head-injured and deceased participants wore a helmet. Conclusions There is strong evidence to support the protective value of helmets in reducing the risk of head injuries in skiing and snowboarding. There is no good evidence to support the claim that the use of helmets leads to an increase risk of cervical spine injuries or neck injuries.

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– The effectiveness of helmet wear in skiers and snowboarders: a systematic review.