Skiing and Snowboarding Injuries

Introduction

Recreational skiing and snowboarding has been gaining popularity over recent years. The 2020/21 season recorded 10.5 million participants, the highest ever recorded since NSAA started tracking 1996/97.¹ Furthermore, the 2020/21 season recorded 59 million visits in the United States, which is the 5^th highest recorded since 1978/79.²

The rate of injuries in skiing and snowboarding has steadily decreased over the years due to the adoption of protective gear, helmets in particular.^{3, 4} Despite this, there are several well-described orthopedic injuries specific to the participation of these sports.

Unique injury patterns of skiing and snowboarding exist due to the differences in equipment and movement requirements. In general, lower extremity injuries are more common in skiing, while upper extremity injuries are more common in snowboarding.⁵ The incidence of spine injuries are higher in skiers than snowboarders.⁵

Here are common injuries sustained, exercises to prepare for the slopes, and injury prevention and safety tips:

Common Skiing Injuries

• Knee ligamentous injuries (ACL, MCL)
• Hand and thumb injuries (thumb UCL injuries)
• Tibial shaft fractures

Common Snowboarding Injuries

• Wrist injuries (distal radius fractures)
• Shoulder injuries (clavicle fractures, glenohumeral dislocations)
• Foot and ankle injuries (ankle fractures, talus fractures)

Common Injuries in Both Sports

• Spinal fractures
• Sacral fractures, pubic rami fractures
• Hip dislocations and fracture-dislocations

(Telgheder & Kistler)

---

Prevention

Here are some exercises to get you ready for the season!

Skiing

---

Snowboarding

---

Warm Up and Cool Down Appropriately

• Performing a warm up routine that includes dynamic stretching can help loosen up your body and get yourself both mentally and physically prepared for the activity. Here are videos of good dynamic stretching routines:
  • Skiing
  • Snowboarding

---

Other Safety Tips and Strategies

• Safety equipment
  • Wear a well-fitting helmet!
    • Helmet use in skiers and snowboarders is associated with up to 60% reduction in risk for head injuries^{6, 7}
  • Novice snowboarders may want to wear wrist guards and padded shorts to protect from wrist and tailbone injuries during falls

• Learn from the pros
  • If you’re just getting started, consider taking a lesson! Experienced instructors will teach you proper techniques, help you familiarize with various terrains, and educate you on mountain rules and etiquette. Not only will you improve faster, you will also learn to enjoy the sport safely
• Take it easy on the first run
  • This will help you get into a rhythm and set the tone for the rest of the day. It also allows you to get a feel of the snow quality and the overall conditions of the mountain. Choose a run that is wide and less challenging for you, and focus on form instead of speed
• Get plenty of rest
  • Most injuries occur when the body is fatigued
• Ensure all equipment is functioning properly
  • Some mountains have courtesy tool benches with screwdrivers and hex keys at the top or bottom of ski lifts if you need your bindings tightened. Otherwise, bring it into the ski shop and they will be happy to help you
• Know your limits!
  • Go down the slopes at your appropriate level. Don’t go down a black run if the blues are very challenging for you

• Be aware of surroundings
  • Slow down and look around where trails merge. Maintain a safe speed when in a crowded area or on a run with many beginners
• Keep your ears unplugged
  • Avoid wearing headphones so that you can hear verbal warnings
• Wrap it up early
  • Most injuries occur on the last run of the day, when the slopes become icier and visibility decreases due to the sun setting. Combined that with fatigue will increase the risk for getting hurt
• Stay hydrated and again, wear a helmet!

---

What to do if someone gets hurt?

• Notify ski patrol
  • There should be contact information on your ski pass

• Gather location details
  • Note the run you are on, and the closest trail intersection. If you are near a ski lift, search for markers on the closest tower. These will help ski patrol locate you and the injured party
• Warn others
  • While waiting for ski patrol, stick skis/snowboards upright and uphill of the injured person to warn others and divert traffic away from the area

---

References

1. National Ski Areas Association. Estimated Snowsports Participants: U.S. Visitors to U.S. Resorts, 1996/97 – 2020/21. Lakewood (CO): National Ski Areas Association; 2021.
2. National Ski Areas Association. Estimated U.S. Snowsports Visits by Region, 1978/79 – 2020/2021. Lakewood (CO): National Ski Areas Association; 2021.
3. Shealy JE, Ettlinger CF, Johnson RJ. 2010/2011 NSAA 10-year interval injury study. J ASTM Int. 2013; (STP1582):93-111.
4. National Ski Areas Association. Helmet Use Among U.S. Skiers and Snowboarders 2019-20 Season. Lakewood (CO): National Ski Areas Association; 2021.
5. Telgheder ZL, Kistler BJ. Ski and Snowboard – Related Orthopedic Injuries. Orthop Clin North Am. 2020;51(4):461-469. doi:10.1016/j.ocl.2020.06.004
6. Sulheim S, Holme I, Ekeland A, Bahr R. Helmet Use and Risk of Head Injuries in Alpine Skiers and Snowboarders. JAMA. 2006;295(8):919–924. doi:10.1001/jama.295.8.919
7. Haider AH, Saleem T, Bilaniuk JW, Barraco RD; Eastern Association for the Surgery of Trauma Injury ControlViolence Prevention Committee. An evidence-based review: efficacy of safety helmets in the reduction of head injuries in recreational skiers and snowboarders. J Trauma Acute Care Surg. 2012;73(5):1340-1347. doi:10.1097/TA.0b013e318270bbca