Completion rates and injuries in alpine races during the 1994 Olympic Winter Games

The starting lists for the alpine disciplines during the 1994 Olympic Winter Games in Lillehammer totalled 555 racers, but only 354 of them (64%) completed the different races. The race completion rate was 43% in the slalom, 51% in the giant slalom, 75% in the super giant slalom and 91% in the downhill. In combined downhill/slalom the race completion rate was 60%, but 96% in the downhill and 68% in the slalom part of the combination, respectively. Only three injuries were recorded, all in females. Including the training competitions a total of 1541 runs through the different alpine courses was recorded during the games. This means an injury rate of 1.9 injuries per 1000 runs. For downhill the injury rate was only 1.1 per 1000 runs. If the injury rate is related to the number of skiers who did not finish the race because of falls or skiing errors, the rate was 21.1 injuries per 1000 falls (skiing errors) for all alpine races. In conclusion, the race completion rate was twice as high in downhill as in slalom, and the injury rate was low.     

Evaluation of skiing injuries by Injury Severity Score

The goal of this study was to evaluate the Injury Severity Score (ISS) in an alpine area. Hafjell Alpine Centre was the 1994 Winter Olympic Alpine arena in Lillehammer. A total of 2,044,484 lift transportations and 183 injuries were registered in the two winter seasons 1991 and 1992. The injury rate was 1.8 injuries per 1000 skier days. The mean ISS was 3.6 per injury for this particular alpine area. Thirty-six per cent of the injured were women and 35.5% were between 15 and 19 years of age. There was no difference in mean ISS between male and female skiers, but mean ISS was higher in adolescents than in the other age groups. Injuries to the knee represented the single most frequently injured body region, but injuries to the abdomen had the highest mean ISS. Alpine skiers suffered more severe injuries than telemark and snowboard skiers. Severe injuries (ISS > 16) were recorded when unexpected objects, such as a grooming machine, a net, a root, etc., appeared on the slope. The Abbreviated Injury Scale (AIS) and ISS give us additional information about the condition of the slopes, and their use as a tool in preventing skiing injuries is recommended.     

Physiology of Alpine skiing

Physiological profiles of elite Alpine skiers reveal the importance of muscular strength, anaerobic power, anaerobic endurance, aerobic endurance, coordination, agility, balance, and flexibility. On-hill snow training and dryland training programmes should focus on the elevation of these fitness components. Physical characteristics of elite skiers reveal an average height and body mass. Today, successful skiers are taller and heavier than their predecessors. Slalom skiers tend to be leaner than skiers in other events while the downhill racers are the heaviest. Elite skiers have strong legs when peak torque is measured during isometric and isokinetic conditions involving knee extension, which may be a specific adaptation since the skier is in a crouched position for a prolonged period when racing. Leg strength correlates significantly with performance in the downhill and giant slalom events. The glycolytic contribution in the slalom and giant slalom events is about 40% of the total energy cost. Following a race, blood lactate concentration averages 9 to 13 mmol/L. A muscle lactate concentration of 24 mmol/kg wet muscle tissue has been reported. Elite skiers have higher lactate values than advanced or novice skiers. The aerobic demands of competitive Alpine skiing may approach (90 to 95%) of the athlete's maximal aerobic power. Maximal heart rate is achieved during the latter part of the race. Elite skiers have a high VO2max. This may reflect their training programme and not the actual demands of the sport. When turning, muscular activity acts to impede blood flow and oxygen delivery. As a consequence, anaerobic metabolism is increased. Glycogen studies show significant utilisation from both slow and fast twitch muscle fibres. Skilled and unskilled skiers differ with respect to glycogen utilisation. Skilled skiers have greater glycogen depletion in the slow twitch fibres compared to unskilled skiers. Muscle glycogen decreases by about 32 mmol/kg wet muscle tissue following a day of ski training. Glycogen depletion may contribute to the injury pattern which peaks toward the end of the ski day. The risk of injury has been estimated at 17 injuries per 1000 skier days. When the severity criterion was an injury causing the skier to miss 3 days of skiing or visit a physician, the risk was 2 injuries per 1000 skier-days.(ABSTRACT TRUNCATED AT 400 WORDS)     

Injuries in elite motorcycle racing in Japan

Objectives: To investigate the incidence and pattern of injuries, relative risks, and factors affecting incidence among elite motorcycle competitors in Japan. Methods: A total of 117 elite motorcycle competitors including 36 road racers, 60 motocross racers, and 21 trial bike riders completed a questionnaire about injuries. Results: Sixty major injuries (25 in road racing, 32 in motocross, and three in trial bike riding) were reported. The most common injuries were fractures (45), followed by ligament injuries (8), dislocations (5), and soft tissue injuries (2). The overall injury rate was 22.4 per 1000 hours, and the death rate was zero. There was no significant correlation between risk of injury and age, experience, or accumulated competition points. Conclusions: Injury rates in competitions such as road racing and motocross are high, and therefore additional safety measures are needed to protect competitors from injury.     

第14届世界游泳锦标赛运动员损伤与疾病调查

目的:了解高水平游泳运动员在国际赛事中的损伤与疾病发生特点。方法:对第14届世界游泳锦标赛中前往医疗站就诊的运动员的损伤和疾病情况进行登记。医疗站医生收集运动员的医疗报告,每天上报给组委会医疗保障部,比赛结束后统一分析处理。按照国际奥委会损伤疾病监控系统(IOC injury and illness surveillance system)对运动员的损伤和疾病情况进行归类、统计分析,与以往数据比较。结果:整个赛期2165名注册运动员中,172名运动员就诊,运动损伤53例(24‰),女性运动员损伤发生率(n=21,18‰)低于男性(n=32,32‰)。游泳项目的损伤病例数最多(n=20),公开水域项目的损伤发生率最高(50‰)。运动损伤好发部位为头部躯干(35.8%)、下肢(35.8%)。最常见的损伤类型为皮肤擦伤,占全部就诊运动损伤病例的34%。整个赛期共发生疾病99例(46‰),呼吸道感染高发(n=40,40.4%),因牙齿问题到定点医院就诊的运动员人数最多(n=10,8例牙齿疾病,2例外伤导致牙齿断裂)。结果显示:与历届游泳锦标赛相比,本次比赛中运动员损伤发生率大为下降,呼吸系统感染是运动员的最常见疾病。预防牙病和牙齿健康应该得到重视。     

Safety assessment of jumps in ski racing

The influence of important parameters on the flight trajectory for jumps in downhill World Cup races was investigated. To quantify the impact injury risk at landing, the parameter equivalent landing height (ELH) was introduced, which considered a variable slope inclination during the landing movement. Altogether, 145 runs at four different jumps in World Cup races and trainings were recorded and analyzed. A simulation model was developed to predict the flight phase of the skier. Drag and lift areas were selected by parameter identification to fit the simulation trajectory to the two‐dimensional data from the video analysis. The maximum values of the ELH which can be absorbed with muscle force was taken from the study of Minetti et al. for elite female and male ski racers. A sensitivity analysis based on the four jumps showed that ELH is mainly influenced by takeoff angle, takeoff speed, and the steepness of the landing surface. With the help of the developed simulation software, it should be possible to predict the ELH for jumps in advance. In case of an excessive ELH, improvements can be made by changing the takeoff inclination or the approach speed.     

The Harstad injury prevention study: the epidemiology of sports injuries. An 8 year study.

OBJECTIVE--To describe the epidemiology of sports injuries occurring in a community during 8 years and to evaluate the outcome of an intervention implemented against injuries occurring in downhill skiing. METHODS--Hospital treated sports injuries occurring in Harstad, Norway (population 22 600) were recorded prospectively during an 8 year period. A prevention programme targeting downhill skiing injuries was evaluated. RESULTS--2234 sports injuries accounted for 17.2% of recorded unintentional injuries. Two out of three injuries occurred in team sports. Soccer accounted for 44.8% of all sports injuries. Downhill skiing injuries had higher mean score on the abbreviated injury scale than all other sports analysed combined (P < 0.01). Postintervention injury rates for downhill skiing were reduced by 15% when adjusting for exposure (P = 0.24). Further observations are needed for assessing the effectiveness of the downhill skiing safety programme. CONCLUSIONS--Strategies for future sports injury prevention include community involvement, particularly sports organisations. Local data analysis seems to justify some priorities, for example, promotion of helmet use in downhill skiing for young adolescents and prevention of lower limb fractures in male soccer players 15+ years old. Prospective hospital recording of injuries provides a tool for the design and outcome evaluation of sports injury intervention research.     

Effect of trail design and grooming on the incidence of injuries at alpine ski areas

Objectives: To identify the conditions at certain sites on slopes known as black spots for injury.

Method: In the Hafjell and Voss alpine ski areas in Norway, 1410 skiing injuries were recorded from December 1990 through the 1996 season. In Hafjell, 183 of these injuries were plotted on an area map during the two first seasons. Similarly, in Voss, 214 injuries were plotted on an area map for two seasons. During the last three seasons in Hafjell, 835 ski injuries were related to 6712 snow grooming hours and 6 829 084 lift journeys.

Results: The mean injury rate was 2.2 injuries per 1000 skier days, and the mean injury severity score (ISS) was 3.1. Accumulations of injuries at three sites (black spots) were recorded on the Hafjell area map. These injuries represented 40% of all injuries in the alpine area (p<0.05). Seven injury accumulation sites were recorded on the alpine area map of Voss, representing 22% of the total injuries (p>0.05). Grooming of the slopes was rated poor for the 49% of injuries that occurred at the sites of injury concentration and significantly different (27%) from injuries that occurred at random in Hafjell. The corresponding values in Voss were 50% and 25% respectively. Grooming hours appeared to be inversely proportional to the number of injuries: R = –0.99 (p<0.02). The mean ISS declined significantly in Hafjell over the observation period (p<0.001).

Conclusion: Inappropriate trail design and slope grooming seem to result in an accumulation of injuries at certain sites. Modification in construction and maintenance of the courses may reduce the number of injuries and mean ISS.

     

Reduction of injuries in downhill skiing by use of an instructional ski-video: a prospective randomised intervention study

Despite various attempts at prevention, injury in downhill skiing continues to be a worrisome recreational problem. The purpose of this study was to test the effect of an instructional ski video on the behaviour and injuries of 763 downhill skiers. They were enrolled in two study groups, based on whether or not an instructional video had been shown in their bus on the way to a skiing resort. The video focussed on information regarding how to get started in downhill skiing and injury prevention. The outcome parameters, behaviour (binding test and adjustment), injury risk, type and consequence, were registered on the return trip 8 days later by a questionnaire. In the intervention group all outcome parameters changed significantly. The binding test was performed by 86% in the intervention group and by only 59% in the control group (P < 0.05). Adjustment of the bindings was done by 22% in the intervention group vs 14% in the control group. Regarding injury risk, 205 injuries were seen in 158 persons (20.7%) which is 26 injured skiers per 1000 skier-days and 33.6 injuries per 1000 skier-days. In the intervention group 16% of all skiers were injured vs 23% in the control group, yielding a reduction in injury risk of 30% (P < 0.05). Injuries caused by falls were seen in 12.6% in the intervention group vs 16.2% in the control group (P < 0.05). Injuries caused by collision were seen in 6% of the intervention group vs 12% in the control group (P < 0.05). The overall mean injury risk was 16 injuries per 1000 falls. Knee injuries made up 32.6% of the total. For inexperienced skiers the knee injury risk was significantly lower if the bindings had been tested (P < 0.05). Therefore, an instructional ski video can change the behaviour of downhill skiers and reduce the injury risk and consequences significantly. Received: 26 March 1997 Accepted: 20 December 1997     

Injuries among elite snowboarders (FIS Snowboard World Cup)

Background

Although snowboarding is already established as an Olympic sport, it is still a developing sport, with new disciplines, more demanding snow installations, and spectacular tricks. A recent study on subjects at Norwegian national elite level showed that injury risk is high and that injuries among competitive snowboarders differ from those seen in recreational snowboarders, with fewer wrist injuries and more knee and back injuries.

Objective

To describe the incidence and type of injuries among female and male snowboarders at international elite level.

Method

At the last race of the Fédération Internationale de Ski Snowboard World Cup, acute injuries resulting in missed participation and overuse injuries influencing performance, were recorded during a retrospective interview (91% response rate). The registration period was from April 2002 (end of season) until March 2003. Exposure was recorded as the number of runs in all disciplines, and the incidence was calculated as number of injuries per 1000 runs.

Results

The 258 athletes interviewed reported 3193 competition days (n = 46 879 runs) in all disciplines. In total, 135 acute injuries were recorded; 62 (46%) during competition in the official disciplines. Of the 135 acute injuries, the most common injury locations were knee (n = 24; 18%), shoulder (n = 18; 13%), back (n = 17; 13%), and wrist (n = 11; 8%). The overall incidence during competition was 1.3 (95% confidence interval 1.0 to 1.7) injuries per 1000 runs; 2.3 (0.9 to 3.8) for big air (n = 10), 1.9 (1.1 to 2.8) for halfpipe (n = 21), 2.1 (1.2 to 3.0) for snowboard cross (n = 20), 0.6 (0.2 to 1.0) for parallel giant slalom (n = 8), and 0.3 (0.0 to 0.7) for parallel slalom (n = 3). The severity of injuries was graded based on time loss (27% lost >21 days) and score on the Abbreviated Injury Scale (AIS) (38% AIS 1, 61% AIS 2 and 1% AIS 3). There were 122 overuse injuries, 38 (31%) of these to the knee.

Conclusion

The injury risk for big air, snowboard cross, and halfpipe disciplines is high, while that for the snowboard slalom disciplines is lower. The injury pattern is different from recreational athletes, with a greater share of knee injuries and fewer wrist injuries. Compared with national level, the injury risk appears to be lower at World Cup level.     

Treatment of acute combined knee instabilities and subsequent sport performance

Severe knee ligament injuries have ruined many sport careers, but this may be prevented by appropriate treatment. A short review of the treatment of combined knee instabilities is presented and illustrated by four clinical cases involving skiing racers on the Norwegian alpine and free-style World Cup teams. All of them went back to racing after surgical treatment. One improved, one regained and one partially regained their preinjury World Cup standings. The fourth racer suffered from arthrofibrosis postoperatively. The was unable to carry through a full racing season after rehabilitation due to a new injury. The mean World Cup rankings of the racers was 24 before compared with 14.6 after the injury. In conclusion, it is possible to continue ski racing at the top level even after severe knee injuries.     

Quality assessment of athletic trainers

This paper reports the first published assessment of the quality of services provided by athletic trainers. Medical coverage for the 1985 Junior Olympic Games was provided by certified athletic trainers (ATC), physicians, and other health care personnel. This study assessed the services of the 30 attending ATCs who managed 121 significant injuries. Standard injury information was collected by the ATCs and separately collected by their physicians. Nine months after the Games, phone interviews were conducted with the injured participants and assessment questionnaires were given to the attending physicians. Results revealed that young, injured, Junior Olympic participants generally did not inform their parents about their injuries or medical contact while at the Games. Athletes and physicians overwhelmingly agreed that they were positively impressed with the capabilities of the ATCs with whom they had contact. About 70% recovered from the symptoms and limitations of injury, as determined by the athlete, within the month following the Games. About 17% sustained some type of injury recurrence to the same body part, and at 9 months about 97% of the athletes had fully recovered from their injuries. These data not only indicate that athletic trainers can accurately identify minor athletic injury but signify the importance of long-term followup in our athletic populations. Multisport events, such as the Junior Olympic Games, impose considerable problems to a communication effort. The athletic trainer, as an ever-present figure in collegiate and professional circles, can be the central focus of an adequate communication effort regarding the patient care of other athletic populations.     

Injuries in young female players in European team handball

The purpose of this study was to examine the nature, extent and severity of sports injuries in young female players in European team handball and to identify the etiological factors involved in the injuries. Twenty-two teams with 217 players, aged 16–18 years, participated in the study. A very high injury incidence during games was observed, with 40.7 injuries/1000 hours of game. Backplayers had the highest incidence (54.8/1000 hours), which is five times higher than any previously recorded injury incidence in players in European team handball. We found that 92.9% of injuries were traumatic and 7.1% were from overuse. One-hundred and twenty-four of the 211 injuries were traumatic injuries of the lower extremities. Of these 63 (51%) were without contact with an opponent. The study confirmed that European tesm handball is a sport that has a very high injury rate, especially regarding young female players. Field position and earlier injuries are major risk factors, with an earlier injury being the single highest risk factor and with backplayers having a significantly higher number of injuries than players in other field positions.     

Pre-race health status and medical events during the 2005 World Adventure Racing Championships

Adventure racing is a wilderness multisport endurance event with the potential for significant injury and illness; however specific contributing factors have not been extensively studied. A prospective cross-sectional study was conducted that collected data during the 2005 Adventure Racing World Championship on pre-, in- and post-race injury and illness and determined pre-race training volumes and health profiles in 184 athletes (46 teams of 4 athletes). In the 6 months prior to the event, 79.9% of athletes reported an injury or illness. Fifty-nine cases of injury or illness were recorded during the race; representing an overall rate of 2.5 injuries per 1000 race-hours and 1.0 illness per 1000 race-hours. This incidence could be considered low compared to some sports, but the rate is tempered by the time on course exposure of 16,774 race-hours. Respiratory conditions were the single-most common condition resulting in race withdrawal. There was a moderate, but not statistically significantly, association (OR = 4.61, p = 0.083, 95% CI 0.82–26.08) between pre-race illness and in-race illness. Forty-four (95%) teams responded to a post-race questionnaire with 30% of the athletes reporting a new injury and 12% reporting a new illness in the week following the race. Understanding contributing factors to injury and illness during adventure racing will aid implementation of race medical coverage, preventative strategies and increase participation and performance.     

Rugby World Cup 2003 injury surveillance project

Objectives: To study match injury patterns and incidence during the Rugby World Cup 2003 (RWC 2003); to compare these patterns and rates with comparative rugby injury data; and to assess differences between teams playing at different levels (eight finalists v 12 non-finalists). Methods: Data were collected prospectively during the tournament. All injuries were recorded by the 20 participating team physicians. These were submitted to the tournament medical officer. An injury was defined as an event which forced a player either to leave the field or to miss a subsequent game or both. Results: 189 injuries were recorded over 48 matches. This corresponds to 97.9 injuries per 1000 player-hours. Pool matches yielded a higher injury rate than non-pool matches. The 12 non-finalist teams sustained significantly higher injury rates than the eight finalist teams. The player positions open side flanker, inside centre, and number 8 were the most frequently injured positions. There was a low concussion rate, which may reflect under-reporting. The non-finalist teams had a higher rate of recurrent injury. Conclusions: The injury rate was higher than comparative data. Mismatches in the areas of skill, fitness, and the availability of resources for medical care of players may explain these differences.     

Football injuries during European Championships 2004–2005

The risk of injury in football is high, but few studies have compared men’s and women’s football injuries. The purpose of this prospective study was to analyse the exposure and injury characteristics of European Championships in football and to compare data for men, women and male youth players. The national teams of all 32 countries (672 players) that qualified to the men’s European Championship 2004, the women’s European Championship 2005 and the men’s Under-19 European Championship 2005 were studied. Individual training and match exposure was documented during the tournaments as well as time loss injuries. The overall injury incidence was 14 times higher during match play than during training (34.6 vs. 2.4 injuries per 1000 h, P < 0.0001). There were no differences in match and training injury incidences between the championships. Teams eliminated in the women’s championship had a significantly higher match injury incidence compared to teams going to the semi-finals (65.4 vs. 5.0 injuries per 1000 h, P = 0.02). Non-contact mechanisms were ascribed for 41% of the match injuries. One-fifth of all injuries were severe with absence from play longer than 4 weeks. In conclusion, injury incidences during the European Championships studied were very similar and it seems thus that the risk of injury in international football is at least not higher in women than in men. The teams eliminated in the women’s championship had a significantly higher match injury incidence than the teams going to the final stage. Finally, the high frequency of non-contact injury is worrying from a prevention perspective and should be addressed in future studies.     

Snow sports injuries in Scotland: a case-control study

OBJECTIVES: To examine the incidence and patterns of snow sports injuries at the three largest commercial ski areas in Scotland and to identify factors associated with injury risk. METHODS: A prospective case-control study of all injured people at Cairngorm, Glenshee, and Nevis Range ski areas during the 1999-2000 winter season. Personal details, snow sports related variables, diagnosis, and treatment were recorded. Control data were collected at random from uninjured people at all three areas. Random counts were performed to analyse the composition of the on slope population. RESULTS: A total of 732 injuries were recorded in 674 people. Control data were collected from 336 people. The injury rate for the study was 3.7 injuries per 1000 skier days. Alpine skiers comprised 67% of the on slope population, snowboarders 26%, skiboarders 4%, and telemark skiers 2%. Lower limb injuries and sprains were the commonest injuries in alpine skiers and skiboarders. Snowboarders sustained more injuries to the upper limb and axial areas. Skiboarders and snowboarders had a higher incidence of fractures. After adjustment for other variables, three factors were all independently associated with injury: snowboarding (odds ratio (OR) 4.07, 95% confidence interval (CI) 1.65 to 10.08), alpine skiing (OR 3.82, CI 1.6 to 9.13), and age <16 years (OR 1.9, CI 1.14 to 3.17). More than five days of experience in the current season and at least one week of experience in total had a protective effect against injury. CONCLUSIONS: Despite a change in the composition of the alpine population at Scottish ski areas, the overall rate and pattern of injury are similar to those reported previously in comparable studies. Several factors are associated with an increased risk of injury and should be targeted in future injury prevention campaigns.     

Accident prevention in competitive cycling

A prospective study of risk factors and injury patterns of competitive cyclists in 10 races at altitudes over 1,500 meters was carried out over 4 years. In 1986, 1,500 licensed racers were compared to a similar group of over 3,900 racers in the 3 previous years to determine if the incidence and severity of injury could be lessened. Factors addressed were the use of helmets, binding-type pedals, equipment inspection, improved medical coverage, and the prevention of acute mountain sickness and exposure. The injury rate and injuries per 100 hours of racing competition were half of that seen in prior years. Severity of injury was lessened as over 80% of the injured racers returned to competition within 1 week in contrast to only 66% during the period from 1983 to 1985. A successful program for injury prevention and the lessening of the severity of injury at altitudes is proposed.