Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2009

01-11-2009 | Sports Medicine

Distribution of injury mechanisms and related factors in ACL-injured female carving skiers

Authors: Gerhard Ruedl, Ingrid Linortner, Alois Schranz, Christian Fink, Kurt Schindelwig, Werner Nachbauer, Martin Burtscher

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2009

Login to get access

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.
Literature
1.
go back to reference Bahr R, Krosshaug T (2005) Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med 39:324–329CrossRefPubMed Bahr R, Krosshaug T (2005) Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med 39:324–329CrossRefPubMed
2.
go back to reference Beynnon BD, Ettlinger CF, Johnson RJ (2007) Epidemiology and mechanisms of ACL injury in alpine skiing. In: Hewett TE, Shultz SJ, Griffin LY (eds) Understanding and preventing noncontact ACL injuries. American Orthopaedic Society for Sports Medicine. Human Kinetics, Champaign, pp 183–188 Beynnon BD, Ettlinger CF, Johnson RJ (2007) Epidemiology and mechanisms of ACL injury in alpine skiing. In: Hewett TE, Shultz SJ, Griffin LY (eds) Understanding and preventing noncontact ACL injuries. American Orthopaedic Society for Sports Medicine. Human Kinetics, Champaign, pp 183–188
3.
go back to reference Burtscher M, Nachbauer W (1999) Injury risk of Austrian skiers and comparison of the injury pattern of traditional and carving skiers. In: Österreichisches Kuratorium für Alpine Sicherheit (eds) Sicherheit im Bergland, Innsbruck, Austria, pp 107–115 (in German) Burtscher M, Nachbauer W (1999) Injury risk of Austrian skiers and comparison of the injury pattern of traditional and carving skiers. In: Österreichisches Kuratorium für Alpine Sicherheit (eds) Sicherheit im Bergland, Innsbruck, Austria, pp 107–115 (in German)
4.
go back to reference Burtscher M, Gatterer H, Flatz M, Sommersacher R, Woldrich T, Ruedl G, Hotter B, Lee A, Nachbauer W (2008) Effects of modern ski equipment on the overall injury rate and the pattern of injury location in Alpine skiing. Clin J Sport Med 18:355–357CrossRefPubMed Burtscher M, Gatterer H, Flatz M, Sommersacher R, Woldrich T, Ruedl G, Hotter B, Lee A, Nachbauer W (2008) Effects of modern ski equipment on the overall injury rate and the pattern of injury location in Alpine skiing. Clin J Sport Med 18:355–357CrossRefPubMed
5.
go back to reference Burtscher M, Sommersacher R, Ruedl G, Nachbauer W (2009) Potential risk factors for knee injuries in alpine skiers. Journal of ASTM International 6:1–4CrossRef Burtscher M, Sommersacher R, Ruedl G, Nachbauer W (2009) Potential risk factors for knee injuries in alpine skiers. Journal of ASTM International 6:1–4CrossRef
6.
go back to reference Ekeland A, Sulheim S, Rodven A (2003) Injuries in Norwegian ski resorts 2000–2002. In: Abstract book of the 15th international congress on skiing trauma and skiing safety. St. Moritz/Pontressina, Switzerland, pp E1–E3 Ekeland A, Sulheim S, Rodven A (2003) Injuries in Norwegian ski resorts 2000–2002. In: Abstract book of the 15th international congress on skiing trauma and skiing safety. St. Moritz/Pontressina, Switzerland, pp E1–E3
7.
go back to reference Ettlinger CF, Johnson RJ, Shealy JE (2006) Functional and release characteristics of alpine ski equipment. In: Johnson RJ, Shealy JE, Yamagishi T (eds) Skiing trauma and safety: sixteenth volume. ASTM, Mayfield, pp 65–74CrossRef Ettlinger CF, Johnson RJ, Shealy JE (2006) Functional and release characteristics of alpine ski equipment. In: Johnson RJ, Shealy JE, Yamagishi T (eds) Skiing trauma and safety: sixteenth volume. ASTM, Mayfield, pp 65–74CrossRef
8.
go back to reference Goulet C, Hagel BE, Hamel D, Legare G (2009) Self-reported skill level and injury severity in skiers and snowboarders. J Sci Med Sport (Epub ahead of print) Goulet C, Hagel BE, Hamel D, Legare G (2009) Self-reported skill level and injury severity in skiers and snowboarders. J Sci Med Sport (Epub ahead of print)
9.
go back to reference Greenwald RM, Toelcke T (1997) Gender differences in alpine skiing injuries: a profile of the knee-injured skier. In: Johnson RJ, Mote CD, Ekeland E (eds) Skiing trauma and safety: eleventh volume. ASTM, Baltimore, pp 111–121CrossRef Greenwald RM, Toelcke T (1997) Gender differences in alpine skiing injuries: a profile of the knee-injured skier. In: Johnson RJ, Mote CD, Ekeland E (eds) Skiing trauma and safety: eleventh volume. ASTM, Baltimore, pp 111–121CrossRef
11.
go back to reference Hewett ET (2000) Neuromuscular and hormonal factors associated with knee injuries in female athletes. Sports Med 29:313–327CrossRefPubMed Hewett ET (2000) Neuromuscular and hormonal factors associated with knee injuries in female athletes. Sports Med 29:313–327CrossRefPubMed
12.
go back to reference Hewett TE, Meyer GD, Ford KR (2006) Anterior cruciate ligament injuries in female athletes: Part 1, mechanism and risk factors. Am J Sports Med 34:299–311CrossRefPubMed Hewett TE, Meyer GD, Ford KR (2006) Anterior cruciate ligament injuries in female athletes: Part 1, mechanism and risk factors. Am J Sports Med 34:299–311CrossRefPubMed
13.
go back to reference Hintermeister RA (1997) What do we know about super-side skis? Sportverletz Sportschaden 11:137–139CrossRefPubMed Hintermeister RA (1997) What do we know about super-side skis? Sportverletz Sportschaden 11:137–139CrossRefPubMed
14.
go back to reference Hull ML (1997) Analysis of skiing accidents involving combined injuries to the medial collateral and anterior cruciate ligaments. Am J Sports Med 25:35–40CrossRefPubMed Hull ML (1997) Analysis of skiing accidents involving combined injuries to the medial collateral and anterior cruciate ligaments. Am J Sports Med 25:35–40CrossRefPubMed
15.
go back to reference International Organization for Standardization (2004) Assembly, adjustment and inspection of an alpine ski/binding/boot (S-B-B) system ISO 11088, Geneva, Switzerland International Organization for Standardization (2004) Assembly, adjustment and inspection of an alpine ski/binding/boot (S-B-B) system ISO 11088, Geneva, Switzerland
16.
go back to reference Järvinen M, Natri A, Laurila S, Kannus P (1994) Mechanisms of anterior cruciate ligament ruptures in skiing. Knee Surg Sports Traumatol Arthrosc 2:224–228CrossRefPubMed Järvinen M, Natri A, Laurila S, Kannus P (1994) Mechanisms of anterior cruciate ligament ruptures in skiing. Knee Surg Sports Traumatol Arthrosc 2:224–228CrossRefPubMed
17.
go back to reference Johnson RJ, Ettlinger CF, Shealy JF, Meader C (1997) Impact of super side cut skis on the epidemiology of skiing injuries. Sportverletz Sportschaden 11:150–152CrossRefPubMed Johnson RJ, Ettlinger CF, Shealy JF, Meader C (1997) Impact of super side cut skis on the epidemiology of skiing injuries. Sportverletz Sportschaden 11:150–152CrossRefPubMed
18.
go back to reference Johnson RJ, Ettlinger CF, Shealy JF (2006) Injury trends, risk factors involving ACL injuries in alpine skiing. Abstracts of the sixteenth international symposium on ski trauma, skiing safety, Arai Mountain, Niigata, Japan, 17–23 April 2005. Knee Surg Sports Traumatol Arthrosc 14:101 Johnson RJ, Ettlinger CF, Shealy JF (2006) Injury trends, risk factors involving ACL injuries in alpine skiing. Abstracts of the sixteenth international symposium on ski trauma, skiing safety, Arai Mountain, Niigata, Japan, 17–23 April 2005. Knee Surg Sports Traumatol Arthrosc 14:101
19.
go back to reference Köhne G, Kusche H, Schaller C, Gutsfeld P (2007) Ski accidents—changes since introduction of carving ski. Sportorthopädie Sporttraumatologie 23:63–67 (in German) Köhne G, Kusche H, Schaller C, Gutsfeld P (2007) Ski accidents—changes since introduction of carving ski. Sportorthopädie Sporttraumatologie 23:63–67 (in German)
20.
go back to reference Krosshaug T, Andersen TE, Olsen OE, Myklebust G, Bahr R (2005) Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities. Br J Sports Med 39:330–339CrossRefPubMed Krosshaug T, Andersen TE, Olsen OE, Myklebust G, Bahr R (2005) Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities. Br J Sports Med 39:330–339CrossRefPubMed
21.
go back to reference LaPorte JD, Binet MH, Fenet N, Constans D (2006) Ski bindings and lower leg injuries: a two year case-control study in Avoriaz. Abstracts of the sixteenth international symposium on ski trauma and skiing safety, Arai Mountain, Niigata, Japan, 17–23 April 2005. Knee Surg Sports Traumatol Arthrosc 14:100–101 LaPorte JD, Binet MH, Fenet N, Constans D (2006) Ski bindings and lower leg injuries: a two year case-control study in Avoriaz. Abstracts of the sixteenth international symposium on ski trauma and skiing safety, Arai Mountain, Niigata, Japan, 17–23 April 2005. Knee Surg Sports Traumatol Arthrosc 14:100–101
22.
go back to reference Laporte JD, Binet MH, Fenet N, Constans D, Joubert P (2009) Ski bindings and lower leg injuries, a case control study in Flaine 2006. In: Johnson R, Shealy J, Langran M (eds) Skiing trauma and safety: seventeenth volume. J ASTM Intl, Bridgeport, pp 77–88 Laporte JD, Binet MH, Fenet N, Constans D, Joubert P (2009) Ski bindings and lower leg injuries, a case control study in Flaine 2006. In: Johnson R, Shealy J, Langran M (eds) Skiing trauma and safety: seventeenth volume. J ASTM Intl, Bridgeport, pp 77–88
23.
go back to reference Merkur A, Whelan KM, Kuah E, Choo P (2003) The effect of ski shape on injury occurrence in downhill skiing. In: Johnson RJ, Lamont MK, Shealy JE (eds) Skiing trauma and safety: fourteenth volume. ASTM, Saline, pp 129–139CrossRef Merkur A, Whelan KM, Kuah E, Choo P (2003) The effect of ski shape on injury occurrence in downhill skiing. In: Johnson RJ, Lamont MK, Shealy JE (eds) Skiing trauma and safety: fourteenth volume. ASTM, Saline, pp 129–139CrossRef
24.
go back to reference Nachbauer W, Kaps P (1995) Cruciate ligament forces during landing in downhill skiing, In: Häkkinen K, Keskinen KL, Komi PV, Mero A (eds) Book of abstracts, XVth congress of the international society of biomechanics, Jyväskylä, Finland, 2–6 July 1995, pp 654–655 Nachbauer W, Kaps P (1995) Cruciate ligament forces during landing in downhill skiing, In: Häkkinen K, Keskinen KL, Komi PV, Mero A (eds) Book of abstracts, XVth congress of the international society of biomechanics, Jyväskylä, Finland, 2–6 July 1995, pp 654–655
25.
go back to reference Nachbauer W, Hoser C, Fink C (2004) Injury mechanisms of anterior cruciate ligament tears in alpine ski racing. Knee Surg Sports Traumatol Arthrosc 12:176 Nachbauer W, Hoser C, Fink C (2004) Injury mechanisms of anterior cruciate ligament tears in alpine ski racing. Knee Surg Sports Traumatol Arthrosc 12:176
26.
go back to reference Natri A, Beynnon BD, Ettlinger CF, Johnson RJ, Shealy JE (1999) Alpine ski bindings and injuries. Current findings. Sports Med 28:35–48CrossRefPubMed Natri A, Beynnon BD, Ettlinger CF, Johnson RJ, Shealy JE (1999) Alpine ski bindings and injuries. Current findings. Sports Med 28:35–48CrossRefPubMed
27.
go back to reference Olsen OE, Myklebust G, Engebretsen L, Bahr R (2004) Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. Am J Sports Med 32:1002–1012CrossRefPubMed Olsen OE, Myklebust G, Engebretsen L, Bahr R (2004) Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. Am J Sports Med 32:1002–1012CrossRefPubMed
28.
go back to reference Shimokochi Y, Shultz SJ (2008) Mechanisms of noncontact anterior cruciate ligament injury. J Athl Train 43:396–408PubMedCrossRef Shimokochi Y, Shultz SJ (2008) Mechanisms of noncontact anterior cruciate ligament injury. J Athl Train 43:396–408PubMedCrossRef
29.
go back to reference Sinning WE (1985) Body composition and athletic performance. In: Clarke DH, Eckert HM (eds) Limits of human performance. The Academy Papers, Champaign, pp 45–56 Sinning WE (1985) Body composition and athletic performance. In: Clarke DH, Eckert HM (eds) Limits of human performance. The Academy Papers, Champaign, pp 45–56
30.
go back to reference Sulheim S, Ekeland A, Bahr R (2007) Self-estimation of ability among skiers and snowboarders in alpine skiing resort. Knee Surg Sports Traumatol Arthrosc 15:665–670CrossRefPubMed Sulheim S, Ekeland A, Bahr R (2007) Self-estimation of ability among skiers and snowboarders in alpine skiing resort. Knee Surg Sports Traumatol Arthrosc 15:665–670CrossRefPubMed
31.
go back to reference Urabe Y, Ochi M, Onari K, Ikuta Y (2002) Anterior cruciate ligament injury in recreational alpine skiers: analysis of mechanisms and strategy for prevention. J Orthop Sci 7:1–5CrossRefPubMed Urabe Y, Ochi M, Onari K, Ikuta Y (2002) Anterior cruciate ligament injury in recreational alpine skiers: analysis of mechanisms and strategy for prevention. J Orthop Sci 7:1–5CrossRefPubMed
33.
go back to reference Yu B, Kirkendall DT, Garret WE (2002) Anterior cruciate ligament injuries in female athletes: anatomy, physiology, and motor control. Sports Med Arthrosc Rev 10:58–68CrossRef Yu B, Kirkendall DT, Garret WE (2002) Anterior cruciate ligament injuries in female athletes: anatomy, physiology, and motor control. Sports Med Arthrosc Rev 10:58–68CrossRef
Metadata
Title
Distribution of injury mechanisms and related factors in ACL-injured female carving skiers
Authors
Gerhard Ruedl
Ingrid Linortner
Alois Schranz
Christian Fink
Kurt Schindelwig
Werner Nachbauer
Martin Burtscher
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2009
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-009-0860-7

Other articles of this Issue 11/2009

Knee Surgery, Sports Traumatology, Arthroscopy 11/2009 Go to the issue