What are the most frequent winter sports injuries?

We were asked to write an article for the latest Podiatry Review that's just been released by the Institute of Chiropodists and Podiatrists on the most frequent winter sports injuries with a focus on skiing and the lower limb.  

Winter is coming has been a famous phrase this year and now it’s here it’s estimated that over 1 million of us Brits will go on a winter sports holiday with about 80% skiing, 16% snowboarding and 4% skating, climbing, sledding etc. [1]
Sadly injuries are part and parcel of winter sports for a multitude of reasons such as crashes, overuse, lack of fitness, equipment failure or just bad luck. Injuries associated with winter sports affect the whole body but for the purposes of this article we’ll give an overview of the most common but be focussing on those affecting the lower limbs.  We certainly won’t be mentioning the helmet vs non helmet debate.
How frequent are injuries?
There are a number of studies of injury rates for skiers and snowboarders with results ranging from 1-6 injuries per thousand skiing days to 2-16 injuries per thousand snowboarding days[2]. For the more adventurous ice climbing only has estimated injury rates of 4 per thousand hours[3]. 
Over the last ten years sledding has increased in popularity with moonlight sledding being an increasing popular past-time and thus injury rates here have increased too. Indeed one insurance company[4]found their breakdown of claims related to winter sports injuries was as follows:
34% snowboarding
33% skiing
21% sledding
12% skating
So what are the main injuries?
The knees are the number one and typically account for around 30%[5]of all winter sports injuries. This is not just because of how much they are used in most winter sports but the number of ways they can be injured. Most people only have one winter holiday a year so it’s an intense amount of exercise on muscles and ligaments in a way they may not be used to.  As such the strains and pains that come from overuse are common but also medial collateral ligament (MCL) or anterior cruciate ligament (ACL) injuries account for the majority[6]of knee injuries.
The harder boots used in skiing protect the ankles but give a higher chance of knee injuries.  ACL damage tends to happen when trying to stop falling by squatting with arms out and the weight goes on the inside edge of the downhill ski causing a twisting motion. MCL injuries tend to happen during crashes when an edge is caught and it stresses the medial ligament. Dislocations and knee fractures also occur along with leg fractures although these are less common.
With no poles for balance and both feet connected to the board without an automatic release mechanism then for learners a bruised bottom is the most embarrassing injury when learning to snowboard but wrist injuries are the most commonly recorded accounting for over 20%[7]of snowboarding injuries. The impact of landing often causes shoulder problems too. Knee injuries in snowboarders are less common than skiers, accounting for 16% of injuries[8]and most knee injuries tend to happen not whilst snowboarding but from getting on and off ski lifts when one foot is fastened to the board and the other is pushing. Twisting while falling over risks injury to the knees as does the impact from crashing, particularly at speed and on icy ground.
The softer boots used in snowboarding are easier to walk in and feel more flexible but offer less protection and as such lead to increased vulnerability to ankle sprains and fractures. 'Snowboarders ankle’ refers to a fracture of the lateral process of the talus due to the fact it is 15 times[9]more likely in snowboarders than the general population.  The lateral process of the talus is above the heel bone on the outerside of the ankle.
In sledding then lower leg injuries are very common with knee sprains accounting for 13% of injuries followed by ankle sprains (11.5%), and ankle/leg fractures (9%).[10]Its thought the increase in sledding injuries is down to the rise in its popularity and particularly that of ‘moonlit sledding’ and the potential effects of après ski.
It’s estimated that with the rise of winter time temporary ice rinks that at least 4%[11]of the UK population ice skates which is one of the few winter sports that is done predominantly in the UK and not abroad. Skating injuries tend to be focused on the upper body from outstretched arms trying to break a fall. Ankle and knee injuries do still occur but account for just 7%[12]each of total injury numbers and tend to occur from twisting to avoid falling leading to strains and tears.

Find your nearest winter sports injury specialist at Sportsinjuyfix.com

[2]Ekeland, Sulheim, and Rodven, "Injury Rates and Injury Types in Alpine Skiing, Telemarking, and Snowboarding," Journal of ASTM International, Vol. 2, No. 5, 2005, pp. 1-9,
[3]Schöffl et al. “Injury Risk Evaluation in Water Ice Climbing” Med Sport 13 (4): 210–218, 2009
[6]Jordan et al.  Anterior cruciate ligament injury/reinjury in alpine ski racing: a narrative review Open Access J Sports Med. 2017; 8: 71–83

Paletta and Warren Knee injuries and Alpine skiing. Treatment and rehabilitation. Sports Med.1994 Jun;17(6):411-23.
[7]Kim et. al. Am J Sports Med.2012 Apr;40(4):770-6.
[8]Worldwide Insure research 2017 https://www.worldwideinsure.com/travel-blog/2017/01/common-snowboarding-injuries-avoid/
[9]Mussman and Poirer J Chiropr Med. 2010 Dec; 9(4): 174–178
[10]Corra and Di Giorgi Sledding injuries: is safety in this winter pastime overlooked? A three-year survey in South-Tyrol J Trauma Manag Outcomes. 2007; 1: 5.
[11]Barr et al. Int Orthop. 2010 Jun; 34(5): 743–746.
[12]US National Electronic Injury Surveillance System data - https://product-injuries.healthgrove.com/l/88/Ice-Skating


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