Review Article
Difference in Injury Risk between Male and Female Alpine Skiers: Review of the Literature
Brittany Ammerman*, Margot Richards, Ryann Davie, Natalie Pahapill and Karen Sutton
Published: 03 April, 2024 | Volume 9 - Issue 2 | Pages: 011-014
Alpine skiing is popular at varying levels of competitiveness with many skiers participating recreationally and elite skiers competing in downhill, super-G, giant slalom, slalom, and combined events in the World Cup and in the Winter Olympic Games. The rate of injury in alpine skiing is high both recreationally and competitively and methods to reduce injury rates are needed. Additionally, it is well-established in other sports that the risk of injury for an athlete varies based on gender. The purpose of this review is to determine how injury risk differs for each gender of alpine skier. Injury rates vary throughout the literature but point towards males being at a higher risk for overall injury and upper body injuries while females are at a higher risk for knee injuries. Even the specific knee injuries for which each gender is at risk varies with medial collateral ligament (MCL) injuries more common in males and anterior cruciate ligament (ACL) injuries more common in females. More studies are needed to confirm the differences in injury risks and how these risks may differ across levels of competition, thus allowing regulations and injury prevention methods that may be tailored specifically to the injuries an alpine skier is most susceptible to.
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DOI: 10.29328/journal.jsmt.1001075
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Keywords:
Alpine skiing; Sports injury; Gender differences; Injury risk
References
- Venkat R. What is alpine skiing? Know all the events and rules. Olympics.com. 2022. https://olympics.com/en/news/alpine-skiing-winter-olympics-sport
- Vanat L. International Report on Snow & Mountain Tourism - Overview of the Key Industry Figures for Ski Resorts. 15th 2014. https://sielok.hu/files/RM-world-report-2014.pdf
- Kuta S. This past winter was the busiest ski season ever. Smithsonian Magazine. 2024. https://www.smithsonianmag.com/smart-news/busiest-ski-season-ever-180980242/
- Burtscher M, Gatterer H, Flatz M, Sommersacher R, Woldrich T, Ruedl G, Hotter B, Lee A, Nachbauer W. Effects of modern ski equipment on the overall injury rate and the pattern of injury location in Alpine skiing. Clin J Sport Med. 2008 Jul;18(4):355-7. doi: 10.1097/MJT.0b013e31815fd0fe. PMID: 18614888.
- Wagner M, Liebensteiner M, Dammerer D, Neugebauer J, Nardelli P, Brunner A. Incidence of alpine skiing and snowboarding injuries. Injury. 2023 Aug;54(8):110830. doi: 10.1016/j.injury.2023.05.061. Epub 2023 May 18. PMID: 37246115.
- Barth M, Platzer HP, Forstinger CA. In-competition severe injury events in elite alpine ski racing from 1997 to 2020: the case of the austrian ski team. Sports Med Open. 2022; 8:4. doi:10.1186/s40798-021-00384-w
- Shi H, Jiang Y, Ren S, Hu X, Huang H, Ao Y. Sex differences in the knee orthopaedic injury patterns among recreational alpine skiers. BMC Sports Sci Med Rehabil. 2020 Dec 4;12(1):74. doi: 10.1186/s13102-020-00224-6. PMID: 33292435; PMCID: PMC7718676.
- Viola RW, Steadman JR, Mair SD, Briggs KK, Sterett WI. Anterior cruciate ligament injury incidence among male and female professional alpine skiers. Am J Sports Med. 1999 Nov-Dec;27(6):792-5. doi: 10.1177/03635465990270061701. PMID: 10569367.
- Vermeulen B, Clijsen R, Fässler R, Taeymans J, D’Hondt E, Aerenhouts D. Event-specific body characteristics of elite alpine skiers in relation to international rankings. Advances in Anthropology. 2017; 7(2):94-106. doi:10.4236/aa.2017.72007
- Flørenes TW, Bere T, Nordsletten L, Heir S, Bahr R. Injuries among male and female World Cup alpine skiers. Br J Sports Med. 2009 Dec;43(13):973-8. doi: 10.1136/bjsm.2009.068759. PMID: 19945979.
- Schiff MA, Caine DJ, O’Halloran R. Injury prevention in sports. Am J Lifestyle Med. 2010; 4(1):42-64. doi:10.1177/1559827609348446
- Matzkin E, Garvey K. Sex Differences in Common Sports-Related Injuries. NASN Sch Nurse. 2019 Sep;34(5):266-269. doi: 10.1177/1942602X19840809. Epub 2019 Mar 28. PMID: 30920893.
- Mai C, Mai P, Hinz M, Saenger R, Seil R, Tischer T, Roessler PP. Females show worse functional outcome and quality of life compared to males 2 years after meniscus surgery: Data analysis from the German Arthroscopy Registry. Knee Surg Sports Traumatol Arthrosc. 2024 Mar 7. doi: 10.1002/ksa.12131. Epub ahead of print. PMID: 38454792.
- Fröhlich S, Helbling M, Fucentese SF, Karlen W, Frey WO, Spörri J. Injury risks among elite competitive alpine skiers are underestimated if not registered prospectively, over the entire season and regardless of whether requiring medical attention. Knee Surg Sports Traumatol Arthrosc. 2021 May;29(5):1635-1643. doi: 10.1007/s00167-020-06110-5. Epub 2020 Jun 16. PMID: 32556431.
- Bere T, Flørenes TW, Nordsletten L, Bahr R. Sex differences in the risk of injury in World Cup alpine skiers: a 6-year cohort study. Br J Sports Med. 2014 Jan;48(1):36-40. doi: 10.1136/bjsports-2013-092206. Epub 2013 May 14. PMID: 23673520.
- Dickson TJ, Terwiel FA. Injury trends in alpine skiing and a snowboarding over the decade 2008-09 to 2017-18. J Sci Med Sport. 2021 Oct;24(10):1055-1060. doi: 10.1016/j.jsams.2020.12.001. Epub 2020 Dec 11. PMID: 33384220.
- Bere T, Flørenes TW, Krosshaug T, Haugen P, Svandal I, Nordsletten L, Bahr R. A systematic video analysis of 69 injury cases in World Cup alpine skiing. Scand J Med Sci Sports. 2014 Aug;24(4):667-77. doi: 10.1111/sms.12038. Epub 2013 Jan 10. PMID: 23301907.
- Fröhlich S, Pazeller S, Cherati AS, Müller E, Frey WO, Spörri J. Overuse injuries in the knee, back and hip of top elite female alpine skiers during the off-season preparation period: prevalence, severity and their association with traumatic preinjuries and training load. BMJ Open Sport Exerc Med. 2020 Dec 24;6(1):e000892. doi: 10.1136/bmjsem-2020-000892. PMID: 33408876; PMCID: PMC7768963.
- Ruedl G, Pocecco E, Sommersacher R, Gatterer H, Kopp M, Nachbauer W, Burtscher M. Factors associated with self-reported risk-taking behaviour on ski slopes. Br J Sports Med. 2010 Feb;44(3):204-6. doi: 10.1136/bjsm.2009.066779. PMID: 20231601.
- Raschner C, Hildebrandt C, Mohr J, Müller L. Sex Differences in Balance Among Alpine Ski Racers: Cross-Sectional Age Comparisons. Percept Mot Skills. 2017 Dec;124(6):1134-1150. doi: 10.1177/0031512517730730. Epub 2017 Sep 13. PMID: 28901201.
- Westin M, Alricsson M, Werner S. Injury profile of competitive alpine skiers: a five-year cohort study. Knee Surg Sports Traumatol Arthrosc. 2012 Jun;20(6):1175-81. doi: 10.1007/s00167-012-1921-x. Epub 2012 Feb 19. PMID: 22349602.
- Bishop G. New equipment rules for 2012 alpine season are criticized. The New York Times. https://www.nytimes.com/2011/08/24/sports/new-equipment-rules-for-skiing-are-criticized.html. Published August 24, 2011. Accessed March 26, 2024.
- Müller E, Spörri J, Kröll J, Hörterer H. Equipment designed to reduce risk of severe traumatic injuries in alpine ski racing: constructive collaboration between the International Ski Federation, industry and science. Br J Sports Med. 2016 Jan;50(1):1-2. doi: 10.1136/bjsports-2015-095689. PMID: 26702012.
- Haaland B, Steenstrup SE, Bere T, Bahr R, Nordsletten L. Injury rate and injury patterns in FIS World Cup Alpine skiing (2006-2015): have the new ski regulations made an impact? Br J Sports Med. 2016 Jan;50(1):32-6. doi: 10.1136/bjsports-2015-095467. Epub 2015 Nov 11. PMID: 26559877.
- Platzer HP, Barth M, Giger A, Schröcksnadel P, Nachbauer W. Did injury incidence in alpine ski racing change after equipment regulations? An evaluation based on the injury surveillance system of the Austrian Ski Federation. J Sci Med Sport. 2021 Oct;24(10):1044-1048. doi: 10.1016/j.jsams.2020.07.005. Epub 2020 Jul 24. PMID: 32807655.
- Tarka MC, Davey A, Lonza GC, O'Brien CM, Delaney JP, Endres NK. Alpine Ski Racing Injuries. Sports Health. 2019 May/Jun;11(3):265-271. doi: 10.1177/1941738119825842. Epub 2019 Jan 28. PMID: 30689522; PMCID: PMC6537318.
- Wagner M, Pfurtscheller S, Dammerer D, Nardelli P, Kaufmann G, Brunner A. Emergency Service Assistance for Injuries on Alpine Ski Slopes: A Cross-Sectional Study. Prehosp Disaster Med. 2022 Dec;37(6):778-782. doi: 10.1017/S1049023X22001364. Epub 2022 Oct 6. PMID: 36199228.
- Park SK, Stefanyshyn DJ, Loitz-Ramage B, Hart DA, Ronsky JL. Changing hormone levels during the menstrual cycle affect knee laxity and stiffness in healthy female subjects. Am J Sports Med. 2009 Mar;37(3):588-98. doi: 10.1177/0363546508326713. Epub 2009 Jan 27. PMID: 19174550.
- Barth M, Platzer HP, Giger A, Nachbauer W, Schröcksnadel P. Acute on-snow severe injury events in elite alpine ski racing from 1997 to 2019: the Injury Surveillance System of the Austrian Ski Federation. Br J Sports Med. 2020 Oct 6:bjsports-2020-102752. doi: 10.1136/bjsports-2020-102752. Epub ahead of print. PMID: 33023882.
- Heinrich D, van den Bogert AJ, Nachbauer W. Predicting neuromuscular control patterns that minimize ACL forces during injury-prone jump-landing manoeuvres in downhill skiing using a musculoskeletal simulation model. Eur J Sport Sci. 2023 May;23(5):703-713. doi: 10.1080/17461391.2022.2064770. Epub 2022 May 12. PMID: 35400304.
- Westin M, Harringe ML, Engström B, Alricsson M, Werner S. Risk Factors for Anterior Cruciate Ligament Injury in Competitive Adolescent Alpine Skiers. Orthop J Sports Med. 2018 Apr 23;6(4):2325967118766830. doi: 10.1177/2325967118766830. PMID: 29780835; PMCID: PMC5954346.
- Dominguez-Navarro F, Casaña J, Perez-Dominguez B, Ricart-Luna B, Cotolí-Suárez P, Calatayud J. Dynamic balance and explosive strength appears to better explain single leg hop test results among young elite female basketball athletes. Sci Rep. 2023 Apr 4;13(1):5476. doi: 10.1038/s41598-023-31178-7. PMID: 37016001; PMCID: PMC10073233.
- Schmitt KU, Hörterer N, Vogt M, Frey WO, Lorenzetti S. Investigating physical fitness and race performance as determinants for the ACL injury risk in Alpine ski racing. BMC Sports Sci Med Rehabil. 2016 Aug 17;8:23. doi: 10.1186/s13102-016-0049-6. PMID: 27540485; PMCID: PMC4989489.
- Ireland ML. The female ACL: why is it more prone to injury? Orthop Clin North Am. 2002 Oct;33(4):637-51. doi: 10.1016/s0030-5898(02)00028-7. PMID: 12528906.
- Ruedl G, Webhofer M, Linortner I, Schranz A, Fink C, Patterson C, Nachbauer W, Burtscher M. ACL injury mechanisms and related factors in male and female carving skiers: a retrospective study. Int J Sports Med. 2011 Oct;32(10):801-6. doi: 10.1055/s-0031-1279719. Epub 2011 Jun 21. PMID: 21695668.
- Choi WR, Yang JH, Jeong SY, Lee JK. MRI comparison of injury mechanism and anatomical factors between sexes in non-contact anterior cruciate ligament injuries. PLoS One. 2019 Aug 1;14(8):e0219586. doi: 10.1371/journal.pone.0219586. PMID: 31369583; PMCID: PMC6675514.
- Sturnick DR, Vacek PM, DeSarno MJ, Gardner-Morse MG, Tourville TW, Slauterbeck JR, Johnson RJ, Shultz SJ, Beynnon BD. Combined anatomic factors predicting risk of anterior cruciate ligament injury for males and females. Am J Sports Med. 2015 Apr;43(4):839-47. doi: 10.1177/0363546514563277. Epub 2015 Jan 12. PMID: 25583759; PMCID: PMC6607022.
- Herzberg SD, Motu'apuaka ML, Lambert W, Fu R, Brady J, Guise JM. The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2017 Jul 21;5(7):2325967117718781. doi: 10.1177/2325967117718781. PMID: 28795075; PMCID: PMC5524267.
- Westin M, Harringe ML, Engström B, Alricsson M, Werner S. Prevention of Anterior Cruciate Ligament Injuries in Competitive Adolescent Alpine Skiers. Front Sports Act Living. 2020 Mar 6;2:11. doi: 10.3389/fspor.2020.00011. PMID: 33345006; PMCID: PMC7739649.
- Raschner C, Platzer HP, Patterson C, Werner I, Huber R, Hildebrandt C. The relationship between ACL injuries and physical fitness in young competitive ski racers: a 10-year longitudinal study. Br J Sports Med. 2012 Dec;46(15):1065-71. doi: 10.1136/bjsports-2012-091050. Epub 2012 Sep 11. PMID: 22968156.
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