As winter has finally hit Southern Ontario and our local ski hills have started to open their facilities for skiers and snowboarders, it seems like an appropriate time to remind ourselves that these recreational activities don’t come without the potential risk for injuries. While hockey seems like the obvious winter sport for injuries, skiing and snowboarding actually accounts for twice the number of hospitalization when compared with hockey. In 2010-11 there were 2329 hospital admissions for ski/snowboard related injuries in Canada versus 1114 for hockey-related injuries. Snowboarding is estimated for 25% of the nonfatal outdoor recreational injuries requiring emergency care.

When we look at age groups children and teens aged 7 to 17 years old have a higher rate of injury when compared to older and younger participants and boys from 10-19 accounted for 689 out of the 2329 (nearly 30%) of the ski and snowboarding injuries and in this age group 81% of all winter injuries were to boys.

Skiers are more likely to be injured by collisions whereas snowboarders are more likely to be injured by a fall. In downhill skiing, the most common injury site is the lower extremity (40-60%) with head and neck being neck frequent (10-20%) followed by the upper extremity (15-25%) and the thumb (10-20%). In snowboarding the upper extremity accounts for 50% of the injuries with the most common injury being the wrist (22%). Head injuries are more common in snowboarders than skiers.

Among young skiers, 40-50% of injuries occur among beginners and expert skiers and snowboarders seem to have lower injury rates overall, however they may be at risk for more severe injuries.

Injury rates have declined over the past few years thanks in part to improvements in ski equipment in particular bindings and boots. Although proper setup of bindings to the particular skier ability level and weight is important as 96% of lower extremity injuries in adult skiers in one study showed that the ski bindings did not release when the injury occurred.

Environmental factors also play into injury rates as it has been shown that groomed trails result in less injuries as compared to ice, damp snow and narrow overcrowded trails and snowboard injuries seemed to occur less on deep snow, fresh snow or groomed slopes.

In 2010-11 415 Canadians were hospitalized for head injuries sustained during winter sports and

nearly one-third of these occurred during skiing/snowboarding. It has been shown that helmets significantly reduce the risk of head injuries in skiers ad snowboarders by 35% from a systematic review. A recent review also concluded that helmets did not increase the frequency of neck injuries. Another form of protective equipment is wrist guards which have been shown to reduce the incidence of wrist injuries in snowboarders significantly, however currently only 5-6% or less of snowboarders wear wrist guards.

Proper instruction has also shown to decrease the risk of lower extremity injuries in skiers.

Recommendations

Proper instruction

Proper equipment setup and maintenance

Pre-season fitness and proper warm-up including stretching

Pay attention to environment and make wise choices.

References

Canadian Paediatric Society. (2012). Skiing and snowboarding injury prevention.

Canadian Institute for Health Information. (2015). Number of hospitilizations due to winter sports and recreational activities.