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NEW YORK (Reuters Life!) - A turning, off-balance skier leaning backwards is a recipe for knee disaster, according to a report from a panel of sports medicine and skiing experts.
The group picked apart videos of 20 World Cup skiers who had suffered an anterior cruciate ligament (ACL) tear, an injury that wipes the skier out for a year and can have health consequences down the road.
"Prior to this study we really had no idea how these potentially devastating injuries, like ACL injuries, actually happen in World Cup skiers," said Roald Bahr, from the Norwegian School of Sports Sciences and one of the report's authors, of the report published in the American Journal of Sports Medicine.
"Most people probably think that they happen as the skier is crashing, tumbling down the course. As the study really shows, the ligament is torn while the skier is still skiing, and then they crash."
Coming to that conclusion wasn't necessarily enjoyable -- the experts each had to review videos of the run that led to the injury, on their own, to determine the exact moment of the ACL tear. Then they came to a consensus.
After that, they recorded all the details of the moment of injury, the skier's behavior and situation, as well as the angles of joints and position of limbs.
"Once you've spotted what actually happens, it becomes very, very clear that there's a consistent pattern here," Bahr told Reuters Health.
Bahr and his colleagues observed the injuries to skiers in the downhill, slalom, giant slalom, and super-G events.
The toughest situation is when a skier is trying to make a turn on the course, but leaning too far backwards and inwards into the turn while off-balance.
That causes the outer ski to lift off the snow -- and when the skier tries to reach out with their leg to get the ski back on the ground, the very back of the ski hits the snow, pulling the leg with it and rotating the lower leg.
The force on the knee caused by that rotation is too much for the ACL, one of four ligaments connecting the thighbone to the shinbone, to take.
ACL tears also happened when skiers were forced into a split, when their inner ski hooked on to a gate during a turn, and when they landed on the back of their skis after a jump.
Bahr said that wet and slushy snow, more common late in the ski season, makes it more likely for the back of the ski to catch on the snow, upping a skier's chance of ACL injury.
And although those injuries often heal up within a year, he explained that people who have suffered ACL tears have a much higher risk of getting arthritis in the future, regardless of the treatment they get.
The findings of the report may have implications for preventing future ACL injuries, with Bahr saying that even though the study only included world-class athletes, recreational skiers get the same injuries.
"Perhaps it is possible to train the skiers to recognize that position and bail out in time," he added.
The message is to learn to fall and weight the downhill ski, even when you are afraid, said Michael Tuggy, a physician at Swedish Medical Center in Seattle and a former ski patroller.
"The natural tendency is to fall back into the hill, off the downhill ski, which is the perfect setup for an ACL tear," he told Reuters Health in an email.
(Reporting by Genevra Pittman at Reuters Health; editing by Elaine Lies)
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The group picked apart videos of 20 World Cup skiers who had suffered an anterior cruciate ligament (ACL) tear, an injury that wipes the skier out for a year and can have health consequences down the road.
"Prior to this study we really had no idea how these potentially devastating injuries, like ACL injuries, actually happen in World Cup skiers," said Roald Bahr, from the Norwegian School of Sports Sciences and one of the report's authors, of the report published in the American Journal of Sports Medicine.
"Most people probably think that they happen as the skier is crashing, tumbling down the course. As the study really shows, the ligament is torn while the skier is still skiing, and then they crash."
Coming to that conclusion wasn't necessarily enjoyable -- the experts each had to review videos of the run that led to the injury, on their own, to determine the exact moment of the ACL tear. Then they came to a consensus.
After that, they recorded all the details of the moment of injury, the skier's behavior and situation, as well as the angles of joints and position of limbs.
"Once you've spotted what actually happens, it becomes very, very clear that there's a consistent pattern here," Bahr told Reuters Health.
Bahr and his colleagues observed the injuries to skiers in the downhill, slalom, giant slalom, and super-G events.
The toughest situation is when a skier is trying to make a turn on the course, but leaning too far backwards and inwards into the turn while off-balance.
That causes the outer ski to lift off the snow -- and when the skier tries to reach out with their leg to get the ski back on the ground, the very back of the ski hits the snow, pulling the leg with it and rotating the lower leg.
The force on the knee caused by that rotation is too much for the ACL, one of four ligaments connecting the thighbone to the shinbone, to take.
ACL tears also happened when skiers were forced into a split, when their inner ski hooked on to a gate during a turn, and when they landed on the back of their skis after a jump.
Bahr said that wet and slushy snow, more common late in the ski season, makes it more likely for the back of the ski to catch on the snow, upping a skier's chance of ACL injury.
And although those injuries often heal up within a year, he explained that people who have suffered ACL tears have a much higher risk of getting arthritis in the future, regardless of the treatment they get.
The findings of the report may have implications for preventing future ACL injuries, with Bahr saying that even though the study only included world-class athletes, recreational skiers get the same injuries.
"Perhaps it is possible to train the skiers to recognize that position and bail out in time," he added.
The message is to learn to fall and weight the downhill ski, even when you are afraid, said Michael Tuggy, a physician at Swedish Medical Center in Seattle and a former ski patroller.
"The natural tendency is to fall back into the hill, off the downhill ski, which is the perfect setup for an ACL tear," he told Reuters Health in an email.
(Reporting by Genevra Pittman at Reuters Health; editing by Elaine Lies)
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