By Dr. George Ahlbäumer
Over the last decade the number of worldwide participants in snowboarding increased from one-million to an estimated twelve-million. Paralleling this amazing growth has come a greater incidence of snowboard injuries.
Data from the U.S. National Electronic Injury Surveillance System showed that between 1993 and 1997 the number of snowboard injuries increased by almost 300 percent. During that same time, according to figures from American Sports Data, snowboard participation rose 192 percent.
Since 1989, scientific research has focused on collecting snowboarding injuries that show the sport has its own specific injury pattern. However, it's not only researchers who are getting more interested in snowboard-related injuries. The costs associated with treating these injuries has also risen tremendously, and insurance companies are aware of this fact.
In Switzerland, the average health-related cost per snowboard injury is approximately 2,000 U.S. dollars, according to a bulletin published by SUVA, the Swiss injury insurance association. This figure is probably even higher in the United States.
Because insurance companies view snowboarding as a potentially dangerous sports activity, there has been a push from that community to include snowboarding in the insurance liability disclosure form. For example, when signing up for life insurance, applicants would be asked if they were snowboarders. This helps the insurance companies identify individuals who participate in “risky” activities, and answering “yes” could force the applicant to pay higher insurance premiums. Currently, rock climbing and paragliding are a few of the activities listed on the disclosure form in some countries.
Industry Responsibility Should the snowboarding industry take responsibility for injury prevention? In my opinion the answer is yes. By reacting proactively, the snowboard industry can avoid restrictions from governmental authorities that could directly affect their markets.
In addition, the support and development of useful protective devices in connection with scientific research and the support of public awareness about these safety devices would be an important step to make snowboarding safer, while keeping it an enjoyable and youth-oriented sport activity.
Statistics And Facts According to a May, 1995 article in Sports Medicine magazine entitled “Snowboard Injuries, An Overview,” the average snowboarder is male (with a male to female ratio of three to one) and in his early twenties. While this article is slightly dated, the facts are still close.
Scientific reports differ regarding the injury risk in snowboarding, but studies mainly find an injury rate of four to six injuries per 1,000 visits-comparable to those of skiing.
Although skiing and snowboarding have a comparable rate of injury, the type of injury and the typical victim vary. In the skiing population, 34 percent of those injured are beginners. However, in snowboarding the majority (49 to 60 percent, depending on the survey) are beginners. This clearly is a reflection of the participant profile of this developing sport.
About 47 percent of all snowboarding injuries occur to the lower limbs and 33 percent to the upper limbs, according to three different studies. According to the U.S. Consumer Product Safety Commission study entitled, “Skiing Helmets: An Evaluation Of The Potential To Reduce Head Injury,” published in January 1999, head injuries amount for nine to fourteen percent of all snowboarding injuries.
According to the Sports Medicine study, more than 36 percent of all injuries occur during the first four days of snowboarding. Of these injuries 61 percent are wrist fractures and sprains. In the wider snowboarding population, wrist injuries also constitute the most frequent overall injury, accounting for 33 peercent. Ankle injuries take second place with an incidence of 28 percent.
The most common type of injuries are sprains (31 to 53 percent of cases), particularly to the ankle (23 to 26 percent). This is followed by fractures (24 to 27 percent) and contusions (twelve to nineteen percent).
Compared with skiing injuries, studies show that snowboarders have 2.4 times as many fractures (mainly of the wrist), fewer knee injuries, but more ankle injuries.
According to the data collected, the typical snowboarding knee injury is less severe than those associated with skiing. Ankle injuries are more common with soft boots, whereas knee injuries and distal tibia fractures are more common with hard boots.
If the current data is correct, the increasing popularity of soft-boot step-in systems might lead to an increasing number of ankle sprains. One reason could be the stiff interface between boot and binding, which induces torsion forces more directly to the foot. But more data is required to prove the significance of this claim.
Only a minority of snowboarders wear boots with stabilization or reinforcement to protect the ankle. One reason also might be that the availability of functional protective devices for the ankle is limited.
For wrist protection the scenario is similar. According to the Swiss Multicenter Snowboard Study, only about sixteen percent of snowboarders surveyed wore wrist protection.
Approximately 88 percent of all snowboarders who sustained a wrist fracture were not wearing wrist protection. A 1997 study entitled “Injury Risk In Snowboarding” showed that wrist guards seem to reduce the risk of an injury by five times.
Although effective, wrist guards are hardly a cure all. Wrist injuries still occur despite the use of wrist protection. According to the International Symposium of Ski Trauma and Skiing Safety, held in May 1997 in Whistler, British Columbia, this is primarily because most of the equipment available at the time did not meet vital safety requirements. These requirements are namely shock-absorption, the prevention of excessive extension of the wrist, and, above all, protection to the proximal part of the forearm.
The main cause of wrist injuries are falls backward on the extended wrist. This specific injury mechanism has to be addressed in the design of wrist guards, otherwise the effectiveness of such a device might be in question. Wrist guards should not too long and should allow a muscular counter-reaction. Developing functional wrist guards and incorporating ankle stabilization systems in current boot designs appears sensible to prevent the most common injuries in snowboarding.
-------------------Dr. Georg Ahlbäumer is working as an orthopedic surgeon at the Alpine resort St. Moritz in Switzerland. Together with the Biomex Protection research team of the Clinic Gut in St. Moritz, he has successfully worked several years on biomechanical solutions to prevent injuries in the field of sports. For a full list of the studies mentioned in the article, e-mail him: Info@biomex-protection.com