Sports Medicine

, Volume 37, Issue 6, pp 485–499 | Cite as

Downhill Ski Injuries in Children and Adolescents

  • Michael C. MeyersEmail author
  • C. Matthew LaurentJr
  • Robert W. Higgins
  • William A. Skelly
Review Article


Downhill skiing is considered to be an enjoyable activity for children and adolescents, but it is not without its risks and injuries. Injury rates now range between 3.9 and 9.1 injuries per 1000 skier days, and there has been a well documented increase in the number of trauma cases and fatalities associated with this sport. Head and neck injuries are considered the primary cause of fatal injuries and constitute 11–20% of total injuries among children and adolescents. Cranial trauma is responsible for up to 54% of total hospital injuries and 67% of all fatalities, whereas thoracoabdominal and spine injuries comprise 4–10% of fatalities. Furthermore, there has been an increase in the proportion of upper extremity trauma with acromioclavicular dislocations, and clavicle and humeral fractures accounting for the majority (22–79%) of the injuries. However, the most common and potentially serious injuries in children and adolescents are those to the lower extremity, with knee sprains and anterior cruciate ligament tears accounting for up to 47.7% of total injuries. Knee sprains and grade III ligament trauma associated with lower leg fractures account for 39–77% of ski injuries in this young population.

Approximately 15% of downhill skiing injuries among children and adolescents are caused by musculoskeletal immaturity. Other factors include excessive fatigue, age, level of experience, and inappropriate or improperly adjusted equipment. Collisions and falls constitute a significant portion (up to 76%) of trauma, and are commonly associated with excessive speed, adverse slope conditions, overconfidence leading to carelessness, and behavioural patterns within and among gender. The type and severity of injuries are typically functions of biomechanical efficiency, skiing velocity or slope conditions; however, a multiplicative array of intrinsic and extrinsic factors may simultaneously be involved. Despite extensive efforts to provide a comprehensive picture of the aetiology of injury, limitations have hampered reporting. These limitations include age and injury awareness, data collection challenges, lack of uniformity in the definition or delineation of age classification and lack of knowledge of predisposing factors prior to injury.

Since skill level is the primary impetus in minimising ski injuries, formal instruction focusing on strategies such as collision avoidance and helmet use, fall training minimising lower extremity trauma, altering ski technique and avoiding behaviours that lead to excessive risk are, therefore, highly recommended. Skiing equipment should be outfitted to match the young skier’s height, weight, level of experience, boot size and slope conditions. Additionally, particular attention should be paid to slope management (i.e. overcrowding, trail and obstacle marker upkeep) and minimising any opportunity for excessive speed where children are present. Whether increases in knowledge, education and technology will reduce predisposition to injury among this population remains to be seen. As with all high-risk sports, the answer may lie in increased wisdom and responsibility of both the skier and the parent to ensure an adequate level of ability, self-control and simply common sense as they venture out on the slopes.


Ulnar Collateral Ligament Musculoskeletal Immaturity Cranial Trauma Excessive Speed Multiplicative Array 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.


  1. 1.
    Chambers HG. Ligament injuries in children and adolescents. In: Pedowitz RA, O’Connor JJ, Akeson WB, editors. Daniel’s knee injuries: ligament and cartilage structure, function, injury, and repair. Philadelphia (PA): Lippincott, Williams and Wiltons, 2003: 587–98Google Scholar
  2. 2.
    Natri A, Johnson RJ. Skiing. In: Garrett WE, Kirkendall DT, Squire DL, editors. Principles and practice of primary care sports medicine. Philadelphia (PA): Lippincott, Williams and Wilkins, 2001: 553–61Google Scholar
  3. 3.
    Hunter RE. Skiing injuries. Am J Sports Med 1999; 27 (3): 381–9PubMedGoogle Scholar
  4. 4.
    US Consumer Product Safety Commission. Skiing helmets: an evaluation of the potential to reduce head injury. Washington (DC): US Government Printing Office, 1999Google Scholar
  5. 5.
    Xiang H, Stallones L, Smith GA. Downhill skiing injury fatalities among children. Inj Prev 2004; 10: 99–102PubMedCrossRefGoogle Scholar
  6. 6.
    Xiang H, Stallones L. Deaths associated with snow skiing in Colorado 1980–1981 to 2000–2001 ski seasons. Injury 2003; 34 (12): 892–6PubMedCrossRefGoogle Scholar
  7. 7.
    Bergstrom KA, Ekeland A. Effect of trail design and grooming on the incidence of injuries at alpine ski areas. Br J Sports Med 2004; 38: 264–8PubMedCrossRefGoogle Scholar
  8. 8.
    Skokan EG, Junklas EP, Kadish H. Serious winter sport injuries in children and adolescents requiring hospitalization. Am J Emerg Med 2003; 21 (2): 95–9CrossRefGoogle Scholar
  9. 9.
    Bagel BE, Gentler C, Platt RW, et al. Injuries among skiers and snowboarders in Quebec. Epidemiology 2004; 15 (3): 279–86CrossRefGoogle Scholar
  10. 10.
    Langran M, Selvaraj S. Snow sports injuries in Scotland: a casecontrol study. Br J Sports Med 2002; 36: 135–40PubMedCrossRefGoogle Scholar
  11. 11.
    Bagel BE, Meeuwisse WB, Mohtadi NG, et al. Skiing and snowboarding injuries in the children and adolescents of Southern Alberta. Clin J Sports Med 1999; 9 (1): 9–17CrossRefGoogle Scholar
  12. 12.
    Deibert M, Aronsson D, Johnson R, et al. Skiing injuries in children, adolescents, and adults. J Bone Joint Surg Am 1998; 80 (1): 25–32PubMedCrossRefGoogle Scholar
  13. 13.
    Urabe Y, Ochi M, Onari K, et al. Anterior cruciate ligament injury in recreational alpine skiers: analysis of mechanisms and strategy for prevention. J Orthop Sci 2002; 7: 1–5PubMedCrossRefGoogle Scholar
  14. 14.
    Danielson K. Swedish measures for reduction of skiing accidents with special reference to children. Orthop Clin North Am 1976; 7: 59–61Google Scholar
  15. 15.
    Sherry E, Korbel P, Henderson A. Children’s skiing injuries in Australia. Med J Aust 1987; 149: 193–5Google Scholar
  16. 16.
    Garrick JG, Requa RE. Injury patterns in children and adolescent skiers. Am J Sports Med 1979; 7: 245–8PubMedCrossRefGoogle Scholar
  17. 17.
    Xiang H, Kelleher K, Shields BJ, et al. Skiing- and snowboarding-related injuries treated in US emergency departments, 2002. J Trauma 2005; 58 (1): 112–8CrossRefGoogle Scholar
  18. 18.
    Pecina M. Injuries in downhill (alpine) skiing. Croatian Med J 2002; 43 (3): 257–60Google Scholar
  19. 19.
    Hackam DJ, Kreller M, Pearl RH. Snow-related recreational injuries in children: assessment of morbidity and management strategies. J Pediatr Slag 2000; 35: 1409–10Google Scholar
  20. 20.
    Hunter M, Erhart S, Drudger A, et al. Severe skiing injuries: a retrospective analysis of 361 patients including mechanism of trauma, severity of injury, and mortality. J Trauma 1995; 39 (4): 737–41CrossRefGoogle Scholar
  21. 21.
    Bagel BE, Pless IB, Gentler C, et al. Quality of information on risk factors reported by ski patrols. Inj Prev 2004; 10: 275–9CrossRefGoogle Scholar
  22. 22.
    Machold W, Kwasny O, Gabler P, et al. Risk of injury through snowboarding. J Trauma 2000; 48: 1109–14PubMedCrossRefGoogle Scholar
  23. 23.
    Van Mechelen W, Hlobil H, Kemper HCG. Incidence, severity, aetiology and prevention of sports injuries: a review of concepts. Sports Med 1992; 14 (2): 82–99CrossRefGoogle Scholar
  24. 24.
    Walter SO, Sutton JR, McIntosh JM, et al. The aetiology of sports injuries: a review of methodologies. Sports Med 1985; 2: 47–58PubMedCrossRefGoogle Scholar
  25. 25.
    Lanes PC, Abbott PJ. The Colorado snowboarding injury study. In: Johnson RJ, editor. Skiing trauma and safety. Vol. 12. Philadelphia (PA): American Society for Testing and Materials, 1999: 141–9Google Scholar
  26. 26.
    Dentirag B, Oncan T, Durak K. An evaluation of knee ligament injuries encountered in skiers at the Utudag Ski Center. Acta Orthop Traumaticl True 2004; 38 (5): 313–6Google Scholar
  27. 27.
    Goulet C, Regnier G, Grimard G, et al. Risk factors associated with alpine skiing injuries in children: a case control study. Am J Sports Med 1999; 27: 644–50PubMedGoogle Scholar
  28. 28.
    Sulheim S, Holme I, Ekeland A, et al. Helmet use and risk of head injuries in alpine skiers and snowboarders. JAMA 2006; 295 (8): 919–24PubMedCrossRefGoogle Scholar
  29. 29.
    Floyd T. Alpine skiing, snowboarding, and spine trauma. Arch Orthop Trauma Sorg 2001; 121: 433–6CrossRefGoogle Scholar
  30. 30.
    Schram H, Gerner HJ. Paralysis from sport and diving accidents. Clin J Sports Med 2001; 11 (1): 17–22CrossRefGoogle Scholar
  31. 31.
    Gassner R, Vasquez Garcia J, Leja W, et al. Traumatic dental injuries and Alpine skiing. Ended Dent Traumaticl 2000; 16 (3): 122–7CrossRefGoogle Scholar
  32. 32.
    O’Neill OF, McGlone MR. Injury risk in first time snowboarders versus first-time skiers. Am J Sports Med 1999; 27 (1): 94–7PubMedGoogle Scholar
  33. 33.
    Bagel B. Skiing and snowboarding injuries. Med Sports Sci 2005; 48: 74–119Google Scholar
  34. 34.
    Osler T, Baker SP, Long W. A modification of the injury severity score that both improves and simplifies scoring. J Trauma 1997; 43: 922–5PubMedCrossRefGoogle Scholar
  35. 35.
    Corra S, Conci A, Contort G, et al. Skiing and snowboarding injuries and their impact on the emergency care system in South Tyrol: a retrospective analysis for the winter season 2001–2002. Inj Control Sat Promot 2004; 11 (4): 2281–5Google Scholar
  36. 36.
    Diamond PT, Gale SO, Denkraus HK. Head injuries in skiers: an analysis of injury severity and outcome. Brain Inj 2001; 15 (5): 429 34PubMedCrossRefGoogle Scholar
  37. 37.
    Heir S, Krosshaug T, Rordven A, et al. Injuries in alpine skiing related to age groups [abstract]. In: Puddu GC, Mariani P, editors. Proceedings of the 10th Congress of European Society of Sports Traumatology, Knee Surgery and Arthroscopy; 2002 Apr 23–27. Rome: F Beglionant, 2002: 407Google Scholar
  38. 38.
    Fukuda O, Takaba M, Saito T, et al. Head injuries in snowboarders compared with head injuries in skiers: a prospective analysis of 1076 patients from 1994 to 1999 in Niigata, Japan. Am J Sports Med 2001; 29: 437–40PubMedGoogle Scholar
  39. 39.
    Macnab AJ, Smith T, Gagnon FA, et al. Effect of helmet wear on the incidence of head/face and cervical spine injuries in young skiers and snowboarders. Inj Prev 2002; 8: 324–7PubMedCrossRefGoogle Scholar
  40. 40.
    Levy S, Hawker A, Hemnunger L, et al. Analysis of head injuries among skiers and snowboarders. J Trauma 2002; 53: 695–704PubMedCrossRefGoogle Scholar
  41. 41.
    Tub T, Hachl O, Hohlrieder M, et al. Dentofacial trauma in sport accidents. Gen Dent 2002; 50 (3): 274–9Google Scholar
  42. 42.
    De Gioanni PP, Mazzeo R, Servadio F. Sports activities and maxillofacial injuries: current epidermologic and clinical aspects relative to a series of 379 cases. Minerva Stomatol 2000; 49 (1): 21–6PubMedGoogle Scholar
  43. 43.
    Gassner R, Ulmer H, Tuli T, et al. Incidence of oral and maxillofacial skiing injuries due to different injury mechanisms. J Oral Maxillofac Surg 1999; 57 (9): 1068–73PubMedCrossRefGoogle Scholar
  44. 44.
    Johnson B, Christensen C, Dirusso S, et al. A need for reevaluadon of sports participation recommendations for children with a solitary kidney. J Urol 2005; 174 (2): 686–9PubMedCrossRefGoogle Scholar
  45. 45.
    Wan I, Corvino TF, Greenfield SP. The incidence ofrecreational genitourinary and abdominal injuries in the Western New York pediatric population. J Urol 2003; 170 (4): 1525–7PubMedCrossRefGoogle Scholar
  46. 46.
    Radmayr C, Oswald J, Muller E, et al. Blunt renal trauma in children: 26 years clinical experience in an alpine region. Eur Urol 2002; 42 (3): 297–300PubMedCrossRefGoogle Scholar
  47. 47.
    Michaud K, Remain N, Brandt-Casadevall C, et al. Sudden death related to small coronary artery disease. Am J Forensic Med Pathol 2001; 22 (3): 225–7PubMedCrossRefGoogle Scholar
  48. 48.
    Jackson AB, Dijkers M, Devivo MJ, et al. A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil 2004; 85 (11 ): 1740–8PubMedCrossRefGoogle Scholar
  49. 49.
    Pratt JA, Winston KR, Brennan R. Spine and spinal cord injuries in downhill skiers. J Trauma 1995; 39: 1115–8CrossRefGoogle Scholar
  50. 50.
    Rachbauer F, Sterzinger W, Eibl G. Radiographic abnormalities in the thoracolumbar spine of young elite skiers. Am J Sports Med 2001; 29 (4): 446–9PubMedGoogle Scholar
  51. 51.
    Dohjima T, Surni Y, Ohno T, et al. The dangers of snowboarding: a 9-year prospective comparison of snowboarding and skiing injuries. Acta Orthop Scand 2001; 72 (6): 657–60PubMedCrossRefGoogle Scholar
  52. 52.
    Henry M. Fractures and dislocations of the hand. In: Bucholtz RW, Beckman JD, editors. Rockwoord and Green’s fractures in adults. Philadelphia (PA): Lippincott, Williams and Wilkins, 2002: 732–3Google Scholar
  53. 53.
    Kozin SH. Fractures and dislocations along the pediatric thumb ray. Hand Clin 2006; 22 (1): 19–29PubMedCrossRefGoogle Scholar
  54. 54.
    Pitts G, Willoughby J, Uhl TL. Rehabilitation of wrist and hand injuries. In: Andrews JR, Harrelson GL, Wilk KE, editors. Physical rehabilitation of the injured athlete. Philadelphia (PA): Saunders, 2004: 619–29Google Scholar
  55. 55.
    Davies MB, Wright JE, Edwards MS. True skier’s thumb in childhood. Injury 2002; 33 (2): 186–7PubMedCrossRefGoogle Scholar
  56. 56.
    Major NM. Sports medicine imaging. In: Garrett WE, Kirkendall DT, Squire DL, editors. Principles and practice of primary care sports medicine. Philadelphia (PA): Lippincott, Williams and Wilkins, 2001: 57–65Google Scholar
  57. 57.
    Stener B. Displacement of the ruptured ulnar collateral ligament of the metacarpophalangeal joint of the thumb: a clinical and anatomical study. J Bone Joint Slrrg 1962; 44: 869–79Google Scholar
  58. 58.
    Ekeland A, Rodven A. Injuries in Norwegian ski resorts 1998–2000 [abstract]. In: Puddu GC, Mariam P, editors. Proceedings of the 10th Congress of European Society of Sports Traumatology, Knee Surgery and Arthoscopy; 2002 Apr 23–27. Rome: F Begliomini, 2002: 416Google Scholar
  59. 59.
    Gulick DW, Mote CD. Design of a learning binding for alpine skiing. In: Johnson RJ, Zucco P, Shealy JE, editors. Skiing trauma and safety. Volume 13. Philadelphia (PA): American Society for Testing and Materials, 2000: 20–49Google Scholar
  60. 60.
    Rossi MJ, Lubowitz JH, Guttman D. The skier’s knee. Arthros copy 2003; 19: 75–84CrossRefGoogle Scholar
  61. 61.
    Bagel BE, Pless IB, Goulet C, et al. Effectiveness of helmets in skiers and snowboarders: case-control and case crossover study [abstract] [published erratum appears in Br Med J 2005 Feb 12; 330 (7487): 345]. Br Med J 2005 Feb 5; 330 (7486): 281CrossRefGoogle Scholar
  62. 62.
    Werner S, Willis K. Self-release of ski-binding. Int J Sports Med 2002; 23 (7): 530–5PubMedCrossRefGoogle Scholar
  63. 63.
    Bruening D, Richards JG. Optimal ankle axis position for articulated boots. Sports Biomech 2005; 4 (2): 215–25PubMedCrossRefGoogle Scholar
  64. 64.
    Tudor A, Sestan B, Nemec B, et al. Infra-articular calcaneal fracture in a 14-year-old com pefing skier: casereport. Croatian Med J 2003; 44 (6): 764–6Google Scholar
  65. 65.
    Bauer G, Mutschler W. Infra-articular juvenile calcaneal fracture in skiing [in German]. Sportverletz Sportschaden 1989; 3: 183–6PubMedCrossRefGoogle Scholar
  66. 66.
    Inokuchi S, Usamti N, Hiraishi E, et al. Calcaneal fractures in children. J Pediatr Orthop 1998; 18: 469–74PubMedGoogle Scholar
  67. 67.
    Wilkins KE, Aroojis AJ. The present status of children’s fractures. In: Beaty JB, Kasser JR, editors. Rockwoord and Wiltons’ fractures in children. Philadelphia (PA): Lippincott, Williams and Wilkins, 2001: 13–5Google Scholar
  68. 68.
    Gissane C, White J, Kerr K, et al. An operational model to investigate contact sports injuries. Med Sci Sports Exerc 2001; 33 (12): 1999–2003PubMedCrossRefGoogle Scholar
  69. 69.
    Rotating R, Gerner T, Engebretsen L. Risk of injury during alpine and telemark skiing and snowboarding: the equipment-specific distance-correlated injury index. Am J Sports Med 2000; 28: 506–8Google Scholar
  70. 70.
    Maffulli N, Baxter-Jones AD. Common skeletal injuries in young athletes. Sports Med 1995; 19: 137–49PubMedCrossRefGoogle Scholar
  71. 71.
    Efflinger C, Johnson RJ, Shealy JE. A method to help reduce the risk of serious knee sprains incurred in alpine skiing. Am J Sports Med 1995; 23: 531–7CrossRefGoogle Scholar
  72. 72.
    Asang E. Injury thresholds of the leg: ten years of research on safety in skiing. Int Ser Spent Sci 1978; 5: 103–29Google Scholar
  73. 73.
    Lange J, Asang E. Comparison of the shinbone loading capacities of children and adults. Int Ser Sport Sci 1978; 5: 209–18Google Scholar
  74. 74.
    Moreland MS. Skiing injuries in children. Clin Sports Med 1982; 1: 241–51PubMedGoogle Scholar
  75. 75.
    Huber EG, Ginzel H, Tilscher H. Mechanical stress on the skeleton of children and adolescents participating in different types of sports [in German]. Schweiz Ztschr Sportmed 1982; 30: 106–10Google Scholar
  76. 76.
    Kirkendall DT. Mechanisms of peripheral fatigue. Med Sci Sports Exerc 1990; 22: 444–9PubMedGoogle Scholar
  77. 77.
    Steadman JR, Swanson KR, Atkins JW, et al. Training for alpine skiing. Clin Orttrop 1987; 216: 348Google Scholar
  78. 78.
    Appell HJ, Snares JM, Duarte JA. Exercise, muscle damage, and fatigue. Sports Med 1992; 13: 108–15PubMedCrossRefGoogle Scholar
  79. 79.
    Watson AWS. Sports injuries: incidence, causes and prevention. Phys Ther Rev 1997; 2: 135–51CrossRefGoogle Scholar
  80. 80.
    Binkrmeister RA, O’Connor DD, Gillman CJ, et al. Muscle activity in slalom and giant slalom skiing. Med Sci Sports Exerc 1995; 27: 315–22Google Scholar
  81. 81.
    Szmedra L, Im J, Nioka S, et al. Hemoglobin/myoglobin oxygen desaturation during Alpine skiing. Med Sci Sports Exerc 2001; 33 (2): 232–6PubMedGoogle Scholar
  82. 82.
    Eriksson E, Forsberg A, Nilsson J, et al. Muscle strength, EMG activity, and oxygen uptake during downhill skiing. In: Asmussen E, Jorgensen K, editors. Biomechanics VI-A. Baltimore (MD): University Park Press, 1978: 54–61Google Scholar
  83. 83.
    Robinson M. Hazards of alpine sports. Aust Fam Physician 1991; 20 (7): 961–70PubMedGoogle Scholar
  84. 84.
    Garrick JG. The epiderrriology of ski injuries. Minn Med 1971; 54: 17–8PubMedGoogle Scholar
  85. 85.
    Ungerholm S, Gustavsson J. Skiing safety in children: a prospective study of downhill skiing injuries and their relation to the skier and his equipment. Int J Sports Med 1985; 6: 353–8PubMedCrossRefGoogle Scholar
  86. 86.
    Ungerholm S, Engkvist J, Gierup J, et al. Skiing injuries in children and adults: a comparative study from an 8-year period. But J Sports Med 1983; 4: 236–40Google Scholar
  87. 87.
    Meyers MC, Bourgeois AE, LeUnes A. Pain coping response of collegiate athletes involved in high contact, high injury-potendal sport. Int J Sport Psych 2001; 31 (4): 1–14Google Scholar
  88. 88.
    Meyers MC, Bourgeois AE, Stewart S, et al. Predicting pain response in athletes: development and assessment of the Sports Inventory for Pain. J Sport Exerc Psych 1992; 14: 249–61Google Scholar
  89. 89.
    Junge A, Dvorak J. Influence of definition and data collection on the incidence of injuries in football. Am J Sports Med 2000; 28 (5): S40–6PubMedGoogle Scholar
  90. 90.
    Lysens RJ, de Weerdt W, Nieuwboer A. Factors associated with injury proneness. Sports Med 1991; 12 (5): 281–9PubMedCrossRefGoogle Scholar
  91. 91.
    Shorter NA, Jensen PE, Bethany JH, et al. Skiing injuries in children and adolescents. J Trauma 1996; 40: 997–1001PubMedCrossRefGoogle Scholar
  92. 92.
    Cadman RE, Macnab AJ. Age and gender: two epidemiological factors in skiing and snowboarding injuries. Skiing trauma and skiing safety: 10th International Symposium. Philadelphia (PA): American Society for Testing and Materials, 1996: 58–65Google Scholar
  93. 93.
    Ekeland A, Holkmcen A, Lystad H. Skiing injuries in alpine recreational skiers. In: Johnson RJ, Mote CD, Inner MH, editors. Skiing trauma and safety: 7th International Symposium [American Society of Testing and Materials special technical publication 1022]. Philadelphia (PA): American Society for Testing and Materials, 1989: 41–50Google Scholar
  94. 94.
    Shealy JE, Efflinger CF, Johnson RJ. Rates and modalities of death in the US: snowboarding and skiing differences — 1991/92 through 1998/99. In: Johnson RJ, Zucco P, Shealy JE, editors. Skiing trauma and safety. Volume 13. Philadelphia (PA): American Society for Testing and Materials, 2000: 132–8Google Scholar
  95. 95.
    Brown JM, Ramsey LC, Weiss AL. Ski helmets: an idea whose time has come. Contemp Pediafr 1997; 14: 115–25Google Scholar
  96. 96.
    Parkinson GW, Hike KE. Bicycle helmet assessment during well visits reveals severe shortcomings in condition and fit. Pediatrics 2003; 112: 320–3PubMedCrossRefGoogle Scholar
  97. 97.
    Levy AS, Smith RH. Neurologic injuries in skiers and snowboarders. Serum Neurol 2000; 20: 233–45Google Scholar
  98. 98.
    Kip P, Hunter RE. Cervical spinal fractures in Alpine skiers. Orthopedics 1995; 18: 737–41PubMedGoogle Scholar
  99. 99.
    Macnab AJ, Cadman R. Demographics of alpine skiing and snowboarding injury: lessons for prevention programs. Inj Prev 1996; 2: 286–9PubMedCrossRefGoogle Scholar
  100. 100.
    Dickman CA, Papadopoulos SM, Sonntag VKH, et al. Traumatic atlanto-occipital dislocations. J Spinal Disord 1993; 6: 300–13PubMedCrossRefGoogle Scholar
  101. 101.
    Penniman D. Customs and practices at US ski areas for mitigating common hazards through trail configuration and maintenance. In: Johnson RJ, editor. Skiing trauma and safety [American Society of Testing and Materials special technical publicafion 1345]. West Conshohocken (PA): American Society for Testing and Materials, 1999: 354–4Google Scholar
  102. 102.
    Johnson RJ, Ettlinger CF, Shealy JE. Skier injury trends. In: Johnson RJ, Mote CD, editors. Skiing trauma and safety [American Society of Testing and Materials special technical publication 1022]. Philadelphia (PA): American Society for Testing and Materials, 1993: 11–22Google Scholar
  103. 103.
    Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. Am Psychologist 2003; 58 (1): 5–14CrossRefGoogle Scholar
  104. 104.
    Courtenay WH. Constructions of masculinity and their influence on men’s well being: a theory of gender and health. Sac Sci Med 2000; 50: 1385–401CrossRefGoogle Scholar
  105. 105.
    Kelsall HL, Finch CF. A review of injury countermeasures and their effectiveness for alpine skiing. Melbourne (VIC): Monash University Accident Research Center, 1996: 136Google Scholar
  106. 106.
    Tarazi F, Dvorak ME, Wing PC. Spinal injuries in skiers and snowboarders. Am J Sports Med 1999; 27: 177–80PubMedGoogle Scholar
  107. 107.
    Meyers MC, Brown BR, Bloom JA. Fast pitch softball injuries. Sports Med 2001; 31 (1): 61–73PubMedCrossRefGoogle Scholar
  108. 108.
    Prager BI, Fitton WL, Cahill BR, et al. High school football injuries: a prospective study and pitfalls of data collection. Am J Sports Med 1989; 17 (5): 681–5PubMedCrossRefGoogle Scholar
  109. 109.
    Kopper T, Steffgen J, Gore C, et al. Qualified rescue by ski patrols: safety for the skier. Int J Sports Med 2002; 23: 524–9CrossRefGoogle Scholar
  110. 110.
    Speer KP, Warren RF, Wickiewicz TL. Observations on the injury mechanism of anterior cruciate tears in skiers. Am J Sports Med 1995; 23: 77–81PubMedCrossRefGoogle Scholar
  111. 111.
    Pless CE, Pless IB. How well they remember: the accuracy of parental reports. Arch Pediafr Adolesc Med 1995; 149: 553–8CrossRefGoogle Scholar
  112. 112.
    Harel Y, Overpeck MD, Jones D, et al. The effects of recall on estimating annual nonfatal injury rates for children and adolescents. Am J Public Health 1994; 84: 599–605PubMedCrossRefGoogle Scholar
  113. 113.
    Tapper EM, Moritz JR. Changing patterns in ski injuries. Phys Sportsmed 1974; 2: 39–47Google Scholar
  114. 114.
    Dirckx JH, editor. Steadman’s concise medical dictionary for the health professions. Philadelphia (PA): Lippincott Williams and Wilkins, 2001Google Scholar
  115. 115.
    Meeuwisse WH. Assessing causation in sports injury: a murltifactorial model. Clin J Sport Med 1994; 4:166–70CrossRefGoogle Scholar
  116. 116.
    Meyers MC, Barnhill BS. Incidence, causes and severity of game-related high school football injuries on FieldTurf versus natural grass: a 5 -year prospective study. Am J Sports Med 2004; 32: 1626–38PubMedCrossRefGoogle Scholar
  117. 117.
    Macnab AJ, Cadman R, Greenlaw J. Physician-directed injury prevention for young skiers and snowboarders. Paediatr Child Health 1998; 3: 325–9PubMedGoogle Scholar
  118. 118.
    Finch CF, Kelsall HL. The effectiveness of ski bindings and their professional adjustment for preventing alpine skiing injuries. Sports Med 1998; 25: 407–16PubMedCrossRefGoogle Scholar
  119. 119.
    American Society of Testing and Materials (ASTM). Standard specifications for helmets used for recreational snow sports [ASTM F2040]. West Conshohocken (PA): ASTM, 2000Google Scholar
  120. 120.
    Ekeland A, Nordsletten L. Equipment related injuries in skiing. Sports Med 1994; 17: 283–7PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Michael C. Meyers
    • 1
    Email author
  • C. Matthew LaurentJr
    • 2
  • Robert W. Higgins
    • 3
  • William A. Skelly
    • 4
  1. 1.Human Performance Research Laboratory, Department of Sports and Exercise SciencesWest Texas A&M University (WTAMU)CanyonUSA
  2. 2.Department of KinesiologyUniversity of AlabamaTuscaloosaUSA
  3. 3.Amarillo Sports Medicine and Orthopedic CenterAmarilloUSA
  4. 4.Department of Health, Physical Education, Recreation, and CoachingUniversity of Wisconsin — WhitewaterMilwaukeeUSA

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