Stay Safe on the Snow | Sports Medicine December 2012

Winter is my favorite time of year to go play in the Green Mountains. This is not the case for everyone. Many people often steer clear of the snowy peaks for fear of breaking a leg. No need to get paranoid, though; It is safer than you think, especially if you use the correct equipment and have good awareness. Here are some statistics and safety-awareness tips for how to play it safe on snow.
The risks of an injury while skiing or snowboarding are much lower than most people believe. For every 1,000 people on the slopes per day, statistically only two to four will sustain an injury that requires medical attention, about 0.2 to 0.4 percent. Snow sport fatalities are in fact very rare, only one fatality on the slopes every 1.5 million skier days. Excess speed and/or jump heights are usually the main factors involved in most fatalities on the slopes. Therefore, ski or ride in control and within your ability level at all times.

A Scottish injury study, season 2009‒10, suggests snowboarders (5.31 injuries per 1,000 ski days) have been shown to have the most injuries on the slopes versus Alpine (2.38 per 1,000) and telemark (1.13 per 1,000) skiers. Most injuries for snowboarders are wrist, shoulder, and head related, while most skier injuries are lower-extremity related. Knee injuries occur most frequently with Alpine skiers, with the MCL/ACL (ligament) sprains being the most frequent, oftentimes due to catching an edge. Snowboarders come in second, due to falling on the knees or twisting the knee while getting on/off chairlifts. Telemark skiers have the fewest knee injuries and the fewest injuries overall.

A study from an Alberta ski resort over a period of two seasons (2008‒09 and 2009‒10) showed an overall injury rate in terrain parks of one injury per 1,333 runs. This is less than 0.1 percent, which is a very small percentage. Injury rates were highest on jumps and half-pipes (both 2.56 injuries/1,000 runs) and kickers (0.61 injuries/1,000 runs).

Jake Shealy, from the Sugarbush research group, claims that during the last 20 years, US ski areas have gone from strict no-jumping policies to allowing jumping at almost 100 percent of ski areas, and the fatality and serious-injury rates have not altered. Therefore, it would seem the terrain park is not the problem. Terrain park injuries do occur, and they can be very serious. However, serious terrain park injuries, consistently are most common among snowboarders who are under 25, and who have expert experience, and who are attempting inversion jumps and getting big air. These injuries often result in head/spine trauma. The good news is our ski resorts are gaining much experience at building safe terrain parks, if only our young riders would follow suit and know their limits.

In conclusion, this is great news for the female tele-skier catching big air off a kicker in the terrain park. Their injury rate is very low. Just kidding, of course. Overall, the snow sports injury rate is a very small percentage for everyone. And would be even less if we all took the correct precautions. The smart skier/rider will test the terrain park for proper takeoff and landing—before going big.

Injury Prevention Tips
Wear a helmet! According to Vermont’s own Dr. Rob Williams, founder of PHAT (Protect your Head at All Times), the medical literature is very clear that helmets are an effective method of decreasing the chance of sustaining a traumatic brain injury while riding. Helmets appear to prevent about 40 to 60 percent of head injuries. Helmets don’t cause neck injuries. Helmets don’t make people ski and ride more recklessly. A report by the Consumer Product Safety Commission revealed that 7,700 head injuries could be prevented every year if skiers and snowboarders wore helmets.

Snowboarders, especially beginners, should also wear wrist, elbow, and knee guards. These guards work very well and could save you an emergency room visit. Also, take your back foot out of the binding when ascending to use the lift system. And when getting on/off the chair, keep that board straight. Finally, when stopped, move to the side of the slopes and kneel uphill to see oncoming skiers/riders.

Skiers should avoid attempting to recover from the inevitable fall, “getting in the back seat” leaning too far back on tails of skis, or getting up from a fall when not fully stopped. All three of these most likely will result in something painful.
Always make sure equipment has been tuned and safety checked to match your ability. If jumping, then use a spotter to check for a safe landing and also to warn oncoming skiers/riders. If you are tired, then take a break. Catch up with your buds later. And save the cold Buds for après ski.

Winter Hikers and Runners
Screw your shoes! Seriously, go out and get some 3/8- and 1/2-inch sheet metal screws with hex head (#8). Obviously this is for a traditional running a shoe, with traditional heel-toe ramp. Not recommended for Five Finger folks. With a power or hand drill, place the screws directly into the sole of the shoe. Use the longer 1/2-inch screws in the back (the heel) and the 3/8-inch screws in the front (the forefoot). Skip the midsole. How many screws to use is your preference (see for how-to video). Place about six screws into the heel region and about 8 screws into the toe region. Screw Gramma and Grampa’s shoes too—they need it more than us. The screws work great. And best of all, you can take them (the screws, and Gramma and Grampa too) out come springtime.

Hikers should also try using adjustable alpine poles to help with balance on the snowy or icy slopes. Studies indicate they not only help with balance, but they also help decrease the load and pain on your knees. Heck, grab some for Gramma and Grampa too.

Andy Bowen

Andy Bowen MS, PT is co-owner of Green Mountain Rehabilitation & Sports Medicine and the new Green Mountain Running Medicine Shop in Burlington. He loves playing in the beautiful Green Mountain state with his family and friends. You can contact him through