Most telemark skiers worry the most about injuring their knees while earning their turns. The study certainly supports this concern, as the most common injury is to the knee (about 30-35% of all injuries reported).
There are basically 2 groups of injuries: sprains and ligament tears. Mild sprains heal rapidly and may involve the medial collateral ligament (MCL). The more significant season-ending injuries are those that involve the MCL and/or the anterior cruciate ligament (ACL).
The combination of torsional stress and valgus force on the knee results in the common MCL/ACL injury shown in the animated sequence here on the right. This injury is commonly found when the skier catches the inner edge of a lightly weighted or non-weighted ski.
This can occur when the uphill ski—early in the initiation of a turn—is not weighted properly or is flat on the snow instead of being used to carve the early part of the turn.
Ooooh, this looks pleasant! How do I avoid it?
Both of these injuries have one common feature, they evolve when the rear ski is not properly edged and/or weighted. In other words, the inside edge of the rear ski is cutting into the snow instead of the outside edge.
In the combined MCL/ACL injury, the front inside edge is caught then the ski is pulled out away from the body and center of balance, twisting the knee using the ski tip as the fulcrum.
In the pure ACL injury, the tail of the ski is usually weighted and contacting the snow, and as the skier falls back on to the tail, it pushes the lower leg forward, placing shearing forces across the flexed knee.
|What training technique can be done to prevent these injuries?|
|The following principles will very likely reduce your risk of injury if you can put them into practice.
Equipment and Injury
|Telemark binding selection guide. Earn Your Turns|
What about bindings?
Releasable bindings were used by 11.8% of the skiers, and these skiers had 11% knee injuries in the study groups. The survival analysis shows a definite trend to lower injury rates with the releasable bindings, though it is not statistically significant (but very close). It seems probable with a larger data set that it would be significant since this trend has been consistent.
|Releasable bindings, though not fool proof, appear to be a good safety feature consider strongly.|
The 1997-8 ski season was particularly devastating among backcountry skiers with a higher rate of avalanche fatalities due to several group fatalities this year. The 1998-1999 season continued the trend of more backcountry deaths, particularly among snowboarders near ski areas. The routine use of avalanche beacons in the backcountry has become the standard practice of many skiers in the North America even though incidents involving skiers in this part of the country are quite low.
The number of deaths each year due to avalanche among backcountry skiers (not heli-skiers) in the US and Canada is usually less than ten (6 in 1996) and 40 percent occur during high avalanche risk periods. Avoidance of these situations is preferable to the use of beacons as a thin safety net. The beacon can’t dig you out. Beware of the group bravado effect—we tend to take more risk when we ski in a group but it is a false sense of security. Never ski a slope you wouldn’t ski alone.
How often do we get hurt?
In the past, skiing injuries have be described in terms of thousands skier-days, that is the number of injuries that occur for every 1000 skiers skiing one day each. Though there are different ways to describe the injury rate, this is conceptually one that most of us can relate to well.
The overall injury rate is 8.7/1000 skier-days, the vast majority occurring at lift areas. This may seem high compare to alpine skiing whose rate is quoted at 3-4/1000, but up to 60 % of those injuries go unreported to physicians or the ski patrol which is where those numbers came from in most of those studies. In self-reporting alpine skiing studies, the rate of injury is about 9.8/1000 skier-days in the late 70’s but with the decrease in alpine skiing injuries, the real rate is more likely to be 7/1000 based on more recent estimates.
Another consideration is comparing injury rates in number of vertical feet skied. The backcountry hut data produced an injury rate that is 1/10 of that of telemarkers as a whole and this is likely do to the amount of vertical feet skied on a average day when comparing backcountry skiing to lift area skiing.
|Another way of looking at injuries is called Survival Analysis. This is expressed in median number of days to injury or how many days of skiing can we get away with before half of us are injured. This method allows for multivariate analysis of different risk factors and can tell us which are more likely to be significant with relatively smaller numbers.|
|The graph illustrates the percent of injuries sustained in various sites and the type of injury. Sprains of various joints are the most common type of injury and most heal within a month. I have received more reports of lower leg fractures but most of these have been associate with collisions with a fixed object (tree or post), not a boot top fracture that is common in alpine skiers. Thumb injuries have been reported at higher rates than in the past years.|
Snow conditions during which injuries happen cover the gamut of what skiers experience during the season.
Experience and Injury
|The impact of the increase rate of injuries at lift areas is revealed by the high number of injuries sustained skiing on packed powder surfaces.||As seen earlier in the study, the injury rate varies with level of experience. Current data shows the following injury rates based on level of skier.|
|Snow conditions||Percent of injuries||Level of skier||Overall Injury Rate||Knee Injury Rate|
|Over 50 % of all types of injuries occur in packed powder and crusty conditions according to the respondents. All the more reason to ski backcountry powder. Any snow condition that is predisposed to edges being caught up in a fall are higher risk.|
Risk factors for injuries in alpine skiing, telemark skiing and snowboarding case control study, Sulheim S, Holme I, Rødven A, Ekeland A, Bahr R. Br J Sports Med. 2011 Dec;45(16):1303-9. doi: 10.1136/bjsports-2011-090407. Epub 2011 Nov 15.
Myths Concerning Alpine Skiing Injuries, Robert J. Johnson MD, Carl F. Ettlinger MS, Jasper E. Shealy PhD. Sports Health. 2009 Nov; 1(6): 486–492. doi: 10.1177/1941738109347964
Telemark skiing injuries: a three-year study, Federiuk CS, Zechnich AD, Vargyas GA. Wilderness Environ Med. 1997 Nov;8(4):204-10.
Injury Rates and Injury Types in Alpine Skiing, Telemarking, and Snowboarding, Ekeland A, Sulheim S, Rødven A. Journal of ASTM International, Vol. 2, No. 5, 2005, pp. 1-9, https://doi.org/10.1520/JAI12526. ISSN 1546-962X