Snowmobile trauma, alcohol and the law: a reply.
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Alcoholic Intoxication↗
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Snow skiing injuries.
BACKGROUND: Skiing is a sport that has exploded in popularity over the past 20 years. There are estimated to be 200 million skiers worldwide. OBJECTIVE: This article outlines the type and prevalence of ski injuries, and measures that have been made to reduce the incidence of injuries to skiers. DISCUSSION: The incidence of injury has decreased with the development of improved equipment, resort management and skier preparation. This decrease has been reflected in a lower rate of foot, ankle and tibial injuries. The overall incidence of knee injuries has increased and in particular an increase in more serious knee injuries. Snowboard injuries now account for approximately half the presentations to ski resort medical centres.
Ankle Injuries↗
Snowmobile injuries in North America.
The snowmobile was developed to move people and supplies, and for emergencies in regions where heavy snow prohibited the use of conventional vehicles. Today, snowmobiling has become a popular winter sport enjoyed by more than 2 million people of all ages in North America. However, the modern snowmobile can weigh in excess of 600 pounds and travel at speeds exceeding 90 miles per hour. Each year snowmobile accidents produce approximately 200 deaths and 14,000 injuries. Excess speed, alcohol, driver inexperience, and poor judgment are the leading causes of accidents. Injuries incurred in children and adults often are extremity fractures, but can involve any organ system. Similar to motor vehicle accidents, multisystem trauma occurs frequently with head injury the leading cause of death. Reduction in injury and death rates is urgently needed and can be accomplished through education and legislation.
Adolescent↗
Injuries among elite snowboarders (FIS Snowboard World Cup).
BACKGROUND: Although snowboarding is already established as an Olympic sport, it is still a developing sport, with new disciplines, more demanding snow installations, and spectacular tricks. A recent study on subjects at Norwegian national elite level showed that injury risk is high and that injuries among competitive snowboarders differ from those seen in recreational snowboarders, with fewer wrist injuries and more knee and back injuries. OBJECTIVE: To describe the incidence and type of injuries among female and male snowboarders at international elite level. METHOD: At the last race of the Fédération Internationale de Ski Snowboard World Cup, acute injuries resulting in missed participation and overuse injuries influencing performance, were recorded during a retrospective interview (91% response rate). The registration period was from April 2002 (end of season) until March 2003. Exposure was recorded as the number of runs in all disciplines, and the incidence was calculated as number of injuries per 1000 runs. RESULTS: The 258 athletes interviewed reported 3193 competition days (n = 46 879 runs) in all disciplines. In total, 135 acute injuries were recorded; 62 (46%) during competition in the official disciplines. Of the 135 acute injuries, the most common injury locations were knee (n = 24; 18%), shoulder (n = 18; 13%), back (n = 17; 13%), and wrist (n = 11; 8%). The overall incidence during competition was 1.3 (95% confidence interval 1.0 to 1.7) injuries per 1000 runs; 2.3 (0.9 to 3.8) for big air (n = 10), 1.9 (1.1 to 2.8) for halfpipe (n = 21), 2.1 (1.2 to 3.0) for snowboard cross (n = 20), 0.6 (0.2 to 1.0) for parallel giant slalom (n = 8), and 0.3 (0.0 to 0.7) for parallel slalom (n = 3). The severity of injuries was graded based on time loss (27% lost >21 days) and score on the Abbreviated Injury Scale (AIS) (38% AIS 1, 61% AIS 2 and 1% AIS 3). There were 122 overuse injuries, 38 (31%) of these to the knee. CONCLUSION: The injury risk for big air, snowboard cross, and halfpipe disciplines is high, while that for the snowboard slalom disciplines is lower. The injury pattern is different from recreational athletes, with a greater share of knee injuries and fewer wrist injuries. Compared with national level, the injury risk appears to be lower at World Cup level.
Adult↗
Snow skiing combined anterior cruciate ligament/medial collateral ligament disruptions.
Recent reports indicate that combined anterior cruciate ligament/medial collateral ligament (ACL/MCL) knee injuries are usually associated with a lateral meniscus tear. In our center, snow skiing is the athletic activity most frequently associated with this double-ligament injury complex. A sports-specific analysis was undertaken to evaluate the hypothesis that the snow skiing ligament injury is different from similar injuries caused by other athletic activities. Of a total of 64 acute arthroscopically confirmed tears of both the MCL and ACL, 23 were caused by snow skiing and 41 by nonskiing activities. There were fewer lateral meniscus tears in skiers (43%) when compared with the nonskiers (88%). Skiers also had fewer medial meniscus tears (13%) than did nonskiers (37%). No medial meniscus tears occurred in the absence of a lateral meniscus tear. Although 78% of the skiers were women, only 12% of the nonskiers were women. Skiers were older (average age 35 years) than the nonskiers (average age 28 years). The right knee was injured almost twice as frequently as the left. These data suggest that the double (ACL/MCL) ligament injury in skiers might be distinctly different from that in nonskiers.
Adolescent↗
Combined injuries of the anterior cruciate and medial collateral ligaments of the knee. Effect of treatment on stability and function of the joint.
We performed a retrospective study of sixty-six patients (forty-one male and twenty-five female) who had a combined injury of the anterior cruciate and medial collateral ligaments. Our purpose was to determine the prevalence of late valgus instability of the knee. The mean age of the patients was thirty-five years (range, sixteen to sixty-three years). The mean follow-up interval was forty-five months (range, twenty-one to 108 months). Twenty patients had been injured while snow-skiing; twenty-four, during other sports activities; seven, in a motor-vehicle accident; and the remaining fifteen, during activities of daily living. Eleven patients had reconstruction of the anterior cruciate ligament and repair of the medial collateral ligament, thirty-three had reconstruction of only the anterior cruciate ligament, and twenty-two were managed non-operatively. There was no evidence of valgus instability on clinical examination at the most recent follow-up visit. However, there was evidence of instability on stress roentgenograms of the knee in eight (13 per cent) of sixty patients. With the numbers available, we could detect no relationship between the presence of valgus instability and the method of treatment of the ligamentous tears ( p > 0.4). We also compared the results for twenty-one of the thirty-three patients who had a combined ligamentous injury and reconstruction of only the anterior cruciate ligament with those for thirty-seven patients who had reconstruction of an isolated tear of the anterior cruciate ligament. After a mean follow-up interval of thirty-five months (range, twenty-one to sixty-six months), there was no difference in the anterior displacement, impairment of function, level of participation in sports activities, results of the one-leg-hop for distance test, or strength as determined by testing on a Cybex machine. On the basis of the findings in this study, we believe that, when there is mild or moderate valgus instability, an injury of the medial collateral ligament does not need to be repaired when the anterior cruciate ligament is repaired after a combined ligamentous injury.
Adolescent↗
MRI of snow skiing and snowboarding injuries.
Snow skiing has been called "the world's oldest sport," "the fastest non-motorized sport on Earth," and "the riskiest sport undertaken by adults on a routine basis." This article discusses the common mechanisms for orthopedic injuries occurring in two of the most popular winter sports in the world that have a reputation for an inherently high risk of injury: alpine skiing and snowboarding. The emphasis herein is on magnetic resonance imaging of characteristic injuries in skiers (knee, thumb, shoulder) and in snowboarders (wrist, forearm, ankle). Spine injuries in snowboarders and skiers are also discussed.
Ankle Injuries↗
Incidence of tibial fracture in child skiers.
Skiing is an increasingly popular sport amongst both adults and children. Opportunities for skiing within the United Kingdom are limited, but the introduction of increasing numbers of dry ski slopes has made the sport more available. The nature of injuries sustained by adults on snow and dry slopes is well documented, but this is less true of childhood injury, especially on dry slopes. A consecutive series of 92 patients with skiing injuries is presented. Both dry slope and snow slope injuries are included. The incidence of tibial fracture in children was ten times that of adults. The nature of all injuries sustained during the study period is documented, the childhood tibial fractures are described in detail, and possible aetiological factors are discussed.
Adolescent↗
The energy expenditure of snowshoeing in packed vs. unpacked snow at low-level walking speeds.
Snowshoeing is currently ranked as one of the top 20 participatory sports in the United States, and the number of participants almost tripled, from 440,000 to 1.2 million in 1998. Despite this large increase in participation, no scientific evidence exists to quantify any physiologic response to the activity. Therefore, the purpose of this investigation was to assess the energy expenditure of snowshoeing at selected low-level speeds and evaluate its acceptability as a form of aerobic conditioning exercise. Ten habitually active subjects (7 men, 3 women, mean age = 24 +/- 3.9 years, mass = 76.6 +/- 14.5 kg, height = 173.7 +/- 9.6 cm) were recruited. Steady state heart rate data were determined from 2 treadmill tests at 4 and 6 mph. Steady state heart rates at 4 mph and 6 mph from treadmill speeds were then reproduced outdoors under 2 snow conditions, packed, and unpacked snow, while caloric expenditure and speed were determined. Expired gases were collected in Douglas bags for both snowshoe and treadmill trials and then analyzed and corrected indoors for the fractional concentrations of carbon dioxide and oxygen. Data analyses indicate that caloric expenditure during snowshoeing may be considerably higher than previously reported. Snowshoeing on packed snow at 2.95 mph elicited a similar heart rate and energy expenditure response as walking on a treadmill at 4 mph or snowshoeing in unpacked snow at 2.04 mph (Vo(2) = 18.18 +/- 0.8 ml x kg(-1) x min(-1)). Snowshoeing on packed snow at 3.97 mph elicited the same heart rate and energy expenditure response as walking on a treadmill at 6 mph or snowshoeing on unpacked snow at 2.87 mph (Vo(2) = 36.72 +/- 0.8 ml x kg(-1) x min(-1)). Furthermore, increasing walking speed on snow by just 1 mph at slow speeds (2 and 3 mph) resulted in approximately twice the energy expenditure. Our data indicate that current estimates of energy expenditure while snowshoeing underestimate by greater than 50%. Apparently the energy expenditure during snowshoeing is much higher than previously considered and varies considerably because of snow terrain. Furthermore, energy expenditure levels similar to walking can be achieved on snowshoes at much slower speeds. This study represents an original investigation into energy expenditure during snowshoeing.
Anaerobic Threshold↗
Anabolic steroids.
Anabolic steroids have been employed extensively in equine practice over the past 25 years. Their usefulness is largely dependent on subjective opinions, as only minimal studies have been carried out in horses. Therefore, their use will vary markedly between practitioners depending on their personal experiences and pressures by trainers to use them. They form part of rational therapy in a variety of conditions. In addition to use for increasing muscle mass, they are used to a varying extent in the raising of yearlings and in the training and racing of horses with the view of improving performance. However, in almost all countries, the latter use is largely curtailed, and the presence of these substances in postrace urine samples constitutes use of an illegal substance. To detect the use of anabolic steroids, including testosterone, sensitive ELISA tests for screening and GC/MS for confirmation have been developed. These compounds can be used safely. Risks can be encountered if too high doses are used, as horses may become difficult to manage due to increased aggressiveness and other stallion-like behavior. Reproductive efficiency in both stallions and mares may be temporarily impaired, but this is quite rapidly reversible following cessation of treatment.
Anabolic Agents↗
The incidence of meniscal tears associated with acute anterior cruciate ligament disruption secondary to snow skiing accidents.
In the acutely traumatized knee, meniscal tears are commonly encountered with an anterior cruciate ligament (ACL) injury. Because of the high incidence of ACL injuries related to snow skiing, a retrospective study was conducted to determine the incidence and location of concomitant meniscal injuries in a series of 328 acute ACL tears resulting from snow-skiing accidents. Seventy-five (23%) of the ACL injuries had coexistent meniscal injuries--43 (13%) lateral and 32 (10%) medial menisci. Thirty-two (43%) of the 75 meniscal tears were peripheral detachments from the capsule (red-red tears), which often heal without surgical intervention. Findings from this study indicate that the incidence of meniscal damage in acute knee injuries secondary to snow skiing accidents is substantially lower than in knee injuries sustained during other sports activities, which range from 53% to 65% in previous studies.
Anterior Cruciate Ligament↗
Medicolegal aspects of athletic cervical spine injury.
Approximately 10,000 Americans suffer catastrophic cervical spinal cord injuries each year. Most are caused by automobile accidents; however, many of these crippling injuries are related to participation in sports. This article evaluates the legal aspects of neck injury resulting from participation in a number of athletic events, including football, wrestling, gymnastics, snow skiing, ice hockey, diving, and surfing.
Athletic Injuries↗
Golf science research at the beginning of the twenty-first century.
At the beginning of the twenty-first century, there are 30,000 golf courses and 55 million people who play golf worldwide. In the USA alone, the value of golf club memberships sold in the 1990s was US dollar 3.2 billion. Underpinning this significant human activity is a wide variety of people researching and applying science to sustain and develop the game. The 11 golf science disciplines recognized by the World Scientific Congress of Golf have reported 311 papers at four world congresses since 1990. Additionally, scientific papers have been published in discipline-specific peer-reviewed journals, research has been sponsored by the two governing bodies of golf, the Royal and Ancient Golf Club of St. Andrews and the United States Golf Association, and confidential research is undertaken by commercial companies, especially equipment manufacturers. This paper reviews much of this human endeavour and points the way forward for future research into golf.
Biomedical Research↗
Snowboarding injuries.
Snowboarding is a popular winter sport that involves riding a single board down a ski slope or on a half-pipe snow ramp. Compared with injuries resulting from traditional alpine skiing, snowboarding injuries occur more frequently in the upper extremities and ankles and less frequently in the knees. Different types of snowboard equipment, rider stance and snowboarding activity tend to result in different types of injury. Snowboarder's ankle, a fracture of the lateral talus, must be considered in a snowboarder with a "severe ankle sprain" that has not responded to treatment. Risk of injury may be lowered by using protective equipment, such as a helmet and wrist guards.
Humans↗
Ergogenic aids to performance in the race horse: nutrients or drugs.
Since the domestication of the horse and its use in various types of athletic competition, its diet has developed from that associated with grazing to feeding of additional energy in the form of grains up to the present situation when numerous supplements are fed in hopes of enhancing performance. Many if not all of these may be considered as ergogenic aids, and under the rules of racing in many countries should be considered as a prohibited substance. Until recently, a blind eye has been turned to whether the rules should be enforced against many nutritional supplements, for example, vitamins and amino acids, especially when given in amounts vastly in excess of normal requirements. However, although arguably a nutrient, large doses of sodium bicarbonate and possibly other compounds with the potential of improving buffering capacity have been used extensively, and rules and detection methods have been introduced to curtail this. This paper reviews the nutritional supplements currently in use and discusses whether the singling out of alkalinizing agents as an enforceable prohibited substance is justified, whereas other substances such as fats can be supplemented in high amounts.
Animal Feed↗
Orthopedic aspects and safety factors in snow skiing.
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Adolescent↗