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The history of skiing dates as far back as 4000 BC.1 While these early skiers primarily used this mode of locomotion for warfare or hunting, it can be safely assumed that recreational aspects of skiing took place and that noncombat-related ski injuries most likely occurred in this population. The Norwegian Army held the first recorded organized skiing competition in 1767, and thereafter, the sport quickly grew in popularity in the European countries.1 Skiing remained relatively unknown in North America until the 1932 Lake Placid Olympics. Advances in skiing techniques, skiing instruction, ski equipment design, automated lifts, easier ski destination access, international competitive events, and media exposure have increased the popularity of downhill skiing. Recreational participation has grown to approximately four million in the United States alone.2 However, with these advances, new patterns of athletic injuries also have emerged.2-15 Injury tracking and clinical database research have been instrumental in leading to the development of better equipment designs and have had a dramatic influence on the etiology and treatment of injuries incurred during alpine skiing. This chapter addresses the evolution of these advances, outlines the current trends in injuries and injury rates associated with alpine skiing, and discusses current biomechanical research and scientific developments governing the application of preventative injury training and postinjury rehabilitation in today’s ski industry. As the reader will note, skiing injuries can encompass nearly every joint in the body. Thus, sections pertaining to mechanisms of injury, injury prevention, and rehabilitation will be associated with the most commonly injured joints among all skiers—the knee, shoulder, and hand.

Traditional professional and Olympic alpine ski racing venues consist of four major areas with varying levels of technical challenges. The slalom venue is often divided into two general events, the slalom and the giant slalom. The slalom is characterized by short-radius turns and requires technical skills to maintain carry speeds through a series of gates (the number of gates is variable but typically is between 45 and 75). Although it is considered a slower, more technical event, world-class alpine racers can ski a slalom course in 0:50:00 to 0:75:00 seconds (s) and can attain speeds of 35 to 50 miles/h. The giant slalom is similar in that racers must use technical skills to navigate a series of gates (35 to 60); however, the turns generally are wider (larger radius), speeds average 40 to 60 miles/h, and the race can last for 0:50:00 seconds to 1:20:00 minutes. The “super G” race is a longer event, lasting from 0:75:00 s to 2:30:00 min, possesses fewer gates (20 to 25) allowing for greater-radius turns, and racers can achieve speeds ranging from 65 to 75 miles/h. The downhill event is characterized by 15 to 25 gates and lasts approximately 2:00:00 to 2:30:00 min. World-class downhillers can achieve speeds in excess of 80 miles/h through the course.

As skiing has become more popular, newer venues also have emerged. ...

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