Volume 28, Issue 154, December 2024

Risk factors of Anterior Crucial Ligament injuries in alpine skiing. A review of the literature

Aleksandra Stremel^1♦, Emilia Bachoń², Jan Siemianowski³, Michalina Doligalska⁴, Weronika Kotnis⁵, Zuzanna Bałoniak⁶, Agnieszka Leszyńska⁷, Aleksandra Jonkisz², Julia Bałoniak², Gabriela Skurzyńska⁸

¹Centre of Postgraduate Medical Education, Orłowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
²Clinical Hospital in Poznan, Przybyszewskiego 49, 60-355 Poznań, Poland
³Central Teaching Hospital of the Medical University of Lodz, Pomorska 251, 92-213 Łódź, Poland
⁴Medical Hospital in Garwolin, Lubelska 50, 08-400 Garwolin, Poland
⁵Medical University of Lodz, Kościuszki 4, 90-419 Łódź, Poland
⁶Warsaw Southern Hospital, Rotmistrza Witolda Pileckiego 99, 02-781 Warszawa, Poland
⁷Poznan University of Medical Sciences, Collegium Maius, Fredry 10, 61- 701 Poznań, Poland
⁸District Health Center in Otwock, Batorego 44, 05-400 Otwock, Poland

^♦Corresponding Author
Centre of Postgraduate Medical Education, Orłowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland

ABSTRACT

Anterior cruciate ligament (ACL) injuries are the most frequently occurring knee injuries in alpine skiing and represent a significant challenge for both professional athletes and recreational participants. Women with their combination of biomechanical and hormonal risks, as well as novice skiers with their skill-related influences, are particularly vulnerable to ACL injury. These injuries account for 15–21% of all knee traumas in the sport, often stemming from noncontact mechanisms like twisting falls or improper weight distribution during dynamic maneuvers. The injury risk can be amplified by the interaction between intrinsic factors, such as sex, age, anatomical characteristics, neuromuscular imbalances, and extrinsic elements, including equipment setup and environmental conditions. Females exhibit a threefold higher risk than males, influenced by hormonal and biomechanical differences, while side-to-side knee laxity and neuromuscular asymmetries heighten susceptibility in competitive athletes. Equipment, mainly worn ski boot soles or misadjusted bindings, contributes to accidents by compromising ski-boot-binding functionality. Preventative strategies targeting neuromuscular training, proper equipment maintenance, and education about environmental adaptations show promise in mitigating the risk of injury due to environmental factors like icy or grippy snow and cold temperatures. However, reinjury remains a concern, especially for adolescents returning to sport within two years post-ACL reconstruction. Through reviewing 28 studies, this paper creates an overview of the multifactorial cause of ACL injuries in skiing to indicate the need for individually tailored prevention strategies and to stimulate further research regarding risk-reducing interventions in skiing.

Keywords: Knee, Anterior cruciate ligament (ACL), Alpine skiing, Risk factors, Injury

Medical Science, 2024, 28, e154ms3495

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DOI: https://doi.org/10.54905/disssi.v28i154.e154ms3495

Published: 27 December 2024