Program Helps Avoid Acl Injuries
Back in the 1970s, lots of skiers broke their legs. These days, broken legs have declined by 90 percent, thanks to advances in boot and binding technology. But a more insidious injury has tripled and is now far more common - serious knee injuries involving the anterior cruciate ligament, or ACL.
“What we have today is the chance of blowing out your knee in one in 2,500 skier visits,” said Carl Ettlinger, a mechanical engineer with Vermont Safety Research Inc.
Ettlinger’s firm, which trains ski technicians and does ski-safety research, and two Eastern universities have just completed a 13-year study of ski injuries that will be published later this year in the American Journal of Sports Medicine.
But what should matter to every skier out there today isn’t the research. It’s the training program the researchers have developed to help skiers avoid ACL injuries a program that cut those injuries by 62 percent among ski instructors and patrollers in the study.
An ACL injury is a serious and painful one that often requires years of rehabilitation. Treatment is not always successful.
Schweitzer Mountain Resort is among more than 80 ski resorts nationwide that have signed up to use the ACL injury-prevention training program for their employees. “An ACL injury will put you out for a long while in the ski business,” said Dick Deam, Schweitzer’s safety director.
A blown-out knee in the ski school right at the start of the season prompted lots of interest in the program among Schweitzer’s ski instructors, who watched videos, discussed techniques and studied pamphlets and diagrams. Just a few weeks into the ski season, Deam said, “The ski school had probably shown it a dozen or more times.”
The reasons for the shocking increase in ACL injuries a sixth of the knee sprains in the ‘70s involved the ACL, now it’s two thirds have to do with modern ski boots and skis, along with more subtle changes in trail grooming and skiing style, Ettlinger said.
With the ski boot’s stiff back and the snappy tail of the modern ski, “What we have is a finely tuned carving device. And if we put ourselves in the wrong position, which is easy to do because all of our basic instincts work against us … we’re exceedingly vulnerable.”
The study found three common skiing situations that can lead to ACL injury. They are:
Attempting to get up while still moving after a fall.
Attempting to recover from an off-balance position.
Attempting to sit down after losing control.
The study also found six characteristics of ski accidents that produce ACL injuries. When all six are present, Ettlinger said, ACL injury to the downhill leg is imminent. The plus side of that is that avoiding as many of these elements as possible when you start to lose control can prevent the injury. The six typical factors are:
Uphill arm back.
Skier off-balance to the rear.
Hips are below the knees.
Uphill ski is unweighted.
All weight is on the inside edge of the downhill ski tail.
Upper body is generally facing the downhill ski.
The first three on that list are things that don’t fit in with good skiing technique, so they can be avoided by routinely trying to:
Keep arms forward (this is the answer to so many skiing technique problems!).
Keep hips above knees.
Maintain balance and control.
But if you’re already starting to fall, it’s a little hard to tell yourself to “maintain balance and control.”
The program offers these tips:
Don’t straighten your legs when you fall. Keep your knees flexed.
Don’t try to get up until you’ve stopped sliding. When you’re down, stay down.
Don’t land on your hand. Keep your arms up and forward.
Technology was able to deal with the broken-leg problem, because it was caused by more primitive ski equipment. But the knee injury problem is more complex, Ettlinger said. Its most common cause is the way we move and react when we get off-balance to the rear.
“This is a very subtle injury,” he said. “It’s not the result of a fall. In most cases, it’s the injury that causes the fall.”
The anti-ACL injury program includes a pamphlet and 17-minute video that are available to individuals, ski clubs and other noncommercial users for $33; call (802) 899-4738.
The first phase of the program has been targeted at ski resorts who rely on employees to ski for a living. But the new video is made for average skiers.
MEMO: This column runs every other Sunday.