Long-Term Athletic Development in Youth Alpine Ski Racing: The Effect of Physical Fitness, Ski Racing Technique, Anthropometrics and Biological Maturity Status on Injuries

Alpine ski racing is known to be a sport with a high risk of injuries. Because most studies have focused mainly on top-level athletes and on traumatic injuries, limited research exists about injury risk factors among youth ski racers. The aim of this study was to determine the intrinsic risk factors (anthropometrics, biological maturity, physical fitness, racing technique) for injury among youth alpine ski racers. Study participants were 81 youth ski racers attending a ski boarding school (50 males, 31 females; 9–14 years). A prospective longitudinal cohort design was used to monitor sports-related risk factors over two seasons and traumatic (TI) and overuse injuries (OI). At the beginning of the study, anthropometric characteristics (body height, body weight, sitting height, body mass index); biological maturity [status age at peak height velocity (APHV)]; physical performance parameters related to jump coordination, maximal leg and core strength, explosive and reactive strength, balance and endurance; and ski racing technique were assessed. Z score transformations normalized the age groups. Multivariate binary logistic regression (dependent variable: injury yes/no) and multivariate linear regression analyses (dependent variable: injury severity in total days of absence from training) were calculated. T-tests and multivariate analyses of variance were used to reveal differences between injured and non-injured athletes and between injury severity groups. The level of significance was set to p < 0.05. Relatively low rates of injuries were reported for both traumatic (0.63 TI/athlete) and overuse injuries (0.21 OI/athlete). Athletes with higher body weight, body height, and sitting height; lower APHV values; better core flexion strength; smaller core flexion:extension strength ratio; shorter drop jump contact time; and higher drop jump reactive strength index were at a lower injury risk or more vulnerable for fewer days of absence from training. However, significant differences between injured and non-injured athletes were only observed with respect to the drop jump reactive strength index. Regular documentation of anthropometric characteristics, biological maturity and physical fitness parameters is crucial to help to prevent injury in youth ski racing. The present findings suggest that neuromuscular training should be incorporated into the training regimen of youth ski racers to prevent injuries.

[1]  Aliza K Nedimyer,et al.  Comment on: “Incidence, Severity, Aetiology and Prevention of Sports Injuries: A Review of Concepts” , 2019, Sports Medicine.

[2]  E. Müller,et al.  Injuries and illnesses in a cohort of elite youth alpine ski racers and the influence of biological maturity and relative age: a two-season prospective study , 2017, Open access journal of sports medicine.

[3]  H. Baur,et al.  Neuromuscular response of the trunk to sudden gait disturbances: Forward vs. backward perturbation. , 2016, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[4]  E. Müller,et al.  Biological Maturity Status Strongly Intensifies the Relative Age Effect in Alpine Ski Racing , 2016, PloS one.

[5]  E. Müller,et al.  How to Prevent Injuries in Alpine Ski Racing: What Do We Know and Where Do We Go from Here? , 2016, Sports Medicine.

[6]  Alicia M Montalvo,et al.  Integrative Neuromuscular Training and Injury Prevention in Youth Athletes. Part I: Identifying Risk Factors , 2016 .

[7]  David G. Behm,et al.  Effects of Resistance Training in Youth Athletes on Muscular Fitness and Athletic Performance: A Conceptual Model for Long-Term Athlete Development , 2016, Front. Physiol..

[8]  Romain Meeusen,et al.  How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury , 2016, British Journal of Sports Medicine.

[9]  Tim J Gabbett,et al.  The training—injury prevention paradox: should athletes be training smarter and harder? , 2016, British Journal of Sports Medicine.

[10]  R. Bahr,et al.  Injury rate and injury patterns in FIS World Cup Alpine skiing (2006–2015): have the new ski regulations made an impact? , 2015, British Journal of Sports Medicine.

[11]  C. Visscher,et al.  Anthropometric Injury Risk Factors in Elite-standard Youth Soccer , 2015, International Journal of Sports Medicine.

[12]  Erich Müller,et al.  Potential Mechanisms Leading to Overuse Injuries of the Back in Alpine Ski Racing , 2015, The American journal of sports medicine.

[13]  J. L. Whittaker,et al.  Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis , 2015, British Journal of Sports Medicine.

[14]  T. Best,et al.  Long-term athletic development- part 1: a pathway for all youth. , 2015, Journal of strength and conditioning research.

[15]  Carolin Hildebrandt,et al.  Die Erhebung des biologischen Entwicklungsstandes für die Talentselektion – welche Methode eignet sich? , 2015, Sportverletzung · Sportschaden.

[16]  L. Dugas,et al.  Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes , 2015, The American journal of sports medicine.

[17]  C. Visscher,et al.  Importance of Peak Height Velocity Timing in Terms of Injuries in Talented Soccer Players , 2015, International Journal of Sports Medicine.

[18]  D. Caine,et al.  The child and adolescent athlete: a review of three potentially serious injuries , 2014, BMC Sports Science, Medicine and Rehabilitation.

[19]  G. Myer,et al.  Chronological age vs. biological maturation: implications for exercise programming in youth. , 2014, Journal of strength and conditioning research.

[20]  G. Landry,et al.  Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine , 2014, British Journal of Sports Medicine.

[21]  C. Raschner,et al.  Traumatic and overuse injuries among elite adolescent alpine skiers : a two-year retrospective analysis : original research article , 2013 .

[22]  C. Raschner,et al.  Current performance testing trends in junior and elite Austrian alpine ski, snowboard and ski cross racers , 2013 .

[23]  A. Esterman,et al.  The relationship between pre-season fitness testing and injury in elite junior Australian football players. , 2013, Journal of science and medicine in sport.

[24]  R. Bahr,et al.  Sex differences in the risk of injury in World Cup alpine skiers: a 6-year cohort study , 2013, British Journal of Sports Medicine.

[25]  Roald Bahr,et al.  Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire , 2012, British Journal of Sports Medicine.

[26]  Christian Raschner,et al.  The relationship between ACL injuries and physical fitness in young competitive ski racers: a 10-year longitudinal study , 2012, British Journal of Sports Medicine.

[27]  W. Taube,et al.  Improved postural control after slackline training is accompanied by reduced H‐reflexes , 2012, Scandinavian journal of medicine & science in sports.

[28]  M. Alricsson,et al.  Injury profile of competitive alpine skiers: a five-year cohort study , 2012, Knee Surgery, Sports Traumatology, Arthroscopy.

[29]  L. Micheli,et al.  Training the child athlete: physical fitness, health and injury , 2011, British Journal of Sports Medicine.

[30]  T. Hewett,et al.  When to Initiate Integrative Neuromuscular Training to Reduce Sports-Related Injuries and Enhance Health in Youth? , 2011, Current sports medicine reports.

[31]  Veit Senner,et al.  Mechanisms of anterior cruciate ligament injury in world cup alpine skiing: a systematic video analysis of 20 cases , 2011, British Journal of Sports Medicine.

[32]  A Gollhofer,et al.  Slackline Training for Balance and Strength Promotion , 2010, International journal of sports medicine.

[33]  K. Pfeifer,et al.  Neuromuscular training for sports injury prevention: a systematic review. , 2010, Medicine and science in sports and exercise.

[34]  V. Denaro,et al.  Long-term health outcomes of youth sports injuries , 2009, British Journal of Sports Medicine.

[35]  R. Bahr,et al.  Injuries among male and female World Cup alpine skiers , 2009, British Journal of Sports Medicine.

[36]  P. Doherty,et al.  Investigation of growth, development, and factors associated with injury in elite schoolboy footballers: prospective study , 2009, BMJ : British Medical Journal.

[37]  Kevin R Ford,et al.  The Relationship of Hamstrings and Quadriceps Strength to Anterior Cruciate Ligament Injury in Female Athletes , 2009, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[38]  A Gollhofer,et al.  Spinal and supraspinal adaptations associated with balance training and their functional relevance , 2008, Acta physiologica.

[39]  L. Engebretsen,et al.  Injury surveillance in multi-sport events: the International Olympic Committee approach , 2008, British Journal of Sports Medicine.

[40]  T. Hewett,et al.  Deficits in Neuromuscular Control of the Trunk Predict Knee Injury Risk , 2007, The American journal of sports medicine.

[41]  Lauren B Sherar,et al.  Do physical maturity and birth date predict talent in male youth ice hockey players? , 2007, Journal of sports sciences.

[42]  C. Carling,et al.  Biological maturity and injury in elite youth football , 2006, Scandinavian journal of medicine & science in sports.

[43]  Carolyn A Emery,et al.  Injury Prevention in Child and Adolescent Sport: Whose Responsibility Is It? , 2006, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[44]  Wolfgang Taube,et al.  Direct corticospinal pathways contribute to neuromuscular control of perturbed stance. , 2006, Journal of applied physiology.

[45]  R. Bahr,et al.  Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries , 2006, British Journal of Sports Medicine.

[46]  T. Hewett,et al.  Specialized neuromuscular training to improve neuromuscular function and biomechanics in a patient with quiescent juvenile rheumatoid arthritis. , 2005, Physical therapy.

[47]  T. Hewett,et al.  Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes: A Prospective Study , 2005, The American journal of sports medicine.

[48]  Morten Essendrop,et al.  Training can modify back muscle response to sudden trunk loading , 2004, European Spine Journal.

[49]  E Raas,et al.  Physical and physiological factors associated with success in professional alpine skiing. , 2003, International journal of sports medicine.

[50]  G. Beunen,et al.  An assessment of maturity from anthropometric measurements. , 2002, Medicine and science in sports and exercise.

[51]  W. Mechelen,et al.  Incidence, Severity, Aetiology and Prevention of Sports Injuries , 1992 .

[52]  E. Müller,et al.  [The assessment of biological maturation for talent selection - which method can be used?]. , 2015, Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin.

[53]  Nicole J Chimera,et al.  Association of y balance test reach asymmetry and injury in division I athletes. , 2015, Medicine and science in sports and exercise.

[54]  G. Landry,et al.  Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. , 2014, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[55]  T. Hewett,et al.  When to initiate integrative neuromuscular training to reduce sports-related injuries in youth? , 2012 .

[56]  O. Jenni,et al.  Neue Wachstumskurven für die Schweiz , 2011 .

[57]  Colin W Fuller,et al.  The Influence of Methodological Issues on the Results and Conclusions from Epidemiological Studies of Sports Injuries , 2006, Sports medicine.

[58]  S. Lyman,et al.  The effect of neuromuscular training on the incidence of knee injury in female athletes: a prospective study. , 2000, The American journal of sports medicine.

[59]  W. Herzog,et al.  Open Access Journal of Sports Medicine Dovepress Anterior Cruciate Ligament Injury/reinjury in Alpine Ski Racing: a Narrative Review , 2022 .