Injury risks among elite competitive alpine skiers are underestimated if not registered prospectively, over the entire season and regardless of whether requiring medical attention



Prospective studies assessing the injuries occurring in elite competitive alpine skiers are lacking, and a full picture of all injuries, including those not requiring medical attention, is absent. Likewise, little is known about the sex-specific injury risks and patterns of elite skiers throughout an entire season (i.e. an off-season preparation period and a competition period). Accordingly, this study investigated the injuries of a national team cohort with respect to season period and sex.


Over an entire season, all injuries occurring in 44 Swiss National Ski Team members (25 females and 19 males) were registered, regardless of whether they required medical attention. Skiers were prospectively monitored by the Oslo Sports Trauma Research Centre (OSTRC) questionnaire and by continuously updated team medical records. Finally, these data were used as a reference for supplemental interviews, in which the correctness and completeness of the prospective data were verified.


The risk of suffering at least one injury during an entire season was 75.0% with a 95% confidence interval (73.1%, 76.9%) for traumatic injuries, and 52.3% (50.0%, 54.5%) for overuse injuries. Traumatic injuries concerned the head, lower leg and knee, while overuse injuries affected the lumbar spine, knee and hip. During the competition period, skiers were more prone to traumatic injuries, while during the off-season preparation period, skiers’ risk was higher for overuse injuries. Over an entire season, there were no sex differences. However, females were more vulnerable to traumatic injuries during the preparation period and overuse injuries during the competition period, while males had a higher risk for overuse injuries during the preparation period.


When prospectively registering injuries among elite competitive alpine skiers over an entire season, regardless of whether the injuries required medical attention, the injury risks were alarmingly high and substantially larger than those previously reported. Moreover, since injury risks and patterns are season period and sex dependent, it is strongly recommended that (1) injury registration focuses on both the off-season preparation period and the competition period and (2) prevention efforts are specifically tailored to the sex of the athletes.

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We would like to thank all participants and team staff involved.


This study was generously supported by the Balgrist Foundation, Swiss-Ski, the “Stiftung Passion Schneesport,” and the “Stiftung zur Förderung des alpinen Skisportes in der Schweiz (SFSS)” as part of the ISPA Project Grant.

Author information




JS conceptualised and designed the study. JS recruited the participants and organised the data collection. WK and JS designed, built and maintained the digital assessment tools. SF, MH, LP and JS collected the data. SF, MH, LP and JS processed the data and performed the statistical analysis. All authors substantially contributed to the interpretation of data. SF, MH and JS drafted the manuscript; all authors revised it critically, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work.

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Correspondence to Jörg Spörri.

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The authors have no relevant conflict of interest to declare.

Ethical approval

The current study was approved by the institutional review board of the Balgrist University Hospital and the cantonal ethic committee (KEK-ZH-NR: 2017-01395), and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Written informed consent was obtained from all participants.

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Fröhlich, S., Helbling, M., Fucentese, S.F. et al. Injury risks among elite competitive alpine skiers are underestimated if not registered prospectively, over the entire season and regardless of whether requiring medical attention. Knee Surg Sports Traumatol Arthrosc (2020).

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  • Epidemiology
  • Periodization
  • Gender-specific injuries
  • Athletes
  • Injury prevention
  • Alpine ski racing