Background It is well known that professional football has a high injury risk. The FIS Injury Surveillance System increases our knowledge of injuries to elite skiers and snowboarders. But what is more dangerous?

Objective To compare the injury risk in World Cup (WC) skiing and snowboarding with Norwegian professional football (Tippeligaen).

Design/Setting We conducted season-ending interviews with athletes from selected WC-teams in alpine skiing, freestyle skiing and snowboarding during the 2006–2007 and 2007–2008 winter seasons on acute injuries sustained (November through mid-March). Injury information was prospectively collected from medical staff in all Tippeliga-teams (n=16) and extracted from mid-March through July for the 2007 and 2008 seasons to best imitate the skiing/snowboarding season. Injury rate was calculated as number of injuries per 100 athletes per season.

Results Among 521 alpine, 416 freestyle and 421 snowboard athletes we registered 155, 115 and 159 time-loss injuries, corresponding to 29.8 (95% CI 25.1 to 34.4), 27.6 (22.6–32.7) and 37.8 (31.9–43.6) injuries per 100 athletes per season. In Tippeligaen, 308 time-loss injuries were recorded among 440 players, corresponding to 70.0 (62.2–77.8) injuries per 100 players (RR: 2.4 (1.9–2.9) vs alpine, 2.5 (2.0–3.2) vs freestyle and 1.9 (1.5–2.2) vs snowboard). The rate of severe injuries (absence >28 days) was 11.3 (8.4–14.2), 13.8 (10.2–17.3), and 14.4 (10.8–18.1) injuries per 100 alpine, snowboard and freestyle athletes per season and 9.3 (6.5–12.2) in football. The rate of severe injuries was higher in freestyle skiing compared to football (RR: 1.5, 1.0–2.3) while no difference was found between football and alpine skiing (RR: 0.8, 0.6–1.2) or snowboarding (RR: 0.7, 0.5–1.0).

Conclusion The injury risk among WC skiers and snowboarders is high, but only half of that in elite Norwegian football. However, the risk for severe injuries is the same in alpine skiing and snowboarding as in football, and even higher in freestyle skiing.