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The relationship between ACL injuries and physical fitness in young competitive ski racers: a 10-year longitudinal study
  1. Christian Raschner1,
  2. Hans-Peter Platzer1,
  3. Carson Patterson1,
  4. Inge Werner1,
  5. Reinhard Huber2,
  6. Carolin Hildebrandt1
  1. 1Department of Sport Science, University of Innsbruck, Innsbruck, Austria
  2. 2Sporttherapy Mag. Huber, Neu-Rum, Austria
  1. Correspondence to Dr Christian Raschner, Department of Sport Science, University of Innsbruck, Fuerstenweg 185, Innsbruck A-6020, Austria; Christian.Raschner{at}


Background Epidemiological studies have shown a high incidence of anterior cruciate ligament (ACL) injuries among competitive alpine skiers. Little is known regarding modifiable risk factors in young skiers. There are still uncertainties in gender-related risk factors.

Objective The purpose of this study was to determine the relationship between ACL injuries and internal risk factors.

Methods Retrospective data analyses were performed based on a group of 175 female and 195 male alpine ski racers between the ages of 14 and 19 years. The athletes underwent physical testing annually from 1996 to 2006. Z score transformations normalised the age groups. Multivariate binary logistic regressions were calculated for men and women separately to detect significant predictors of ACL ruptures. t Tests were computed to reveal the differences in test scores between injured and non-injured athletes.

Results A total of 57 (15%) ACL injuries occurred. The female−male risk ratio (RR) was higher in females (2.3, 95% CI 1.3 to 4.2). Z scores for relative leg force, ratio of absolute core flexion to extension force, relative core strength and reactive strength index were predictive variables for men. Z scores of all of these predictive variables except relative leg force were higher in the non-injured group. The ratios of absolute flexion to extension force and absolute core strength were predictive covariates for women. Z scores for absolute core strength were higher in the non-injured group.

Conclusions The risk of ACL injury was greater in female athletes. The findings suggest that core strength is a predominant critical factor for ACL injuries in young ski racers.

  • Ski injuries
  • ACL
  • Adolescents
  • Fitness testing

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