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Acute on-snow severe injury events in elite alpine ski racing from 1997 to 2019: the Injury Surveillance System of the Austrian Ski Federation
  1. Michael Barth1,2,3,
  2. Hans-Peter Platzer1,
  3. Anton Giger4,
  4. Werner Nachbauer1,
  5. Peter Schröcksnadel4
  1. 1Department of Sport Science, University of Innsbruck, Innsbruck, Tyrol, Austria
  2. 2Department of Business & Society, University of Applied Sciences Kufstein Tirol–FH Kufstein, Kufstein, Tyrol, Austria
  3. 3Department of Sports Science, Saarland University, Saarbrücken, Saarland, Germany
  4. 4Austrian Ski Federation, Innsbruck, Tyrol, Austria
  1. Correspondence to Dr Michael Barth, Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Tyrol, Austria; michael.barth{at}


Objectives The study aimed to (1) determine the incidence and gender-specific risk ratio of acute on-snow severe injury events (SIE) in elite alpine ski racing, (2) examine the development of SIE over 22 seasons, and (3) analyse SIE with respect to the severely injured body parts and structures.

Methods Data recorded in the Austrian Ski Federation’s Injury Surveillance System over 22 seasons were analysed. The Austrian Ski Team consists of four groups: Team National (n=477), Team A (n=444), Team B (n=696) and Team C (n=608). Team National and Team A comprised World Cup, Team B European Cup and Team C junior alpine ski racers. Simple and multiple Poisson regressions were calculated.

Results The SIE incidence was 15.7 (95% CI 14.2 to 17.5) per 100 skier seasons. ACL injury events accounted for 70.8% of severe knee injury events and 48.6% of SIE. The incidence of severe ACL injury events was 7.6 (95% CI 6.6 to 8.9). Female World Cup alpine ski racers had a 1.65 times (95% CI 1.02 to 2.69) higher risk of severe ACL injury events than their male counterparts.

Conclusion The incidence of acute on-snow SIE in World Cup alpine ski racing was higher than previously reported. Despite various prevention efforts, the average seasonal incidence of SIE in World and European Cup alpine ski racers has grown from approximately 11 in 1997 to 23 in 2019; thus with roughly one more injured athlete every second season.

  • alpine skiing
  • injuries
  • knee injuries
  • knee ACL
  • anterior cruciate ligament

Statistics from


  • Contributors Conceptualisation of the project and methodology: MB, HPP, WN, PS, AG. Data collection and organisation: MB, HPP, WN, PS, AG. Data analysis: MB, HPP, WN. Writing original draft: MB, HPP, WN. Manuscript review and editing: MB, HPP, WN.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval This survey was conducted according to the ‘ethical guidelines for surveys’ approved by the Institutional Review Board of the Department of Sport Science as well as the Board for Ethical Issues of the University of Innsbruck. Approval number (‘Ethical Guidelines for Surveys conducted at the Department of Sport Science’): Certificate of Good Standing, 25/2016. All athletes gave written informed consent that anonymised data could be used for scientific purpose.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data generated or analysed during this study are included in this published article.

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