RT Journal Article SR Electronic T1 The relationship between ACL injuries and physical fitness in young competitive ski racers: a 10-year longitudinal study JF British Journal of Sports Medicine JO Br J Sports Med FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine SP 1065 OP 1071 DO 10.1136/bjsports-2012-091050 VO 46 IS 15 A1 Christian Raschner A1 Hans-Peter Platzer A1 Carson Patterson A1 Inge Werner A1 Reinhard Huber A1 Carolin Hildebrandt YR 2012 UL http://bjsm.bmj.com/content/46/15/1065.abstract AB 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.