In the winter months, thousands of families hit the slopes to go skiing or snowboarding. It's fun for all the family -- but it's important to get fit beforehand and take every precaution to help prevent injury.
In this blog Mr Jonathan Bell, Consultant Orthopaedic Knee Surgeon at Wimbledon Clinics, looks at why children and adolescents in particular suffer ski injuries and what parents can do to minimise the risk.
Ski injuries occur in approximately three per 1,000 skier days, so they are still relatively rare. But when we look at the age group 10-19 it becomes clear that they are over-represented. In other words, teenagers on the ski slopes are picking up more injuries than the adults.
At Wimbledon Clinics we have many years’ experience in treating teenagers because of where we are located -- in our local area there are lots of ski families with children skiing both recreationally and on the ski race circuit through their schools or race clubs Europe-wide throughout the year -- and because of our experience in treating large numbers of children who play sports, often to a high level, including skiing.
While there are a number of common skiing injuries, the knee is the most frequently injured joint.
Why are teenagers at greater risk?
As young people progress from childhood to adolescence, they are changing hormonally; this affects them physiologically leading to significant strength changes, which means they can generate bigger forces. They also enter a very rapid growth phase, and this growth phase often occurs before their strength and coordination has fully developed.
This means that they are at increased risk of physical injury -- they are growing rapidly, they've still effectively got children's strength and bodies, and their ligaments and bones haven't caught up.
At the same time, due to their hormones, they are becoming risk-takers -- they are experimenting with taking risks. The two groups most at risk of injury are beginners and experienced children. For those families with very experienced, accomplished skiers and racers, the combination of increased risk-taking combined with physiological changes and sometimes being pushed too hard when racing can result in a rather unhealthy mix.
Parents should insist on their teenager skiing with some adult supervision. Many teenagers seem to ski with their peers rather than an adult.
Additionally, the message of safety needs to be ingrained at a very early age; this is especially evident given some of the tragedies of recent years with children off-piste.
Some of the children and teenagers in our area are technically capable of skiing to a fairly high level -- both through race gates and off-piste. Their technical capability often far outstrips their maturity and understanding of how to mitigate risk.
Therefore it is up to us as parents to set a good example to our children when it comes to safety both on and off-piste.
We also need to also make sure that our children have the right kit for the right conditions.
I am sadly seeing many children injured when they are messing around on their race skis between training sessions -- not only are these skis not appropriate for recreational skiing, but the bindings are often done up too tightly so they don't release.
In the past, I have bought second-hand skis for my children from eBay and, although it's tempting to leave them unadjusted, you must get the kit adjusted to fit your child's foot size, weight and ski capability. Skiing on second-hand or borrowed kit that hasn't been adjusted correctly has been shown to have an 800% higher risk of injury.
My experience is that rental shops on the slopes will adjust bindings for no more cost to me than a gratuity to the ski tech.
While skiing is a wonderful sport and an opportunity to learn about risk-taking and how to manage it, it's imperative that we recognise the vulnerability of children as they go from childhood to adolescence as this sport has the potential to create serious injury if these areas are neglected.
Although we would expect to get someone back skiing after they've had an ACL operation, it would be far better to avoid it in the first place.
Our Injury Prevention Screening Programme screens children (and adults) to look for strength and flexibility issues that could be addressed through physiotherapy, stretching or strengthening that might reduce the risk of injury.
Mr Jonathan Bell
Consultant Orthopaedic Knee Surgeon at Wimbledon Clinics
Jonathan has 20 years' experience of treating knee injuries in children and adolescents. He has previously worked in orthopaedics at Great Ormond Street Hospital in London.