Once the exclusive domain of teenage daredevils, snowboarding is now an Olympic sport and the growing popularity of the sport has, in turn, revitalized interest in downhill skiing. In fact, nearly seven million snowboarders account for the 57 million ski lift tickets sold in the United States. However, as the popularity of snowboarding and alpine skiing increases, so does the potential for injuries, says the American Physical Therapy Association (APTA).

Two-thirds of snowboard injuries affect the upper extremities, with the most common injuries occurring to the wrist and shoulder. However, there is an injury unique to snowboarding — “snowboarder’s fracture,” a fracture of the talus, a bone in the middle of the ankle joint, that occurs when the rider’s foot is pushed suddenly upward and outward during a fall.

The predominant injuries in downhill skiing occur to the lower extremities, such as the knee, leg, and ankle. The most well-known knee injury among skiers is to the anterior cruciate ligament (ACL), which typically occurs when ski bindings don’t release during a hard fall and, in serious cases, may require reconstructive surgery.

An injury unique to downhill skiers of all levels, is “skier’s thumb”, when the thumb ligament that provides hand stability is damaged. Often dismissed as merely a sprain, this condition, if left untreated, may require surgery. Skier’s thumb typically occurs when skiers fall on their poles during a fall, or during a “pole plant,” when the ski pole is stuck in the snow but the skier keeps moving.
For skilled snowboarders, the greatest danger is landing incorrectly. There is a high incidence of head injuries among more advanced riders, who tend to be more fearless and board through back woods dense with trees. The most common injuries among advanced snowboarders, in addition to head trauma and spinal injury, are sprains and fractures of the wrists, shoulders, knees, and ankles.

For advanced skiers, the greatest risk is velocity. When skiers pick up too much speed and lose control, they run the risk of multiple traumas, including severe head injuries and thigh fractures, when they hit obstacles at such a high speed.

For beginner snowboarders, the accident profile is different. Because the feet are strapped to the board in non-release bindings, less-experienced “boarders” tend to fall over when they catch the front or back edge of the board. The most common injuries among beginner “boarders” are wrist fractures and sprains.
Most novice skiers don’t know how to fall correctly and tend to fall forward. Because of this, the shinbones breaks right at the exact spot where ski boots end, a condition known as a “tib-fib” or “boot top” fracture, because both the tibia and fibula are fractured.

Strengthening both the upper and lower body, a critical component of skiing and snowboarding safety, is best accomplished on a year-round basis. But if that isn’t possible, at least twelve weeks of conditioning before venturing onto the slopes is recommended. A stronger, more flexible body will tolerate a fall better.

Another way to prevent injuries is by using protective gear and properly fitted equipment. Snowboarders should wear wrist guards and kneepads. Additionally, APTA recommends that snowboarders and downhill skiers wear a protective helmet, as most fatal injuries are head injuries.
APTA advises that skiers should not ski above their ability; know when they’re tired (most accidents occur at the end of the day, she notes); and have ski bindings set to the appropriate level depending on leg strength and skill.

APTA also recommends a regimen of stretching, strengthening, flexibility and endurance exercises to prevent injury and to promote maximum enjoyment. Following are APTA’s suggested stretches for snowboarding and skiing:
Rotation – Stand with feet shoulder-width apart and arms stretched out in front of you. Try to look behind you, and twist your trunk and arms as far as you can in the direction you are looking. Hold for 30 seconds, then repeat in the opposite direction.
Flexion – Stand with feet shoulder-width apart. Squat all the way down and wrap your arms around your bent legs and hold for 30 seconds.
Extension – Kneel on the ground and grab your heels with both hands. Look up towards the sky and push your stomach forward as far as you can. Hold for 30 seconds. Remember to breathe normally!
Hamstring Stretch – Lay on the floor with your feet against the wall. Slowly walk up the wall until your legs are at a 45 to 60 degree angle with the floor. Making sure your heels stay in contact with the wall, bend your knees and bring your buttocks closer to the wall. Hold position for 3 minutes.

The American Physical Therapy Association is a national professional organization representing more than 66,000 physical therapists, physical therapist assistants, and students. Its goal is to foster improvements in physical therapy practice, research and education. For more information, please visit www.apta.org