Telemark skiing injuries: Characteristics and risk factors

Objective. - To determine the types of injuries associated with telemark skiing and the effects of ability level, equipment, and terrain. Methods. A survey was mailed to a sample of North American telemark skiers. Results. - Completed surveys were returned by 548 telemarkers (response rate = 74.5%). The mean age was 42.7 (±9.3) years, and 69% were male. A total of 439 injury events resulted in 494 body injuries, reported by 285 skiers (52%). Lower- extremity injuries (n = 231) were more frequent than upper-extremity injuries (n = 187). Knee injuries were most common with 128 cases, followed by 80 thumb, 66 shoulder, and 44 ankle injuries. Surgery was required in 39 cases. Skiers suffering thumb injuries with sequela lasting greater than 3 months were 10.1 times less likely to have sought medical attention than skiers with other long-term injuries (p < 0.001). Injuries occurred more often at lift- served ski areas (74.2%) than in the backcountry (25.8% [p < 0.001, OR = 2.09]). There was no association between boot type and overall knee or ankle injury, but risk of severe ankle injury was increased in leather boots compared to plastic (OR = 8.0, CI = 1.05, 60.59). Release bindings were used by 27.9% of all skiers but were in use in only 18.7% of injury events, suggesting that release plates have a protective effect against injury (OR = 0.59, p < 0.001). In 66 of 82 injuries (80.5%) sustained while using release bindings, the bindings did not release. Conclusions. - The knee, thumb, shoulder, and ankle are most frequently injured telemark skiing. Injuries are more likely to occur at lift-served areas than in the backcountry. Thumb injuries are often ignored and may result in long-term sequela. Ankle injuries appear more severe in leather boots. Release bindings appear protective against injury, but they often do not release.