Westin M.1,2, Harringe M.L.1,2, Engström B.1, Alricsson M.3, Werner S.1
1Karolinska Institutet, Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Stockholm, Sweden, 2Hela Kroppen Physiotherapy, Stockholm, Sweden, 3Mid Sweden University, Swedish Winter Sport Research Centre, Department of Health Sciences, Östersund, Sweden
Background: Anterior cruciate ligament (ACL) injury is one of the most serious injuries among Swedish alpine ski high school students. An ACL injury forces the skier to stop skiing for several months, and some skiers even have to give up their skiing career. Therefore, an ACL injury prevention program might play an important role in competitive adolescent alpine skiers.
Purpose: To evaluate whether a specific prevention program could reduce the incidence of ACL injuries in competitive adolescent alpine skiers.
Methods: This is a prospective ACL injury prevention study. The intervention group consisted of alpine skiers studying at the Swedish ski high schools during the ski seasons 2011/2012 and 2012/2013 (n=305). Alpine skiers, who attended the Swedish ski high schools between the seasons 2006/2007 and 2010/2011 served as a control group (n=431). The prevention program was based on a video education on awareness of how to avoid ACL injury risk situations. It also included suggestions of both indoor and outdoor exercises on snow focusing on core stability and neuromuscular control. Alpine skiing is an equilateral sport. Therefore, the goal of the prevention was to encourage the skiers to practice these exercises to perform equally good on both legs. The outcome measure consisted of the number and incidence of ACL injuries during a two year period of prevention in comparison with five control years.
Results: The two years of prevention resulted in 12 ACL injuries (3.9 %) compared with 35 ACL injuries during the control period (8 %). The absolute risk rate showed a decreased incidence rate of -0.22
(CI -0.44-0.00)/100 months attending a ski high school in favor of the intervention group.
Conclusion(s): A prevention program focusing on the skier´s ability to perform neuromuscular exercises equally good on both legs led to a reduction of ACL injuries in Swedish alpine ski high school students.
Implications: An ACL injury can lead to a re-injury or a new knee injury and long-term impaired knee function with a reduced activity level ending up in early onset of knee osteoarthritis.
Funding acknowledgements: We would like to thank Sweden National Centre for Research in Sport for economic support.
Topic: Sport & sports injuries
Ethics approval: The present investigation was approved by the Regional Ethics Committee in Stockholm, Dnr 2006/833-31/1
All authors, affiliations and abstracts have been published as submitted.
