In-Competition Severe Injury Events in Elite Alpine Ski Racing from 1997 to 2020: The Case of the Austrian Ski Team.

BACKGROUND: To increase safety in elite alpine ski racing Injury Surveillance Systems were implemented and preventive measures introduced. However, studies analysing the change in athletes' injury risk by controlling for their exposure are still scarce. OBJECTIVES: This study aimed to describe and analyse the risk of in-competition severe injury events (SIEcomp) in elite alpine ski racing. METHODS: Data recorded in the Austrian Ski Federation's Injury Surveillance System were used to analyse the SIEcomp incidence. Information on athletes' competition exposure was obtained from the official website of the International Ski Federation. In 23 seasons, 2333 skier seasons were recorded for the Austrian Ski Team. Within a total of 114,531 runs 169 SIEcomp occurred. Generalised Estimating Equation for Poisson Regressions were applied. RESULTS: The SIEcomp incidence per 1000 runs was 1.48 [95% confidence interval (CI) 1.26-1.73] for elite alpine ski racers and 2.21 (95% CI 1.79-2.75) for the subgroup of World Cup racers. A significant sex difference was detected for the subgroup of junior racers with a higher risk for female athletes [risk ratio (RR): 2.97, 95% CI 1.46-6.05]. Between the seasons of 1997 and 2020, the seasonal SIEcomp incidence increased by a factor of 2.67 for elite alpine ski racers and 3.53 for World Cup racers. Downhill (2.75, 95% CI 2.18-3.47) had the highest SIEcomp incidence, followed by super-G (1.94, 95% CI 1.30-2.88), giant slalom (1.40, 95% CI 1.06-1.85), and slalom (0.64, 95% CI 0.43-0.96). CONCLUSION: Although many preventive measures have been implemented in elite alpine ski racing, the risk of SIEcomp has increased over the last two decades.

Conservative treatment of iliotibial band syndrome in runners: Are we targeting the right goals?

OBJECTIVE: Iliotibial band syndrome (ITBS) is presumably caused by excessive tension in the iliotibial band (ITB) leading to compression and inflammation of tissues lying beneath it. Usually managed conservatively, there is a lack of scientific evidence supporting the treatment recommendations, and high symptom recurrence rates cast doubt on their causal effectiveness. This review discusses the influence of common physiotherapeutic measures on risk factors contributing to tissue compression beneath the ITB. METHODS: The potential pathogenic factors are presented on the basis of a simple biomechanical model showing the forces acting on the lateral aspect of the knee. Existent literature on the most commonly prescribed physiotherapeutic interventions is critically discussed against the background of this model. Practical recommendations for the optimization of physiotherapy are derived. RESULTS: According to biomechanical considerations, ITBS may be promoted by anatomical predisposition, joint malalignments, aberrant activation of inserting muscles as well as excessive ITB stiffness. Hip abductor strengthening may correct excessive hip adduction but also increase ITB strain. Intermittent stretching interventions are unlikely to change the ITB's length or mechanical properties. Running retraining is a promising yet understudied intervention. CONCLUSIONS: High-quality research directly testing different physiotherapeutic treatment approaches in randomized controlled trials is needed.