The "Wide World of Sports" image of a fallen skier tumbling out of control down a mountain is indelibly etched in the memory of every older alpinist who's stepped into a binding. And today's blizzard of videos of skiers and boarders tackling sick terrain — and sometimes injuring themselves in the effort — only amplifies the image.
Against that backdrop comes the November/ December issue of the magazine "Sports Health: A Multidisciplinary Approach." In it, Dr. Robert Johnson, a professor emeritus of orthopedics at the University of Vermont, takes aim at a dozen alpine skiing myths, aiming to debunk them.
"There are many common misperceptions about skiing safety and equipment needs," said Johnson, lead author of the report.
Among them: the assumption that skiing is inherently dangerous and that lessons or overall fitness reduce the risk of injury.
Johnson's team reviewed sports medicine literature concerning 12 of the most common topics related to alpine skiing, concluding "all or at least part of each of the myths could not be substantiated."
Not everyone agrees with all of Johnson's conclusions, particularly his assertion there's no evidence ski lessons decrease the risk of injury.
"Taking lessons is a great way to learn the mountain rules, how to load chairs, how to fall properly so you have a lesser chance of being injured," said Di Hibner, general manager at Alyeska Ski Resort 40 miles south of Anchorage, Alaska.
She also disputes the conclusion there's no evidence exercise and conditioning reduce ski injuries.
"It is very important to maintain a healthy lifestyle," said Hibner, who said she's never been injured in 30 years of skiing ("knock on wood").
"Getting in shape and then maintaining good physical conditioning is extremely important. Work out those muscles you need for balance, like your core. I find yoga and strength training plus cardio four times a week will suit most folks.
"If you are in shape, you will enjoy the sport more — whether it is telemark skiing, snowboarding or alpine skiing. Plus, I believe it limits your chances of injury."
Over the past three seasons, the Alyeska resort in Alaska has averaged 417 injuries per season, Hibner said. The breakdown:
2006-07: Total of 166,133 skiers and riders suffering 356 injuries — or 0.21 percent.
2007-08: Total of 168,839 skiers and riders suffering 449 injuries — or 0.26 percent.
2008-09: Total of 170,888 skiers and riders suffering 445 total injuries — or 0.26 percent.
"Most of these injuries are minor — like a muscle strain or a ligament sprain or tear," Hibner said. "We have very few serious injuries."
Two skiers have died on Alyeska in 20 years, the last during a free ski competition on precarious terrain two years ago.
"These types of competitions do have risk when participants are competing, pushing their limits to the extreme and are on very steep slopes (with) exposed rocky areas," Hibner said.
That type of skiing is well beyond the scope of most recreational skiers. Perhaps most important to the ordinary recreational skier is knowing when to quit.
"We have a bewitching hour here on the mountain — the time when most injuries occur. It is the end of the day and is usually related to being exhausted from a long day of hitting the slopes.
"Knowing when you have had enough for the day can save you."
To deal with the inevitable injuries, Alyeska — like most resorts — has a big staff looking out for its customers. It has 25 people on its ski patrol and snow safety staff, plus three patrollers in training and 20 part timers. Buttressing that staff are about 80 volunteer National Ski Patrol members, about 20 of whom show up on weekends or holidays.
They deal with injuries on the hill, patrol slow zones, enforce the mountain rules and handle chair lift evacuation and rope lines. Paid staffers also handle avalanche control work, shooting Howitzers to release potential avalanches.
Injured skiers are taken down the mountain by sled to the resort's aid room. If the injury suggests hospitalization, the fire department is called.
Occasionally, if there is a serious injury, an ambulance will meet ski patrollers at the base of the tram to save time.
Skiers with minor injuries are often referred to a local clinic.
Among the ski patrollers are doctors, nurses, firefighters, paramedics, emergency medical technicians and physical therapists.
"It is great to have this depth when it comes to managing injuries on the hill," Hibner said.
Setting The Record Straight
According to Sports Health magazine:
1. Myth: "Skiing is among the most dangerous activities."
Truth: Actually, the annual fatality rate per million hours of exposure (0.12) is between that of driving a car (0.30) and riding a bicycle (0.07).
2. Myth: "Broken legs have been traded for blown-out knees."
Truth: The increase in anterior cruciate ligament injuries came later than the decrease in lower-leg injuries. The two involve completely different mechanisms of injury.
3. Myth: "All you need know is your DIN (release indicator value) number and you can adjust your bindings."
Truth: Inspection and calibration of ski bindings is a complex process that requires specialized tools, equipment and trained technicians who set release settings according to height, weight, age and skiing ability. Ignoring those recommendations increases your chance of injury.
4. Myth: "Toe and heel pieces must be set to the same release indicator value or the bindings won't function right."
Truth: Skiers should have personalized release/retention settings that may mean different indicator values at the toe and heel.
5. Myth: "Formal ski instruction will make you safer."
Truth: In most studies done in North America and Europe, skiing lessons did not decrease the risk of injury and have not been shown to be an effective method for injury prevention.
6. Myth: "The shorter the ski, the less torque is applied to the leg in a fall. Therefore, short skis don't need release bindings."
Truth: Several studies have shown a three- to 20-fold increase in the incidence of ankle and tibia fractures for persons using skiboarder (short trick skis) compared to traditional alpine skis. Release bindings should be a requirement for skis of any length.
7. Myth: "Young bones bend rather than break, so there's no point spending a lot of money on children's equipment."
Truth: Children are at the highest risk for equipment-related injuries. Properly functioning equipment is critical if that risk is to be minimized.
8. Myth: "When buying boots for children, leave plenty of room for fast-growing feet."
Truth: Poor fitting boots are a major factor leading to lower leg fractures and sprains among young skiers. If the foot can easily move within the boot, the binding release function is compromised.
9. Myth: "If you think you're going to fall, just relax and let it happen."
Truth: Skiers should assume the posture of a parachutist just before landing and keep joints moderately flexed. Muscles of the extremities and trunk should be strongly contracted; this response will stiffen and protect bones and joints.
10. Myth: "Exercise is the best way to avoid skiing-related injuries."
Truth: There is no convincing evidence that conditioning of any type can reduce the risk of alpine skiing injuries. However, there is no downside to good physical condition and it may improve the enjoyment of skiing.
11. Myth: "Tighter standards that mandate lower release setting will reduce the risk of an ACL injury."
Truth: The primary mechanisms for ACL injury is not related to binding function, so any reduction in the binding release values would not reduce the risk of ACL injury but could increase the frequency of inadvertent releases.
12. Myth: "Buying new ski equipment is safer than renting."
Truth: Rental equipment from reputable shops is inspected for proper function as well as wear and tear every time it's rented; user-owned equipment is normally inspected only at the beginning of each season.