See link below for a pilot study I understood for assessing shoulder joint-position sense. A full clinical follow study is now underway.
When I bought my first snowboard 10 years ago, the sales assistant told me, “snowboarding is 25% about your skills on a board and 75% about looking cool”. The snow-sports fashion industry has infiltrated every snowboard movie since the sports inception, and its baggy legacy hangs beautifully from Seasonnaires all over the world.
Yet the oversized T-shirts and low-hanging pants of today’s teenage ‘park rats’ often hide a deadly secret: In the world of snow sports, fashion can be dangerous.
In 2013, World-class freestyle snowboarder Kevin Pearce starred in “The Crash Reel”; an autobiographical documentary film detailing his partial recovery from a severe brain injury. Following his life-changing injury in 2009, Kevin may never snowboard at the top level again. Happily however, he survived his accident at Park City in Utah, a fact he attributes to wearing a helmet.
Two years on from Kevin’s tragic injury, the biggest-budget snowboard film of all time dominated iPads and laptops around the world. “The Art of Flight” (2011) featured Travis Rice, a would-be role model for impressionable young riders, throwing down huge back-country cliff drops in Alaska and hitting kickers the size of small mountains, much of the time without wearing a helmet.
Head injuries are the leading cause of severe injury and death among snowboarders. Happily, helmet usage among snowboarders is increasing. While only 25% of riders in 2002/2003 wore helmets, 57% wore them in 2009 /2010. This figure rose to 67% in 2011/12, and this trend has continued following Michael Schumacher’s high profile injury in December 2013. According to the Journal of Trauma and Acute Surgery Care, wearing a helmet clearly reduces the risk of head injury during skiing and snowboarding and does not increase the risk of neck injury or ‘risk compensation behavior’.
Severe head injuries can be horrific, but fortunately they are fairly uncommon. Most snowboard injuries affect the upper limb, with 20% involving the wrist. In fact, wrist injuries are 10 times more common in snowboarders than skiers. Two thirds of these injuries are fractures. Many experienced snowboarders believe that wrist fractures only affect novices. While they are indeed more common among those new to the sport, advanced riders are relatively more likely to sustain ‘intra-articular’ or ‘communicated’ fractures. These are complex injuries which require surgery and frequently result in a permanent reduction in wrist motion, with subsequent osteoarthritis and long-term pain.
There is a popular myth in snowboarding that wrist guards increase the risk of a serious fracture by “breaking the bones further up the arm”. I have heard this repeatedly over the last 10 years while hanging around resorts, guiding holiday guests and treating injured snowboarders both in the Alps and in the UK. In fact, while I was donning my wrist guards for a park night at the Snow Centre in Hemel Hempstead last week, a member of staff helpfully informed me that I was going to “break my arm”.
The evidence is clear: This is simply not true. Wrist guards are beneficial in preventing serious wrist injuries, yet fewer than 10% of riders wear them. There is a nearly three-fold increase in wrist injuries among riders who do not use wrist protection. Children and inexperienced snowboarders are most likely to benefit.
Most concerns about wrist guards seem to relate to the idea they will simply transfer injury to other forearm locations. It is true that wrist guards should possess a degree of flexibility to avoid generating localised forces above or the below the device, but studies have failed to demonstrate increased rates of injuries to other parts of the arm. On a personal level, I have only ever seen one wrist fracture in a rider wearing wrist guards. The patient was an experienced park rider and the fracture occurred at his wrist joint, rather than further up the arm.
As a sports physiotherapist, I am passionate about minimising the risk to young people involved in extreme sports, but I am myself not immune to peer-pressure. In 2012, I fell off a rail in Montgenevre and dislocated my right acromioclavicular joint (where the collar bone meets the shoulder blade). I was pleased that the local doctor checked if I was wearing a helmet and wrist guards, but she did not enquire whether I was using any shoulder protection. My injury is common among snowboarders and might have been avoided had I been wearing the back and shoulder protection that I now use.
But where does it all stop? Should we go snowboarding wrapped up in cotton wool? Well, British doctors seem have an infuriating habit are telling patients that “common things occur commonly”. There is certainly some sense in this. My view is that we should promote devices that reduce the risk of common injuries, especially where they do not restrict snowboarders while on the mountain. For me, my essential gear includes helmet, wrist guards and shoulder/back protection. I use impact shorts when hitting rails (usually with my backside), and never go off-piste without local knowledge along with my transceiver, shovel and probe.
It is in the spirit of snowboarding not to conform to stereotypes, so I encourage young riders not to be labelled as ‘dumb snowboarder’. Ignore urban myths and don’t bow down to fashion. Instead, use common sense and follow the science. Wear protective gear and have fun. Body armour may not be fashionable, but neither is a devatating head injury, returning from a ski season in January or having osteoarthritis in your 30’s.
We look to the people at the top of any sport to promote the safety of youngsters taking it up. “The Fourth Phase”, the major new snowboard film from Red Bull Media House, promises to be their biggest production to date. Why then, are trailers for this film already available online showing the stars launching mind-blowing jumps without helmets? With a release planned for 2016, these riders should be wearing helmets, even if it means they can’t model their sponsors’ latest beanies.