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Very little data exists for ice climbing, and although severe injuries and fatalities occur, most recognized injuries are of minor severity and are comparable with other outdoor sports [ 27 , 32 ]. In mountaineering, additional environmental factors avalanches, crevasses, altitude-induced illnesses with neurological dysfunction, etc. The sports of wave surfing is ever growing with a huge market involved, commercialization of surfing apparel and the surfing lifestyle, fashion trends, and media coverage.

In , it was estimated that there were more than 2. Despite being one of the most popular outdoor sports in the world, less than ten studies have been conducted on wave surfing. Surfing is considered relatively safe compared to more traditional sports. A survey of self-reported injuries in Australia in found 3. A recent Australian survey found a rate of 2. The injury rate found was 5. The relative injury risk was calculated to be 2.

In a Web site-based survey, individuals reported acute injuries and chronic injuries [ 44 ]. This data correlates well with previous reports showing high incidence of lacerations caused by the sharp fin, the tail, or the nose of the surfboard. An interesting finding showed a considerable proportion of head injury, in contrast to the fact very few surfers use protective headgear [ 44 , 45 ].

Fatality rates are unknown in surfing. Reports from Hawaii from to found that bodyboarders and surfers accounted for 17 of ocean-related drownings [ 46 ]. This data includes fatal shark attacks. Skiing and snowboarding are the two main piste-based snow sports. With roots in Nordic cross-country skiing, Alpine skiing gradually evolved over time from method of transportation in Scandinavia thousands of years ago into the present recreational and competitive sport, becoming a winter Olympic sports in Garmisch in , with snowboarding becoming an Olympic sports in Fig.

Recent estimation report around million skiers and 70 million snowboarders active in the world today. The current risk of a recreational snow-sport-related injury is between 2 and 4 injuries per participant days [ 50 ], a risk much lower than in popular sports such as football and rugby, and has decreased steadily over recent years [ 51 ] thanks to improvements in equipment, ski area design and maintenance, and piste preparation [ 51 ].

The risk of injury from recreational Alpine skiing is generally accepted to be between 1 and 2 injuries per participant days [ 50 , 52 ]. Prior to the introduction of release bindings, fractures of the lower leg were common from twisting forces transmitted unmitigated from the ski up to the lower leg. Injury types breakdown in Alpine skiing. From [ 69 ].


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Commonly injured areas in Alpine skiing. Upper limb injuries feature strongly with either the thumb or the shoulder being involved following a fall onto an outstretched hand. If left untreated, this may lead to long-term functional disability. The four commonest shoulder injuries to affect skiers and snowboarders are anterior dislocation of the glenohumeral joint, acromioclavicular AC joint disruption, clavicle fracture, and fracture of the proximal humerus.

The incidence of shoulder injuries is higher in snowboarders [ 55 ]. The risk of injury from snowboarding is generally estimated at about twice that of Alpine skiing and currently stands at between 2 and 4 injuries per participant days [ 52 ].


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  • Snowboarders are more likely to injure their upper limb than their lower limb [ 53 ]. Unlike skiers, when losing balance, snowboarders cannot step out a leg to regain balance. As a result, falls due to loss of balance are frequent, and not surprisingly, beginner snowboarders are at highest risk. This commonly results in falls on an outstretched hand and places the upper limb, and the wrist joint in particular, at high risk of injury [ 56 ]. Snowboarders suffer a higher rate of shoulder joint injuries due to an increased tendency to fall onto the upper limb [ 53 ].

    Jumps and other aerial maneuvers, commonly performed in snowboarding, are associated with a relatively small but definite risk of injury to the spine [ 58 — 60 ]. Injury types breakdown in snowboarding. The injury risk among professional skiers and snowboarders is approximately three times that of recreational participants [ 61 ] and has been calculated to be 17 injuries per ski runs [ 62 ].

    The knee is the commonest injury area among competitive skiers and snowboarders [ 61 — 63 ]. Knee injuries account for about one third of all skiing injuries. Most are minor soft tissue sprains.


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    • The medial collateral ligament MCL is commonly injured as a result of valgus force to the knee as the ski unintentionally splays the lower leg outward. Most grade 1 and 2 injuries will settle with conservative treatment. The most serious soft tissue knee injury involves the anterior cruciate ligament ACL. This important ligament may be injured in isolation or in combination with other structures.

      While it is possible to ski without an ACL, this requires considerable effort and rehabilitation to maintain knee stability, muscle bulk, and proprioception. Most orthopedic surgeons recommend ACL reconstruction for those who wish to ski at or above an intermediate level. Knee injuries among snowboarders are much less common and usually result from direct trauma to the anterior aspect of the knee.

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      The fatality risk in snow sports is even lower at one death per 1. This equates to approximately 39 traumatic deaths per year in the USA out of a total of almost 60 million participant days source: These fatality rates are much lower compared to other popular recreational activities such as swimming and cycling [ 64 ]. The commonest cause of a traumatic snow-sport-related death is a high-speed collision with a static object tree, pylon, or another person [ 65 , 66 ]. Many of these deaths involve head injuries [ 66 ]. Non-traumatic causes of death on the slopes include ischemic heart disease, hypothermia, and medical events such as acute severe asthma attacks [ 65 ].

      Unless the event is witnessed, self-extraction from the tree well is nearly impossible. The trapped individual tends to cause more snow to fall into the pit as they struggle to try to extract and death usually resulting from hypothermia or asphyxiation from snow falling in [ 68 ]. Extreme sports are increasing in popularity, being fun to participate in and exciting to watch.

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      However, extreme sports athletes are more likely to return to their pre-injury levels of activity than the general population following treatment. All authors contributed to the data collection and drafting of the manuscript. All authors read and approved the final manuscript. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

      National Center for Biotechnology Information , U. J Orthop Surg Res. Published online Apr Lior Laver , 1 Ioannis P. Pengas , 2 and Omer Mei-Dan 3, 4. Author information Article notes Copyright and License information Disclaimer. Received Nov 15; Accepted Mar This article has been cited by other articles in PMC. Associated Data Data Availability Statement Data sharing are not applicable to this article as no datasets were generated or analyzed during the current study. Abstract Extreme sports ES are usually pursued in remote locations with little or no access to medical care with the athlete competing against oneself or the forces of nature.

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      Background The definition of extreme sports ES inhabits any sports featuring high speed, height, real or perceived danger, a high level of physical exertion, and highly specialized gear or spectacular stunts and involves elements of increased risk. Epidemiology of extreme sports injuries Despite great evolution in traditional sports epidemiology, injury mechanisms in ES are less understood.

      Specific extreme sports and their associated injuries Skydiving Skydiving is a major air sports of parachuting from an aircraft, the International Parachuting Commission IPC reported in approximately 5. Open in a separate window.

      Injuries in extreme sports

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