Snowboarding is the most rapidly growing winter sport and with it's growth is the rapid rise of serious orthopaedic injuries. What is alarming to orthopaedists is the similarity of snowboard injuries today to skiing injuries of thirty years ago. Here is what is happening.

Snowboarding started out with steel-edged, composite boards attached to loose boots with straps. Control of the board was performed by varying the weight of the two feet towards forward and backward tilt of the board relative to the snow.

As technology has evolved, snowboarders now are beginning to change from soft boots with strap bindings, to stiff boots with rigid metal, non-release bindings. With this evolution, the injury pattern has changed and is remarkably similar to the old ankle fractures seen in the early days of plastic boots with non-release ski bindings. We now are seeing ankle fractures and distal tibia and fibula fractures as snowboarders fall, twist, and hear the nauseating crack of the fracturing bone.

Injuries occur at a similar rate to skiing of 3 to 4 injuries per 1,000 exposure days. However, the rate of fractures is markedly higher in snowboarders at 38% of injuries compared to 15% of skiing injuries.* The mild to moderate snowboarding injuries are predominately located in the ankle and wrist with more severe injuries resulting from contact with trees or other skiers. The wrist and ankle injuries, including fractures and sprains, led to a wider use of wrist splints particularly for beginning snowboarders. The contact injuries, due to their severity, has led to the use of helmets which is now strongly recommended for all snowboarders.

Knee injuries are currently uncommon in snowboarders except when they hit a tree. Then, instead of tearing the anterior cruciate ligament that the skier tears when he falls backwards or twists, the snowboarder tears the posterior cruciate ligament as his forward leg contacts the immovable object. The direct posterior force ruptures the ligament and leaves the knee unstable.

Shoulder injuries have occurred at a rate similar to skiing with the primary injuries being separated AC joints, dislocations, and torn rotator cuffs. All three injuries frequently require surgical repair for optimal results.

At this time, we recommend that snowboarders wear wrist supports, helmets, soft boots with strap bindings, and stay in control. If off the trail, board with a buddy, and bring along a walkie talkie. If an injury occurs, contacting the ski patrol may be lifesaving.

For more information, contact The Stone Clinic at 415-563-3110. Our team includes an orthopaedic surgeon, nurse practitioner, and physical therapists oriented toward the prevention and care of sports injuries.

*11th International Congress on Ski Trauma and Skiing Saftey. April 1995