Introduction
Despite a decade of extensive research and prevention efforts, the risk of injuries in elite alpine ski racing is still high.1–3 According to a recent study, the risk of suffering at least one injury during an entire season is as high as 95%, which corresponds to an absolute injury rate of 184.1 injuries per 100 athletes per season.2 This is particularly striking since approximately one-third of all injuries are severe (>28 days of absence in training and competition).2 Thus, injuries, especially severe ones, are obvious in alpine ski racing and preventative action is required.
Consequently, the International Ski Federation (FIS) has recently launched a long-term project: the ‘FIS Injury Surveillance and Prevention Programme’ (ISPP) to prevent and reduce the number of injuries.4 Under FIS ISPP, a group of experts, the ‘Alpine Injury Prevention Working Group’ works to identify the most important injury hot-spots through methodical injury surveillance and evaluation to propose effective solutions and projects for implementation. As a foundation for prioritising the work agenda and to give voice to all relevant stakeholders, the current study was designed to hear and understand alpine ski racing stakeholders’ perceptions on key injury risk factors and potential countermeasures.
A similar process was already initiated by FIS 10 years ago with a qualitative interview study involving expert stakeholders from the World Cup (WC) alpine ski racing community, which explored perceived risk factor categories and ranked them according to their impact on injury risk.5 In total, 32 risk factor categories within the basic categories athlete, course, equipment and snow were derived from this qualitative study approach. They were subsequently ranked regarding their perceived impact on injury risk.5 However, our knowledge of effective injury prevention has increased significantly in certain areas over the past decade (eg, course setting).6–11 In other areas, there have been further developments and adaptations to new competition rules (eg, equipment), which may even have recently undermined the rules and led to changes in specific risk factors and injury patterns.1 12 Accordingly, it is likely that experts’ perceptions have also altered or even that new perceived risk factor categories may have emerged. Thus, there is a renewed need for an updated assessment of corresponding expert perceptions.
In this context, an important yet absent perspective are stakeholder role and competition level-dependent differences in experts’ perceptions on risk factor categories, especially for younger athletes competing on the European Cup (EC) or FIS-race levels. To date, most research in alpine ski racing focused on the protection of WC athletes13; however, severe injuries are relatively frequent among younger athletes as well.14–16 Accordingly, knowing and understanding the perceptions of expert stakeholders competing/working on levels lower than WC is crucial for deriving and implementing successful, specifically tailored prevention measures. Moreover, giving all relevant stakeholders a voice may help achieve better countermeasures during the implementation stages.17
Based on these considerations, the aims of the current study were: (1) to update experts’ priorities of perceived key injury risk factor categories in alpine ski racing based on a framework derived 10 years ago; (2) to assess potential priority differences among expert subgroups in dependency of their stakeholder roles the level of competition at which they operate; (3) to identify additional emerging risk factors and (4) to compile a list with countermeasure suggestions for all risk factors reported.