Top 5 Injuries Facing Skiers in Denver, Colorado and How You Can Protect Yourself

Ski season is fast approaching here in Denver, Colorado with some resorts opening in a few weeks. While skiing is an amazing outdoor activity that can provide great exercise it also unfortunately comes with some risks to health that are worth reviewing. Some of these health risks can be mitigated while some are unavoidable. Here are the Top 5 Injuries Facing Skiers.

Top 5 Injuries Facing Skiers and Snowboarders

1. Traumatic Brain Injury: Head injury is the leading cause of death and catastrophic injury, with concussions and traumatic brain injuries being particularly common, especially in snowboarders and young males. Helmet use significantly reduces risk but does not eliminate it.

2. Spinal Cord Injury: Spinal cord injury is less common than head injury but carries a high risk of permanent disability. The incidence is increasing, particularly with high-speed and acrobatic activities.

3. Lower Extremity/Knee Injury: These are most frequent in skiers, with anterior cruciate ligament (ACL) tears and other knee ligament injuries being predominant. These injuries are more common in beginners, children, and females.

4. Upper Extremity Injuries: are more common in snowboarders, with wrist fractures and sprains, shoulder injuries, and clavicle fractures being the most frequent. Wrist guards are effective in reducing wrist injuries in snowboarders.

5. Other Fractures: (including clavicle, distal radius, and lower extremity fractures) are common in both sports, with snowboarders at higher risk for upper limb fractures and skiers for lower limb fractures. Fractures account for a significant proportion of emergency department visits.

How Can We Mitigate Risk For These Injuries?

Practicing in Denver, Colorado we tend to see almost every single one of these types of injuries multiple times a year unfortunately. Anecdotally, my patients are generally avid and experienced skiers and they tend to get injured not because of a mistake on their part but it is quite common that another person ran into them accidentally. Or just simply getting on and off the lift when injury is least expected that will catch experienced skiers. The story often starts with "It was the last run of the day...".

Mitigating Joint and Extremity Injuries

The latest randomized controlled trials and meta-analyses demonstrate that neuromuscular training (NMT) programs incorporating lower extremity balance, strength, agility, and change-of-direction exercises are effective in reducing lower extremity injury risk in downhill skiers. A 2025 meta-analysis of 24 RCTs found that NMT programs reduced overall lower extremity injury risk by 27% (RR 0.73, 95% CI 0.67–0.79), with optimal effects for knee injuries, especially in male adolescents aged 12–18 years. The most effective dosage was 20–30 minutes per session, 1–2 sessions per week, sustained for at least 6 months.

A 2022 controlled experimental study in youth competitive alpine skiers showed that a targeted NMT program performed at least once weekly for 12 months led to significantly lower rates of both traumatic and overuse injuries, particularly at the knee and lower back. Another RCT in elite junior skiers demonstrated that an 8-week body-weight NMT program improved dynamic balance, a key protective factor against injury, though it did not affect vertical jump performance.

Systematic reviews and meta-analyses in broader athletic populations confirm that multi-component NMT programs (including plyometrics, proprioception, and core strengthening) reduce acute knee injuries (RR 0.46) and ankle sprains (RR 0.50). The most robust injury reductions are seen with programs that are sport-specific, include consistent feedback on technique, and are implemented with high compliance over several months.

In summary, regular, multi-component neuromuscular training programs—especially those emphasizing balance, agility, and strength, performed at least weekly for 20–30 minutes over 6 months or longer—are the most evidence-based strategy for injury prevention in downhill skiers. I usually recommend a combination of high repetition belted squats, single-leg pistol squats calf raises, Nordic-curls, planks and back extensions.

Reducing Risks of Traumatic Brain Injuries

Helmet use is effective in reducing the incidence and severity of head injuries in both skiing and snowboarding. The American Academy of Pediatrics recommends universal helmet use for children and adolescents, citing strong evidence for a reduction in head injury risk (OR 0.58, 90% CI 0.51–0.77) and no increase in neck injury risk. Helmeted individuals admitted to the ICU have significantly lower injury severity scores than those not wearing helmets. While a lot of the data concerns adolescents it definitely applies to the adult population.

When selecting a helmet for injury prevention in skiing and snowboarding, the following features should be considered: helmets designed specifically for snow sports (skiing and snowboarding) should be selected, as sport-specific engineering provides optimal protection; bicycle helmets should not be used for snow sports. Proper fit is essential: the helmet should fit snugly, cover the forehead, and be secured with a chin strap; damaged, outgrown, or previously used helmets with unknown integrity should be replaced. Helmets meeting recognized safety standards (e.g., ASTM, CE) are strongly recommended, as evidence shows they significantly reduce the risk and severity of head injuries without increasing neck or cervical spine injury risk. Real-world data support helmet effectiveness in reducing head injury risk for all ages and skill levels, with additional benefits for children and adolescents; helmet use is associated with lower injury severity and shorter hospital stays.

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References:

The Preventive Effects of Neuromuscular Training on Lower Extremity Sports Injuries in Adolescent and Young Athletes: A Systematic Review and Meta-Analysis. Li Y, Zhu W.

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The Injury Prevention Programme for Youth Competitive Alpine Skiers: A Controlled 12-Month Experimental Study in a Real-World Training Setting. Schoeb T, Fröhlich S, Frey WO, et al.

Frontiers in Physiology. 2022;13:826212. doi:10.3389/fphys.2022.826212.

Effects of an 8-Week Body-Weight Neuromuscular Training on Dynamic Balance and Vertical Jump Performances in Elite Junior Skiing Athletes: A Randomized Controlled Trial. Vitale JA, La Torre A, Banfi G, Bonato M.

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