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Associated factors, nonlinear risk patterns and effect heterogeneity of severe injuries in recreational skiers and snowboarders.

Frontiers in public healthยทApril 2026ยทXiaoyu Ling, Lijun Long, Dongting Jiang et al.
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Key Finding

Knee protector use, cautious risk behavior, and advanced skill level each reduced severe ski injury odds by approximately 50%, while collisions with other participants increased severity risk by 51%.

What This Means For You

This study examined what factors contribute to severe injuries among recreational skiers and snowboarders at Chinese ski resorts. Researchers analyzed data from 2,369 injured adults over three winter seasons, finding that 14.3% suffered severe injuries with an injury severity score above 15. The study found several important protective factors: wearing knee protectors reduced severe injury risk by 43%, cautious skiing behavior reduced risk by 54%, and advanced skill level reduced risk by 54%. Conversely, collisions with other skiers or snowboarders increased severe injury risk by 51%. The research also revealed that certain safety practices like warming up before skiing and checking equipment bindings were especially protective for high-risk groups such as beginners and those who engage in risky behavior. Environmental conditions like snow depth also showed complex relationships with injury severity. While this study focuses on winter sports injury prevention and does not directly relate to acupuncture treatment, it's worth noting that acupuncture practitioners may see patients recovering from such sports injuries. Acupuncture has been explored in sports medicine settings for pain management and recovery support, though this particular study did not examine acupuncture interventions. If you're considering acupuncture for sports injury recovery or pain management, consult with a licensed acupuncturist certified by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

Clinical Notes for Practitioners

This retrospective cross-sectional study analyzed 2,369 injured adult skiers and snowboarders treated at two Chinese ski resorts (2021-2024), identifying risk factors for severe injury (ISS>15). Using Firth-penalized logistic regression with restricted cubic splines, investigators found 339 (14.3%) participants sustained severe injuries. Significant protective factors included knee protector use (OR=0.57, p=0.005), cautious risk behavior (OR=0.46, p<0.001), and advanced skill level (OR=0.46, p=0.023). Collisions with other participants increased severity risk (OR=1.51, p=0.011). Nonlinear dose-response relationships were observed for age, BMI, temperature, and snow depth. Effect modification analysis revealed warm-up exercises and binding checks provided stronger protection in high-risk subgroups, though with imprecise estimates. The study supports risk-stratified prevention strategies in winter sports medicine. Note: This study does not address acupuncture interventions and falls outside traditional acupuncture research scope.

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