Subject: “Down A Slippery Slope” The Wallstreet Journal – (1/8/99)
Answer: My colleague Dr. Jasper Shealy and I were interviewed by the WSJ authors and their staff for this article. While we take some credit for redirecting their efforts, the resulting article is incorrect and incomplete. The interviewers made it very plain that they were looking for the sensational and were not interested in any good news. After stating that skiing is getting more dangerous, the authors give the reader two alternatives; 1) ski slowly and avoid high-tech equipment, 2) quit. There is more to the story.

“High-Tech ski equipment and ski area upgrades,” the lead says in a box on page one January 8, “has had an unintended consequence–a jump in debilitating, even catastrophic injuries.” Then in a page and a half of the Weekend Journal the authors proceed to de-construct much of their own thesis. Let me help them finish the job.

By “debilitating” injury the authors make it plain they mean serious knee sprains, usually involving the ACL. We first reported this epidemic sixteen years ago in 1983. Although the injury rate continued to rise, and now accounts for a quarter of all medically significant injuries and half the treatment dollars spent each year, the rate of increase has abated and is today relatively flat. There has been no recent “jump” and we can find no connection between “high-tech” equipment and this injury. In fact our studies show that the new shape skis may actually reduce the risk of injuries of all types if the skier goes through an orientation program.

However, of greater importance is what is left out of the article–the good news on knees. In a study published in the October 1995 issue of the American Journal of Sports Medicine we reported a more than 55% reduction in ACL sprains among ski area employees following a highly structured video-based training session. The lessons learned in that study are now available to the public at any ski shop via a free pamphlet, “Tips For Knee Friendly Skiing.” More than a million have been distributed over the past three seasons, paid for by the major ski equipment suppliers.

The rest of the opening argument bears equal scrutiny. “Catastrophic injuries” is a nebulous term that has yet to be clearly defined and is therefore not a reliable statistic over time. It is also a hard statistic for a small ski area to report accurately. Small areas are unlikely to have a medical clinic and staff which can accurately diagnose a catastrophic injury and follow up to confirm the long term prognosis. As the number of ski areas decreases, leaving fewer but larger and better managed facilities, we can expect the reporting to improve. This process has been going on for decades but it has accelerated in recent years, thus further skewing the data. At present, there is no credible evidence that catastrophic injuries are increasing at a statistically significant rate. The statement regarding fatalities is equally specious. Expressed as a rate, the reported change over ten years is not statistically significant. We are certainly not looking at a “jump” in fatalities or any other category.

But in the most ludicrous argument of all the authors imply that ski areas are somehow negligent for providing faster lifts and better trail grooming and snow making, because skiers will take more runs and ski faster. By this argument we should indict Eisenhower for creating the interstate highway system. And while on the subject of highways, would we all be safer if we left the potholes unfilled? The problems of speed and congestion on the slopes are not unlike the problems on our nation’s highways and the solutions are not dissimilar. Loss of control and failure to properly assess the conditions are the root cause of most accidents in skiing. Skiers, like drivers, must learn the rule of the road (“Your Responsibility Code” available everywhere), learn to turn or stop quickly in an emergency, and most important of all, learn to expect the unexpected.

High speed lifts, while challenging the ski area to disperse skiers and avoid congestion are not, in our opinion, a contributing cause of skier fatigue as charged by the authors. It’s hard to argue that a long wait in line and a slow cold ride on a cramped lift will provide the respite necessary to avoid fatigue.

The risks of injury in skiing are not enhanced by the new hardware but there is ample evidence that they can be abated by new software for the on-board computer–the skier. Training–much of it non-verbal–is a proven and inexpensive means to make a popular risk exercise less risky and more popular.–CFE