Skiing and Snowboarding Injury Prevention

Skiing and snowboarding are some of the most popular winter sports. While proper technique and equipment can prevent many injuries, there is risk of injury in any sport that involves moving quickly down a mountain. Many different injuries are possible from skiing and snowboarding. Here are some of the most common injuries and ways to prevent them.

Thumb Sprain

One of the most common upper extremity skiing injuries is a sprained thumb. A sprained thumb is an injury to the ligament or ligaments around the joint of the thumb. A ligament is the soft tissue structure that connects one bone to another to hold it in place. A ligament stabilizes the thumb on each side where it attaches to the bone next to it. The most common thumb ligament injury in skiers occurs at the first knuckle (the joint closer to your wrist). There are two main ligaments that hold this joint in place. The ulnar collateral ligament (UCL) is on the side near the index finger. The radial collateral ligament (RCL) is on the other side (Figure 1). The UCL is the most commonly injured. This injury is so common among skiers that it is sometimes called “skier’s thumb” or “gamekeeper’s thumb.”

Prevention

A thumb ligament injury – or thumb sprain – typically occurs with a fall when the ski pole does not release from the hand. While falling, the pole bends the thumb in a stressful position and the ligament is stretched or torn. Three ways to avoid this injury are:

• Never place your hand down on the snow to try to avoid a fall. Fall with your whole body.
• Do not place your hands through the strap attached to the ski pole, as demonstrated in Figure 2. The strap should be held alongside the pole. This helps the pole release from your hand in case of a fall.
• Try to let go of the pole when falling. Do not try to use the pole to stop your fall.

Symptoms

If your thumb hurts after a fall, it may be from a UCL injury or “thumb sprain.” Your thumb might also feel unstable, particularly when you are trying to pinch or grasp. If your symptoms do not go away, you should visit a hand surgeon. Your surgeon will help determine if your ligament is stretched or torn and how this should be treated.

Treatment

A partial tear and some complete tears can be treated with a cast or splint. Other complete tears need to be repaired surgically. Check out the thumb sprain page for more information on treatment.

Wrist and Forearm Fractures

Wrist and forearm fractures are common injuries from skiing or snowboarding. The natural protective reaction to an unexpected fall is to stop oneself. The hands are placed outstretched to stop the fall, which can lead to a wrist injury (Figure 3).

Prevention

• To prevent wrist and forearm fractures, try not to place your hand down on the snow to stop your fall. Try to fall backward onto your bottom if you are snowboarding, or off to one side if you are skiing.
• Wear wrist guards beneath your gloves or gloves that have built-in wrist guards in case you do fall onto your wrist.

Symptoms

If your wrist or forearm hurts after a fall, particularly if it hurts worse with motion, you may have a fracture. Other signs and symptoms of fracture are swelling, deformity, or tenderness directly over area. Read about 5 Signs of a Wrist Fracture for more detailed information.

Treatment

If you injure your wrist while snowboarding, visit a hand surgeon. Your doctor will examine your wrist and may use x-rays, an MRI, or a CT scan to diagnose the problem. Treatment may consist of a splint, cast, or surgery. Surgery usually involves putting the bones back into the correct alignment and placing metal implants such as pins, plates, or screws to hold the fracture that way until it heals.

Wrist Sprain

Sometimes, a fall onto an outstretched hand does not break a bone, but instead causes an injury to a ligament in the wrist. This is referred to as a sprained wrist. Wrist sprains can also be caused by a sudden twisting motion with the wrist in an abnormal position.

The wrist is made up of many ligaments (Figure 4). The two most commonly injured in skiers or snowboarders are the scapholunate ligament (SL ligament) and the triangular fibrocartilage complex (TFCC).

Prevention

Wrist sprains are prevented in the same way as wrist and forearm fractures, detailed above.

Symptoms

If your wrist or forearm hurts after a fall, particularly if it hurts worse with motion, you may have a sprained wrist. Pain that is worse with motion, swelling, and bruising can all be signs of a wrist sprain.

Treatment

If you injure your wrist while snowboarding, visit a hand surgeon. Your doctor will examine your wrist and may use x-rays, an MRI, or a CT scan to diagnose the problem.

Wrist sprains are commonly treated without surgery. Rest, ice, and splinting is enough to improve symptoms in most people. Sometimes, with a very bad ligament injury or an injury that does not heal on its own, surgery is required to repair or reconstruct the ligament.

---

© 2023 American Society for Surgery of the Hand. This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand. Find a hand surgeon near you.