Material und Pisten sind noch nicht ausgereizt, der Bewegungsapparat des Skirennläufers schon
“Ein spektakulärer Sturz ist für die Werbung mehr wert als ein zweiter oder dritter Platz.“ Dieser Satz eines ehemaligen Skirennläufers und jetzigen Promotion-Managers einer Skiartikelfirma zeigt deutlich den Trend im alpinen Skirennsport und hier insbesondere in den schnellen Disziplinen wie Abfahrtslauf und Super-G. Durch immer schnelleres Material und entsprechende Streckenführung werden derzeit Spitzengeschwindigkeiten über 150 km/h (Wengen, Januar 2005) erreicht. Immer wieder kommt es auch heutzutage noch zu schweren Stürzen und erheblichen Verletzungen. Betroffen sind nicht nur Rennläufer der hinteren Startgruppe, sondern im vermehrten Maße auch die Besten – siehe Martina Ertl im Superriesenslalom der Weltmeisterschaft von Bormio am Sonntag.
Seit 1980 führen die Ärzte des internationalen Skiverbandes FIS kritische Analysen bei Weltcup-Abfahrtsrennen der Damen und Herren durch. Vor ein bis zwei Jahrzehnten waren die Streckenabsicherungen noch äußerst mangelhaft. Holzzäune, hart gefrorene Strohballen und ähnliche Materialien boten keine wesentliche Sicherheit. Eine schlechte Pistenpräparation erhöhte das Sturzrisiko beträchtlich. Sieben wichtige Sicherheitspunkte wurden von 1980 bis jetzt verglichen. Während 1980 noch 90 Prozent der Pisten mit mangelhaft eingestuft werden mussten, waren dies 1990 noch 50 Prozent und 2000 lediglich 10 Prozent.
Durch zahlreiche Interventionen, Vorschläge und Anträge konnten die Sicherheitsprobleme der letzten Jahre weitgehend beseitigt werden. Bestrebungen des Internationalen Skiverbandes FIS, seiner Sicherheitsexperten und des Medizinischen Komitees haben entsprechende Wirkung gezeigt. Inzwischen wird jedes Jahr vom Medizinischen Komitee des internationalen Skiverbandes ein entsprechender Medicial-Guide aufgelegt, der für den Veranstalter von Weltcup-Rennen alle zu erfüllenden Sicherheitsaspekte enthält.
Die Streckenabsicherungen wurden durch geeignete Materialen, insbesondere Fangnetze und Abweisplanen stark verbessert. Eine schnelle Rennunterbrechung wird durch entsprechende Flaggenposten – ähnlich der Formel-1 – gewährleistet, so dass sachgemäße Bergung und Versorgung des Rennläufers möglich sind. Die Abtransportgeräte sind mit Vakuummatratzen bestückt. Der Kontakt der begleitenden Mannschaftsärzte mit der regionalen Rettungsorganisation funktioniert nahezu reibungslos. Trotz alledem bleibt der alpine Abfahrtslauf eine Risikosportart. Bis auf Helm und Rückenprotektor ist der Rennläufer ohne jeglichen Schutz. Stürze erfolgen auf stark vereisten und extrem harten Pisten.
Der Medical Guide enthält insbesondere Vorgaben für den Veranstalter. So muss ein Verantwortlicher für das Sanitäts- und Rettungswesen benannt sein. Das örtliche Organisationskomitee benennt einen Arzt, der für die Verbindung mit den Mannschaftsärzten und der örtlichen Rettungsorganisation verantwortlich ist. Weiterhin müssen Informationsdokumente für die Mannschaftsführung und die Mannschaftsärzte erstellt sein, die eingezeichnete Rettungs- und Hubschrauberlandeplätze über die Strecke verteilt anzeigen. Außerdem gibt es regelmäßige Treffen der Mannschaftsärzte mit dem verantwortlichen Wettkampfarzt vor Ort.
Für den Abtransport von Verletzten während Training und Wettkampf existieren detaillierte Organisationspläne. Ein Notarztwagen ist ab dem ersten Trainingstag im Ziel vorhanden. Weiterhin ist ein Hubschrauber mit allen Rettungsmöglichkeiten stationiert. Über die gesamte Rennstrecke müssen mindestens fünf Rettungsstellen vorhanden sein. Diese Rettungsstellen sind klar gekennzeichnet und mit zwei Mitgliedern der Bergwacht und einem Arzt besetzt. Eine entsprechende Notfallausrüstung mit Wiederbelebungseinheit findet sich an jeder Rettungsstelle. Über die Strecke verteilte Flaggenposten können sofort ein Rennen unterbrechen und einen bereits auf der Strecke befindlichen Rennläufer abwinken.
Für größere Rennveranstaltungen wird vom internationalen Skiverband ein medizinischer Supervisor bestimmt, der bereits im Vorfeld die Einhaltung der entsprechenden Vorgaben kontrolliert. Während des Trainings und der Rennen stellt er die Verbindungsperson zwischen dem Organisationskomitee und dem internationalen Skiverband her. Er ist für die Einhaltung der im Medical-Guide vorgegebenen Vorschriften verantwortlich.
Trotz aller Sicherheitsmaßnahmen bleibt der alpine Skirennlauf in den Disziplinen Abfahrt und Super-G eine Risikosportart. Leider kommt es auch in der heutigen Zeit immer wieder zu schweren Verletzungen, die insbesondere durch hohe Geschwindigkeiten, extreme Sprünge und schwierige Streckenführung zu Stande kommen. Selbstverständlich spielen auch das immer weiter entwickelte Material und der Kunstschnee eine entsprechende Rolle.
Es ist die Aufgabe der Sportmediziner und der Sicherheitsexperten, den Rennläufer möglichst von schweren Verletzungen zu schützen. Material und Rennpisten sind sicher noch nicht am Limit, der menschliche Bewegungsapparat allerdings schon lang.
Dr. med. Hubert Hörterer, 31. Januar 2005
Der Autor ist für die Alpine Skiweltmeisterschaft 2005 in Bormio/Italien als Medical Supervisor nominiert worden; er ist damit verantwortlich für die Einhaltung aller FIS-Richtlinien – medizinische Organisation – Doping – Sicherheit – auf den Pisten und außerhalb der Pisten; Dr. Hubert Hörterer ist Facharzt für Orthopädie/Sportmedizin sowie Facharzt für Physikalische und Rehabilitative Medizin; er arbeitet seit Mai 1989 als Chefarzt und Ärztlicher Direktor des Medical Park St. Hubertus in Bad Wiessee; in der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin wirkt Dr. Hubert Hörterer als Vorstandsmitglied; zudem steht er den Verbandsärzten Deutschlands vor; er war als Arzt bei acht Olympischen Spielen im Einsatz; im Internationalen Skiverband unterstützt er die medizinisch-wissenschaftliche Kommission; ein Foto von Dr. Hubert Hörterer kann zur Verfügung gestellt werden.
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