Erhöhung der Mehrfachverletzungen beim Skicarving – Handgelenke der Snowboarder besonders gefährdet
Sowohl der traditionelle Skisport mit der neuen dynamischen Schwungtechnik Carving (to carve = schneiden), wie auch der mittlerweile etablierte Snowboardsport erfreuen sich anhaltender Beliebtheit. Weltweit stehen 100 Millionen Skiläufer einer Zahl von 10 Millionen Snowboardern gegenüber. Die Ausübung beider Sportdisziplinen wird von einem sehr unterschiedlichen Alterskollektiv bestritten. Im Schnitt beträgt der durchschnittliche Altersunterschied in den Verletzungsstatistiken ein Jahrzehnt, das heisst, Snowboarder betreiben den Sport hauptsächlich im zweiten und dritten Lebensjahrzehnt. Dies erklärt auch das Risikoverhalten der Jugendlichen, welches auch im Snowboardsport zum Ausdruck kommt. Speziell die Freestyledisziplinen mit akrobatischen Einlagen in den künstlich gebauten Halfpipes werden von einem enorm jungen Kollektiv von zwölf- bis knapp zwanzigjährigen Sportlern ausgeübt, während erfahrene Snowboarder sich den Alpindisziplinen und seit zwei bis drei Jahren dem Freeriden, dem Fahren im freien Gelände auf unpräpariertem Schnee, verschreiben. Das “Hiken” mit Schneeschuhen und dem Snowboard am Rucksack liegt voll im Trend.
Gegenläufig dazu hat der alpine Skisport durch die taillierten Carvingskier, die es in unterschiedlichsten Längen, Breiten und Taillierungen gibt, auch für die Jugend einen neuen Aufschwung genommen und das Alterskollektiv der Skiläufer wurde wieder verjüngt. “Herminator und Co”, die prominenten alpinen Skirennfahrer und Skirennfahrerinnen, haben dazu mit ihrer Vorbildwirkung dem Skisport neues Leben eingehaucht . Das gemeinsame Geheimnis ist sowohl für Snowboarder, aber auch für Skicarver der geschnittene Schwung. Die Beschleunigung, die beim Zug auf der Kante entsteht, vermittelt dem Sportler ein neues Kurvengefühl ähnlich einem “Motorradfahren auf Schnee”.
Bereits 1977 hat der österreichische Skipionier Reinhard Fischer aus Niederösterreich die Beschleunigungstechnik, heute Carvingtechnik genannt, erfunden und dem Österreichischen Ski-Verband (ÖSV), Skiexperten und Trainern für die Kaderläufer angeboten. Leider wurde er weder von der Industrie noch von den Experten erhört. 1982 hat er dann ein Snowboard der Länge nach durchgeschnitten und das erste Paar Carvingskier, genannt ” Snowrider”, war geboren. Eine deutsche Skifirma namens Voigt (VR-Ski) stand zu dieser Idee und produziert (seither) bis dato den “Snowrider ” Fischers, alle anderen Skifirmen haben diese Erfindung kopiert.
Betrachtet man nun beide Sportarten aus sportmedizinischer Sicht, so ergeben sich wesentliche Unterschiede bezüglich der Verletzungsmuster und Verletzungsursachen, wenngleich durch die Ski-Carvingtechnik eine Annäherung der Verletzungsmuster zum Snowboardsport erfolgt.
Die kontinuierliche Erfassung von Ski- und Snowboardunfalldaten erlaubt mittlerweile eine gute Übersicht der Verletzungsmuster. Seit 1995/96 wurden auch zum ersten Mal Ski-Carvingverletzungen neben den traditionellen Ski-Verletzungen erfaßt. Trotz zunehmender Anzahl an Ski-Carvern und nahezu gleichbleibender Zahl an Snowboardern zeigen sich nur marginale Veränderungen. Der Anteil von traditionellen Skiläufern zu Skicarvern war in der Saison 2000/01 circa 50:50. Auffällig bei den Skicarvern ist im Gegensatz zu den traditionellen Skiläufern, die den Driftschwung bevorzugen, eine Erhöhung der Mehrfachverletzungen von 8 auf 14 Prozent, das heisst, mehrere Körperteile werden bei einem Sturz lädiert.
Knieverletzungen liegen mit bis zu 39 Prozent an erster Stelle ähnlich dem traditionellen Skilauf. Speziell beim Verschneiden in Rückenlage dürfte der Carvingski etwas verletzungsfördernder sein als der schwach taillierte Normalski, der ein Wegrutschen ermöglicht. Eine statistische Signifikanz ist jedoch aus den bisherigen Verletzungsdaten nicht zu erkennen. Beim Snowboarden hat die fixierte Beinstellung durch Festhaltebindungen einen protektiven Effekt auf die Kniegelenke und mit bis zu 25 Prozent liegen die Knieverletzungen beim Snowboarden weit unter dem der Skiläufer. In Abhängigkeit vom verwendeten Schuhmaterial Hard-, Soft- oder der neuen Hybridboots (in Kombination mit Soft-Step-in-Bindungen) kommt es zu unterschiedlich ausgeprägten Verletzungsmustern am Knie oder Sprunggelenk. Im Gegensatz zum Skilauf treten Kreuzbandverletzungen eher selten auf.
Umgekehrt verhält es sich mit den Verletzungen der oberen Extremitäten, die in unterschiedlichen Snowboard-Studien mit bis zu 50 Prozent vertreten sind. Beim ungeübten Snowboarder steht das Handgelenk mit bis zu 36 Prozent aller Verletzungen und mit 53 Prozent aller schweren Verletzungen an erster Stelle.
Beim bereits geübten Snowboarder ist vor allem das Schultergelenk mit bis zu 19 Prozent beteiligt. Hier sind es vor allem Schulterverrenkungen, die als schwerwiegende Verletzungen zu rechnen sind. Beim traditionellen Skilauf wie auch beim Skicarving sind die Läsionen der oberen Extremitäten im Vergleich dazu wesentlich geringer, Schulterverletzungen sind aber ebenso mit bis zu 18 Prozent häufig vertreten. Durch den Schneekontakt beim Carven erwarten wir mit Zunahme der Verbreitung diese Sports auch höhere Verletzungszahlen im Bereich der Unterarme, Handgelenke und Finger. Auffällig ist jedoch die Zunahme an Rumpf und Oberschenkelverletzung bei Carven gegenüber dem traditionellen Skilauf um ca. 10 Prozent.
Zusammenfassend kann man sagen, der Wintersport hat durch den Snowboardsport und den Carvingboom durch den dynamischeren Fahrstil eine Änderung erfahren, an die sich die Pistenteilnehmer erst zunehmend gewöhnen und anpassen. Ohne Schulung sollte jedoch weder der Snowboardsport noch das Skicarving ausgeübt werden. Dies zeigten zum einen die hohen Anfängerverletzungszahlen beim Snowboarden, wie auch die Gruppe der verletzten Carver, die sich hauptsächlich aus sehr erfahrenen Skiläufern (>90%) zusammensetzt und eine hohe Zahl (>50%) von Verletzungen am Knie, besonders vordere Kreuzbandverletzungen, erleiden.
Dr. Klaus Dann Facharzt für Unfallchirurgie & Sporttraumatologie, Sportarzt
Vizepräsident GOTS Österreich
Praxisgemeinschaft Paincare
Mariahilferstraße 105/1/16, 1060 Wien
Tel: +43 1 59 555 22, Fax: +43 1 59 555 22 99
e-mail: office@paincare.at
Manhattan Med Team
Heiligenstädter Lände 17, 1190 Wien
Tel: +43 1 368 73 11, Fax: +43 1 3687311 27
e-mail: k.dann@aon.at
https://www.dann.at
Literatur
- Dingerkus ML. (2001) , Vortrag 3. Internationaler Kongress für Wintersportmedizin Garmisch-Partenkirchen, Abstractband Carving und Snowboarden – ist das Verletzungsrisiko vergleichbar?
- Dann K., Boldrino C., Kristen K.-H., Ring G. (1997), TW Sport + Medizin 9,3; 128 -132 Verletzungsrisiko und Risikofaktoren beim Snowboarden
- Hörterer H. (2000), Medizin & Praxis “Sportverletzungen I”; 12-14 Carvingskifahren – Verletzungen und Prophylaxe
- Machold W., Kolonja A., Kwasny O., Fuchs M. (1999), Sportverl. – Sportschad. 13; 1-7 Verletzungsrisiken beim Snowboarden
- Abu-Laban Riyad. (1991), Can Med Assoc J 145, 1097 – 1102 Snowboarding injuries: an analysis and comparison with alpine skiing injuries
- Schaff P., Gläser H. (2001), Sport. Orthop. Traumatol. 17,1; 38 – 39 Skiunfälle
- Wambacher M., Hausberger K., Wischatta R., Gabl M. (2001), Vortrag Jahreskongress der GOTS Abstract 39 in Sport. Orthop. Traumatol. 17,2; 115 Einfluss der Ausrüstung auf das Verletzungsmuster von Knie-und Sprunggelenk beim Snowboarden
Dr. Klaus Dann
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