ACL Injuries in Kids

A snowHead

Hi All

Definitely a paranoid discussion! but what is the risk of ACL injuries in kids learning to ski. We have just come back from La Plagne with Esprit (they are fantastic with kids - holiday was amazing) and our oldest (5 yo) has been skiing with Esprit/ESF for the past 3 years and doing really well. However given the sat back snow plough position and the quite deep snow this time it crossed my mined about the risk of injury. I would feel terrible if she ever did serious damage that meant she was off her feet or had trouble playing for for a serious amount of time at this age!.

That said I have not heard of many/any kids skiing injuries like that and given that all young kids learn to Ski like that then it must be fairly low risk.

Other thoughts were :
- She is very hypermobile in all joints, this might be a good thing as it would take a lot to damage her ligaments and she has has to develop muscle strength to cope with it. That said I can argue counter to this!
- If she did ever fully rupture it the options for surgery are bad (random article off the internet https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445144/)
- There is an interesting point in that article above about falling when skiing.
- Her exposure time is small 2-3 hours per day skiing and all of that in slow controlled snakes behind ski instructors (that said I have seen small kids on lessons going over small jump in snow plough and falling)
- Ski bindings were very low and set by the hire shop.
- Ironically the most damage she did to herself was a knee twist on a trampoline and she couldn't weight bear for a few hours (fully checked out and no real lasting damage, but it has probably made me more aware)

So I guess does anyone have any experience or thoughts? She loves skiing and we have the most amazing family holidays so im just trying to square the risk as im a worry wart!

Cheers

A snowHead

I'd say in general kids are small, light, flexible and probably in better shape than most adults so the chances of injury are far lower than the rest of us, the seriousness of any injury is likely to be less and the prospects for recovery are far higher.

She loves skiing and you have great holidays so you'd be mad not to go.

So it's very unlikely that anything bad is going to happen, and you aren't going to cancel the holiday, so all you can really do is chill out, relax and enjoy the holiday.

Have a great time!

Well, the person's real but it's just a made up name, see?

Kids binding are often set very low, which helps no end. As above kids are much bendier than adults, and less prone to setting dins at levels higher than their abilities. Embarassed

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Thanks @olderscot & @blarblahblah nice and reassuring words. We actually just got back, so no fear of cancelling and yeah it was a truly magic family holiday as we have a 2 yo as well and our yearly ski holidays are more valuable/relaxing/fun and special than our summer ones.

The thought came to me post the holiday as 2 people in the hotel took out their ACL and were heavily braced and immobile, obviously the kids where asking lots of questions and it has since made me think that as an adult I make the choice to take the (small) risk and wondered what the consequences would be if it was one of my kids. I guess my view is an ACL/ligament rupture is far worse than a break because of the growth plates and the huge focused effort required to recover being a huge challenge for a child.

@blarblahblah, yes the dins were very low indeed and I checked they were releasing fine.

I was just very interested in other peoples feelings on this, im guessing stats on it the incident rates would be very low, probably a lot lower than trampolines in the UK!!!!.

Anyway, snowHeads is much more fun if you do.

Paranoid android.

I'm sure someone with a medical training could explain the differences in joint, bones and ligaments in young children, but generally they are pretty darn resilient, because they have to be to survive growing up, so stuff tends to break alot less then with us. Other than their bones being softer and bendier (like a the branch of sappling rather than an old tree like us), I'm guessing the ligaments and joints are a lot looser and have more flex ?

Both of mine (now 6 and 9) have wiped out numerous times (alot!) where their bindings haven't released and their legs are twisted completely 180 degrees with skis pointing in opposite directions. Makes me whince to look at it. Happened several times to my 6 year old on our last trip, the 9 year old not to much now as he tends not to fall even on ice and crud (the git! snowHead

). Once or twice he was actually able to lift his leg and twist one of the skis back around, once or twice I had to help him and one or twice it was a bit painful and bit of yelping. But up and back on them every time.

I suspect their biggest risk of serious injury is if they are in a collision with another skier (an adult), or a they loose control and hit a tree/sign/rock/cliff edge. Straight falling/twisting injuries, I would guess, are pretty rare. I'm sure you'd find studies on it if you googled it. I don't tend to worry about mine now in straight falls, I've seen it happen and picked them up from all sorts of contorted positions more times than I can remember. I am more concerned of other skier collisions, or the 9 year old who has a tendancy to dive off the edge of the piste or up the sides.

So try and relax, yes keep your wits about you, but don't overly worry. It won't be long before your 5 year old is better than you. My 9 year old is certainly better than me if conditions get sketchy, cruddy, icy and lumpy.
I can still have him on a powder day though snowHead

So the only real question remains, why keep her exposure time to 2-3 hours a day ? If she enjoys it, take her out on the slopes after lessons (after rest/snack/lunch/choc stop etc Very Happy

)
Our youngest when he was 5 did a week of lessons that was 4 days x 4.25 hours, and 2 days all day (and when he was 4 he did 6 days of 4.25 hours). And we took him out in the afternoons on the half days to bimble around the easier slopes (sometimes just for an hour sometimes till lift closing). Just have plenty of energy snacks for them and be ready to dive in somewhere warm if you need to. This year he is 6 and launched himself off the Courchevel airbag a couple of times. Proud moment. Smile

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Thanks again for the great replies ...

After all it is free

If it helps as a point of comparison (though not specifically related to ACL's), I cracked the Alna Head (top of the forearm) in my right arm in 2009 falling down a hill whilst hiking. I never regained the full ability to straighten my arm or hypersextend it. I get to around 170 deg (give or take). My daughter aged 5 was doing gymnastics and landed awkwardly off a piece of apparatus. She broke her left arm in a similar position. this was at he beginning of October 2016. She can fully straighten her arm and hyperextend it.

Kids bounce back ok - provided its not so serious that its life threatening or they lose a limb or suffer a neck/spinal injury they recover.

haha, ski time is indeed valuable @taemo, ! It is a worthwhile investment though missing some of your time to up the kids game as they really do come on quick - the more they do young the more it becomes second nature. My 9 y.o. is now great fun to rip around with. The 6 y.o. is getting there.

If it's any consellation I think paranoia is born with the parenthood and I was petrified the first time I saw them on a chairlift (which I'm guessing was between 4-5) in their ski class. The eldest I'm chilled with now, but I'm still nervous riding the lift with my 6 year old. Their little legs just don't seem long enough leaving them perched on the edge of the seat. He of course is fine, quite happily sat there but I'm always telling him to shuffle over so both skis are over the foot rest. I get that rolling eye look back "Dad I'm fine".
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@taemo,

Our daughter is hyper mobile too (as is her mum). My wife was alert to it, discussed it with the doctor at an early stage plus a sports physio and we got clear advice that she should work on strengthening muscles and avoid gymnastics.

She started skiing at 3 and for the first 3 years or so we had our hearts in our mouths a bit - some falls would result in her in outrageous positions that were bad for us to see and terrified strangers! Snowplough always seemed high risk and we were really glad when she started to ski parallel and the carve - it made the chance of legs going in wildly different directions much smaller! We kept on her case whenever she showed signs of getting lazy/exploiting her hyper mobility to get up and were always urging her to go parallel quickly. That seemed to work.

Otherwise, she does seem susceptible to finger and wrist injuries - I think they bend back to the point that bones get stressed rather than protected by ligaments. After two breakages playing in goal (football) we have banned her from goalkeeping (with coaches support). Now 12 she does play football, hockey and netball (did pick up a finger sprain recently...) so it's not a big problem.

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BTW - my wife didn't realise she was hypermobile until she was an adult. Some bad habits had crept in by then and she has patella arthritis as a result of poor knee tracking because the joints were not that stable - more strength work as a child could have avoided that.

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Thanks @Gazza, nice to hear the stories and I definitely know what you mean about the chair lifts, when we realised that should must have been on one in her lesson and that she was probably sat with someone she didn't know we were very nervous. I do have to say that ESF and Esprit are fantastic though, there was an Esprit member with them all the time and our daughter responded very well to them/ESF teaching her in a group of her peers. Wife and I are definitely looking forward to those years where we can ski with them all together, now she has the basics I can take her to Hemel as we are not too far away.

@jedster Interesting and thanks for the advice. My wife too is very hypermobile but interestingly spent her childhood years doing gymnastics! she also skis and swears she has got away with a lot due to being hypermobile.
I started running a few years back and discovered parkrun, and I have recently found out there is a kids 2K run on Sunday, so that is something we could start with.

*Apologies Moderators, also realised this topic might have been better placed in "Ski Fitness, Exercise, Injury and Rehab"

You know it makes sense.

Biggest risk with kids, as with many adults, is having too big boots so if buying boots for kids avoid getting too much 'growing room'. The problem is that the leg/foot torques up in the boot a lot before it starts pushing/pulling the boot out of the bindings which adds a lot more load to the bones/ligaments etc.

Also learn how to check the binding adjustment/forward pressure/din settings etc as a busy rental shop rat can easily make a mistake.

Otherwise you'll just go on seeing the one name:

Thanks @spyderjon - good to talk to you again. I did look at the din setting and tried pulling the boots out in the various directions, but the only check I know as an adult is manually, once engaged in the bindings skis lift/force the heal out, then angle the ski and force the toe out. If you can do that then your some way towards being ok - but I doubt I would convince a 5yo to do it Smile

.

Oh re-reading your post again I think you talking about just double checking the actual setup rather than testing the release, ie the din is correct for her weight and set the same all round and the binding adjustment/forward pressure is set correctly to the size of the boot.

Anyway thanks.

A snowHead

hi @taemo, unfortunately it does happen, our 10 year old daughter fractured a bone in her knee last feb half term on our first ever family ski holiday. I must admit, I was racked with guilt for weeks afterwards as I had been pushing for the family to go skiing for years. Thankfully she recovered reasonably quickly, and even enjoyed the attention at school being on crutches with a leg cast!!!

it was a bit of a worry going away again this xmas as we thought she would be really nervous and not want to go again, but apart from a minor wobble on the gondola going up the first day, she grew in confidence speedily, so much so i had to reign her speed in.
it seems like out of all of the family she is going to be my ski companion, as whilst wife and child no 1 were happy to sit on the restaurant terrace, child no2 was eager to navigate the slopes together.

Though to be fair, I don't think you ever stop worrying about them hurting themselves!!!

A snowHead

@terrygarason ouch, so glad it was all ok in the end and she was keen to get back in the saddle. Was it just a fall or a collision?

I think you can be very unlucky, I just watched a fall on the new series of "The Jump" some celeb woman who could ski quite well, took such an innocuous fall which ended in her landing badly.

There was an interesting part in the article I linked to above about learning to fall properly, not relaxing but staying a little tight and prepared. Not really though about it before but it made a lot of sense. But I'm not sure I agree with the one bit that said sitting down was a good thing would have though that would put your knees at much higher risk.

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@taemo, it was a fall, she was not going very fast on a green run though i didn't see it as she was behind me, seemed she crossed her skis but they didn't release.

like you, one of the things i enjoy the most is sitting on the chair with my kids chatting and admiring the view!!!

thing is, over the weekend we took the girls to one of those trampoline centres that are sprouting up all over the place without any consequences, but saw an item on the web yesterday where someone incurred life changing injuries. i suppose there are dangers in all activities and we just have to try and be relaxed about it.

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So I heard (no idea whether its true) from an acquaintance whose daughter had broken her knee that young kids are more likely to break their knee rather than rupture their ACL.

Help!!

ACL Injuries in Kids

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