THE EFFECTIVENESS OF SKI BINDINGS AND THEIR PROFESSIONAL ADJUSTMENT FOR PREVENTING ALPINE SKIING INJURIES

This article presents a critical review of the extent to which alpine ski bindings and their adjustment have been formally demonstrated to p revent injuries. It considers a range of evidence, from anecdotal evid ence and informed opinion to biomechanical studies, testing of equipme nt, epidemiological studies and controlled field evaluations. A total of 15 published studies examining the effectiveness of bindings and th eir adjustment were identified. All of these included anecdotal or inf ormed opinion, and all but one focused on equipment design. Seven stud ies involved the testing of bindings or binding prototypes, 2 studies presented biomechanical models of the forces involved in binding opera tion, 6 reported an epidemiological evaluation of ski bindings and 2 c onsidered skiers' behaviours towards binding adjustment. Some of the r eviewed articles relate to the study of the biomechanics of ski bindin gs and their release in response to various loads and loading patterns . Other studies examined the contribution of bindings and binding-rele ase to lower extremity, equipment-related injuries, the effect of vari ous methods of binding adjustment on injury risk and the determinants of skiers' behaviour relating to professional binding adjustment. Most of the evidence suggests that currently used bindings are insufficien t for the multidirectional release required to reduce the risk of inju ry to the lower limb, especially at the knee. This evidence suggests t hat further technical developments and innovations are required. The s tandard of the manufacture of bindings and boots also needs to be cons idered. The optimal adjustment of bindings using a testing device has been shown to be associated with a reduced risk of lower extremity inj ury. Generally, however, the adjustment of bindings has been shown to be inadequate, especially for children's bindings. Recommendations for further research, development and implementation with respect to ski bindings and their adjustment are given in this article.