For USSA Medical Department, education and research is integral for the advancement of knowledge and understanding of injuries in the sports of skiing and snowboarding, developing advanced skills and knowledge for both medical staff and pool participants who work closely with USSA athletes, as well as developing strategies effective in the prevention of injury and illness in our athletes. The current areas of emphasis include:

• Provision of general healthcare information to athletes. Athlete healthcare education is extremely important in the prevention of illness/injuries. Yearly, USSA medical attempts to educate athletes and coaching staff in a variety of subtopics.
• Publishing an Athletes Guide to Staying Healthy While Traveling, Training, and Competing Worldwide
• Distribution of the FIS Medical Guide and USSA Medical Manual
• Talks on health and immunization
• Staff continuing education
• Coaches education in injury prevention
• Anti-doping education

First Responder Course
Yearly, USSA provides a First Responder course for staff, along with providing continuing education monies for individual staff education development. During summers, we hold a weekly in-service education session on a variety of topics.

Health Issue Management Strategy
During the Annual Sports Physical Exams, medical conditions are identified and handled on an individual basis. The development of strategies to address medical issues is critical to integrate into the overall program design and management.

Injury Prevention Strategies
It is essential to develop strategies to identify, as well as measure, common injuries in skiing and snowboarding. USSA is working on streamlining injury data collection (implementing a computer injury information/monitoring system) and developing ways to decipher and interpret this information. In addition, we have been working on collecting data in pre-season screens: core stabilization. This is useful in collecting quantitative information as well as providing an additional “tool” to identify dysfunction and muscle imbalances not identified in the general and orthopedic physical exam. We are currently working on improving these “tools” through science, literature research, and practical experience as well as trying to evaluate past data.

USSA Medical Emergencies in Skiing and Snowboarding (MESS) CME Course
In 2004, USSA inaugurated a Medical Emergencies CME Course, which provides education and practical skill development for USSA Medical Pool in acute injury triage and illness commonly seen when traveling with elite level skiing and snowboarding teams. This course is designed specifically for volunteer staff of the USSA Medical Pool. It will be held annually in conjunction with a USSA athletics event. The course provides NATABOC CEU credit for athletic trainers and CME for physicians/medical providers. The 2007 course will be held in Beaver Creek, CO during the Men’s Alpine Birds of Prey Competition. This course is required for the USSA Medical Pool (once every three years for physician pool and for PT/ATC pool).

For information on this year's MESS Course, please see the Clinics/Seminars section.

To reduce the number of injuries suffered by top-level athletes, FIS is developing an Injury Surveillance System (ISS) for all FIS disciplines. The FIS ISS will be led by the Oslo Sports Trauma Research Center and supported by dj Orthopedics.

The main objective of the FIS Injury Surveillance System is to provide reliable data on injury trends in international skiing and snowboarding at the elite level. Specific objectives include:

• Monitoring injury patterns in all FIS disciplines
• Monitoring trends in injury risk with time
• Providing background data for in-depth studies of the causes of injury for particular injury types in specific disciplines, e.g. knee and head injuries in alpine skiing and snowboarding.

Gathering the Data
The FIS ISS will be developed based on the injury reporting system already established by the FIS Medical Commission, and will commence data collection at the beginning of the 2006-2007 winter season. Injury and exposure data for the FIS ISS will be collected from all FIS competitions. For the purposes of the FIS ISS, a reportable injury is defined as: all injuries that occur during competition or official training and require attention by medical personnel. If multiple injuries result from the same accident, the report should include information on all injuries. An example would be a skier who suffers a concussion, fractured ribs and a punctured lung from the same fall.

The Injury Reports are collected by FIS for medico-legal purposes and the ISS protocol will be submitted to the National Committees for Research Ethics in Norway. All data entered into the ISS will be anonymized, and the identity of injured athletes will be protected.

Roles and Responsibilities – who needs to do what?

• The event technical delegate (TD) needs to collect the Injury Reports for all injuries occurring during competition or official training at their event. TDs at World Cup events should fax the Injury reports from their events to the FIS administration within three days.
• To obtain technical medical information to complete the reports, the TD should request the help of a medically trained individual (event medical supervisor, physician, physical therapist, athletic trainer, ski patrol), when available.
• Event TDs should also check whether tapes or videos were taken of the injury by team coaching staff or others, and provide information on contact details to obtain a copy of the injury videotapes.
• FIS Administration will check the Injury Reports for completeness of the event and personal information.
• The Oslo Sports Trauma Research Center will monitor the injury data for World Cup events on a continuous basis and actively contact TDs, team staff or athletes, to obtain missing information. It will also collect exposure data through the FIS results database.
• Oslo Sports Trauma Research Center will also validate the Injury Report data by comparison with data obtained through other sources, such as coach/athlete interviews and team medical personnel records.
• After the end of the season, the Oslo Sports Trauma Research Center will cross-check video recordings with the injury reports and analyze them to describe the mechanisms of injury.

FIS ISS Steering Committee and Reporting
A Steering Committee has been established with three members, including the chair, appointed by FIS and the other two by the Oslo Sports Trauma Research Center (OSTRC). The Steering Committee consists of Bengt Saltin, FIS (chair), Hans Spring, FIS, Eero Hyvärinen, FIS, Roald Bahr, OSTRC and Stig Heir, OSTRC. The Steering Committee will meet twice yearly to report on the ISS and related research activities. The Steering Committee will also handle requests from other research groups for access to data from the ISS.

Reports will be presented to the FIS Medical Commission and other relevant FIS commissions annually for review. The reports will serve as the basis for a risk management process, whereby the data are used to identify injury risk in FIS competitions and ensure that every possible effort is made to protect the health of the athletes.