Perceptions of experts on key injury risk factors in alpine ski racing as a function of stakeholder role and associated level of competition

Objectives (1) To update experts' priorities of perceived key injury risk factors in alpine ski racing based on a framework and list derived 10 years ago, (2) to identify additionally emerging risk factors since then and (3) to compile a list with countermeasure suggestions. Methods A sample of 532 expert stakeholders (athletes, coaches, team medical staff, Ski Racing Suppliers (SRS) and International Ski Federation (FIS) representatives) from the World Cup (WC), European Cup (EC) and FIS-race level participated in a cross-sectional online survey. Experts were asked to name those risk factors with the highest believed impact on injury risk and rank them according to their current priority from a predefined list. In addition, experts were encouraged to name additional (not listed) risk factors and to suggest countermeasures. Results Regardless of stakeholder role and competition level, snow-related factors appeared to have the highest perceived priority. However, WC athletes' and coaches' perceptions were also related to equipment, while at the EC and FIS-race level fatigue and physical fitness-related factors were considered important. Athletes' perceptions were largely in agreement with SRS (ie, snow-related and equipment-related factors). At the same time, while coaches, team medical staff and FIS representatives additionally emphasised fatigue and physical fitness-related factors. Conclusion Experts' perceptions on key injury risk factors in alpine ski racing depend on the stakeholder role and differ between the competition levels. Thus, to develop effective prevention measures and to successfully implement them, all relevant stakeholders should be given a voice, and prevention efforts should be targeted to the specific level