the skier into a softer flexing ski boot, the movement patterns are easier to learn and the skier is likely to progress more quickly.
Other aspects which should be assessed are the cuff angle in both the frontal and sagittal planes. The cuff angle is the angle that the upper part (the part which fits around the tibia) of the ski boot makes with the lower part that fits around the foot. If a skier has a tibial varum deformity then the angle of the cuff should match the leg alignment or it is difficult for the skier to stand flat on his/her ski. Similarly if the cuff angle is bending the ankle too far forwards, it is difficult for the skier to extend the ankle at lead change of the turn. The tongue position on the liner and the fit of the shell around the medial malleolus and navicular should also be looked at to determine whether it is interfering with function. It is essential to consider both the comfort and the functional fit of the ski boot to allow the correct movement patterns of the foot and leg to occur through the ski turn without being impeded or disrupted by ski equipment.
DYNAMIC ANALYSIS AND SKI INSTRUCTION The final element in assessing the skier is the dynamic analysis and ski instructor input. Poor movement patterns during skiing can cause inefficient edging and early muscle fatigue and may be a cause of the over-use injury. Ski instructors often now use video analysis feedback to their clients to provide visual feedback and enhance understanding.
CONCLUSION All the aspects described above should be considered when assessing and treating the injured skier. Although acute traumat- ic injuries are part of the risk of skiing, skiing enjoyment can be enhanced by ensuring ultimate biomechanical function between the skier and their ski equipment is achieved.
THE AUTHOR Sophie Cox BSc (podiatry), SRCh, MChS completed her training at Brighton University in 1998 with a BSc (Hons) in podiatry. Her spe- cialist areas are biomechanics and sports injuries and she has a par- ticular interest in computerised gait analysis. Sophie spent three years working in Canada where she worked with the University of British Columbia Sports Medicine Clinic in Vancouver. She combined her clinical work with golf analysis, cycling alignment and skiing
analysis. Since her return to the UK Sophie has worked in private practice in the London area and has lectured extensively on her work in gait analysis and sports medicine along with treating many elite athletes. Sophie has also recently joined the sportEX medicine editorial advisory board.
References 1. Subotnik S. The biomechanical basis of skiing. Podiatric Sports Medicine 2. Thomas P. Ski Injuries. Capital Doctor February 2003. 3. Basch D. Ski boot biomechanics. Journal of the American Podiatry Association 1984;74(1):48-50