International Society for Snowports Medicine

There is enough mechanical and biomechanical evidence to assert that it is possible to reduce knee injuries in alpine skiing, especially those involving the ACL, with appropriately designed, manufactured and adjusted ski bindings.

The presentations and demonstrations at SITEMSH and ISSS meetings, especially at SITEMSH since November of 2014, show ample support for this assertion.

Conventional modes of release are laterally at the toe and vertically at the heel.  To accomplish a reduction in knee injuries, ski bindings also need to have a mode of release, laterally at the heel.

This additional mode allows ski bindings to respond to lateral loads centred on the inside edge of ski, close to and at the rear of the centre of the boot heel.

These loads result in a combination of valgus and inward rotational moments on the knee.

These two moments together, not individually, have been shown to be responsible for increasing the risk of inducing injurious strains to the ACL.  Apparently most of the ACL injuries in alpine skiing are caused by these kinds of loads.

Conventional bindings cannot respond appropriately, and clinical trials with new ski bindings should be designed to verify this thesis.


Howell, R., 2017. Mitigation of acl rupture in alpine skiing through ski bindings. British Journal of Sports Medicine, 51(4), pp.332-332.

Howell, R.J., KneeBinding Inc, 2008. Alpine ski binding heel unit. U.S. Patent 7,318,598.

Madura, J.M. and Brown, C.A., 2014. Protecting the ACL in Alpine skiing with load-limiting bind-ing plates. Science and Skiing VI.

Madura, J.M. and Brown, C.A., 2014. Axiomatic Design of Bindings and Plates to Protect the ACL in Alpine Skiing and Reduce the Likelihood of Inadvertent Release," in , edited by Johnson, R., Shealy, J., and Greenwald, R. (West Conshohocken, PA: ASTM International, 2014), 1-16.

Madura, J. and Brown, C., 2013. A comparative study of decompositions in axiomatic design applied to safety of the anterior cruciate ligament in alpine skiing. Proceedings of ICAD2013 The Seventh International Conference on Axiomatic Design Worcester – June 27-28, 2013 ICAD-2013-30