The Tyranny Of Performance

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A couple of years ago, while I was writing a profile of Bill Esrey, the genial, athletic CEO of the Sprint communications company, I heard that he'd suffered a severe knee injury at Vail. Dick Steadman, the renowned knee surgeon, performed an operation he's done hundreds of times, re-attaching Esrey's torn anterior cruciate ligament (ACL).

Having just skied with Esrey a week before his mishap, I saw he was an expert. Coached over the years by the best instructors, he was wearing what looked to me to be stiff competition boots and shaped skis. I called him to learn more about his injury.

"It was ridiculous, in a way," he said. "I was moving at maybe three or four miles an hour when I felt my ski trapped under me." The only thing that gave way was Esrey's knee.

Hanging up the phone, I wondered: In what other sport do you use gear that allows you, scarcely moving, to suffer an injury generating 10 grand in medical bills and months of rehab? Isn't there a better solution? Or choice? When I enter a ski shop, is the salesperson able to offer me equipment that might reduce my chances of incurring knee injury? The primary option offered by the industry is gear that promises to raise your performance from advanced to expert-and beyond.

Not that there's anything wrong with gear that enables you to carve like Hermann Maier. But a significant number of today's skiers might prefer the option of buying skis, boots and bindings capable of reducing knee-injury risk.

The problem began 20 years ago when better bindings and anti-friction devices produced a sharp decline in every kind of injury, with one exception: knees. An epidemic of knee blowouts coincided with two developments:

The arrival of higher and stiffer boots that pitch the lower leg about 15 degrees forward;

Recreational skiers emulating what racers had been doing for some time, emphasizing a wider stance and independent leg action. The result? Instead of skiers fracturing their lower leg or tibia, now softly encased in the boot shaft, the injury moved up to the knee. The most common of these knee injuries occurs when terrain forces your upper body into a position you may have seen in a televised soccer match: A player's knee is exaggeratedly bent forward while his back is level with the ground. In a similar position in skiing, you'd expect the binding to release, but it's unable to detect the forces acting on the knee. The ligament stabilizing the tibia to the upper leg bone is torn, or even severed. That ligament is famously known as the ACL. There are ways to reduce the risk of ACL injuries. They were identified eight years ago by Jasper Shealy, Dr. Robert Johnson and the nation's leading binding expert, Carl Ettlinger. A voluble, often indignant Vermonter, Ettlinger found ways to train skiers to avoid injury. For example, by knowing how to fall (don't fight it, hands forward, rotate in the direction the skis are going) you can prevent a leg from becoming trapped. When Ettlinger expanded his ACL-theories into a training program at 22 ski areas, the incidence of knee injury among instructors and patrollers dropped by 62 percent. He fervently believes that if we could all be trained to ski with his avoidance techniques, the knee problem would fade away. But he hasn't found much support. The reality is that a massive defensive-skiing education program for millions of skiers is impractical. The solution, if there is one, will have to come from altering the design of boots, skis and bindings. Manufacturers have shown little enthusiasm for marketing product safety features, however. They don't like to promote a negative image of the sport. . .that it may lead to injury. And they're wary that claims of a product's safety will expose them to suits by lawyers for plaintiffs who've been injured. Nonetheless, there's a growing consensus that a device, which could relieve or release the pressure of the lower leg against the back of the boot in ffalls, may reduce injury. I discussed the idea last winter with Dr. Steadman. He notes that the incidence of knee injury, after skyrocketing in the Eighties, has leveled off, perhaps because of people using shorter skis. Do you think, I asked Steadman, that a backward releasing mechanism on the boot would also help? "If it doesn't inadvertently release or pre-release when you're skiing," he answered, "then my intuition says, 'yes.' I use a Salomon boot that has a device on the back that can be set for 'Ski' or 'Walk.' In the 'Walk' mode, the back of the boot is softer. I use that setting when I ski." Funny, I thought. Here's the world's foremost knee doctor employing a home-made remedy to protect his joints. After 20 years of knee injuries, you'd think we would be further advanced. Steadman's intuition has become a reality this winter. Lange is introducing a boot with a backward releasing device. The boot's upper cuff-held in a locked forward position, as is likely the case with your own boots-will release when you lose balance backwards. It allows the leg to straighten to a less stressed vertical position. Once the skier regains his balance, the cuff re-engages in its original forward position. Lange claims its system can be adjusted to suit a skier's ability, strength, weight and aggressiveness. How will we know whether users experience fewer knee injuries? The company plans to compare the incidence of knee injury among skiers who rent the new Lange boots with renters of conventional boots. Ettlinger doesn't yet endorse the Lange device, but like Steadman he thinks rearward pressure-mitigation would help. "Imagine a spring located where the back lacing was on boots 40 years ago," he conjectures. Located atop the back of the boot, it would be a smart device, knowing when to deflect force.Ettlinger also hopes that the day will come when bindings, designed to thwart tibia fractures, will be smart enough to detect knee-menacing forces. He also believes it's possible to design knee-friendly ski tails, having a convex running surface, dulled edges and reduced torsional stiffness. "You'd be able to skid the skis more easily," Ettlinger says, reducing the risk of an edge catching and trapping the leg. That people would skid turns is heresy to performance purists. In 1993, the same purists derided one of America's greatest ski racers, Brooks Dodge, when he wrote an article for me suggesting a simple prevention of knee injury. Put skiers, proposed Dodge, in softer, lower boots, which are known, through on-slope research, to correlate with reduced knee injury. Experts scoffed at Dodge's suggestion. Who, after all, would buy low soft boots that might lower performance? What would happen to our egos? In my view, consumers should be able to choose between performance and knee risk. Fresh approaches to gear design ought to be encouraged. And manufacturers and retailers might revise the way they market the sport. Perhaps, they need to genuflect to a new god. Fry's only serious injury in the last 50 years was a sprained ankle: a result of wearing low leather boots, which prevented the injury from occurring to his knee. Read Fry's columns at skimag.com. Contact him at JFry@skimag.com.