Ski Mountaineering as a Competitive Sport: Anthropometry, Injuries and Illnesses

Ski mountaineering (skimo) is an evolving competitive sport with a long tradition and has recently been included in the 2026 Winter Olympics. Previous research focused on physiology and performance analysis, while data on injuries in competitive skimo are not yet available.This study aimed to determine the anthropometric and demographic characteristics as well as the rates and distribution of injuries and illnesses in competitive skimo and to compare them between World Cup and recreational athletes.Cross-sectional studyData were collected using a detailed trilingual questionnaire administered either face-to-face or online at two major ski mountaineering events. Injury locations were classified according to the Orchard Sports Injury and Illness Classification System, and the severity of injuries was determined. A statistical data analysis was performed, and correlations were calculated.Out of 196 participants (78.6% male, 21.4% female), 111 were recreational athletes (RA), and 85 were World Cup athletes (WC). RA (median age 42) were significantly older than WC (median age 22). WC had significantly lower height and body weight than RA and a lower BMI. The incidence of exercise-induced bronchial asthma was significantly higher in WC (16.5%) than in RA (2.7%). More training hours, a lower BMI, younger age, and fewer recovery days were associated with a higher incidence of colds and respiratory infections per season. The prevalence of anorexia athletica was 17.9% in female WC, 5.3% in male WC, and 0% in RA. Fifty-nine injuries were reported by 43 individuals (21.9%). Thirty-six injuries (59.3%) were acute, 23 (40.7%) were chronic. The knee was the most commonly injured body part, followed by the lower leg and ankle. The most common type of injury involved the ligaments and joint capsule. The average injury score was 1.6 ± 0.6 (UIAA classification). Most acute injuries (90.3%) occurred during descent, whereas most overuse injuries (90.9%) occurred during ascent. Most acute injuries involved the knee during descent, whereas most chronic injuries were skin lesions and ulcers caused by full-carbon racing boots.This study presents the first data on ski mountaineering injuries. A high incidence of respiratory infections and exercise-induced bronchospasm has been reported and should be addressed in prophylaxis. Similarly, relative energy deficiency in sports and anorexia athletica should be addressed. Most acute injuries resemble those in alpine skiing, and prevention is difficult. Chronic skin wounds caused by carbon boots should be addressed in collaboration with the manufacturing industry. Overall, further research on injury surveillance is needed.