Making its debut at the Winter Olympics this year, ski mountaineering is not considered particularly risky. But beware of the fad effect, warned Jean-Luc Le Masle-Lastiolas, MD, a sports physician and interventional sonographer in Annecy, a town in southeastern France near the Alps.

Beware of Widespread Enthusiasm

Ski mountaineering will be featured for the first time at the Winter Olympics in a few days, in Milan-Cortina, Italy. In its recreational form, usually called “ski touring,” it involves alternating ascents (skis equipped with climbing skins to prevent backward sliding, or, on the steepest sections, ascending on foot in boots) and descents (skis — without climbing skins — on the feet), in the style of alpine skiing, often for long durations.

At the 2026 Olympics, on February 19 and 21, ski mountaineering will be contested in a sprint (individual men’s and women’s events) and a mixed relay. The sprint is a very short format — about 3 minutes of effort — consisting of an uphill section with transitions (with skis and skins, without skis, then again with skis and skins), followed by a downhill slalom segment without skins.

While the Olympics are an opportunity to showcase this very physical sport, the media spotlight could increase risky participation among athletes who do not know the mountains and are not trained, in particular, in avalanche victim search techniques, warned Le Masle-Lastiolas.

Risks Depend on Conditions

Apart from that, and with the exception of national- or international-level competitors, who are already well monitored medically, there is no need to treat ski mountaineering differently from other cross-country sports, according to the sports doctor.

“It is, like running or triathlon, an aerobic sport,” he said. “Medically, it is not considered a high-risk sport, and contraindications are quite rare, although it’s better to have an ECG if you practice regularly and to check cardiovascular risk factors after the age 50.”

If ski mountaineering is practiced competitively and at high intensity, iron consumption can be increased by the exertion, thus increasing the risk for anemia, secondary amenorrhea in women, and bone insufficiency. Appropriate medical monitoring is then necessary.

As for the risks inherent to practicing in mountain activities, such as hypothermia and acute mountain sickness, they also depend on the conditions and can be avoided with the proper equipment, knowledge of the weather conditions, and by always going with companions. One should descend if headaches, nausea, or extreme fatigue occur.

Epidemiology of Injuries

According to Le Masle-Lastiolas, “tendinopathies predominate because ski mountaineering places heavy strain on the quadriceps and hamstrings, and because the boots are fairly rigid there is little plantar flexion, so tension is high on these muscle groups and on the lower-limb tendons.”

A recent medical thesis (2024) examining this relatively under-researched sport supports his observations. Among ski-mountaineering competitors, “most lower-limb injuries are tendon lesions (29.8%) followed by ligament injuries (21.1%),” wrote Louise Renard of the Faculty of Medicine, University Clermont Auvergne, Clermont-Ferrand, France.

This story was translated from Medscape's French edition.