They often take place in remote locations and in variable environmental conditions (weather, terrain) with little or no access to medical care, and even if medical care is available, it usually faces challenges related to longer response and transport times, access to few resources, limed provider experience due to low patient volume, and more extreme geographical and environmental challenges. These ES activities tend to be individual and can be pursued both competitively and non-competitively. The definition of extreme sports (ES) inhabits any sports featuring high speed, height, real or perceived danger, a high level of physical exertion, and highly specialized gear or spectacular stunts and involves elements of increased risk. The purpose of this review is to provide an epidemiologic overview of common injuries affecting the extreme athletes through a focus on a few of the most popular and exciting extreme sports. Appropriate safety gear is essential for protection from severe or fatal injuries as the margins for error in these sports are small. The management of the injured extreme sports athlete is a challenge to surgeons and sports physicians. These relate to the temperament of the athletes themselves, the particular epidemiology of injury, the initial management following injury, treatment decisions, and rehabilitation. Medical personnel treating the ES athlete need to be aware there are numerous differences which must be appreciated between the common traditional sports and this newly developing area. Recent data suggest that the risk and severity of injury in some ES is unexpectedly high. Popularity for such sports has increased exponentially over the past two decades with dedicated TV channels, Internet sites, high-rating competitions, and high-profile sponsors drawing more participants. They involve high speed, height, real or perceived danger, a high level of physical exertion, spectacular stunts, and heightened risk element or death. Extreme sports (ES) are usually pursued in remote locations with little or no access to medical care with the athlete competing against oneself or the forces of nature.
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