Alpine ski racing is one of the most popular sports in many countries; nevertheless, selection disadvantages and severe injuries result in high dropout rates. In this review we summarize existing knowledge about the specific challenges associated with selection bias and injuries, and their effects on talent development in ski racing. The relative age effect (RAE) appears in all age categories of national Austrian and international alpine ski racing. Relatively younger athletes seem to only have a chance for selection if they are early maturing. Talent selection processes should consider both the biological maturity status as well as the relative age; additionally, a competition system based on a rotating cut-off date might contribute to a reduction of RAE. Youth and adolescent ski racers report lower injury rates compared to World Cup athletes. The knee was the most affected body part in relation to traumatic injuries. The most frequently reported overuse injuries were knee pain (youth) and low back pain (adolescent level). Athlete-related modifiable risk factors were core strength, neuromuscular control, leg extension strength and limb asymmetries. Based on these findings, prevention measures should be expanded to contribute to long-term injury prevention. In future research more multi-disciplinary, longitudinal studies should be performed.
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