How to Avoid Upper Extremity Injuries While Enjoying Your Favorite Winter Sports

Falling is Inevitable

Ice skating, skiing, snowboarding, and other winter sports and activities are common causes of upper extremity injuries.

During the winter months OSS surgeons seem to treat more upper body extremities.

People who live in the Pacific Northwest don’t let rain or snow get in the way of outdoor activities, which can sometimes carry with it potential injury.

Ice Skating

Winter Sport Injuries

If you’re learning how to ski for the first time or are an avid skier, falling is inevitable. Skier’s thumb, or an injury of the ligaments that connect the bones in your thumb, is a common upper extremity skiing injury. The injury occurs when, during a fall, the ski pole handle places sideways pressure on the thumb causing stress to the ligament.

To prevent injury to the ligament during a fall, avoid using the wrist straps of the ski pole or keep them loose to allow you to quickly release the poles. Simple finger grooves in the handle have ergonomic appeal, allowing easy grasp.Skaters and snowboarders share a similar risk of falling. Wrist and elbow fractures are most at risk as while attempting to catch ourselves with an outstretched arm.

Skaters and snowboarders share a similar risk of falling. Wrist and elbow fractures are most at risk as while attempting to catch ourselves with an outstretched arm.

How to Avoid Upper Extremity Injuries While Enjoying Your Favorite Winter Sports

OSS would like to offer the following tips to avoid falling in any winter sport:

  • Use properly maintained equipment adjusted for your body, skill level and terrain. Consider taking classes from a professional instructor who can give you safety advice.
  • General conditioning prior to engaging in wintertime sports optimizes your strength and endurance as well as decreases the likelihood of falls.
  • Be aware of your terrain and snow conditions, as well as people of all skill levels who may or may not know how to stop.
  • Plan ahead when preparing to exit a ski lift, and communicate your plan to other passengers.
  • Respect pain and fatigue. It is important to know your limits and recognize the signs of fatigue and stop before your body is unable to keep up with you.
Winter Sports | Snowboarding

A rule of thumb when you are out and about enjoying your favorite winter sports is to attempt to fall toward your uphill side and avoid reaching out or behind you while skiing or snowboarding. Use your forearms.

Falling safely is a skill you can practice and master, beginning on easier slopes. Wrist guards are particularly important for snowboarders. Boarding gloves with built-in wrist guards are available.

If you do experience pain after a fall while enjoying one of these winter activities, it is very important to be evaluated by an OSS physician. OSS physicians are experts in sports medicine for adults and children.

If you believe you are suffering from a winter sports injury and need specialized orthopedic care, the surgeons at Orthopedic Specialists of Seattle provide excellent treatment options available for you. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

Preventing Ski Injuries Through Conditioning

A busy ski resort in the United States may see dozens of injuries on the slopes each day.

As an orthopedic surgeon, I also see many patients with ski-related injuries throughout the season. Most injuries are the result of poor conditioning, or equipment failure.

Ski Injury Prevention

Common Ski Injuries

The most common injuries amongst downhill skiers are knee sprains, shoulder injuries, head/face injuries and wrist/thumb injuries. The knee is the most commonly injured joint, resulting in about one third of all ski injuries. Injury rates and type vary with uncontrollable factors such as weather and snow conditions. Proper equipment and conditioning, however, are factors that we can control.

Equipment

When skiers examine their equipment, it’s important to make sure that:

  • Skis, poles, and boots are in good condition and properly sized for the individual’s weight, size and skill.
  • Binding are adjusted and tested prior to each ski season.
  • Helmets are properly fitted and checked for damage prior to the ski season.
  • Sunglasses, goggles and sunscreen are part of one’s safety equipment.

Conditioning

Skiers can increase their safety and performance this winter by starting with a pre-conditioning program that includes four components: endurance, strength, flexibility, and balance. Aerobic fitness is the key to preventing the end of the day injuries (the last run).

Cross training, which includes multiple sports and activities in the conditioning regimen, has become popular, especially with a seasonal sport such as skiing. Strength and flexibility focusing on the legs and trunk are vital in injury prevention specific for skiing. Balance training has been shown to be the single most important exercise for preventing ACL tears in women.

A typical conditioning program can include:

1. Aerobic fitness (5 days/week for at least 30 minutes)

  • Running
  • Cycling
  • Swimming
  • Elliptical or stair climber
  • Jumping rope
  • Treadmill

2. Strength (3 days/week, 2 sets of 60 seconds each)

  • Leg press
  • Wall squats
  • Hamstring curls
  • Toe raises
  • Lateral leg raises
  • Sit-ups

3. Flexibility (daily, 2 sets of 60 seconds each)

  • Hamstring stretches
  • Achilles stretches
  • Quad stretches

4. Balance Exercises (daily, 2 sets of 60 seconds)

  • Standing on one leg, perform mini squats
  • Single leg hop, holding for five (5) seconds, repeat

In addition to a conditioning program, skiers need to adequately warm up – an activity that is often neglected with skiing. No one would think of running out on the football field or onto the basketball court without warming up first.

But with skiing, one typically sits in the car for an hour or more to get to the slopes, and then stands in line for tickets and for the lift, before finally sitting on the chair for several minutes. By the time one has arrived on the top of the hill, he or she is often stiff and cold.

It’s important for skiers to remember to warm up and stretch before starting down the hill. Often an easy, predictable run is a good idea before heading to the more challenging terrain. The few minutes spent warming up will be well worthwhile in injury prevention.

More about Knee Injuries

Every ski season, I treat many knee injuries. In the 1970′s, ankle injuries were more common, resulting from soft, leather boots. The development of stiffer boots has transferred much of the force to the knee.

Medial Collateral Ligament

The most common knee injury from skiing is the MCL (medial collateral ligament) injury. It often results from catching an edge or having the skis diverge, so that the foot is forced away from the body. This creates a distraction force on the inside of the knee.

Fortunately, the MCL has a good blood supply, and can be treated non-operatively, with a period of bracing for 4-8 weeks, depending on the severity of the injury.

Anterior Cruciate Ligament

ACL (anterior cruciate ligament) injuries are also common skiing injuries. They are thought to occur from the forces created by the long lever arm of the ski that are transmitted to the knee ligaments. Commonly, the ACL is injured with a hyperextension mechanism.

In expert skiers, we see ACL injuries when saving a backwards fall by a strong quadriceps contraction, pulling the tibia (lower leg) forward with enough force to rupture the ACL.

Recent boot and binding technology has reduced the rate of ACL injuries. In young, active individuals, the ACL injuries often require surgical reconstruction. Success rates from surgery are excellent, but require aggressive rehabilitation and six months of recovery time before one can return to skiing or other twisting or pivoting sports.

No one wants to go down the path of surgery and recovery. But too many people wait to think about preparing for skiing until half way through the season, when snow has already accumulated and they are on their way to the top of the mountain. Many times, this is too late.

Although injury is a risk we all take when participating in any sport, a conscientious approach to skiing – including equipment inspection and conditioning – will minimize the occurrence. Not only will these precautions reduce injury rate, but they will also enhance performance, decrease fatigue, and ultimately, increase one’s enjoyment of the sport.

If you believe you are suffering from a knee-related injury and need specialized orthopedic care, the surgeons at Orthopedic Specialists of Seattle provide excellent treatment options available for you.

Jack-O-Lantern Carving Safety Tips

Every October, carved pumpkins peer out from porches and doorsteps in the United States and other parts of the world. Gourd-like orange fruits inscribed with ghoulish faces and illuminated by candles are a sure sign that Halloween and the holiday season is upon us. The practice of decorating “jack-o’-lanterns” – the name comes from an Irish folktale about a man named Stingy Jack – originated in Ireland, where large turnips and potatoes served as an early canvas. Irish immigrants brought the tradition to America, home of the pumpkin, and it became an integral part of Halloween festivities.

Click Here and find pumpkin carving safety tips for you and your loved ones!

pumpkin-carving

Reduce Your Chances for Injury While on the Football Field

Week four of the Seattle Seahawks football season has taken a few hits. Eight players are on this week’s injury list. It’s a reminder to both professional and non-professional athletes that playing smart is the best way to reduce your chances of injury in this contact sport.

The 8 Most Common Football Injuries:Football Helmets

Not including head injuries, the most common musculoskeletal injuries include:

1) ACL injuries – The anterior cruciate ligament in the knee can become damaged or torn when a player is impacted from the front or rear.
2) MCL injuries – Injury to the medial collateral ligament in the knee is also very common because it occurs when the knee is impacted from the side.
3) Torn meniscus – When a player rotates their body while a foot stays planted, the knee can twist, causing the meniscus to tear.
4) Ankle sprains and strains – Perhaps the most common injury in all sports, ankles are susceptible to soft tissue damage when pivoting, changing direction, or putting too much pressure on the joint.
5) Muscle contusions – A strong impact to a large muscle, usually in the thigh, can cause a contusion. This is basically a large, deep bruise that can impair muscle function.
6) Torn hamstrings – Bursts of speed can cause the hamstrings to tear if the player is not conditioned or properly warmed up.
7) Shoulder tendinitis – Frequent throwing can cause overuse injuries like shoulder tendinitis from repetitive motions.
8) Shoulder separation or dislocation – A direct blow below the shoulder can cause a separation of the acromioclavicular joint, while a dislocation occurs when the head of the humerus detaches from the scapula.

The treatment protocol for these football injuries varies and can range from basic RICE (rest, ice, compression, elevation) to surgery, with several options in between. For all of these injuries, RICE can be improved with active cold and compression therapies to help speed up the healing process for injuries. Cold compression therapy can also be used after surgery to help speed up the recovery process.

According to Dr. Peterson, “While injuries are an unavoidable consequence of contact sports, indeed any sport, the risk of injury can be dramatically lowered by proper background training and techniques. Additionally, proper conditioning can speed recovery times after injury reduce the chance of recurrent injury.”

Here are some helpful tips on how you can reduce your chances of a football injury:

-Have a pre-season health and wellness evaluation
-Perform proper warm-up and cool-down routines
-Consistently incorporate strength training and stretching
-Hydrate adequately to maintain health and minimize cramps
-Stay active during summer break to prepare for return to sports in the fall
-Wear properly fitted protective equipment, such as a helmet, pads, and mouthguard
-Tackle with the head up and do not lead with the helmet
-Speak to a sports medicine professional at OSS if you have any concerns about football injuries or football injury prevention strategies

If you believe you are suffering from a sports-related injury and need specialized orthopedic care, the orthopedic surgeons at OSS provide excellent treatment options for your injury. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

Ulnar Wrist Pain in Tennis – Tips to Help Prevent Injury

The 2014 US Open Tennis tournament was filled with ups and downs this year. Mirin Cilic beat out some top seeded players to win the men’s championship and the favorite on the women’s side, Serena Williams won the title. Years of training, wins and losses have been part of any tennis player’s repertoire, so have injuries.

Ulnar Wrist

Wrist injuries are common for tennis players and elite professionals. The anatomic location of the wrist and its major role in the kinetic chain needed in stroke production, it is unfortunately a common site of pain and disability. Often, the pain presents on the pinkie-side, or ulnar side, of the wrist.

Many players experience this ulnar pain in the non-dominant hand during two-handed backhand strokes. In this stroke, the top hand is placed in extreme ulnar deviation and extension, while dynamically moving from supination to pronation. This same motion-type occurs in many tennis strokes, and as such can lead to acute and chronic ulnar wrist injuries.

Tennis players can present with an acute event of sudden onset – either after a violent fall with the wrist in extension and pronation/supination, or after hitting the tennis ball and having an immediate feeling of ulnar wrist pain. According to Dr. Weil, “Ulnar sided wrist pain in tennis players can often be due to tendinitis and can be treated in a conservative fashion. Sometimes degeneration of the cartilage of the wrist can occur.

If you are experiencing pain for more than a few days while playing tennis an evaluation by an orthopedic surgeon is recommended.” When the presentation of pain is chronic and insidious, the ulnar wrist pain arises over the course of days or weeks, and the athlete usually cannot recall a single inciting injury.

Wrist injuries in tennis players often result from over-use, improper technique, and even using the wrong equipment. Also, excessive wrist motion during the stroke will predispose a player to injury. Some things to consider to help prevent ulnar wrist pain:

  • Equipment: Using the wrong grip size, wrong strings, and improper string tension can all lead to wrist pain. The grip size can determine the amount of force needed to hold the racket through the stroke, leading to increased firmness of grip and potential injury. Too firm a grip can restrict free movement of the arm. The grip should be only as firm as necessary to ensure proper stroke technique.
  • Grip: Extreme grips like a Western will compromise the position of the wrist, forearm, and elbow which places additional stress on the adjacent muscles and tendons. For the two-handed backhand player, use of the continental grip on the bottom hand and the Eastern forehand grip on the top hand is preferable. Players using extreme grips (Western) place their wrist and forearm in positions that place additional stress on the muscles, tendons, and ligaments and can predispose them to injury. Additionally, another breakdown in technique is when the player uses the wrist and hand as primary force generators during ball strike. The wrist and hand must be viewed as links in the kinetic chain whereby large forces generated from the ground, lower extremity, and trunk are transferred.
  • Position of wrist at ball strike: In the two handed back-hand, the tendency for some players is to place the top hand in extreme extension and ulnar deviation prior to ball strike. The thought is to power the ball into creating topspin at contact. By using the Eastern Forehand grip in the top hand (left hand in right handed players) and by incorporating the players’ core and lower body/legs into the stroke properly, the lower body/core can load the energy and transfer load and energy up the kinetic chain into the arm and wrist to abate some of the torsional stress on the wrist.
  • Physical: Due to the physical demands of tennis and all of the repetition that is involved, tennis play causes the dominant playing side to over-develop which leads to overall body muscle imbalance. Exercises that strengthen the wrist, forearm and elbow include wrist curls, radial and ulnar deviation resistance maneuvers, and ball dribble off the floor then wall to improve both strength and endurance.

Helpful tips to prevent wrist injury:

1) Choose your equipment carefully, take into account level of play and age.

2) Be sure to use proper grip and technical skills, and be open to reviewing these periodically, even using video, making note of changes in swing mechanics pre and post ball strike.

3) Have a daily routine to include strength and flexibility exercises that increase stamina and maintain range of motion; this should include the hands, wrists, forearms, elbows, and shoulders.

4) Have elastic bands in your bag to allow you to perform strength exercises anytime and have them easily accessible; also, you should be able to perform this routine away from the supervision of coaches, trainers, and parents.

5) Perform strengthening exercises after practice or match play or on “off” days where not hitting is done to avoid muscle fatigue during play.

If you believe you are suffering from a tennis-related injury and need specialized orthopedic care, Orthopedic Specialists of Seattle provide excellent treatment options available for you. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.