Slippery When Wet – Pedestrian Safety on the Streets of Seattle

The snow flurry that came and went over this Thanksgiving holiday in Seattle gave way to icy roads, wet and slippery sidewalks and driveways across our fair city. As challenging as winter can be in the Pacific Northwest, it is equally a challenging time of year for pedestrians who navigate this great city on two feet.

Most fractures are caused by falls, including fractures of the spine and hip.

Over 95% of hip fractures are caused by falls, and the rate of hip fractures is twice as high for women as it is for men.

The injuries caused by these falls can make it difficult for anyone to enjoy the normal activities of daily living like walking.

Pedestrian Safety Tips

Seattle OSS has a few tips for you to keep in mind while navigating the streets of Seattle including:

Proper footwear – Pedestrians should wear the proper footwear for the weather conditions, such as shoes and boots with appropriate traction. Rain, frost, ice, and snow can make walking on footpaths very dangerous, so proper footwear can help prevent a dangerous slip and fall. Also, walkers should wear gloves in order to break their fall if they do slip, and keep gloved hands out of their pockets for the same reason.
Proper clothing – Wear high visibility clothing to make yourself more visible to vehicles.
Avoid walking on the streets – Freezing weather tends to turn roads into an icy hazard. Be aware of your surroundings and stay on the sidewalks or clear, cleaned paths.
If you can’t avoid ice and snow, take shorter, slower steps to reduce the risk of a slip and fall and subsequent injuries, particularly when using the steps at any building as these can be dangerous when covered with snow or ice.

If you experienced a fall and need specialized orthopedic care, the surgeons at Orthopedic Specialists of Seattle provide excellent treatment options available for you.

‘Mixin’ It Up’ Does Wonders for Kids in Sports

Fall and winter sports season is upon us! Boys are playing football. Girls are doing their cheer routines at games.

Cross-country, field hockey, tennis, and volleyball players are in full swing at high schools across the country.

While kids are eager to jump right into these activities, injuries this time of year increase.

Why Do More Sports Injuries Occur in the Fall and Winter?

Sudden increases in activity level
Unpredictable weather and changes in playing surface. Shifting weather patterns are another factor that contributes to sports injuries in the fall and winter.
Muscle fatigue – During the summer months, kids move freely. Suddenly, when school starts, students are cramped into an uncomfortable school desk for eight hours a day. The hips remain flexed at 90-degrees, and the brain focuses on keeping the hip flexors, hamstrings, and spinal erectors engaged to maintain a sitting position. Unfortunately, these are the opposite muscles the body needs to prevent common sports injuries.

What Are the Most Common Fall and Winter Sports Injuries and How Are They Prevented?

Slowly ramping up activity levels over the course of a few months leading into preseason can minimize the risk significantly.

Students should spend at least 10 minutes warming up every practice and devote twice as long to end-of-practice stretches to prevent injuries including:

Tendon injuries
Muscle pulls
Stress Fractures

Middle-school-age children come in with growth plate injuries. A growth plate injury occurs at either end of the leg bone.

A damaged growth plate may lead to arthritis, crooked bones, or limbs that do not grow long enough — although these circumstances are rare. More often than not, kids rebound from a growth plate injury without any further consequences.

To prevent these injuries, be sure you oversee your child’s strength training to ensure he or she is not lifting too much weight too fast. You also want to see that your child is using the proper form.

Playing in extreme cold, certain medications, neurological disorders, metabolic diseases, and genetic factors are believed to all play a role in the development of growth plate injuries as well. It is important to speak with a sports medicine professional to determine whether your child may be at risk for a growth plate injury.

When high school athletes begin to get tired, they get sloppy. Fatigue is the number one factor in ankle sprains. Teach your child to recognize signs of fatigue so he or she can request a break if the coach doesn’t see it.

Some of these early signals may include some or all of the following symptoms:

Inconsistent performance
Decreased focus
Shortness of breath
Muscle twitches
Depression or irritability
Severe thirst
Generalized weakness
Nausea
Muscle cramps
Dizziness
Headaches

According to Dr. Downer, “Mix it up, don’t just play one sport. Instead be diverse and try different types of sporting activities throughout the year. Staying active keeps you well-conditioned and less likely to experience an injury.”

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.

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.

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.

Avocados vs. UFC Fighter… and the Winner is?

avocado-cut-3a Who knew you would have to watch your back, or should we say hand, when making the family’s homemade guacamole? Avocados; they look innocent enough, but did you know that avocados are the cause of hundreds of hand injuries a year?

Take for example, UFC Tri Star Welterweight contender, Rory MacDonald. He gave himself a deep cut in his left hand while cutting an avocado at home, prompting a trip to the emergency room and making him worry he’d have to drop out of his UFC 170 fight against Demian Maia. Fortunately for MacDonald, he received stitches for his hand injury.

The danger is hidden inside the avocado. Avocados have a soft creamy skin, easily sliceable, but inside, the pit also needs to be removed carefully. Often times, this is done by stabbing the end of a knife onto the pit and twisting it off. If not done properly, the knife can glance off the pit and cut your hand.

You can also injure yourself when slicing the inside of the avocado while it rests in the palm of your hand; the pressure may be too great and accidentally, you slice right through the peel and your palm along with it, hitting an artery, nerve or tendon in the process.

Slicing an artery, nerve or tendon can be serious. It is possible to have a partial injury to a tendon and still move the hand normally, but there is a risk that the tendon could rupture completely. According to Dr. Ruhlman, “Knife injuries from cutting an avocado are among the most common injuries I see, and unfortunately, often cause an injury that needs surgical repair. Hopefully, awareness of this common injury might prevent a rate of such a devastating injury.” By using the proper tools and technique, injury can easily be prevented. If you do cut yourself it might mean surgery and possible months of therapy.

OSS has several providers specializing in hand injuries. If you are suffering from a hand-related injury, contact OSS to schedule an appointment with one of our physicians at (206) 633-8100.

Avoiding Spring Gardening Injuries

Spring weather in the Pacific Northwest is beautiful and although we still have rain showers, it is the best time for gardening and getting in some spring cleaning. If you are like some of us here at OSS, gardening is a popular hobby. Over time however, it can take a toll on your body. Creating a dream garden requires repetitive bending, kneeling, reaching, and twisting that may result in putting an extensive amount of strain on your muscles and joints.

According to Dr. Scott Ruhlman, “Spring time is a great time to get outside and do yard work. In this case the old adage rings true, that an ounce of prevention is much more than a pound of cure. Use the proper tools and body positioning when gardening. I am not only a hand surgeon but an avid gardener too.”

Raking, digging and planting may present injuries and OSS would like to share some helpful tips to keep you pain-free while you garden:

Sunscreen – Fair-weather skin tends to burn faster and in the Pacific Northwest when we see the sun peek out from the clouds, we rush to catch some of those sunshine rays. Use sunscreen with SPF and wear a wide brimmed hat.
Light Stretching and Walk – Before you take on your dream garden, do some light stretching so that your muscles can warm up and take a short walk to get your blood flowing.
Spread out your Workload – If your garden took a toll over the winter months, pace yourself and spread out the work; this gives you the opportunity to see your garden progress and prevents you from injury by doing all the work at once.
Kneeling vs. Bending – Place less strain on your back by avoiding bending; kneel instead. Wear kneepads and use a cushioned mat to comfort your knees while working on the ground.
Keep Moving – Long periods of time in one position will put stress on your muscles and joints; so keep moving so that you avoid overworking specific areas of your body
Lift Cautiously – Lift with your legs and not your back when carrying heavy loads and remember to hold objects close to your body when lifting.

If you believe you are suffering from a gardening-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 or consultation with Dr. Ruhlman.