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.

MLB World Series Injuries

Rounding the Bases to Catching Fly Balls

MLB World SeriesThe 2014 Major League World Series begins this week with a frenzy of predictions from the sports experts and fans from both the San Francisco Giants and the Kansas City Royals predicting that their respective team will win.

Baseball, a game routed in tradition, history, superstition and sometimes, injuries.


Common Injuries

baseball_gloveMore than 627,000 baseball injuries each year are treated by medical professionals, according to the U.S. Consumer Products Safety Commission. Baseball is not a contact sport, but contact with a ball, bat, or another player results in the most serious injuries.

The most common injuries include repetitive use injuries to the shoulder and elbow, muscle pulls, contusions, ligament injuries, black eyes, concussions and lacerations. Knee injuries also are relatively common.

Some of these injuries can be career ending if severe enough, as joint replacement sometimes does not work well for athletes.

Your feet also take a beating when playing baseball. Baseball players are at risk from various injuries, including:

1. Ankle sprains may occur while running, fielding balls, stepping on or sliding into bases. Sprains should be evaluated by a foot and ankle surgeon to determine the extent of injury, including possible peroneal tendon injuries or fractures. The foot and ankle surgeon will develop a treatment plan: failure to fully treat and rehabilitate a sprain may lead to chronic ankle instability and recurrent sprains.

2. Overuse or excessive training may sideline some athletes with Achilles tendinopathy or heel pain (often plantar fasiciitis, or calcaneal apophysitis in children and adolescents).

3. Contusions may occur from impact with the ball or contact with other players.

4. Cleats may pose challenges in the forefoot and aggravation of neuromas, sesamoids, bunions, and hammertoes. To stay at the top of your game, ensure that cleats are fitted properly and have injuries evaluated by a foot and ankle surgeon.

According to Dr. Reed, “While baseball is a less violent sport than football, athletes can be prone to foot and ankle injuries often due to the quick bursts of required running or sliding. Orthopedic foot and ankle surgeons are uniquely trained to provide expert care of baseball-related injuries, including turf toe, osteochondral defects, ankle instability and Achilles tendinitis or rupture.”

Good luck to both the Giants and the Royals! Here’s hoping no one gets put on the DL list during the series!

If you believe you are suffering from a sports-related injury and need specialized care, the physicians 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.

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.