For many, this time of year brings with it the excitement of winter sports such as skiing and snowboarding on Southern California’s famous slopes. Skiing, as with any high speed, high impact sport, comes with the risk of injury. Skiing is a great way to exercise. It combines the exhilaration of speed and movement in a spectacular mountain setting. Skiing demands aerobic conditioning, strength and balance. Ski injuries can be significant and serious. Even if you are a world-class athlete with decades of experience under your belt, getting hurt is often unavoidable.
Did you know that a third of all skiing injuries affect the knee? And women are particularly at risk from ACL injures on the ski slopes. Recognizing the injury when it occurs and treating it properly is the best way to quicken recovery time and increase the chances of a return to the slopes before the end of the season.
Let’s take a look at some of the most common ski-related injuries, how to prevent them and some treatment options available to you
Common Ski-Related Knee Injuries:
MCL Injuries
The knee is the most common area of the body to sustain a skiing related injury. There are four major ligaments in the knee. These ligaments include: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). The MCL is the most common ligament in the knee to sustain injury while skiing or snowboarding. The most common mechanism of injury to this ligament occurs when the knee joint twists or undergoes excessive valgus force. In skiing, this happens most commonly during a fall. The MCL is crucial to providing rotational stability to the knee joint. When this ligament is damaged, the knee may feel like loose or unstable with certain movements.
To prevent an MCL tear, make sure bodyweight is balanced in a snowplow position.
ACL Injuries
The next most likely ligament to be injured, and probably is the most widely discussed ligament in the knee, is the ACL. The ACL is a ligament that runs anteriorly through the middle of the knee joint from the lower leg (tibia) to the upper leg (femur). It acts to protect the knee from dangerous ranges of motion and forces in and across the knee joint including hyper-extension, forward translation (gliding) of the tibia, and extreme rotation. ACL injuries can occur in both contact and non-contact situations. Most commonly ACL injuries happen with a sudden stop or change of direction when the knee is near full extension and a twisting mechanism is applied across the knee joint. When these injuries occur it is common for one to hear and or feel a “pop” in the knee and many times feel like the knee buckles or gives out.
To avoid this painful injury, make sure to land from a jump with your weight forward; if you land with your weight too far back, the force from the landing can tear the ACL.
Meniscus Injuries
Bruising or tearing to the meniscus is frequently encountered skiing injuries. The medial meniscus and lateral meniscus are located on either side of the joint, between the cartilage surfaces of the femur and tibia and act as shock absorbers to reduce the stresses between the tibia and the femur. Injuries to menisci may result from twisting the knee when maneuvering ski turns or from a bad landing following a jump.
Fractures
Decades ago, broken legs were common because skis would often not come off at the right time. Advancements in technology, including improved binding-release settings and parabolic skis have notably decreased the number of lower-leg injuries, especially shinbone fractures. It is now more common to see injuries to the ligaments of the knee, though fractures do still occur.
Wrist or Ankle Injury Skiing
Ankle sprains are common injuries among skiers, as are wrist sprains. For beginners, the issue very often occurs from not knowing how to properly slow down and stop. A sudden, awkward pivot in an effort to stop or slow down can easily roll the ankle or send a skier to the ground where they try to brace the impact by putting their hands forward.
Even though ski boots often provide good support and stability, it is not always enough for beginners who do not have ankles conditioned for skiing. And gloves do not provide any support for the wrists. In either case, the impact to the wrist or knee joint can leave the ligaments, tendons, muscles and other soft tissue inflamed, bruised and painful when moved or touched.
Shoulder Injuries
The rotator cuff is made up of a group of muscles and tendons. These work together to stabilize the shoulder joint. A rotator cuff injury is common during a fall while skiing, especially if the fall isn’t controlled. Learning how to control a fall and when to give up and fall sideways instead of continuing to hurtle down a slope is a vital skill for any skier. With the help of a rotator cuff doctor, San Francisco residents who sustain shoulder injuries while skiing can regain mobility.
Who Is At Risk?
In a recent clinical study, the average age of injured skiers was 30.3 years (range, 24 to 35.4 years), and the populations at greatest risk of injury are children/adolescents and adults over age 50. However, another study found no difference in risk in the older age group, with the exception of tibial plateau fractures. Numerous risk factors for skiing injuries have been identified and include: age, sex, skiing experience level, self-assessed skill level, body mass index, and trail difficulty.
How Injuries Happen
Most injuries are fall-related, and while most occurred on groomed intermediate (blue) runs, the quick-change line between groomed and ungroomed snow has claimed plenty of skiers.
Other causes include:
- Poor physical preparation: Knee movement is key to skiing. Squats are essential to building fitness for this particular sport as they draw on trunk and leg muscles in the same manner as the sport maneuver itself.
- Mental errors: This could include poor judgement due to age (too young or too old) or lack of skill or expertise (choosing a trail too far above ability), losing focus, fatigue.
- Obesity, as it hampers flexibility and increases forces.
- Poorly fitting equipment (Boots too snug or bindings release set too tight)
- Incorrect equipment (wrong type of skis)
Injury Prevention Works
Skiing is an equilateral sport, where athletes need good neuromuscular balance between the quadriceps and hamstring muscles and between the dominant and non-dominant leg, as well as good postural control. ACL injuries are known to impair neuromuscular function, making primary prevention ideal, and secondary prevention mandatory for when such injuries do occur.
Beginners are at the highest risk of injury, and so proper education, sport-specific instruction, and education on risk awareness is important for novices. Education should include use of protective equipment and proper chairlift technique. Helmet use has been shown to decrease risk and severity of head injuries without increasing risk of cervical spine injury or risk-taking. Other prevention techniques that show possible benefit include neuromuscular training and improving core strength.
- Prepare yourself before skiing
If you have not put on skis in a while, it is best to prepare your body with some conditioning exercises at least 6 weeks prior to skiing. Include exercises such as walking lunges, wall squats and at least 30 minutes of intense cardio several times per week to strengthen your knees and leg muscles.
- Perform warm-up exercises
Cold muscles are more prone to injury, so it is best to perform at least 15 minutes of simple stretching exercises before hitting the slopes.
- Know the ice or snow conditions and be aware of your skill level
The condition of the snow can change the terrain, so it is important for you to be familiar with the snow condition and stick to the slopes suitable to your level.
- Fall the right way
Take the fall; fighting it is how ligaments get torn. If you can, sit down to break the momentum. Pull your limbs in towards the torso. This will prevent you from dislocating your shoulder or straining your knee when you fall from a jump.
- Don’t overdo it
Forget trying to impress your friends. Start out on easier terrain and improve your skills gradually. And even before that, get in shape with proper training.
- Follow the skier’s “code of conduct”
The common-sense rules you see posted on the slopes are for your protection and the safety of others.
- Take breaks. Sure you want to maximize your ski time. But injury rates increase with fatigue. Rest when you need to, and stay hydrated with water or sport drinks.
Treatment Methods for Common Skiing Injuries
Treatment approaches for a snow skiing injury will vary depending on the type and severity of the issue.
1. The RICE Method
RICE stands for Rest, Ice, Compression, and Elevation. This conservative approach is effective for minor strains, tears, or some tendonitis issues. This is especially critical in the first 72 hours of an injury.
Rest gives the injured area time to heal, while ice can help reduce inflammation and pain caused by the injury. A compression bandage or wrap will support the joint and reduce movement. If possible, elevate the injured area above the heart to reduce swelling.
2. Taping and Strapping
Proper taping and strapping can help support areas like the wrist or knee to reduce stress on muscles and other soft-tissue by providing extra tension. Some skiers will preemptively tape areas prone to injury in an effort to avoid worsening any problematic joints. This can also help skiers with a minor strain to enjoy a day on the slopes or compete in an event.
3. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are over-the-counter pain medications, like ibuprofen, which can help lessen injury related pain and will aid in decreasing inflammation. Depending on the injury, some skiers may require a steroid or cortisone injection to reduce inflammation and pain that is more serious.
4. Physical Therapy
For many types of injuries, even minor ones, physical therapy is often a good way to strengthen the injured area during recovery, as well as learn proper form and techniques to avoid further injury.
5. Surgery
Typically, surgery is a last resort for healing or repairing many skiing injuries after all of the more conservative treatment approaches have failed to work. Invasive fixes are usually limited to serious ACL or MCL tears in the knee that need reconstruction, or the severe build-up of scar tissue that requires breaking up.
Unfortunately, surgery comes with longer recovery times and there are always inherent risks associated with it. A thorough discussion with a physician is suggested to make sure it is the best option.
Call Ventura Orthopedics Today!
While skiing can be a fun and adventurous way to spend winter months, skiing injuries unfortunately can and do happen. When you are facing any type of skiing injury, it is important to see a top orthopedic specialist for proper diagnosis and treatment. The experienced and dedicated sports medicine doctors and surgeons at Ventura Orthopedics are here for you. If you are concerned about a skiing-related injury, talk to the experts at Ventura Orthopedics today.
Call us today at 800-698-1280 to schedule an appointment.
