Ski injuries and their Prevention 
 
Injuries 
Skiing has become accessible to more people. Faster ski lifts and expansion of trails at ski areas, as well as improved snow making capabilities, have increased the numbers of skiers on the slopes. Over the years there have also been dramatic changes in the equipment as well. Ski boots have evolved from soft leather cut boots to mid-calf plastic boots that rigidly support from the lower leg and ankle. Advancements in sophisticated multi-directional release bindings continue to reduce the number of lower extremity injuries. Falls injuries, account for approximately 75-85% of skiing injuries. Collisions with objects including other skiers, account for between 11-20%, while incidents involving ski lifts contribute between 2-9%. 
Studies demonstrate that the majority of injuries are sprains, followed by fractures, lacerations and dislocations. While fractures were more common prior to these equipment changes, it is now more common to see injuries to the ligaments of the knee. This could possibly be partly attributed to the change in design of the equipment over the years. 
 
Ligament Injuries: 
The most common injury to the knee is damage to the medial collateral ligament (MCL). This injury occurs with slow twisting falls or when beginners maintain a snowplow position for lengthy periods and stress the ligament. Virtually all degrees of MCL sprains can be managed conservatively with bracing and limited range of motion, and physiotherapy. 
A similar shearing force can occur when the lower leg is suddenly twisted away from the upper leg as in “catching an edge.” These injuries often require surgical repair and extensive rehabilitation. Fractures of both the femur and tibia occur more commonly with violent twisting falls or collisions. 
Injuries to upper extremities account for approximately 30-40% of all injuries. The most vulnerable joint of the upper body is the thumb. Injury to the ulnar collateral ligament of the thumb is second in frequency only to MCL injuries of the knee. These injuries occur when a skier falls on an outstretched arm that is still gripping the pole. The thumb is suddenly pulled outward, injuring this joint. It may be that using poles with straps rather than the fitted grip may result in fewer injuries. 
Like knee sprains, sprains of the thumb are graded first degree, second degree or third degree, depending upon the severity of damage to the ligament. Surprisingly, injuries to the thumb can be serious and, if not cared for properly, can result in long term disability.  
 
A protective cast is used in nearly all cases for lengths of time varying from three to six weeks. Physiotherapy is very useful to speed up recovery and return to full function. Infrequently surgery is required. 
While fractures of the upper extremity are infrequent, dislocations of the shoulder are quite common. 
 
Good quality rehabilitation of the joint is vital to prevent recurrence and be assured of a complete recovery. Surgical repair is sometimes necessary to restore the joint to a more functional state.  
 
Skiing should be discontinued if it causes further pain. 
Top tips for avoiding ski injuries 
 
1. Take lessons 
The better your technique, the less chance you will put undue strain on your joints. 
 
2. Set your bindings correctly 
Skiers using incorrectly adjusted skis and bindings are eight times more likely to suffer injury. Crank up the DIN setting (which controls how easily the bindings snap open) beyond what is appropriate for your weight and ability, and you are asking for trouble. When hiring skis, know your weight in kilograms, and be honest about your ability. 
 
3. Take a rest day 
The highest risk of accident is after 3pm on the third day of your holiday. This is because muscle fatigue reaches its peak 48 hours after you start your holiday. 
 
4. Take the lift at the end of the day 
You will be tired, the pistes may be icy and crowded, and there will probably be bare patches in the snow - a perfect recipe for a fall. 
 
5. Control your weight 
The heavier you are, the more strain you are putting on your knees. 
 
6. Take nutritional supplements if you suffer from osteoarthritis 
Both glucosamine and chondroitin, which are available from chemist shops, are known to have beneficial effects. 
 
7. Keep within your comfort zone 
Control is good, bravado is bad, and icy moguls - at least if you already have any damage to your knees - are very bad indeed. 
 
8. Don't drink alcohol at lunchtime 
It slows your reactions and makes you more reckless. 
 
9. Ski off-peak 
The quieter the slopes the less danger there will be of your being called on to take sudden evasive action. 
 
10. Don't wear a knee brace 
According to Bell, the only skiers who might benefit from a brace are those who are returning to the sport with an old or partially healed ligament injury (they might want to use a hinged brace), or those with mild arthritis (who might benefit from a neoprene sleeve). Otherwise, skiing without a brace improves the ability of the muscles around the knee to respond effectively to the different stresses and strains. 
 
11. Seek advice immediately after an injury 
Clinics in ski resorts are well versed in treating knee pain. Above all, do not ski with a swollen knee: put ice on it, and take anti-inflammatories until the swelling subsides. 
 
12. Consider snowboarding 
Snowboarders are less prone to the twisting effect that causes knee injury. (On the other hand, they are more at risk of head and wrist injury.) 
 
Remember that everyone heals at a different rate. 
 
If you have suffered with an injury and need some advice or treatment please do not hesitate to contact us. 
 
"We Know How Your Body Works" 
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