Category Archives: winter injuries

Hitting the Slopes

Following the first snowfall to hit the GTA and a forecast that’s predicting a very snowy winter, many are groaning and complaining…minus the avid skiers and snowboarders who are eagerly awaiting to hit the slopes. If you’re one of the many who have waited well over six months to dust off your equipment, surely you don’t want to cut your season short with an injury.

Who is at risk?

Research has shown that the risk of injury is higher for the following individuals:

  1. Snowboarders vs. skiers;
  2. Beginners;
  3. Younger participants;
  4. Participants who rent their equipment or use improper equipment;
  5. Athletes with insufficient core strength/muscle imbalances;
  6. Athletes with an underlying injury.

Mechanism of Injuries

  • More experienced skiers sustain an injury related to jumps, while beginners sustain injuries related to falls;
  • Snowboarders are 3x more likely to experience injuries related to jumps, while only 10% of injuries are related to collisions (with objects or other people);
  • Skiers will likely injure their knees due to sudden changes in direction of the legs in regards to the torso;
  • Skiers tend to injure their knees following these distinct mechanisms:
    • The slip-catch: where the outer ski catches the inside edge, forcing the knee into internal rotation and valgus;
    • Landing from a jump with most of their weight back, the skier will land with their knee extended and the boot heel will catch the snow;
    • During forward falling positions when the inside edge of the ski engages the snow.

Common Injuries

While skiers and snowboarders share the slopes, they have very different injury patterns across all skill levels. Skiers will typically injure their lower body, specifically their knees, while snowboarders are more likely to injure their upper body, especially their wrists.

Knees:

Skiers are more likely to injure their knees than snowboarders do, with a prevalence rate of between 30-50%. Injuries generally occur following a traumatic event (i.e., falls, collisions, sudden changes in direction and twisting accidents). Injuries include meniscus and ligament tears (especially to the ACL and MCL), osteochondral lesions and occasional muscle strains and fractures. Overuse injuries are also common in skiers, with patellar tendinopathy being the most common.

Ankles:

Ankle injuries, such as sprains and fractures, are more common in snowboarders due to boots that do not fit properly. Skiers are less likely to have injuries to the ankle due to the higher and stiffer boot.

Skiers Thumb:

Injury to the ligaments on the inside of the thumb is common in skiers following an incident where the thumb gets caught in the strap of a ski pole or the snow.

Wrist Injuries:

20-40% of snowboarding injuries occur at the wrist, with the majority being fractures following a fall on an outstretched hand. Wearing wrist guards can significantly decrease the risk of injuries to the wrist.

Concussions:

HIgh speeds, acrobatic movements, falls and risk of collision make both skiing and snowboarding high risk sports for concussions. Studies have shown that concussions account for 20% of all ski and snowboarding injuries. While helmets prevent skull fractures and facial injuries, the research is inconclusive as to whether or not it helps in the prevention of concussions.

Prevention Strategies

  1. Lessons:

Lessons with a skilled instructor will dramatically reduce the risk of injury to beginners and novices.

  1. Education:

Research has shown that a large number of injuries are a result of poor decision making and risky behaviours, especially in younger, inexperienced athletes. Be sure to ski and snowboard within your limits, with regards to terrain, speed and experience. Cusimano et al (2012) examined whether an instructional safety video and handout could minimize the risk of injury in young, novice skiers and snowboarders. Their education video included basic information about helmet use, equipment, trail and terrain sign interpretation, and emergency procedures. The study had promising results by demonstrating that a little bit of knowledge and education goes a long way in preventing injuries.

  1. Conditioning:

These sports require a combination of strength, balance and endurance. Embarking on a week-long ski trip, following a year of being sedentary, will increase your chances of suffering an injury. Proper conditioning prior to the start of the ski season/trip will help prepare the appropriate muscles. Furthermore, overuse injuries can generally be prevented with proper conditioning.

  1. Equipment:

Ensure your equipment is safe, fits well and is appropriate for your skill level.

  1. Snow conditions/weather/course conditions

While these factors are out of your control, be aware of the conditions prior to skiing/snowboarding (i.e., poor visibility, technical/challenging runs, fatigue, etc.) and make smart choices as to when you should get off the slopes.

Don’t get stuck sitting in the chalet sipping hot cocoa while you heal an injury. Follow some of these tips and enjoy the slopes this winter

Cusimano et al., (2012). Evaluation of ski and snowboard injury prevention program. International Journal of Injury control and Safety Promotion.

Mayr et al., (2016). Prevention of Injuries and Overuse in Sports Directory for Physicians, Physiotherapists, Sports Scientists and Coaches.

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Fitness Fridays – A Safe Approach to Cold Weather Exercise

A great article by stopsportsinjury.org

Winter is a time when people often struggle to maintain their exercise routines. Falling temperatures should not be an excuse to avoid exercise, however. In addition to helping improve cardiovascular conditioning, burn calories, and lose weight, exercise during this period can improve overall health.

Regular exercise can decrease the rate of common illnesses, such as colds, and some medical professionals suggest that exercise may improve mental health, boost energy, and prevent or reduce depression. Spending hours in the gym lifting weights or repeatedly using treadmills and elliptical machines can become tiresome. However, with appropriate planning and adherence to some basic clothing and exercise principles, almost anyone can get a great outdoor workout in cold weather.

Clothing

The main point to remember about clothing for outdoor, cold-weather exercise is to wear layers. Layers allow the athlete to remove a garment or put it back on to adjust to changes in temperature and the body’s heat production. A combination of three layers is optimal to prevent heat loss. The innermost layer should consist of polyester fabric that wicks away moisture from the body. Avoid cotton as it absorbs sweat and could keep the body wet. The second layer can be thin or heavy depending on the climate and exercise. Usually fleece, down, wool, or synthetic fabrics make good second layers that can be put on or removed as needed. Finally, the outermost layer should be a windproof and waterproof shell. Nylon fabrics such as Gore-Tex and similar materials are sufficiently breathable but repel wind and water. The goal with all layered clothing is to stay warm and prevent heat loss without causing overheating and excessive sweating.

Below are some basic additional tips to prepare for outdoor exercise in the cold:

Avoid Overdressing

Wearing too many layers or clothing that is too thick and warm can make the athlete feel as if it 20-30 degrees warmer. This can lead to too much sweating, causing the body to become wet and cold. In general, if dressed with appropriately, one should feel slightly cold when starting to exercise.

Protect the Head and Extremities

It is important to protect the head, hands, and feet. To minimize the amount of heat lost, the body decreases blood flow to the hands and feet. Wearing gloves or mittens on the hands and a pair of warm, moisture-wicking socks on the feet will usually protect the extremities. Wearing a hat can decrease the large percentage of body heat that is normally lost from the head in cold weather.

Sunglasses and Sunscreen

Snow and ice can reflect a tremendous amount of sunlight. One should wear sunglasses to protect eyes against the light and glare. Wearing sunscreen on the face and using lip balm with sunscreen to block ultraviolet rays and prevent sunburn is important in the winter, just as it is in the summer.

Shoes

To decrease the chance of slipping and suffering an injury, wearing appropriate shoes in these conditions is critical. Shoes with studs or prominent tread can help on trails or slick roads and sidewalks. Check shoes for excessive wear and change to newer ones if the current pair is worn.

Fluids

Athletes often forget to hydrate enough in the winter. Body fluids are lost through sweating and breathing in cold months just as they are in the heat of the summer months. Drinking enough water or sports drinks before and during exercise and replacing fluids after exercise is important. Adding slightly warm fluids to water bottles before going outside will help keep the fluids from getting too cold to drink.

Run into the Wind

Running experts recommend athletes run into the wind at the beginning of a run, while sweat levels are still low. Sweat production increases as exercise continues. If the second half of a run is directed into a strong wind, the air flowing past a runner with sweat-dampened clothes can feel extremely cold and cause a drop in body temperature.

Recognize and Avoid Hypothermia and Frostbite

Athletes must recognize the signs of serious cold-temperature injuries, such as hypothermia and frostbite, and prevent them. Loss of feeling, tingling, or loss or color in the face, hands, fingers, and toes are signs that frostbite could be developing. Mental status changes such as confusion or disorientation, slurred speech, and uncontrolled shivering can be signs of impending hypothermia. If the athlete is concerned about these types of changes, he or she needs to get into a warmer environment immediately and slowly warm the body and the parts that are affected.

By Dana Clark