Inside
Physio Professionals Newsletter July 2013
this issue P.1&2
Skiing Injury Prevention
P ro f e ssi o n a l D e ve l o p me n t Physio Professionals prides itself in its continuing staff education initiatives.
Skiing Injury Prevention:
Staff
Michelle Crew (nee: Peauril) Masters of Physiotherapy Level 3 Sports Physio AIS SHOULDERS / BACK PAIN
Andy Magill B.Sc. Physiotherapy (Hons) Level 1 Sports Physio KNEE / LOWER LIMB
Tim Garrett B. Sc Physiotherapy
A busy ski resort may see dozens of injuries on the slopes each day. As physiotherapists, we see many patients with ski-related injuries throughout the season. Although accidents do happen, most injuries are the result of poor conditioning or equipment failure. The most common injuries amongst skiers and snowboarders are knee sprains, shoulder injuries, head/face injuries and wrist/thumb injuries. The knee is the most commonly injured joint, resulting in over a third of all 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.
Level 1 Sports Physio NECK / HEADACHES
Andrew Crew Remedial/Sports Massage Performance Bike Fit Accredited Track and Field / Cycling Coach
Physiotherapy
Common Ski Injuries A wide range of injuries occur on the slopes. Knee injuries are very common, particularly injuries of the major knee ligaments. Because skiers and snowboarders frequently put their arms out to break a fall, shoulder injuries — such as
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dislocations and sprains — often occur. Fractures around the shoulder, wrist and lower leg are also common. Head injuries also occur and can be especially serious. 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. ACL (anterior cruciate ligament) injuries are also common skiing and snowboarding injuries. They are thought to occur from the forces created by the long lever arm of the ski or board that are transmitted to the knee ligaments. Commonly, the ACL is injured with a hyperextension mechanism or awkward twisting during a fall. 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. The ACL injuries often require surgical reconstruction. Success rates from surgery are excellent, but require aggressive rehabilitation and 9-12 months of recovery time before one can return to skiing or other twisting or pivoting sports.
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Proper Preparation 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. Several strategies can help prevent ski injuries, such as having the appropriate equipment and choosing ski runs that match your level of experience. Taking ski lessons is especially important for new skiers — learning how to fall correctly and safely can reduce the risk for injury. Even experienced skiers can improve by taking a lesson. Be sure you are in good physical condition before you set out on a ski outing. If you are out of shape, select ski runs carefully and gradually build your way up to more challenging trails. Many ski injuries happen at the end of the day, when people overexert themselves to finish that one last run before the day’s end. A majority of these injuries can easily be prevented if you prepare by keeping in good physical condition and stopping when you are tired or in pain.
Conditioning For Your Ski Trip Skiers can increase their safety and performance 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, particularly in females.
An example of a 6-week conditioning program in preparation for your ski trip: 1. Aerobic fitness (3 days/week for at least 30 minutes) Running Cycling Swimming Elliptical or stair climber Jumping rope Treadmill 2. Strength (2 days/week, 3 sets of 10 of each) Step-ups Lunges Wall squats Hamstring curls Toe raises Lateral leg raises Sit-ups 3. Flexibility (daily, 2 sets of 30 seconds each) Hamstring stretches Calf stretches Quad stretches Glut stretches 4. Balance Exercises (daily, 2 sets of 30 seconds) Standing on one leg, perform mini squats Single leg hop, holding landing for 5 seconds, repeat
Preparation On The Slopes Warm up - Research studies have shown that cold muscles are more prone to injury. Hydrate - Even mild levels of dehydration can affect physical ability and endurance. Drink plenty of water before, during, and after skiing. Know safety rules - Understand and abide by all rules of the ski resort. Ensure a Safe Environment - Stay on marked trails and avoid potential avalanche. Prepare for Injuries - Make sure everyone is aware of proper procedures for getting help if injuries. For more information regarding injury management or prevention contact one of the physiotherapists at Physio Professionals. Michelle Crew— Physiotherapist
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