Ski team doc offers injury prevention tips

Most of the 28-plus million Americans who take to the slopes each winter are well aware of the preparations that need to be made to ensure safety — from preseason strengthening and flexibility workouts to servicing equipment. But many ski and snowboard enthusiasts still approach the first few runs of the season with some apprehension. The fear: an early season injury that could relegate them to the lodge for the rest of the winter.

MOST OF THE 28-PLUS MILLION AMERICANS who take to the slopes each winter are well aware of the preparations that need to be made to ensure safety — from preseason strengthening and flexibility workouts to servicing equipment. But many ski and snowboard enthusiasts still approach the first few runs of the season with some apprehension. The fear: an early season injury that could relegate them to the lodge for the rest of the winter.
    "After months off the slopes, the body needs time and practice to readjust to the physical requirements of skiing and boarding — even when participants have spent months training in advance of the season," explains Dr. Kevin Plancher, a leading New York-area orthopedist and an official surgeon of the U.S. Ski and Snowboard teams. "This is a time when novice and expert alike, for different reasons, may be prone to injury." Dr. Plancher explains, while new skiers and boarders are likely to sustain an injury relating to inexperience, the more advanced participants can become injured when attempting to do too much too fast. "Expecting to jump right back in to the sport at the level at which they left off in March can get many well-trained, experienced skiers and boarders into trouble early in the season," Dr. Plancher warns.

Avoiding early season injury
    Skiing and snowboarding are among the most physically demanding sports, due in large part to the stress they place on the ligaments in the body. "Ligaments are responsible for providing much of the body’s flexibility, which is critical in a sport like skiing or snowboarding," Plancher says. "The most relied-upon ligaments — and the most prone to injury — in skiing and snowboarding are those of the knees [about 25 percent of all ski injuries], followed by the hands. We frequently see early season injuries that affect the anterior cruciate ligament and the medial meniscus in the knee, along with the ulnar collateral ligament located at the base of the thumb webspace," Plancher explains. While knee ligament strains and tears can occur during active skiing and boarding, most injuries to the thumb happen during a fall, when the grip on the ski pole can jam the thumb backward, causing an injury now known as "skier’s thumb."
    Dr. Plancher recommends these steps that skiers and snowboarders can take during the first few excursions of the season to reduce the risk of early injury:

• Get the lay of the land: Even if participants are visiting a resort they’ve skied or boarded before, Dr. Plancher always recommends reviewing slope maps, lift systems and resort policies for any changes that may have been made during the off-season. "Know key information, such as the location of first-aid stations and the guidelines regarding mid-run injuries," he advises, adding that injured skiers and boarders on the slopes can pose additional collision hazards to themselves and to others if they are not quickly relocated to a safety zone.

• Take a refresher course: "A brief 30-minute group or private lesson provides an opportunity for novices to practice in a controlled situation, and allows experts to hone skills that have lain dormant for months," Dr. Plancher points out. He encourages skiers to practice falling safely as well, paying attention to the positioning of poles and bindings to reduce risk of ligament strains. “What’s more, a lesson will give participants insight into the particular resort’s topography, the day’s snow and weather conditions, and other variables that can affect performance.”

What to do if you sustain an early season injury
    "The good news," Plancher says, "is that most ski- and snowboard-related ligament injuries are not serious." However, failing to recognize and properly treat minor injuries can cause them to manifest into more complicated health issues. Following are guidelines for assessing and treating an early season injury to maximize recovery and hasten a return to the slopes:

• Recognize the injury: "The temptation to ski or board through an injury, especially in the first few days of the season, is understandably high, because participants have been waiting for months to return to a sport they love," Plancher concedes. "However, recognizing the injury and relieving pressure on the ligaments immediately are critical to reducing the long-term affect of the injury and getting them back onto the slopes as quickly as possible," he advises. Sudden pain after a fall or during a maneuver in which the ligaments are in flex, or a "popping” sound at the knee followed by acute pain, are signs of ligament injury and should prompt skiers and boarders to seek help in evacuating the slope.

• RICE: Few sports enthusiasts are unfamiliar with this term, which stands for Rest, Ice, Compression and Elevation. Plancher recommends icing a sore joint in 30-minutes on/30-minutes off intervals for up to three hours. "If swelling and pain remain the same or worsen during that time, patients should seek medical attention," he advises.

• Consult an expert: Skiers and snowboarders who want the fastest possible return to the season should consult an orthopedic sports medicine physician to evaluate the injury. "There are many options — from physical therapy to orthopedic braces and other devices — that can help speed healing and hasten a patient’s return to the slopes," Dr. Plancher reveals. "In addition, an orthopedic specialist can provide a number of leading-edge surgical options that reduce both the invasiveness and the recovery time usually associated with surgery," he explains. "It can be possible today to have injuries surgically repaired in October or November and be back on the slopes for the new year," Dr. Plancher concludes.

Kevin D. Plancher, M.D., M.S., F.A.C.S., F.A.A.O.S, is a leading orthopedic surgeon and sports medicine expert with extensive practice in knee, shoulder, elbow and hand injuries. Dr. Plancher is an Associate Clinical Professor in Orthopaedics at Albert Einstein College of Medicine in New York. He is o
n the Editorial Review Board of the Journal of American Academy of Orthopaedic Surgeons and the American Journal of Medicine and Sports. Check out his site at www.plancherortho.com.