PREVENTING ALPINE SKI INJURIES

The commonest injuries seen amongst alpine skiers are knee sprains, thumb sprains and shoulder injuries.

(a) The commonest single injury to an alpine skier is a grade I-II sprain of the medial collateral ligament on the inside of the knee. Usually these result from a twisting fall when the lower leg bends outwards relative to the thigh. An additional factor may be a failure of the ski binding to release. These injuries also result from a ‘snowplough gone wrong’, especially when the skier has a wide,  unstable stance (as in the picture on the right). Although no releasable ski binding currently available could ever claim to protect the skier against all such injuries, correct functioning of the boot-binding interface maximises the chances of correct binding release occurring and consequently reduces the risk of this injury. To keep your boot-binding interface in top condition, I recommend the following:

Have your bindings serviced at least once a season – bindings are mechanical devices that require cleaning, lubrication, and re-setting. Think of all that salt, dirt, rust etc playing havoc with the internal springs….. Studies have shown that un-serviced bindings are less likely to release because (for example) although they may be set at say 6, in fact the springs have become a bit stiffer through lack of care and as a result they actually act as if they were set at 8. Ideally, if you ski alot you should have your bindings serviced every 15 ski days.

Avoid walking about too much whilst wearing your ski boots. The sole of the boot is designed to fit snugly into the binding plate so that it “transmits” accurate information between the ski, the binding and your lower leg. If the ski boot sole becomes worn down, the efficiency of the boot-binding interface may be compromised

If you are hiring your gear, always go to a reputable rental facility and, if the staff or equipment don’t inspire confidence, go elsewhere. Carving skis should be the norm now and it’s worth paying a bit more money for good quality kit. A lack of carving skis in a rental facility may be an indication to go elsewhere.

Never borrow someone else’s skis unless either you or they know what you’re doing and can properly readjust bindings to the correct settings! As already mentioned, our research indicates that those who borrow gear are 8 x (yes, eight times!) more likely to be injured than

Finally – and most importantly, get into the habit of performing a test on your ski bindings everyday. This simple procedure ensures that your bindings are set correctly for your needs, has been demonstrated to reduce the risk of injury and is endorsed by experts from the International Society for Skiing Safety. The link above will take you to a page with more detailed information about this procedure.

(b) Certain situations increase the risk of a serious knee sprain (anterior cruciate ligament tear). The commonest mechanism of ACL injury is the so-called ‘Phantom Foot’ which classically occurs in three situations….

1. Attempting to get up whilst still moving after a fall
2. Leaning right back on your skis or attempting to sit down after losing control
3. Attempting to recover from an inevitable fall

To avoid such injuries –

► In a fall, keep your arms forward and your hands over your skis if possible
► Don’t fully straighten your legs when you fall – try and keep them bent
► After a fall, don’t try to get up until you have stopped

Recent ACL friendly developments included Lange’s rear release boot system. This seemed to be a positive step towards reducing the incidence of ACL injuries – but sadly did not prove to be a commercial success and is no longer available.  Recent binding developments may offer a new ray of hope in the fight to reduce ACL injuries from alpine skiing.

(c) Skiing with your hands inside the ski pole straps incorrectly can lock your hand to the pole in a fall, the pole then acts as a lever on the thumb and this greatly increases the risk of injury to the thumb joint.  Whilst no one device or piece of advice has any direct evidence to support its use, using the pole straps correctly should help. Some researchers advocate that you should ski with your hands outside the pole straps (i.e. don’t use the pole straps). Two exceptions to this rule would be when skiing in deep powder snow on piste though where the loss of a pole could be a major problem, or if skiing off-piste when poles may help you to “swim” in the event of an avalanche.

(d) Contrary to popular belief, it has been proven in several studies that skiers are more likely to collide with and injure fellow skiers than are snowboarders. Keep a close eye on everyone else on the piste! It is the responsibility of the uphill skier or snowboarder to avoid collisions with those below them (just as in a car accident, the rear car is usually held responsible in a front/back

(e) If you have already sustained an ACL injury and/or undergone reconstructive surgery, consider wearing a hinged knee brace Ottawa.

If you have any questions or would like additional information on this matter please speak with your physiotherapist at any of our three locations which can be found at our Orleans physiotherapy, Westboro Physiotherapy and Barrhaven Physiotherapy locations.

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PREVENTING SNOWBOARDING INJURIES

The commonest injuries are to the wrist, shoulder and head. The risk of sustaining a fracture is at least twice that of skiers.  If you have any questions or would like additional information on this matter please speak with your physiotherapist at any of our three locations which can be found at our Orleans physiotherapy, Westboro Physiotherapy and Barrhaven Physiotherapy locations.

(a) The main concern for snowboarders (especially beginners) is the risk of a wrist fracture. It is estimated that 95,000 wrist fractures occur world-wide every season amongst snowboarders, although (again) the absolute risk of an injury is still very low with one wrist fracture for every 1200 days snowboarding. The problem is that the natural reaction to falling having lost balance on a snowboard is to land on an outstretched hand. The forces of the fall are absorbed by the wrist joint and injury results. Beginners, being more likely to lose balance (and fall) are at the highest risk of injury of all.

Wrist guards have now been conclusively shown to reduce the risk of a wrist injury and ideally should be worn by all snowboarders – but beginners especially. For the reasons why and much more information on wrist injuries and wrist guards click on the relevant links on the left . On the wrist guard page, you will also find specific information on some recommended wrist guards.

(b) Soft boots are recommended for beginners – they allow more maneuverability.

(c) Consider attaching the board to your lead foot with a security leash. Secure this before getting into your bindings to prevent a “runaway” board which could cause injury to others as well as being an expensive loss to you!

(d) Stop on one side of the piste and kneel or stand facing up-hill in order to see oncoming traffic rather than sitting down in the middle of the piste.

(e) The rear foot should be detached from the bindings when ascending on lifts. Be careful when one foot is out of the binding though – in effect you have a “fat ski” on one leg and are prone to knee injuries from unexpected twists (e.g. when using a surface lift like a T-bar or when dismounting from a chairlift)

(f) Be aware of the so called “snowboarder’s ankle” – this is a fracture of the lateral process of the talus bone in the foot and is very important as it can lead to long term arthritis if undiagnosed and not treated correctly. It resembles a bad ankle sprain and one major problem is that most doctors outside of ski areas will never have heard of it!! If you have persisting pain in your ankle 7 days or more after an injury from boarding this is a possible reason! Get on to your doctor – it can need a CT scan to diagnose as plain x-rays don’t show this area of the foot up very well. Be persistent or your pain will be!!!! 

(g) If jumping, always get someone else to act as a “spotter” for you near the landing area – this should ensure that neither you nor someone else get a nasty shock when you come in to land. We know have some detailed information on the risks and patterns of injury associated with terrain parks.

(h) As I’ve already mentioned, watch out for tree wells – basically holes under big trees which have a deceptive covering of snow. Often these lie just to the side of marked pistes and are like the pits of trapdoor spiders! Fall in without someone seeing you (and this is usually what happens) and you’re in BIG trouble! Ongoing research indicates that snowboarders are at higher risk of tree wells than skiers.