Its that time of year again when many of our clients, and possibly some potential clients, head to the slopes for an annual week or two of exhilarating downhill skiing.
Now, skiing is a fantastic sport, but unfortunately it can yield many injuries, Here we cover a few of the most common downhill ski injuries and add a few tips to try to help you prevent injuring yourself, and ruining that all important holiday.
The most common sites for injury are the knee, head and shoulder.
Knee injuries.
Since in down hill skiing the ankle is usually supported in a rigid boot, the knee takes more than its normal share of injuries as forces are transferred up the limb to the knee. Knee ligament injuries are a common feature in skiing, and injury can occur to any of the medial, lateral or cruciate ligaments. The lateral and medial ligaments can be injured in collisions or falls, or in the case of the medial ligament, even when the leg is pulled out in the snow plough position, or catching an edge in the parallel position. Injury to the medial ligament of the knee is indeed the most common of all alpine ski injuries, accounting for 20-25% of all injuries.
The anterior cruciate is also commonly injured. Again this can be through collision and falls, or twisting when catching the ski. However it can also be injured when landing from a jump, when the skier sits right back on their haunches.
Other knee injuries occurring are meniscal tears (cartilage) and fractures, which again are commonly injured in falls and collisions.
Treatment of injuries will normally follow the RICE protocol for soft tissue injuries, (Rest, Ice, Compression, Elevation). However with the more severe ligament tears, for instance the anterior cruciate (ACL), repair and reconstruction operations are occurring more frequently in resorts. This is quite controversial. In the UK it is generally deemed best practice to wait for the initial injury to settle down before performing surgeru, usually at least 6 weeks later. In some areas though, for instance France and USA, surgeons are performing ACL reconstructions immediately. Who is right or wrong will be debated for years to come. There are pros and cons to both arguments, but if you find yourself in the unfortunate position of having to decide between immediate surgery and waiting, ensure you have a lengthy discussion with the surgeon before proceeding.
Shoulder injuries
The worst shoulder injuries sustained when skiing tend to be through fall and collisions. Dislocation from falling onto the shoulder or an outstretched hand is common, treated in hospital for relocation. Do not let any want to be medic in your group try and relocate your shoulder as he has seen it done in casualty or on a sports pitch. This is usually tried by putting a foot in the arm pit and pulling on the arm. When done by someone experienced and trained relocation can occur easily, but it often needs doing under anaesthetic and if performed wrongly will be extremely painful and can result in nerve damage. I speak from experience, I saw it tried on a rugby pitch by a qualified doctor, and I wouldn’t swap places with the poor chap who was screaming in agony after 1/2 hour of continued, failed attempts, even if you offered me a million pounds.
Fracture of the clavicle and acromio-clavicular joint strains often occur after falls onto the point of the shoulder, treated with slings and rest initially, and then physio.
Fractures of the humerus (upper arm bone) also occur from falls / collisions, and may result in operations to reduce the fracture and stabilize the bone with pins/ screws.
Head injuries, again from collisions and falls, can account for up to 20% of ski injuries. The injury is from impact, and this can be with another skier, another structure or piece of equipment, and also the skiing surface. Most head injuries are minor, being cuts and abrasions, but they can be serious and unfortunately sometimes (although happily rarely) fatal. The onset of helmets in recent years has gone from geek to cool, which can only be a good thing.
Spinal injuries
The two main causes of injury in skiing are flexion/hyperextension injuries, (similar to whiplash) and compression injuries. The former affects the cervical spine, and can result in soft tissue and joint injuries, along with nerve damage and fractures. Collisions again are the most common cause of this type of injury, but it can also be caused from losing control or from jumps.
Compression injuries occur when landing from jumps, commonly from landing on ones bottom, occasionally from landing on extended knees. Compression injures in the neck also occur from landing in the head / neck in a fall. Again serious injuries are rare but do occur.
Thumb Injuries
I was going to leave this one out, but thought that as one injury has the name skiers thumb, thought it would be a big ommission that I would be castigated for by my physio friends. Skiers thumb is a rupture or sprain of the Ulna Collateral Ligament, usually caused by the thumb being forced outwards by the ski pole. Treatment required is immobilisation and can lead to surgery. A good test if this is suspected, if the skier has made it back to the bar, is to ask the injured person to hold a pint glass. Often they will drop it, so dont fill it with any expensive liquid beforehand.
I will add our tips for preparation and avoiding injury soon.
I would like to thank the website ski-injury.com for some of the info and statistics provided in this short article.
