Preventing Common Ski Injuries
Once again, many are heading north to the slopes and most will return invigorated, tanned, and happy. Some, unfortunately, will return with slings or crutches, pale and unhappy. Here are some common ski injuries and how to avoid.
Well over half of the ski injuries involve the lower extremities, and most of these favor the knee and leg.
Knee sprains are by far the most common injuries. The ligaments along the inside of the knee are injured when a skier catches the inner edge of a ski in the snow and the foot rotates outward as the body continues forward. Stress is then placed on the inner side of the knee, which is forced into a “knock-knee” position as the skier falls. The ligament will be stretched (sprained) if the force is minimal and if the bindings release. Otherwise, the ligament can be completely torn. Another potentially dangerous position is the “snow plow”—where both knees are knocked and the body weight is placed on the inner edge of the ski. A fall will place direct force against the inside of the knee.
Catching the outer edge of the ski may injure the ligament that lies along the outside of the knee. This can occur if the tips of the skis accidentally cross and the skier falls sideways. The leg on the side of the fall will twist inward and will remain straight. Stress is placed on the outer ligaments.
The new shorter, shaped skis place more stress on the knees than the former, longer skis.
Especially stress on the medial collateral ligiment(MCL).
Prevention of these injuries mainly centers around adequate bindings. It has been reported that a high percentage of lower extremity injuries result from a failure of bindings to release. Quality bindings properly mounted and maintained will prevent many knee injuries. Various knee braces can also be worn and, to some extent, can provide protection. A brace with metal sidings and hinges can comfortably be worn under ski pants and allow an acceptable degree of knee mobility.
Another common injury is the tibial fracture—or broken leg. This occurs when the leg is forced against the hard boot top during a fall. The leg can also break when the bindings fail to release and the leg is twisted. This torque can snap the bone. Again, proper bindings are the best insurance against this unfortunate and incapacitating injury.
If inadequate bindings are a cause of knee and leg injuries, faulty pole technique can contribute to upper extremity injuries—specifically the shoulder or thumb.
Shoulder dislocations are very commonly treated at base clinics. The shoulder can dislocate when a backwards force is applied to the outstretched arm and the shoulder is levered forward. Thus, a skier who falls on his outstretched (abducted) arm may sustain this injury. Frequently, however, the arm is levered by a planted pole; as the body continues forward, the arm is forcibly stretched and rotated outward, aggravating the injury and making a dislocation more likely. Slalom racers who grasp too long on their planted poles are especially susceptible to this type of injury.
A shoulder dislocation is very painful and requires immediate setting to relocate the joint. Multiple dislocations can eventually produce a damaged, unstable shoulder, and surgery will frequently be required to repair it. One way to avoid this injury is to be aware of the mechanism and try to eliminate excessive pole planting. Poles with strapless hand grips, which release better from the skier’s hand, may also prevent this injury. If a skier has a dislocated shoulder, he or she might consider a brace to check excessive shoulder stretching. These braces are custom made, but they are light, comfortable, and usually don’t interfere with normal skiing. They can be worn inconspicuously under the ski jacket. ( I have personal experience on this matter, as I dislocated my shoulder twice while skiing—once on a bunny trail at Stratton-when I first learned to ski—but again, and less embarrassingly, on a real black diamond trail—Nosedive—at Stowe, a few years later. I successfully skied down Nosedive without falling and ,of course, at the bottom on level terrain, slipped and fell. I had a custom made brace made which I wore thereafter and never again dislocated my shoulder.)
The other notorious injury caused by ski poles is damage to the ligament on the inside of the thumb. Since the pole is grasped between the thumb and the index finger, sudden force along the pole can jam the handle of the pole into the base of the thumb and injure the ligament. This is a serious injury which is treated with a cast and perhaps surgery. Pole straps incorrectly positioned can result in greater risk of this accident. A strap held around the palm just below the base of the thumb can be stretched. The strap should properly lie around the wrist, well away from the thumb. The risk of thumb injuries may also be decreased—although not eliminated—by using poles with a strapless type of hand grip.
Finally, here are five useful tips for prevention of ski injuries:
- Service your bindings at the start of each ski season.
- Stay fit prior to the ski vacation.
- Do warm-up exercises before you go out.
- Quit whenever you feel tired.
- Don’t be a daredevil.
Please note: these articles are for general information. They are not intended to serve as medical advice or treatment for a specific problem. Diagnosis and treatment of a problem can only be accomplished in person by a qualified physician.