By Michael Cushing, MD
Georgia Bone and Joint, LLC
Ski and snowboarding injuries are coming in to our office. The snow is on the slopes, the chair lifts are up and running and the weekend warriors are out. The combination of poor conditioning, inflexible joints and stiff muscles leads to injury on the slopes.
Skiing injuries involve the knee 45 percent of the time. Other common joints injured skiing include the thumb (skier’s thumb) and the shoulder. Younger, lighter and less experienced skiers are at increased risk. Beginners are 33 percent more likely to get injured than the experienced skier. Females commonly injure their knee, while males have more shoulder and head injuries.
The most common knee injury is rupture of the medial collateral ligament(MCL). This occurs when an edge of a ski catches or the skis diverge away from the body. Because the MCL has a good blood supply, the injury is usually treated conservatively with bracing for 4-8 weeks. The next most common injury to the knee is rupture of the ACL (anterior cruciate ligament). When a skier falls back on their skis and then contracts their quadriceps to regain balance, this puts a significant stress on the ACL and leads to rupture. Typically, in young and active patients, this requires surgical reconstruction. The success rates of surgery are excellent. It requires aggressive rehabilitation and six months recovery to return to sports/skiing. Also injured in the knee are the meniscus. The meniscus are two rings of cartilage that sit between the two bones of the knee. The meniscus is commonly injured when the foot is fixed and the knee is twisted. Arthroscopic surgery is often needed to treat these injuries.
Skier’s thumb occurs when a pole pulls the thumb away from the hand. There is a very important ligament at the base of the thumb that ruptures. This injury is commonly treated with a period of immobilization. Occasionally, surgery is required for the more severe injuries. Two common injuries to the shoulder are AC joint sprains and clavicle fractures. The AC joint is where the clavicle meets the scapula (wing bone). When a skier falls on the point (superior aspect) of the shoulder, the ligaments that hold the clavicle to the scapula are torn. Again, this injury is commonly treated conservatively with a sling for four weeks. The more severe the AC joint sprains are treated with surgery.
As with any injury, prevention is the key. Proper preparation and conditioning will help reduce the risk of injury from skier fatigue. Preparing for a ski trip should include an exercise program for 6-12 weeks before going skiing. This would include aerobic fitness like an elliptical, cycling or running 3-5 days a week. A strength program and a flexibility program concentrating on the lower extremities (hamstrings, Achilles and Quadriceps) are important as well. There are some important safety measures to take before you ski. Most importantly is proper equipment and equipment maintenance.
Lastly, warming up and down effectively as well as stretching before are important steps to take. A ski trip is much more enjoyable when injury is avoided.
For more information, visit www.georgiaboneandjoint.org