by Dr Donald Kuah

The Australian domestic ski season is quickly approaching, and like most sports, preparation is the key. The difference is that unlike many other sports, many participate in snowsports who are generally unfit, sedentary, or only participate in the sport once or twice a year. The injury patterns in recent decades have been influenced by the rise in snowboarding and also the drastic changes in the ski shape and technology of ski equipment.

SOME QUICK FACTS

• Snowboarders are three times more likely to be injured in a jump than skiers.
  
• Collisions (objects or people) account for only 10% of injury in boarders (less than skiing) .
  
• Skiing off-piste raises the risk of injury eightfold
  
• Knee injuries from skiing are common and account for 1/3 of all skiing injuries.

INJURY PREVENTION

Some key recommendations for reducing risk of injury:-
  Prepare before heading down to the skifields, improving flexibility, fitness and snow specific strengthening. A good sports physiotherapist or exercise physiologist familiar with snowsports can provide a good programme
  Avoid skiing/boarding till fatigued
  Avoid skiing/boarding under influence of drugs or alcohol
  Avoid skiing/boarding beyond your abilities
  Do ski with friends and take lessons if you feel the need
  Ensure your equipment is safe and in good working order

COMMON SNOWSPORT INJURIES

KNEE INJURIES - The most common knee injuries are ligament tears such as medial ligament and anterior cruciate ligament (ACL). Cartilage injuries, kneecap dislocations and fractures are also not uncommon. The key initially is to minimize swelling and loss of quadriceps muscle and to seek an accurate diagnosis.

ANKLE INJURIES - These are seen most commonly in snowboarders and more often than not, involves a fracture. The ankle tends to be well protected in a ski boot.

SKIER’S THUMB - This is a fairly common ski injury and if not taken seriously, can result in long term pain and weakness with your pinch grip.

SHOULDER INJURIES - Common shoulder injuries include dislocations, clavicle fractures, rotator cuff tears (in older people), and A-C joint injuries.

WRIST INJURIES - Wrist fractures have become far more common on the ski field since snowboarding was introduced in the 1990s. Wrist injuries have been reported to make up 20-40% of snowboard injuries. Of these, two-thirds are fractures. Hence, if you sustain a wrist fracture whilst boarding, you should seek medical attention and consider getting an xray.

INITIAL INJURY MANAGEMENT

For acute injuries the principles of the R.I.C.E.D. regimen should be followed:

Rest
Minimise weight-bearing activity.

Ice
Generally 20 minutes every 2-3 hours when awake
(educate patient to avoid ice burns)

Compression
Use a double Tubigrip® bandage
(for convenience and compliance of icing) or crepe bandage

Elevation
Preferably above level of the heart
(should include bedtime)

Diagnosis
Seek help from your health professional

Oral anti-inflammatories for 5-7 days may also be helpful. If injured, you should also avoid H.A.R.M.

Heat
Includes skin lotions, lamp, spa and sauna

Alcohol
Increases swelling

Run / ski / dance (etc)

Massage
Leads to increase blood flow and, therefore, swelling

CONCLUSION

Skiing and snowboarding are the dominant snow sports in Australia. Preparation is key to injury prevention, but accidents still occur. If injured, seek appropriate medical attention. The ski patrol in each of the ski resorts are well trained first aiders and a re a good first port of call.