By: Dr. ET Mejia
As I returned from our annual family ski vacation, I wondered what my office waiting room would look like, usually packed with patients that stacked up while I was out of the office. It occurred to me that this is the time of the year when I see a flood of winter sports injuries superimposed on the typical seasonal basketball, wrestling, hockey, and other outdoor activities.
While skiing in beautiful Big Sky, Montana, I couldn’t help but think of common themes that can contribute to a skiing injury. Some of these injuries include knee ligament tears, meniscus tears, patella dislocations, shoulder dislocations, rotator cuff tears, shoulder separations, and clavicle fractures, among others. One common denominator is an obvious one: less-experienced skiers are more susceptible to a skiing injury. However, there are other contributing factors, such as level of fitness, snow conditions, equipment, etc.
I decided to list a few items that can lead to a skiing injury and will hopefully raise awareness to winter enthusiasts as they flock to the ski slopes. I have experienced or witnessed most of these, so I am sure many of you can relate. These tips have nothing to do with skiing techniques, but with simple common sense.
Fatigue: This plays a huge role in ski injuries, just as it does in many other sports. The cost of ski trips can be substantial, and we all feel the need to get our money’s worth. Often we start the day without a warmup or even without pre-season fitness build-up. Skiers may feel fatigue setting in when their thighs get tired and they start to “feel the burn” or start cramping towards the end of the day. That is when the skiing gets a little sloppy and less crisp. It is a setup for disaster. The problem is that it can be cumulative. The next day the thighs are sore and you start the day in less than optimal condition. Most skiing injuries that I see have occurred either toward the end of the vacation or at the end of a day.
Terrain: It is self-evident that each individual should ski within their ski level. This is a hard one,since we all wish to improve and push the limits. It is helpful to go with someone that is sensitive to your skill level and knows the terrain better than you.
I get grief for spending a lot of time checking out trail maps, but it helps me stay out of trouble. Once you make a wrong turn, you may find yourself stuck going down a run that is more difficult than you can handle. That may be the time where you either skate back to where you made the wrong turn, or take off your skis and walk back.
I sustained an ACL tear 27 years ago skiing “off piste” (outside trail boundaries) through trees. It was exhilarating, but one wrong twist made a huge difference in my knee forever. Finally, moguls can be the breaking point for some skiers, especially in steep conditions or when the skier is fatigued and sloppy.
Ski conditions and visibility: These are huge factors which can make any terrain more treacherous. Freezing rain can coat your goggles, blowing winds and snow can create white-out conditions, and deep powder can make it difficult to maneuver. Icy slopes can also affect your maneuverability, and frankly, they are not fun. It is best to plan ahead, be aware of weather for the day, and avoid hazardous ski conditions, even if it calls for skipping a day.
Pride: This is another tough one, since often people ski in groups. You are encouraged to follow the leader, often in terrain that is beyond your ski level. It may be equivalent to “hanging with the wrong crowd.” There is nothing wrong with saying, “I’ll meet you at the end of the run,” and taking an easier trail, instead of slugging it out with the rest of the group. There is no shame in sticking to groomed trails and advancing at your own comfort level.
Awareness: A skiing injury can occur with collisions or “close calls”. Like car accidents, often the injured skier is not at fault. The aviation term, “head on a swivel” comes to mind. It is best to be a defensive skier, just as we should be defensive drivers. You will be prepared to make a correction by assuming that the skier near you or above you may make a sudden unexpected turn. If you are passing someone, make them aware of where you are. Likewise, be listening for noise behind you, which means that you should not be wearing earphones or earbuds while skiing!
Equipment: This one is obvious, and I am by no means qualified to give advice on equipment. However, tuning your skis, checking the boots and bindings, and preparing your gear ahead of time will hopefully keep you out of trouble. Rental equipment usually means equipment that you are not familiar with. The binding release is set according to ski level and weight, so be honest with yourself about these when communicating with rental staff. You can always tweak the binding release later in the day. The same goes with new equipment, or switching from skiing to snowboarding and vice versa. Take some time on the easier slopes to familiarize yourself with the gear. This goes back to Pride and Terrain as stated above.
Hopefully these reminders will be helpful for injury-free enjoyment of our winter season. As for all outdoor activities, planning and prevention are critical for safety.