Ski Safety Tip: Drop the Poles

No one plans to fall during a ski run, but if it happens you can avoid a hand injury known as skier’s thumb simply by letting go of your ski poles.  

Along with other skiing-related injuries such as concussionstorn knee ligaments and shoulder dislocations, skier’s thumb one of the most common conditions Dr. David Wei and the other specialists at the ONS Hand & Upper Extremity Center see during ski season.

While not as serious or debilitating as the other skiing calamities, skier’s thumb can be extremely painful. It can limit the ability to perform many common daily tasks such as grasping or opening jars, pinching your fingers to pick up something or writing with a pen.  And it’s a stubborn injury. It can take 4 – 6 weeks to heal and sometimes longer.

WHAT IS SKIER’S THUMB? 

Skier’s thumb occurs when one of the two main ligaments that support the thumb, the radio- collateral ligament, is abruptly stretched beyond its limits. It is typically referred to as skier’s thumb because it commonly results when a skier falls with an outstretched hand while holding a ski pole. But, this condition can occur in other contact sports where the thumb is vulnerable to injury, such as football, rugby, or lacrosse. Most often, the ligament is strained when the thumb is jammed backwards and out to the side, but strains can occur on any side of the thumb.  Although skier’s thumb is typically caused by a single accident, repetitive gripping and twisting motions can create a painful chronic condition.

SYMPTOMS OF SKIER’S THUMB 

The most common symptoms of skier’s thumb include swelling, throbbing pain, and decreased range of motion. Bruising can appear a few days after the incident.

  • Pain is at the base of the thumb, usually at the side of the web space between the thumb and index finger

  • Swelling is usually at the base of the thumb

  • Pain, weakness or difficulty gripping using the thumb and index finger

  • Bruising along the inside of the thumb

  • Pain when moving the thumb

TREATING SKIER’S THUMB 

Moderate, partial ligament injuries may be managed with ice compression, anti-inflammatory medication and immobilization using a splint.  However, Dr. Wei, notes, “If the thumb is unstable during physical exam, an MRI can help determine if a special lesion, known as a Stener lesion, is present.  If this is the case, surgery may then be required for proper healing of the ligament and stability of the joint.”  Surgery may also be necessary if the ligament suffered a complete tear and is very unstable.

During recovery from this injury, either with nonoperative or operative treatment, a certified hand therapists may be called in to help rebuild strength and mobility to the thumb.

PREVENTING SKIER’S THUMB 

Experts advise skiers to keep the hands outside of the pole straps so they can easily drop and release during a fall.

 

Getting Ready for the Slopes: Ski Conditioning

chalonChalon Lefebvre is the Clinical Manager and Coordinator for Education at ONS Physical Therapy. Chalon is from Vermont where she was a ski racer and continues to lecture on ski injury prevention, the following is her expert advice for the season:

Certain exercises come to mind when I think about growing up as a ski racer in Vermont. Wall sits, crunches, push-ups, lateral bounds and lots and lots of box jumps got me into shape but were they really the best exercises for ski conditioning? Not necessarily, but they were on the right track. As a physical therapist, I now understand skiing and the biomechanics that go along with the sport. I understand the appropriate exercises that help to prevent injury while conditioning people so they are ready to enjoy the season.

Skiing can be broken down into concentric (muscles shorten/lifting portion of the movement against gravity) and eccentric (lowering portion while lengthening) movements. Skiing starts at the top of the mountain, as you ski down, you perform eccentric movements the entire way, resisting gravity’s pull by controlling your body’s movements. EMG studies have shown that throughout the ski turn, the prime movers and stabilizers change at different points in the turn and therefore it is important to work your muscles in functional patterns consistent with the sport.

1) Lunges are an amazing exercise for skiers. Lunges work the quadriceps, glutes and hamstrings. Both your legs are working independently of one another in concentric and eccentric motions. To perform a good lunch, stand with both feet positioned shoulder width apart and step forward with one foot making sure to step far enough so that your knee does not extend past your toes and your shin is nearly vertical, and then step back into the start position. This exercise can progress to walking lunges or by lunging while holding dumbbells in your hands. Once you are proficient, you can make these a plyometric exercise by jumping in between each lunge.

2) Squats, whether one footed and two footed, work your quadriceps and glutes. Start with your feet shoulder width apart with your back slightly arched. Initiate the squat by sitting back and down keeping your weight through your heels. Lower yourself so that your thighs are parallel to the floor (or as low as you can) being careful not to let your knees fall in front of your toes. This exercise should be done at high repetitions for endurance.

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3) The Romanian deadlift is one of the best and most functional hamstring exercises. ACL tears often occur because people have a strength imbalance between their quadriceps and hamstrings. Stand holding a barbell or a dumbbell in each hand with your feet shoulder width apart. Maintain the lordosis in your lower back and keep a slight bend in your knees, lower the weight towards the floor until you feel a slight stretch in your hamstrings. Reverse the movement by contracting your hamstrings and glutes and push your hips forward as you return to the starting position. This exercise can also be done on one.

4) Planks and side planks work your abdominals, erector spinae, and glutes. Both of these exercises will provide you with the core strength that you need to be able to hold yourself upright while skiing. Lie on your stomach; place your hands at either side of your chest and tuck your elbows in at your sides. Keep your back flat, and push up onto your toes and elbows so that your body is off the floor. Pull your abdominals into your spine and try to maintain this position for 10 seconds to two minutes. If this is too challenging, this can also be down on your knees. A side plank is done using one arm and on one side at a time.

5) Lateral bounds work on agility and reaction time and when done consecutively will carry over to your ski turns. They can be done one footed or two footed. Create a line on the floor and jump sideways across the line, when your feet land, immediately jump back to the other side. This can be done for time as well as number of repetitions.

Although this is just a taste of what I would include in a ski conditioning program but are some of my favorite exercises for keeping my clients injury free and having fun on the mountain.

Looks like more snow is in the forecast, we have some skiing tips for you!

skierThe knee is the most vulnerable body part for any athlete, including skiers. Downhill skiing produces large amounts of torque on the knee, challenging the integrity of ligaments and tendons. Whether from a fall or overuse, the most common injuries in skiers are tears to the MCL (Medial Collateral Ligament) or ACL (Anterior Cruciate Ligament), two important structures that give our knee stability.  When a skier is thrown off balance, his skis will sometimes shoot out in front of him, creating extra torque on the knees and damaging our stabilizing structures.

Both novice and experienced skiers are at risk of hurting their knees. We frequently see novice skiers hurt themselves when they do not know how to turn, stop or fall properly. Taking lessons and working with an instructor goes a long way in preventing knee injuries for beginner skiers. Experienced skiers frequently take risks and assume that they can manage faster speeds on any slope.  Many injuries, whether you are a beginner or an experienced skier, are related to weather conditions. It is important to realize that as visibility and surface conditions deteriorate, the slope or trail level goes up. In poor visibility or icy conditions, a beginner trail becomes an intermediate trail, and an intermediate slope becomes advanced slope. Keep injury prevention in mind, if the conditions are difficult, ski down a level.

A second reason injuries occur is fatigue. Most skiers’ bodies are not accustomed to exercising 6-8 straight hours. In addition, many skiers push their bodies to take advantage of the whole day, even when they start to feel tired and stiff.  For this reason, injuries tend to happen at the end of the day.

Having the knowledge of what places skiers at a higher risk for knee injuries, we are passing on recommendations about how to stay safe on the slopes.  Both beginners and experienced skiers can benefit from these tips!

  1. Start a conditioning program a few months before your first ski trip. Leg strengthening, flexibility and balance are important aspects of an adequate ski conditioning program.
  2. Ski with good technique. Maintain your balance and control, keep your hips above your knees, keep your arms forward, and maintain a safe speed.
  3. Learn how to fall correctly: keep your legs together, keep your chin to your chest and your arms up and forward.
  4. Pay attention to weather conditions and remember to ski down a level if conditions deteriorate.
  5. Listen to your body. If you start to feel pain or stiffness upon exiting the lift chair, then you should probably make that run your last. Head to the lodge and enjoy a warm drink by the fire.

Good luck and stay warm!

If you become injured, while skiing, remember, ONS sports medicine physicians are trained at the top universities and hospitals in the country and have expertise in the latest treatments for sports-related injuries in high-performance and recreational athletes.

Orthopaedic and Neurosurgery Specialists, PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit https://onsmd.com/ or call 203.869.1145.

 

Ever Injured Yourself Skiing or Snowboarding?

Have you ever injured yourself skiing or snowboarding? Injuries on the slopes can ruin a good season, even for the pros. Just last week, we posted Dr. Katie Vadasdi’s discussion about the knee injury of Olympic Gold Medalist, Lindsey Vonn whose injury forced her to pull out of the upcoming Sochi 2014 Winter Olympics. Recently, another famed Olympian suffered an ankle injury.

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Two-time Olympic Gold Medalist, Shaun White suffered a sprained left ankle Thursday during the Slopestyle qualifiers. He landed the Olympic spot in Slopestyle but decided not to attend the X Games in Aspen this coming weekend.  “So far, the plan is still not to attend X,” White said Friday. “Especially considering how much work this has been to qualify for the Olympics. It’s that time of, what do I really want to work on before the Olympics and you’ve only got one week to really crank it out.”

ONS orthopedic and trauma specialist surgeon Steven Hindman, MD, who specializes in foot and ankle surgery and is a panel speaker for topics such as ski and snowboarding injuries shared his expert opinion on Shaun’s decision saying, “I think he made the right decision in taking a break this weekend and not attending the X Games. Shaun White, being one of the best, if not, the best athlete in his sport, knows what he can and cannot handle. He knows he can push the very difficult tricks and moves that he does. The Olympics are once every 4 years, it is critical to prepare and not over-do it especially when healing a previous injury.”

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Another expert opinion came from ONS orthopedic surgeon Michael Clain, MD, who specializes in foot and ankle surgery and sports medicine. Dr. Clain said “most ankle sprains are fine with rest, immobilization and rehab. I’d expect him to be able to compete just fine at the level for which he qualified for.”

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When you have a mild sprain, remember rest, immobilization and rehab are best before you head back to the slopes.

For more on ski and snowboarding injury prevention, click below
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For more on foot and ankle conditions and treatments, click below https://onsmd.com/specialty/foot-and-ankle/

Orthopaedic and Neurosurgery Specialists, PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit www.onsmd.com or call 203.869.1145.