Winter Sports Injuries Can Be Debilitating And Difficult To Diagnose

FARMINGTON — The number of skiers and snowboarders heading for the slopes is climbing, and so is the number of visits to hospital emergency rooms with ski and board related injuries. Sports medicine expert Robert Arciero, MD, an orthopedic surgeon at the UConn Health Center, has some helpful tips and information about two particularly worrisome injuries that can befall snow-sport enthusiasts.

ACL injury – the injury Alpine skiers fear most. The anterior cruciate ligament, commonly referred to as the ACL, is located in the center of the knee and is one of the knee’s most important stabilizers. An injury to the ACL, which crisscrosses with the posterior cruciate ligament, often requires surgery and long rehabilitation. This injury can put a skier in the lodge instead of on the slopes, for many seasons to come.

As with so many medical problems, prevention is the best treatment, said Dr Arciero. “Start with a conditioned body -- the legs, trunk, and cardiovascular system. Be sure bindings and boots are properly fitted and adjusted for weight and ability,” he said. “In the event of an accident, the risk of injury can be reduced through technique and the right response.”

According to Dr Arciero, the two most important things a skier can do to prevent an injury are to always maintain balance and control and to learn how to fall correctly. “When you’re falling, it’s not so easy to think about how you’re falling, but try to keep arms forward, skis together, and hands over the skis,” he said. “Avoid landing on your hand, keep your knees flexed once you’ve fallen, and don’t try to get up while you’re still sliding.”

Dr Arciero said an ACL injury is most likely as the skier loses balance and the downhill ski continues to turn. This forces the legs to twist in opposite directions and the back of the ski causes the knee to twist, he said. “High stiff boots may prevent ankle and leg injuries, but can contribute to knee injuries because of the twisting action.”

Snowboarders beware of an LPT injury, snowboarder’s ankle. Fracture of the lateral process of the talus bone in the ankle has become more and more common among snowboarders. It happens most often after a jump. According to Dr Arciero, the combination of compression, and the ankle turning in, can cause an ankle sprain or the more serious LPT injury. What makes an LPT injury problematic is that it is difficult to diagnose. The injury often mimics a simple ankle sprain and is frequently undetectable on a normal X-ray, said Dr Arciero.

“If a snowboarder still has severe pain or cannot bear weight on an injured ankle after a week, he or she should seek medical attention and tell the doctor about the injury. It may need a CT scan to diagnose the problem,” he said. “Left untreated, an LPT injury can lead to the early development of arthritis and long-term disability leading to severe degeneration of the ankle joint.”

The US Consumer Product Safety Commission estimates that 84,200 skiing injuries and 37,600 snowboarding injuries were treated in US hospital emergency rooms in 1997. The most common injuries were to the knee and ankle sprains and fractures.

Dr Arciero said remember conditioning, equipment, balance, and control, and if that doesn’t work, fall well. “Hijinks on the slopes is not a good idea,” he said. “Serious injuries can occur, or worse.”

General safety tips for skiers and snowboarders:

Beginners, seek out instruction. Learn from an expert instructor. Injuries are more likely to befall a novice. A beginner who thinks he can teach himself has a fool for an instructor.

Don’t overestimate your ability. Be sure your equipment is appropriate for you and your level of skill. Buy them from a reputable dealer. If rented skis, board, boots or bindings don’t feel right, say so, and have them fitted properly.

Warm up and cool down with stretches with special focus on the hamstrings, thighs, hips, and calves.

The slopes are exhilarating, but everyone gets tired. Rest or quit for the day, when you begin to feel tired. Most injuries happen after noontime when fatigue begins to set in.