Ask a Vail Sports Doc: Injuries can come with poor snow conditions
January 9, 2018
As we are all aware, we are lacking for snow. Old-timers I speak to in my office tell me that this winter is like the winter of 1977. With minimal snow on the slopes and limited terrain open, the chances of injury are increased. The ground is very hard and fractures are more common with bad falls or collisions.
A study from 2010 showed that an estimated 11.5 million people participated in skiing whereas 8.2 million people snowboarded. Another study showed that there was a higher incidence of injuries associated with snowboarding compared to skiing.
The most common snowboarding injuries were wrist injuries, whereas the most common ski injuries were ACL tears. Injuries to the lower extremities has decreased significantly since the 1970s, probably due to improved bindings.
Head injuries account for approximately 15 percent of all reported snowboarding injuries and are the most common cause of morbidity and death amongst snowboarders. The ground is very hard out there, especially now, so wear your helmet.
“Head injuries account for approximately 15 percent of all reported snowboarding injuries and are the most common cause of morbidity and death amongst snowboarders. The ground is very hard out there, especially now, so wear your helmet.”
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Spine injuries predominantly effect the lumbar and thoracic spine. Thankfully cervical spine injuries are less common as these can often cause injury to the spinal cord and lead to paralysis. Back pain in young elite skiers is not uncommon.
One study looked at the spine X-rays of elite skiers younger than 17 and compared them to the X-rays of recreational skiers of the same age and found that elite skiers already demonstrated some radiographic wear and tear changes in their spine. This can lead to back pain at a younger age.
Shoulder injuries, particularly clavicle fractures, are common in snowboarders. These injuries usually occur in the terrain park. I fix a lot of clavicle fractures during the winter. Personally, if I had to choose a fracture to have, then this would be it, as they heal well and patients can return to activities much more quickly than with most other fractures.
I also see a significant number of shoulder dislocations in the winter. Shoulder dislocations in patients older than the age of 25 can usually be treated without surgery, but male patients under the age of 25 who have a first time shoulder dislocation have a high incidence of recurrent dislocations and often require arthroscopic surgery to stabilize their shoulder.
A study performed by my hand partner showed that wrist injuries accounted for 21 percent of all snowboarding injuries. Of these, 80 percent were fractures of the wrist. A fall forward (toe side) was more likely to result in a shoulder injury, whereas a fall backwards (heel side) was more likely to result in a wrist injury.
Knee injuries are more common in skiers than in snowboarders. Half of knee injuries involve the ACL. ACL injuries are more common in women than in men. Back weighted landings and sudden internal rotation to the knee with the knee in a knock kneed alignment has been found to be the dominant causes of ACL tears in skiers.
This same mechanism can also cause MCL tears, tibial plateau fractures and meniscal tears. Most patients who see me with ACL tears report the dreaded pop and immediate swelling in the knee. Within weeks of tearing your ACL, your knee will feel markedly better, but I caution people not to resume cutting and pivoting sports such as skiing with an ACL deficient knee. One study showed a 6 times higher risk of further injury to an ACL deficient knee than to a knee with an intact ACL.
Most patients who sustain an ACL tear require ACL reconstruction surgery, but for the past several years, I have been repairing certain types of ACL tears which preserves the native ACL and is a much faster recovery.
Dr. Rick Cunningham is a knee and shoulder sports medicine specialist with Vail-Summit Orthopaedics. He is a physician for the U.S. Ski Team. Be sure to visit his website at http://www.vailknee.com. For more information about Vail-Summit Orthopaedics, visit http://www.vsortho.com.
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