Tearing up the slopes
He managed to walk out of Wildcard, a black diamond glade run in Game Creek Bowl, but four days later he underwent knee surgery to reconstruct both his anterior cruciate ligament, or ACL, and his media collateral ligament, MCL.
“I heard the snap right away and the pain was instant,” says Duffield, a yacht captain who is still recuperating in Vail from his surgery. “I got the rest of my ski pass refunded, but I ended up spending more than $15,000.”
Before their ski vacations are over, hundreds of skiers will learn not only to ski bumps, but also what a torn ACL or a sprained MCL feels like.
“A torn ACL and an injured MCL are very common ski injuries,” says Dr. Richard Cunningham, an orthopedic surgeon with Vail-Summit Orthopedics and Sports Medicine.
“We perform about 500 surgeries over the course of a winter and 1,200 in a year,” in Eagle and Summit counties, Cunningham says. Approximately two out of every 1,000 skiers will have a serious injury, he says.
In the winter, Cunningham says, doctors at his two clinics in Vail and Frisco treat five times more ACL injuries than they do in the summer.
“On a holiday weekend there could be 60,000 skiers in Summit and Eagle counties. That’s about 120 serious injuries happening and probably 75 percent are orthopedic injuries,” says Cunningham, who carries a beeper every day and has one day off a month in the winter.
At the Steadman Hawkins Clinic in Vail, orthopedic surgeons perform about 2,000 knee surgeries a year, says Dr. Bill Sterett.
“Our practice doesn’t change much because people come off-season from all over the country and the world to get surgeries,” Sterett says. “But we reach a peak in the winter, when we sometimes do eight to 10 knee surgeries a day.”
Despite hundreds of injuries on the slopes, the injury rate in skiing is markedly down compared to 20 years ago, Sterett says.
“I would say accidents are down 30 percent,” Sterett says. “An improvement in the equipment has lowered overall injury rates.”
Years ago, the most common injuries were ankle fractures because skiers wore leather boots, Sterett says.
“Once the boots improved, there were tibia fractures because of the bindings,” he adds. “Now that the bindings have improved, a higher percentage of the injuries are to the ligaments.”
Still, about 60 percent of all ski injuries are knee injuries; and about 60 percent are injuries to the MCL, Sterett says.
“The good news is that the MCL heals on its own,” Sterett says. “The ACL tear gets more attention because it needs surgery.”
Skiing has a lower overall injury rate than high school basketball or football because of the amount of people doing it at the same time, Sterett says.
“What is different is that we might have 20,000 people skiing at any given time, compared to 22 playing football,” Sterett says.
It’s more typical to see ACL injuries in skiers than in snowboarders, Cunningham adds.
“Torn ACLs and tibia fractures are the most common ski-related injuries,” he says. “A ski is a long lever that can place tremendous forces across the knee when someone has a fall. Another thing that’s common is people fall backwards and usually twist from one side to the other, instead of letting themselves fall, then the quadriceps muscle pulls the tibia forward and that places stress on the ACL.”
About 80 percent of ski-related ACL injuries happen to skiers.
“You can see wrist dislocations and upper body fractures in snowboarders,” he says.
The type of snow also can be a factor in the accident and the type of injury sustained, Sterett says.
“Heavier snow is more often involved in causing orthopedic injuries,” Sterett says. “When the snow is hard, we see more fractures. When it’s soft, you see more knee injuries”
Physical and finance loss
Until January, Bill Rodkey, 56, of Arrowhead, who has skied for more than 20 years, had never hurt his knees on the slopes. But on a powder day at Beaver Creek, Rodkey, tore both his ACLs. He says he leaned back and heard his right knee popping.
“Then, I fell and did my other ACL,” says Rodkey, who underwent surgery in Vail on his two knees and is now recuperating at the Howard Head Sports Medicine Center.
“I leaned back on my skis, the snow was heavy,” Rodkey says, while doing his rehab exercises on a stationary bike.
For Duffield, who extended his stay in Vail, the whole ski vacation ended up being more expensive than he’d planned.
“I learned never to ski without health insurance again,” Duffield says. In addition to having to pay for his surgery, Duffield also lost his job in Florida where he was supposed to work as the captain of a yacht.
“The other thing I learned is to never ski beyond your ability,” he says. “Don’t follow your peers blindly.”
It will take Duffield six months to recover from his surgery. An avid rock climber, surfer and biker, he says he is taking his recovery seriously.
“I’ll do whatever the physiotherapists expect of me,” he says. “I need to concentrate on the recovery. Sports are the most important part of my life, so I’d like to heal correctly.”
Rodkey says although skiing is a dangerous sport, one has to take risks.
“I might stay off the heavy powder next time,” he says.
In the meantime, he does his rehabilitation at home multiple times a day.
“I hope to be on my mountain bike by June, hiking by August and skiing by Thanksgiving,” he says.
Veronica Whitney can be reached at 949-0555, ext. 454 or at email@example.com.
Although ski injuries are sometimes unavoidable, local orthopedic surgeons say skiers and snowboarders can take preventive steps to avoid them.
“Don’t be a weekend warrior,” says Dr. Bill Sterett of the Steadman Hawkins Clinic in Vail. “Be in good shape for skiing. Most of the injuries occur when people have been skiing for more than three hours without a break.”
Dr. Richard Cunningham, an orthopedic surgeon with Vail-Summit Orthopedics and Sports Medicine, says keeping the muscles around the knee strong is key to good performance on the slopes.
“Going into the season with good strong quadriceps and hamstring muscles and being cardiovascularly fit is also very important,” Cunningham says. “We see more injuries on people from out of town, who are in less optimal shape than people who live locally.
“Most injuries are in people who aren’t physically in shape, they aren’t used to the altitude and they are probably skiing terrain above their abilities.”
About 75 percent of the most severe fractures happen to out-of-town skiers, Cunningham says.
“Most of the people who live here know their abilities and the terrain a little better,” he says. “They don’t put themselves in compromising situations.”
Other preventive measures includes having the equipment set correctly, Sterett says.
“That means having the bindings set accordingly to the weight and height of the skier and his skiing ability. The majority of the knee tears come from bindings not releasing,” he says. “I’d recommend skiers have their bindings professionally set. Here in the valley most ski shops do a great job.”