The Top 3 Snow Skiing Stretches
The origin of skiing dates back to 3,000 BC when hunter-gatherers used animal tusks for transportation over ice. Modern day skiing, however, is thought to have evolved some 200 years ago in the Scandinavian countries.
Types of skiing include Alpine skiing, Nordic Skiing, Nordic jumping, free style skiing, telemark skiing, and backcountry skiing. Although not a contact sport, high speeds, high impact collisions, awkward landings and great forces at work on the knee joints make it injury prone.
Skiing is a high speed sport that requires strength, endurance, balance, skill, and co-ordination. Muscles involved are the quadriceps, hamstrings, glutes, abdominals and those of the lower back and arms.
Of particular interest are the joints of the lower limbs, which bear the brunt of the forces passing through the body while skiing. The knee joint is the most important joint in skiing, with the ankle joint, the wrist, thumb and shoulder girdle being the other joints of importance. Improvement in skiing boots and bindings protect the foot, ankle and the tibia from injury. However, this results in the ground forces being transmitted to the semi-flexed knee.
Most Common Snow Skiing Injuries
Skiing is generally considered to be a sport with a high injury risk. Although, recent advances in design of equipment, as well as technique, has resulted in a drastic reduction of risk. However, injuries to the anterior cruciate ligament of the knee, and spinal injuries, continue to occur at an alarming rate. Thumb injuries are also a common occurrence. While head, neck and spinal injuries are associated with graver outcomes.
Knee Injuries: Recent research shows the incidence of knee injuries to be on the rise. A third of all injuries in skiing are related to the knee joint, with ligament injury being the most common presentation. Menisci, cruciate and collateral injuries are involved either singly or in combination.
Meniscal injuries usually occur when a skier falls and twists the lower leg and there is delay in or failure of the ski binding to release. History of twisting trauma on the knee, pain, swelling, inability to bend the knee, clicking and “giving way” of the knee diagnoses the condition.
Two common anterior cruciate ligament (ACL) injuries are the phantom foot injury where the skier falls backwards with twisting on the downhill leg, and the boot induced injury that occurs due to a high impact, off balance landing. Symptoms of a torn ACL are an audible “pop” at the time of injury, extreme pain, swelling and stiffness (inability to straighten the leg). Clinically, a positive anterior drawer and Lachman’s test are diagnostic.
O’Donohue’s triad is characterised by simultaneous injury to the ACL, medical meniscus and the medial collateral ligament.
Knee injuries are initially treated with the R.I.C.E.R. (Rest, Ice, Compression, Elevation and Referral) principle followed by use of knee supports, mobility exercises and graded exercise to strengthen the quadriceps. Also, pain suppression using pain killers, heat therapy, message, and electrotherapy are effective treatment options. Severe cases of ligament injuries may require surgical reconstruction.
Tibial and Ankle Injuries: With improvement in skiing equipment, incidence of foot and lower leg injuries have shown a decrease in frequency. Tibial spiral fractures and boot top injuries (impingement on the front of the boot) are common occurrences. Use of low boots and failure to release bindings can cause ankle fractures.
Hip Injuries: These occur as a result of impacts with flexed hips. Posterior dislocation of the hip joint is the most common presentation.
Upper Limb Injuries: Shoulder injuries include dislocations, rotator cuff tears, and acromioclavicular joint injuries. Usual mechanisms responsible are fall on an outstretched hand and combined abduction and external rotation force when the skier goes past a firmly planted pole.
Collar bone injuries can also occur as a result of a fall onto an outstretched hand. Pain over the collar bone, swelling and visible bone deformity immediately after injury, are the hallmark of diagnosis. Treatment strategies include the use of a figure-of-eight bandage or shoulder braces, pain management, rehabilitation and strengthening of the structure in and around the shoulder girdle.
Skier’s thumb is the result of an injury to the ulnar collateral ligament of the thumb. The usual mechanism of injury is a fall with the hand firmly grasping the ski pole. Characteristic symptoms are pain on bending the thumb backwards and in the webbing between the thumb and the forefinger, plus swelling and instability of the joint at the base of the thumb. Treatment includes pain management, support in the form of thumb spica, mobility and strengthening exercises. Inability to treat skier’s thumb properly results in a residual component of instability that may require surgical intervention.
Spinal Injuries: Alongside ACL injuries, the incidence of trauma to the spine has also shown an upward trend in recent years. Researchers blame increasing speeds attainted and high impact collisions for this. Most of these injuries occur due to falls or improper landing during jumping.
Head and Neck Injuries: Head, neck and spinal injuries are mainly responsible for the mortality and morbidity associated with skiing injuries, with traumatic brain injury being the single largest cause of death. These are more common in younger, more advanced and adventurous skiers. High speed impacts are mainly responsible. Research supports the use of helmets, which drastically reduces the head injuries without increasing the incidence of a neck injury.
The Top 3 Snow Skiing Stretches
Stretching is one of the most under-utilized techniques for improving athletic performance, preventing sports injury and properly rehabilitating sprain and strain injury. Don’t make the mistake of thinking that something as simple as stretching won’t be effective. Below are 3 very beneficial stretches for snow skiing; obviously there are a lot more, but these are a great place to start. Please make special note of the instructions below each stretch.
Lying Knee Roll-over Stretch: While lying on your back, bend your knees and let them fall to one side. Keep your arms out to the side and let your back and hips rotate with your knees.
Kneeling Quad Stretch: Kneel on one foot and the other knee. If needed, hold on to something to keep your balance and then push your hips forward.
Standing Toe-up Achilles Stretch: Stand upright and place the ball of your foot onto a step or raised object. Bend your knee and lean forward.
Injury Prevention Strategies
- Seek advice on biomechanical problems like varus deformity of knee, high arches, over-pronation, etc. Use orthotics as advised by sports medicine professionals.
- Undergo physical conditioning for improved muscular strength, endurance, co-ordination, and reflexes.
- Select proper ski equipment, boots and difficulty of slope according to skier ability.
- Include a proper warm up and cool down, with stretching exercises involving the hamstrings, quadriceps, iliotibial tract, and calves.
- Drink fluids to prevent dehydration.
- Shielding from the elements: protect the eyes from glare, prevent laceration or abrasions due to exposure of skin, and use layered clothing suitable for a particular condition.
- Recreational skiers on a skiing holiday should follow the rule of three: after two days of skiing, the muscles of the lower limb are fatigued and therefore less able to protect against injuries. The rule of three thus recommends a stop before 3 pm each day, skiing for not more than 3,000m each day and taking the third day off.
Call Dr. Kelly Cunningham at Austin Ortho + Biologics to be evaluated or with any questions
Experts in Orthopedic, Regenerative Sports Medicine and PRP/stem cell treatment in Central Texas