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December 3, 2014

Winter tune-up is key to injury-free fun

Winter tune-up is key to injury-free fun

By Karen D. Lorentz

Instead of dreading winter, which admittedly can be challenging, there are steps we can take to enjoy a fun, rewarding, and injury-free snow season as well as a warm time outdoors!

Yes, many fear falls and accidents on slippery surfaces and others dread the cold. Reality check: life in general is full of risk. You can fall down your stairs at home or trip over something or slip on an unanchored rug.

So the first tip is to prevent those situations that might lead to injury by exercising good judgment and some personal control. For example, around the house, you can anchor rugs, hold onto the railing when doing the stairs, and make sure you don’t leave things where you can trip over them. By making those good choices, you are exercising control and can begin to eliminate that fear of falling.

In her presentation on concussions at a recent winter sports workshop at the Dartmouth Hitchcock Medical Center, Dr. Kristine Karlson noted that wearing sneakers in slush and snow sets you up for slipping and falling backward and hitting your head. It’s common sense to wear boots, she noted. Yet how many of us have dashed out to car or mailbox in inappropriate footwear (for the conditions)?

It’s up to us to exercise caution and make good choices. But that doesn’t mean choosing to stay inside and hibernate all winter.

Just as we tune up the car and put on snow tires, there are many things we can do to prevent injuries, starting with salting or sanding our walkways. We can lean forward as we walk outdoors so if we slip, we fall forward a short distance and don’t land backwards on our heads. We can also attach Yak Trax® to our boots to help keep us upright (they’re like crampons that go over your shoes or boots for better traction). Using ski or hiking poles can also give added stability.  When playing pond ice hockey, wearing helmets is necessary for adults, not just kids, Dr. Karlson noted.

Preventing winter sports injuries

There are many things we can do to help prevent winter sports injuries on the slopes.

Take a lesson. Instruction can help keep you safe by imparting good skiing/snowboarding technique. Lessons are not just for beginners. Recreational skiers and snowboarders can benefit from a review of proper stance, which can help to prevent ACL injuries (tearing the anterior cruciate or collateral ligaments located in the knee area). Even if you know how to get down a blue or black diamond trail, ask your instructor to review how to fall as well as how to land a jump so you can prevent the ACL injury.

Check your equipment. Make sure you have appropriate and properly tuned equipment. If your bindings are too tight or too loose, you risk injury. Get them checked, as we often gain or lose weight and/or become better skiers. The shop technician will adjust them to your situation. Equipment should also be properly sized and appropriate to your ability.

Wear a helmet. Dr. Karlson noted that “any approved helmet” for your sport is fine and you don’t have to pay a bundle for bells and whistles. About half of U.S. skiers and snowboarders routinely wear helmets and ski areas do not universally require them. Dr. Karlson said requiring them “would be a good idea,” noting that that they can offer protection from “unexpected hits.” Wearing a helmet means the helmet absorbs some of the impact if someone bumps or runs into you or causes you to fall. But she also noted that helmets don’t prevent concussions. They can help turn a potentially lethal injury into a concussion, she said. The use of protective equipment has been associated with a 43 percent reduction in the rate of head, neck, and face injuries. Dr. Karlson said adults should wear helmets, not just kids.

For snowboarders going into terrain parks, wrist guards and elbow and kneepads are recommended.

Use good judgment. Don’t ski or ride when you’re tired. Most injuries occur after lunch and when people are fatigued. It’s important to stay adequately hydrated so stop to rest every couple of hours and drink water or get a hot beverage.

Knowing the Responsibility Code is a start. Parents have an important role to play in educating children of all ages about safe skiing and snowboarding practices. Lessons are key but so is a review of the Responsibility Code. Be sure they avoid terrain beyond their ability, too, and have a discussion with them about skiing out of bounds. If they get lost, you end up losing precious ski or relaxing time, to say nothing of the worry or dangers of spending a night in the woods. Friends don’t take beginner friends to the top of the mountain for their first run on skis or snowboards. Real friends know that is what the beginner hill is for.

Get in condition. Dr. Marcos Coe, who addressed the subject of lower extremity injuries at the DHMC workshop, noted that it is important for “weekend warriors” to do some physical training. Strength training is good but stretching alone has little efficacy, he noted, saying research shows that “dynamic stretching” prepares your body for exertion and sports performance. Do some sport-specific exercises and you’ll have a better time on the slopes and be less apt to injure yourself. Jason Godsell, a strength training and injury specialist, stressed the importance of balance and strength training, noting for example that recreational snowboarders can help prevent rotator cuff injuries through rotation exercises with emphasis not on resistance but more repetitions.

Dress appropriately. By wearing layers and using hand or feet warmers if needed, you can remain warm and dry on the slopes due to the high-tech fabrics now used in snow-sport clothing. Jeans and cotton shirts are a no-no. Wicking fabrics work to keep you warm by keeping you dry.

Thousands of skiers and snowboarders enjoy snow sports every year and the injury rate is actually much lower than many years ago. It’s true that injuries can happen but most snow-sport injuries are minor and can be treated with rest, bracing, and non-steroidal anti-inflammatory medication. Physical therapy helps, also. However, for some fractures and ligament injuries, surgical intervention may be necessary and that can mean a three-to-six month recovery period.

But by using common sense, obeying the Code, taking lessons, exercising to build strength and agility, and making sure your equipment is in good working order, you can reduce your risk and increase your fun on the trails. Most importantly, wear a helmet, but ski or ride as if you weren’t wearing one, and always stay in control.

By following these simple but important steps, you’ll be well on the road to having fun outdoors and loving winter.

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