Although skiing has a reputation as a dangerous sport, research has shown that general skiing injury rates have reduced by 50% over the last fifteen years. Even so, it is almost as common for a skier to talk about their most recent injury as it is a road runner!
Most common skiing injuries
Medial ligament sprain or MCL injury is a tear of the ligament on the inside of the knee, it is usually a result of direct impact or twisting motion. A medial ligament injury is common in contact sports such as football and rugby, as well as martial arts. They can also occur in daily life through falls and twists of the knee joint. Symptoms of MCL are graded 1, 2 or 3 depend on the severity of the injury. Read more on how Medial ligament sprain is graded and how it is treated.
Fractured collar bone
A clavicle fracture or broken collar bone is a fracture of the clavicle bone which runs along the front of the shoulder to the breast bone or sternum in the middle of the chest. The fracture may have happened as a result of a fall onto the shoulder or an outstretched arm. Main symptoms include pain on the collar bone which may be severe, also swelling over the area and a bony deformity may be felt. Read more on treatment of clavicle fractures.
AC joint injury
AC joint separation or AC joint sprain is an injury to the ligament that holds the acromioclavicular joint together at the top of the shoulder. It is usually caused by fall onto an outstretched arm. A grade 1 sprain is very mild and a grade 6 injury would be very severe. Getting early treatment and support through taping is important to avoid long term problems or shoulder deformity. The Symptoms include pain right at the end of the collar bone on the top of the shoulder. Initially the pain my be widespread throughout the shoulder but become more localized to a bony point on the top of the shoulder later on. Read more on treatment for AC joint separation.
Medial meniscus injury
A torn meniscus is a tear to the semi circular cartilage in the knee joint causing pain on the inside of the knee. This injury is usually by a direct impact in contact sports or twisting but can also occur in older athletes through gradual degeneration. Treatment depends on how bad the injury is and may require surgery. Symptoms include pain on the inside of the knee which may be of sudden onset but can also occur gradually. The patient will usually experience pain when fully bending the knee or squatting down. There may be swelling present but not always and the patient may also complain of the knee locking or giving way. Read more on causes and treatment of medial meniscus tear.
A thumb sprain occurs when the thumb is bent out of it's normal range of movement, usually backwards. Damage occurs to the ligaments supporting the joint at the bottom of the thumb. Symptoms include pain when the thumb is bent backwards, also pain in the web of the thumb when it is moved. There may be swelling over the metacarpo-phalangeal joint at the base of the thumb and the patient may have laxity and instability in the joint. Watch video of how to treat and tape a thumb sprain.
Immediate first aid for acute injuries
The PRICE principles are the gold standard set for treating acute sports injuries. The acronym stands stands for Protection, Rest, Ice, Compression and Elevation and should be applied as early as possible and continued for at least the first 24-72 hours.
Protection of the damaged tissue is vital to prevent further damage and enable the healing process to start efficiently and effectively. There are a number of ways to protect the injured area all with the same aim of limiting further movement and use of the joint/muscle/ligament/tendon. One way this can be achieved is using a support or splint.
In the early stages, rest is one of the most important components of the P.R.I.C.E principle but is often neglected or ignored. It does not only refer to the prolonged period of time that the athlete will be out of action but also to the immediate period after the injury.
An athlete must know when to stop training and allow the injured area to heal otherwise repetitive minor injuries can often result in a more severe injury that keeps the athlete out for much longer.
If an injury is sustained during sporting activity some athletes have a tendency to 'run it off'. This implies that by continuing to participate in the exercise, the injury will simply go away. In fact, in the majority of cases this is not true and is not advisable.
Ice therapy, also known as cryotherapy, is one of the most widely known and used treatment modalities for acute sports injuries. It is cheap, easy to use and requires very little time to or expertise to prepare.
The application of ice to an injury, in the acute phase can substantially decrease the extent of the damage. It achieves this in a number of different ways:
Decreases the amount of bleeding by closing down the blood vessels (called vasoconstriction).
Reduces pain (pain gate theory)
Reduces muscle spasm
Reduces the risk of cell death (also called necrosis) by decreasing the rate of metabolism
Ice is usually applied to the injured site by means of a bag filled with crushed ice which is wrapped in a damp towel. The damp towel is essential as it forms a barrier between the bag of ice and the skin and reduces the risk of an “ice burn”. DO NOT leave the ice on for more than 15 minutes as you could cause an “ice burn”.
There are a small number of areas that you should not apply ice to which include the neck, the outside bone of the elbow, the collar bone (upper end), the front of the hip (bony part) and the outer bone of the knee. The reason for this is there is a superficial nerve just below the skin in these areas that can be damaged by applying ice to it. Always check for contraindications.
Applying compression to an injured area minimises the amount of swelling that forms after an injury in two ways and should be applied for the first 24 to 72 hours from the onset of injury. Compression can be applied through a number of methods. The most effective of these is by using a compression bandage which is an elasticated bandage that simply fits around the affected limb.
Elevation of the injured limb is the final principle of PRICE but is equally as important as the other 4. Elevation allows gravity to drain the fluid away from the injured site. This aids in decreasing the swelling which in turn may decrease the pain associated with the oedema (swelling).
Read more on PRICE principles
Skiing Injury Statistics
The most likely part of the body to get injured is the knee which accounts for some 45% of skiing injuries. Although general injury rates have decreased over the last fifteen years severe knee injuries such as ACL ruptures have increased 172% over the last 15 years.
Research suggests that younger, lighter and less experienced skiers are at highest risk of injury. Beginners are thought to be 33% more likely to be injured than the more experienced skier. Women are more likely to sustain knee injuries whilst men are more likely to injure their head or shoulder.