Downhill skiing and snowboarding are great ways to stay active during the winter months.

Downhill skiing and snowboarding are great ways to stay active during the winter months.

Authors: Dr. Elizabeth Matzkin, Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital (BWH) and Team Physician for Stonehill College Athletics; Nicole Durand PT, DPT, a physical therapist in the Rehabilitation Department at Brigham and Women’s/Mass General Health Care Center; and Emily Brook, BA, a research assistant in the BWH Women’s Sports Medicine Program.

Downhill skiing and snowboarding are great ways to stay active during the winter months. However, it is important to recognize that injuries can happen, regardless of your skill level. Before you hit the slopes this winter, make sure you are aware of the unexpected things that can happen. As always, see a doctor if you suspect an injury. Below, we describe some of the most common injuries associated with skiing and snowboarding and provide tips to prevent injuries.

Common Skiing and Snowboarding Injuries

  • Shoulder – Falling on an outstretched arm or direct force to the upper arm during a fall can cause a shoulder dislocation. Typically, a dislocation is extremely painful, and you should see a physician immediately. Other common shoulder injuries include rotator cuff or labrum (cartilage) tears.
  • Head – Hitting your head during a fall is a common injury that can have serious consequences, ranging from a concussion to long-term brain injury or even death.

A concussion is a mild traumatic brain injury, which should first be addressed in a hospital to rule out any more serious damage to the brain or skull. In the case of a concussion, a team of specialists will work together to treat the symptoms. Your treatment team may include a neurologist, neuro-ophthalmalogist, physical therapist, or psychiatrist. Beginning the rehabilitation process as soon as possible is recommended.

To avoid head injury, all skiers and snowboarders should take proper precautions by wearing a helmet. Though helmets have been shown to reduce head injury significantly, it’s estimated only 40 percent of skiers wear them.

Ski Injuries

  • Thumb – The thumb often absorbs the impact when a skier falls with the ski pole still in their hand. This can cause a fracture of the bones or a sprain or tear of the UCL (ulnar collateral ligament). This type of injury is specific to skiing and is often referred to as “skier’s thumb.” The thumb joint is deceivingly important in grip strength, and any injuries should be seen by a physician to rule out a fracture or tear.
  • Knee – When a skier falls and their boot bindings don’t release, the ski can cause an outward rotation or twisting of the lower leg while the upper leg stays in place. The twisting force puts pressure on the knee joint, sometimes great enough to tear the ACL (anterior cruciate ligament) or MCL (medial collateral ligament). Knee injuries are not as common among snowboarders. Snowboarding decreases the chance for a twisting or rotation of the knees because both legs are strapped to the board.

Snowboard Injuries

  • Upper Extremity/Wrist – Snowboarders are more likely to sustain an upper extremity fracture compared to skiers, with most fractures occurring in the wrist. Wrist injuries are most common in the beginner snowboarder who is trying to learn a stable stance. While skiers may be able to catch a fall by adjusting their legs, snowboarders don’t have that option and often try to break a fall with their wrists. Wrist fractures can cause long-term damage if not treated correctly, so it is important to see a physician if you feel wrist pain after a fall.
  • Ankle – While upper extremity injuries are more common among snowboarders, ankle injuries also can occur, particularly when wearing softshell boots. Most beginner snowboarders choose to wear softshell boots, which allow for more ankle movement to maneuver the board. Jumps and falls also can twist the ankle, causing a sprain.

Preventing Injury

With proper training, you may be able to reduce your risk of skiing and snowboarding injuries. Increasing cardiovascular endurance is important, given the degree of strain you put on the heart musculature while skiing and snowboarding. Activities to improve cardiovascular endurance include biking, swimming, using the elliptical, treadmill, or stepper.

Weight training and resistance exercises to strengthen the knees and hips (particularly the gluteus, lateral hip, and quad musculature) can assist with the maneuvers required on the hill. Exercises that focus on maintaining control in the eccentric (lowering) phase will help you maintain proper form on the hill.

Taking lessons to improve your skills and using the proper equipment, especially helmets, are also ways to reduce your risk of injury and safely enjoy ski or snowboard season.

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