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Going Skiing!

Skiing has become a major winter activity holiday for many Irish people. While there are great physical and psychological highs from this most physical activity, some risks attach too.

Skiing produces some common injuries. Apart from general achy soft tissues associated with skiing, at the simplest, muscle bruises and ligament strains are fairly common and can be eased with self-management techniques.

The usual RICE rule for soft tissue injuries applies: rest, ice, compression and elevation. Damage limitation includes stopping skiing, getting ice on the injured part, bandaging it so that swelling is controlled and keeping the area raised to prevent pooling of swelling within the first 24 hours. Although a soak in a hot bath might seem very attractive after a fall on the slopes, this is in fact one of the worst things you can do. Soaking in a hot bath too early after injury increases blood flow to the damaged tissues. This makes the situation worse and prolongs rather than shortens healing. Over the counter medication, either painkillers or anti-inflammatories are helpful. If badly shaken and sore after a fall, taking a day out to rest and heal is often sufficient to allow the enthusiastic skier back on the slopes 36 hours later.

Broken bones do happen. Fractures need appropriate local immediate medical intervention. Hospitals and clinics in skiing regions have great expertise in treating fractures, because they see so many. Limbs are most at risk in terms of bony damage. Unfortunately a break marks the end of activity for the holiday. Broken fingers, wrists, shoulders, thighs and ankles need to be stabilised locally before returning home. The great thing about fractures is that healing is usually very predictable and straightforward. Physiotherapy may be required when the plaster is removed, but rehabilitation often yields near perfect results.

Thumb and knee ligaments are at particular risk in skiing. Thumbs can be overstrained in falls or by getting caught around ski poles, often getting on or off ski lifts. A strained thumb needs correct splinting to ensure good healing. Unfortunately many skiers ignore what may appear to be a small thumb injury and can still be in trouble many weeks later. In this case physiotherapy can make all the difference in longterm outcome.

Knees withstand huge stress curving down the slopes. The ligament along the inner side of the knee or the ACL buried deep within the joint can be strained or fully torn. Either case is a serious injury and should be initially seen by local medical teams. Knee ligament injuries have ended many the professional sportsperson’s career.

The extent of damage, age and lifestyle are all factors in deciding on appropriate immediate medical intervention. Young physically active persons with complete rupture of knee ligaments are ideal candidates for surgery, which is often the only way to ensure full recovery. Sometimes conservative (non-surgical) management is the treatment of choice when taking lifestyle or age into account. Irrespective, extensive physiotherapy and correct rehabilitation over many months are essential to get the knee moving well again in normal daily life let alone getting back to sport.

Perhaps surprisingly the spine tends to withstand bumps and falls to a large extent. However persistent spinal stiffness several weeks after skiing can be worth discussing with a Chartered Physiotherapist. Occasionally one or two small joints make have become locked and just need some manual therapy to assist recovery.

If you are reading this before you depart, there is an excellent exercise to get you ready for speeding down the slopes. As you can imagine, skiing works the legs really hard. An extended period of time bent over skis involves considerable stress on the thigh muscles and knee joints. The following exercise is a great pre-toner for this region.

Standing with your back to the wall, place feet hip distance apart and 40-50 centimetres away from the wall (further away if you are very tall). Next lean back so that your whole spine is in contact with the wall. Keeping your back on the wall, bend your knees so that you slide down the wall until your knees are almost at a right angle. Start by holding this surprisingly challenging position for 20seconds. Build up to 3 minutes gradually over a couple of weeks. It is hard to maintain this position for a prolonged time, but it is worth it when your legs withstand day after day of powering down those powdery slopes.

Go to it, and come home in one piece please!
Mairead O’Riordan, MSc, MISCP is a senior Chartered Physiotherapist & CEO of TherapyXperts, an allied health network dedicated to clinical excellence.
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