Thrill-Seeking Snowboarders, Skiers at Higher Risk for Injuries

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Once the exclusive domain of teenage daredevils, snowboarding is now an Olympic sport and the growing popularity of the sport has, in turn, revitalized interest in downhill skiing. In fact, nearly seven million snowboarders account for the 57 million ski lift tickets sold in the United States. However, as the popularity of snowboarding and alpine skiing increases, so does the potential for injuries, says the American Physical Therapy Association (APTA).

Common Snowboard and Ski Injuries

"Two-thirds of snowboard injuries affect the upper extremities, with the most common injuries occurring to the wrist and shoulder," says Dean Walker, PT, a physical therapist at Durango Sports Club Physical Therapy in Durango, CO. However, Walker notes, there is an injury unique to snowboarding - "snowboarder's fracture," a fracture of the talus, a bone in the middle of the ankle joint, that occurs when the rider's foot is pushed suddenly upward and outward during a fall.

Debbie Cyphers, PT, a physical therapist at Methodist Sports Medicine Center in Indianapolis, IN, adds that the predominant injuries in downhill skiing occur to the lower extremities, such as the knee, leg, and ankle. A member of the National Ski Patrol, a volunteer organization which renders on-slope outdoor emergency care to injured skiers and boarders, Cyphers notes that a common ski injury involves the medial collateral ligament (MCL), which spans the distance from the end of the thigh bone to the top of the shin bone on the inside of the knee joint. The more well-known knee injury among skiers is to the anterior cruciate ligament (ACL), which typically occurs when ski bindings don't release during a hard fall and, in serious cases, may require reconstructive surgery.

An injury unique to downhill skiers of all levels, says Cyphers, is "skier's thumb," when the thumb ligament that provides hand stability is damaged. Often dismissed as merely a sprain, this condition, if left untreated, may require surgery. "Skier's thumb typically occurs when skiers fall on their poles during a fall, or during a "pole plant," when the ski pole is stuck in the snow but the skier keeps moving," says Cyphers.

Snowboarding Risks Differ According to Skill

The Advanced Set: For skilled snowboarders, the greatest danger is landing incorrectly, says Walker. He also notes that there is a high incidence of head injuries among more advanced riders, who tend to be more fearless and board through back woods dense with trees. "The most common injuries among advanced snowboarders, in addition to head trauma and spinal injury, are sprains and fractures of the wrists, shoulders, knees, and ankles." He adds, "The younger but more experienced generation wants to try the bigger jumps, but if they land wrong, their bodies can't sustain the force of the impact."

For advanced skiers, the greatest risk is velocity, says Cyphers. "When skiers pick up too much speed and lose control, they run the risk of multiple traumas, including severe head injuries and thigh fractures, when they hit obstacles at such a high speed."

The Beginners: For beginner snowboarders, the accident profile is different. Because the feet are strapped to the board in non-release bindings, less-experienced "boarders" tend to fall over when they catch the front or back edge of the board. "Because of the attachment of the body to the bindings, you can't prevent a fall by adjusting your legs," observes Walker. He adds that the most common injuries among beginner "boarders" are wrist fractures and sprains.

Most novice skiers don't know how to fall correctly and tend to fall forward, says Cyphers. "Because of this, the shinbones breaks right at the exact spot where ski boots end, a condition known as a "tib-fib" or "boot top" fracture, because both the tibia and fibula are fractured.

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Cyphers mentions that physical therapists have recently been seeing a marked increase in teenage patients who have been injured while using "trick skis," which are shorter than normal downhill skis and which don't feature binding releases.

Accidents Can be Preventable

Strengthening both the upper and lower body, a critical component of skiing and snowboarding safety, is best accomplished on a year-round basis, Walker says. But if that isn't possible, he suggests at least twelve weeks of conditioning before venturing onto the slopes. "A stronger, more flexible body will tolerate a fall better," Walker explains. "The underlying message is that snowboarding and skiing safety have to entail a lifestyle commitment. Maintaining a proper fitness level is essential and winter athletes need to incorporate it naturally into their fitness routines."

Another way to prevent injuries is by using protective gear and properly fitted equipment. Walker recommends that snowboarders wear wrist guards and kneepads. Additionally, APTA recommends that snowboarders and downhill skiers wear a protective helmet, as most fatal injuries are head injuries. According to Walker, "A well-designed and properly fitting helmet will definitely decrease the likelihood of a head injury because it absorbs and spreads the force of impact over a larger surface."

Cyphers advises that skiers should not ski above their ability; know when they're tired (most accidents occur at the end of the day, she notes); and have ski bindings set to the appropriate level depending on leg strength and skill.

Suggested Stretches

APTA also recommends a regimen of stretching, strengthening, flexibility and endurance exercises to prevent injury and to promote maximum enjoyment. According to Walker, "A good overall stretch, before and after hitting the slopes is important in skiing, but especially so in snowboarding, which entails a lot more freedom of movement than skiing. Riders are moving around in a lot of different directions, so good flexibility is important." Following are APTA's suggested stretches for snowboarding and skiing:

Rotation - Stand with feet shoulder-width apart and arms stretched out in front of you. Try to look behind you, and twist your trunk and arms as far as you can in the direction you are looking. Hold for 30 seconds, then repeat in the opposite direction.

Flexion - Stand with feet shoulder-width apart. Squat all the way down and wrap your arms around your bent legs and hold for 30 seconds.

Extension - Kneel on the ground and grab your heels with both hands. Look up towards the sky and push your stomach forward as far as you can. Hold for 30 seconds. Remember to breathe normally!

Hamstring Stretch - "Lay on the floor with your feet against the wall. Slowly walk up the wall until your legs are at a 45 to 60 degree angle with the floor. Making sure your heels stay in contact with the wall, bend your knees and bring your buttocks closer to the wall. Hold position for 3 minutes.

The American Physical Therapy Association is a national professional organization representing more than 66,000 physical therapists, physical therapist assistants, and students. For more information, please visit www.apta.org

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