Snowboarding And Skiing Injuries Advice Including Acl Injury And Achilles Tendon Rupture

It is that time of year again when many people go skiing and snowboarding only to return as ‘patients’, following a variety of different injuries.  The two sports are quite different and so are their injuries.  We shall look at a knee injury common in skiing, an ankle injury common in both sports and a wrist injury common in snowboarding.

Knee injury – Anterior Cruciate injury

What is the injury
The Anterior Cruciate Ligament (ACL) joins the ends of your thigh bone (femur) and your shin bone (tibia) together, and through little strain gauges within it, helps your brain understand the amount of pressure going through your knee.  This allows your brain to make reflex decisions about how much muscle strength to switch on to protect your knee when you’re skiing.  Sometimes when your muscles are weak, you are untrained or if you were to hit a mogul abnormally, this usually efficient process doesn’t work and you get injured, sometimes tearing or rupturing your ACL.  When this happens you will often hear a snap or tear in the knee and immediately know that it ‘went’.  Your knee will usually swell and it often becomes difficult to take weight through your knee too due to pain and also because it feels unstable.  Sometimes this injury will require surgery.

How it is treated
Acute  As with any acute traumatic injury, Rest, Ice, Compression and Elevation (R.I.C.E) can be useful. While there is swelling in the joint, a compressive knee brace can help reduce the fluid build-up and also protect it while it is vulnerable.
Brace/support – Compression Cold Therapy – Cryo/K

Rehab  Once the swelling has gone down you can start to think more about getting the knee stronger again and to start to use it more normally.  At this time its really helpful to use a Rehab-type brace to provide extra protection while you are starting to put the joint under more controlled pressure and also to keep the swelling in check.

Brace/support – ACL/PCL Functional Knee Brace
Part number: CIFK

Prevention For a period of time after your injury it is often advisable to wear a sports brace to provide support as you build back into skiing again.  It is important that the brace is not too cumbersome so as to prevent freedom of movement and also not being too supportive to prevent the muscles from learning how to work properly again.
Brace/support – CoolMesh Hinged Patella Control Support
Part number: MPHK

Exercise tip
During the acute phase it is important to rest the joint so it has time to recover, but it is also important to keep it as mobile as possible.  Getting the balance right between the 2 is crucial to a quick and effective recovery.  Sitting on a friction-free surface like a wooden floor and slowly bending and straightening your knee can be very helpful if your knee is stiff, gradually increasing the range as you work at the exercise.

Ankle injury – Achilles Tendon rupture

What is the injury
Although over the last 20 years the number of ankle injuries have reduced while skiing and snowboarding, they can still occur, even inside a protective ski or snowboarding boot.  One example is a ruptured Achilles Tendon (AT), particularly common if you are male and over 40, when the tendon tends to weaken anyway.  The AT is part of the calf muscle and its job is to push you forward when you walk and to help control the landing when you ski or snowboard.  If the landing is ill-timed or awkward then you are more at risk of rupturing your AT.  You will often know if you have ruptured it from a sharp stabbing pain at the back of your leg near your heel, people typically will feel like they’ve been shot.  This means you will not be able to walk and when you are lying on your front you will not be able to point your foot.  This is a very serious injury and

needs to be managed quickly and correctly to get you back skiing or snowboarding again.

How it is treated

Acute – very early on a decision needs to be made whether you will need surgery or not, and your background and sports intensity and frequency will have a bearing on the right decision for you.  As with all soft tissue injuries Rest, Ice, Compression and Elevation (R.I.C.E) is helpful while this decision is being made.  Your medic or therapist will supervise this but if surgery is not required in your case, then you will need a brace that completely fixes your ankle and stops it from moving.  This may allow the 2 ends of the AT to knit together again. 
Brace/support – CRYO/A – Compression Cold Therapy

Rehab – Once the AT has started to knit together (with or without surgery), then you must start to use it again and gradually build up its strength and mobility.  At this point a support to allow controlled movement while still offering some protection is important.
Brace/support – AAB

Prevention – The best way to prevent this injury is to have great calf flexibility and strength.  If you perform a sport that requires a lot of jumping or landing your AT should be quite well prepared for skiing and snowboarding. 
Brace/support – Stirrup Ankle Brace with Air/Gel Pads
Part number: AGSAB

Exercise tip
Calf stretching with your knee bent and straight is important to regain the full bend in your ankle again.  Also your calf strength must be regained quickly too.  Sitting with a weight on your knee while raising your heel up and down will help to strengthen the right muscles.  Try putting the balls of your feet on a 2″ block, this is will increase the stretch at the bottom of the movement.

Wrist injury – Dislocation of the carpal bones in the wrist

What is the injury
The carpals are the small, delicate bones at the bottom of your hand where it joins your wrist.  They can be dislocated by a heavy fall while you are snowboarding, and can very painful indeed. It is initially hard to tell the difference between this dislocation and a fracture.

How it is treated
Acute – Make sure its a dislocation of the carpals and not a fracture by seeing a doctor and getting an x-ray. Assuming its a dislocation then it should be protected by using a firm brace and the R.I.C.E method.
Brace/support – CoolMesh Wrist Palm Brace
Part number: MWP

Rehab – when you have clearance to do so, you need to start to gently mobilise the wrist by doing specific exercises which you will be shown by your therapist.

Prevention – People often find that a support to help you return to snowboarding gives you the confidence to start to use it again yet still provide some help until its stronger.
Brace/support – 3D Wrist Palm Support With Gel Pad – FKW – BB
Part number: BM/EWB

Exercise tip
A good one to start with when you are ready is to hold your hands up in front of you with your palms facing each other as if you were praying, with your fingers pointing to the ceiling.  Keep your arms still and elbows as high as they will go.  Keeping your hands together, slowly turn your hands so your fingers are pointing away from you and then towards you.  Start slowly and gradually increase over the coming weeks.

For more information about Pain Control and to purchase a knee support