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What Doctors Don't Tell You

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August 2018 (Vol. 3 Issue 6)

Skiing safely

About the author: 

Skiing safely image

There's no doubt that skiing is good for you

There's no doubt that skiing is good for you. Downhill (also called 'alpine') skiing is a highly aerobic activity (Clin Orthop Relat Res, 1987; March: 34-8), and cross-country skiing is said to be the most aerobically complete, involving an intense workout of most of the joints, tendons and muscles of the upper, as well as the lower, body (Sports Med, 1989; 8: 346-70).

A low-impact sport, cross-country skiing is also a healthy option for the 80 per cent of people who have a bad back. Beyond that, you engage with the outdoors and breathe in clean mountain air surrounded by breathtaking scenery.

Advances in equipment have decreased injuries on the slopes overall from the 1960s to 1990s, from 7 injuries/1000 days of skiing down to 2 injuries/1000 ski days, where it's remained ever since (Sportverletz Sportschaden, 1994; 8: 73-82).

Most safety measures focus on preventing injury to the extremities, and may also be responsible for the decreases in fractures, particularly of the clavicle (collar bone), forearm and hand; torn muscles; strained ligaments; and dislocated shoulders (Injury, 1996; 27: 423-35).

CNS injuries on the increase

In 1998, Sonny Bono died when he collided with a tree while skiing near Lake Tahoe. Later that year, Michael Kennedy, one of Robert Kennedy's children, died in a similar accident. These shocking deaths brought home to many that the dangers of skiing extend beyond broken legs.

Neurological injuries involving the head or spine are the one type of injury that is on the rise (Semin Neurol, 2000; 20: 233-45). A study from McGill University in Montreal found that the rate of head and neck injury in US and Canadian skiers is rapidly increasing (Can J Public Health, 2003; 94: 558-62; Epidemiology, 2004; 15: 279-86).

Injuries to the head now comprise 3-15 per cent of all skiing and snow-boarding injuries, with spinal injury accounting for 1-13 per cent, and peripheral nerve injuries, for a further 1 per cent (Semin Neurol, 2000; 20: 233-45).

These types of injuries are more common in Europe, where the slopes are far more crowded. One study in Italy's South Tyrol found an incidence 200 times that of the US, with more than two neurological injuries for every 1000 skier days, and 1.6 deaths/1 million skier days (Inj Control Saf Promot, 2004; 11: 281-5).

The problem has to do with tech-nology that enables skiers to progress to higher skill levels and faster speeds before they're ready to. Special track machines, for instance, allow advanced skiers to reach speeds of 60-80 km per hour (Sports Med, 1989; 8: 346-70).

Men tend to outrank women for injuries. The Italian study also found that, besides men, the older skiers and those unfamiliar with the slopes are more likely to get hurt. And most fatalities are among skiers who aren't wearing a helmet.

So, you may be better served by leaving your Prada ski hat at home and adopting a helmet instead.

Lynne McTaggart

Playing it safe on the slopes

Train for at least four weeks beforehand. All forms of skiing require muscle and aerobic capacity. The best training includes cross-country equipment, stairmaster, aerobics or spin classes, swimming, hiking or specialist ski training. Also work on upper- and lower-body exercises

that promote muscular fitness. Work on your knees (the patellofemoral joints), in particular, and be sure to include exercises that strengthen your core, back and shoulders.

- Warm up by stretching the hamstrings and quadriceps, lower back, shoulders and neck for at least 10 minutes. Chiropractor and skiing expert Terry Weyman recommends doing vertical and diagonal 'hops' with your ankles together, using a double arm swing as you leap-rather like a small skiing jump. Land with a deep knee bend to absorb the

jump, and leap again in the air. Repeat several times on each side, and then change to vertical jumps followed by side-to-side jumps.

- Don't stint on equipment; use the latest multimode-release bindings and modern midcalf boots. Ensure that your boots fit well. If your ski kit has been sitting for any length of time, have it checked by a qualified

ski technician, who should ensure that it all works properly. Use poles without a broad superior plate to avoid injury to the thumbs.

- Start below your level of competence. If you haven't skied for a while, take some ski-school lessons. Pack it in at the first sign of tiredness; injuries peak during states of fatigue, usually during the last run of the

day and on the third day on the slopes.

- Ensure that you are well layered in terms of clothing; many skiing accidents involve hypothermia.

- Don't ski after drinking a lot of alcohol. Be especially careful during the first run of the day and the one after lunch. In both cases, you are more likely to hurt yourself.

- Vary your activities. Much as you may love to ski, consider alternating with activities such as snowshoeing, or even a good massage to give your muscles a chance to recover.

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