Jose Bascones, Lister Hospital’s Lead Outpatient Physiotherapist, has been offering insight into the potential injuries caused by the popular winter sport, and what you can be doing to prepare before you hit the slopes.
We are now fast approaching the winter festive session; a season of celebrations, last minute Christmas shopping and of course ski holidays. Whether you are a seasoned skier, or heading to the slopes for the first time, your winter getaway can be the highlight of the season.
The anticipation of a ski holiday reminds me of the build up to the London Marathon. Excitement to face the challenge is high, but everyone differs in the amount of preparation or training they undertake. The main difference between the two being, people seemingly train harder when both feet are on the ground.
The ‘fun’ holiday element of a ski trip distracts from the reality, which is that skiing is an extreme sport in which we have little control over what we can do in order to avoid injuries, regardless of our experience. Whether there is an equipment failure, poor fitness levels, overconfidence of our own abilities, the icy patch that we did not see, or just another person on the slopes losing control, these can create the perfect environment for disaster.
Ski injures are not to be taken lightly. Injuries such as head collisions can be life threatening, which is why wearing the right protection, being sensible on the slopes and having a good pre-season fitness check-up are strongly advisable in order to minimise the risk of injury. Here are some the most common non-life threatening ski injuries we at the Lister can encounter:
Rotator cuff tears
Head of humerus fractures
Ligament injuries (mainly ACL and MCL)
Fractures (mainly tibial plateau and femoral condyle)
The majority of the ski injuries occur on the knees, one of the most common we see being the anterior cruciate ligament (ACL) tear. The ACL is one of the two intraarticular ligaments of the knee that joins the femur with the tibia. It runs diagonally crossing over the other cruciate ligament PCL. There are different degrees of damage that can be sustained:
Grade 1: Sprained. The ligament has been slightly damaged, sustaining a stretch but without any rupture of its fibres.
Grade 2: Partial tear. The ligament has been stretched and some, but not all (some specialist would consider less than 50%, others between 50%-75%), of the ligament has been torn.
Grade 3: Total tear. The ligament has completely torn all its fibres and there is a complete separation between them.
When the ligament is injured, usually a “pop” coming from the joint can be heard, followed by an immediate swelling on the knee, loss of range of motion and pain. These symptoms will gradually disappear over the following weeks. However, because one of the ACL functions is to provide stability in the joint (avoiding the tibia to move forward from the femur, as well as providing rotational stability) it is the sense of instability in the joint that will create most problems over time.
In order to determine if the ligament has been damaged or not, there are specific tests that your physiotherapist or consultant specialist can do to test the function of your ACL. Imaging tests such as an MRI scan can provide detailed evidence of the structural integrity of the ligament, providing supporting evidence on the degree of damage.
In the unfortunate event of ligament damage, it can be treated surgically by reconstructing the ligament using different types of grafts. However not all ACL injuries require surgery, they can also be treated by a specific course of physiotherapy. Your consultant specialist would be able to examine your knee and advise you on which procedure would be most suitable for your case.
Our recommendation is to treat it preventively. If you are thinking of hitting the slopes this season, we suggest you arrange an appointment with your physiotherapist. He/she will be able to assess the overall state of your knee, as well as the general function of your legs and back. This can help to address the areas that might require some attention before your trip, such hip muscle strengthening and core muscle activation.
If you have any questions or concerns, please give the team a call on 0207824 8041 and arrange to see one of our expert physiotherapists. We look forward to welcoming you to The Lister Hospital Outpatient Physiotherapy Clinic, based in Chelsea Medical Centre. 272 King’s Road London SW3 5AW.