With the arrival of winter, outdoor activities are carried out in colder and snowier environments, making it more important to take appropriate measures to avoid injuries due to the drop in temperature, which causes an increase in the mechanical stiffness of body tissues, or due to the practice of sports.
Among the winter sports with the largest number of followers is skiing: it is practiced by more than 200 million people worldwide. When the first snow falls, many enthusiasts take to the ski slopes, sometimes without the right physical condition or the minimum recommended technique. As a result, the probability of injury in skiing is 2.6 to 3.9 injuries per 1,000 skiers per day.
Injuries, in any type of modality, are generally due to falls or collisions, mainly caused by lack of technique or inexperience: more than half of the accidents that end in injury (55%) occur during the first seven days of learning. Similarly, overconfidence and recklessness are associated with a higher number of accidents, as is poor physical preparation.
The most serious injuries are concentrated in about 60% in the lower extremities, especially in the knee, the part of the body that works the hardest and withstands the most pressure; 20% affect the hands; 10% are head injuries; and the rest are usually spinal injuries and burns.
What are the most common injuries?
A list of the most frequent injuries is as follows, divided into bone and joint injuries.
Bone injuries:
- Tibia: by mechanism of rotation of the knee on the ankle that is held by the boot.
- Fibula: by direct blows on the external side of the leg.
- Femur: by fall with high energy trauma.
- Ulna and Radius: when supporting the hands when falling, they are more frequent in the practice of snowboarding.
- Clavicle: due to falls on the shoulder.
Joint injuries:
- Ankles: ankle sprains. They are more frequent in cross-country skiers because the boot is soft and lower.
- Knees: the most frequent are injuries of the internal lateral ligament and the posterior cruciate ligament, since the knee rotates on the ankle that is fixed in the boot.
- Skier’s thumb: due to poor positioning of the strap of the ski poles that pulls the thumb when falling and injures the ligament of the lateral side of the finger.
- Shoulder dislocations: due to direct strong traumatism.
- Wrist sprains: due to poor positioning of the wrist in the fall.
Wrist sprains are generally caused by falling on your fist while holding a cane. It is present in more than 16.3% of cases: if, after a fall, you feel pain when moving your thumb, especially in flexion or when making a forceful grip with your hand, you should go to a clinical center for assessment and diagnosis.
Another injury worth mentioning is the wrist fracture (Colle’s or scaphoid fracture), which is particularly common in amateurs, especially beginners. The main reason is that it is the support area used to cushion falls, and it is usually done with the entire limb in extension and supporting the hand with the wrist also extended. As a preventive measure it is advisable to use wrist protectors and, for beginners, it is better to go with the hand in hand and when falling support the fist instead of the hand. It is essential to learn to fall without placing the hand, but to put the limb inward and let it fall supporting the arm and shoulder as if you wanted to roll, and learn to fall to avoid hard blows.
Can physiotherapy help to enjoy winter activities?
Absolutely yes, with two very specific actions:
- Prevention: the physiotherapist, knowing the winter activity you want to do, will be able to evaluate postural and muscular deficits and propose therapeutic exercise routines for their correction, as well as design a maintenance and control plan that minimizes the risk of injury. Undoubtedly, this is the most important action, since a good prevention will avoid the risk of injury, except for unforeseen traumatisms.
- Treatment: once the injury is diagnosed, an early therapy program will shorten your period of disability and above all will ensure an effective recovery.
Tips for winter sports
In order to practice any winter sport safely, the following should be considered:
- Have a good breakfast (dairy products, cereals and fruit) to avoid a loss of concentration and strength, and take some food -such as an energy bar or nuts- to help replenish energy.
- The warm-up should be progressive and include joint flexibility exercises that the physiotherapist may recommend, depending on the activity.
- Good technique and a series of rules to avoid falls, as well as learning to fall in the least injurious way, can prevent up to 80% of injuries to the locomotor system. Figures also indicate that half of the accidents occur among beginners with 48% and experts with 31%.
- When the first symptoms of fatigue are noticed, the activity should be abandoned; injuries late in the day or on the last descent are more frequent and are related to fatigue caused by excessive physical activity or lack of sleep.