Winter Sports Injury Prevention


Winter Sports Injury Prevention

According to the U.S. Consumer Product Safety Commission, winter sports brought in 200,000 injuries to hospitals, doctors’ offices and emergency rooms in 2018 alone. If you’re into winter sports, you should know that there are ways to better prepare your body for these activities, and preventative measures that can be taken. Doing so will help keep you safe, so you can participate in your favorite winter activities. Whether you’re into ice hockey, ice skating, skiing, or even simple walks around the block in cold weather, there are winter-specific obstacles that you should be aware of.

After sitting at your desk all week with plans to hit the slopes on the weekend, it is vital that you properly prepare your body for this transition. Simple decisions such as warming up thoroughly and using protective gear, can help reduce your chance of injury.

Types of Winter Sports Injuries

All winter sports have risk – some are preventable and others are not. Injuries include fractures of the upper and lower extremities, back and neck injuries, ligament tears (ACL and MCL), spinal cord injury, concussion, traumatic brain injury (TBI), and simple muscle sprains and tears.

Clothing and Protective Gear

The risk of falling during winter sports is high and may be reduced if you wear properly fitted gear related to your sport, prepare your body for participation, and know your limits. Proper equipment in sports like hockey, skiing, and snowboarding is essential. Borrowing or renting gear may be appropriate, but you want to make sure it fits you! Protective gear in both skiing and ice hockey includes a helmet with eye protection and a warm base layer. For hockey, remember the neck guard, and make sure there are no gaps between your pants and the tops of the shin guards where a puck could cause a contusion. Of course, the fit of the ski boot, snowboard shoe, and hockey or figure skate are essential to injury prevention. Figure skaters and hockey players often seek Physical Therapy for pain in their feet due to improperly fitted skates.

Dynamic Warm-Up

A dynamic warm-up has been shown to prevent injuries and is the mechanism to properly warm-up before participating in sports. Dynamic stretching involves movements that increase heart rate, blood flow, deep muscle temperature, respiratory rate, viscosity of joint fluids, and perspiration1 while actively lengthening the muscles.

Dynamic warm-up exercises should be done until the athlete has reached the maximum range of motion in all their joints. Proper warm-up can take the beginner 30 minutes and the advanced 10 to 15 minutes.  It is extremely important to note that passive or static stretching should not be performed as a warm-up exercise. Passive, relaxed stretches, have a calming effect and can make the athlete sleepy.2 Passive stretching, which is also beneficial for injury prevention, should be completed during the cool down phase after exercise has ceased.

To begin a general warm-up, start with 5 minutes of aerobic activity2 (e.g. jumping rope, slide board, jogging in place, jumping jacks.) This will improve the flexibility of the muscles and prepare the body for dynamic stretches.  Next, perform the following movements, starting with the head and finishing with the lower extremities:

Head: (repeat 5 times gently and slowly)

  • Look up and down then turn head to the right and then to the left
  • Side bend ear to the right shoulder and then to the left shoulder

Upper Extremities: (repeat 5 to 8 times on each arm)

  • Wrist circles: clockwise and counter-clockwise
  • Roll shoulders back and down (arms at sides)
  • Elbow circles: hands on shoulders and circle elbows backwards squeezing scapula
  • Arm circles: stretch arms up over head lengthening the spine then lower arms and cross in front of the body repeat bringing the arms up and then lower crossing arms behind the back

Trunk: (repeat 5 times slowly)

  • Turn trunk to the right and then to the left (pain-free range of motion)

Lower Extremities: (repeat 10 to 12 times on each leg)

  • Ankle circles – clockwise and counter-clockwise
  • Calf pumps: Standing, place right toe behind the left foot, bend the left knee allowing the right heel to touch the floor, then straighten the left knee while lifting the right heel off the floor. Repeat with opposite leg.
  • Hip swings – forward and back: Swing one leg forward then backward (keep the spine straight). Repeat with opposite leg.
  • Hip circles: Standing on one leg, “draw” a large circle with the free knee (clockwise and counter-clockwise).
  • Chicken walk: Walking forward, bend one knee backwards, as if kicking the buttocks, and continue walking forward while alternating legs.
  • Knee hugs: Walking forward, bend the right hip and pull the right knee to chest with both arms, walking forward while alternating legs, keeping the spine straight.
  • Crossover pull: Walking forward, bend the right hip and pull the right knee to chest with left arm. Continue walking forward while alternating legs, keeping the spine straight.
  • Frankenstein walk: Walking forward, kick one leg up while keeping the knee straight, alternating legs.

Fitness and Training

Another factor you can control is your fitness level. Whether you are a high level athlete or weekend warrior, you can prepare for physical activity. Injuries can be caused when there are great differences in strength or flexibility between two muscles, or you are participating at a level greater than your physical strength. To address strength deficits, prepare with cardiovascular training. Incorporate both aerobic and anaerobic training.

  • Aerobic: 20 to 30 minutes or longer of non-stop exercise, such as the bike, treadmill, stair climber, at 70 to 85% of the maximum heart rate.
  • Anaerobic training: Interval with high-intensity exercise at 85% to 95% maximum heart rate, and low-intensity exercise interval at 70% maximum heart rate.

Incorporate these body weight exercises to address core, upper and lower extremity weakness:

  • Squats with correct technique
  • Single leg balance exercises
  • Heel raises
  • Supine bridges
  • Planks
  • Push-up
  • Lower abdominal training
  • Chair dips

Finally, incorporate stretching and foam rolling after exercise and sport participation to improve flexibility and decrease post exercise muscle soreness.

Hold each stretch 30 to 60 seconds, then repeat 3x on each leg:

  • Calf stretch: Gastrocnemius and Soleus
  • Quadriceps
  • Hip Flexor (Iliopsoas)
  • Hamstring
  • Hip Rotator (Pirfomis)
  • Groin Stretch (Short Adductor)
  • Groin Stretch (Long Adductor)
Allison Stringer

Allison Stringer MS, PT, FAAOMPT, CHA

Clinical Director, Physical Therapist, Compliance Specialist

Allison Stringer, Physical Therapist, is Clinical Director of Professional Physical Therapy in Salem, MA. Allison received her Master’s Degree in Physical Therapy from Simmons College and achieved the status of Fellow of the American Academy of Orthopedic Manual Physical Therapists after she completed the Institute of Orthopedic Manual Physical Therapy program.  Allison specializes in manual Physical Therapy for patients with orthopedic injuries to the spine and extremities, sports medicine, and wide range of women’s health issues including incontinence.

Sources:

https://orthoinfo.aaos.org/en/staying-healthy/winter-sports-injury-prevention

https://www.hss.edu/conditions_snow-sports-injury-prevention-tips.asp

https://www.chop.edu/news/health-tip/perfect-10-winter-sports-safety-tips

References:

  1. Baechle, T. Essentials of Strength Training And Conditioning.  Human Kinetics, Champaign, IL 1994
  2. Kurz, T Science of Sports Training: How To Plan And Control Training For Peak Performance.            Stadion, Island Pond, VT, 1991.