Monday Medical: Ski Conditions and Common Injuries


Fresh powder or hard snow conditions don’t just determine which ski slopes you choose to descend first – they can also impact the types of injuries you need to watch out for.

Dr. Adam Wilson, Steamboat Springs orthopedic surgeon and medical staff member at UCHealth Yampa Valley Medical Center, describes the most common orthopedic injuries based on mountain conditions below.

Fresh powder? Beware of tension and tears.

“When we have fresh snow and deep powder, we see more ligament and soft tissue injuries,” Wilson said. “They are much more common with fresh snow because you have more torsion forces. People grab a ski or their board and fall, and their arm gets stuck behind them.

For skiers, these injuries include tearing the anterior cruciate ligament (ACL) or medial collateral ligament (MCL) of the knee; for skateboarders, dislocated shoulders are more common.

Although these injuries do not always require emergency surgery, it may be helpful to get checked out quickly.

For example, with an ACL or MCL tear, an x-ray the same day of the injury can confirm that there is not also a tibial plateau fracture. If the injury is only to the soft tissues, patients often wait for the swelling to go down and the range of motion to return before continuing with treatment.

“We can take X-rays and put an arm brace or get a knee brace, and then the patient can usually go home and see us the next week,” Wilson said. “Usually they don’t need to go straight to surgery.”

Hard snow? Watch out for broken bones.

“With the hardpack we see a lot of broken bones – broken legs, broken collar bones, arm bones and shoulder fractures,” Wilson said. “You basically fall on concrete.”

Snowboarders tend to fall on their arms and shoulders, so they can suffer more collarbone, shoulder and wrist injuries. For skiers, knee and leg injuries are more common.

While skiers and snowboarders can sometimes descend the mountain after a ligament injury, a broken bone usually means they need the help of a ski patrol.

Some broken bones require surgery or even emergency surgery. About three-quarters of collarbone fractures seen at Steamboat end up being repaired with surgery, while about half of shoulder dislocations require surgery.

“It depends on the extent of the damage,” Wilson said. “Bad labral tears or rotator cuff tears often require surgery.”

Prevention tips, regardless of the condition

Start by building a good base of strength. “With knee injuries, having good lower body strength heading into the ski season is as important as anything,” Wilson said.

Always ski within your abilities and be careful when skiing in trees.

“Some people may be pressured into doing something they’re not as comfortable with, but skiing within your comfort level can help you avoid injury,” Wilson said.

Be sure to use good gear that fits properly and is suitable for the weather, such as low-light goggles when it’s snowing hard.

And remember, being an experienced skier or snowboarder doesn’t mean you’re immune to injury. “Yes, the best skiers tend to learn how to fall, but they can go faster on more difficult terrain and can feel the same forces as beginners,” Wilson said.

Recover from an injury

Fractures generally take two to four months to heal, while soft tissue injuries can take four to eight months.

Wilson encourages patients through the recovery process by reminding them that while these recovery times may seem long, patients will return to full activity. Although they may not be able to return to skiing soon after the injury, they may be able to engage in bicycling or other low impact activities.

“Our goal is to get people doing what they love,” Wilson said. “We see good success in getting people back to skiing and snowboarding by next season, or with a few breaks, even within the same season.”


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