Anchorage Daily News

The second I went down, I knew something was wrong.

Click to enlarge

Story tools

Comments (0)

E-mail a friend

Print

Share on Facebook

Digg this

Seed Newsvine

Send link via AIM

Follow on Twitter

Font size : A | A | A

Skiing down a gentle slope on the last run of the day, I caught my ski tip on a chunk of ice buried under the fresh snow. The skis came to an abrupt halt while the rest of my body twisted, continuing to head downhill.

An internal "twang," like a rubber band finally giving way, snapped in my right knee and the pain was immediate, intense and nauseating.

Skiing the rest of the way down the hill on one leg, I spent the rest of the afternoon icing the knee with snow packed in a baggie. It did little to relieve the pain, but I was sure it would eventually be OK.

Turns out, it wasn't. After finally visiting a doctor a week later, the diagnosis was in: a torn anterior cruciate ligament, or ACL, one of the most common ski injuries of winter.

While winter can be a beautiful time of year, with snow falling, lakes freezing and lots of opportunity for outdoor activity, it also is one of the busiest for Alaska doctors and physical therapists, who say that injuries caused by slips, falls and accidents can be difficult to avoid.

"Last year when it thawed and then got cold again and we got all that snow, it was predictable," said orthopedic surgeon Dr. William Mills, with Orthopedic Physicians Anchorage. "We were all looking out the window, going, 'This is really bad,' because people's mindsets change as soon as it's spring, and it's like, 'Yee-haw.'

"Sure enough, a few days later there was this string of patients coming in with injuries from falls."

Short of staying in the house, though, what is one to do?

The experts have a few suggestions:

1. Wear or use the appropriate gear.

2. Be realistic about abilities and limits.

3. Slow down.

"The biggest thing we see, of course, is falls," said Marissa Cole, a physical therapist with Select Physical Therapy, which has offices in Anchorage, Eagle River and Palmer. "Someone comes in and has pulled something or broken something, and most of the time it is because they didn't have appropriate footwear."

Wearing inexpensive ice grippers or cleats on ones' shoes is the easiest way to reduce the risk of falling, Cole said. Older patients or those with mobility issues would do well to have canes or walkers to help stabilize them when it is slippery out.

And if you're already on crutches for an existing injury, she said? Don't make matters worse by depending on them on the ice. Small cleats, like tiny crampons, can be attached to the rubbers tips of crutches to keep them stable when outside.

Helmets are a good choice too for those involved in skiing and even such activities as sledding, experts agree. The American Academy of Orthopaedic Surgeons, on its Web site, cited a U.S. Consumer Product Safety Commission study that reported roughly 74,000 sledding, snow tubing and tobogganing-related accidents for the year 2004.

Mills suggests kids, especially, wear helmets during these activities. Also, never sled downhill headfirst, and use a sled that can steer.

Joy Backstrum, a physical therapist at the Physical Therapy Place in Anchorage said often winter injuries are the result of underlying fitness deficiencies that have not been addressed. To best avoid injuries, she encourages patients to strengthen their core muscles so that when their extremities are put to the test, they can withstand the added stress.

"Most of us in our culture have been taught to use our back as a hinge because it is an easier lever, but it was never meant to be a hinge," she said. "We should be using our hips."

So, when, for instance, people who normally get very little physical exercise go out to shovel their driveways for three hours while bending at the back, it is no surprise when they end up in her office with problems.

"I tell people who ask, 'What should I do to get strong, what machine should I do at the club?' to go outside and find a hill and do hill repeats. Everybody's got a hill somewhere, and if they go out and walk it or run it and use their glutes, what they're doing is training their body to flex at the hips.

"This works for shoveling, going backcountry skiing, whatever," she added. "As we get older, we have to be smarter."

Cole calls this the "weekend warrior" syndrome, and she treats patients who have suffered overuse injuries that were caused by simply not being prepared for the demands.

Ask for help, she suggests. Rather than shovel the driveway in one four-hour-long session, take breaks and stretch.

"They'll go through and do it all in one bout without giving themselves a rest," she said. "Then the damage is done, and they feel it the next day."

For those who've pushed their limits, there is the generally accepted "R-I-C-E" method of therapy, which stands for "rest," "ice," "compression" and "elevation," Cole said. Patients can follow this method at home to get some relief from their injuries.

"Always acutely you want to use ice for things when you have the inflammation phase," she said. "And that will or can last for several days and sometimes does get better on its own."

Mills, who sees patients ranging from Olympic-caliber athletes to elderly shut-ins, said the most common wintertime injuries include ligament tears, dislocated kneecaps, shoulder dislocations and bone breaks. These injuries are the result of too much torque being put on a particular joint -- whether from falls, trying to stop oneself from falling or from overuse.

Last year he treated an elementary-school-age boy who suffered a patellar dislocation -- or kneecap dislocation -- after falling on ice at the playground. What seemed like a simple tumble turned out to be quite serious, he said, and could affect the boy's kneecap health when he is an adult.

Now when Mills has patients, he counsels them that recovery can be slow, sometimes more than a year. And physical therapy is usually a key component to that recovery.

Cole, at her practice, said a lot of her wintertime clients are those who have been in car accidents, sliding off icy roads or being injured upon impact with other vehicles.

"We get a lot of neck and midback injuries in the winter," she said. "Come February, about 50 percent of our patients are those who've been involved in car accidents."

Something as simple as slowing down, or leaving larger gaps between vehicles, is a way to avoid injuries, she said.

"It's that time of year," she said, "and you just have to be careful."

Freelance writer Melissa DeVaughn lives in Chugiak.

Protect your skin

When the snow and ice of winter arrive, the slips and falls, torn ligaments and broken bones are what we most often worry about. But come winter, we also must not forget our first defense against the cold: our skin. This protective outer layer keeps us cool in the summer and warm in the winter, but it can only do so much.

• Exposed to too much cold, skin will freeze, and exposed to too much sun, it will burn. Both can be deadly.

• Dr. William Mills Jr., an Anchorage doctor and noted expert on hypothermia and frostbite (and father to Dr. William Mills III, the orthopedic surgeon), said the target cell for freezing injury is cartilage, which means fingers and toes are most susceptible, although ears, noses and other extremities are at risk too.

• Frostbite can occur in temperatures as high as 30 or 40 degrees, especially if victims become wet or over-exerted and dehydrated.

• Rewarming frostbite injuries is crucial, the most effective method being soaking in warm water at less than 120 degrees.

• Wearing sunscreen, too, is a vital part of staying injury-free in the winter. Even though it is cold out, the sun's reflective rays off a white landscape can increase the chance of severe sunburn, which can lead to skin cancer.

• Wear at least a 15 SPF (sun protection factor) sunscreen while skiing, snowboarding or sledding, recommends the nonprofit Sun Safety Alliance, which works to reduce the incidence of skin cancer.

-- Melissa DeVaughn

ADVERTISEMENT