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Knee injuries - BBC report

 Poster: A snowHead
Poster: A snowHead
http://news.bbc.co.uk/1/hi/health/7178561.stm
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Exactly what happened to my boss a couple of weeks back. And guess what? I have to stand in for him on our annual corporate ski trip.

Every cloud has a silver lining, eh? snowHead
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Quote:
More than nine out of ten of the injured skiers were women, with an average age of 40.


Ladies, you have been warned Shocked
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The day off advice is good - how many of us actually do that and instead get progressively worse/ more tired.
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I wonder if shorter skis and the more open modern stance has anything to do with it ?

It seems to me that skiing with a more closed stance, feet together with more equal weighting might reduce the possibility of 'wrenching' an individual knee ? Absolutely no evidence for this though Puzzled

Also doing more walking to the slopes is probably also helpful for warming up and avoiding injury. I wonder if more chairlifts (less draglifts) are an indirect cause also ?
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"Skiing is a strange sport which requires no intrinsic strength or skill" rolling eyes
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Peter S, I read somewhere that when falling (especially backwards) the shape of new ski's encourages the ski turn as you fall.
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After all it is free Go on u know u want to!
Frosty the Snowman, that's what i thought - a big sidecut encourages the ski to turn sharply without much input from the skier. if you're in the back seat with lots of stress on the knee a sharp twisting movement can cause the ACL to go pop very easily
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Quote:
if you're in the back seat with lots of stress on the knee a sharp twisting movement can cause the ACL to go pop very easily

sounds right. The times I've felt a knee in danger (not counting the only really big injury I did, which was Cairngorm yonks ago and well before short shaped skis) have been when I've been thrown into the back seat, generally skiing like a camel. When the weight is well forward over the feet, everything feels more secure. My 40 year old sister in law fits the statistic perfectly - serious ACL injury followed by a reconstruction, falling at top of chairlift . She perfectly reflects the "no instrinsic strength or skill" comment too. Beginners are equally likely, maybe more likely, to injure their knees just pottering on an easy slope, especially if snow is chopped up, or falling off a lift. We have elderly (ie 60, same age as us) friends arriving tomorrow - they've been doing some serious cycling and exercises to try to get in trim, and also swim regularly. They are also competent skiers, though their lessons were many years ago (they had a catch up private lesson here last year). All this, coupled with caution and being a bit careful where to go, reduces their chances of injury. The big TOs maybe have a responsibility to educate people more fully about the need for preparation? Two of our visitors were badly injured in ski lessons (one a private lesson) last year. One of them was a pretty strong ex-Marine, who does irrigation for a living, so not a couch potato. Overweight, though!! So just having lessons is not necessarily a defence either, though it's obviously vital.

One probem with 40 year old women of my acquaintance is that they're often really scared of falling - which leads to tension, hanging back, and to contorted attempts to stay up, no matter what. Friends we spoke to last week were a case in point. Mum, rather nervous, not very good skier, badly needs lessons (and has skis too long for her....) was v pleased she had only fallen once in the week. Their 16 year old son, strong and fit and a great skier who "goes for it" all the time, said he'd fallen over heaps. Struggling to avoid falling over, or being very scared of falling over, must contribute a lot to some of those injuries. When you teach kids to sail dinghies you get them capsizing right at the beginning, and they soon lose their fear (the problem becomes stopping the little sods from capsizing all the time). Maybe all putative new skiers over 30 should spend a day on a snowboard to start with, to learn that falling is not a disaster!

Not sure about modern boots being higher, though? Are they?
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The "modern boots" referred to in the article are the ones made in the past 30-35 years. There's been no change in the height of ski boots since the mid to late 1970s.
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pam w, I will confess to not liking to fall over - I'm not that scared of the fall, but I still find getting up quite difficult and it robs me of quite a lot of my energy reserves for the day. However, I think the key is not so much to avoid rescuing the situ if you can (usually by sticking a turn in IME) but to make sure you just go with it and not fight it once you are past the point of no return.
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We discussed this some time ago with a physio, chiropractor and Warren Smith.

"Take the fall" was the overwhelming advice.

It is the fight to stay up, putting huge strain on knees, that does the damage in a huge number of accidents.

Take the fall, take the bruise....and don't take the blood wagon.
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http://www.ski-injury.com/gss.htm
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 You know it makes sense.
You know it makes sense.
rungsp wrote:


Take the fall, take the bruise....and don't take the blood wagon.


Easier said than done unfortunately Confused I hate falling (being prone to dislocate various bits of my body rolling eyes ) & although I know I must stay low when I fall, my instinct is to stand upright - usually with the winding down the windows arm action!! The result, not suprisingly, is messy Confused How do I recondition my natural instincts?
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grizzlybear, Welcome to snowHead - & that has to be the grizzliest set of injury photos ever Skullie
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Well on our 10 day Austria trip (in 12 sleeps time in case there is anyone who's not aware Toofy Grin ) I will be having at least 1 day off. I'm not as fit as I should be so will need a lazy day to recover. To quote a close friend (who, on finishing the warm up on a fitness video, plonked herself onto the sofa & lit a fag) "I know my limits" Smile
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Heard a chap who does lots of the ACLs for the Army talk about this. He said low speed (so bindings don't eject) twisting falls in unfit middle-aged women were about the most dangerous for knees.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Quote:
How do I recondition my natural instincts?

spend a day or two on a snowboard - not kidding. If I can do it, so can you. It makes a big difference. You soon learn that falling is not too big a deal, you soon learn to fall properly to reduce the pain, and it's much easier to get up again on a board than on skis. You just roll the board over your head and stand up.
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pam w, Maybe next year............
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Anyway, snowHeads is much more fun if you do.
Quote:

How do I recondition my natural instincts?

Take some judo lesson?

I caution against pam w's advice. You risk dislocating your shoulder on the first fall.
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abc wrote:
Take some judo lesson?
This is useful advice, but I think it might take some time for the techniques to become second nature. My son is a judoka and I noticed he was using his breakfall (Ukemi) techniques when he had his first couple of days on a snowboard at Christmas.
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NickB wrote:
"Skiing is a strange sport which requires no intrinsic strength or skill" rolling eyes


They just don't get it do they? We need a 'muggles' word for non-skiers. Some of these doctors are so self-righteous - I know we have loads on here, so apologies to them in advance for deep offence inevitably caused wink
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
abc, I've been advised never to try snowboarding for that very reason wink
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I've only ever felt minor twisting injuries at low speed silly crashes where a bumb catches you unawares. Any fast falls have been totally painless with skis releasing fine.
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Me too, Scarpa, tended to cack it painfully when being lazy or tired later in the day. Biggest head over heels skydive just left me winded and in a lot less lasting pain than some silly knee twists
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geri wrote:
grizzlybear, Welcome to snowHead - & that has to be the grizzliest set of injury photos ever Skullie

Grizzliest ones I saw was a series of a guy in scotland who had gone up in the air and landed, literally impaled himself on a snow-fence post about 1 1/2 or 2" accross. They cut the post and took him to hospital with the end still in his intestines.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
snowball wrote:
geri wrote:
grizzlybear, Welcome to snowHead - & that has to be the grizzliest set of injury photos ever Skullie

Grizzliest ones I saw was a series of a guy in scotland who had gone up in the air and landed, literally impaled himself on a snow-fence post about 1 1/2 or 2" accross. They cut the post and took him to hospital with the end still in his intestines.


Eugh TMI! Mad
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So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
They showed them as part of a first aid course "what would you do with this injury" sort of thing Shocked
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 You know it makes sense.
You know it makes sense.
NickB wrote:
abc wrote:
Take some judo lesson?
This is useful advice, but I think it might take some time for the techniques to become second nature. My son is a judoka and I noticed he was using his breakfall (Ukemi) techniques when he had his first couple of days on a snowboard at Christmas.


Ukemis are great. Give you the confidence to bail out before you wipe out, assuming you have that option.
20 years training and I'll quite happily sit down before I fall down.

The other important thing you get from Ukemi, is relaxing, as hitting the floor isn't a major issue.
I was lucky enough to walk away from a motorcycle accident before Christmas as well, parked the bike in a ditch Skullie
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
I think there is a combination of things

a) People being scared of falling and so leaning back and therefore not fully in control of their skis, plus they are going slowly - exactly the circumstances under which bindings will not release.
b) Ski design as above
c) General level of fitness, and particularly quadriceps strength. A huge number of people, particularly women and particularly over 40, don't have enough strength in their quads to get up from sitting to standing without using their arms. Given this, then their knee is going to be massively less protected than somebody with good quads strength. (Before anybody comments, I'm 50, female and have good quads strength, but then I am a fitness instructor!).
d) Effect of altitude on cardiovascular function and particularly endurance - it will be lower, even if you are fit before travelling, and most people aren't. So people get tired quickly, try to ski for longer than they should before taking a rest, and hence their muscles aren't working to full efficiency. If they need muscles to protect the knee when they fall, they are too fatigued to work.

Of these I think lack of fitness is primary - most people don't do more than an hour's exercise a month, and then think they can do 6 hours a day without any problem at all. And it is exercise that pushes your anaerobic threshold, so that kind of fitness won't be gained by a little bit of gentle pottering, or a nice gentle yoga class. They also have poor core stability and therefore are putting greater stress on the lower limb than people with good core. I've got a lot of friends who do no exercise or training, or a little bit of yoga of gentle swimming (don't get me wrong, I think yoga is good, but doesn't prepare you for skiing on its own) and then go skiing for a week.
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The problem is most tourists forget it is a week or two Sports activity & NOT a vacation. Never get the two confused.

Most tourists I see skiing in St Anton are not fit at all. There straight from the desk job to the slopes.

They pound the slopes 6hrs a day & party all night. The NET result will be injuries. The worse time for injuries is when you stop for a break/lunch etc and start again . It is like any sport your body/muscles become cold & weak and this is when injuries occur most.
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kermit wrote:

The other important thing you get from Ukemi, is relaxing, as hitting the floor isn't a major issue.


Absolutely. I practised judo for six years as a kid, and I've found the general principles of breakfalls are a great help with skiing falls: (a) relax, (b) keep your head from hitting the floor, and (c) DON'T put your hand out to save yourself unless you like broken wrists.
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