Tips for preventing ski injuries

Tips for preventing ski injuries

Ski season is in full swing — but an injury can put you out of commission until next year’s first snowfall. Here’s how to stay safe on the slopes all winter long.

While many people huddle inside during the winter months, away from “bomb cyclones” and blizzards, a select few know that the best way to beat wintry weather is to embrace it — on the ski slopes, that is!

As any seasoned skier will tell you, however, their beloved sport does come with the risk of injury. Fortunately, taking some simple precautions before you hit the slopes can help you stay in peak condition regardless of how many tumbles you take.

We’ve outlined some of the most common injuries that afflict skiers, and what you can do to prevent them.

MCL Injuries

A number of injuries can affect the medial collateral ligament (MCL), but the most common by far is an MCL tears. In skiing, MCL tears most often occur when the skier falls while attempting to slow or stop in a snowplow position, in which the tips of the skis are pointed toward each other. To avoid injury in this position, make sure to always keep your weight balanced. In addition, sticking to runs with which you’re comfortable can reduce the need to enter the snowplow position at all.

ACL Injuries

A variety of falls on the slopes can result in a tear of the anterior cruciante ligament (ACL). It most commonly happens after a forward fall, during which the inner edge of the front of the ski becomes embedded in the snow, trapping the leg in the process. It can also occur when the top of the back of the boot pushes the tibia (the weight-bearing bone in the leg) forward, away from the femur. On other occasions, it arises when the skier leans back on the skis, loses balance, and falls backward. Strengthening the hamstrings, wearing proper bindings, and using shorter skis can all reduce the risk of sustaining an ACL tear.


Like torn ligaments, fractures are most commonly caused by falls while skiing. The wrist and ankles are particularly susceptible to breaks. To help avoid broken bones, always wear adequate protective gear and practice proper techniques for falling. Increasing cardiovascular endurance and developing the surrounding muscles can also be beneficial.

Shoulder Dislocations

Most shoulder dislocations happen when skiers fall, either directly onto the shoulder or onto an outstretched hand or arm. This injury results in heavy, immediate pain, significantly restricts the shoulder’s range of motion, and can leave it misshapen. Since dislocations are caused by sudden trauma, they can be difficult to anticipate, but strengthening the rotator cuff muscles, especially if you have previously dislocated your shoulder, can lower the risk of a dislocation. As with other common skiing injuries, employing proper form will also minimize the possibility of a dislocation.

Spinal Injuries

Aside from protecting the spinal cord, the spine ensures the strength and stability of the back. It is made up of various bony segments called vertebrae separated by pieces of fibrocartilaginous tissue called intervertebral discs, any of which can be injured while skiing. Some ways to avoid spinal injuries include using spine protectors, sticking to trails on which you are comfortable, using proper equipment, and learning the technique for “safe” falls.

While some ski injuries are immediately apparent, others can be more subtle, slowly progressing with time. Fortunately, the talented team of specialists at New York Bone and Joint has extensive experience working in sports medicine and can quickly diagnose and treat any of these common problems. If you think you may have suffered an injury during your latest trip to the mountain, call us today to schedule a consultation, or if the injury has been recent, stop in to our Orthopedic Urgent Care!

What Is a Cortisone Shot?

What Is a Cortisone Shot?

Cortisone shots can potentially provide long-lasting relief from pain and inflammation in the joints.

Many injections can greatly reduce pain and inflammation caused by musculoskeletal injuries or chronic conditions such as arthritis, significantly shortening recovery timelines and providing lasting relief. One shot we particularly recommend to patients entails an injection of cortisone into a damaged joint. We’ll tell you what you need to know about this tried-and-true treatment for pain and inflammation in the joints.

What Is a Cortisone Shot?

A cortisone shot is an injection composed of a corticosteroid medication and a local anesthetic. Used to relieve pain and inflammation, it’s most commonly injected into a joint, often in the shoulder, hip, or knee. These shots are often one option in a comprehensive treatment plan for chronic inflammatory conditions such as arthritis, tendinitis, or rotator cuff impingements or tears.

How Long Does a Cortisone Shot Last?

A cortisone shot’s effectiveness depends on the severity of the patient’s condition. In most cases, pain and inflammation will marginally increase for about 48 hours following the injection, and will decrease precipitously thereafter. In some cases, a single injection can provide relief for as long as several months.

Generally, cortisone shots should only be given two times per joint per year. Repeated cortisone injections can damage the cartilage in the joint.

What Are the Side Effects of a Cortisone Shot?

Cortisone shots are typically safe in moderation, but since they infrequently lead to serious complications, they should be taken under a doctor’s supervision. Be sure to let your doctor know if you suffer from diabetes or other any other conditions affecting your blood sugar levels, as well as any medications that you are currently taking.

Most cortisone shots have some minor side effects, including a temporary uptick in pain and inflammation in and around the joint, and a thinning and lightening of the skin around the site of the injection. In some cases, however, they can result in a sudden spike in blood sugar if you’re diabetic and have poorly controlled blood sugar levels. .

What If the Cortisone Shot Doesn’t Work?

Cortisone shots provide a source of temporary relief from inflammation and pain. They will not solve the underlying problem, and pain may gradually return as the shot’s effectiveness subsides. As a result, cortisone shots should be administered as part of a more comprehensive treatment plan that may include physical therapy or surgery.

Fortunately, our team of orthopedic specialists at Comprehensive Orthopaedics has several years of experience in treating joint problems. Regardless of your specific condition, we’ll work with you to develop a personalized treatment plan that provides lasting relief from your symptoms.

Study Gets to the Core of Back Pain in Runners

Study Gets to the Core of Back Pain in Runners

The onset of back pain among runners may stem from a general weakness in their deep core muscles, new research indicates.

Such deep muscles are located well below the more superficial muscles typified by the classic six-pack abs of fitness magazine fame, the researchers noted.

Using computer simulations, they found that runners with relatively weak deep core muscles end up relying more and more on their superficial muscles to keep on running. The result is a higher risk for back pain.

“We measured the dimensions of runners’ bodies and how they moved to create a computer model that’s specific to that person,” said study lead author Ajit Chaudhari. “That allows us to examine how every bone moves and how much pressure is put on each joint.”

Chaudhari is an associate professor of physical therapy and biomedical engineering at Ohio State University’s Wexner Medical Center.

The investigators found that “when your deep core is weak, your body is able to compensate in a way that allows you to essentially run the same way,” Chaudhari said in a medical center news release, “but that increases the load on your spine in a way that may lead to low back pain.”

The study team said it’s not uncommon to find avid athletes who fail to put sufficient focus on their deep core strength, perhaps because superficial muscle maintenance tends to get a lot more public attention.

However, Chaudhari said, “working on a six-pack and trying to become a better runner is definitely not the same thing.

“If you look at great runners, they don’t typically have a six-pack, but their muscles are very fit,” he said. “Static exercises that force you to fire your core and hold your body in place are what’s really going to make you a better runner.”

The study was published online recently in the Journal of Biomechanics.

More information

The American Academy of Family Physicians has information on low back pain.

SOURCE: Ohio State University Wexner Medical Center, news release, Jan. 3, 2018

Electrical Pulses May Ease Pain From ‘Slipped’ Disc

Electrical Pulses May Ease Pain From ‘Slipped’ Disc

Radiofrequency ablation:

A new treatment that aims electrical pulses at irritated nerves around the spinal cord appears effective at relieving chronic lower back pain and sciatica, a preliminary study suggests.

The minimally invasive procedure, called image-guided pulsed radiofrequency, eased lingering pain in 80 percent of 10 patients after a single 10-minute treatment. Ninety percent were able to avoid surgery.

“Given the very low risk profile of this technique, patients suffering herniated disc and nerve root compression symptoms may undergo a safe and fast recovery, going back to normal activities within days,” said study author Dr. Alessandro Napoli. He’s an interventional radiologist at Sapienza University, in Rome, Italy.

“In fact,” he added, “one of the dramatic advantages of this technology is that we can perform it in a day-surgery setting, without anesthesia, and [patients] go home the same day.”

Napoli’s study is scheduled for presentation Wednesday at the Radiological Society of North America’s annual meeting, in Chicago. Studies presented at scientific conferences typically haven’t been peer-reviewed or published, and results are considered preliminary.

About 8 in 10 people suffer from lower back pain at some point in their lives, according to study documents. This pain can be due to a herniated disc in the lower spine. Sciatica is radiating leg pain caused by a pinched nerve in the lower spine, which also may be due to a herniated disc.

Also called a slipped or ruptured disc, a herniated disc occurs when the spongy material inside a spinal disc squeezes through its tough outer shell because of aging or injury. This material can press on surrounding nerves, causing pain and numbness or tingling in the legs, according to the American Academy of Orthopaedic Surgeons (AAOS).

Conservative, nonsurgical approaches typically ease symptoms of a herniated disc over time, according to the AAOS. These treatments include rest, gentle exercise, pain relievers, anti-inflammatory drugs, cold or hot compresses and physical therapy.

However, about 20 percent of those with acute low back pain don’t find relief through these measures. That leads some to decide on surgery to remove disc material pressing on their spinal nerves. For these people, Napoli said, image-guided pulsed radiofrequency treatment may become a viable option if larger studies reinforce his findings.

Napoli’s research included 80 people who had experienced at least three months of low back pain from a herniated disc that hadn’t responded to conservative treatments.

Image-guided pulsed radiofrequency treatment uses computed tomography — a CT scan — to help physicians insert a needle to the location of the herniated disc and surrounding nerves. A probe that’s inserted through the needle tip delivers pulsed radiofrequency energy to the area over a 10-minute period, resolving the herniation without touching the disc, Napoli explained.

More than 80 percent of the 80 study participants were pain-free a year after a single treatment. Six people required a second treatment session.

Pulsed radiofrequency has been widely used in pain medicine for other types of chronic pain, Napoli noted.

He said the treatment works by “eliminating the inflammation process” in nerves surrounding the herniated disc, hindering painful muscle contractions. “The aim was to interrupt this cycle and give the body the chance to restore a natural healing,” he added.

Dr. Scott Roberts, a physiatrist with Christiana Care Health System in Wilmington, Del., said the new findings showed “an impressive drop in pain and improvement in function.” However, he noted that the research didn’t include a control group for comparison with people not given the treatment.

“With no control group, we don’t know how much of the improvement we’re seeing would have happened anyway,” Roberts said. “I was very encouraged by [the study] because its results are significant, but it’s far from conclusive without a control group.”

Don’t Let Summer Strain Your Back

Don’t Let Summer Strain Your Back

Summer is the time when everyone dives into yard work and takes family vacations. But all that time spent bending, lifting and traveling can strain your back, spine experts say.

An estimated 3.7 million Americans sought care for back pain and injuries at doctors’ offices in the summer of 2014, according to the American Academy of Orthopaedic Surgeons (AAOS).

“Many back injuries occur from sudden movements during daily activities such as bending, lifting and twisting,” said Dr. Afshin Razi, a spokesperson for the academy.

“Always be mindful of the way you’re positioning your body and practice safe lifting techniques during these motions. Keep the core muscles in your back and abdomen strong and flexible. Strengthening your core muscles will help to support your spine,” Razi said in an AAOS news release.

The academy offers these tips for protecting yourself from back injuries during the summer:

  • Lift heavy items with your legs instead of your back, and don’t bend over. Bend your knees instead and keep your back straight.
  • Get someone to help you lift heavy objects. Turn to your friends or family or hire someone to assist.
  • Pack as lightly as possible when traveling, and try to spread heavier items among several boxes or bags.
  • Take breaks, regardless of whether you’re sitting or working, and stretch between tasks.
  • Watch your posture and sit with your back in a slightly arched position. Your chair should support your lower back and your head and shoulders should be upright.
  • Be careful about your footwear. Your shoes should fit properly and have rubber non-skid soles to protect you from falling, especially when you’re traveling or working outdoors.
  • If you’re outside, make sure hoses, rakes and garden tools are out of your path so you don’t trip over them.
  • Pets like to be underfoot and can pose a tripping hazard. Consider putting a bell on your pet so you know its location when it’s moving around.
Seniors Get Good Results From Herniated Disc Surgery

Seniors Get Good Results From Herniated Disc Surgery

People over age 65 shouldn’t avoid surgery for a herniated disc just because of their age. Seniors benefit from the procedure as much as younger patients, Norwegian research shows.

The study involved more than 5,500 people with a herniated, or “slipped” disc. The condition occurs when one of the discs that cushions bones in the spine gets damaged, causing it to push forward. The result is lower back pain that can extend to the leg and foot, and even lead to paralysis.

Exercise, heat and pain medication provide relief in some cases. But people with severe pain or disability may need surgery, according to researchers at St. Olav’s Hospital in Trondheim, Norway and the Norwegian University of Science and Technology (NTNU).

The investigators compared patient-reported outcomes after disc surgery. The study included nearly 5,200 patients under age 65, and about 380 older patients.

The researchers reported that older patients had less back pain after surgery than younger patients. But the seniors experienced more minor complications and had slightly longer hospital stays. However, the study authors said that these issues were not serious and didn’t affect the success of their treatment.

“This study shows that it is fully possible to do good surgical research on elderly patients,” study leader Mattis Madsbu said in a NTNU news release. Madsbu is a medical student at the university.

The study was published recently in JAMA Surgery.

More information

The U.S. National Library of Medicine has more about herniated discs.

SOURCE: The Norwegian University of Science and Technology, news release, May 2017