Long Turns with Pole Half Kneeling. ⢠Start by getting into a half kneeling position. Start by getting into a half kne
Preventing Winter Injuries Brian D Busconi, M.D. Chief of Sports Medicine & Arthroscopy UMass Memorial Medical Center
[email protected] @ g
Types of Injuries • • • • • • •
Sprains and strains Di l Dislocations i Fractures T i ll att the Typically th endd off the th day. d Overexertion and fatigue. “One One last run before the day day'ss end. end ” (Hometown (H t B Buffet ff t Syndrome S dr ) Easily prevented with preparation, good physical conditioning, staying alert and stopping when tired or in pain.
Preventing Injuries • M Maintain i t i your fitness fit level l l during d i the th off-season, ff th then continue during the season since deconditioned bodies are pre-disposed pre disposed to injuries. injuries • Promptly address any injuries to avoid secondary injuries. • 3-4 3 4 months to prepare for winter sports; more intense sports up to 6 months. • Pre Pre-season season training should include aerobic work and core strength training.
Important Muscles • Hamstrings are major protectors of the Anterior Cruciate Ligament (ACL). • Skiing, Skiing snowboarding and snowshoeing are quadriceps and gluteus dominant activities. Cross-country country skiing and skating have more lateral • Cross push.
• Core stabilizes the lumbar spine (low back). back) • Dysfunction of these muscles can result in injury. • Lower Crossed Syndrome
Lower Crossed Syndrome • • • • •
Hours of sitting with hips flexed. Adaptive shortening of hip flexors. Brain thinks the hip flexors are working. Opposite muscles (glutes) are inhibited. With major pelvic stabilizers (glutes) shut down muscles above b (l (lower back) b k) andd below b l (hamstrings) (h i ) tighten. i h • Opposite muscles (abs/quads) shut down. • Now N prone tto injury i j since i primary i muscles l usedd for f skiing are shut down with LCS.
= tigh t = we a k P rim a ry S kkiin g M u scle s
Stretch and Strengthen • Stretch • Deep Hip Flexors • Hip Flexor Stretch – Half Half-Kneeling Kneeling • Long Turns with Pole – Half-Kneeling
• Strengthen g • Glutes and Quads • Lunges • Lunges with Arm Pulls
• Endurance • HIIT
Hip Flexor Stretch – Half Half-Kneeling Kneeling • Start in the half-kneelingg position p with your right knee down and your left foot forward. • Take both hands and p place them on your right hip. • Keeping your spine neutral and using yyour hands to prevent p anyy rotation of the pelvis, slowly lunge forward until you feel a big stretch in the hip flexors. • Try T to stay tallll throughout h h the h exercise. • Make it a little tougher by putting your palms l together h and d reaching hi your arms straight overhead to the ceiling.
Long Turns with Pole – Half Half-Kneeling Kneeling • Start by getting into a half kneeling position with your front foot placed directly in front of your down knee. • Sit as tall as possible possible. • Raise a ski pole up over your head and continue to try and sit as tall as possible. • Slowly begin to rotate your trunk and the pole as far as possible in both directions. epeat this th s movement ove e t 155 times t es to each side. s de. • Repeat • Go slow enough to maintain a good posture and good balance.
Lunges • From a standing position start by taking a large step forward with your right foot. • Pretend Pr t d like lik you are r standing t di on a balance beam (narrow your base) and lower your torso and pelvis down k i your posture upright. keeping i h • Allow your back heel to come off the gground and make sure your y front knee stays over your front ankle (Don't let your front knee go forward past your ankle!!!). • Repeat on the other side.
Lunge with Arm Pulls • Start byy attachingg a resistance band at waist height. • Facing the door, grab both handles and back away from the door. • Now perform a lunge towards the door and simultaneously pull your arms down and back keeping your arms straight. • An A alternative lt ti to t pulling lli both b th arms down d at the same time is to alternate each arm one at a time. • This forces your core to stabilize a rotational force and adds an additional level of difficulty to this exercise.
Endurance – HIIT (High Intensity Interval Training) • Downhill skiingg is done in intervals. • 30 second workout is the ideal place to start with Interval p training. • Make sure that you stretch, warm up p and warm down p properly p y for every workout. • Go fast enough to feel that the last few seconds feel almost impossible to keep running. • Don’t save yourself for later, give it all up p front.
M a ke su re you con su lt with you r p h ysicia n p rior to sta rtin g a n y e xe rcise p rogra m !
AAOS Recommendations • Never participate alone in a winter sport. • Keep in shape and condition muscles before participating in winter activities. • Warm up p thoroughly g y before playing. p y g Cold muscles,, tendons and ligaments are vulnerable to injury. • Wear appropriate protective gear, including goggles, helmets, gloves and padding. p g • Check that equipment is in good working order and used properly. • Wear several layers of light, loose and water- and wind-resistant clothingg for warmth and protection. p Layering y g allows you y to accommodate your body's constantly changing temperature. • Wear proper footwear that provides warmth and dryness, as well as ample p ankle support. pp
AAOS Recommendations • Know and abide by all rules of the sport in which you are participating. • Take a lesson (or several) from a qualified instructor, especially in sports like skiing and snow boarding. Learning how to fall correctly andd safely f l can reduce d the h risk i k off injury. i j • Pay attention to warnings about upcoming storms and severe drops in temperature to ensure safety. • Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if injuries occur. occur • Drink plenty of water before, during and after activities. • Avoid participating in sports when you are in pain or exhausted.
Helmets: Hagel, I et al. • A ssu m p tion th a t th ey a re h elp fu l is b a sed on b icycle h elm et d a ta th a t d oes p rove u sefu ln ess • C h ild ren h a ve la rge h ea d :b od y ra tio • C ou ld h elm ets exert excessive b en d in g or twistin g on th e n eck in sim p le fa lls
Helmets: Hagel, I et al. Conclusions: • W ea rin g h elm et m a y red u ce risk of h ea d in ju ry b y 2 9 -5 6 % •A lt lth ou gh g n ott sta t ttistica t lly ll sign gn ifica f n tt, th t ere wa s a tren t nd towa rd h elm et u se ca u sin g a n in crea se in n eck in ju ries. Limitations: •S n owsp ort p a rticip a n ts th a t fell b u t were n ot in ju re d a s a resu lt of wea rin g a h elm et cou ld n ot h a ve b een rep orte d •B en efits of wea rin g a h elm et m a y h a ve b een u n d erestim a ted
Thank You We Want You Safe On The Slopes!
