Jan 14, 2014

Interviewer: Make this year an injury-free year, whether you ski or snowboard. That's coming up next on The Scope.

Announcer: Medical news and research University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: The ski season opening up, the snowboarding season opening up and Jackson Hole, just like Salt Lake City, we've got some great opportunities to do those types of things. We're with Dr. Jeffrey Greenbaum from St. John's Medical Center in Jackson Hole. Let's talk about preparing for the season; first of all, if you're a skier or snowboarder, we want to do it without getting hurt. What are some thoughts that you have?

Dr. Greenbaum: Well, of course, as far as preparation is concerned, it's the same as with any athletic endeavor and, you want to be in condition. So it's probably wise to go out and take some kind of fitness class, and here in Jackson Hole, and I'm certain in Salt Lake City, we have specific ski fitness classes that focus on getting your legs and core prepared for the season.

Interviewer: So how far in advance should somebody start getting in shape for the season or snowboarding?

Dr. Greenbaum: Of course, you could always stay in shape, but probably the most typical is about a month or six weeks before the ski season to begin a fitness course.

Interviewer: What about stretching? Like, are there two or three stretches you would absolutely recommend somebody do?

Dr. Greenbaum: You need to stretch the areas which you consider to be important, whether they be your hamstrings, or your low back, or it might even be your shoulders.

Interviewer: Gotcha. What do you stretch before you hit the slopes?

Dr. Greenbaum: Definitely hamstrings and definitely back.

Interviewer: Are you a skier or a snowboarder?

Dr. Greenbaum: I'm a skier.

Interviewer: Are there different potential injuries between the two?

Dr. Greenbaum: Oh, absolutely.

Interviewer: All right. So let's talk about skiing injuries. What are some of the more common things you want to watch out for?

Dr. Greenbaum: Well, every skier wants to watch out for knee injuries. Probably the most concerning knee injuries are the ACL tear or the fracture of the upper tibia, the tibial plateau. Generally, these types of injuries are caused by twisting and tumbling falls when your ski binding does not release.

Interviewer: Oh. So how can you avoid that then?

Dr. Greenbaum: Make sure that your gear is properly adjusted.

Interviewer: Yeah.

Dr. Greenbaum: Make sure that your boots fit you correctly. Make sure that your bindings are not antiquated or obsolete, and that the person who adjusted them is actually a certified technician.

Interviewer: So that equipment really makes a big difference, it sounds like.

Dr. Greenbaum: Well, it's the equipment actually which results in the injury because you're locked into the ski.

Interviewer: What about snowboarders? What are they looking at?

Dr. Greenbaum: Snowboarders have a lot of injuries to their shoulders and wrists.

Interviewer: They're, again, from falls.

Dr. Greenbaum: Yes.

Interviewer: Is there anything you can do?

Dr. Greenbaum: Well, for beginner snowboarders, it's very wise to wear pads and wrist guards.

Interviewer: Okay. Any other types of things you'd want to do?

Dr. Greenbaum: As far as snowboarding is concerned?

Interviewer: Yeah, to prevent injury.

Dr. Greenbaum: Take a lesson.

Interviewer: Probably true for skiing or snowboarding.

Dr. Greenbaum: It is true.

Interviewer: You really need to have some sort of sense of control if you need to maneuver quickly, I'd imagine.

Dr. Greenbaum: Yes, and, of course, with a lot of mountain sports there's a sense from some individuals that they can simply pick up the equipment and go at it without having a lesson. That's usually a mistake.

Interviewer: Yeah. What about head injuries? You see more and more people finally wearing helmets. I suppose helmets are finally becoming accepted.

Dr. Greenbaum: Helmets are much more popular these days.

Interviewer: Yeah.

Dr. Greenbaum: I think the popularity of helmets originated with snowboarders who have a blind spot that skiers never had.

Interviewer: Oh, okay.

Dr. Greenbaum: And snowboarders really did bring the helmets to the scene and skiers have followed suit.

Interviewer: That's good. That must make you fee pretty good.

Dr. Greenbaum: Well, we're definitely seeing a lot less of the minor head injuries that we used to see.

Interviewer: All right. So if somebody falls on the snow, it's soft. What's happening there exactly?

Dr. Greenbaum: No, it's not always soft.

Interviewer: Okay.

Dr. Greenbaum: A lot of the snow is firm, particularly when it's paced down, particularly when you've gone through a thaw and freeze cycle.

Interviewer: And how much of a bonk to the head does it take to cause some injury? Probably less that one might think?

Dr. Greenbaum: Oh, a slow speed falls definitely can result in head injuries.

Interviewer: Mm-hmm.

Dr. Greenbaum: They're usually mild to moderate head injuries but they can be severe.

Interviewer: All right.

Dr. Greenbaum: Again, it's not so much how fast you fall it's what you hit. You can be going only 5 miles an hour and hit your head against a tree and I'm certain that would not bode well for you.

Interviewer: So it sounds like equipment is the answer, being in shape, maybe doing some stretching, but equipment. Checking your equipment, wearing some wrist guards, wearing some helmets. Any other thoughts on avoiding injuries this year?

Dr. Greenbaum: Be prepared before you come out skiing or snowboarding. Make sure you have the proper equipment and that you are physically and mentally prepared. People show up for vacation and it's very stressful and intense just getting here. The next day, they hit the slopes and maybe they haven't prepared, such as eating a proper breakfast. You really want to be careful.

Interviewer: And that stuff really makes a difference, in your opinion?

Dr. Greenbaum: I really do think so. A lot of our visitors are injured in their first few runs and others are certainly injured on their last runs of the day, when they're worn out.

Interviewer: If I get an injury, how do I know if I need to come to the hospital?

Dr. Greenbaum: This is always a difficult question and that's asked of my friends frequently. I think that as far as coming to the emergency department, or to the clinic at the base of the ski area, come there if you have an injury which is so severe that you think that you're going to need to take a strong pain medication for it, or certainly if you're incapable of using that body part. In other words, if your knee doesn't work or wrist does not work, it's time to have it checked.

Announcer: We're your daily dose of science, conversation and medicine. This is The Scope, the University of Utah Health Sciences Radio.

For Patients