18 Nov 2003 06:44:38
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Recreational Figure Skating FAQ - Injuries

Archive-name: sports/skating/ice/rec-skate/injuries
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Last-modified: Oct 26 2003
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7 Injuries

Many of the injuries sustained while skating happen as the result of a
fall. Of those, the most common by far and easiest to deal with is a
bruised ego. Don't worry, everyone who has ever skated has fallen.
They've fallen because they forgot to take their blade guards off.
They've fallen by just shifting their weight while standing still.
They've even fallen holding on to the rail. As one pro once said,
"There isn't a fall I haven't perfected."

The second most common injury is a bruised body. Bruises very rarely
result in complications, although if you keep on falling the same spot
you may think about getting padding or similar protective equipment.

Occasionally a fall can result in a more serious injury. In these
cases, the standard treatment is RICE (Rest, Ice, Compression,
Elevation) and a compulsory visit to the doctor if the pain is intense
or you suspect a fracture.With some luck, the injury will not keep you
off the ice during the whole or part of the recovery period, but be
cautious and do not do things that might aggravate the injury. Pain is
usually a good indicator that you are overstepping the boundaries. If
doing something causes pain or a worsening of the pain, don't do it!

In addition to accidental injuries, skating can, under certain
conditions, cause or aggravate overuse injuries.

7.1 Concussion

The potentially most sinister type of injury is a concussion. Always
try to tuck your head when falling so you don't hit it, but if you do
and you either suffer a period of unconsciousness or are dizzy or
disoriented after you get up, get off the ice and have someone drive
you to a doctor. This is not something you should take lightly.
Chances are it's nothing, but evaluation, close monitoring and timely
reaction greatly minimize the consequences if it's something serious -
why take a risk?

7.2 Arm injuries

Arm injuries in general can mostly be prevented by NOT putting your
arms out to catch your falls. Of course, if it's a choice between your
face and your arm and you must put your arm out, be sure and do it
with a bent elbow. If you fall backwards with an outstretched arm you
are likely to injure your wrist. This is one of the most common
injuries for skaters. With some luck, the injury is just a sprain. A
sprained wrist feels sore, particularly when pressing it, and may
swell somewhat. The pain decreases gradually and is gone after a few
days or a couple of weeks.

If you experience severe pain and the wrist swells up or if you notice
bruising you should get an x-ray to rule out a fracture. Although the
two bones in the forearm (radius and ulna) are the most likely to
break, you can also fracture the small bone in the wrist just behind
the thumb bone (navicula). This is usually a hairline fracture and
hard to see with x-rays.If the pain persists after two weeks have the
wrist x-rayed again (by then the fracture will have started to heal
and will actually be easier to see. A navicular fracture should be
properly diagnosed, because it can lead to chronic pain and disability
in the wrist if untreated.

It is not unusual to find skaters with AOSS back on the ice the day
after an arm injury, even involving broken bones. While skating with
your arm in a cast is not recommended, if you have AOSS you're going
to do it anyway. So, suggestions are to get a light cast, made of
fiberglass and available in a wide variety of bright colors. These
casts are not affected by moisture and are more durable (besides
matching nicely with your skating outfit :-). If you are skating after
injuring a joint such as the knee or ankle, neoprene braces not only
provide support for the injured joint, they also provide warmth
allowing the muscles to function optimally.

7.3 Knee injuries

Landing your knee when you fall, although quite painful, has often no
worse consequences than a bruise. If you hit your knee, get off the
ice, put ice on the knee and put your foot up. You want to apply the
ice for 20 minutes and be sure and keep a piece of cloth between the
ice and the skin to prevent frostbite.

In some rare cases, a hard blow to the knee can be a cause of
misalignment of the knee cap, which in turn can lead to chronic knee
pain by wearing down of the cartilage. This condition is known as
"chondromalacia patellae". Most often, the misalignment of the knee is
caused by an strength unbalance between the inner and outer thigh
muscles. The hip configuration can also contribute to this problem
(and it is a reason why it affects women more frequently than men).
The best cure and prevention is off-ice exercises which strengthen the
leg muscles, particularly the inner quads.

If you twist the knee (for instance on a bad jump landing or spin
entry) you can hurt the knee ligaments. Frequently the damage is to
the medial collateral ligament (MCL). A sprain or rupture of this
ligament is characterized by pain on the inner side of the knee and
possibly, a feeling of instability on the knee. Although complete
rupture of the ligament could keep you off the ice for weeks, this
type of injury usually heals well with a combination or rest and
physiotherapy. On the other hand, damage to the Anterior Cruciate
Ligament (ACL) (at the front of the knee below the knee cap) often
requires surgery. A tear of the ACL can sometimes be recognized by the
knee "giving out" when putting weight on it. Your doctor may order a
MRI scan to confirm the diagnostic and rule out cartilage damage.

Paradoxically, it is probably easier to sprain your knee practicing
jumps off-ice than on the ice, because on an unchecked landing your
foot is more likely to stick to the floor while you upper body
continues to rotate, putting lots of torque on the knee. To avoid
this, never "stick" a landing on the floor, but do a little hop as
soon as you feel your toes touching the floor; even better, land on
two feet.

7.4 Foot injuries

Probably the most common cause of foot pain is boots that are laced
too tightly over the instep. The lacing should be snug but not so
tight as to cut off circulation or pinch the foot. If your boots feel
too tight (e.g., at the ball of the foot) even when the lacing is
loosened, the boots may be just too small for you. Have the fit
checked at a competent skate shop.

Many skaters (especially beginners) have a tendency to clench their
toes while skating, which can cause the foot to cramp. This problem
can also be caused or aggravated by boots that are too loose, keeping
your weight too far forward on the blade.

Another cause of foot pain is either excessive tightness or tendinitis
of the Achilles tendon. You can do "wall push-ups" to stretch this
tendon: stand about 3 feet from a wall and lean forward against it,
keeping your feet flat on the floor. You can also do a lunge stretch,
keeping your weight on your rear foot with the heel on the floor and
the toe pointing forward.

A common foot ailment that afflicts skaters is called "plantar
fasciitis", and it's a form of tendinitis that affects the bottoms of
the feet. Typical treatment includes resting the feet,
anti-inflammatory drugs such as ibuprofen, and custom orthotics to
provide more support for the foot.

7.4.1 Bumps on feet

Many of the foot injuries suffered by skaters are often a consequence
of breaking in a new pair of skates. Bumps on the feet (bunions,
cysts, bursitis or callus formation) and accompanying pain are a
common reaction to pressure and continuing distress to underlying
tissues, tendons or nerves. If you are lucky, the pain will go away as
you break in the boot (although sometimes the bumps stay). However, it
is better to use protective padding or have the boot punched out at
the earliest sign of discomfort. This will benefit both your feet and
your skating.

Malleolar bursitis is characterized by painful inflammation and
swelling on the medial protruding ankle bones. If you suffer from
this, you can try stretching out the boots at the sides by placing
golf balls or a similarly hard object (baby food jars and walnuts are
other suggestions) by the ankle area inside the boots and leaving them
laced tightly overnight. While skating, you can prevent this problem
by protecting your ankles with silicon sleeves (like Bunga Pads). Once
the condition flares up, it is better to use padding around the ankle
bone rather than on top it, in order to keep pressure off the bump as
it heals.

Lace bite arises from pressure of the laces over the extensor hallucis
tendon, which runs from the front of the lower leg to the base of the
big toe. Lace bite can result in the appearance of cysts and, in the
long term, the development of tendinitis. Silicon sleeves or pads
applied over the tendon are very effective to prevent or alleviate the
problem. If you start experiencing this problem as the boots age, you
can also get the boot tongue rebuilt by the boot manufacturer.

For many of the above mentioned foot problems, any time you take off
of skating will probably make the healing faster.If you really want to
give your feet ultimate treatment, soak them in a very warm (even hot)
bath for a half an hour occasionally. Try once/twice a week. Improving
your circulation in this manner will facilitate your body's process of
returning your feet to their original condition.

Of course, it will help if you can also identify and solve the primary
cause of the problem, whether it is the boot fit, on- or off-ice
exercise or other. If the problem persists for weeks or gets worse,
you should stop skating and consult a podiatrist or sports medicine
specialist. You can risk serious damage to your feet otherwise.