19 Apr 2005 04:12:02
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Recreational Figure Skating FAQ - Injuries

Archive-name: sports/skating/ice/rec-skate/injuries
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Last-modified: Sep 4 2004
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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.

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