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Safety on the slopes

Tags: bones , ski , winter

To help you prepare for winter sports activities, our expert web discussion offered live advice on everything from preparing for falls and coping with aches and pains on the slopes, to avoiding injury while out running during the colder months.

Our expert David Williams, a physiologist here at AXA PPP healthcare, was on hand to answers all your questions. Here is what he had to say:

Jane asked:Hi David, I am going on my first ski holiday this January and not quite sure what to expect. My friends, who have more experience, are already doing exercises to prepare, but I'm not sure where to start. I love the dry slopes, but they can be expensive.

David Williams: Hi Jane. Firstly, I’m very jealous of you. Skiing holidays are fantastic. What are your current exercise levels?

Jane:My current exercise levels are okay, at the gym 3 times a week

David Williams:I think if you are in the gym 3 times a week doing various cardiovascular and core strengthening exercises this should be fine.

Jane:Thanks. At the dry slopes I often feel my hips and ankles ache after skiing for a while. Is there anything I can do to target this in particular?

David Williams:Jane, is this the first time you have used a "real snow" ski slope? The impact is less of that than a dry slope so this should help for a start. However, plenty of flexibility exercises such as stretching (back, hamstrings and glutes) will aid this along with core exercises. Check out this website for various core exercises in relation to skiing. http://ultraskier.com/ski-fitness/core

Ruth asked: I'm prone to tendinitis in my wrists which got really sore last year after falling a lot. What would be best to prevent/treat if it happens again?

David Williams:Ruth, I think the best thing for you to do is lightly strap your wrists before you go on the slopes and also take some ibuprofen to reduce the swelling.

Nick asked:Hi David is there anything that can be done for supporting your shins? When I have skied before I have found they tend to get quite sore after a couple of days of heavy skiing/falling over.

David Williams:Hi Nick. Directly supporting shins is difficult, I think it is important to take care of them whilst skiing. Compression socks will help reduce swelling and if the pain arises again it may be a good idea to apply ice to the affected area and use some sort of anti-inflammatory.

Fiona asked:Hi David. My dad hit a rock and broke his lower leg in several places while snowboarding 2 years ago. After a long recovery he is now booked up for another trip in the New Year, but we are all concerned. Apart from avoiding more dangerous routes, what can he do to help ensure he doesn't put too much pressure on his injured leg? He is in his late 40s.

David Williams:Hi Fiona. It is important that your father has received clearance to go on this holiday from his GP/Surgeon. However, with regards to not putting too much pressure on his leg, this will be down to him. It will be important that he doesn't over stretch himself in regards to the difficulty of the slope. Also, if he starts to feel pains, he must stop.

Fiona:Thanks, he's had it cleared with his doctor and had physiotherapy, I'll pass this info on. I'm worried he might brush off pain as being the usual aches that come with the sport - do you know of any signs that he mustn't ignore?

David Williams:Fiona, any pain is a warning. If he starts to feel pain, it is important for him to rest. The pain may go away and then he can start again, however if the pain persists he should consult with someone who is able to help him.

Charlie asked:Hi, when snowboarding the arches of my feet really hurt, is there anything I can do about that?

David Williams:Snowboarding is a highly aerobic activity that relies on the feet for turning, body support, and impact absorption. Without any foot arch support, the feet can pronate inside the snowboard boot. This can lead to plantar fasciitis, metatarsalgia, and posterior tibial tendonitis. In plain English - massive foot pain. Most snowboard boots come with stock foot beds that provide little arch support or impact protection. What's the solution? Buy some aftermarket arch supports that prevent foot pronation and offer impact protection while snowboarding. The foot will be stabilized and protected during weight bearing exercise.

Taking this a step further you may want to consult a podiatrist who will be able to customise some insoles for you. It’s very common among the snowboarding community.

John asked:Hi David. When I ski I sometimes go on a path that could take all day to complete, what snacks/drinks would you recommend taking on one of these all day trips to keep up my energy levels?

David Williams:Hi John. It is very important to stay hydrated if you are out for extended periods of time. Water is good; however, you may want to take some isotonic sports drinks. These have had a bad press in the last year but for this type of purpose they are very useful. With regards to food, make sure you eat well before you go out for the day. A breakfast of slow release carbohydrates such as porridge would be good for this. During the day you may want to snack on bananas and flapjacks (my personal choice). Sarnies on wholemeal bread are a good choice also.

Charlie asked:What first aid things should I have in my backpack before heading out on the slopes?

David Williams:Charlie, there are patrols that man the slopes with first aid kits and they are usually in attendance very quickly. However, I think you would take material that can be made into a sling, a heat blanket, some water and plasters for minor cuts.

Lesley asked:I always have trouble with my Coccyx - since a snowboarding accident from a few years ago. I've worn those impact shorts now but is there anything else that helps with that type of pain?

David Williams:Lesley thanks for the question. I think it’s a case of "pre-hab" for this. Make sure that you are well warmed up before you ski. Also in your gym routine if you work on flexibility exercises for the lower back and pelvic girdle this may also be of help. Try taking some sort of pain relief before you hit the slopes too.

Lesley:I think sometimes it's about doing too much and getting tired towards the end of the day and falling over with fatigue. What do you reckon to back supports for snowboarding? My hubby has a lower back problem and I wasn't sure if it would do anything at all to protect or whether it was more of a gimmick? I have knee and wrist supports and he wears none of that. Helmets also seem to be common place in Canadian resorts but in Europe less so

David Williams:Lesley, firstly I think helmets are a must when it comes to snowboarding and skiing. Personally, I never hit the slopes without one. I know people who use the back supports and some like them and some do not. Biomechanically they help support the lower back, but this can depend on technique and ability levels of the snowboarder. I'd say try one because if it provides some relief and stability then it will be worth it.

Lesley:Thanks for the responses much appreciated. I guess with any Winter sport there is risk of injury - I think it does help to be fit before you go and to not overdo it with being over keen to get out there on the slopes all day with no break!

David Williams:Absolutely Lesley, it is important to take regular breaks and keep yourself hydrated. Also if you have been taking part in the "after slope activities" this makes it even more important to rehydrate and make sure that you have had a meal before you hit the slopes again.

Lesley:I never leave home without a full healthy breakfast especially on a snowboarding day. My after slope activities normally involve a Jacuzzi to ease the muscles and lots of sleep! Can't think of any more questions but really good to find some info out :-)

David Williams:Thanks Lesley, I agree with you on the Jacuzzi to ease the aches and pains. Good preparation for the next day I think.

AXA PPP healthcare:Hi David one of our bloggers has asked a question about musculoskeletal health "Hi. I’m an 18 year old female. I’ve been quite active playing netball from the age of 8. For the past 6 months, I’ve been suffering from aches and pains in my mid to lower back. The pain builds up if I stand/sit for more than an hour, and when I sleep. When I wake up in the mornings, I often have to reach for my toes to click (sounds like a pop) my lower back, which is the only pain and tension relief that’s effective. Doctors have given me anti-inflammatories before but that only aided the pain in my hips and knees, which also builds up and is relieved by clicking. Any ideas as to what it could be and what else to do?"

David Williams:I think it is important that further investigation is taken into this problem in the mid to lower back. A consultation with an osteopath may be of use. However, I think flexibility work and work on core strength may aid you in dealing with the problem.

Winston P asked:Hi, my knees feel weak/ sore when I sit down or stand up, this started happening when I took up long-distance running. Have snowboarded in the past on winter holidays but am worried this could worsen the knee pain as snowboarding always seems to involve a lot of knee joint activity. Would skiing be the safer option?

David Williams:Hi Winston, According to a study published in the Western Journal of Medicine, snowboarders are less likely to sustain knee injuries than skiers (17% of snowboarders vs. 39% of skiers). Furthermore, those knee injuries that are sustained by snowboarders are more likely to result from impact than torsional, or twisting, forces. Because the snowboarder’s lower legs are kept in the same plane during falls due to non-releasing bindings, major knee injuries are not nearly the concern they are for skiers.

I believe that if you feel your knees are not the strength they used to be, then snowboarding would be the better option for you.

The Ski club of Great Britain has a very informative website with regards to ski/snowboard fitness. This can be sourced here http://www.skiclub.co.uk/skiclub/skiclubtv/playlist.aspx?categoryID=6

Becky asked:Hi David, whilst skiing a couple of years ago, I broke my leg - spiral fracture to the tibia and had a nail put through my knee into the bone with a couple of screws holding it in place. Ever since, my knee hasn’t quite been the same. I had x-rays that have come back inconclusive. I think the cold affects it much more to the point where sometimes I cannot move it. Is there anything you can suggest?

David Williams:Hi Becky, that sounds like a bad break and having numerous knee reconstructions myself I can sympathise with you. I think you could have a touch of arthritis and/or tendonitis; it is important to keep the joint warm and moving and may be an idea to use a compression bandage around the affected area.

AXA PPP healthcare:Hi David one of our Twitter followers has asked a question about falling over while skiing- are there any tips to make sure you minimise injury?

David Williams:Even expert skiers say, "If you're not falling, you're not trying." The point is, everyone falls -- from beginners to double-black-cruising true experts -- and falling properly prevents devastating hand and knee injuries. Resist the urge to put your hand out to catch yourself; instead, land on your rear end or the side of your leg. Don't attempt to rise until you are fully stopped, with your front tips facing the side of the trail, and push up to standing using your uphill hand and ski. Do not stand up while your front tips face downhill.

Warming up helps your body adjust to the skis, the snow conditions and the air temperature. Don't attack that off-piste glade trail just yet; instead, take two or three beginner or intermediate runs first. Once your muscles feel warm, stretch your hamstrings, quadriceps and calves. Hold stretches for 30 seconds, but don't bounce. Make sure your shins, feet and ankles fit snugly in your boots and tighten the settings if your ankles shift easily. You should still be able to wiggle your toes.

Jane asked:It's interesting to read that skiing is harder on the knees than snowboarding; I thought it would be the other way round! Does strapping the knees (as I know some joggers do) make a difference for skiers? Or is that a bad idea?

David Williams:Personal preference I think Jane. I certainly would not advise anyone to strap their knees if they didn’t have an existing injury. However, some people feel "safer" when things are strapped (such as ankles and knees). I would advise anyone who felt that their knees were weak to work on strengthening exercises before they went on a skiing holiday and use strapping as a last resort.

Deigo Bervasquez asked:Hello, I recently moved to UK and as a keen runner, I was wondering if you could make any recommendations to help avoid injury when running in the UK winter? (It’s cold!)

David Williams:Hi Deigo. I think in winter Warm up becomes even more important, make sure this is done properly and stretching is also undertaken.

Layering the body in clothes is important. Your first layer should be a thin, moisture wicking material that will pull the sweat away from your skin. You definitely should avoid cotton as it will hold the moisture and will keep you wet which can be extremely uncomfortable at any temperature but even more so when it dips below freezing. A middle layer for insulation is definitely recommended when it gets really cold out. A thin fleece would be a good option here. An outer breathable wind-resistant layer will protect you from the cold wind and snow or rain but will also allow heat and moisture to escape to keep you comfortable during your workout. You want to make sure that you don’t overdress and feel toasty warm as soon as you go outside. You should actually feel a little chilly before you start your workout so that you’ll be comfortable when you get moving and start sweating.

Even though it is cold, I must emphasise how important it is to stay hydrated. Make sure you take in water before, during and after a long run.

Adjust your expectations for speed and time when you are running in the winter. Know that the same distance is going to take you longer to run when the ground is slippery and snowy. You are still getting a great workout so try not to push to make a certain time. You may also want to increase the stability of your shoes slightly when running. Some people change to a trail running shoe to better negotiate the different running surface.

AXA PPP healthcare:Hi David one of our Facebook followers has asked if there are any tips for preparing children for skiing holidays?

David Williams:Good waterproof shoes or boots are ideal for after skiing and playing in the snow. Sunglasses with a strong UV protection are a must regardless of whether the sun is shining or not because of the glare from the snow. Comfortable clothes rather than dress-up stuff. Thick tights (even for boys) to go under trousers when long underwear isn’t enough. This would be especially important in higher altitude resorts particularly during January when it’s coldest. Check the fit of gloves and mittens before leaving home and see whether they stay on when wearing the ski jacket or snow suit. Mittens that are too small are worse than those that are too big and most children seem to have too small mittens (or gloves). An extra set of old gloves can be ideal for those snowball fights or sledging in the afternoon which can leave gloves wet and cold making them very uncomfortable to wear while skiing.

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