Graceful Health: Have fun on the slopes, not accidents

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I love skiing. Anyone who knows me, knows that's true. There's nothing I like better than putting on my skis and helmet and heading down the slopes on a beautiful bluebird day.

You do wear a helmet when you ski or snowboard, don't you? As much as I love skiing, I also know it can be dangerous. I work in the Emergency Department at Grace Cottage Hospital, so I see what can happen. I'd like to share some information about the most common injuries and some tips for preventing them.

Let's start with head injuries. These days, most people do wear a helmet when skiing or snowboarding, and that's important. On average, about 40 people in North America die each year during these activities, according to the National Ski Areas Association. At least half of these have died from head injuries, and most who died were not wearing a helmet. So a helmet is important protection against joining these statistics.

A few words of caution about helmets: Be sure to wear a helmet specifically designed for skiing. Bike helmets are not good for skiing. Also, make sure the helmet does not impede your vision, since injuries from crashing into another skier are too common. Make sure you can see those around you. Finally, don't be lulled into thinking that, because you are wearing a helmet, you can throw caution to the wind. Safety rules always apply.

It's also important to be honest with yourself. Skiing and snowboarding are only fun when your ability matches what you do. It is okay to challenge yourself a little, but don't let peer pressure lead you into a situation where your skills are not a good match for conditions.

Here's a quick quiz: Which of the following situations is most likely to cause an accident?

1. You've been skiing all day, your muscles are worn, and you decide to take one last run.

2. It's your first day out for the season.

3. Your buddies want to go off-terrain, and ski in the trees. You join them.

If you answered "all of the above," you are correct. Most injuries occur at the end of the day, when you are tired and don't realize it; when you push yourself early in the season, before your muscles are in condition; and when you ski on unpredictable terrain.

Weather conditions are also a big factor. Anyone who skis regularly in Vermont knows that one day the slopes might tend to be icy, whereas a heavy snowfall overnight can cause deep drifts that require completely different technique. Don't assume that the same slope will be the same, day after day. Watch the weather.

Thankfully, the number of fatalities on the slopes is fairly small, but close to 200,000 people per year end up in U.S. emergency rooms or doctors' offices for skiing and snowboarding strains and accidents, according to the Consumer Product Safety Commission.

Listen to your body, be aware of your muscles, and take breaks. Skiing and snowboarding rely on muscles that may not work that hard in your other endeavors. While there is no scientific study proving that an exercise regimen before the season can prevent snow-sport injuries, it just makes sense that building up certain muscles over time and warming up before each outing will help you enjoy skiing more and help keep you safe.

The most common injuries that occur while skiing affect the knees, especially tears to the anterior cruciate ligament; shoulder dislocations and sprains; lower leg and wrist fractures; broken or sprained thumbs; and neck and head injuries, including concussions.

It may sound funny, but one of the most important things you should learn is how to fall. When you fall, the tendency is to put out your arms to break the fall, but this often leads to shoulder, arm, wrist, and hand injuries. Here is some advice from the Vermont Ski Safety Equipment company: "Learn how to fall, when to fall, and how to stop after a fall. Keep every joint in your body flexed moderately legs together chin against your chest arms up and forward. Be prepared to use your arms to protect your head. After the fall, if you don't stop immediately, get into a position that allows you to see where you are going resist the instinct to fully straighten your legs." You might also find it helpful to read their pamphlet "Tips for Knee-Friendly Skiing," available at many ski shops and online at www.vermontskisafety.com.

One final tip before we all head out to the slopes for some winter fun. Stay hydrated. Even mild dehydration can affect your ability to ski. And remember, being hydrated means drinking plenty of water, not alcohol!

With these tips in mind, let's go out and have a safe and wonderful season. See you on the slopes!

Dr. Kimona Alin is director of the Grace Cottage Hospital Emergency Department. She joined Grace Cottage in 2002 as a member of the Family Health Clinic. Dr. Alin holds a Bachelor's in biochemistry from SUNY and an M.D. and a Ph.D. in microbiology from Columbia University Medical School. She completed three years of orthopedics residency at Albert Einstein, then switched to family practice and completed her family medicine residency at the University of Massachusetts.

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