Archive-name: sports/skating/ice/rec-skate/injuries
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Last-modified: 15 July 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, you should 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 can be
caused by boots that are too loose, keeping your weight too far
forward on the blade, or just bad habits.
Another cause of foot pain is excessive tightness of the Achilles
tendon. You can do "wall push-ups" to stretch: 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.
If your feet continue to hurt after you've stopped skating and taken
your boots off, or if you cannot skate at all without pain, or if you
have continuing problems with stiffness and soreness in the feet, you
should stop skating and consult a podiatrist or sports medicine
specialist. You can risk serious damage to your feet otherwise. The
common foot ailment that afflicts skaters is called "plantar
fasciitis", and it's a form of tendonitis 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
It is not unusual for bumps to occur on your feet while you are
breaking in a new pair of skates. A bump could reflect a temporary
reaction - swelling, bruising or callus formation, injury of only
cosmetic significance or continuing distress to underlying tissues,
vessels or nerves. Some of these things can be ignored, others may
become progressively worse or points of chronic irritation if the
source of irritation isn't removed.
Get the coach to actually look at the problem and offer suggestions.
If the problem persists or becomes painful again, you might want to
check with a doctor, podiatrist or sports medicine clinic to get a
better idea of what the bump means and whether it's worth worrying
about. It might be a good idea to bring your skates along.
Here's something suggested by Geoff Gallo that you can try to protect
the injured areas while skating. Get some 1/4'' thick (or slightly
thicker) felt. The felt has to be thicker than the bump by a good
margin. Cut a donut of felt three times in diameter bigger than the
bump. (You'll need at least a square foot or two, because you need
about 12 pads since you'll re-use a pad about three times before its
too thin.) The purpose of the donut is to keep the pressure OFF of the
bump while you skate. The hole in the donut should be slightly bigger
than the bump on your ankle. Attach it securely in place to your skin
with cloth medical tape. Nylon socks over top will help to reduce
friction.
If the laces put high pressure on the area you are trying to protect,
use 1/2'' felt. You get the felt from a good pharmacist who supplies
physical therapists. Using 1'' wide tape, tape the donut over the bump
so the bump is neatly centered inside the hole. Use plenty of tape.
*Always* wear this when you skate. You should notice good improvement
within a month. After that you can forget about the pad and it
probably wont come back.
Any time you take off of skating will help. Also try to limit you
footwear to low cut sneakers (or equivalent) to relieve your feet. 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 original
condition.