Archive-name: sports/skating/ice/rec-skate/injuries
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Last-modified: Apr 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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