Safety on the slopes

By RIDGELY OCHS
LONG ISLAND NEWSDAY
f we're in for a cold, snowy winter, what better way to spend it than on the slopes? Just make sure you don't get crazy and try to do more than you can do, experts advise.
"Always ski under control and at speeds consistent with your ability," said Dr. John MacGillivray, an orthopedic surgeon at the Hospital for Special Surgery in Manhattan. Dr. MacGillivray has been skiing for 36 years and has served as a team physician to the U.S. Olympic snowboarding team. Skiing when you're overtired can also lead to serious injuries because your body is not as quick to react, he said.
Not being in shape can also be a problem, said Dr. Richard D'Agostino, a sports medicine physician at North Shore University Hospital in Manhasset, N.Y.
"Alpine sports are pretty demanding," Dr. D'Agostino said. "They require everything -- good leg strength, coordination, flexibility. Preseason conditioning is very important. We recommend patients spend several months preparing for their season and do simple things like running, biking and even swimming, along with weight-lifting activities."
Here's a look at each sport and its risks:
Snowboarding
For the second season in a row, snowboarding is the fastest-growing U.S. sport, with a total of 5.3 million participants, according to the National Sporting Goods Association. In most ski areas, snowboarders now account for 20 percent to 40 percent of all users, according to www.ski-injury.com, a Web site maintained by Dr. Mike Langran, the ski patrol doctor at CairnGorm Mountain in the Scottish Highlands and a general practitioner. Dr. Langran is British National Secretary of the International Society for Skiing Safety.
Not surprisingly, snowboarding also accounts for a fair number of the injuries. According to Dr. Langran's data from Scotland, there are about 3-5 injuries per 1,000 "boarder days," compared to 2-4 injuries per 1,000 skier days. A 1999 article in the journal American Family Physician said most happen to novices: About a quarter occur during a snowboarder's first experience and almost half occur during the first season.
Because of the way a snowboarder stands on the board (with feet fixed in boots at right angles on the board, leaning back, with knees flexed) the tendency is to fall backward. Thus most injuries are to the wrist as the boarder tries to stop the fall. The second most likely injury is to the ankle, which can twist during a jump landing.
Snowboarding equipment has improved tremendously in the last few years, Dr. MacGillivray said, and every boarder should wear a good set of wrist guards (some are incorporated as part of the glove), a helmet and boots that have been designed for boarding. Soft boots tend to place boarders at risk for ankle injuries; hard boots place them at risk for injuries above the boot top.
Some suggest that inexperienced boarders keep hands clenched in a fist to keep from falling on an open hand. The problem, Dr. D'Agostino said, is we may instinctively still open our hand to block a fall.
Downhill skiing
The greatest number of downhill-skiing injuries occur to the knee, Drs. MacGillivray and D'Agostino said -- especially to the anterior cruciate ligament, or ACL, inside the knee. In fact, torn ligaments from a bad landing account for about two-thirds of all knee injuries, Dr. MacGillivray said. Twisted knees are also common.
"Skier's thumb" occurs when the skier jams a thumb in the loop handle of the pole and tears a ligament during a fall. To prevent this, the skier should try to throw the poles away when falling, Dr. MacGillivray said. To prevent dislocating your shoulder as you fall, "try to keep your hands in front and sort of roll," he advised.
Running into trees or other stationary objects can also cause shoulder dislocations or head injuries -- or worse. Dr. MacGillivray said skiers -- especially those 17 and under -- should wear helmets.
Some question whether wearing a helmet can prevent deaths, most of which occur when a skier or boarder is out of control and slams into a tree or person. In 1997, the American Medical Association said that, although rare, skiers and snowboarders under 17 had about twice the risk of a head injury compared to someone older. The AMA said it backed voluntary use of helmets for those 17 and under but said there was "insufficient scientific evidence to support a policy of mandatory use." Nonetheless, it makes sense to wear one.
Cross-country skiing
Most injuries are overuse injuries, such as tendinitis, Dr. D'Agostino said. But cross-country skiers can also suffer knee and ankle injuries if they find themselves going down a steep slope.
Dehydration and overexposure are also risks.