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What is the Mission and Vision of the PMR Service?. British Journal of Sports Medicine September 1 2010 | Volume 44 | Issue 11 | ppg 772-80. 2010 Winter Olympics. one in 10 Olympians experienced an injury and one in 14 suffered an illness.
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British Journal of Sports MedicineSeptember 1 2010 | Volume 44 | Issue 11 | ppg 772-80
2010 Winter Olympics • one in 10 Olympians experienced an injury and one in 14 suffered an illness. • The researchers analyzed information from the 82 national team doctors, which included reports of 287 injuries and 185 illnesses. • out of the 2,567 Olympians, 11.2 percent experienced at least one injury, notes the LA Times. • About 22 percent of those injuries resulted in athletes being unable to compete in their sport. • , • female athletes experienced a higher injury rate than men – 131.1 per 1,000 compared to 93.3 per 1,000.
What were the most dangerous winter sports? • Bobsledding, ice hockey, short-track skating, alpine freestyle skiing, snowboard halfpipe and snowboard cross were associated with the most injuries. • Olympians competing in Nordic skiing events, as well as luge, curling, speed skating, and freestyle moguls had the lowest risk of injury. • The head, spine, and knees were the most common injured areas of the body, and the most common types of injuries were bruising, ligament and muscular sprains.
Winter Olympic Injuries • There was one death — an athlete who died while training for luge. • About 20 percent of female athletes in bobsled, ice hockey, snowboard cross and in freestyle cross and aerials suffered an injury. • Just under 28 percent of male athletes were injured in short track, 17 percent in bobsled, and just under 16 percent in hockey. • About 10 percent of athletes in skeleton, figure and speed skating, curling, snowboard cross and biathlon had at least one illness, 62 percent of which were respiratory infections
Luge • small one- or two-person sled on which one sleds supine (face up) and feet-first. • Steering is done by flexing the sled's runners with the calf of each leg or exerting opposite shoulder pressure to the seat. • Racing sleds weigh (46–55 lb) for singles and (55–66 lb) for doubles. • Lugers can reach speeds of 140 km per hour (87 mph). • Manuel Pfister of Austria, reached a top speed of km 95.69 mph on the track in Whistler, Canada
The sport of luge, like the skeleton and the bobsleigh, originated in the health-spa town of St Moritz, Switzerland, in the mid-to-late 19th century, through the endeavours of hotel entrepreneur Caspar Badrutt. • Badrutt successfully sold the idea of winter resorting, as well as rooms with food, drink, and activities. • His more adventurous English guests began adapting delivery boys' sleds for recreation, which led to collisions with pedestrians as they sped down the lanes and alleys of the village.
Luge Injuries • Has risks. • Though most injuries involve bumps, bruises, broken bones and concussions, fatalities do occasionally occur. • Georgian luger NodarKumaritashvili suffered a fatal crash during his final practice run for the 2010 Winter Olympics in Whistler, British Columbia, Canada. • Kumaritashvili was the fourth athlete to die while in preparation for a Winter Olympics competition, following speed skier Nicolas Bochatay, 27, who died while preparing for the Albertville 1992 games, British luger Kazimierz Kay-Skrzypeski and skier Ross Milne, 19, who both died in the run-up to the Innsbruck 1964 games.
Recreational Bobsledding • Two patients with spinal fractures after were identified. • aged 57 and 54 years, noticed a simultaneous onset of severe back pain during a routine turn on a bobsled track. • Neither was involved in a high-impact injury during the event. Both patients were treated conservatively with resolution of symptoms. • An analysis of the bobsled track revealed that potential forces imparted to the rider may be greater than the yield strength of vertebral bone. • Conclusions: Older athletes may be at greater risk for spinal fracture associated with routine recreational activities. • Bobsledding imparts large amounts of force during routine events and may result in spinal trauma. Older patients, notably those with osteoporosis or metabolic bone disease, should be educated about the risks associated with seemingly benign recreational sports.
Bobsledding • Bobsledding began in the late 19th century in Switzerland and is now recognized as an international sport. • The particular track that the two patients rode is 4380 feet in length, displays a vertical drop of 340 feet, and has a slope of 7.8%. • The sled itself weighs approximately 600 lbs and will reach maximum speeds of 80 miles per hour. • Injuries associated with bobsledding have not been previously described in detail.
WHAT ARE SOME OF THE MOST COMMON FIGURESKATING INJURIES? Common Overuse Injuries • Stress fractures, most commonly to the foot or spine • Stress reactions, such as shin splints and medial tibial stress syndrome • Tendonitis – Achilles, patellar, or peroneal • Muscle strains of the hip • Jumpers knee or patellofemoral syndrome • Apophysitis – Osgood-Schlatter (knee) or iliac crest (hip) • Bursitis in the ankle • Lace bite, an irritation of the tibialis anterior and toe extensor tendon
Common Traumatic Injuries • Ankle sprains and fractures • Dislocation of the patella or shoulder • ACL and meniscal tears • Head injury and concussion • Labral tears of the hip • Lacerations
WHAT CAUSES FIGURE SKATING INJURIES? • Overtraining and Poor Technique • Impact at landing generates deceleration forces measuring up to 100 Gs in adolescent skaters. • This phenomenal force is transmitted throughout the lower extremity contacting the ice and axial skeleton and is the main contributor to the host of injuries sustained in figure skating. • Equipment
Boot stiffness: A stiff skating boot is similar to a cast. The stiffer the boot, the more limited the motion at the ankle and thus the knee, hip, and back. This limited motion may contribute to muscle weakness in the foot and ankle. • Blade placement: Poorly placed blades can cause the skater to shift more to an outside or inside edge. • Blade sharpness: Blades that are too sharp can cause less experienced skaters to be more susceptible to traumatic injuries due to the tendency for the blade to “pull” the skater.
INJURIES IN FIGURE SKATING BE PREVENTED? • Reduce exposure to high-G-force landings by limiting the repetition of jumps—especially poorly mastered or new jumps—per training session. • Increase proficiency with new jumps through off-ice training, use of a harness, and ensuring a proper conception of perfect form prior to on-ice repetitions. • Avoid learning new elements during growth spurts, as this causes increased stress on the body. • Warm up for 5-10 minutes prior to putting on skates and stepping on the ice.
Ice Skating Prevention • Properly fit and break in boots; adjust skate blades and sharpen appropriately. • Inspect ice regularly for chips or gouges that might cause injury. • Perform off-ice conditioning to improve core strength and fitness. • Maintain adequate nutrition. Skaters, particularly girls, are at risk for eating disorders. • Create conversation between coach, skater, and parents to minimize injury and avoid overtraining. • Avoid skating with pain
Figure Skating • The most common injury is to the low back with up to 34 percent of skaters currently experiencing pain. • Up to 26 percent of the skaters experienced alignment and tracking problems of the kneecap (patella). • Hip/groin pain and ankle sprains were each found in 23 percent of those surveyed. Various types of tendonitis in the foot and ankle were encountered at some point in their training by approximately 20 percent of individuals. • Eighteen percent of skaters experienced numbness and tingling as a result of lacing too tight and therefore traumatizing the nerves supplying the foot, while 6 percent had experienced a stress fracture at one time in their career.
Figure Skating • Deformities of the foot deserve special attention because they are common, in fact, too common in figure skaters. • The most frequent finding is a bunion, or angulated big toe, noted in up to 57 percent of skaters. • The navicular bone in the arch of the foot was enlarged 31 percent of the time.
Improper fit or an uncorrected pronation problem of the boot/blade or foot. • Pump bumps, or lumps on the back of the heel, are found in 49 percent of skaters as a result of heel slippage. Friction occurs when a boot or shoe is too wide in the heel for your foot type. • Hammer toes (gnarled and calloused on the top) also result from heel slippage and are found in 18 percent of skaters. • The toes curl in attempt to hold the shoe or skate on the foot. Also related to excess motion and/or insufficient punching of the boot, ankle bursitis is found in 6 percent of skaters. • Skin irritation and lace bite is found 14 percent of the time and can be related to stiff boots, poor fit, or simply lacing too tight.
Figure Skating • Boots that are proportionately too heavy for the skater can impact performance as well as contribute to injury. • The average skate weight to skater weight is 5 percent. • Ratios more than 5 percent appear unnecessary and may contribute to an increased rate of injury. • ice is the hardest landing surface and it has virtually no shock absorption. • Therefore, the joints in the foot, ankle, knee, hip and back must do all the work to absorb the shock upon impact. • skater's foot and ankle are not able to absorb the shock. • Instead, the additional forces are transferred to the knee, hip, and back and can lead to unnecessary strain and load on these joints.
Bendability • the bendability of the ankle in and out of the skate is very important. • Do you know your bendability score? • Here is how you measure bendalbility? • Without skates, put your toes behind a line. Bend your knees over your toes as far as possible without lifting your heels. Have someone measure how far your knees move beyond your toes. Repeat the test in skates with the tip of your blade behind the same line • The goal is to be able to bend equally well or better in skates than out of skates within one or two months of wear. • If you bend less, your boots could be too stiff.
Good Boots and Boot Defects • Boot defects have been found in up to 20 percent of boots manufactured. • Carefully examine the boot • straightest pair of boots that you can, and return any custom boots with faulty alignment before mounting the blade.
Boot Fit • Boot fit problems have been encountered by virtually every skater. • Many of the foot deformities outlined above are a direct result of poor fit. Knowing your foot size, structure and past problems is the best place to start. • Resist the temptation to buy a size larger to accommodate for growth. • Boot problems are not new to the industry. They have existed for years,
Injuries in short track speed skating. • Ninety-five of 150 elite-level skaters (63.3%) were surveyed to collect information on training and competition load as well as on injuries sustained during the 1999-2000 competitive season. • RESULTS: • Sixty-one of the 95 skaters (64.2%) reported sustaining at least one injury. • The knee, ankle, spine, leg, and groin were the most commonly reported sites of injury. • Skaters were also asked to list previous on-ice injuries. • The two most common injuries occurring on-ice before the 1999-2000 season were lacerations from the knee down (11.1%) and ankle fractures (10.2%). • CONCLUSION: • The results of this study suggest that there is a high incidence of injury in competitive short track speed skating
Injuries in elite pair skaters and ice dancers. • Figure skating coaches have become concerned about the increasing number of injuries among competitive skaters, particularly pair skaters. • This study prospectively examines the incidence, severity, and cause of injuries sustained by a group of elite pair skaters and ice dancers. • Thirty-three serious injuries, causing the skater to alter training significantly or to cease training completely for at least 7 consecutive days, were recorded over a 9 month period. • Female senior pair skaters reported an average of 1.4 serious injuries, and other groups averaged greater than 0.5 serious injury per skater.
Ice Dancers • The lower extremities were injured most frequently, and 7 of the 33 serious injuries were directly related to the skating boot. • Eleven serious injuries were caused by lifts. • Few of the serious injuries appeared preventable. • Changes in boot design and the training for lifting maneuvers should be initiated and studied prospectively to attempt to reduce the unacceptably high injury rate among elite pair skaters and ice dancers.
In-line skating injuries. Epidemiology and recommendations for prevention. • In 1993 there was an estimated 12.6 million in-line skaters in the US. • In-line skating is popular because of its affordability and its exercise and recreational value. • The main risk factors for injury include speed, obstacles and hard surfaces. • Using the National Electronic Injury Surveillance System in US hospitals, 31,000 skaters were reported injured over a 12 month period. • Fractures, dislocations, sprains, strains and avulsion made up 67% of all injuries.
In-line skating injuries. • recommended that skaters wear protection equipment including, helmet, wrist guards, knee-pads and elbow-pads. • Although head injuries from skating appear low in numbers, helmet protection is also recommended. • Further studies are required that assess risk factors for injury and environmental and behavioral aspects.
Nordic ski jumping fatalities in the United States: a 50-year summary. • Nordic ski-jumping fatalities are rare events. • Six jumping fatalities have occurred in the United States during the past 50 years. • The fatality rate for nordic ski jumping, estimated to be roughly 12 fatalities/100,000 participants annually, appears to be within the range of fatality rates for other "risky" outdoor sports. • Cervical fractures appear to be the most frequent fatal ski-jumping injury.
Nordic ski jumping injuries. A survey of active American jumpers. • Little data are available in the medical literature on nordic ski jumping injuries. • Injury questionnaires were sent to all active American ski jumpers registered either with the United States Ski Association or with a jumping club registered with the United States Ski Association. • One hundred thirty-three of 286 (46.5%) injury questionnaires were returned. • Eighty-one of the 133 respondents (60.9%) had been injured sufficiently to require examination by a physician at least once during their jumping careers. • This report describes the types and frequencies of injuries sustained by this group of nordic ski jumpers as well as provides demographic data about American ski jumpers. • The risk of injury per 100 participant years was 9.4, a rate less than that reported for most high school or college intermural sports.
Freestyle skiing star Sarah Burke, four-time Winter X Games champion, dies from irreversible brain damage nine days after half- pipe crash horror •Skier was injured on training run in Park City, Utah, nine days ago •Tests showed she had irreversible brain damage after cardiac arrest
Half pipe snowboarding an (un)forgettable experience or an increasing risk for head injury?
Snowboarding has become the most popular winter sport during the last decade. • As a consequence, related injuries have increased dramatically. • A comparison with alpine skiing shows a four to six times higher incidence of head injuries in snowboarders, with subdural haematoma being the most common intracranial pathology.
Shaun White, who fell and hurt his ankle while trying his signature trick, a double-flip above the half-pipe with 3½ twists. • Nearly four years ago at the Winter X Games, he was attempting that same trick in a warm-up run when he banged his face on the halfpipe. • White simply dusted himself off, went back to the top and went through the routine flawlessly to take the title.
XC (Cross-Country/trail) skiing injuries • Based on a prospective study from 5 ski-touring areas in the USA between 1979-81, • Boyle et al determined an injury rate of 0.72/1000 skier days - well below that of alpine skiing and snowboarding • 41% of injuries affected the upper limb, 49% the lower limb and 10% the head, face and trunk. • The commonest upper limb injury reported is the so-called "skier's thumb" - this occurs when a skier falls onto an outstretched hand with the pole still in their grasp. The pole acts as a lever and damages the ulnar collateral ligament. • Most other upper limb injuries involve the shoulder joint - usually as a result of a twisting fall onto the upper limb causing clavicular (collar-bone) fractures, acromio-clavicular joint disruptions or shoulder dislocations.
XC skiing injuries that occurred between 2003 and 2010. • The overall injury rate was 0.1/1000 XC skiing days compared to 1.0/1000 for alpine skiing. • Males and females were injured in equal proportions although injured males tended to be slightly older (average age 42.5 yrs compared to 35.5yrs). • The lower extremity was the commonest area of injury and falls accounted for about 85% of all injuries. • About 8% of events were due to skier exhaustion and fractures made up about 25% of all injuries.
