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Interviewer: Why buying a new pair of skis should also change the way you prepare for your ski season. That's next on The Scope.

Announcer: Medical news and research from University of Utah specialists and physicians you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Dr. David Rothberg is an orthopedic surgeon at the University of Utah Health Care, and the new type of parabolic skis actually mean that you might be opening yourself up to a different type of injury that you are not used to before, and mean that you need to get back to the basics of skiing. Talk about that a little bit. What are you seeing with the new parabolic skis, which are great, they give you so much more control and make it more fun, but they also can make it more dangerous.

Dr. Rothberg: We absolutely love the new ski shapes we are seeing because they allow us to do things that we weren't able to before. We can turn more quickly, we can navigate steeper slopes, and do so with a shorter lighter ski. But one of the problems that we think we are seeing with this is because the ski is shorter and we can turn more quickly we're actually putting more force on our knee. Because of that when you buy your new pair of skis you need to think about your knees fitness and how you're training for the season. As we know to prevent injuries you both need to be fit, and aware of your surroundings but also battle fatigue. When you get fatigued your technique becomes poor and you set yourself up for knee injuries.

Interviewer: So it sounds like if you get a new set of these skis and maybe you are going from an old style you may be in far a little bit of a surprise and you may want to reevaluate your physical condition.

Dr. Rothberg: Absolutely, at the result of some pretty serious knee injuries. The most common thing we see is an MCL strain which really is more of a beginners knee injury, which you have been stuck in the pizza pie, or snow plow position all day long and just strained the inside of the knee. Further more we start to see more ligament injuries, like an ACL tear which is so common. Both in non-ski athletes and skiers alike where the ski continues down hill with the lower leg, but your body is going backwards and puts that anterior-ly directed force on your tibia and tears the ACL ligament.
Then to a higher level of trauma, what we see so frequently here at the University of Utah is the tibial plateau fracture, or the top of the tibia, base of the knee fracture. We think that a lot of these are coming because you are able to put so much force on the knee with your shorter tighter turn radius.

Interviewer: So even experienced skiers might be a little surprised if they switch to this different type of ski. They're going to get what are typically considered beginner injuries maybe.

Dr. Rothberg: Absolutely, it is all related to how much force you can put on your knee.

Interviewer: You mentioned the importance of being more aware of your surroundings if you switch to this type of ski. What exactly do you mean there and how does that affect what I'm doing on the slopes?

Dr. Rothberg: Being aware of your surroundings is a combination of knowing what is physically around you as in the slope and snow conditions, weather conditions, visibility, and also it is really just as important to know what your own limitations are. Being aware of where you should be on the mountain and when you should be there, and what time of day it is, are you tired and is it time to take a break.

Interviewer: So what is your advise to somebody that if they are switching to a parabolic type ski to maybe help prevent these types of injury that you might be seeing as a result of better control, faster more torque on the body?

Dr. Rothberg: Well control is really going to come from about two or three muscle groups in your body. The obvious ones are your quadriceps and hamstrings, muscles around the knee. But secondarily, the hip stabilizing muscles, the abductors, and then thirdly the core strength. All these things are going to play into your body awareness and balance and ability to manipulate uneven surfaces and abnormal body angles so you can recover from variations as you turn and navigate the slopes.

Interviewer: How do I know before it's to late that maybe I shouldn't be pushing myself as hard as I think I can? Is there a way to determine that?

Dr. Rothberg: That's the hardest question to answer because it is always the last run of the day you get hurt.

Interviewer: Oh, is that because of fatigue?

Dr. Rothberg: No, it's because once you got hurt you're done.

Interviewer: Oh okay, is it last run of the day you get because of fatigue?

Dr. Rothberg: Yeah, probably. In addition to fitness and awareness comes in hydration as well. So one of the important things about being on the mountain is staying adequately hydrated.

Interviewer: Do the new parabolic type of skis actually tire you out more quickly?

Dr. Rothberg: It may not be that the ski itself tires you out more quickly, but your ability to navigate more difficult terrain and push yourself because of the tighter turn radius may in effect cause the fatigue.

Interviewer: So what would your final word of advice be to a skier putting on a pair of parabolic skis?

Dr. Rothberg: I think the most important thing is to know your skill level, be aware of the terrain you are on, and be aware that you are going to be able to make much tighter turns which are going to make you have to react more quickly to the slope that you're on.

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Interviewer: Make this year an injury-free year, whether you ski or snowboard. That's coming up next on The Scope.

Announcer: Medical news and research University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: The ski season opening up, the snowboarding season opening up and Jackson Hole, just like Salt Lake City, we've got some great opportunities to do those types of things. We're with Dr. Jeffrey Greenbaum from St. John's Medical Center in Jackson Hole. Let's talk about preparing for the season; first of all, if you're a skier or snowboarder, we want to do it without getting hurt. What are some thoughts that you have?

Dr. Greenbaum: Well, of course, as far as preparation is concerned, it's the same as with any athletic endeavor and, you want to be in condition. So it's probably wise to go out and take some kind of fitness class, and here in Jackson Hole, and I'm certain in Salt Lake City, we have specific ski fitness classes that focus on getting your legs and core prepared for the season.

Interviewer: So how far in advance should somebody start getting in shape for the season or snowboarding?

Dr. Greenbaum: Of course, you could always stay in shape, but probably the most typical is about a month or six weeks before the ski season to begin a fitness course.

Interviewer: What about stretching? Like, are there two or three stretches you would absolutely recommend somebody do?

Dr. Greenbaum: You need to stretch the areas which you consider to be important, whether they be your hamstrings, or your low back, or it might even be your shoulders.

Interviewer: Gotcha. What do you stretch before you hit the slopes?

Dr. Greenbaum: Definitely hamstrings and definitely back.

Interviewer: Are you a skier or a snowboarder?

Dr. Greenbaum: I'm a skier.

Interviewer: Are there different potential injuries between the two?

Dr. Greenbaum: Oh, absolutely.

Interviewer: All right. So let's talk about skiing injuries. What are some of the more common things you want to watch out for?

Dr. Greenbaum: Well, every skier wants to watch out for knee injuries. Probably the most concerning knee injuries are the ACL tear or the fracture of the upper tibia, the tibial plateau. Generally, these types of injuries are caused by twisting and tumbling falls when your ski binding does not release.

Interviewer: Oh. So how can you avoid that then?

Dr. Greenbaum: Make sure that your gear is properly adjusted.

Interviewer: Yeah.

Dr. Greenbaum: Make sure that your boots fit you correctly. Make sure that your bindings are not antiquated or obsolete, and that the person who adjusted them is actually a certified technician.

Interviewer: So that equipment really makes a big difference, it sounds like.

Dr. Greenbaum: Well, it's the equipment actually which results in the injury because you're locked into the ski.

Interviewer: What about snowboarders? What are they looking at?

Dr. Greenbaum: Snowboarders have a lot of injuries to their shoulders and wrists.

Interviewer: They're, again, from falls.

Dr. Greenbaum: Yes.

Interviewer: Is there anything you can do?

Dr. Greenbaum: Well, for beginner snowboarders, it's very wise to wear pads and wrist guards.

Interviewer: Okay. Any other types of things you'd want to do?

Dr. Greenbaum: As far as snowboarding is concerned?

Interviewer: Yeah, to prevent injury.

Dr. Greenbaum: Take a lesson.

Interviewer: Probably true for skiing or snowboarding.

Dr. Greenbaum: It is true.

Interviewer: You really need to have some sort of sense of control if you need to maneuver quickly, I'd imagine.

Dr. Greenbaum: Yes, and, of course, with a lot of mountain sports there's a sense from some individuals that they can simply pick up the equipment and go at it without having a lesson. That's usually a mistake.

Interviewer: Yeah. What about head injuries? You see more and more people finally wearing helmets. I suppose helmets are finally becoming accepted.

Dr. Greenbaum: Helmets are much more popular these days.

Interviewer: Yeah.

Dr. Greenbaum: I think the popularity of helmets originated with snowboarders who have a blind spot that skiers never had.

Interviewer: Oh, okay.

Dr. Greenbaum: And snowboarders really did bring the helmets to the scene and skiers have followed suit.

Interviewer: That's good. That must make you fee pretty good.

Dr. Greenbaum: Well, we're definitely seeing a lot less of the minor head injuries that we used to see.

Interviewer: All right. So if somebody falls on the snow, it's soft. What's happening there exactly?

Dr. Greenbaum: No, it's not always soft.

Interviewer: Okay.

Dr. Greenbaum: A lot of the snow is firm, particularly when it's paced down, particularly when you've gone through a thaw and freeze cycle.

Interviewer: And how much of a bonk to the head does it take to cause some injury? Probably less that one might think?

Dr. Greenbaum: Oh, a slow speed falls definitely can result in head injuries.

Interviewer: Mm-hmm.

Dr. Greenbaum: They're usually mild to moderate head injuries but they can be severe.

Interviewer: All right.

Dr. Greenbaum: Again, it's not so much how fast you fall it's what you hit. You can be going only 5 miles an hour and hit your head against a tree and I'm certain that would not bode well for you.

Interviewer: So it sounds like equipment is the answer, being in shape, maybe doing some stretching, but equipment. Checking your equipment, wearing some wrist guards, wearing some helmets. Any other thoughts on avoiding injuries this year?

Dr. Greenbaum: Be prepared before you come out skiing or snowboarding. Make sure you have the proper equipment and that you are physically and mentally prepared. People show up for vacation and it's very stressful and intense just getting here. The next day, they hit the slopes and maybe they haven't prepared, such as eating a proper breakfast. You really want to be careful.

Interviewer: And that stuff really makes a difference, in your opinion?

Dr. Greenbaum: I really do think so. A lot of our visitors are injured in their first few runs and others are certainly injured on their last runs of the day, when they're worn out.

Interviewer: If I get an injury, how do I know if I need to come to the hospital?

Dr. Greenbaum: This is always a difficult question and that's asked of my friends frequently. I think that as far as coming to the emergency department, or to the clinic at the base of the ski area, come there if you have an injury which is so severe that you think that you're going to need to take a strong pain medication for it, or certainly if you're incapable of using that body part. In other words, if your knee doesn't work or wrist does not work, it's time to have it checked.

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