1. I.M. Doctor M.D. Office City, State COMMON WINTER INJURIES (AND HOW TO PREVENT THEM) I.M. Doctor, M.D. My Office My City, State

2. The information in this presentation was provided to the presenter by the American Academy of Orthopaedic Surgeons and may be modified. Endorsement of this presentation by the AAOS is not implied or inferred. Thank you to A. Herbert Alexander, MD for his significant contributions to the content of this presentation.

3. Winter Sports Injuries  Orthopaedic surgeons  Specific injuries  What they are  How they occur  How to avoid them  General precautions  Safety gear  Conditioning  Instruction

4. What is an orthopaedic surgeon?  MD who specializes in treatment and health maintenance of musculoskeletal system (bones, joints, ligaments, muscles, tendons, cartilage and spine)

5. What is an orthopaedic surgeon?  The expert in treating the musculoskeletal system  The expert in maintaining musculoskeletal health

6. Educating an Orthopaedic Surgeon  College  Medical School  Internship  Orthopaedic Residency  Fellowship (optional)  2 Years Practice TOTAL 4 1 4 (1) 2 16 years!

7. What do orthopaedic surgeons do?  Diagnose  Treat  Medication  Physical Therapy  Exercise  Brace  Surgery  Prevent

8. Winter Injuries by Sport

9. Snow Skiing  More than 131,000 injuries in 2007  Cost U.S. more than $4 billion

10. Snowboarding  149,000 injuries in 2007

11. Ice Hockey and Ice Skating  47,600 ice hockey injuries in 2007 z58,400 ice skating injuries in 2007

12. Sledding  More than 106,900 injuries in 2007  Majority of injuries happen to children aged 14 and under

13. Winter Injuries by Type of Injury

14. Sports Injuries  Common Winter Sport-Related Injuries  Head injuries  Shoulder dislocation or fracture  Elbow injuries  Hand or finger injuries  Broken legs  Knee injuries  Ankle injuries

15. Head Injuries  10% of winter sport injuries are head injuries  Protect your head by wearing a helmet!

16. Shoulder Injuries  Glenoid  Humeral head Reproduced with permission from Bernstein J, Blazar PE, Campbell JT, et al: Anatomy, in Bernstein J (ed): Musculoskeletal Medicine. Rosemont, IL American Academy of Orthopaedic Surgeons, 2003

17. Shoulder Injuries: Dislocation Normal Dislocated

18. Shoulder Injuries: Acromioclavicular Dislocation AC joint Illustration Reproduced with permission from Bernstein J, Blazar PE, Campbell JT, et al: Anatomy, in Bernstein J (ed): Musculoskeletal Medicine. Rosemont, IL American Academy of Orthopaedic Surgeons, 2003 18

19. Shoulder Injuries: Rotator Cuff Tear

20. Shoulder Injuries: Clavicle Fracture NormalFracture

21. Elbow Injuries: Dislocation

22. Elbow Injuries: Radial Head Fracture  Signs and Symptoms:  Pain on the outside of the elbow  Swelling in the elbow joint  Difficulty in bending or straightening the elbow accompanied by pain  Inability or difficulty in turning the forearm (palm up to palm down or vice versa)

23. Hand and Finger Injuries: Ulnar Collateral Ligament Tear  “Gamekeeper’s thumb”  Ski pole-related

24. Knee Injuries  Bruises  Sprains  PCL  MCL  LCL Illustration reproduced with permission from The Body Almanac, American Academy of Orthopaedic Surgeons, 2003

25. Knee Injuries: ACL Injury  Direct blow to knee  Non-contact injury, with foot plant  Landing on straight leg  Making abrupt stops  “Back seat” skiing

26. Knee Injuries: ACL Tear zInjury may require surgery zRehabilitation following surgery zReturn to sports when strength, balance, and coordination are normal

27. Knee Injuries: Meniscus Tear Normal meniscusTorn meniscus

28. Broken Legs: Tibial Fracture  Common in winter sports, particularly skiing  Can usually be treated without surgery

29. Ankle Injuries: Snowboarder’s ankle

30.  Common in winter sports, particularly skiing  Can usually be treated without surgery Treatment

31. When to See the Doctor  Inability to play  Decreased ability to play  Visible deformity  Severe pain

32. Treatment  R.I.C.E. – Rest, Ice, Compression, and Elevation  Modify athletic activity  Cooperation and communication between patient, parents, coaches, and physician

33. Tips for Preventing Winter Sports Injuries

34. Preventing Winter Sports Injuries  General sports conditioning  Warm up and stretch before engaging in activity  Safety gear and skilled instruction  Snow skiing  Snowboarding  Sledding

35. Preventing Sports Injuries  Jump box  Half squats

36. Preventing Sports Injuries  Balance board  Aerobic exercise

37. Preventing Sports Injuries Warming up and stretching are two separate steps!

38. Preventing Sports Injuries  Marching  Walk in place  Mimic the sport Warm up:

39. Preventing Sports Injuries  You should NOT feel pain  Hold stretch 30 seconds  Relax into the stretch Stretching:

40. Preventing Sports Injuries  Know and abide by rules  Using proper equipment  Receive expert instruction  Pay attention to fatigue

41. Preventing Sports Injuries  Wear appropriate protective gear  Know how to use equipment  Never “play through pain”

42. Preventing Sports Injuries: How to Fall

43.  Hands together, forward, over skis  Skis together  Weight forward  FALL, don’t fight it!

44. Preventing Injuries: Sledding zAdult supervision zSafe sled paths zHelmets

45. Designated areas only No public streets No sledding on plastic sheets Preventing Injuries: Sledding Do Don’t

46. Environmental Injuries  Injury due to cold  Dehydration  Sunburn

47. Environmental Injuries  Wear proper eye wear  Goggles  Sunglasses  UV protection  Visual clarity  Different lighting/different lenses

48. Rules to Play by  Understand the activity  Learn the skills properly  Use appropriate equipment  Wear protective gear  Warm up and stretch  See your physician if you’re injured

49. American Academy of Orthopaedic Surgeons 6300 N. River Road Rosemont, IL 60018 orthoinfo.org Resources

50. What are your questions and concerns? Winter Sports Injuries

51.  Remember, your orthopaedic surgeon can help get you back in the game Winter Sports Injuries