Preventing Winter InjuriesPreventing Winter InjuriesCastro Valley Ski ClubCastro Valley Ski Club

01/21/200901/21/2009

Darrell S. Lavin, DCDarrell S. Lavin, DCLavin ChiropracticLavin Chiropractic

20995 Redwood Road20995 Redwood RoadCastro Valley, CA 94546Castro Valley, CA 94546

510-727-0660510-727-0660doclavin@sbcglobal.netdoclavin@sbcglobal.net

Darrell S. Lavin, DC, QME, CGFIDarrell S. Lavin, DC, QME, CGFI

Doctor of Chiropractic (20 years)Doctor of Chiropractic (20 years) Qualified Medical ExaminerQualified Medical Examiner Certified Chiropractic Sports PractitionerCertified Chiropractic Sports Practitioner Certified Golf Fitness Instructor (Titleist Certified Golf Fitness Instructor (Titleist

Performance Institute)Performance Institute) Yada, yada, yadaYada, yada, yada

Some NumbersSome Numbers

133,585 injuries from snow skiing133,585 injuries from snow skiing 127,643 injuries from snow boarding127,643 injuries from snow boarding 55,666 injuries from ice skating55,666 injuries from ice skating 55,311 injuries from ice hockey55,311 injuries from ice hockey 38,395 injuries from sledding and 38,395 injuries from sledding and

tobogganingtobogganing 20,390 injuries from snowmobiling20,390 injuries from snowmobilingSource: 2006, the U.S. Consumer Product Safety CommissionSource: 2006, the U.S. Consumer Product Safety Commission

Types of InjuriesTypes of Injuries

Sprains and strainsSprains and strains DislocationsDislocations FracturesFractures Typically at the end of the day.Typically at the end of the day. Overexertion and fatigue.Overexertion and fatigue. ““One last run before the day's end.” (Hometown One last run before the day's end.” (Hometown

Buffet Syndrome)Buffet Syndrome) Easily prevented with preparation, good physical Easily prevented with preparation, good physical

conditioning, staying alert and stopping when tired conditioning, staying alert and stopping when tired or in pain. or in pain.

Preventing InjuriesPreventing Injuries

Maintain your fitness level during the off-season, Maintain your fitness level during the off-season, then continue during the season since then continue during the season since deconditioned bodies are pre-disposed to injuries.deconditioned bodies are pre-disposed to injuries.

Promptly address any injuries to avoid secondary Promptly address any injuries to avoid secondary injuries.injuries.

3-4 months to prepare for winter sports; more 3-4 months to prepare for winter sports; more intense sports up to 6 months.intense sports up to 6 months.

Pre-season training should include aerobic work Pre-season training should include aerobic work and core strength training.and core strength training.

Important MusclesImportant Muscles

HamstringsHamstrings are major protectors of the Anterior are major protectors of the Anterior Cruciate Ligament (ACL).Cruciate Ligament (ACL).

Skiing, snowboarding and snowshoeing are Skiing, snowboarding and snowshoeing are quadriceps and gluteusquadriceps and gluteus dominant activities. dominant activities.

Cross-country skiing and skating have more lateral Cross-country skiing and skating have more lateral push.push.

CoreCore stabilizes the lumbar spine (low back). stabilizes the lumbar spine (low back). Dysfunction of these muscles can result in injury.Dysfunction of these muscles can result in injury. Lower Crossed SyndromeLower Crossed Syndrome

Lower Crossed SyndromeLower Crossed Syndrome Hours of sitting with hips flexed.Hours of sitting with hips flexed. Adaptive shortening of hip flexors.Adaptive shortening of hip flexors. Brain thinks the hip flexors are working.Brain thinks the hip flexors are working. Opposite muscles (glutes) are inhibited.Opposite muscles (glutes) are inhibited. With major pelvic stabilizers (glutes) shut down With major pelvic stabilizers (glutes) shut down

muscles above (lower back) and below muscles above (lower back) and below (hamstrings) tighten.(hamstrings) tighten.

Opposite muscles (abs/quads) shut down.Opposite muscles (abs/quads) shut down. Now prone to injury since primary muscles used Now prone to injury since primary muscles used

for skiing are shut down with LCS.for skiing are shut down with LCS.

Primary Skiing Muscles

= tight= weak

Stretch and StrengthenStretch and Strengthen

StretchStretch– Deep Hip FlexorsDeep Hip Flexors

Hip Flexor Stretch – Half-KneelingHip Flexor Stretch – Half-Kneeling Long Turns with Pole – Half-KneelingLong Turns with Pole – Half-Kneeling

StrengthenStrengthen– Glutes and QuadsGlutes and Quads

LungesLunges Lunges with Arm PullsLunges with Arm Pulls

EnduranceEndurance HIITHIIT

Hip Flexor Stretch – Half-KneelingHip Flexor Stretch – Half-Kneeling

Start in the half-kneeling Start in the half-kneeling position with your right knee position with your right knee down and your left foot forward.  down and your left foot forward. 

Take both hands and place Take both hands and place them on your right hip.  them on your right hip. 

Keeping your spine neutral and Keeping your spine neutral and using your hands to prevent any using your hands to prevent any rotation of the pelvis, slowly rotation of the pelvis, slowly lunge forward until you feel a big lunge forward until you feel a big stretch in the hip flexors.  stretch in the hip flexors. 

Try to stay tall throughout the Try to stay tall throughout the exercise. exercise.

Make it a little tougher by putting Make it a little tougher by putting your palms together and your palms together and reaching your arms straight reaching your arms straight overhead to the ceiling.overhead to the ceiling.

Long Turns with Pole – Half-KneelingLong Turns with Pole – Half-Kneeling

Start by getting into a  half kneeling Start by getting into a  half kneeling position with your front foot placed position with your front foot placed directly in front of your down knee.  directly in front of your down knee. 

Sit as tall as possible.  Sit as tall as possible.   Raise a ski pole up over your head Raise a ski pole up over your head

and continue to try and sit as tall as and continue to try and sit as tall as possible.  possible. 

Slowly begin to rotate your trunk and Slowly begin to rotate your trunk and the pole as far as possible in both the pole as far as possible in both directions.  directions. 

Repeat this movement 15 times to Repeat this movement 15 times to each side.  each side. 

Go slow enough to maintain a good Go slow enough to maintain a good posture and good balance. posture and good balance.

LungesLunges

From a standing position start by From a standing position start by taking a large step forward with taking a large step forward with your right foot.  your right foot. 

Pretend like you are standing on Pretend like you are standing on a balance beam (narrow your a balance beam (narrow your base) and lower your torso and base) and lower your torso and pelvis down keeping your posture pelvis down keeping your posture upright.  upright. 

Allow your back heel to come off Allow your back heel to come off the ground and make sure your the ground and make sure your front knee stays over your front front knee stays over your front ankle (Don't let your front knee go ankle (Don't let your front knee go forward past your ankle!!!).  forward past your ankle!!!). 

Repeat on the other side. Repeat on the other side.

Lunge with Arm PullsLunge with Arm Pulls

Start by attaching a resistance band Start by attaching a resistance band at waist height.  at waist height. 

Facing the door, grab both handles Facing the door, grab both handles and back away from the door.  and back away from the door. 

Now perform a lunge towards the Now perform a lunge towards the door and simultaneously pull your door and simultaneously pull your arms down and back keeping your arms down and back keeping your arms straight. arms straight.

An alternative to pulling both arms An alternative to pulling both arms down at the same time is to down at the same time is to alternate each arm one at a time.  alternate each arm one at a time. 

This forces your core to stabilize a This forces your core to stabilize a rotational force and adds an rotational force and adds an additional level of difficulty to this additional level of difficulty to this exercise.exercise.

Endurance – HIITEndurance – HIIT(High Intensity Interval Training)(High Intensity Interval Training)

Downhill skiing is done in Downhill skiing is done in intervals.intervals.

30 second workout is the 30 second workout is the ideal place to start with ideal place to start with Interval training. Interval training.

Make sure that you stretch, Make sure that you stretch, warm up and warm down warm up and warm down properly for every workout. properly for every workout.

Go fast enough to feel that Go fast enough to feel that the last few seconds feel the last few seconds feel almost impossible to keep almost impossible to keep running.running.

Don’t save yourself for later, Don’t save yourself for later, give it all up front.give it all up front.

Make sure you consult with your physician prior to starting any exercise program!

AAOS RecommendationsAAOS Recommendations Never participate alone in a winter sport. Never participate alone in a winter sport. Keep in shape and condition muscles before participating in Keep in shape and condition muscles before participating in

winter activities. winter activities. Warm up thoroughly before playing. Cold muscles, tendons and Warm up thoroughly before playing. Cold muscles, tendons and

ligaments are vulnerable to injury. ligaments are vulnerable to injury. Wear appropriate protective gear, including goggles, helmets, Wear appropriate protective gear, including goggles, helmets,

gloves and padding. gloves and padding. Check that equipment is in good working order and used Check that equipment is in good working order and used

properly. properly. Wear several layers of light, loose and water- and wind-resistant Wear several layers of light, loose and water- and wind-resistant

clothing for warmth and protection. Layering allows you to clothing for warmth and protection. Layering allows you to accommodate your body's constantly changing temperature. accommodate your body's constantly changing temperature.

Wear proper footwear that provides warmth and dryness, as well Wear proper footwear that provides warmth and dryness, as well as ample ankle support.as ample ankle support.

AAOS RecommendationsAAOS Recommendations Know and abide by all rules of the sport in which you are Know and abide by all rules of the sport in which you are

participating. participating. Take a lesson (or several) from a qualified instructor, especially Take a lesson (or several) from a qualified instructor, especially

in sports like skiing and snow boarding. Learning how to fall in sports like skiing and snow boarding. Learning how to fall correctly and safely can reduce the risk of injury. correctly and safely can reduce the risk of injury.

Pay attention to warnings about upcoming storms and severe Pay attention to warnings about upcoming storms and severe drops in temperature to ensure safety. drops in temperature to ensure safety.

Seek shelter and medical attention immediately if you, or anyone Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if everyone is aware of proper procedures for getting help, if injuries occur. injuries occur.

Drink plenty of water before, during and after activities. Drink plenty of water before, during and after activities. Avoid participating in sports when you are in pain or exhausted.Avoid participating in sports when you are in pain or exhausted.

THANK YOU!