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Tips To Prevent (& Recover From) Winter Injuries
 
Published Thursday, March 2, 2017
by Dan Corsetti

New Hampshire experienced five significant snowstorms in February, which was great for skiing but brought on the drudgery of shoveling. Whether you’re removing heavy snow from your driveway or enjoying an active day on the slopes, it’s important to prevent injuries and know what to do should one occur.

Use these tips to prevent (or recover from) injuries:

Ease into it. If you’ve been hibernating all winter, don’t be overly ambitious on your first day outside. If the most exercise you’ve gotten lately is lifting the remote to binge watch Netflix, don’t expect to spend a full weekend skiing 10 hours per day. Start slowly to avoid injuries and frustration.  

Pay attention to your body mechanics. When shoveling heavy snow, push the snow, keeping the shovel in front of you, which is the safest way to reduce the risk for injury. However, if you have to lift the snow, keep a low center of gravity, bend at the knees and hips, keep a straight spine, hold the shovel close to your body, and walk to the place where you wish to dump the snow. When skiing and snowboarding, a progressive strengthening program prior to the season will be your best bet for reducing your risk for injury.

Watch the repetition. Shoveling snow—repeated, heavy lifting with a twisting component—means an increased risk for injuries, especially if you bend at your lower spine and rotate to throw the heavy snow over your shoulder. Repeated lifting and twisting of heavy loads can be dangerous, especially for those who are not often physically active, or have had previous back injuries. Likewise, long days on the ski slopes, especially if you’ve been sedentary before your ski trip, may increase the risk for a painful experience.

Understand your injury. If you become injured, know what to look for and how injuries normally progress. With an acute back strain, the first one to three days are usually quite painful, and that's normal, even if the symptoms are intense. Fear, stress, and anxiety can increase the pain, so worrying about your injury is one of the worst things you can do. Most injuries hurt way worse than the true amount of damage done, and this is protective in nature. Respect your symptoms, but keep moving. If your back, knee or hip is acutely injured, research shows that resting it can be detrimental in the long run, so it's important to stay moving in whatever capacity you can manage, with a gradual progression to regular activity.

Know when you need professional help. If your systems persist beyond a week or two, or if they become noticeably worse, see a physical therapist. Physical therapists have the expertise to screen and treat the injured area, and knowledge of where to send you if your symptoms require further evaluation. If they’re properly managed, a large proportion of musculoskeletal injuries do not need aggressive or invasive procedures.

Know when to go to the ER. Physical therapists should be the provider of choice for initial consult of musculoskeletal injuries as they are more than capable for the management of painful conditions. However, go to the emergency room if you experience: 

  • Unrelenting pain that cannot be modified with changing positions;
  • Night pain inconsistent with positional change;
  • Numbness/tingling/pins and needles in the groin region;
  • Difficulty controlling bowel/bladder function;
  • Unexplained shortness of breath;
  • Progressive neurological loss including sensation and reflexes that does not change or improve.

Stretch. Many people skip this important step, but it's worth taking a few minutes at the beginning and end of any physical activity, whether that’s an hour of shoveling or an afternoon of ice skating, to properly stretch. Stretching recommendations have recently changed. Now we advise our clients not to do static stretching, where you hold your stretch for 30 seconds or longer, before physical activity. Instead, do dynamic stretching, an active stretch where you only hold the position for a few seconds at a time, then repeat the stretch 10 to 15 times. Static stretching is still appropriate after a workout, as part of a cool down, to help with overall flexibility.

Don’t rely on X-Rays and MRIs. Most people believe that diagnostic imaging, including X-Ray and MRI, are fundamental for diagnosing the cause of their back pain. This couldn't be farther from the truth. Research over the past 10 to 15 years has shown that having diagnostic imaging prior to conservative management of the condition can both increase the cost of care associated with the injury, and lead to worse outcomes. This is often a result of scary age-related wrinkles found on the image blamed for the cause of the pain, leading to fear of movement, thoughts of disability, and other negative thoughts that limit the patient’s capacity to improve. Nobody looks perfect on an MRI. In fact, most people above the age of 20 will show arthritic changes, disc degeneration, disc bulges/prolapses, meniscus tears and these can be normal. It’s often not necessary to get this really expensive selfie.

Dr. Daniel R Corsetti III, PT, DPT, works at Sport & Spine Physical Therapy Inc. in Portsmouth, which provides customized treatment to relieve pain, improve movement and restore function. He specializes in orthopedics. For more information, visit nhsportandspine.com or call 603-431-9700.


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