This is the Preparing for Ski Season webinar that I did for Pure Sports Medicine, alongside my colleagues, on 17th November 2020…
Transcript
Welcome everybody to the Pure Sports Medicine Preparing to Ski presentation webinar.
Okay, so, for those who don’t know pure us at Pure Sports Medicine, we’re a multi-disciplinary team of sports and exercise medicine professionals. We have physios, like as myself. We have S&C coaches, like Chris. We have soft tissue therapists, like Yaad, who’s going to join us in a bit and we also have doctors and chiropractors and we run a tendon clinic and Pilates and podiatry and a variety of other sports and exercise medicine professions.
So, if you have any issues with that please come down and see us.
All right, so the plan – objectives – for today: I’m going to start off. My name’s Scott Walker. I’m a physiotherapist, Specialist Musculoskeletal Physiotherapist, and I am going to talk about various causes of common ski injuries and epidemiology. I’m also going to touch on some injury prevention decisions that you can take place whilst on the slopes.
Following on from me will be Chris, who you can probably see here. He’s a strength and conditioning coach and he’s going to talk about the key performance measures to help improve your ski performance, but also transitioning into and referring back to some of the stuff I’ll be talking about in terms of rehabilitation or injury prevention.
Then Yaad is going to join us. He’s our soft tissue therapist. He’s going to talk about preparing for a snow trip. So, how to prepare your soft tissues and the role of mobility in skiing as well as the role of soft tissue therapy and what you can do to help recover from a snow trip.
And then hopefully at the end we’ll have some time for some questions and answers.
I’d like to start the presentation with Why. Why? Why are we doing this presentation?
If you are familiar with Simon Sinek’s work, he always says starts with why.
So, what’s our motivation for giving this presentation and your motivation for preparing for a ski trip, and then, as I said, Yaad and Chris are going to touch on how we can help prevent some of these injuries.
So, let’s talk about epidemiology. We’ve all become expert epidemiologists in infectious diseases over the last year or so but what you may be less aware of is ski injuries.
In terms of joints, the knee is the most susceptible and vulnerable joint in the body, accounting for around a third of all ski injuries. Topping the list is ACL – anterior cruciate ligament – injuries. They account for, of all ski injuries… less common, quite rare actually, in snowboarders – and I’ll touch on snowboarding injuries a little bit later in the presentation however, skiing injuries… account for… they’re the third most common cause of ACL injuries in Britain, after football and rugby.
Following that is other knee injuries, but similarly… as I’ve just referred to ACLs play a massive role in hospitalisations when you end up with a ski injury.
A recent study that came out in August this year found that an ACL was involved in all hospitalizations after a skiing knee injury. Two-thirds of those were ACL. Sorry, two-thirds were ACL plus other knee injuries but over a third of those were ACL of those.
And that’s a fairly recent development. U until the late 90s, MCL, so medial medial collateral ligament, injuries are most common and that’s been attributed to the more performance, shorter and shaped carving skis that came out around then.
Following on from that, head injuries. SOS, a Danish health insurance company, found that they accounted for only about five percent overall of all ski injuries however they can be quite catastrophic. Even so, they’re still a third on the list of most common, similarly females and males generally have head injuries so it’s about – split there so don’t think it’s just the males who are doing stupid things and banging their heads.
And following on from that is other lower extremity injuries and fractures so, as I touched on, why are we doing this presentation? As you can see, this is data from football, but as you can see ACL injuries account for some of the most serious
injuries
you can have and that they can lead up
to days
off from in this case it was
professional sport but
in your case it could be from work from
playing sports and doing the other
things
that you like to do similarly fractures
are quite catastrophic and as we come
down
there’s your knee injuries and these are
some of the most severe injuries you can
have
so preventing them is imperative
sos the danish i think scandinavian
health insurance company found similar
things to the research they found that
around third of injuries were knee
lower limb and then upper limb
and neck and back and pelvic injuries
only accounted for about six percent but
these tend to be some of the more
catastrophic and we’ll touch onto that
touch on that in a bit
so who gets these injuries not just what
injuries do we get
as you can see from this little graph
here it tends to be
teenagers and people in their s who
think they’re pretty good and they’ve
got it and but it also
tends to be um people in in middle age
who either think they’ve still got it or
maybe are starting to get a little bit
more deconditioned and not preparing as
well
and not as ready to to undertake a snow
trip so
i think it’s be very relevant to this
presentation
it has already alluded to there’s about
a
split between males and females
getting sports um ski injuries
okay let’s just quickly touch on
snowboarders snowboarders generally
don’t get the knee injuries they
generally get the more upper limb
injuries with uh fractures and
and wrist wrist brains however they
still
genuinely get these head injuries which
can be quite catastrophic
um in the case of snowboarders males
generally get more head injuries than
females
and then as we come down it’s more
shoulder separations and wrist and
hand injuries spinal injuries only
account
for a small percentage of injuries in
snowboarders but obviously as i’ve
already said they can be some of the
most
catastrophic trophic injuries so well
worth presenting
when you have both skiers and
snowboarders
on the slopes the injury risk
rate increases by about and this
generally
is upper limb and head injuries
including fractures
and um and shoulder separations this is
generally because
i’m not a skier or a snowboarder
particularly but anecdotally
for what i’ve heard treating patients
coming back from snow trips this is
because
snowboarders and skiers generally take
different lines down the mountain
and they generally run into each other
so similarly there’s no change in gender
when you add snowboarders to skiers so
it’s not just
males doing stupid things where you ski
or where you snowboard
plays a massive role on your chances of
getting injured so let’s have a look at
the
terrain park versus the slopes over
over a fifth of all injuries on the at
the snow uh
actually come from the terrain park
where we have these ski
these jumps and half pipes and things
like that
um so skiing and snowboarding
in the terrain park increases your risk
of both head neck back and these
more severe injuries as a result of
doing jumps and aerial move
maneuvers and or falling off these
apparatus you’re not on the ground when
you start these
falls and they increase the risk of
serious injuries
so if you are going to have a little
play at the terrain park
um it’s better i’m sorry i’ll get on to
that in a bit but
what the research does show that it’s
not just either beginners or
intermediate or experts that um
generally hurt themselves more
in the terrain park that’s pretty much
if you even split
amongst those and um percent of all
spiral injuries i do occur in the
terrain park
and these spinal injuries in one
particular study they found that
the uh in us in one snow season there
was spinal injuries
and nine of them were considered frankl
a which is essentially no motor or
century function
below the level of the lesion so that’s
essentially complete
paralysis so quite serious spinal
injuries we’re talking about here
as i’ve started to speak about if you
are going to have a little play around
in the terrain park it’s probably best
to
stick to the the quarter pipes and the
and the rails compared to say your
half pipes and your your jumps compared
to rails
um the injury in half pipe
is you can see the stats there so i’ll
get on to it in a bit but
basically in terms of safety it go in in
terms of most safe it goes from
kickers up to mushrooms jumps and then
half pipes
so i’ve already sort of spoken about
this but what are the primary causes of
these
these injuries so in novices it’s
falling over or
collisions and an experienced snow goes
it’s
generally landing from jumps another key
factor which chris will talk about
is cardiovascular fitness many injuries
many injuries occur when people are
fatigued so there’s definitely a role
for that
also when they’re either drunk or doped
so
we’ll get onto that in a bit but um the
other causes of skin injuries
are incorrectly bound skis which can
lead to predominantly
knee injuries so this can either be the
quality and condition
of the binding or the ski boot itself or
it can be the
an inadequately adjusted binding
let’s have a quick chat about head
injury so this is some
general population stats but only
uh one percent of these are
life-threatening um
and about of them uh concussion which
can last
for months and have ongoing effects
mostly
you get over your head injury and has no
last
no lasting effects however in all three
groups initially these can appear very
very similar this is why we now see
football and rugby
in other sports really really diligent
when it comes to
any kind of head injury and so
recreational skier should be just as
aware of these head injuries
make sure if they occur that people are
monitored
and that it that make sure they don’t
deteriorate very very
very quickly generally stick skies and
snowballs
get get head injuries on easy and middle
slopes if not on in the terrain park
but however snowboarders gen generally
have it
get head injuries on the occipital
region which is essentially the back of
the head so
snowboarders generally fall backwards
onto their heads whereas skies
generally fall forwards or sideways so
that’s why
we need to pay attention to this injury
prevention
we want to decrease any massive personal
suffering with these catastrophic
injuries
the most prevalent injuries that you’re
going to get skiing are the ones that
are going to
have you not doing what you want to do
for months
on on end which with it comes medical
expenses
going to be massively expensive you’re
going to be spending a lot of time with
surgeons and people like myself and the
other people at pure sports medicine
and you’re not going to be performing at
the level that you want to be in
in work life or recreation for several
months
so what can you do whilst on the trip
it’s not hard to tell from what i’ve
talked about but make sure you
warm up properly every day you wear
appropriate clothing
it has it has been found that you’re
more likely to get injured on colder
days or when you are cold
so make sure you warm up and you dress
appropriately try to
limit the apres ski so not too much
alcohol and try to stay away from the
drugs
we all know that having too much alcohol
and other drugs can lead to increased
risk taking and decreased coordination
which is going to
increase your chances of getting injured
make sure you rest up make sure you take
regular breaks you don’t just ski your
day maybe take a
a day off and make sure you get plenty
of sleep so i hate to be a party pooper
but yeah try to avoid
too much partying tonight and too much
apres ski
and wear a helmet um if you’re a
snowboarder
make sure you have some protection
around the back of your head a
snowboarding appropriate helmet
this is some anecdotal information but
apparently i
i did have a patient who was a keen
skier a snowboarder and
no jumper and he avoided wearing a gopro
because he
he claimed that quite often that gopro
if you do
hit your head can be smashed through the
helmet and i believe he said that’s
was what contributed some of um
michael schumacher’s i know what’s
negative michael
schumacher’s um head injuries not that
we know a lot about that not only from
much information has been released about
it
as i’ve alluded to make sure you’re
wearing the
correct skis and make sure they fit you
and they’re being adjusted
for you if you are in a novice or sorry
if you are going to go
on in the terrain park make sure that
you
um are very careful um if you start off
on the kickers
then if you move on to the mushrooms the
jumps and the half pipes
um if you are a novice make sure you
take some lessons
you learn proper use of equipment how to
bind your skis how to
use your equipment make sure you
increase your skill and technique
and you learn the etiquette of the
slopes uh
there’s a lot of information available
on the slopes for preparing
so make sure you read all the safety
tips around
and make sure each day and each moment
you assess the snow conditions and take
them into consideration
along with your ski level all right so
i’m going to pass over to chris now to
talk
more about performance and
rehabilitation and injury prevention
thanks for scott see as scott mentioned
my name’s chris mccann i’m a strength
and conditioning coach for pure sports
medicine
and i’m based at our st paul’s clinic
i’m going to talk mainly through the
strength and conditioning
components of skiing so the first thing
we want to look at is what does sort of
like the academic research tell us about
skiing so here we have sort of the four
key
performance measures that the academic
research tells us
are sort of key performance measures for
ski performance and injury prevention so
they are aerobic capacity muscular
strength
muscular endurance and balance and i’m
going to touch on each one of these now
and give you sort of um tips on how to
train these and the importance of each
one of these so if you can move on to
the next
slide please scott so aerobic capacity
so why is aerobic capacity important in
skiing and why would we want to train
and improve our aerobic capacity
and so when we talk about road capacity
we talk about the function of our heart
and our lungs and our general sort of
cardiovascular respiratory function
so any kind of aerobic training is going
to lead to an increase in our stroke
volume so that’s the amount of blood
that your heart pumps per beat
so with aerobic training we get a bigger
more stronger heart the heart’s like any
other muscle
it can get bigger um and more efficient
so with a heart that has a greater
stroke volume
it’s more efficient therefore it can
pump up more blood with each beat so
therefore our resting heart rate
decreases
our heart becomes more efficient to
pumping out the same amount of blood
but a lower heart rate um a more
efficient heart is going to give us
greater recovery rates
i know an overall better health so our
heart is able to
pump blood around the body better we’re
able to
remove waste products from exercise
better so
from a skiing standpoint each time you
go on a run a more efficient heart
um it’s going to help you recover from
those each time day to day as well it’s
going to help you recover better
so if you think you know a day ski and
you might spend five or six hours on the
slopes
you know that’s quite a high increase in
activity from general sort of daily life
so it’s quite a high
spike in what we would class as your
sort of daily load
a greater um more efficient aerobic
capacity a better
heart and everything it’s going to give
you a better chance of recovering on
from day to day as well as during your
runs
and then obviously like scott touched on
a lot of injuries do come as a result of
fatigue so the fitter you are
aerobically
the better you are recovering the less
chance you are of getting
tired and leading to a fatigue-related
injury at a sort of the same sort of
level of intensity
um so if you want to move on to the next
slide please scott
so how do we go about training our
aerobic capacity how do we go about
getting those adaptations that i just
mentioned
well so the main thing sort of to do it
is long slow duration activities
so that can be a run a bike or a cross
trainer
a lot of stuff these days does focus on
sort of like high intensity like short
bursts
getting a lot of um a lot of work done a
small amount of time
but the research does show that the most
effective thing at improving
our aerobic capacity is long slow
duration activities and when you look at
research
into sports such as distance running um
sort of like the very successful elite
distance runners the kenyans the
ethiopians
you know of their training is made up
through long slow duration activity
rather than high intensity so we know
this is a method that really works
so you want to look at when you go
through this kind of training
is you want your heart rate somewhere
between to beats per minute
and you want to start around minutes
time so just
gradually going for minutes
continuously there’s a good starting
point if you’re someone that’s generally
not well trained or if you’re looking
as a starting point to get yourself fit
for skiing
um so as i switched on the heart is like
any other muscle
it needs to be put into tension for a
long period of time to be able to grow
and this is essentially what this kind
of training does the heart
contracts and relaxes it works on the
strain of the exercise and
it gets bigger more efficient as i just
touched on
so as i said like minutes would be a
good place to start again with all the
sort of wearable technology you have
these days whether it’s garmin’s
or apple watches you know it’s really
easy to sort of keep an eye on your
heart rate make sure
that you’re staying within this band you
don’t want to go too high because you’ll
get tired really quickly and then your
heart rate sort of map will look
you don’t want it looking up and down
you want to stay within that window
for a really long and consistent period
of time
minutes is a good starting point and
you want to like any kind of training
program
gradually increase that work so if you
go to the next slide please scott
so here is a really simple example of
how you might want to structure
an aerobic based training program so if
you took sort of like eight weeks is a
good sort of time period where
with any kind of physical capacity eight
weeks is a good sort of time period
where you set to see any kind of
um difference really any shorter time
period
the chances of you seeing any kind of
improvements are quite slim
but eight weeks is a good starting point
obviously if you had weeks to get
ready for a skiing holiday
or some kind of skiing competition or
any kind of athletic
competition to improve a physical
capacity that like the more time the
better essentially
but if we look at this here you know if
you look at starting points of
minutes
and you just gradually increase by five
minutes each week
you get to week eight and you’re doing
more than double what you started at
and that’s basically what sort of any
kind of training program aims to
accomplish
just to gradually increase your loading
gradually increase what your norm is
and so we know that you’re fitter your
body’s able to handle more your body has
a greater capacity for work
so this can be done on the bike on the
cross trainer a run
unless you’re you know if you’re a very
experienced runner you’re running for an
hour spray might be a bit too difficult
but so that’s why we want to sort of
maybe focus more on the non-impact modes
of um training so like a stationary bike
or a pedal bike
a cross trainer in gym and you know you
might want to do something like this
i would say minimal twice a week um but
you know you have time to fit in three
or four times a week you’re gonna get
more benefit
and the key thing is just to make sure
that you stay within that heart rate
threshold of to beats per minute
nice and steady again this type of
training isn’t supposed to make you feel
um sort of dead and thrown up in a
bucket after
it’s you know you should be able to do
this kind of training
at that um heart rate window for
for you know minutes to minutes
easily and you should be able to help
hold a conversation with someone while
you do it so you know if you have a
partner
um or a friend you’re on trip with and
you want to decide to train together
you know you should be able to do this
kind of aerobic training and have a
conversation throughout
with no problem um so again it’s not
maybe the most glamorous way of training
but it is
super effective it leads to all those
adaptations that i spoke about earlier
and it’s going to make you generally
more healthy fitter
better over capacity is going to do the
world of good on the slopes so if you go
to the next slide form please scott so
now we’ll talk about
the muscular strength and endurance
component of skiing like i mentioned
earlier
so why is it important that we have
greater strength and great endurance
well from a performance standpoint the
stronger we are the more force we’re
able to produce so the more force you’re
able to produce means you’ll be able to
propel yourself forward
or upwards or whatever kind of athletic
activity it is you’re doing
so the more force you’re able to apply
in sort of ground contact time
the faster you’ll be able to be able to
travel more efficiently be able to
travel
but it’s also being able to tolerate
forces so anytime you
uh produce force you’re going to get
forced back so if we take a ground
reaction force
for every action there’s an equal laptop
so reactions every time you put force
into the ground an equal amount of force
is going to come back at you
now our muscles tendons and ligaments
will generally absorb those forces for
us but if our muscles aren’t as
um as strong as they could be it’s going
to be the tendons and ligaments that
take up those forces and that’s not what
we want
as scott mentioned earlier acl injuries
are
very prevalent in skiing and one of the
key
injury factors when we look at the
research into acl injuries is something
called ligament dominance
where it’s people’s muscles aren’t
developed enough to dissipate the forces
that they’re put under and so
um the force is then
absorbed by ligaments instead that
attendance that leads to failure that
leads to injury
so by getting our muscles stronger they
are able to dissipate these forces away
from the key structural components of
the ligaments and the tendons
and generally a making our muscles more
stronger more
um that may come what was more robust as
a whole
so you want to think of our muscles as
sort of like an elastic band
so they get they lengthen and they
shorten they lengthen and they shorten
i know you think the amount of times
that they’re lengthening shorten when
you
ski or when you run for example if you
do that to an elastic band for so long
it’s going to get worn out and it’s
going to get thin whereas a stronger
more thicker more robust elastic band
that’s not going to happen
that’s sort of like a good analogy to
think of as to why strength training
resistance training
training your muscles to handle the load
handle the forces that they’re going to
be put under
is really important and also when we
look at it from a load standpoint
if you are going from sort of you know
general population life where you might
spend
you know your day in an office you might
maybe get one to two sessions in a week
then you’re going on a skiing holiday
where you’re spending five to six hours
on the slopes moving it’s a huge spiking
your activity levels that your body’s
not used to that your body
might not necessarily be able to handle
if it hasn’t had the key preparation
with the strength training being able to
handle those forces
but it’s not used to be important so
that’s really why we want to focus on
our muscle strength and muscular
endurance alongside increasing or
aerobic capacity next slide please scott
so how do we go about training our
muscles
to get stronger and more robust
so when we look at the scientific
research into skiing and we look at the
emg studies that have been done
which an emg for those that are unaware
is sort of basically
monitors the activity level of muscles
so they stick electrodes onto your
muscles
they get you to replicate the movements
and they monitor the activity of those
muscles
so emg studies have shown that skiing is
a total body exercise there’s a lot of
activity
in the upper body as well as a lot of
activity in the lower body
so we need to make sure that we train
top and bottom
and so one of the key things that i
would say to anyone starting off a
strength training program
is the first thing you need to do is
just to make sure that you can do any
key exercises
to the squat deadlift a lunge or any
kind of upper body
pressing or pulling movements you need
to be able to do them safely and
efficiently
because the first thing that can fail
when you start adding load is your
technique and that could
be potential injury if your technique is
sound and your movement is really
efficient and smooth
you’re going to be able to push the way
you lift week on week and keep yourself
trending upwards
and improving and getting stronger so
that’s a really important
thing to start with is make sure your
technique is dead-on
before you start your program and now
move on to my next point you have to
make sure that your training program is
progressive
so there’s no point in doing the same
exercises for the same weights
for weeks and weeks months and months on
end there’s no improvement
so you need to make sure that you start
a certain point
and that you give yourself a window
opportunity each week to
jump up in the load so the weight that
you lift each week
so it’s not necessarily about going into
the gym lifting as much as you can
destroying yourself because you leave
yourself no window for
um improvement for the next week if you
go in and you fail on every exercise
because you’re just trying to lift as
much as you can
where’s the window for opportunity like
where do you improve you go that you go
the next week and you try to do the same
what if you fail again you know there’s
no improvement so sometimes you might
have to take a step back from what
you’ve been doing previously
to give yourself that little window of
opportunity to improve
but if you can make small small um
increases week on week those really add
up and i’ll show that in a graphic a
little later on
um and for me that’s one of the most
important things for anyone starting any
kind of training program
is make sure that you are thinking about
how your sessions stack up not just week
to week but month to month because what
you do today in your session
will affect what you do tomorrow and
that will then affect the following week
so as long as you give yourself plenty
of scope to keep getting those little
gains each week
you’ll go much further than just trying
to destroy yourself and lift as much as
you can
in one session and then the final point
on this slide is that you have to
monitor your load throughout
so it’s really important to make a note
of what it is you’re doing
how you’re doing it and the weight that
you’re using
because without that information when it
comes to refreshing your program
when it comes to moving on to the next
stage if you don’t have the data
to um advise you on the next step then
you’re sort of in a bit of no man’s land
um whereas when you have the data you
know what is you’ve done previously so
you know okay here’s my scope to
increase
um i know i can’t really jump too much
because i don’t want there to be a
massive spike in the loading because
that could
lead to potential injury then but when
you have the data with you you can make
really informed decisions
or if you come see a professional like
me i can monitor the data for you i then
have the data to
properly make informed decisions about
the next part of your program
and how to advance you in the most
efficient and safe steps
um so if you’re onto the next slide
please scott
so this here is an example of a really
sort of basic
um strength training program that you
would do to increase your muscular
strength and muscle insurance
really simple this could be done in a
gym this could be done at home with
quite minimal
my quite minimal equipment um and it’s
broken down into
two four week blocks so weeks one to
four and then weeks five to eight
really simple exercises that don’t take
up a lot of space don’t take up a lot of
equipment
um but you can see that they are we have
two sort of key
lower body exercises so a squat and an
rd else that’s a deadlift variation
they’re going to target the most the key
muscles involved in skin so our quads
our glutes or hamstrings
and then we have also two upper body
exercises so floor press and bent over
row
that’s going to make sure there’s an
equal distribution between the amount of
weight we’re
pressing and pulling and then some core
work so really basic side
plank and a side plank again this
program is super simple
um you know anyone who’s at any kind of
fitness level could start this at a
certain point
um and they’d be able to move on or you
know if you’re more trained you’d
obviously look at doing some more
advanced training um you know if you’re
looking to someone that’s
sort of a really keen skier and someone
that was training to really sort of push
their performance in a skiing
event you know you’d look at maybe doing
some isometrics because you spend a lot
of time in that
deep squat position things like that but
again it’s just to give you
um you know an idea of what a training
program can look like how our training
program progresses
so if you see from weeks one to four and
five to eight in those key low body
exercises
we drop a rep but we add a set so we
drop a rep which means we can it gives
us a window to increase the load to
increase the weight that we use on that
exercise
um and that’s sort of the type of things
that we do to you know to um
to keep you on improving and increasing
the load that you’re that you’re using
um
next step please scott so this
um diagram here slash chart
is just basically a chart that you would
produce based on
your weekly loading so this is a really
basic chart that i use to
illustrate to people if you add one
kilogram a week
to an exercise program that’s consisted
of four exercises
and say you did each of those exercises
for reps for four sets
this is what your loading would look
like so your loading is the kilograms
that you lifted so your total loading
for a session
is the amount of weight you lift for the
number of reps for the number of sets
and that gives us this arbitrary number
here
which is the kilograms you lifted so as
you can see
by adding one kilogram each week you go
from
kilograms to
it’s quite a significant jump in four
weeks
so you can see how those that small
window that i talked about earlier
i’ve given yourself that opportunity to
increase and you know one kilogram
increase
increasing one kilogram is each week is
a small
increase but it can lead over time to
you know
as i can illustrate here you know quite
a big jump in the load and if you sort
of
were to scale that carry on for eight
weeks you know you’d improve even more
obviously we can’t keep adding weight
every single week that’s not how
the body works obviously you have to
look at other more advanced ways
of um increasing your loading getting
you increasing the capacity of your body
as a whole
and that’s obviously like the job of
someone like myself to do for you
um but this just simply illustrates the
points i’m making about
by making sure that you monitor the
things that you’re doing in your
training session
you’re able to produce um the numbers
like this so you know
come week four you’re like oh i’ve
improved x amount
i know now that my body can handle
kilograms of load
within the week so going forward there’s
no need for me to drop that because i
don’t want to decondition my body
i want to keep slowly progressing
upwards and by monitoring what you do in
your training sessions
you give yourself the ability to do that
uh
next slide please scott
so balance why would we want to focus on
our balance training
so balance is really important in any
kind of sport really
but skiing obviously specifically so it
keeps our joints aligned it
um prevents us getting into any kind of
compromising positions so sort of
one that’s very common in skiing is
obviously the knees diving in knee
valgus
we call it um really bad position to get
in
um and so
um that’s why we would one obviously
focus on a balance engine to prevent any
kind of
compromising positions like that
controls our center of mass it makes us
more efficient at shifting our body
weight
in more efficient ways um coordinating
complex movements so
um you know anything that involves
multi-directional things with
sort of stuff going on in front of us
that we have to coordinate to you know
being able to stay on balance
and take that information in and process
it and move on
is really important and obviously our
scott um touched on a lot of skiing
injuries
um as a result of falls so obviously
the better balance we have the more we
can prevent ourselves from falling
and we want to move on to the next
likely scott
thank you so here’s how you would sort
of
a very basic easy way to go about
balance training
so it’s as simple as literally standing
on one foot
and trying to hold that for a certain
amount of time monitor that time so
note it down and then again if it’s
seconds
one week then the next week you might
want to focus on okay i want to try and
stand on one foot for
to seconds do that for a couple of
weeks then you would move on to step two
where you want to stand on one foot on
an unstable surface so something like a
yoga block
or a bosu ball a bosu board rather um
something that’s gonna um something
that’s unstable it’s gonna make you work
a bit harder than step one
so again stand on one foot for ten
seconds on the unstable surface
holding it for a certain amount of time
jot it down give yourself
room for improvement next week so go two
to three seconds more in the following
week
do that for two to three weeks then your
next step would be adding proprioceptive
work
so again with with this you’d even then
go back to step one
where you might close your eyes you
might ask someone to pass you a ball so
you’re
you’re reaching for the ball at the same
time as you’re balancing
so you can with this one step three you
could even go back to step one do that
on a stable surface then move on to
doing that on an unstable surface
then you want to go into step four we’re
adding a bit more dynamic movement so
for example
rather than time we do this now for reps
so for example you want to hop on one
leg or hop from one leg to the other
and hold it hold your balance can you
stick that landing
in a really controlled position and
again we could move this on from a
stable surface to an unstable surface
um and this is how you would go about um
going through your balance training to
make sure that you give yourself the
best possible chance
of when you’re skiing to prevent those
fours prevent those compromising
positions that might get you injured
and so that’s all from me now i’m going
to hand over to yad
who’s joining us
hi guys you’re out mate yeah
so uh thank you very much for joining in
sorry for being
slightly late to the panel i had to
finish with a patient i’m going to
discuss about the soft tissue
aspect of the ski holiday so we’re going
to talk about two
key points one of them is free so before
the ski holiday starts and we’ll talk
about the mobility the flexibility
aspect of it
and the strength which first touch
from all aspects and then we’re going to
discuss about the post
um ski holiday uh and we’ll see
basically if you can click again um
scott for me
and during opposite ski holiday
injury prevention self-care and then in
the end
the maintenance those are the most
important things that we are going to
discuss and a next slide for me thanks
um so before the holiday we have the
most important thing is
working on the strength and working on
the mobility the strength aspect
chris touched quite brilliantly and
broke it down really nicely into the
tips and things you need to do
eight weeks or so before if you can
click on the first one for me
thank you scott so the strength is
basically the ability to withstand
the long duration of the gear up
exercise we are not talking about
one go exercise is going to be a long
time if you’re going for a weekend or
for a week
basically your body needs to withstand
that long
exercise with gear up so there’s
definitely new
stuff you need to do and that’s what
chris is talking about
and the other aspect is the mobility um
chris another click thank you great so
mobility and flexibility is just
my side of the things we need to
understand if you
are able to move freely and nicely
in the movements that ski is requiring
and of course we’re doing everything
with gear up
so it’s basically complex movements with
gear
and we need to add more factors to the
situations
the factors and leaks you consider are
the weather of course we’re going to
have
cold weather wind is not a friend to our
muscles especially in cold
we’re going to have restricted gear
we’re going to have a new range of
motion that maybe the newest ones that
never tried ski before they’re going to
be required to
familiarize themselves you’re going to
have heavy gear
some people find it light but some
people might find it very heavy for them
and basically hours of muscle use so
this is an overuse and overload
on the muscles that usually we don’t use
that much
a click for me thank you very much
so before the the ski event will start
we’ll have to have a couple of sessions
at least a month before
to work on those aspects i just
discussed about
so first thing we’ll have to target
specific muscles that we know that
either going to be
injured in the ski so we’re discussing
about lower back pelvic
hands arms shoulders everything that my
knees of course everything that might
get injured in that but also muscles
that are
you suffering from problems we need to
assess the range of motion
that you have see how flexible you are
what kind of limitations you are and
identify them
and work on those limitations it’s
crucial for you to get to
the ski um as much as
freely and pain-free as possible once
we’re assessing this we’ll
we’ll start to work on more advanced
techniques one of them is called sdr
which is soft tissue release it’s
basically stretching the muscles
through a false grip and then met which
is muscle energy technique
really nice technique works on the
principle of
reciprocal inhibition really really good
one and on top of that we need to make
sure that you get to the ski event
pain free so if you have suffering any
pain or any you know
stiffness we need to get you to the
event
completely pain-free and flush out any
ways of inflammation that you have
or you carry it out through the ears and
then get to an
optimized muscle reaction next time for
me
thank you during the ski event because
there’s something called self-awareness
injury prevention
starts with self-awareness we all know
that those key events might
be either boozy or some drugs will be
involved
which is okay everyone to himself but we
need to know our limits if you know that
you are not going to push yourself too
much or you’re going to drink too much
know the next day to rest and sleep well
eat well
hydrate when i say hiking it’s mostly
water
during those long duration of sessions
and know when to stop if you feel a bit
pain if you feel
that niggle comes in and you have an
issue with that knee over that elbow
don’t push yourself too hard don’t get
to that point that you are going to
injure yourself then regret
for the rest of that ski holiday hold
back relax
and get some rest after we discussed
about the injury prevention we’ll talk
about the self-care which is
super easy to have nowadays there’s all
sorts of tools and
homemade stuff you can take with you
from foam roller to lacrosse or spiky
balls
massage guns like their guns and and
those kind of things
and peanut will i’ll show you a picture
in a second if you don’t know what a pin
it is
ice or hot packs which are really nice
to have whenever you have like a bit of
a swollen ankle or swollen
wrist so those are the pictures of the
foam roller and the peanut is those two
bowls attached together some of them are
electric which are vibrating you can use
that either on your neck
or when you want to put them it could be
glutes anywhere else
they’re really nice and they do a good
job they’re going the same
another click for me um scott so those
are crossbars or spiky balls they do a
good job
all of those are nice twigs to use uh
they will do a nice job
a temporary job but they will help you
out to carry yourself through that
stiffness or pain that you have in the
ski event
and the most important thing after we do
this prevention and self-care
is the minded another click for me thank
you
be aware of the timeline if you know
that you’re going to finish that
event within a couple of days book in
advance a couple of sessions with me
so after you come back from the ski
event we’ll come in and we’ll do
the post treatment protocol which is
just about the next thing
so the soft tissue treatment protocol
will be mostly maintenance and then
recovery unless
we have an injury if that’s if that’s an
if that’s the case then
you might target those specific areas or
injuries or strains you had during that
sessions it could be
raised this could be your ankles it
could be your knees
your lower back all of those you need to
target understand what’s going on assess
the injury or the strength
and then move on forward to um
what’s going on if we need to involve
other
people to join us like chris to join us
or a physiotherapist
or we are talking about stiff and rigid
movement once we understand the whole
picture
we can move on to the uh treatment
itself we might involve again
str and mbt in those sessions which is
definitely going to be helpful
but mostly we’re going to use much more
of a soft approach
flushing out your inflammation taking
care of the muscles that
gone through a very long exercise
period of time and of course assess your
pain pain is a
crucial element in the whole thing if
you’re coming back from
your ski holiday and then you need to go
back to work or in regular life and you
suffer from that pain
that’s going to be um debilitating and
this is going to stop you to do the
recovery that you’re
supposed to do so we need to reduce that
sensitivity of your muscles
if it’s general or if it’s slow we need
to reduce that pain
and reduce the stress elements you just
had although it’s a holiday
the ski itself is a stress factor in our
body
we need to reduce that put you back in
that previous condition that you’re
going
to sleep well and recover well and then
um release you back to your home
that was me from the softy shoot with my
approach
i hope that was covering most of the
things that you were thinking about
good thanks chad yes thank you
so thank you guys um if you’ve got any
specific questions for
either of any of us um either for myself
as a physio or
chris as an snc coach or yard from a
soft tissue
therapy point of view um you can shoot
us an email