3 most common Skiing Injuries and how to try and avoid them

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Foot and lower leg muscle strains / tendinopathies – these are common when skiing and tend to be caused by overuse of poorly conditioned muscles. Sore and tight calves is a very common complaint on an evening after a day’s skiing. Going out for another hard day on these sore muscles increases your likelihood of straining the muscles. Depending on how you ski and how well conditioned your feet and ankles are will determine which of your muscles are going to take the brunt of this stress, and therefore where you will get sore.

For different people the symptoms can vary from pains in their feet, around the ankles or further up the lower leg. These injuries are best avoided by making sure you do a good mobility and strengthening program for a couple of months prior to your ski holiday. Making sure you have correctly fitted and comfortable boots can also help to minimise the stress on your feet and ankles. If you hire boots and are struggling after the first day or two then go back and ask for them to be refitted. Poor technique when learning to ski will also be a potential for overloading your lower leg and foot muscles and can lead to increasing soreness throughout the week. A couple of tailored lessons can be a simple fix for this and will set you up much better for future pain free skiing.

Knee ligament/cartilage injuries – due to the nature of skiing and the fact that your foot is fixed to a ski can exert a lot of pressure on the knee joint when it all goes wrong. Falling whilst skiing is the biggest culprit for this type of injury so prevention is the ultimate way to best avoid these injuries. Ensuring that your equipment is in good shape and correctly fitted can help to decrease the incidence of falls and reduce risks when they do happen. If your skis are not the right length, your boots are poorly fitting or your bindings are set up wrong you will greatly increase the likelihood of trauma when you fall.

Knowing your body and your abilities will also allow you to better judge the conditions and whether you are up to the challenge when planning your day. Misjudging your abilities and being over faced is another large cause for nasty falls. This does not just apply to your ability to get from the top of the mountain to the bottom, you are at a higher risk if you are not as well versed at reading the weather, the terrain, the changing types of snow, the type of light, etc. Which all comes with years of experience. It can also include your lift skills! That is your ability to get on and off a lift without getting in a tangle, and even your ability to judge the people getting on the lift around you and whether they are likely to trip you up at the other end. A slow speed fall off a lift can have just as n asty an outcome with the right amount of twist!

Doing a pre ski holiday leg workout is a great way to ensure your muscles and joints are conditioned to some of the stresses that they will be put under when on a ski holiday. See our article on preparing for your ski holiday. Being strong before you start could help with your ability to get yourself out of trouble.

Wrist fractures and Skiers thumb – this is another common injury that occurs whilst skiing, and again is caused by the falling over. The above points therefore all apply along with a few extras. How you fall will determine what you injure. Learning to fall without stretching out your arms or trying to put your hands down will greatly minimise the risk of wrist injuries. Skiers thumb is a ligament injury to the base of the thumbs that occurs when falling and holding onto your poles. You should always try to let go of your poles when you fall to prevent them from causing further injury.

Booked/Booking a Ski Holiday – Time to think about fitness & injury prevention!!

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A winter sports holiday for many is a unique type of holiday, occuring for one or possibly two weeks a year if you’re lucky. While passionate skiers like to use this opportunity to get as much time on the slopes as possible, winter sport holidays can involve some long days, pushing the body to complete movements unlike anything else we tend to do in normal daily life. This exposure to sudden unaccustomed activity, especially for us unseasoned skiers and snowboarders, is a recipe for injury.

This is where targeted Sports Conditioning exercises come into play! Putting the effort in during the weeks prior to your holiday is the perfect way to reduce the risk of injuries on holiday and help you get the most out of your time away.

If you are like many weekend warriors and you spend the majority of your week sat at a desk, then behind a steering wheel and finally at the dinner table and onto the sofa, a great place to start is by increasing the amount of time throughout the day that you spend on your feet. Even if this means standing to take phone calls, when chatting to colleagues, or going for a walk every lunch time. It will pay off when you need your feet to spend a whole day in ski boots.

In addition to these small daily changes, a tailormade exercise routine including exercises such as squats, wall sits and side lunges in the weeks prior to your trip will allow you to gradually increase exposure to prolonged periods of exercise and give your ski specific muscles time to strengthen. It takes at least 6-8 weeks of structured loading to increase the strength of your muscles so it is essential to get started in good time before you leave (that said, it is never too late to get started!).

Once the basics are mastered, you can then gradually increase the amount of weight you hold when doing these exercises to make sure you continue to push your limits and strengthen to the max. Another thing to include in ski prep is balance work. Staying upright on skis and the constant shifting from one leg to the other requires some finely tuned balance skills. Including some balance work in your ski prep could be as simple as gradually increasing the amount of time you can balance on one leg. This can even be done throughout your work day to help increase the amount of time up on your feet – try lasting a whole phone call stood on one leg. Or you could get fancy and use equipment such as a BOSU ball or wobble cushion to add an extra ski specific challenge to the above strengthening exercises.

Enhancing your training to push yourself further, keep you motivated and physically challenged is a key part of your ski fitness. Our Ski Fit Package provides advice on which exercises to complete, not only saving you time but also ensuring you head to the slopes in the best possible position. While standard strenght exercises form a good base, the use of a Ski Fit programme will challenge you further, progressing your base line exercises and keeping you body engaged and strong.

Our Ski Fit package includes:
• 4 x individual Sports Conditioning sessions – perfect for keeping you accountable in the lead up to your holiday
• 2 x sports massage – to relieve any niggles or tightness before you get out on the slopes
• gym and home based workout plans tailored to you and the demands of skiing

Call 01454 540066 to book your space on our Ski Fit programme!

How to do a successful cool down

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Session ended, you are tired… but please do a cool down – your body will thank you

Just as warming up in preparation for exercise is important and beneficial to your body, a cool down is just as important and beneficial.

Cooling down after exercise allows your body time to readjust to the pace of daily life and helps minimise soreness the following day. A cool down can also be a great time to give your muscles a much needed stretch out and reduce the risk of chronic shortening of your soft tissues from the repetition of your usual tasks.

The key aspects of a decent cool down include:

  • Allowing your heart rate and breathing time to return to normal taking the time to cool down will ensure you can return to a resting heart and breathing rate and reduce the stress on your body.
  • Give your core body temperature time to return to normal.  You’ve all done it, briskly walked somewhere outdoors and rushed inside and sat down so you weren’t late … and then immediately started to feel like you are overheating and sweating from parts of your body you didn’t even know could sweat! It is important to gradually decrease your activity level and ensure you have reduced your temperature before charging off into the next part of your day. This is to ensure you do not overheat and allows the body to return to a resting level of homeostasis.
  • Returning your circulation from your extremities.  This is important to reduce the risk of dizziness or fainting. When you exercise your circulation increases and is diverted to your muscles, when you stop exercising the rate of your circulation decreases. If this happens too quickly your blood pools in your larger muscles of the extremities and you can experience a drop in circulation to your brain, causing dizziness and fainting.
  • Ensures you can make the most of the feel good hormones that are released when you exercise.  Giving yourself time to reflect on your exercise achievements helps you to maintain a positive frame of mind often gained from exercise. It also allows you to recognise that feel good feeling following exercise and can help to motivate you to exercise again in the not too distant future.

But what should you do?

A cool down should be designed to gradually decrease the speed you are moving around at. Walking for 5-10 minutes is a simple way to do this. It must also include some end of range stretches of all your major muscle groups to increase range of movement and flexibility.

What’s a warm up and is it really that necessary?

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Pilates, the difference between a “Fitness Class Pilates” and what we offer.

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Pilates has been a buzz word in the fitness and wellness industries for a while now. With everyone now offering Pilates of some form it can be confusing where to start. The easiest distinction to make between classes is who is teaching them – this can guide you in whether it is a Fitness Pilates class (run by a fitness instructor and commonly held in a gym or leisure facility) or if it is a Clinical Pilates class (run by a rehab specialist such as a physiotherapist or sports therapist).

Pilates classes can vary greatly, make sure you attend one that is best suited to your needs. A Pilates class is similar to many other types of fitness class in that it is only as good as its instructor, and the logistics of how the classes are run. You will have a very different experience in a class of 40 people with one instructor demonstrating a rehearsed routine than you will in a class of 6 with personalised exercises and the instructor being able to come around a individually coach you on correct technique.

 

If you are not carrying any injuries, and you are well versed in what the finer differences between correct and incorrect core

control technique are, and you want to do Pilates for the fitness buzz and to know you’ve done some general core work in your week, then your local gyms’ inclusive Pilates classes could suit you just fine. Fitness Pilates however is not for everyone. If you are carrying an injury or have a history of back problems or an underlying reason why you would have a not so great core (post baby, post-surgery, a long period of inactivity, etc) then you are likely to be better suited to a Clinical Pilates class. Some people who are familiar with regular exercise do a period of 1:1 Pilates sessions in order to learn the important details of the techniques, and how to best tailor the exercises to themselves, and then feel confident that they can attend Fitness Pilates.

What we offer: Here at The Physio Clinic we run Clinical Pilates classes and 1:1 Clinical Pilates sessions. These are run by a Sports Therapist who specialises in rehabilitation and movement control. In the group classes we take a maximum of 6 people and can tailor the exercises to your needs to ensure you get the most from the class. They are mat work based classes and we use small equipment such as Pilates balls and resistance bands. The 1:1 Clinical Pilates service is a great way to learn the basics if you have never done any Pilates before, or if you are recovering from an injury and want to be confident in your technique. These 1:1 sessions can be continued if you like the personal experience, or alternatively you can progress into a class once you feel confident.

If you would like more information on our Pilates service then check out the website https://www.thephysioclinicbristol.co.uk/pilates/ or call us in clinic 01454 540066

Why Pilates can benefit everyone

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Pilates is a form of low-impact exercise that aims to strengthen core muscles while improving postural alignment and general flexibility. Pilates movements tend to target the core, although the exercises work other areas of your body as well. You can do Pilates with or without equipment. Some classes use large specialist Pilates equipment, but the majority will be a mat-work based class with small equipment such as Pilates balls and resistance bands to compliment or progress the exercises. Expect the moves to involve slow, precise movements and breath control.  Typically, classes tend to supply any equipment needed and you just need to turn up in the right place wearing clothes that are not going to restrict your movement. This makes it an easy type of exercise to take up with minimal upfront investment.

Your ‘core’ is a name given to the deep muscles that control the finer movements of your trunk. This includes your shoulder blades, rib cage, abdomen, spine, pelvis, and hips. The core muscles are typically broad, flat, deep muscles that are designed to work at a relatively low level for a prolonged period of time. This means in order to maximise your potential to train these muscles you need to do low level control exercises for a prolonged period of time – such as Pilates.

Done well, Pilates can teach somebody the finer details of how to perform efficient movement. They learn how to get from one position to another efficiently as opposed to just copying movements. It can also teach a variety of movement strategies, so somebody can know how to utilise a different movement pattern when they are doing something repetitive or fatiguing – this can help to reduce wear and tear of always moving in the same way. Another useful technique learnt in Pilates is to differentiate between movements that require your spine to be still and stable and movements that require your spine to bend. This skill is a key part of avoiding low back pain and injuries.

When learnt properly Pilates can be used as a way to be aware if you are moving efficiently and can then be applied in many other situations. This means the movements and techniques learnt in Pilates can be used to improve your posture and control in daily activities as well as improving your body awareness and technique when doing sports or manual jobs. The ability to move well and have good core control can greatly reduce the stress on some commonly injured parts of your body and decrease the rate of wear and tear.

Difference between a Strain & Sprain explained

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Simply put – you strain a muscle and you sprain a ligament.

Muscles have a large contractile function and are responsible for creating force and moving your skeleton. When a muscle is strained, most commonly, it means that you have torn a few fibres within the muscle. This means that those fibres are broken and need to heal; that the fibres immediately surrounding the torn ones will contract in an effort to protect the damaged area from further trauma; that the muscle as a whole is unable to work properly.

When you experience a muscle strain that muscle will then be painful to contract and to stretch. You should be able to use all the other muscles around it so you may still be able to move around. Depending on how many fibres you have damaged will determine how bad the strain is, and therefore how long it will take you to recover. It is important to protect a muscle strain in its initial stage of healing to prevent further damage and to allow it to heal at an optimal length. This means avoiding any painful contracting or stretching of th

at muscle for the first few days to weeks, depending on how bad the initial injury is. It is then important to gradually load the muscle back to full strength as it will be weak following the injury. Loading it too much or to soon could lead to further damage. Not loading it enough will leave residual weakness and leave you susceptible to reinjury in the future.

A ligament does not contract. It is responsible for holding a joint in place and runs from one bone to another. Typically, each ligament is designed to be strong in a certain direction to withstand any forces put on the joint in that direction, and to limit excessive movement. This ensures that when a muscle contracts it moves the skeleton in a specific, predictable direction. It also limits the amount of unnecessary compression or shearing forces going through the joint, to minimise wear a tear.

When a ligament is sprained it loses some of its tensile strength and becomes easier to stretch. This hurts, and it makes the joint less stable and the ligament susceptible to further injury. With a ligament sprain it is good to keep doing regular gentle range of movement exercises and static strengthening to help keep the muscles active to compensate for the ligament injury. Dependent on which ligament you injure and how bad it is you may benefit from some strapping or a brace to help support the joint whilst it heels. Once the ligament is more stable it is important to do some rehab exercises to get the joint strong and balanced again.

What is DOMS, am I injured?

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DOMS stands for Delayed Onset Muscle Soreness, and it occurs as a result of exerting your muscles. When you do an activity that is new, or you are working harder or for longer than usual, the extra stress on the tissues of your body causes micro trauma. These are microscopic tears in the fibres and occur widespread throughout the muscle groups being used. This usually results in widespread soreness in one or multiple areas of your body 1-3 days after the activity, and the soreness can last quite a few days.

This is totally normal. As these tiny microscopic tears heal they create slightly stronger muscles. It is important that our muscles go through this process in order to allow us to adapt and change, so we get better able to withstand the stresses of a new task in the future. However, it is not possible to predict when DOMS will strike. Not everybody gets it and some people seem to suffer more than others.

As a general rule it is more likely when starting out doing exercise, when doing something new, or when working harder than normal. This means as you keep training it does get better, you won’t always feel like that after exercise. For some this is reassuring to know it is possible to exercise and not feel sore the next day, and for others a lack of DOMS means they are due an upgrade to their program and should be working harder!

Certain types of exercise are more likely to cause DOMS than others. Typically exercises with a high eccentric load are more likely to cause soreness. Eccentric is the lowering phase of a muscle (or the deceleration phase), for example when you bring the weight

back down towards your chest in a chest press.

This means that things like speed work, explosive/plyometric tasks, and repetitive high speed change of direction, all have a higher likelihood of causing soreness the next day. Clear examples of exercises with an eccentric focus would be jumping off of a box, or catching a heavy medicine ball. Generally exercises will always have an element of concentric and eccentric demands, with other muscles working isometrically to control the movement, but you can modify them to increase or decrease the bias accordingly. This knowledge can allow you to control the amount of soreness you are likely to have following exercise. This information is also useful if you do not like DOMS. Doing a graded program that starts with basic isometric and steady concentric exercises and builds up in intensity and speed of movements slowly is more suited to managing DOMS.

There have been lots of studies into what we can do to reduce the soreness that occurs after exercise. The majority of which have shown there is very little we can do to shorten the length of time the soreness lasts. But there are things that we can do to make sure it does not last longer than normal. These include basic things like keeping active and moving around lots despite the soreness, do not repeat a hard activity or workout that targets the same area until the soreness has calmed down, drink plenty of water and eat well, and use things that usually give you a feel good effect (such as a hot bath or some gentle stretches). Some people who are training hard and need to recover as quickly as possible could also look into using the Compex for improved recovery. You are able to hire a Compex unit from The Physio Clinic to try it out.

 

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It is possible to create too much DOMS. Sudden extreme exercise can cause Rhabdomyolysis. This is rare and unlikely but possible. It causes extreme levels of post exercise soreness, rigidity (loss of range of movement due to rigid muscles), lack of urine or urine that is very dark in colour, and this takes longer to recover from that just DOMS. It is due to excessive levels of microtrauma that results in high levels of creatine kinase in the blood and puts excessive stress on your kidneys.

Unlike DOMS, Rhabdomyolysis is a serious condition that requires medical attention. You need all the symptoms for it to be Rhabdomyolysis, if you are just excessively stiff and sore after exercise … you just have bad DOMS, plan better next time.

Do you run holding a water bottle? Don’t.

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Why do Runners not use their Glutes and what can they do about it

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The biggest factor affecting anybody’s hips these days is sitting. We were not designed to sit in a chair and we certainly were not designed to stay there for long periods of time. Keeping your hip at 90 degrees and sitting on your butt holds the glutes in a lengthened position, this will cause them to find it harder to activate and over time can make them harder to recruit. This position also allows your hip flexors, the muscles in the front of your hips, to shorten.

Muscles work in pairs, so if your hip flexors are short and overactive they will also encourage your glutes to turn off. This is just one example of something that we do all the time that will have a direct impact on how well we recruit our glute muscles. If we do not spend enough time warming up prior to exercise and activation our glutes on purpose to overcome these effects then it will directly affect running technique.

See our other article on why the glutes are so important.

In runners the glutes are important in controlling the forces that go through your lower limb as it hits the ground. They play a big part in absorbing the impact from the floor and regenerating it into the next step

Running in particular does not actually do much to improve the glute function. Yet we know they are useful muscles in making you a more efficient runner. Run training typically just involves running, and many runners are guilty of not doing any conditioning outside of this. Running in straight lines will not greatly challenge the glutes or help them improve. To activate and strengthen glute muscles the best exercises revolve around twisting movements and moving sideways – this is because this creates a high demand on the right muscles.