For those of you who will be jetting off on a skiing holiday over the next few months, the sports injuries experts at Nuffield Health Bristol Hospital, The Chesterfield offer some advice on how to stay safe on the slopes.

It happens every year around this time. That morning you have to de-ice the car before work for the first time, or find your warmest, woolliest scarf to wear as you walk the kids to school. Those tell-tale signs winter is on its way. And while the highlight of winter for many of us is Christmas, New Year’s Eve, or the Strictly Come Dancing final, for others the season brings with it the annual pilgrimage to the ski resorts of Europe or North America.

Skiing and snowboarding, like all sports, include an element of risk for those who participate, not least because they involve hurtling down slippery mountains at speed! Nobody wants their dream holiday to be scuppered by a trip to the local emergency department, and whether it’s just a sprain or a more serious break, injuries sustained while skiing and snowboarding can be extremely disruptive. Someone who understands this well is Dr Stuart Miller, one of Nuffield Health’s expert Sports Physicians.

Based at Nuffield Health’s Bristol Hospital, The Chesterfield in Clifton, Dr Miller not only cares for many of Bristol’s sports and exercise enthusiasts, he is also Chief Medical Officer to the British Paralympic Team, and a sports physician within the English Institute of Sport.

Dr Miller says: “As far as high-octane sports go, skiing on the whole is relatively safe, and serious injuries are not common. However, for those who are affected, it can be unpleasant and could spell the end of a much longed-for sporting holiday.

“Knee ligaments are the most common site for injury among skiers, whereas snowboarders are more likely to hurt their wrists or shoulders. The pressure put on these muscles and joints while out on the slopes is quite distinct and not necessarily something your body is prepared for, even if you have a high general level of fitness.”

Pre-ski

Nobody heads to Chamonix, Val Thorens or Whistler with injury in mind, but it’s important that both professional and novice skiers take measures to reduce their risk of accident and injury by preparing well before hitting the piste.

Dr Miller said: “Preparation is key when it comes to sporting holidays, especially skiing. Ideally you should speak to your physiotherapist or gym trainer a few months before your holiday to set up an exercise regime that will improve your lower limb strength and flexibility, as well as your core stability. This will not only help to lower the risk of injury but will also reduce fatigue and make your holiday that bit more enjoyable. At Nuffield Health we run Preventing Injury workshops for this very reason.

“Once you’re at the ski resort, you really need to make sure you’re using the correct equipment. The introduction of Carver skis has dramatically reduced injury, particularly to knees. Learning how to take advantage of their unique ability to turn easily is extremely important and it’s worth getting a few lessons. It might surprise you to know that many significant knee injuries occur at slow speed, so beginners are particularly vulnerable.”

To help you keep safe and have fun on the slopes, Dr Miller has these tips:
  • Warm up – Go for a brisk walk and do some gentle stretches and joint movement exercises.
  • Ski within your capabilities – Don’t be persuaded to try slopes and speeds you can’t cope with.
  • Wear a helmet – Significant head injuries can occur in high speed collisions and when hitting icy slopes, so wearing a helmet really is a no- brainer!
  • Wear snug ski boots – To help prevent ankle injuries, have your bindings professionally checked and adjusted, and ensure you have ski edges that are sharp enough to control the ski. Don’t opt for cheap equipment, particularly at the end of the season when kit can become worn out.
  • Get the right length skis – It might sound obvious but this will differ depending on your height, experience, and how you ski.
  • Use the correct DIN setting – DIN is the industry adopted scale of release force settings for ski bindings. Using the correct setting determines how easily your boots are released from your skis, and getting it wrong can cause serious injuries when you fall.
  • Warm down – Make sure to do some stretches in the evening, so you’re fit and ready to start again the next morning.

Aprés-ski

On average, only two per 1,000 skiing days and five per 1,000 snowboarding days will result in the need for medical attention. Even then, most injuries on a skiing holiday are sustained away from the slopes, i.e. falling over in the resort!

However, if injury does occur it is vital to seek professional advice as soon as possible, and set up a training programme that will not only repair the damage but ensure a full recovery.

Dr Miller said: “Most skiing injuries affect the lower limbs, primarily the knee, as the skis strapped to the feet can cause abnormal twisting movements. Ligaments within the knee try to prevent excessive movement, which means they can often be the first to sustain damage. It is important to remember that just because a bone isn’t broken, it doesn’t mean the injury isn’t serious.

“At Nuffield Health Bristol Hospital, The Chesterfield, we have a team of specialist consultants and physiotherapists dedicated to repairing joint and sports injuries. Our patients also benefit from our unique Recovery Plus programme which offers tailor-made support to help build joint movement, strength and control, not to mention overall wellbeing, following an operation. So if you’re injured while out on the slopes, it’s a good place to visit for a follow-up consultation once you’re back home.” (For more information about Recovery Plus, see below.)

For less serious injuries, Dr Miller suggests following the simple steps of PRICE, which stands for Protect, Rest, Ice, Compress and Elevate, and can be applied to all minor sports injuries, not just those endured on the ski slopes:

  • Protect the injured joint/limb, for example by using a splint or brace to support.
  • Rest to prevent further injury. If you’ve injured your leg, take your weight off it and avoid continued movement. If it’s your arm, avoid lifting anything and try to keep it still.
  • Ice the injury regularly. Create an ice pack rather than placing ice directly onto your skin, which can burn.
  • Compress with an elasticated bandage, splint or Tubigrip. Be careful not to wrap it too tightly though, because this can cut off circulation to the area below the bandage and cause further swelling.
  • Elevate the affected body part, ideally above heart level. This will also help to reduce the swelling.

If you are in a lot of pain or you suspect your injury is a break, seek immediate medical attention. It can be tempting to continue having fun on the slopes, but your injury could get worse or you could do yourself more harm than good. Have a friend help you safely down the mountain, and seek medical help.

Dr Stuart Miller

Dr Stuart Miller is a pioneer of Sports Medicine, specialising in a wide range of sports and musculoskeletal injuries in both recreational and elite athletes, as well as the less active population. His particular interests include running injuries, groin pain and injuries from racquet sports, rugby and football.
He is Chief Medical Officer for the British Paralympic Association, and was the lead doctor for the Paralympic team in Rio 2016, Beijing 2008 and the 2014 Winter Paralympics in Sochi. In 2012, he was the Lead Sports Physician for the London Olympics and Paralympic Games, looking after the welfare of athletes from all over the world, which Stuart describes as the highlight of his career.

He is also a founding fellow of the Faculty of Sport and Exercise Medicine, and in 2008 became the first formally recognised specialist in Sport and Exercise Medicine. At a more local level, he is a Senior Sports Physician within the English Institute of Sport at the University of Bath, and until recently was also the University’s Clinical Director of Sport and Exercise Medicine.

In his spare time, Dr Miller is a keen sportsman, having competed in rugby, swimming, athletics and football. He also enjoys tennis, badminton, long distance walking, and cycling, and took up karate while looking after the national team.

Dr Miller holds clinics at Nuffield Health Bristol Hospital, The Chesterfield every Thursday from 2pm-6pm. To book an appointment, call 0117 911 5339.

Recovery Plus

Recovery Plus is Nuffield Health’s flagship recovery programme available free of charge to our private patients who have surgery at Nuffield Health Bristol Hospital, The Chesterfield. It embodies Nuffield Health’s complete end-to-end approach to healthcare, providing you with the support you need to get back on your feet faster after your procedure, following post-operative physiotherapy.

Recovery Plus provides you with a personal recovery programme, health check, exercise and diet advice, together with a 3 month membership at a Nuffield Health Fitness and Wellbeing Gym and your own recovery coach. So if you do sustain an injury on your skiing holiday which requires further treatment and physiotherapy at home, Recovery Plus will ensure you’re doing everything you can to maximise your recovery, and get back on the slopes next season.

For more information about Recovery Plus, visit our website: nuffieldhealth.com/hospitals/bristol/recovery-plus or, for more information on Nuffield Health Bristol Hospital, The Chesterfield call us on 0117 911 5339 or visit our website: nuffieldhealth.com