Keeping snow sports pain-free | March 8, 2006 | Palo Alto Weekly | Palo Alto Online |

Palo Alto Weekly

- March 8, 2006

Keeping snow sports pain-free

Skiing, snowboarding injuries can be lessened with exercise

by Rachel Hill

As winter lingers in the Sierras, many local residents are continuing to trek eastward to enjoy snowy adventures. Skiing and snowboarding offer exciting thrills, but participants who neglect to consider the risks these sports pose could find themselves among the thousands of athletes injured each year.

According to The Journal of Trauma, there were an estimated 77,300 skiing injuries seen in hospital emergency rooms across the country in 2002. There were around 62,000 snowboarding-related injuries in 2002 as well.

Skiers and snowboarders can sustain a wide range of injuries through the two sports, including wrist fractures, arm injuries and knee injuries. Shoulder injuries and torn knee ligaments are the most common.

Orthopedic surgeon Dr. Alan Mishra witnesses firsthand the repercussions of skiing and snowboarding accidents. Mishra is an orthopedic surgeon at Menlo Medical Clinic and a clinical assistant professor of orthopedic surgery at the Stanford University Medical Center.

In his practice, he sees between five and seven patients a day with snow-sport injuries.

A skier himself, Mishra feels it's important to educate the public on injury prevention and treatment for skiing and snowboarding disorders.

Several factors affect the severity and type of injuries, including gender and physical-fitness level. Seasoned skiers experience more severe injuries from the sport than novices due to their fearlessness in testing their capabilities, according to the doctor.

"The novice skier needs to be better prepared or understand what they can and cannot do. A novice skier can fall down and injure themselves because they don't have the skill level," Mishra said. "The advanced skiers or snowboarders for a higher level have more severe injuries because they're putting themselves in more dangerous terrain."

Unlike skiing, snowboarding lacks poles to help the athlete balance and may result in a more severe injury; however, skiing poses a higher risk for knee damage and may need surgery to correct. According to Mishra there are about 24,000 ACL (knee ligament) tears among the U.S. population a year.

Exercise, conditioning and stretching can help prevent or lessen injuries on the slopes, however, Mishra said. The doctor has created a regimen, called the "Power Knee Program," to aid in that goal. It involves stretches for the hamstring, quadriceps and Achilles.

Mishra also recommends a five minute warm-up and five-minute cool down bike routine to condition the body with both anaerobic and aerobic exercises. Keeping the ski equipment is in good condition and up-to-date also helps. But overall, he said, one of the best ways to prevent against a skiing or snowboarding injury is to know one's limits.

Orthopedic surgeon and sports physician Dr. Warren King said some of the worst skiing injuries he worked on are dislocated knees and shoulder damage. The surgeon also noted that injuries stemming from contact with object on the slopes, such as trees, can cause an insurmountable damage on one's body.

Fortunately, depending on the severity of the skiing or snowboarding accident, the long-term consequences on the body can be small after treatment.

"As long as they're (the injuries) treated appropriately in rehabilitation, they will have very insignificant long-term consequences," King said.

Over time, arthritis can be one of the only lingering effects.

King said after an ACL tear, a skier could return in four months to the slopes; broken bones heal in about six weeks. King said with cartilage injuries, a skier can be up and going in about three to four weeks.

Regular, routine conditioning is the key to preventing injuries while enjoying snow sports, King said. He's acquainted with skiers who are more than 70 years old and can ski the mountain at his pace all day long.

"The reason they can do that is because they're active everyday," King said. "People need to understand if you work your bodies and work your minds everyday with a little bit of exercise then your body will do amazing things for many many decades."

Although regular exercise beforehand is integral in preventing an injury on the slopes, rehabilitation is important for regaining full mobility after an accident.

Lisa Riedle injured her shoulder during a skiing vacation at Squaw Valley, which left her with pain so bad it woke her every night. She sought surgery from Mishra.

"I first tried to do rehab on my own with stretching, strengthening and controlling the inflation, but it progressively got worse over time," said Riedle, herself a physical therapist.

After surgery, "the recovery period totally took me three to four months to gain full strength, but I had return of my range of motion in two weeks and was able to return to work after six weeks," she said.

Her rehabilitation treatment started two days after surgery. Riedel said she used atypical rehabilitation stretches, including yoga. As an avid skier, she won't be letting her latest shoulder keep her from the slopes; she's looking forward to returning to the sport.

Mishra has set up a Web site with examples of his Power Knee Program at


Posted by Patricia, a resident of Palo Alto High School
on Feb 25, 2008 at 1:10 pm

Check out a similar article about sports injuries at:
Web Link

Posted by news watcher, a resident of Another Palo Alto neighborhood
on Feb 25, 2008 at 3:18 pm

Getting lost seems to be almost as serious and frequent nowadays. Some sort of gps homing gizmo should be available to rent and a prerequisite for all the advanced slopes.

Posted by Carol Zupp, a resident of another community
on Jul 9, 2008 at 6:25 pm

On our local news cast in Fresno, CA I saw a Dr. Alan Mishra help tennis elbow with Platlet Rich Plasma. It heals degenerative cartliage. Is this the correct Dr.Mishra? If so, I'd like to know if this treatment could possibly help knees with degernative arthritis. I don't see how it could hurt to try since it is a person's own platlets that are used. Thanks

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