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Downhill Skiing Related Knee Injury

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1. Downhill Skiing Related Knee Injury

Downhill Skiing Related Knee Injury Downhill Skiing Related Knee Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Downhill (...) Skiing Related Knee Injury Downhill Skiing Related Knee Injury Aka: Downhill Skiing Related Knee Injury , Knee Injury in Downhill Skiing II. Epidemiology Injuries account for one third of adult ski injuries III. Causes: Common ski injuries Medial Collateral Ligament Tear or MCL (25%) Valgus stress at knee while skier falls Beginner ski position: Internal rotation and valgus or wedge knee position or ACL (25%) Phantom Injury (most common mechanism) loses balance, g weight posteriorly flexed

2019 FP Notebook

2. How to prevent ski injuries: tips from an orthopedic surgeon

How to prevent ski injuries: tips from an orthopedic surgeon How to prevent ski injuries: tips from an orthopedic surgeon How to prevent ski injuries: tips from an orthopedic surgeon | | March 7, 2019 41 Shares Ski season is here, and it’s time to think about how we can avoid injuries on the slopes. As an orthopaedic surgeon, I most often see knee injuries, but also plenty of wrist, elbow and shoulder injuries as well. Hopefully, you’ve done some pre-season conditioning — but if not, go ahead (...) and start now! Obviously, avoid a heavy workout the day before your first ski day, but if you have time to become more regularly active with your cardio, strength and flexibility routine, get started with that. It’s important to increase intensity, duration, and weight slowly to avoid injury. Don’t let your injury avoidance plan injure you! Always talk to your doctor about starting an exercise program. Morning warm-up Before you start down the mountain, you will want to make sure all your muscles

2019 KevinMD blog

3. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention

pathology including damage to the joint (patellofemoral and/or tibiofemoral), ligaments, meniscus, or patellar tendon. Articles that focused on preventing knee injuries as a whole were included, but so too were articles focused on only one type of knee injury (eg, anterior cruciate ligament [ACL] injuries or patellofemoral pain). This CPG delineates between evidence related to ACL injuries and all knee injuries. Mechanism of injury included both contact (injuries as a result of collision with another (...) Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention | Journal of Orthopaedic & Sports Physical Therapy ADVERTISEMENT Journal of Orthopaedic & Sports Physical Therapy | | | | | > > > Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention Clinical Practice Guidelines Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention Clinical Practice Guidelines Linked to the International

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2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

4. ACL injuries in middle-age athletes

without an intact ACL because the knee simply feels “loose” or unstable. And if the knee shifts around too much because that ACL is gone, then other injuries can occur — meniscus (your knee’s shock absorbing cartilage) tears, injuries to the smooth cartilage that lines the joints (which then can lead to arthritis), or the remaining supportive ligaments can be sprained or torn as well. Suppose you’re a 40-something (or beyond), you love playing soccer, going downhill skiing and training with CrossFit (...) are seeing are injuries related to the increased level of activity. One area of interest is anterior cruciate ligament injury in the over-40 age group. The anterior cruciate ligament, or ACL, is one of the ligaments that connect the femur (thigh bone) to the tibia (shin bone), and it controls the back and forth motion in the knee. Specifically, it keeps the tibia from sliding too far forward, while also avoiding too much rotation in the knee. Injuries of the ACL occur when there is a rapid change

2018 KevinMD blog

5. Sports Physicals (Treatment)

water) Fencing Field events (high jump, pole vault) Floor hockey Gymnastics Handball Horseback riding Racquetball Skating (ice, inline, roller) Skiing (cross-country, downhill, water) Softball Squash Ultimate Frisbee Volleyball Windsurfing/surfing Archery Badminton Bodybuilding Canoeing/kayaking (flat water) Crew/rowing Curling Dancing Field events (discus, javelin, shot put) Golf Orienteering Power lifting Race walking Riflery Rope jumping Running Sailing Scuba diving Strength training Swimming (...) Table tennis Tennis Track Weight lifting *Participation not recommended by the AAP. [ ] The AAFP, AMSSM, AOASM, and AOSSM have no recommendation against boxing. Table 4. Sports of High to Moderate Intensity Sports With High to Moderate Dynamic and Static Demands Sports With High to Moderate Dynamic and Low Static Demands Sports With Low Dynamic and High to Moderate Static Demands Boxing* Crew/rowing Cross-country skiing Cycling Downhill skiing Fencing Football Ice hockey Rugby Running (sprinting

2014 eMedicine.com

6. Sports Physicals (Overview)

water) Fencing Field events (high jump, pole vault) Floor hockey Gymnastics Handball Horseback riding Racquetball Skating (ice, inline, roller) Skiing (cross-country, downhill, water) Softball Squash Ultimate Frisbee Volleyball Windsurfing/surfing Archery Badminton Bodybuilding Canoeing/kayaking (flat water) Crew/rowing Curling Dancing Field events (discus, javelin, shot put) Golf Orienteering Power lifting Race walking Riflery Rope jumping Running Sailing Scuba diving Strength training Swimming (...) Table tennis Tennis Track Weight lifting *Participation not recommended by the AAP. [ ] The AAFP, AMSSM, AOASM, and AOSSM have no recommendation against boxing. Table 4. Sports of High to Moderate Intensity Sports With High to Moderate Dynamic and Static Demands Sports With High to Moderate Dynamic and Low Static Demands Sports With Low Dynamic and High to Moderate Static Demands Boxing* Crew/rowing Cross-country skiing Cycling Downhill skiing Fencing Football Ice hockey Rugby Running (sprinting

2014 eMedicine.com

7. Iliotibial Band Syndrome (Overview)

. [ , , , , , , ] This condition is, therefore, most common in long-distance runners and cyclists. ITBS may also be observed in athletes who participate in volleyball, tennis, soccer, football, skiing, weight lifting, and aerobics. [ ] The image below illustrates active stretching of the ITB. This illustration demonstrates active stretching of the iliotibial band (ITB). The athlete stands a comfortable distance from a wall and, with the contralateral knee extended, leans the proximal shoulder against the wall to stretch (...) the ipsilateral ITB. See , a Critical Images slideshow, to help diagnose and treat injuries from a football game that can result in minor to severe complications. For patient education resources, see the . Also, see patient education articles , , , and . See also Medscape Drugs & Diseases articles and . See also the Medscape CME & Education topic . Next: Epidemiology Frequency United States ITBS is the most common cause of lateral knee pain in runners. Although few studies are available regarding

2014 eMedicine.com

8. Sports Physicals (Follow-up)

water) Fencing Field events (high jump, pole vault) Floor hockey Gymnastics Handball Horseback riding Racquetball Skating (ice, inline, roller) Skiing (cross-country, downhill, water) Softball Squash Ultimate Frisbee Volleyball Windsurfing/surfing Archery Badminton Bodybuilding Canoeing/kayaking (flat water) Crew/rowing Curling Dancing Field events (discus, javelin, shot put) Golf Orienteering Power lifting Race walking Riflery Rope jumping Running Sailing Scuba diving Strength training Swimming (...) Table tennis Tennis Track Weight lifting *Participation not recommended by the AAP. [ ] The AAFP, AMSSM, AOASM, and AOSSM have no recommendation against boxing. Table 4. Sports of High to Moderate Intensity Sports With High to Moderate Dynamic and Static Demands Sports With High to Moderate Dynamic and Low Static Demands Sports With Low Dynamic and High to Moderate Static Demands Boxing* Crew/rowing Cross-country skiing Cycling Downhill skiing Fencing Football Ice hockey Rugby Running (sprinting

2014 eMedicine.com

9. Iliotibial Band Syndrome (Diagnosis)

. [ , , , , , , ] This condition is, therefore, most common in long-distance runners and cyclists. ITBS may also be observed in athletes who participate in volleyball, tennis, soccer, football, skiing, weight lifting, and aerobics. [ ] The image below illustrates active stretching of the ITB. This illustration demonstrates active stretching of the iliotibial band (ITB). The athlete stands a comfortable distance from a wall and, with the contralateral knee extended, leans the proximal shoulder against the wall to stretch (...) the ipsilateral ITB. See , a Critical Images slideshow, to help diagnose and treat injuries from a football game that can result in minor to severe complications. For patient education resources, see the . Also, see patient education articles , , , and . See also Medscape Drugs & Diseases articles and . See also the Medscape CME & Education topic . Next: Epidemiology Frequency United States ITBS is the most common cause of lateral knee pain in runners. Although few studies are available regarding

2014 eMedicine.com

10. Sports Physicals (Diagnosis)

water) Fencing Field events (high jump, pole vault) Floor hockey Gymnastics Handball Horseback riding Racquetball Skating (ice, inline, roller) Skiing (cross-country, downhill, water) Softball Squash Ultimate Frisbee Volleyball Windsurfing/surfing Archery Badminton Bodybuilding Canoeing/kayaking (flat water) Crew/rowing Curling Dancing Field events (discus, javelin, shot put) Golf Orienteering Power lifting Race walking Riflery Rope jumping Running Sailing Scuba diving Strength training Swimming (...) Table tennis Tennis Track Weight lifting *Participation not recommended by the AAP. [ ] The AAFP, AMSSM, AOASM, and AOSSM have no recommendation against boxing. Table 4. Sports of High to Moderate Intensity Sports With High to Moderate Dynamic and Static Demands Sports With High to Moderate Dynamic and Low Static Demands Sports With Low Dynamic and High to Moderate Static Demands Boxing* Crew/rowing Cross-country skiing Cycling Downhill skiing Fencing Football Ice hockey Rugby Running (sprinting

2014 eMedicine.com

11. Gamekeeper Thumb (Diagnosis)

handle. Skier's thumb is the most common upper extremity injury in skiing and is second only to medial collateral ligament (MCL) injury of the knee. Reported injury rates in downhill skiing vary between 2.3 and 4.4 per 1000 skiing days. Of these, between 7% and 9.5% are injuries to the UCL. The incidence of Stener lesion–diagnosed definitively during surgery—was first noted in 64% of patients with clinical UCL injuries. Subsequent studies report between 14% and 87% of patients. Mortality/Morbidity (...) is more a result of delayed treatment of an acute injury. The alternative term skier's thumb was popularized by Gerber et al and has become more synonymous with an acute injury. A significant proportion of these injuries are a result of fall or blows to the thumbs. One of the common mechanisms is a skier landing against the ski pole or ground while the thumb is abducted causing a valgus force on the thumb. Gamekeeper’s thumb, or skier’s thumb, may constitute up to 50% of hand injuries in skiers

2014 eMedicine Emergency Medicine

12. Gamekeeper Thumb (Overview)

handle. Skier's thumb is the most common upper extremity injury in skiing and is second only to medial collateral ligament (MCL) injury of the knee. Reported injury rates in downhill skiing vary between 2.3 and 4.4 per 1000 skiing days. Of these, between 7% and 9.5% are injuries to the UCL. The incidence of Stener lesion–diagnosed definitively during surgery—was first noted in 64% of patients with clinical UCL injuries. Subsequent studies report between 14% and 87% of patients. Mortality/Morbidity (...) is more a result of delayed treatment of an acute injury. The alternative term skier's thumb was popularized by Gerber et al and has become more synonymous with an acute injury. A significant proportion of these injuries are a result of fall or blows to the thumbs. One of the common mechanisms is a skier landing against the ski pole or ground while the thumb is abducted causing a valgus force on the thumb. Gamekeeper’s thumb, or skier’s thumb, may constitute up to 50% of hand injuries in skiers

2014 eMedicine Emergency Medicine

13. Single- vs. Double-Bundle ACL Reconstruction

Outcomes Score [ Time Frame: 3, 6, 1 & 24 months ] The Knee injury and Osteoarthritis Outcomes Score (KOOS) is a secondary outcome measure for hypothesis 2.2. The KOOS is a 42-item patient-reported outcome measure that results in 5 scores - pain, other symptoms, activities of daily living, sports & recreation and knee-related quality of life. Veteran's RAND 12 Item Health Survey [ Time Frame: 3, 6, 12 & 24 months ] The Veteran's RAND 12 Item Health Survey (VR-12) is a secondary outcome for hypothesis (...) clinical outcomes and maintaining joint and cartilage health. Condition or disease Intervention/treatment Phase Anterior Cruciate Ligament Injury Procedure: Anatomic Double-Bundle ACL Reconstruction Procedure: Anatomic Single-Bundle ACL Reconstruction Phase 2 Detailed Description: Anterior cruciate ligament (ACL) reconstruction is the 6th most common orthopaedic procedure. Disruption of the ACL leads to altered knee function and significantly increases the risk for osteoarthritis (OA). Current methods

2011 Clinical Trials

14. Knee Fractures and Dislocations

complications include non-union, delayed union, osteoarthritis, avascular necrosis, fat embolism, and thrombophlebitis. See also separate article . Fractures around the knee are common in children, but the pattern of knee fractures differs. The relatively high proportion of cartilage in growing children may make diagnosis difficult, especially on plain X-ray, and stress radiographs or MRI may be necessary. Dislocations - overview Knee dislocation This is a relatively rare injury resulting from dislocation (...) . Dislocation may occur when the foot is planted on the ground and a rapid change of direction or twisting occurs. Usually pre-existing ligamentous laxity is present, and when patellar dislocation has occurred once, it may recur owing to the consequent ligament damage. Relocation to the patellar groove is often spontaneous as the leg is straightened. [ ] Assessment and investigations Pre-hospital care of knee injuries Full assessment of associated injuries and immediate resuscitation if necessary. Continue

2008 Mentor

15. Snowblading injuries in Eastern Canada (PubMed)

with traumatic injury related to their sport were included. A concussion was defined as any loss of consciousness, amnesia, confusion, disorientation, vertigo, or headache that resulted from injury. The ski patroller reported helmet use on the accident report at the time of injury.Snowbladers present with a unique pattern of injury compared with skiers and snowboarders. The incidence of leg, knee, and ankle/foot injuries were 20.5%, 25.6%, and 10.3% respectively. Concussions represented 11% of all injuries (...) Snowblading injuries in Eastern Canada To evaluate injury patterns of snowbladers and compare them with those of skiers and snowboarders. To determine possible effects of helmet use in these sports on injury to the head and neck.This prospective case series observational study was conducted by collecting the injury reports from the ski patrol during the 1999-2000 season at Mont Tremblant ski resort, Quebec. All participants in downhill winter sports who presented themselves to the ski patrol

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2003 British Journal of Sports Medicine

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