Snowboarding offers an athletic adventure

Over the past thirty years, snowboarding has evolved from a small group of young participants trying to be different, to an Olympic sport. Most recently, snowboarding has increasingly attracted older, winter athletes defecting from the ranks of traditional skiing.

Although there are many comparisons between skiing and snowboarding, the technical approach, as well as the injuries, differs. As opposed to skiing, both feet are braced to a single snowboard and face in the same direction, making lower extremity injuries rare.

The most common snowboarding injuries involve:

Upper extremities. There is a natural inclination to extend the arm to break a fall. This produces a FOOSH (Fall On Out Stretched Hand) injury that can result in a wrist fracture. Other upper extremity injuries include wrist sprains, elbow and shoulder dislocations, rotator cuff injuries and broken collar bones. Upper extremity injuries are by far the most common snowboarding injuries.
Head and neck. Concussions are very common due to the tendency of the board to drift out from under the rider on icy surfaces. This causes trauma to the back of the head and violently flexes the neck. Strained neck muscles and herniated discs may occur.
Low back and hips. Repeatedly falling back will result in contusions to the low back and hips.

Learning to fall by crouching down and gently rolling to the side rather than extending the arm will avoid many upper extremity injuries. Never get on a snowboard without a helmet. Concussions can result in long-term brain damage and even death.

While learning to snowboard, invest in “crash pants” also worn by figure skaters who practice jumps. These fit tightly and are worn under ski pants. They contain padding that protects the low back and hips.

An exercise program with both aerobic and resistive components greatly helps in preparation. Stretching right before going out will keep ligaments limber and less prone to tearing.

After years of skiing, snowboarding may be a great mid-life adventure.

Adversity can lead to physical renewal

This year, Christmas presents the challenge of a weakened economy. New heights of unemployment often come with a loss of health benefits. This situation makes maintaining good health imperative.

A transition period can be a time for physical renewal. Taking time to begin a regular exercise regimen while searching for a new job can have many benefits:

• Improved cardiovascular fitness
• Breaking old habits of smoking, drinking alcohol and overeating
• Professional physical appearance
• Reduced need for prescription medications

These factors improve the odds of finding suitable employment. An employer who provides health benefits is taking a financial risk on the health of each employee. Good health habits count.

Getting started begins with a visit to a family physician for a complete physical. Refill any prescription medications before benefits end.

Once physical limits are defined, combine a healthy diet and a regimen that begins with stretching and walking. Aerobic and resistive workouts are most effective.
Recommended equipment includes comfortable footwear, clothing and inexpensive weights.

If weights aren’t available, exercises such as push-ups and sit-ups will improve muscle tone. Jumping rope and jumping jacks are outstanding.

As a walking regimen progresses, steep hills and stairs should be included. Thirty minutes each day is best and sticking to a regular schedule helps create a sense of discipline necessary for the competitive job market.

Volunteering at a hospital like Backus Hospital or a soup kitchen like St. Vincent de Paul will help keep an active schedule. It can provide valuable networking opportunities with fellow volunteers. Sharing time in the service of others has proven to reduce stress while creating a feeling of accomplishment.

Adversity frequently presents opportunity. Tough economic times may serve as a wake-up call. Take action by recognizing a chance to help yourself and others.

Stay safe while enjoying the slopes

The practice of strapping a board to each foot to make snow travel more manageable dates back to ancient times. Originally utilized to aid hunters, this olden practice has now developed into a major sports industry.

Although there are multiple variations of skiing, alpine and downhill skiing are the most popular and exciting. Amazingly, competitive downhill skiers can now reach speeds in excess of 70 miles per hour. Unfortunately, the nature and degree of injuries are no less dramatic.

Most ski injuries involve the lower extremities and include:

Knee sprain. Excessive twisting of the knee joint will often result in sprained or torn ligaments with subsequent damage to the cartilage.
Broken bones. Collisions and high speed falls will cause bones in the thigh and lower leg to fracture.
Lower spine injuries. Twisting and bending the lumbar spine can cause muscle strains and disc herniation.

Any injury that occurs on a mountain has the potential complexity of being in a remote area. Avoiding hypothermia is another challenge. Fortunately, most resorts provide adequate ski patrol personnel trained in first aid and wilderness medicine.

While many skiers are preparing their equipment and attire for the approaching holiday, skiing fitness should not be overlooked. Geoff Fabry is an experienced skier and supervisor of outpatient physical therapy in Rehabilitation Services at the Backus Outpatient Care Center.

“Any physical preparation for skiing must include a combination of aerobic and resistive training,” Fabry said. He recommends workouts that emphasize the lower extremities and core muscles.

Lunges and squats can be done as part of a strength regimen as well as being included in a stretching program just before going out on the trail. Aerobic exercises such as hill and stair climbing build stamina and fortify core muscles.
Proper physical preparation and utilizing modern, safe ski equipment is crucial to enjoying a day on the slopes.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at, or listen to his podcasts, comment on his blog or buy his book at

Sports medicine doctors sometimes need to separate ‘sports’ and ‘medicine’

When medicine collides with the big business of running a sports franchise, ethical problems may develop. Among these are a lack of credibility for the medical opinions of physicians employed by teams and false medical information generated by teams.

The relationships of sports medicine physicians generally fall into two broad categories:

1. Consulting Physician. In this situation, a physician’s primary responsibility is to provide advice to a client. That advice may include formulating appropriate procedures to be followed regarding prevention and treatment of injuries. It often involves recommending appropriate referral and treatment for athletes.
2. Treating Physician. This role involves a traditional doctor-patient relationship where the only obligation is to do what is best for the athlete, regardless of the interests of a team or other organization.

Sometimes these responsibilities become confused and ethical dilemmas arise.

In boxing, ringside physicians serve as consultants to the boxing commission. The physicians are responsible for making sure that only fighters in excellent health are allowed to participate by carefully screening medical reports and examining each participant before a match.

Ringside physicians also have the authority to end a fight if they believe one fighter is being severely injured. After a fight, the physician must re-examine each fighter and arrange for medical attention if needed.

Ringside physicians must be impartial and are never treating physicians for fighters. They should not be employed by a promoter who stands to financially gain by allowing a questionable fight to proceed.

Confidentiality is imperative in either relationship. Physicians are obligated to share information only with their client or the athlete. Often an athlete or organization may choose to share information with the press. This information may also be a strategic move. Medical information is sometimes concealed because of gambling.

Although sports medicine has created increasingly complex relationships, wise physicians will take a step back and make sure medical ethics are always of paramount importance.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. He also serves as a ringside physician for the Connecticut State Boxing Commission. E-mail him at, or listen to his podcasts, comment on his blog or buy his book at