Skiing, hockey and snowboarding are very popular winter sports among adolescents. There are health risks and injuries associated with each of these sports that may be related to the cool temperature and exposure as well as the potential for injury.
Hypothermia is a condition where the body temperature drops four degrees Fahrenheit or more below the normal temperature range of 97.2 to 99.5 degrees. Adolescents may be at risk for hypothermia under the following conditions during the winter:
-
Exposure to cold weather without proper protection against temperature, wind, rain, ice or snow
-
Wearing cold and wet clothing for a prolonged period
-
Drinking alcohol and exposure to cold weather
Hypothermia occurs when the body’s heat production cannot keep up with the heat loss. The process of heat loss is gradual. The teen with hypothermia may have the following symptoms:
-
Cold hands, feet and face
-
Shivering
-
Listlessness
-
Drowsiness
-
Mental confusion
-
Shallow breathing
-
Stiff muscles
-
Loss of consciousness
A clinician should see teens with these symptoms immediately. Active rewarming is necessary and this may require specialized equipment in a hospital.
Wearing waterproof and windproof garments and dressing in several layers of warm and loose clothing may prevent hypothermia during cold weather. Wearing a hat is especially important since significant heat loss occurs through the head. Staying dry during cold weather is important and teens should never drink alcohol while outside in the colder weather months.
Frostbite occurs when skin or the body tissue just below the skin freezes. The symptoms include skin that is white, blue or pale. The skin is hard to the touch, tingles and feels numb. Most patients who have frostbite complain of numbness in the area. The limb or finger may feel like a chunk of wood. The skin may appear mottled or even pale yellow.
While it is ideal to rewarm the area of frostbite before arrival at a hospital, often this is impractical. The teen may place his or her hands under the armpits or against a warm person’s abdomen. Massage is not generally helpful and may be harmful as tissue may be injured. After arrival at an emergency facility, and the teen is stabilized, the frostbite area will be rapidly rewarmed by immersion in warmed circulating water. The teen may have significant pain during and after the rewarming process. Blisters may form after the thaw, and there may be tissue damage that needs surgical treatment.
Dressing appropriately for the weather may prevent frostbite. The best materials to keep moisture away from the skin and these include polypropylene, polyesters and wool. Gore-Tex mittens are excellent garments for the hands.
If the numbness and tingling resolves after rewarming and there is no tissue damage, then the condition is termed “frostnip.” Since no tissue destruction occurs, this is not true frostbite.
Immersion or trench foot is produced by exposure to wet cold temperatures that are above freezing. This condition occurs when teens’ wear sweat soaked or neoprene socks, vapor-barrier boots or super gaiters. The feet are cool and pale and they are often numb. After the feet are rewarmed, they are red, dry and very painful to the touch. Blisters may develop that require surgical intervention. When a teen is on a prolonged outdoor walk, the feet should be visually inspected on a periodic basis. Changing into dry socks helps to prevent this condition.
Chilblains is a mild injury from cold and dry exposure. Usually these “cold sores” appear in the facial areas or on the hands and feet. Management is usually supportive.
Snow blindness can occur when a teen is exposed to large amounts of reflected sunlight often during skiing while not using protective eyewear. The teen will complain of moderate to severe eye pain, develop tearing, blurred vision and difficulty looking at bright lights about six to twelve hours after the exposure. A clinician should see teens with these symptoms. Treatment includes patching the eye(s), using an antibiotic ointment and follow up care. Sunglasses that decrease most visible light and one hundred percent of ultraviolet light may prevent snow blindness.
Although the number of ski injuries has declined significantly in the past thirty years, there are least 2.5 ski injuries per 1,000 skier days. This data undoubtedly is an underestimate of the injuries that actually occur and the true number may be closer to 5.0 injuries per 1,000 skier days.
A common injury among skiers is rupture of the ulnar collateral ligament that provides stability to the thumb. These injuries may occur when the skier falls on an outstretched hand while holding a ski pole. Consciously discarding the pole during a fall should be taught to every adolescent who is learning to ski. This may prevent injury to the ulnar collateral ligament.
Approximately four to eleven percent of ski injuries are to the shoulder. These include rotator cuff strains or tears, fractures to the clavicle or a dislocated shoulder. Falling on an outstretched arm is one mechanism for this injury.
In alpine skiing, the knee is the most frequently injured area of the body, and the anterior crucial ligament is the area in the knee that appears to be most frequently injured. There is some thought that the equipment improvements that help to protect the foot, ankle and tibia may contribute to increased injury rates to the knee. Improved equipment, instruction and slope management may help to prevent knee injuries.
There are some safety points that adolescents who participate in skiing should follow:
-
Enroll in a conditioning program before the ski season to improve your strength and endurance
-
Have appropriately sized equipment that is adjusted professionally
-
Routinely check the binding releases before you ski
-
Ski under control at speeds that are consistent with your abilities
Eye safety is exceedingly important in hockey. Authorities have documented several different types of eye injuries in adolescents who participate in this sport. A blunt blow to the eye can injure the retina. This may lead to retinal swelling, a tear or retinal detachment. The cornea may be torn, and there also could be bleeding into the anterior chamber of the eye. This is the space behind the cornea and in front of the iris. As a result, all adolescent hockey players should wear full-face protection with a shield over the eyes.
Properly fitted, heavily padded suits should prevent many ice hockey injuries. Shoulders, elbows and shins are padded, and the players wear padded gloves. Every adolescent player should wear a properly fitted mouth guard to protect his or her teeth.
Body checking or intentional body contact may also produce injury in hockey. The American Academy of Pediatrics recommends that body checking not be allowed in youth hockey for adolescents who are fifteen years or younger.
Any hockey player who is heading directly to the hockey rink boards may be at risk for fracture of the cervical spine. To help prevent this injury, in hockey it is best to remember the slogan “HEADS UP, DON’T DUCK” if a teen is heading toward the boards.
Male adolescents are particularly susceptible to snowboarding injuries according to a recent study. The majority of injuries occur during falls resulting from direct impact and the second most common mechanism of injury is collision with a stationary object. These falls occur when attempting to jump. Many of the injuries occur during the adolescent’s first season of snowboarding. Injuries occur most frequently to the head or bones of the extremities. In this sport, both feet are secured to a single board by nonreleasable bindings. No poles are used, so falls are broken by extending the arms resulting in fractures. Proper instruction may help to prevent some snowboarding injuries.
Snowmobiles are a significant risk to the health of adolescents. Head injuries remain the most common cause of death or injury. This usually happens when snowmobiles collide or overturn or riders fall from the vehicles. Some national organizations including the American Academy of Pediatrics recommend that no one under age sixteen years operate a snowmobile. For teens age sixteen years or older, then graduated licensing for operators of snowmobiles has been recommended. No teen should use alcohol or other substances during the operation of a snowmobile, and adults should reinforce this message by being good role models.
Related topics:
Accidents, alcohol, athletic equipment, athletic injuries, blindness, exercise, foot injuries, footwear, head injuries, knee disorders, skin disorders, sports, X-treme sports safety
