Prehab for skiers
Date first posted on eCommunity - 13
February 2010
One of the perks of being a tour operator is that I
get more than my share of
skiing. The flip-side is that I've come to expect more than my share of
injuries. They're mostly bumps and bruises and the occasional muscle
strain,
rather than anything serious, but I try to minimise them nevertheless -
not just
by skiing prudently but by including some strengthening exercises in my
pre-season training. I touched on this a few weeks ago in a posting
about biomechanics.
I've found that a useful way to think about injury prevention is via the
concept of "prehabilitation" or prehab.
The idea behind prehab is that you can avoid many of the most common
injuries in skiing (or in any sport) by targeted physical training. Like many useful
concepts it's open to various definitions, and these range from the
general to the specific.
GENERAL PREHAB
In one version the word prehabilitation is used in a very general way,
almost as a synonym for "prevention". And that broad kind of approach is -
definitely -
applicable to XC skiing. For example, many ski injuries occur as a
result of
tiredness. So, if you can build up your cardiovascular and muscular
endurance in
a general way it will help keep you whole.
To quote from personal experience, last season I suffered a skier's
thumb and a
mild concussion. Both injuries resulted from falls when I was stationary
or
almost stationary. The thumb incident happened while I was talking to
another
skier and my skis just slipped from under me. The concussion incident, a
couple
of days later, happened after I had taken my skis off and was walking
into a
cafe for lunch. I slipped on ice at the doorway, couldn't get my hands
up to
protect myself in time, and head-butted the door-post.
Both incidents seemed at the time to fall into the "just one of those
things"
category. But I don't think they would have happened if I had been
feeling
fresher and more alert. The previous week, with a group of fit and
experienced
track skiers, I had covered 150km on quite hilly terrain and it had left
me just
a little weary.
And so, with that in mind, this year I've upped my pre-season training
volume to
10 hours a week. And I've upped the intensity, too, mainly forsaking
Nordic
walking for road runs and moderately hard gym workouts.
Another example of a general approach to prehabilitation might focus on
bodily
stiffness. Many of us lack flexibility, from too sedentary a lifestyle
and too
much time hunched over computers. And the stiffness makes us ski badly
and fall
over. In that context, a programme of mobilisation and stretching, to
increase
flexibility, could be seen as a general form of injury prevention.
BODY IMBALANCE PREHAB
In a less general version, prehabilitation can refer to a training
approach that
focuses on body imbalances. If you have a recurring lower-back problem,
for
example, it may be caused by tight hamstrings - in which case a
programme of
stretching could help you. Turning that around, a proactive trainer
might say:
if you have tight hamstrings, let's do something about it BEFORE you get
a bad
back. In this version of prehabilitation you avoid injuries by
identifying body
imbalances and remedying them. It's quite a specialised business,
usually the
province of physiotherapists and specially qualified personal trainers,
and is
not generally suitable for a DIY approach.
SPECIFIC PREHAB
A third and much more specific version of prehabilitation can simply
mean
looking at the injuries you've had in the past and trying to do targeted
exercises to strengthen the affected areas. And this is suitable for
DIY, if
you're careful.
My skier's thumb is an example. Skier's thumb involves damage to the
ulnar
collateral ligament at the base of the thumb. The damage is usually
caused when
the thumb is pulled away from the hand in a fall. The pole strap is
often the
mechanical cause of this, as it exerts significant leverage on the joint
as you
fall.
The post-injury RE-HABILITATION approach to skier's thumb usually
involves
movement exercises to restore range of motion, combined with progressive
resistance exercises to restore strength in the surrounding muscles.
A PRE-HABILITATION approach would involve taking a selection of the same
sort of
exercises and including them in your pre-season training. So, for a
previously-damaged thumb you would do some range-of-motion exercises.
And you
would do things to help build strength - like squeezing a tennis ball or
pushing
your thumb out against light resistance bands.
Another possible exercise would be to hold a bath towel and twist and
squeeze
it, as if you were wringing it out. However this exercise shows that you
need to
be a little careful with prehab exercises. Skier's thumb was once more
commonly
known as gamekeeper's thumb, after the Scottish gamekeepers' practice of
killing
rabbits by wringing their necks. So, go easy with the towel. For if you
wring it
too often or too vigorously, you may incur precisely the kind of injury
you are
trying to prevent.
As a starting point for this kind of prehab, I think it's useful to look
at
websites specialising in physiotherapy or sports injury. Check out the
standard
post-injury REHABILITATION exercises for your own specific injury or
weakness,
and then work them up carefully into a programme that maintains range of
motion
and that progressively builds local strength.
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