What injuries do we see most often in the winter?
Ache behind your knee
Whiplash. Catch an edge on your snowboard or hit an unexpected cat track? Signs are a sore, aching, or stiff neck by the end of that day or the next. Whiplash is a strain of the neck muscles and possibly a sprain of the ligaments. When minor, your neck will benefit from letting it rest and heal (and not crashing again). If you have to hold your head with your arms to get out of bed, that’s often a sign of ligamentous instability or fracture. Go see a doctor. Static x-rays will help visualize fractures. Flexion and extension x-rays will show ligamentous instability (You should have seen Dr. Laura’s after her accident?). Even if you don’t hit your head, whiplash can cause concussion/TBI, either in the brainstem or because momentum causes the brain to hit the skull. More on this below.
Ache behind your knee. We see this a lot in the winter, both in skiers and snowboarders. The hamstring and gastrocnemius tendons cross behind the knee and this area often becomes inflamed and sore. Foam rolling your hamstrings and calves regularly can help prevent this. Getting Active Release Techniques here helps relieve the area when it is already inflamed so that you can get back on the mountain.
ACL tear. You hear that pop in your knee, and it starts to feel unstable, and then swell. Well, you may not have heard a pop, but you may still have strained the anterior cruciate ligament (ACL) of the knee and possibly the lateral collateral ligament (LCL). Once you’re safely off the mountain, get some ice on there and elevate your leg to decrease swelling. We screen for ACL tears in our office with the same orthopedic tests that the orthos and PTs do, so we are happy to take a look at it when it’s is not so swollen that it’s immobile. If you’re pretty sure you tore it, you are headed for an MRI, and they will also need to have the swelling down beforehand. From there, if you are surgery bound, know that doing PT before surgery gives you a better outcome and PT after surgery is essential to get full range of motion and function without compensatory patterns. In our office, we often see issues in the hamstring and popliteus (the muscle that crosses behind the knee) months or years after surgery, and we would love to help you fix those. To minimize your chances of an ACL tear: train to improve the muscle balance in the legs, especially strengthening the hamstrings, as well as the core and hip muscles.
Concussion/TBI. Never fall and don’t hit trees. Also wear a helmet in case you do (Scientific Review). Helmets with MIPS (Multi-Directional Impact Protection System) technology are designed to reduce rotational forces caused by the angled impacts to the head. Symptoms of a concussion include: headaches, issues with concentration or memory, balance and coordination dysfunction, dizziness or “seeing stars”, ringing in the ears, nausea, vomiting, issues with fluent speech, generalized fatigue, difficulty sleeping, etc. If you or your child exhibits any of these symptoms after a hit to the head or neck, get it checked.
Shoulder injury. Dislocation, labral tear, rotator cuff injury, AC separation, SLAP tear. To minimize your risk: strength train, avoid the FOOSH- the Fall On Outstretched Hand (it’s safer to fall on your shoulder with your arm tucked by your side), and get ski poles that have a wrist-release. Get medical attention if you have dislocated your shoulder, have any paralysis in your arm or experience extensive weakness or numbness. If something doesn’t feel right and you can move your shoulder, we will check it out for you. If your shoulder hurts so much you can’t move it, we’re going to recommend diagnostic imaging.
As sports chiropractors, we love treating sports injuries. They usually have great stories to go along with the injury as well. So what is it chiropractors can do for the above issues?
Whiplash involves a sprain of the ligaments and strain of the muscles, most often seen in the neck. Immediately after the injury, our job is to diagnose – which tissues are injured, how bad is the injury, and do you need a referral l for imaging- and to help with pain management. Often we use electric stim with interferential current to decrease the pain and muscle inflammation. We may do some light tissue work. We may adjust when it will be beneficial and not increase pain. Likely we will apply some kinesiology tape to support the area. We will talk you through expectations for your injury and create a plan to help you recover.
As you recover, your body will put down scar tissue where the ligaments and muscles were torn. Active Release Techniques works incredibly well on scar tissue and getting soft tissue adhesions release so that function can be restored. Often the area tightens up due to the tension of the muscles and adjusting will help restore your normal range of motion again. At this point, we will also start exercises to regain strength and resilience in the affect muscles and other soft tissue. It turns out there is a lot that we can do as sports chiropractors to help you fully recover from whiplash.