Speed in the Snow By Mark B. Levin, M.D. The Pediatric Group, P.A., Princeton

This is the 57th article written in a series for Princeton Online Click here for an archive of other articles.

Anyone that has tried sledding, alpine skiing or snow-boarding knows the exhilarating feeling of zooming down the hill, weaving in and out to avoid (or to find) bumps and pits. The feeling is akin to having the wind in your hair with the top down in a convertible on the open road. Despite the elation of such an endeavor, we have learned from the sad experiences of others that these activities have inherent risks. The more common snow-related injuries seen by emergency personnel include head injuries (concussions and fractures), sprained or torn knee ligaments, fractured thumbs, wrists, and leg bones, frostbite (see article #50, entitled "Frostbite"), high altitude sickness and dehydration. Although these conditions sound daunting, fun is still the byword if appropriate precautions are taken.

There are several steps to take to promote safety. The first is to understand how your own physical status affects your performance. Just as in any other sport, the stronger, more flexible, better conditioned participant suffers fewer injuries. Consult ski and snow-boarding magazines or a personal trainer for information on how to get into proper condition for those sports. Providing time for rest, food and water during these sports is as important as conditioning. Struggling against the bulky clothing required for warmth magnifies the expenditure of fluid and calories. A well prepared participant will carry a water bottle and a high energy snack. At first glance, one might think that physical conditioning is not necessary for sledding. However, after your third time traipsing up the sledding hill, you will understand why cardiovascular conditioning is important! Fatigue is often a major contributing factor to accidents, both because of imprecise muscle control and faulty judgment. Parents should be sure to advise children before fatigue sets in that the activity is finished for the day. Otherwise, the parents become pack animals toting all their children's equipment home!

Next, assure you have the right equipment in good condition. Sleds should not be cracked or warped. Downhill skis must be waxed, have edges sharpened and have the bindings checked for proper function. Likewise, snow boards should be waxed and have sharp edges. Ancillary equipment is just as important as primary equipment. A snow-boarder should wear wrist guards (in our practice, we commonly hear that a fractured wrist prematurely terminated a winter vacation, as well as the school sports season). Modern ski poles are designed to prevent thumb injuries. If your equipment is old, you would benefit from an upgrade. If you need special equipment for prevention of knee injuries during skiing and snow-boarding, be sure to use it. ALWAYS WEAR A HELMET FOR PARTICIPATION IN THESE SPORTS. Helmets have been shown to reduce the severity of head injuries when used appropriately.

Awareness of the weather and physical environment is critical. With the newer fabrics available in sports clothing, it is easier than ever to dress appropriately for the weather conditions and the particular sport. Resist the temptation to save a few dollars by using clothing or equipment that is not intended for the sport you are trying. It is emotionally difficult to cancel activities that are so much fun, planned so far in advance and dependent so much on fickle weather. When the snow has finally come and the timing is right, we look forward to the event so much that canceling the activity does not even enter our consciousness. Nevertheless, there are circumstances in which cancellation must be considered.

In any sport, practicing the buddy system is a good idea. This is especially true for sports with a higher risk of injury in a remote area where easy access to medical care is problematic. The last caveat is to resist the temptation to perform unwise maneuvers. Showing off on the slopes can only increase the risk of injury. Sometimes parents attempt to join their child on a sled to give the child a faster or longer ride. Greater speed means less control. How would the child fare under the crushing weight of an adult body when the sled overturns?

Fun does not mean unabated risk. With the precautions outlined in this article, you can enjoy winter sports while minimizing your chance of an unhappy ending.

Dr. Mark B. Levin

Dr. Levin has been a member of the staff at The Pediatric Group since 1977. Currently an attending Pediatrician at the Medical Center at Princeton, he has been Chairman, Department of Pediatrics, Medical Center at Princeton, 1984 to 1986, 1989 to 1992, and past President, Medical and Dental Staff, Medical Center at Princeton, 1987 to 1988. Dr. Levin has served on numerous Departmental and hospital committees. He has published original articles both while at Upstate Medical Center in Syracuse and at The Pediatric Group. He has a wife and three children. Dr. Levin enjoys alpine skiing, jogging, hiking and camping, travel, computers and racquetball.

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