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The Sports Medicine Doctor: Concussions in Skiers: Injury Prevention, Part II

By Andrew W. Gottschalk, M.D., Director of Sports Medicine

Champion Orthopedics & Sports Medicine at Cole Memorial Hospital

One of my colleagues exhibits all the signs of addiction. He loves to ski, and he spends the offseason counting the days until the snows return. His spare time is used searching for a sport that can give him the same rush and the same thrill as plunging downhill in winter.

He walked into my office a few months back with a lopsided grin on his face and just stood there. He finally, gleefully erupted a single word.

“Skydiving.”

“Skydiving,” he said again. And then I understood. After years of searching, he had finally found a sport to thrill him when he couldn’t be on the slopes.

“Skydiving almost gives you the same thrill. And you know what?” he continued, “The instructor makes you wear a tight leather cap. You know, so you don’t get a concussion!”

Right. Because you don’t have other worries when you’re throwing yourself out of an airplane.

A concussion is a traumatic brain injury. When the brain experiences acceleration followed by sudden deceleration, it can be traumatized as it slams against the inner skull. We tend to think of bone-crunching football tackles or car crashes as events that result in concussions. While those events certainly may result in concussions, much more subtle forces can also lead to concussions. A soccer player heading a soccer ball. A basketball player being struck in the head by another player’s elbow as he drives for a layup. Anyone, athlete or not, who suffers a fall — even a slow fall — may get a concussion even if the head doesn’t strike the ground or another object.

Concussions are in the news everywhere we look. Many stories focus on football players, because that is the sport in which concussions occur with the highest frequency. But don’t overlook downhill skiing. High velocities and minimal protection result in situations where the risk of concussion may be high.

Scientific studies suggest that helmet use may help prevent concussions in downhill skiers. The problem is, getting skiers to wear helmets can be a hard sell. Some skiers feel restricted when wearing helmets. Others find helmets less than fashionable. To further reduce the risk of concussion, skiers shouldn’t ski beyond their means. Young or novice skiers should be counseled to resist peer pressure to follow their friends down slopes that are too steep or too technically difficult for their skill level.

The treatment of concussions can also be a hard sell. Doctors can’t put casts on traumatized brains as we do with broken bones. And there are no pills that help un-traumatize brains. Instead, we promote rest to give the brain time to heal.

Rest needs to be both physical and mental. It’s hard for skiers to hear that the treatment is “don’t ski.” Even simple brain stimulation can slow the healing process. People who suffer concussions should limit or avoid watching television, talking on the telephone, listening to music, and other mentally stimulating activities.

If skydivers’ parachutes don’t open, they probably have bigger things to worry about than concussions. Downhill skiers, on the other hand, should be aware of what concussions are and how to be proactive in their prevention.

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