OVERUSE INJURIES IN FIGURE SKATING by DR. JEN BURKE BASED ON THE WORK OF DR. MAHLON BRADLEY, foreword by DR. KAT ARBOUR
Training for skating or any sport, even when done safely and appropriately, can potentially lead to overuse injuries. This is because training causes tiny injuries, called microtraumas, to the tendons, bones or joint structures. Recovery and good nutrition al- low the body to naturally repair these micro- traumas, and the body actually heals stronger than before. To train as safely as possible, both on-
and off-ice training should be tailored appro- priately for your age, skating discipline and level. Because there is limited data available regarding overuse injuries and training cer- tain elements repeatedly, specific recommen- dations are not available at this time as far as how many reps are “too many.” However, your coach may want to consider monitoring the number of repetitions per day on skills that could put your body at risk for injury, espe- cially those skills requiring overstretched body positions or repeated impact. This
cumulating more quickly than the body can recover between training sessions. If this is happening, your training routine could be ei- ther too difficult for your current level of con- ditioning (for example, this could be related to strength or flexibility), or the skills you are attempting could be within your ability to perform, but you are practicing them too of- ten without allowing for the recovery needed between training sessions. Listening to your body is the key! Many
would include Biellmann positions, spread eagles, twisted or bent positions, and an ex- cessive number of jumps or falls. An overuse injury starts out as a nag-
ging ache that gradually worsens over time. If an athlete is developing an overuse injury, it is implied that the microtraumas are ac-
overuse injuries can be nipped in the bud by taking time to recover and/or by making slight modifications to the skill causing you pain or injury. An acute injury, such as getting cut by a
blade, breaking a bone, spraining a ligament or pulling a muscle, occurs when the loads applied to your body in one instance exceed what the tissues can handle. There is little to do in the way of training to avoid these unfor- tunate accidents.
Here are Dr. Bradley’s “Top 10” points on avoiding overuse injuries in skating:
At the recent 2012 Professional Skaters Association Conference in Boston, Mass., orthopedic surgeon Mahlon Bradley presented information to the assembly discussing some of the most commonly seen impact-related skating injuries. The majority of injuries in figure skating are overuse injuries. If they are diagnosed and managed early, training is less likely to be significantly disrupted and recovery is faster.
1) Overtraining is common in figure skat-
ing. Be aware of what you are doing off the ice and factor that into your training (e.g., par- ticipating in other sports, not getting enough sleep, etc. can all contribute to overtraining). Recovery is essential to avoid overtraining.
2) Don’t forget about recovery nutrition
as well: healthy food choices and appropri- ate timing of snacks and meals are important. Making sure you get enough sleep (seven to nine hours per night) is important. Think of re- covery as part of training. Remember that re- covery includes both emotional and physical aspects.
3) When an athlete seems to be develop-
ing a chronic injury, open and honest com- munication between coaches, athletes and parents is necessary to identify injuries early and to implement training changes. Com- munication can help prevent more severe or lingering injuries.
4) Young athletes, particularly those
who are going through a growth spurt, are at much higher risk of injury. Bones grow more quickly than tendons (which attach the mus- cles to bone) can stretch. The growth plates are at the end of bones and are particularly vulnerable to stress fracture. During and just after a growth spurt, athletes are often less flexible, more fatigued and can appear as if
they are struggling through their elements. Patience is important during this time, as is decreasing or modifying training, to decrease impact across joints.
5) Choosing the appropriate boot and
blade is critical to helping prevent injury. In- appropriately stiff boots may lead to ankle instability and poor proprioception. Proprio- ception encompasses both the positional awareness of where the body is in space and the unconscious sense of where the body is in relation to itself. Proprioception can be increased by including pattern/agility exer- cises, ankle strengthening exercises and bal- ance exercises in the athlete’s off-ice training program. Specific information on how to train these skills can be found at
www.STARScom-
bine.org — see the downloadable injury pre- vention guide.
6) Stress fractures initially present with an ache in the bone that resolves after train- ing but recurs during the next session, often felt earlier in the session. Even with a few days off, the ache will recur. With continued train- ing, without modification, the ache increases and persists throughout the day. These injuries often occur three to six weeks after increasing the training load. If a stress fracture is not diag- nosed and the athlete’s training not modified, a more significant fracture can occur.
7) Tendonitis initially presents with sore-
ness in the area of the tendon. These injuries can present with a progressive ache or with an acute pain. They often happen after an increase in training load, and are because of asymmetry of muscle strength or relative weakness. Hip or groin tendonitis should be evaluated sooner, rather than later, and physi- cal therapy is typically necessary.
8) Vitamin D is crucial to maintaining bone
health and recovery. Athletes should be tested annually to ensure their Vitamin D levels are within the best-practice range of 50 to 80.
9) Based on tibial shock data (the forces
in your ankle when you land a jump), the impact forces experienced in a jump are the same for a skater whether it is a single, dou- ble or triple jump. The impact forces related to a popped jump have been measured to be higher than that of a correctly executed jump.
10) Be proactive in the management of
your athlete’s injuries. If possible, talk to the physician or physical therapist. Be sure the physician/PT knows what the athlete is do- ing in training (particularly when working on new elements), upcoming events, and your thoughts about how the injury may have occurred. Invite the physician/PT to watch a training session or bring a video to the ap- pointment. Ask questions!
SKATING 13
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