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Sk8Strong Monthly Newsletters > September newsletter:Don't Delay Injury Treatments
September newsletter:Don't Delay Injury Treatments

Aug 30, 2009

*Before we get to this month's article, Sk8Strong would like to inform you that we have made changes to our membership, to provide you with more information than ever, at a lower price! Visit www.sk8strong.com/joinsk8strong.html for more information.

*Adult Training is on sale for the month of September

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**Thank you again to the PSA for the endorsement of Sk8Strong DVDs! We had a record sales month...

This month's article feature is "Don't Delay Injury Treatments"

The majority of skaters deal with some type of injury during their skating career. Some injuries are minor, and symptoms subside in a matter of days. Other, more serious injuries may linger past a few days and require medical treatment. The question is, 'How do I know when to look for medical treatment, and when do I let it heal on its own?' The timeliness in having an injury treated is very important in a skater's rehabilitation process and can save significant training time.

Let's take a skater complaining of lower back pain as an example. There are many different causes of back pain, some minor and some severe. I have worked with several skaters, among many other athletes, with lower back pain, and the amount of time it took them to get into treatment significantly affected their healing process. Skater 'A', as we'll call her, has hypermobility of her spinal joints, meaning she has excessive movement beyond what us clinicians call normal. She also has significant tightness in her hip flexors, hamstrings, quads, and ITBand in her lower extremity. She had been moving towards the levels where she is required to do numerous spin variations with a need for flexibility, and has started to do double jumps. Over time, she has developed a chronic pain in the lower back, yet she has not done her recommended exercise program and did not take recommended time off of the ice. Because of that, she has lost training time and continues to have pain. Finally, after a summer of not being allowed to jump, she takes three weeks off, does consistent physical therapy for a month, and starts to feel better. This was also after mom did not go to the doctor for an x-ray after a month or two.

This situation could clearly have been avoided. First, if I have a skater with hypermobility and centralized low back pain, I want to see and x-ray or bone scan to rule out a stress fracture, which is quite common in figure skaters. This should be done if the pain persists for a few weeks. Second, the skater needed to consistently do the exercise program given to her, as she needed to make big flexibility changes to her hips and legs, and these changes do not happen overnight. Third, the parent needed to get her child into regular physical therapy within a week or two following the complaints of pain, as lower back pain isn't something to fool with.

Skater 'B' has been complaining of knee pain on either side of her kneecap for about three weeks. It comes and goes with jumping, sit spins, and off-ice squatting. It is three months before regionals. Take a look at the two different scenarios that could happen:
1) Skater B begins physical therapy immediately, has x-rays taken, and takes two weeks off from skating (to her chagrin and protest). X-rays show mis-alignment of the patella (kneecap), with no evidence of tears or cartilage damage. The therapist evaluates her and finds flexibility and strength imbalances that are causing the patella to track improperly when she bends or extends her knee, and also flat feet that worsens with a deep squat. Through a month of therapy, the skater is given an exercise regimen to correct her strengh and flexibility deficits, tapes her knees, and gets a pair of sport orthotics in her shoes and skates. The therapist designs a schedule of gradual return to jumping, and she is back to full training within a month.
2) Skater B says the pain is only at a 4/10 level on the pain scale, and continues to go through her normal training routine. Coaches tell her it is growing pains and it will subside with time. After another three weeks, the pain creeps up to a 6/10, and the knee starts giving out on jump landings. Skater B takes a week off, comes back with it a little less painful, and resumes full training. After two more weeks, she can't stand the pain anymore and gets into therapy. She undergoes the same treatment as in scenario 1, yet it takes longer to get better because of the greater amount of inflammation. She is ready to go back on the ice three weeks before regionals. Wonder how she's going to do?

Skater 'C' also complains of lower back pain, yet it is one sided and she feels a burning sensation going down the back of her thigh. Not wanting to anger her coach, who doesn't like complainers, or her parents, who are shelling out a lot of money for her skating, she keeps quiet about it for a month. Finally, her mom notices a limp as she is walking a month after her pain started. Skater C reluctantly tells mom about her symptoms, and mom takes her to an orthopedist. An MRI reveals a bulge in one of her lumbar discs with significant inflammation to the nerve that runs down her leg. The nerve is so irritated that skater C has lost range of motion in her hip. If the skater had told her parents and coaches about the pain when it began, the nerve inflammation and motion restrictions may not have escalated. Now it may takes months of rehabilitation to get the skater back safely onto the ice.

The moral of this story is, it's better to be safe than sorry. Err on the side of caution when dealing with injuries, as you may catch something serious early. Phsyical therapists are your friend :), and they can save you or your skaters precious training time!