Recreational Ice Figure Skating/Injury prevention and off-ice training

Injuries
Many of the injuries sustained while skating happen as the result of a fall. Fortunately most falls do not result in anything worse than a bruise. Bruises very rarely result in complications, although if you keep on falling the same spot you may think about getting padding or similar protective equipment.

Occasionally a fall can result in a more serious injury. In these cases, the standard treatment is RICE (Rest, Ice, Compression, Elevation) and a compulsory visit to the doctor if the pain is intense or you suspect a fracture. With some luck, the injury will not keep you off the ice during the whole or part of the recovery period, but be cautious and do not do things that might aggravate the injury. Pain is usually a good indicator that you are overstepping the boundaries. Try to avoid moves that cause or worsen  the pain.

In addition to accidental injuries, skating can, under certain conditions, cause or aggravate overuse injuries.

Concussion
The potentially most serious type of injury is a concussion. Always try to tuck your head when falling so you do not hit it, but if you do and you either suffer a period of unconsciousness or are dizzy or disoriented after you get up, get off the ice and have someone drive you to a doctor. This is not something you should take lightly. Chances are it is nothing, but evaluation, close monitoring and timely reaction greatly minimize the consequences if it's something serious - why take a risk?

Arm injuries
Arm injuries in general can mostly be prevented by not putting your arms out to catch your falls. Of course, if it is a choice between your face and your arm and you must put your arm out, be sure and do it with a bent elbow. If you fall backwards with an outstretched arm you are likely to injure your wrist. This is one of the most common injuries for skaters. With some luck, the injury is just a sprain. A sprained wrist feels sore, particularly when pressing it, and may swell somewhat. The pain decreases gradually and is gone after a few days or a couple of weeks.

If you experience severe pain and the wrist swells up or if you notice bruising you should get an x-ray to rule out a fracture. Although the two bones in the forearm (radius and ulna) are the most likely to break, you can also fracture the small bone in the wrist just behind the thumb bone (scaphoid). This is usually a hairline fracture and hard to see with x-rays. If the pain persists after two weeks have the wrist x-rayed again; by then the fracture will have started to heal and will actually be easier to see. A scaphoid fracture should be properly diagnosed, because it can lead to chronic pain and disability in the wrist if untreated.

It is not unusual to find dedicated skaters back on the ice the day after an arm injury, even involving broken bones. While skating with your arm in a cast is not recommended, if you are going to do it anyway, get a light cast, made of fiberglass and available in a wide variety of bright colors. These casts are not affected by moisture and are more durable. If you are skating after injuring a joint such as the knee or ankle, neoprene braces not only provide support for the injured joint, they also provide warmth allowing the muscles to function optimally.

Knee injuries
Landing your knee when you fall, although quite painful, has often no worse consequences than a bruise. If you hit your knee, get off the ice, put ice on the knee and put your foot up. You want to apply the ice for 20 minutes and be sure and keep a piece of cloth between the ice and the skin to prevent frostbite.

In some rare cases, a hard blow to the knee can be a cause of misalignment of the knee cap, which in turn can lead to chronic knee pain by wearing down of the cartilage. This condition is known as "chondromalacia patellae". Most often, the misalignment of the knee is caused by an strength unbalance between the inner and outer thigh muscles. The hip configuration can also contribute to this problem (and it is a reason why it affects women more frequently than men). The best cure and prevention is off-ice exercises which strengthen the leg muscles, particularly the inner quads.

If you twist the knee, for instance on a bad jump landing or spin entry, you can hurt the knee ligaments. Frequently the damage is to the medial collateral ligament (MCL). A sprain or rupture of this ligament is characterized by pain on the inner side of the knee and possibly, a feeling of instability on the knee. Although complete rupture of the ligament could keep you off the ice for weeks, this type of injury usually heals well with a combination of rest and physiotherapy. On the other hand, damage to the Anterior Cruciate Ligament (ACL), at the front of the knee below the knee cap) often requires surgery. A tear of the ACL can sometimes be recognized by the knee "giving out" when putting weight on it. Your doctor may order a MRI scan to confirm the diagnostic and rule out cartilage damage. Paradoxically, it is probably easier to sprain your knee practicing jumps off-ice than on the ice, because on an unchecked landing your foot is more likely to stick to the floor while you upper body continues to rotate, putting lots of torque on the knee. To avoid this, never "stick" a landing on the floor, but do a little hop as soon as you feel your toes touching the floor; even better, land on two feet.

Foot injuries
A very common cause of foot pain is boots that are laced too tightly over the instep. The lacing should be snug but not so tight as to cut off circulation or pinch the foot. If your boots feel too tight even when the lacing is loosened, the boots may be just too small for you. Have the fit checked at a competent skate shop. Many skaters, especially beginners, have a tendency to clench their toes while skating, which can cause the foot to cramp. This problem can also be caused or aggravated by boots that are too loose, keeping your weight too far forward on the blade.

Another cause of foot pain is either excessive tightness or tendinitis of the Achilles tendon. You can do "wall push-ups" to stretch this tendon: stand about 3 feet from a wall and lean forward against it, keeping your feet flat on the floor. You can also do a lunge stretch, keeping your weight on your rear foot with the heel on the floor and the toe pointing forward.

A common foot ailment that afflicts skaters is called "plantar fasciitis", and it's a form of tendinitis that affects the bottom of the feet. Typical treatment includes resting the feet, anti-inflammatory drugs such as ibuprofen, and custom orthotics to provide more support for the foot.

Bumps on feet
Many of the foot injuries suffered by skaters are often a consequence of breaking in a new pair of skates or lace bite. Bumps on the feet (bunions, cysts, bursitis or callus formation) and accompanying pain are a common reaction to pressure and continuing distress to underlying tissues, tendons or nerves. If you are lucky, the pain will go away as you break in the boot (although sometimes the bumps stay). However, it is better to use protective padding or have the boot punched out at the earliest sign of discomfort. This will benefit both your feet and your skating.

Malleolar bursitis is characterized by painful inflammation and swelling on the medial protruding ankle bones. If you suffer from this, you can try stretching out the boots at the sides by placing golf balls or a similarly hard object (baby food jars and walnuts are other suggestions) by the ankle area inside the boots and leaving them laced tightly overnight. While skating, you can prevent this problem by protecting your ankles with silicon sleeves (like Bunga Pads). Once the condition flares up, it is better to use padding around the ankle bone rather than over it, in order to keep pressure off the bump as it heals.

For many of the above mentioned foot problems, any time you take off of skating will probably make the healing faster.If you really want to give your feet ultimate treatment, soak them in a very warm (even hot) bath for a half an hour occasionally. Try this once or twice a week. Improving your circulation in this manner will facilitate your body's process of returning your feet to their original condition.

Of course, you should also identify and solve the primary cause of the problem, whether it is the boot fit, on- or off-ice exercise or other. If the problem persists for weeks or gets worse, you should stop skating and consult a podiatrist or sports medicine specialist. You can risk serious damage to your feet otherwise.