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Ice Skating Injuries a Slippery Problem

Slick surface means hands aren't useful in breaking falls, study shows

MONDAY, Jan. 30, 2006 (HealthDay News) -- As youngsters get ready to watch their skating idols perform in the Winter Olympics while dreaming of doing gravity-defying moves on the ice themselves, parents need to keep this in mind: The health of young ice skaters is often on thin ice.

According to new research, ice skaters are almost five times more likely to suffer head and face injuries compared to roller or inline skaters.

The problem lies in how ice skaters fall, the researchers found. While all skaters try to break fall with their arms or hands, ice is a frictionless surface -- so ice skaters' arms or hands often don't break the fall as they should.

Trying to remedy the situation, the U.S. researchers have designed a new type of protective wrist guard.

But other experts say this oversimplifies the problem.

"To my knowledge, head injuries come less from hitting the ice than hitting the boards on the side of the rink," said Dr. Gerard Varlotta, director of sports rehabilitation at the Rusk Institute of Rehabilitation Medicine at New York University Medical Center.

Ice skaters would still need to wear helmets, said Varlotta, a long-time ice hockey player himself who's tended to players on professional roller hockey and ice hockey teams.

According to background information in the study, the American Academy of Pediatrics recommends that inline and roller skaters wear protective gear, but has not issued guidelines for ice skaters.

The authors of this study looked at national data from the Consumer Products Safety Commission, and found that ice skaters were hitting their heads much more often.

They then set out to determine why. To do so, they videotaped more than 400 children while ice skating and while roller or inline skating.

Reporting in the February issue of the British Journal of Sports Medicine, they found that all skaters tended to fall forward and most (90 percent and up) also tried to break the fall with their arms or hands.

However, about 13 percent of ice skaters hit their head when they fell, vs. just 3 percent of roller and inline skaters.

"Ice skaters and other types of skaters were both falling forward, and attempting to put their hands down in the majority of cases," said study author Christy Knox, a research associate at Columbus Children's Hospital Center for Injury Research and Policy, in Ohio. "Unfortunately, when ice skaters put their hands down on the slippery ice surface their hands slid, which wasn't preventing their head and face from hitting the ice."

"When roller skater and inline skaters fall forward and put their hands out, they are able to break their fall because the surface isn't frictionless," added senior study author Dawn Comstock, who is part of the research faculty at the hospital's Center for Injury Research and Policy. "That's why we traditionally have seen a high rate of wrist fractures, and that's why wrist guards were developed."

Typically, wrist guards provide support to the smaller bones in the wrist and forearms, and the plastic or metal in the palm of the wrist guard allows the hands to slide forward to dissipate the energy of the fall.

"We have the opposite problem in [ice] skaters," Comstock said. "They put their hands out, and it's a frictionless surface. So, that means their hands just slip right out. There's no decrease in energy associated with the fall, so their head slams into the ice."

The next logical question was what to do. Wearing a helmet is daunting to many children and, besides, it wouldn't prevent facial injuries unless it was a full-face helmet.

"It's hard enough to get kids in a helmet," Comstock pointed out. "Telling them to wear a full face helmet just to go out and recreationally ice skate would be a hard sell. From an injury prevention standpoint, we want to make sure the piece of equipment will be used."

With the help of other departments at Center for Injury Research and Policy, the authors developed a design for a wrist guard with gripping material on the palm so hands won't slip on the ice.

A provisional patent has been granted and the researchers are currently negotiating with companies to manufacture it.

In the meantime, Knox said, "we do suggest that children wear helmets that are well fitted and appropriately."

Varlotta worried that the new wrist guard may actually aggravate some problems. "If you do fall in ice hockey, you have the ability to glide. That saves you from having wrist and hip and knee injuries," he said. "With this device, you might actually increase the incidence of wrist fractures."

More information

For more on injury prevention, head to the U.S. Centers for Disease Control and Prevention.

SOURCES: Dawn Comstock, Ph.D., research faculty, Columbus Children's Hospital Center for Injury Research and Policy, and assistant professor, pediatrics, Ohio State University College of Medicine, Columbus; Christy Knox, M.A., research associate, Columbus Children's Hospital Center for Injury Research and Policy; Gerard Varlotta, D.O., director, Sports Rehabilitation, Rusk Institute of Rehabilitation Medicine, New York University Medical Center, New York City; February 2006 British Journal of Sports Medicine
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