Ski Injury Series - Hand and Wrist part 2
Welcome to the Ski Injury blog series part 2 by Gus from Kaizen Physiotherapy & Performance. This blog is an extension of the Infographic. Please note that neither the infographic nor this blog should replace on site medical attention! These are an educational resource to help boost knowledge. You can find part one of our ski injury blog here or download and Get the infographic.
This leaflet as part of our collaboration with Massage Me, after some discussions around how we could help British ski goers navigate the confusion of dealing with a serious injury abroad. As Massage Me only provide massage and are unable to advise on any injuries, we have developed some educational content to share out. If you need more advice, you can book Kaizen Physiotherapy & Performance’s injury advice service.
A massive thanks to Mr Dan Shaerf, a specialist Hand and Wrist consultant with many years experience in dealing with these types of injuries. For more information, visit Dan’s website
When there’s no fracture
First thing to be mindful of is that a normal X-Ray doesn’t 100% rule out a fracture! This is especially the case if a scaphoid injury is suspected. The scaphoid is a bone in your hand that sits just under the thumb. Compared to the other bones in your hand, it has a higher risk of AVN (Avasular necrosis). This is a condition where the bone starts to die due to impaired blood flow. If a scaphoid injury is suspected but the scan is clear, it is commonly advised to get re-assessed around a week or two later, as fracture healing can be seen on X-Ray, or an MRI can be done to assess in more detail.
Full movement of the hand and wrist doesn’t necessarily rule out an injury, sometimes you can have a soft-tissue injury (usually the tendons or ligaments). Whilst it’s common to not seek immediate urgent care with a soft-tissue injury, if you still have pain at 2 or 3 weeks that isn’t significantly improving, it’s advisable to get this properly assessed as it is common to miss fractures or ligament injuries.
A common soft tissue injury is called Skier’s thumb. It occurs the strap of a ski pose yanks on the thumb causing a soft-tissue injury (in severe cases it can also cause a fracture). It will usually present with swelling and pain over the bottom of the thumb. This pain is aggravated by pinching as it causes stress to the area. Whilst this kind of injury can be treated on return, and usually doesn’t need surgery. It should be immobilised immediately to allow the injured area to heal.
Returning home
As mentioned in the infographic, you should discuss your return home with the treating medical staff before you leave. Generally speaking, it’s advisable to return home as soon as possible, so that you can be managed by your local medical team.
If seeking NHS care
Depending on the severity, you have 3 main options for getting followed up by your local NHS provider
Contact your GP - contacting your local GP practice to be referred to the orthopaedic team can happen quite quickly. Referrals are usually triaged so that acute injuries that need a timely review are seen at the appropriate time (for example a fracture or an operation). Some injuries have long waiting lists (for example an ACL injury), so you may see a surgeon relatively quickly, but you won’t necessarily be treated quickly.
Visit your local walk-in centre - most walk-in centres are equipped to assess orthopaedic injuries and refer onwards where appropriate. This may be easier than contacting your GP, and involve less waiting than visit the emergency department. If the injury is minor enough that is doesn’t need orthopaedic follow up, the walk-in centre can advise you.
Your local A&E - this is advisible if your symptoms have got significantly worse after your flight, as you can be urgently reviewed by the orthopaedic on call team. However, please bear in mind that most emergency departments are very busy, so you are likely to wait for a long time. Importantly, this doesn’t guarantee that you will see the orthopaedic team immediately. You may be booked an appointment a few days later, this may be a telephone appointment rather than face to face initially.
If seeking private care
If you have insurance cover, you should speak to them first so that they can authorise sessions (either for a medical review or for physiotherapy). If you are self-funding, most private practices will have their own booking system that you can use.
