Ski Holidays and Head Injuries

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In this segment Dr. Brian Cole of Midwest Orthopedics at Rush, Steve Kashul & Dr. Jeremy Alland discuss Holiday ski trips and what parents (and adults!) should know about concussion.

Dr. Jeremy Alland graduated from Rush Medical College in Chicago, IL, where he was awarded the prestigious William H. Harrison, PhD Award for selfless leadership, aspiration and collaboration. He went on to complete a Family Medicine residency at UPMC St. Margaret Hospital in Pittsburgh, PA, where he served as Chief Resident and was peer-selected as the best resident teacher. After residency, he returned to Rush and his hometown of Chicago to complete a fellowship in sports medicine.

During his training, Dr. Alland served as a team physician for the Chicago White Sox, Chicago Bulls, Chicago Fire Soccer Club, DePaul University and multiple high school football, basketball and wrestling teams. Additionally, he has been a part of the finish line medical team at both the Chicago and Pittsburgh marathons. He is board certified by the American Board of Family Medicine and is a member of the American Medical Society of Sports Medicine, American College of Sports Medicine and American Academy of Family Physicians. Jeremy Alland

As a former collegiate baseball pitcher, Jeremy A. Alland, M.D. has a strong passion for sports and medicine. He finds pride in his ability to relate to his patients and strives to help his patients remain active. He specializes in the care of the entire athlete with special interests in the throwing athlete, the golfing athlete, sports performance, and ultrasound-guided procedures.

Dr. Alland is a team physician for the Chicago White Sox, Chicago Fire Soccer Club, Windy City Bulls (Chicago Bulls NBA D-League team), Chicago Dogs, Chicago Blaze and Mount Carmel High School. He previously served as a team physician for DePaul University. He is an active researcher and has authored numerous papers on topics in sports medicine. He also serves as a peer-reviewer for The Journal of Family Practice.

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How Snow Skiing can help keep You Young!

Snow Skiing as a Natural Anti-Aging Remedy

Dr. Charles Bush-Joseph from Midwest Orthopaedics at Rush and Steve Kashul talk with Peter Braun MS, LAT, ATC, ITAT from ATI Physical Therapy. This discussion focuses on how snow skiing can keep you young and what make skiing a unique type of exercise.

The effects of time on one’s body are unavoidable and often substantial. Many of us in the field of medicine are in an endless search to find the perfect sport, activity or exercise that will unlock our physical potential, well into our years. Scientific research has found that there are certain factors that contribute to longevity and sustainability.


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Bone density, lower extremity strength, balance and cardiovascular endurance all play critical roles in maintaining a physically active lifestyle. With this, physicians make an effort to integrate these factors into exercise plans for much of our elderly population. But what if there was a simpler answer? What if we could prescribe involvement in a recreational activity that naturally addresses all these areas? As we unravel the details, we challenge the question; “Is there such a thing as an anti-aging activity?”

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Snow Skiing as a Natural Anti-Aging Remedy

Snow Skiing as a Natural Anti-Aging Remedy

By Brian Rog with Contributions by Peter Braun MS, LAT, ATC, ITAT

The effects of time on one’s body are unavoidable and often substantial. Many of us in the field of medicine are in an endless search to find the perfect sport, activity or exercise that will unlock our physical potential, well into our years. Scientific research has found that there are certain factors that contribute to longevity and sustainability. Bone density, lower extremity strength, balance and cardiovascular endurance all play critical roles in maintaining a physically active lifestyle. With this, physicians make an effort to integrate these factors into exercise plans for much of our elderly population. But what if there was a simpler answer? What if we could prescribe involvement in a recreational activity that naturally addresses all these areas? As we unravel the details, we challenge the question; “Is there such a thing as an anti-aging activity?”

Snow Skiing and bone integrity

As we dive into the leading factors that affect our ability to remain physically active, it is important to begin by discussing the foundation of our musculoskeletal system: our bones. Proper bone integrity allows our joints and muscles to function at peak levels. As more research is released clarifying the comorbid factors associated with aging, we are realizing how important bone density truly is. As we get older, it is natural to lead a more sedentary lifestyle. This reduces the forces exerted on our bones and leads to less deposition and remodeling. Consequently, bones become weaker and more fragile.

There is also a threshold where forces may be too much for a bone to adequately tolerate. Therefore, we don’t see many 60 or 70-year-olds participating in heavy plyometric type activity that requires sprinting, jumping, or heavy lifting. What makes skiing so unique is that the peak force exhibited on the bone is achieved over a longer period of time compared to other activities. If someone is running, the peak force at heel strike happens instantaneously and stress is quickly translated through the bones. In skiing, this process is lengthened due to the natural mechanics of a turn. As we begin to turn while skiing, ground reaction force increases and it doesn’t achieve maximum force until the dynamic center of the turn, and gradually reduces as we bring the skis back underneath the body. There is no sharp or sudden spike in pressure or force. This allows for a healthy and acceptable loading of our joints and bones, which optimizes remodeling.

Snow Skiing and lower extremity strength

Lower extremity strength has been promoted by many as a key to upholding a physically active lifestyle and essential to healthy aging. The biomechanics of a skiing turn activate all lower leg muscles in a complex and symmetrically balanced fashion. The intrinsic muscles in the foot are important to control edge initiation and release. These muscles are also essential to foot rotation, which affects the degree and engagement of an edge throughout the turn. The muscles of the lower leg are important for staying balanced and continuously adjusting to the changing pressure and contact with the snow.

Even during various parts of the turn, the hip flexors, quadriceps and hamstrings help create dynamics and proper leg lengthening necessary to carve and ride the edge of the ski. The core, hip flexors, hip rotators, hamstrings and glutes all work harmoniously to transition our body from the initiation of the turn through to its completion. These muscles are stressed, more or less, depending on the size and shape of the turn, slope of the hill, and conditions of the snow.

The combination of all these components create an exceptional foundation for strengthening. In addition, skiing requires a diversity in motor activation patterns, therefore resisting motor specificity and repetition. The movements of skiing are so complex that when coupled with the aid of gravity and slope as we ski downhill, chronic injuries are minimized when compared to many other recreational sports-activities.

Snow Skiing and the role of balance

Balance is another function that tends to decline with age. The rate of falls and severity of resulting injury are often fatal in the elderly population. There are many contributing factors to one’s overall capacity to stay balanced. It is important to recognize that even as we challenge this system there may be limiting factors, whether centrally or peripherally, that inhibit our skills as we age. But there are few other sports that challenge the body in such a dynamic and functional way as skiing. Proprioception is arguably one of the most important skills in skiing. Awareness of our limbs in space allow us to successfully stay standing as we move down the hill. Even in a static fashion, as we click into our skis there is an immediate and drastic reduction in friction under our feet. This makes even the most finite movements more substantial and challenges our joint awareness and control.

As we begin the move down the hill and turn our skis, this skill becomes exponentially more difficult. Our movements, pressure, center of balance, turn dynamics, turn radius, as well as the snow conditions all affect how we need to position our body over our skis. Furthermore, the skier often must be reactive to many of these factors. To put all this in perspective, it would be like executing a balance exercise in the clinic wherein the surface that we are balancing on is changing, while simultaneously shifting weight from side to side, alternating single leg stance, and also reacting to a stimulus (such as catching a ball). Tremendously complex, right? If there are any benefits of proprioceptive training to improve overall balance as we age, you will definitely see the results if skiing is incorporated into your lifestyle.

Get active, and stay active

Individuals in the physical therapy profession and others in the medical field are continually trying to encourage others to enroll in an active lifestyle. We can all agree, regular exercise is important, but leading a life that incorporates consistent and regular activity throughout the days is the main goal – and it shouldn’t stop at 10,000 steps. What we are doing during the time we are not accumulating steps is just as important. When we observe the scope of different activities we can perform to stay physically active, none are quite as sustainable as skiing. Most skiers set aside an entire day to enjoy time on the mountain. Even other sports that are notoriously lengthy such as golf, hiking, or long distance biking and running, don’t even remotely match an eight hour day.

Although activity isn’t continuous, a single run on the slopes, which typically takes only a few minutes, is just enough time to increase the heart rate and stress the musculoskeletal system before resting on the chairlift. This is a perfect combination of rest and exercise that can easily fill an entire day. The sustainability of skiing is what makes it stand apart from most other sports activities. If the overall goal is to create a physically active lifestyle, skiing may be one of the few solitary solutions that can achieve this goal.

We will never be certain as to what is the best thing to do to resist the effects of aging. Our genetics, our bodies, and our history all have a role that is too intricate for us to predict. However, if there’s one thing that is definitive, it’s the positive impact that exercise and activities like skiing brings to someone’s well-being.

Dealing with a lower body injury?

Recognizing and assessing an injury is the first step in ensuring a speedy and effective recovery. Most individuals are led to believe that surgery or opioids are their only lines of defense when dealing with an injury. Instead, consider physical therapy as a first course of action, even if it’s only a screening, which are complimentary at all ATI locations. Recent research suggest that people who underwent physical therapy enjoyed faster recovery and less pain than those who chose alternative routes such as surgery and opioids. Give PT a try!

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Here’s How Olympic Snowboarder Spencer O’Brien Overcame Rheumatoid Arthritis

Dr. Brian Cole and Steve Kashul talk with Spencer O’Brien about the challenges professional athletes face during competition while managing rheumatoid arthritis. 

Rheumatoid Arthritis is an autoimmune disease that has a severe impact on the joints and can affect other parts of the body as well due to severe swelling. For a professional athlete a diagnosis like this can be physically and emotionally devastating. For O’Brien it was finally an answer to why her body was failing her. She experienced low points, but like a great athlete she persevered, rebuilt herself and triumphed against the odds.

SPENCER O’BRIEN

SNOWBOARDING — TARGETING BEIJING 2022

2018 Olympian – Slopestyle and Big Air
2016 X Games Gold Medalist – Slopestyle
2014 X Games Bronze Medalist – Slopestyle
2014 Olympian – Slopestyle
2013 US Open Champion – Slopestyle
2013 FIS World Championship Gold Medalist – Slopestyle
2012 TTR World Championships Gold Medalist – Slopestyle
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