How To Evaluate Figure Skating Injuries

Author(s): 
By Rachel A. Janowicz, DPM

The United States Figure Skating Association (USFSA) regulates the testing and competition of 170,000 members, a number that represents a 63 percent increase over just one decade.
This surge in popularity can be partially attributed to figure skating becoming more financially accessible in lieu of the newer focus on only the freestyle aspect of the sport. The success of American figure skaters like Michelle Kwan and Brian Boitano have also increased the popularity of the sport.

This greater participation has subsequently brought about a higher level of competition. Both the athletic and artistic aspects require expert conditioning, technique, dance ability and aesthetic presentation. As a result, elite skaters can spend three to five hours a day, five to six days per week on the ice. In addition to their rigorous on-ice practice schedule, these athletes may spend several more hours engaged in off-ice conditioning and ballet classes.
On- and off-ice training dramatically increases when the skater reaches more advanced levels, often coinciding with adolescence and a time of asynchronous bone and soft tissue development. The stress of performing repetitive jumps and other difficult moves during this period of development presents a unique set of circumstances under which skating injuries can occur.1
Given the potential for various injuries among figure skaters, there is a strong need for practitioners who demonstrate a fundamental understanding of the sport and the equipment involved (see “What You Should Know About Skating Boots” below).

Understanding The Biomechanics Of Skate Gait
Stroking, the basis of skate gait, is essentially skating across the ice using a series of push-offs to facilitate momentum. Proper stroking technique is important in that the skater desires maximum speed without having to expend needless energy or put unnecessary stress on the body. Stroking, in conjunction with good balance and posture, consists of the interplay of inside and outside edges.

Simply stated, the skater obtains the inside edge by gliding on the medial side of the blade and obtains the outside edge by gliding on the lateral side. Though the skater constantly changes edges and direction, fundamental skate gait remains the same.
The skater begins with the push off of one blade against the ice to create gliding on the weightbearing side. At the beginning of each stroke, there is a slight flexion of the free or non-weightbearing hip. This is followed by forced hip abduction as the blade concurrently pushes off the ice and produces momentum on the weightbearing skate. The extremity that provided the push then purchases the ice, the body weight shifts accordingly and the mechanism reverses. The weightbearing knee should be slightly bent throughout to keep the center of gravity over the blade rocker and prevent forward canting from the intrinsic heel of the skate. Accordingly, flexibility of the posterior leg is important to prevent injury secondary to this stress.

Key Considerations In Evaluating Skating Injuries
While the podiatrist may assume the boot manufacturer has a level of anatomical understanding when it comes to the foot, evaluating a skater’s biomechanics and the problems that can occur therein is more suited to the orthopedic professional. In addition to emphasizing that the skater bring his or her skates to the appointment, clinicians must weigh several factors in evaluating the injuries of these patients.
Who came with the skater? In addition to parental involvement in the actual visit, it is important to ensure that someone is able to communicate any necessary treatment/training modifications to the skater’s coach.
Evaluate the overall skater. What age and sex is the skater? Does he or she skate in singles, pairs or ice dancing? What level is the skater at? Novice, junior and senior skaters are practicing double and triple jumps. This will provide a guideline as to the physical intensity of the skater’s practices.
Does the skater appear underweight? Both male and female skaters are at risk for eating disorders such as anorexia, which can lead to osteoporosis and other serious health issues.2,5 Making a referral to the pediatrician or primary care physician may be advisable.

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