How To Evaluate Figure Skating Injuries

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How To Evaluate Figure Skating Injuries

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.
Here one can see severe pronation with pes planus, hallux valgus and a small cyst over the Achilles. This patient is an adult figure skater, who has skated for most of her life and reports having skate “boot problems from the very beginning.” (Photos cour
Here one can see severe pronation with pes planus, hallux valgus and a small cyst over the Achilles. This patient is an adult figure skater, who has skated for most of her life and reports having skate “boot problems from the very beginning.” (Photos cour
Here one can see a fifth digital heloma durum. This patient is a 10-year-old female figure skater, who is practicing at a high level (including double jumps). (Photos courtesy of Allison Stringer, PT)
Note the pronounced pronation with PTTD and pes planus. This patient is a 10-year-old female figure skater, who is practicing at a high level (including double jumps). (Photos courtesy of Allison Stringer, PT)
This skate boot has a “dance back” modification that  can help remedy irritation or dermal thickening of the lower posterior leg due to repeated plantarflexion. Achieving this modification involves removing a portion of the posterior-superior upper and in

In order to ensure a thorough assessment of skating injuries and potential causes, the author strongly recommends that these patients bring their skate boots with them to the podiatric appointment.
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Author(s): 
By Rachel A. Janowicz, DPM

Evaluate the boots. Are they too stiff? There should be a slight bend to the upper when applying average force with the hands. Many skaters have various pathologies related to stiff boots. If the skater is practicing double and triple jumps, there is need for more support but not more than previously described.
Contrarily, are the boots breaking down? If worn, crease lines are usually prominent along the medial and lateral upper. Tongue creases are common and not necessarily indicative of detrimental wear.
When were the blades last sharpened? Overly sharp blades stick and dull blades skid. Depending on the weight of the skaters, how much the skaters practice, the intensity at which they skate and their personal preferences, they should sharpen their blades every three weeks to three months with regular use.
If the boots are new, were the blades mounted correctly? A properly placed blade to a boot is like neutral position to an orthotic casting. If the skater is having a difficult time with the inside or outside edge of either skate after a sharpening or replacement, a professional should reevaluate the blades. Most training rinks have someone with expertise in this area or they can refer the skater to a local professional who has this experience. Some boot manufacturers do provide this service.
Is there indication for an orthotic? Orthoses for both the skates and street shoes are reasonable for any skater as skate boots lack arch support. Graphite or thin polypropylene with intrinsic posting and a thin top cover works best. Metatarsal pads or bars are also appropriate for skaters with histories of metatarsal head stress fracture, sesamoiditis or any metatarsalgia.

Send tracings of the manufacturer’s insoles with the prescription and if possible, send an older pair of skate boots. The goal is to make a small enough device that is wide enough so the skater does not pronate into the gap between the orthotic and the medial aspect of the skate.
Is there rubbing from the boot causing soft tissue injury? If a boot modification is necessary, it is helpful to write down detailed instructions for the patient to take to the manufacturer regarding the location and suggested alteration. Marking the area with a pencil can be helpful.

Pertinent Pearls Regarding Acute Injuries
Out of 236 male and female figure skaters at four consecutive World Junior Figure Skating Championships, a study revealed 25 percent of female skaters and 27.9 percent of male skaters sustained some kind of acute skating injury over the course of their careers. The authors of the study found that acute injuries were semi-specific depending on the discipline of the skater involved.1
For instance, contusions and lacerations were common in ice dancing where the man and woman are required to stay close together while engaged in quick changes of direction and hand holds. These injuries were also common for those involved in pair skating, which requires high lifts and big throws. Other acute injuries included traumatic fracture of hands, wrists and arms as well as sprains and strains of shoulders, knees and wrists. Ankle sprains were the most frequently reported injury among all the skating disciplines.1 Interestingly, the researchers noted these injuries occurred most often during off-ice activities.

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