How To Evaluate Figure Skating Injuries
In her article, “The Young Skater,” Angela Smith, MD, postulates that the skater spends so much time in a stiff boot that the peroneal muscles weaken. This is similar to what happens to muscles when in a cast for an extended period.2 When skaters subsequently engage in off-ice training, they are more likely to sprain an ankle. Boots that have worn out or boots without enough upper support may also be the culprit of an on-ice sprain, particularly if the skater engages in rigorous jumping.
When it comes to the prevention and treatment of a figure skater’s acute ankle sprain, there is a two-pronged approach. One should emphasize improving muscle strength via balance and proprioception exercises, which the skater can integrate into an off-ice, cross-training regimen. Clinicians should also encourage skaters to wear a skate boot that provides adequate support while still allowing some ankle plantarflexion/dorsiflexion to promote intrinsic strength.
Other acute skating injuries include Achilles tendon rupture (secondary to jumping), peroneal or posterior tibial tendon rupture, fracture and plantar fascial strain/rupture.
What You Should Know About Chronic Injuries
Lipetz and Kruse say the foot is the most common location of injury to a figure skater, and that most of these foot injuries are overuse injuries.4
Dubravcic-Simunjak, et. al., note that stress fractures are the most frequent chronic injuries in female skaters. Stress fractures of the most common sites — the metatarsals, tibia, fibula and navicular — can occur in both the take-off and landing extremity.1 This suggests that skaters not only place a high level of force on the landing leg but also exert a significant amount of force to vault into the air in order to achieve sufficient height, rotation and distance across the ice.
In support of the effect these forces have on adolescent figure skaters, Oleson, et. al., found that lower bone mass secondary to young age and the prolonged wearing of a stiff skating boot did not contribute to these types of injuries.5
Stress fractures and other injuries may actually feel better in the skates while being made worse by them. A stiff boot is like a short cast and a skater with an injury such as a metatarsal stress fracture may experience minimal or no pain while engaged in lower intensity skating. This creates a false sense of wellness or improvement in the skater’s mind. However, the injury is likely to worsen with rigorous practice. Particularly when one is treating a young skater or one such patient with an enthusiastic parent, it may be preferable to utilize a non-weightbearing cast over a removable Cam walker or stiff-soled shoe for a period of time in order to keep patients off the ice until the injury has healed.