John-Paul Rue, M.D., orthopedic sports medicine surgeon at Mercy Medical Center in Baltimore
John-Paul Rue, M.D., orthopedic sports medicine surgeon at Mercy Medical Center in Baltimore (Mercy Medical Center)

The Winter Olympics are coming to South Korea Feb. 9-25, and all those snow and ice competitions may motivate a lot of people to get back outside, or to try a sport for the first time. But Dr. John-Paul Rue, an orthopedic sports medicine surgeon at Mercy Medical Center in Baltimore, says there are all kinds of injuries that can come from such workouts. He suggests ways to avoid injury, whether you’re a pro or a beginner, and when to recognize when an injury needs medical attention.

What are the most common types of injuries from cold weather sports such as snow boarding, skiing or sledding?


Snowboarders are up to three times more likely to sustain injury than skiers. The use of helmets has dramatically decreased the incidence of serious head injuries, but injury to the shoulders, knees and ankles are still very common. Serious spine and pelvis injuries also can result from major falls. Skiers are often more likely to sustain injury to the knees, particularly with rotational injuries. Improvements to safety equipment, especially binding release mechanisms, have decreased these injuries, but knee injuries such as anterior cruciate ligament (ACL) tears and meniscus tears are still common. Snowboarding injuries more commonly involve the upper extremity, including the shoulders, wrists and hands due to falls. Injuries during sledding are commonly due to the terrain or obstacles, so it’s important to pay attention to your surroundings and ensure that the path is clear of obstructions before you head down the hill.

Is it okay to stretch in the cold to avoid strains or are there other good methods of avoiding injury?

Absolutely, just remember to do a little warm-up exercise before. This will help get the blood pumping to your muscles first, allowing them to warm up and loosen. Remember to keep moving when it’s cold out. If you sit or stand still for a prolonged period of time, do a little warm up exercise, like jumping jacks or arm circles and leg raises to keep the blood flowing to your limbs and muscles.

Is it better to overdress a bit and stay warm or wear layers that can be removed, or do you need to avoid bulk so you can better control your movements?

The best way to dress for outdoor activities in winter is to dress in layers. In general, this will include three basic layers. The base layer, closest to your skin should either be wool, synthetic or silk. This will allow the perspiration from your skin to be wicked away, helping to keep your body temperature regulated.

What age is safe to participate in these kinds of snow sports, and is there an age or indication where people should quit?

The beautiful thing about many winter sports is that there really is no minimum or maximum age requirements. Children can learn to ski and snowboard as soon as they can walk and have enough strength to manage the added weight of the equipment. This is usually around age three. While there is no maximum age, we may tire more easily as we age, and our bones and muscles become more prone to injury. Also, some age-related changes related to decreased flexibility, balance and loss of overall muscle mass may increase the risk of injury in older athletes. But these factors may be off-set by older athletes taking less chances on the slopes, while still enjoying the wonder of gliding down a perfectly groomed mountain trail.

If you do have an ache or strain, how do you treat it your self and when does it need medical attention?

Many aches and strains can be self-managed by following the principles of rest, ice, compression and elevation (RICE). If you are sore a day or so after a good muscle workout, this may just be a sign of delayed onset muscle soreness due to normal breakdown of muscles as they undergo the process of strengthening. If you have significant weakness, swelling, bruising or loss of motion of the affected muscle or joint, or if the injury occurred suddenly with a popping/tearing sensation or sound, you should seek medical treatment as these may be signs of more serious injury.