Olympics 2014: Doctoring From the Sidelines
Olympics 2014: Doctoring From the Sidelines
Editor's Note:
As the Winter Olympics kicks off in Sochi, Russia, Medscape spoke with Robert Glatter, MD, an emergency medicine and former sideline physician for the New York Jets, who explained the most common injuries during competition and how they're treated on the sidelines.
Medscape: The Winter Olympics is home to many high-impact sports, maybe even more so than the Summer Olympics. Ski jumping, snowboarding, speed skating, luge -- these adrenaline-pumping sports are exciting to watch, but they also seem like fertile ground for sports injuries. What are some of the most common injuries to these types of sports?
Dr. Glatter: Many of the injuries that occur during Winter Olympics sports are the equivalent of what you would see with roller derby and NASCAR. Just the competition amongst the skiers can be quite dangerous. They negotiate moguls, jumps, gates, and straightaways. I think the risk for head injuries, concussions, and cervical-spine injuries is much greater with the Winter Olympics than the Summer Olympics.
The most common injuries we see, though, are injuries to the knees, the wrists, and the cervical spine. Knee injuries can range anywhere from contusions to sprains and anterior cruciate ligament or meniscus injuries, or even tibial plateau fractures in high-impact events, such as downhill skiing; in slalom-type events; and during snowboarding.
We also see some low back issues, especially in people who do snowboarding, with the half-pipe. They have sacroiliac joint issues commonly, as well as low back strain after such events, so physical therapy is important in those settings.
Medscape: How does the cold factor into the risk for injury? Is there a higher risk for injury competing in cold weather vs warm weather?
Dr. Glatter: I think as long as the athletes wear layers, which they often try to do, there is not an increased risk. There is an insulating layer that absorbs sweat, a middle layer that provides actual insulation, and an external layer that protects against the elements. That 3-layer sandwich helps to provide insulation.
Sweat decreases the ability to retain heat and can lead to hypothermia. We don't typically see that at the Winter Olympics. There haven't been any significant cases documented. I looked through all the studies from the 2010 games in Vancouver, and there were no cases documented.
It is important to insulate the feet with thick wool socks to guard against hypothermia. Covering the face, cheeks, nose, and ears is also especially important. In a general sense, mittens are better for retaining heat in the fingers because the fingers themselves can help provide better heat to each other than actual gloves. Some athletes do use regular gloves, so that can be an issue. But the athletes and the trainers are very cognizant of the risks for hypothermia and know that layering and insulation are very important.
You do see more respiratory illnesses -- especially upper respiratory illnesses, such as pharyngitis and sinusitis -- in the winter games. With the sometimes close conditions in the Olympic quarters, that can be an issue.
Editor's Note:
As the Winter Olympics kicks off in Sochi, Russia, Medscape spoke with Robert Glatter, MD, an emergency medicine and former sideline physician for the New York Jets, who explained the most common injuries during competition and how they're treated on the sidelines.
Medscape: The Winter Olympics is home to many high-impact sports, maybe even more so than the Summer Olympics. Ski jumping, snowboarding, speed skating, luge -- these adrenaline-pumping sports are exciting to watch, but they also seem like fertile ground for sports injuries. What are some of the most common injuries to these types of sports?
Dr. Glatter: Many of the injuries that occur during Winter Olympics sports are the equivalent of what you would see with roller derby and NASCAR. Just the competition amongst the skiers can be quite dangerous. They negotiate moguls, jumps, gates, and straightaways. I think the risk for head injuries, concussions, and cervical-spine injuries is much greater with the Winter Olympics than the Summer Olympics.
The most common injuries we see, though, are injuries to the knees, the wrists, and the cervical spine. Knee injuries can range anywhere from contusions to sprains and anterior cruciate ligament or meniscus injuries, or even tibial plateau fractures in high-impact events, such as downhill skiing; in slalom-type events; and during snowboarding.
We also see some low back issues, especially in people who do snowboarding, with the half-pipe. They have sacroiliac joint issues commonly, as well as low back strain after such events, so physical therapy is important in those settings.
Medscape: How does the cold factor into the risk for injury? Is there a higher risk for injury competing in cold weather vs warm weather?
Dr. Glatter: I think as long as the athletes wear layers, which they often try to do, there is not an increased risk. There is an insulating layer that absorbs sweat, a middle layer that provides actual insulation, and an external layer that protects against the elements. That 3-layer sandwich helps to provide insulation.
Sweat decreases the ability to retain heat and can lead to hypothermia. We don't typically see that at the Winter Olympics. There haven't been any significant cases documented. I looked through all the studies from the 2010 games in Vancouver, and there were no cases documented.
It is important to insulate the feet with thick wool socks to guard against hypothermia. Covering the face, cheeks, nose, and ears is also especially important. In a general sense, mittens are better for retaining heat in the fingers because the fingers themselves can help provide better heat to each other than actual gloves. Some athletes do use regular gloves, so that can be an issue. But the athletes and the trainers are very cognizant of the risks for hypothermia and know that layering and insulation are very important.
You do see more respiratory illnesses -- especially upper respiratory illnesses, such as pharyngitis and sinusitis -- in the winter games. With the sometimes close conditions in the Olympic quarters, that can be an issue.
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