Monday, February 2, 2009

Snow or Ice at Your Feet: Pick Your Winter’s Worst Enemy

As many of us continue to get pounded with this winter’s weather AND our friend the groundhog predicts six more weeks of this weather, its time to stop and think about your safety on the snow and ice. We have all heard about the dangers of walking on ice, but there are also hazards of walking on snow.

Many of the dangers are obvious. Ice can cause slips and falls which can result in ankle sprains, fractures and other types of injury. The emergency rooms are filled with problems associated with unexpected trauma due to falls from ice. Most women don’t need to be told that it is not safe to wear heels or unstable shoes on icy sidewalks. Walking on ice requires patience, sturdy boots and awareness of your surroundings. Acute ankle injuries are very common in the winter and when it happens, there is no question about it! A fresh injury to the ankle causes pain and swelling and can lead to months of aggravation.

So what about walking on snow? As I walked my dog the last few weeks over snowy banks and neglected sidewalks I realized that we hardly ever talk about the risks specific to walking on the uneven surfaces of snow. Uneven surfaces require strong, responsive tendons and ligaments and are easy to navigate if you have physically fit ankles that have never been injured. However, not everyone can claim to have “virgin” ankles that have never suffered a sprain. Many people have what we call chronic ankle instability that is due from an improperly treated sprain.

The ankle has an outside component and inside component. When most people suffer an ankle sprain, they injure any or all of the three ligaments on the outside of the ankle. It is very common for people to either ignore the problem or seek treatment from an emergency room that is often inadequate. Proper treatment is very important and involves reducing the swelling and immobilizing the ankle immediately after the injury to allow the ligaments to repair in their proper position. Failure to heal in their natural position causes the ligaments to be stretched out, weak and unable to perform their function which is to stabilize the ankle. Re-injury of the ankle occurs easily when the ligaments are stretched. Scar tissue develops and the ligaments no longer have the structure to do their job. Many people with this problem relate that their ankles sprain easily or “give out” often.

The uneven surfaces and varying heights of snow present the perfect opportunity for unstable ankles to give way to re-injury. This type of injury occurs no matter what shoes you are wearing, even stable snow boots. Many people don’t even realize that the injury is occurring because it is unlike the acute ankle injury that occurs with ice. Pain may or may not arise; but is often dull and not likely to alert you to the injury that occurred. The ligaments continue to tear, scar and weaken as this type of repetitive injury continues.

The best advice for treatment of ankle injuries is to have them properly treated when they occur to avoid problems later on. Podiatric physicians will offer either conservative treatment or surgical treatment depending on the severity or situation. Chronic ankle instability can be treated conservatively with ankle braces; but may require surgery to put the ligaments back in the correct position.

Protect your ankles this winter. If you have weak ankles, it is important to remember that walking on snow requires the same careful attention that walking on ice requires. Try to avoid the uneven peaks and valleys of the snow drifts and matted down snow piles on those neglected sidewalks this winter has given us! If the groundhog was right in his prediction, it is going to be a long six weeks for your ankles!