Skiing season can be tough on knees

Combine two quality ski areas, lots of skiers and snowboarders, and every year, there will be a batch of people trying to mend themselves after crashes on the slopes.

It's part of the terrain: braces and casts and limping people showing up at local physical therapy facilities.

Chloe Thornton, a 14-year-old Flathead High School student, tenderly and tentatively stepped into the Flathead Orthopedic Center for her first go at physical therapy this week. She suffered a torn medial collateral ligament in her left knee on Super Bowl Sunday at Whitefish Mountain Resort.

"I was going off this jump and I didn't know what was on the other side," Thornton said. "There was a big bump, and I just totally wiped out."

Physical therapist Keith Ori gently strapped Thornton into a Bio-Dex machine that slowly bends her knee back and forth, incrementally increasing the joint's range of motion.

"They used to operate on these things 10 to 15 years ago," Ori said, referring to Thornton's particular injury. "But now we find that they will heal on their own with the right kind of physical therapy."

Advances in physical therapy and orthopedic care have expedited recovery periods. When Ori started his career 25 years ago, there were knee injuries that would put people in casts for six months and take them out of action for a year.

Now, the same types of injuries often involve non-surgical care, but with aggressive physical therapy that can last two months, with the patient resuming full activity within four months, Ori said.

Knee injuries are common for skiers, and upper-extremity injuries are common for snowboarders, said Ori, who estimates the Flathead Orthopedic physical therapy clinic treats about two dozen people with ski or snowboard injuries every year.

"They come at us all year long," he said. "We get people who get injured and they don't realize how serious it is until later on."

Dr. Albert Olszewski, an orthopedic surgeon at Flathead Orthopedic, said snow conditions play a big part in injuries.

"Usually our big time for ski injuries is the first two or three weeks of the season and the last two or three weeks, because of the quality of the snow," he said.

Early in the season, when snow conditions can be thin, skiers often venture to the margins of groomed slopes where they encounter buried branches. Late in the season, skiers often find themselves in heavy snow.

"You get into the crud and the next thing you know you're having a yard sale," Olszewski said.

This year has presented an unusual challenge - persistently deep snow at Whitefish Mountain Resort and Blacktail Mountain Ski Area.

"We have an exception this year," Olszewski said. "There's so much good snow that it's hard for them to groom it all. As a result, there's a lot of people who are skiing in ungroomed conditions."

And that has led to a small-scale "epidemic" of injuries to young skiers who often have more difficulty cutting through deep snow, Olszewski said.

"We are seeing young kids get hurt because they don't have the strength to control their skis" in deep powder, he said. "They catch an edge or submerge a tip."

The clinic has treated about a dozen young skiers over a short period this winter, Olszewski said.

But every winter, seasoned skiers, too - skiers such as Joe Withey - get injured.

Just as Olszewski described common early-season injuries, the 52-year-old Withey suffered a broken leg skiing in one of his favorite spots near the East Rim area on the second day of business at Whitefish Mountain Resort.

Just a few turns into the slope, "I caught a limb underneath the snow that my ski went under. I came out of my binding but my foot got stuck," said the Kalispell health food store owner.

"I just kept going downhill to my right," Withey said. "I knew immediately what happened. I heard the snap. I just stayed calm and waited for another skier to come by."

Withey said the spiral fracture to his tibia was painful, but not nearly as bad as a back injury - two compressed discs - he suffered last March while skiing.

"That was true pain. This was just a broken leg," said Withey, who considers himself fortunate that he didn't suffer a truly demobilizing injury. He has been skiing for 42 years, typically getting in 50 days a year on the slopes.

Withey was confined to a leg cast up to his groin for six weeks, and a knee-high walking cast for three weeks that soon will be removed. Once that happens, he'll start a physical therapy regimen to stretch out stiff tendons and ligaments and rebuild strength in his leg.

"My ankle is going to be a real challenge for me, because I need to get it stretched out," Withey said.

The Summit Medical Fitness Center's physical therapy clinic gets its share of ski injuries, too.

Physical therapist Pat Heil estimates that the clinic gets "30-plus" ski and snowboarding injuries every winter, and "they are not all that serious, thankfully."

The most common are knee injuries.

"Typically this time of year we end up seeing a fair number of ACL injuries," Heil said, referring to the dreaded anterior cruciate ligament knee injury. "It's a pretty common ski injury."

ACL tears at one time were considered the end to athletic careers, but not any more because of advances in the ability to surgically reconstruct the ligament.

After surgery and three months of rigorous physical therapy, patients are back to light physical activity and within four to six months they often resume their sport.

It takes commitment to get through physical rehabilitation, and Heil noted that a similar amount of commitment before the ski season can reduce risk of injury. The Summit offers preseason ski conditioning programs every year.

"Unfortunately, motivation [for the workouts] is highest once you're injured," he said.

Reporter Jim Mann may be reached at 758-4407 or by e-mail at jmann@dailyinterlake.com