Sierra Samaritans - National Ski Patrol

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d a clear difference indicating that bracing increased knee stability. may also protect the native ACL? Unfortunately, that question has not been directly studied among skiers as it has been among college football players. While there really isn’t enough data to say for sure, my own experience would suggest that it’s likely. So we are left with many more questions than answers. What we do know is that 1) ACL tears are extremely common among many professional athletes and weekend warriors, especially skiers; 2) ACL reconstruction is a highly effective but painful intervention with a 16-week or longer rehabilitation period; 3) temporary ACL bracing is generally recommended after surgery to protect the graft during its most vulnerable phase; 4) reconstructed ACLs can be re-ruptured; and 5) there is solid experimental evidence that bracing reduces strain on the ACL graft during the healing process. What we don’t know for sure is whether bracing will reduce the risk of rerupturing the ACL or even prevent ACL tears in the first place or well after rehab. One brace manufacturer, DonJoy, is so confident that its top-of-the-line brace can prevent re-rupture of the ACL that the company says it will actually pay a portion of the bill if you re-rupture the ACL graft while wearing the brace. Clearly we need more data to answer this central question. In the interim, as I continue to recover from what my wife insists had better be my last ACL reconstruction, I’m left to ponder the fate of my brace. Certainly, being able to pass the PSIA Level III exam without an ACL and while braced has endeared the device to me. I feel a subjective sense of support and security when I wear it, and studies would indicate that I also experience an objective increase in support. What little I lose in range of motion because of the brace I more than make up for knowing that the strain on the knee is relieved while wearing it. Without the brace, I would not have been able to ski at all. For Eric Schlopy, even the slight weight, drag, and movement restriction of a brace can mean the difference between winning and losing. But I’m not Eric Schlopy. I want to ski and ski well, but I hardly notice drawbacks from the brace. What I do notice is my increased sense of stability and confidence. I might be weak-kneed, but I’m no wimp, and I’m not ready to succumb just yet. ✚ References Boughton, B. “Prophylactic: Football Linemen Experience the Greatest Benefit.” The Magazine of Body Movement and Medicine June 2000: 21–25. Nemeth, G. et al. “Electromyographic Activity in Expert Downhill Skiers Using Functional Knee Braces After Anterior Cruciate Ligament Injuries.” The American Journal of Sports Medicine 25, no. 5 (1997): 635–641. Beynnon, B.D. et al. “The Effect of Functional Knee Bracing on the Anterior Cruciate Ligament in the Weightbearing and Non-weightbearing Knee.” The American Journal of Sports Medicine 25, no. 3 (1997): 353–359. Beynnon, B.D. et al. “An In-vivo Investigation of Anterior Cruciate Ligament Strain: The Effect of Functional Knee Bracing and Attachment Strap Tension.” Paper presented at the annual meeting of the Orthopedic Research Society, Orlando, FL. Blickenstaff, K.R. et al. “Analysis of a Semitendinosus Autograph in a Rabbit Model.” American Journal of Sports Medicine 25, no. 4 (1997): 554–559. Dr. Michael Patmas is the medical director of the Providence Ambulatory Care and Education Center in Portland, Oregon. He is a PSIA-certified Level III alpine ski instructor at Mount Hood Meadows, Oregon. W inte r 2005 | Ski Patrol Magazine 21
NUTRITION on the Slopes solutions for the fast food blues BY ROBIN PEGLOW Have you ever found yourself choking down an $8 burger, gnawing through a slightly frozen, less-than-tasty protein bar, or skipping meals altogether only to collapse into a useless, exhausted pile at the end of your shift? Amid the pressures and quick pace of patrolling the slopes and tending to skiers and snowboarders, proper nutrition is often the first thing that falls by the wayside. But the trade-off might be worse than you imagine. A lack of sustenance can definitely spoil more than your day; it can adversely affect your response time, your decision making, and even your ability to empathize with your patients. As a holistic health counselor, I spend my days talking to people about how nutrition can either enhance your daily experience or detract from it. Getting the nutrients you need doesn’t have to be a challenge, and this article explains how even the busiest among us can sustain the energy required to get through the day without fading and fizzling before noon or a couple hours after lunch. The key to good eating, as you might have guessed, is moderation. If you really love fries, go ahead and eat them on occasion. Have a burger now and then. But whatever you do, don’t rely on these things for nutrition. What then, you ask, should I eat? It doesn’t have to be complicated, and it is essentially a matter of getting back to the basics. “The basics” is shorthand for whole grains, fruits, vegetables, legumes (i.e., beans, lentils, and nuts), and healthy proteins such as tofu, salmon or tuna, and antibiotic- and hormone-free meats. Due to the nature of my training in nutrition I recommend choosing organic vegetables and “clean” meats or proteins. While scientists may argue over the benefits of organic and unmodified foods, I suggest them because I believe natural fuel burns cleaner than fuel that contains “additives.” I also tell people to try to stay away from obviously sugary or processed foods on the hill mainly because they tend to sap your energy rather than add to it. Eating healthy should give you the power you need when duty calls. MOM KNEW BEST Aside from the substantial financial toll that on-mountain “convenience food” can have on your wallet, you’d be wise to consider pizza or a burger and fries as a bad nutritional transaction as well. Such items provide little benefit for your body in terms of quality energy. You may crave fat to satisfy a raging hunger, but consuming greasy foods like these will leave you devoid of valuable nutrients. And, no, just taking a vitamin tablet or eating half a dozen protein bars isn’t the answer either. Your body functions best when it gets its nutrients from fresh sources. That’s right, your mom wasn’t just perpetuating some myth by telling you that eating fruits and vegetables would make you grow healthy and strong. Eating right is about far more than simply putting calories down the hatch, and the purpose of consuming nutrient-rich foods is that they provide energy for the vital functions that occur within your body on an ongoing basis. For example, the B vitamins found in foods such as black beans, meat, eggs, nuts, and dairy products support energy production, nervous system function, stress responses, and muscle tone. The folic acid you 24 Ski Patrol Magazine | Winter 2005
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