Swifter, Higher, Stronger, Injury-Free
Sports Medicine and the 2014 Winter Olympics
The wait is finally over! The XXII Winter Olympics in Sochi are here and with the Games comes the thrilling and dramatic competition that spectators crave and the potential for injury or illness that Sports Medicine physicians are always on the lookout for.
Over the next 2+ weeks I’ll try to add a Sports Medicine perspective to the excitement and intrigue surrounding the Winter Olympics by discussing daily an Olympic sport and a common injury/condition associated with it. I’ll try to keep things interesting and pertinent in the topics selected. Additionally, I’ll try to keep things on the lighter side by adding some daily random, useless trivia about each sport. So, without further delay, let’s get started…
EVENT: OPENING CEREMONIES
Granted, this is not so much a sporting event as it is an entertainment spectacle with millions of viewers tuning in around the world. You wouldn’t think that an entertainment event such as this could be linked to a topic of Sports Medicine. However, when you remember all of the spectators attending the various outdoor activities during the next two weeks, you then have an increased risk of these people getting frostbite.
What is it? Frostbite is a cold-related emergency that occurs when skin is exposed to excessive cold for an extended period and the tissue freezes. The most common areas to get frostbite are the fingers, toes, ears, nose and cheeks. People at risk for frostbite are those that spend the majority of their time outdoors such as the homeless, hunters, soldiers and outdoor enthusiasts. In addition, those under the influence of alcohol, smokers, diabetics and anyone with vessel disease are also at an increased risk. As people are exposed to the cold for longer periods, the vessels in their extremities constrict to send more blood to vital organs and minimize heat loss. Gradually, this causes reduced blood flow to the extremities that causes ice crystals to form around the cells comprising them and damages blood vessels eventually causing freezing of tissues.
What are the symptoms? Symptoms of frostbite usually depend on whether the condition is superficial or deep. Superficial frostbite can cause itching, numbness, tingling or burning in the affected area. The skin may appear frozen and pale and may be swollen with blisters containing clear or milky fluid. In deep frostbite the skin may appear blackened and dead and feel solid like wood. Swelling is present and blood-filled blisters are often noted over waxy appearing skin that turns purple as it is rewarmed.
What is the treatment? Treatment of frostbite is removing the patient from the cold environment and then rewarming the frozen tissue. This is accomplished by soaking the area in a water bath of 104-107.6oF for between 15-30 minutes. Significant pain is often present during rewarming so pain medication is usually given. If blistering is present, clear blisters will need to have dead tissue removed while blood-filled ones may or may not be drained. Patients will often be given a tetanus booster if necessary and will need to be observed closely over the first few days following the incident for continued management which includes appropriate wound care, anti-inflammatory medication and whirlpool bath treatments if necessary.
Unfortunately, treatment of frostbite often takes place over weeks to months before the full extent of tissue damage is realized. Usually a decision to amputate is not made until months after the incident and a clearer delineation between living and dead tissue can be made. In the meantime, patients will often suffer from throbbing that begins during rewarming that can last weeks to months. This can then be followed by tingling with occasional shock-like sensations. Additionally, patients can suffer from chronic pain, sensory loss and sensitivity to the cold for many years after the incident.
How can it be prevented? The best way to prevent frostbite is to avoid prolonged exposure to the cold if you can. If that is not an option, then one should dress appropriately for the weather. Dressing in layers with inner layers being synthetic fibers to wick away moisture are the best. Layers should be loose fitting to avoid cutting off circulation and shoes and outer layers should be waterproof to prevent excessive moisture. Socks should be layered as well with inner layers being synthetic fibers and outer layers being wool-based to provide better insulation. Exposed skin, especially the head, face, nose and ears should be covered at all times and smoking and alcohol consumption should be avoided.
Random useless trivia about the Opening Ceremonies: The 2010 Vancouver Olympics were first Olympics to have the Opening Ceremony indoors. They were held at BC Place Stadium which is the home of the Canadian Football League’s BC Lions and Major League Soccer’s Vancouver Whitecaps FC.