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Archive for December 2014

What is Frostbite and How Do I Prevent It?

An interesting article on Frostbite  from Stop Sport Injuries fall issue.


What is Frostbite and How Do I Prevent It?

by Christopher Tucker, MDAthletes participating in outdoor winter sports, such as alpine and cross-country skiing, snowboarding, and mountaineering, are at increased risk for developing frostbite. Frostbite is a condition in which prolonged exposure to cold temperatures cause an injury resulting in tissue damage— starting superficially with the skin and potentially spreading deeper to blood vessels, muscles, tendons, and even bone.

What Does Frostbite Feel Like?

Many people who are developing frostbite experience early symptoms such as numbness or a tingling sensation in the skin, such as the “pins and needles” that you can feel after a hand or foot falls asleep. The affected body part may also be extremely painful, feel itchy, or have a burning sensation. The skin can initially

appear white or grey with a surrounding area of redness, and as frostbite progresses, blisters may form and

the skin will feel hard, waxy, or numb.

Who is at Risk?

While anyone can potentially develop frostbite, both the very young and the elderly are at particularly high risk and should take special precautions to prevent over-exposure in cold environments. In addition, athletes with medical conditions such as diabetes or heart conditions can be at increased risk due to decreased blood flow to the skin.

How Cold is Too Cold?

Generally, the risk of frostbite is low when the outside temperature is above 14°F (-10°C), but that risk can go up significantly with prolonged exposure, increased elevation (>17,000 feet), and increased wind speed.1

How Do You Treat Frostbite?

Preventing injury begins with protection from the elements, which requires getting out of the cold as soon as possible and replacing all wet clothing with dry, warm, insulated layers. Immobilizing the extremity to prevent

damage to the cold, stiff skin and muscles can prevent further injury. Once inside, rewarming the affected extremity should be done rapidly by immersion in a warm water bath at 104°–107.6°F (40°–42°C) for 15 to 30 minutes until thawing is complete.1,2 If warm water is not available, body heat can be used to rewarm the hands or feet, such as tucking them in your armpits. When successful, the skin becomes soft and pinkish again. Avoid rubbing or massaging the skin to avoid damaging the skin or rupturing blisters.

An Ounce of Prevention

While outdoor winter sports provide an excellent opportunity for physical exercise and competition, they can be dangerous if athletes are not properly prepared. Useful tips to help prevent frostbite include:

Check weather forecasts to prepare for inclement weather or avoid extreme weather.

Wear adequate clothing to protect from the cold and wind—dressing in loose-fitting layers, including fabric that wicks away body moisture and sweat is best.

Cover exposed skin with gloves or mittens, a hat, scarf, and face mask, if needed.

Minimize alcohol consumption and tobacco use.

Stay active! Physical activity maintains core body temperature as well as increases blood flow to the hands and feet.


1. Golant A, Nord RM, Paksima N, Posner MA. Cold exposure injuries to the extremities. J Am Acad Orthop Surg. 2008;16:704-15.

2. McIntosh SE, Hamonko M, Freer L, Grissom CK, et al. Wilderness medical society practice guidelines for the prevention and treatment of frostbite. Wilderness Environ Med. 2011;22:156-66.



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Custom Knee Brace Article Georgian Life

Darryl Novotny BScPT, Registered Physiotherapist at Orthopaedic Sport Institute has written an article for Georgian Life December issue about custom knee bracing.

As winter looms and the ski hills are blanketed in snow, many people are reminded that their knee pain may limit, or even stop, their participation in snow-related sports.

Many individuals have been diagnosed with osteoarthritis (OA) of the knee – this is characterized by a loss of the protective cartilage at the end of each bone in your joint, usually more on one side of the knee than the other.  OA generally occurs due to gradual wear and tear of a joint over decades of physical activity, but can also be caused by an injury.

For those situations in which surgery is not yet an option, conservative treatments of OA-related conditions can include:

  • Physiotherapy: OA-symptoms are often related to joint stiffness and weakness of muscles surrounding the affected joint.  Physiotherapy treatments should be directed towards restoring as much motion and muscle strength as possible.
  • Pain relieving modalities: Regulated healthcare practitioners can provide treatments directed towards relieving the symptoms.  These options often include muscle stimulation units, laser, ultrasound and analgesic creams.
  • Oral anti-Inflammatories (NSAID’s)
  • Cortisone injections: This treatment can help many people diminish or even eliminate their symptoms for an extended period of time
  • Hyaluronic Acid (HA) injections: This involves an injection of HA directly into the joint to improve the amount of lubrication in the affected knee joint

While these interventions are sometimes successful, patients do not always experience 100% relief and, as a result, regular physical activity becomes increasingly limited and painful.  The development of Custom OA Knee Unloader braces have led to another non-invasive, drug-free solution for people suffering from knee OA.  These lightweight braces are designed to reduce pressure on the side of the knee that has worn down.  Once fitted, these braces are easy to don and, due to their low-profile build, can easily fit underneath your outdoor skiwear.

For further information on treatment options, please contact the Orthopaedic Sport Institute at (705) 467-0701 or and ask for a consultation with one of our friendly healthcare professionals.  Let us help get you back onto the ski hill!





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