If you haven’t heard of the term “FOOSH,” that’s probably a good thing. It stands for “fall onto an outstretched hand,” and it’s the most common cause of hand and wrist injuries year-round—usually as the result of a slip and fall. But the risk can be higher in winter months, says Nick Maroldi, DPT, Director of the Hand and Upper Extremity Therapy Center at HSS. That’s when he and his team see more wrist fractures among the general public (from sliding on ice) and athletes (particularly snowboarders because of the way they tend to fall).
Fortunately, some such injuries are avoidable, and they’re highly treatable if they do happen. Here’s what Maroldi wants you to know about keeping your hands and wrists safer this season.
Even if you’re just strolling in the city, it’s vital to match your footwear to the conditions. During the colder months, Maroldi suggests starting with some well-fitting low-heeled footwear with a good tread, or going the extra mile and adding crampons if you’ll be walking on even a little bit of ice or snow. Crampons are traction devices that easily slip over the bottom of a shoe to give the soles some extra grip. Though there are spiked versions for serious slogging through snow and ice (think winter hiking), Maroldi recommends the spring-style crampons for everyday use (like clearing snow from your driveway).
It’s true that those loops on the ends of ski poles were made to slip your wrists through, presumably so you don’t lose your gear if you take a spill. However, Maroldi says that using them this way may put you at a greater risk for something called skier’s thumb. If you fall, your thumb can get caught on the loop, which can overstretch the joint or cause a ligament to tear. (Other activities, such as basketball, are also associated with this type of injury.) Depending on the severity, skier’s thumb can be treated with rest, ice, compression and elevation (RICE) and a custom-made splint or it may require surgery. So just to recap: Don’t use those loops.
Like any type of exercise, shoveling should be performed with proper body positioning to avoid injury. Heavy shoveling can irritate the tendons at the base of the thumb. This can lead to painful conditions including intersection syndrome (which hurts a few inches above the wrist) or de Quervain’s tenosynovitis (which causes pain along the wrist’s edge). To avoid these problems, Maroldi recommends keeping your wrists in a neutral position (not bent or extended) while lifting anything, whether that’s a shovel, a dumbbell or a jug of detergent.
“Shoveling shouldn’t require much movement of your arms,” he adds. “You should be lifting with your legs and turning and placing the snow to the side, not slinging it.” Also tackle the task a little bit at a time and take frequent breaks to give your wrists a rest.
These modern machines can help you avoid shoveling-related injuries. But they come with their own set of safety precautions. Maroldi recommends reading the product manual in full, but he also highlights a key point: Never stick your hand in the snowblower blades. If the snowblower is jammed, clearing the jam—even if the machine is off—can cause a release of tension built up in the auger, which means you can still get hurt. Use a broom or shovel handle or other object rather than your hand and arm when working on or clearing out the blades or the chute where the snow blows out.
If you’re a new participant in a winter sport such as snowboarding where falling is a common risk, take lessons with an expert and ask for direction on how to position yourself if you take a tumble. “A good instructor can teach you how to tuck and roll in a way that will allow your shoulder and back area to absorb the force,” says Maroldi.
Also wear any protective gear the instructor recommends, and make sure it all fits well and is in good condition. It’s less annoying to wear a helmet and padding for a day than a brace or a cast for a month or more.
If you do happen to suffer a wrist or hand injury, it can be tough to tell if it’s fractured or just tweaked. Of course, if emergency care is warranted (or you’re afraid it might be), don’t hesitate to seek it right away. As with most other types of health issues, the sooner a hand or wrist injury gets treated professionally, the better the outcome is likely to be.
Otherwise, if the injury isn’t urgent but you’re not better after a few days, seek guidance from a hand and wrist specialist, says Maroldi. Wrists are complex joints that get a lot of use, so it’s vital to put them in good hands when they’re hurt. For example, his team makes customized splints by molding softened thermoplastic to the patient’s hand for a perfect fit. “This provides better fit, more comfort and more stability,” he says. “Most of the over-the-counter braces don’t provide enough support for injuries like skier’s thumb, so it’s important to see a hand specialist.”