Orthopedic surgeon Dr. Kim Stimpson offered some simple advice for skiers and snowboarders to avoid meeting him or his colleagues in a professional setting.

“If you’re going to fall down, fall down,” he said. “Stay down. Don’t try to get up until you’re finished.”

Stimpson, of Northwest Orthopedics and Sports Medicine, was the featured speaker at one of a series of educational sessions at Kalispell Regional Medical Center for medical professionals. His topic, “Common Skiing and Snowboarding Injuries,” provided some jarring statistics about the trail of banged heads, dislocated shoulders, broken wrists and mangled knees coming off America’s ski slopes.

A little more than half a million people get injured in the United States each year with some groups more at risk than others.

“From a gender standpoint, females have a higher incidence of ski injuries than males,” Stimpson said. “Children are more often injured than adults and males are more often severely injured.”

When it comes to specific injuries, men and women skiers have equal opportunity when it comes to anterior cruciate ligament or ACL injuries of the knee. Stimpson said women have slightly more medial collateral ligament or MCL knee injuries.

“We like to say that maybe it’s the size of the ligament — women are usually lighter,” he said. “There’s some sexist idea about the strength involved in all this. Women, in fact, may be more susceptible to equipment issues that have a relationship to skiing injuries.”

Young people have more tibia (shinbone) fractures, according to Stimpson, even though these injuries are on the decline in other groups. He attributed the reduction to better equipment design and pointed out that youths often use hand-me-down equipment.

“Frequently, it doesn’t fit quite right and they tend to get older boots and older bindings,” he said. “All the old equipment seems to be related to more injuries.”

When it comes to skiing versus snowboarding, the latter have a few more injuries. Snowboarders have more upper extremity injuries, especially the wrist, while skiers injure their lower extremities more often.

“Snowboarders are two times as likely to have a fracture when they get hurt,” Stimpson said. “Twenty-five percent of snowboarding injuries are fractures compared to 12.5 percent of ski injuries.”

Deaths do occur, but rarely in both with just .73 deaths per million skier/snowboarder days. Surprisingly, most deaths occur on groomed runs at speeds of 20 to 40 miles per hour.

“There have been 12 reported ski-lift deaths from 1973 to 2006, so the ski lift is not the safest place to be, either,” he said.

On the positive side, Stimpson said trends show fewer ankle, shinbone and thumb injuries. But clavicle (collarbone) and ACL injuries have trended up.

Head injuries also have grown in spite of an increase in helmet use.

“We’re not quite sure why,” he said. “Maybe we think we can ski harder, more dangerously when we have a helmet on.”

The surgeon connected the dip in ankle and shinbones to higher boots and improved bindings in use today.

But saving some parts of the anatomy comes at the expense of another during falls.

“This has a relationship to the amount of knee injuries we are seeing,” he said. “The force has to be dissipated somewhere and it tends to climb up the leg to the knee.”

Skiers also risk damaging the ligament of the thumb, creating what was once known as gamekeeper’s thumb but now is known as skier’s thumb. It makes up 8 to 10 percent of all skiing injuries and could result in a brace for mild injuries or surgery in the worst cases.

Stimpson said it usually happens when a skier falls with the thumb catching in the ski pole strap.

“There’s actually a correct way to put this strap on,” he said. “Don’t go up through the strap; go down through the strap. For those who are extremely fearful, don’t use the strap at all and run the risk of losing your pole.”

Snowboarders score more shoulder damage, at 15 percent of all their injuries compared to 10 percent  for skiers. They suffer rotator cuff tears, shoulder dislocations, separations and fractures.

Stimpson said most of the injuries are secondary to falls or collisions.

“Typically, falls directly to the shoulder result in AC separations or possible clavicle fractures or proximal humerus (shoulder) fractures,” he said. “They can also occur when we fall on our elbow or our wrist and force is directly transmitted to the shoulder.”

Add an external rotation into the same scenario and a snowboarder may leave the slopes with a dislocated shoulder. Stimpson advised treatment sooner rather than later for a less complicated and less painful relocation.

“Surgical repair of shoulder dislocation is something we don’t do terribly often except in young patients,” he said. “Those in their teenage years, early adult life up through 30 have a fairly significant incidence of recurrence of instability.”

Along with faulty equipment, Stimpson said accidents often happen due to going off trail, participating above ability level, ignoring posted warnings and codes of conduct. Fatigue and dehydration also play a role in putting skiers on crutches and snowboarders in slings.

“I take myself as an example. I don’t pay much attention to dehydration when I’m on a mountain,” he said. “And the fatigue; we always get injured on the last run of the day.”

 Reporter Candace Chase may be reached at 758-4436 or by email at cchase@dailyinterlake.com.