Bracing for Winter: System Providers Urge Caution to Prevent Seasonal Injuries

Al and Laura Williams enjoy being outside. In upstate New York, that meant winter weekends with adventures snowmobiling or skiing. One clear, cold morning, the couple headed out with friends on a short ride near Clifton Park.

A few miles into the woods, the snowmobile malfunctioned and the couple rapidly accelerated, striking a large oak tree. Al was thrown into the tree, breaking his pelvis and dislocating both legs. Laura was unconscious and slumped over the snowmobile, bleeding uncontrollably.

Both were taken to Albany Medical Center, where they underwent emergency surgeries: Al for his pelvis, and Laura for numerous facial fractures, and head and eye trauma.

Last month they celebrated their 39th wedding anniversary in Florida, where they now live, healthy, and grateful for the care they received two years ago.

“Snowmobile accidents do a lot of damage—people are going really fast and there is not a lot of protection,” said Richard Uhl, MD, chair of Albany Medical Center’s Department of Orthopedics.

As an orthopedic surgeon, Dr. Uhl expects specific winter sports injuries in patients every year. “Skiers have their own set of injuries,” he said.

Skier’s thumb, which happens when a skier falls and lands on their outstretched thumb, disrupting the ligament on the inside of the thumb, often needs surgical repair. “As ski boots have gotten taller and more secure, injuries have gone further up the leg. We used to see injuries to the ankle, but now people blow out ligaments in the knee or ACL due to twisting.”

He advises all skiers to wear a helmet.

Being at the southern edge of the Adirondack Park, a destination for vacations and recreation in all seasons, Glens Falls Hospital is well prepared to treat outdoors-related injuries. Douglas Girling, DO, is the director of the Glens Falls Hospital Emergency Department.

“As a community hospital, we are often the first stop for these recreational injuries, many of which we are equipped to handle,” Dr. Girling explained. “However, a patient may be transferred to Albany if they have a specific requirement or critical trauma that may need a more intense level of care. This is the great thing about our System.”

As the region’s only Level 1 trauma center and anchor of the Albany Med Health System, Albany Medical Center provides comprehensive trauma services and offers a wide range of specialists and surgical services 24/7.

The Albany Med Health System’s Trauma Program is part of a network of more than 400 emergency medical service provider organizations and hospitals in a 17-county area, and also coordinates community and professional education programs on injury prevention and outreach.

“Regardless of the season, the weather, or the holiday, our trauma team cares for the most complicated cases and urgent surgical needs,” said Kurt Edwards, MD, chief of Trauma and Surgical Critical Care at Albany Medical Center. “Working with our community hospital partners we ensure that they get the most timely and appropriate level of care as close to home as possible.”

System physicians also respond to emergency situations on location and treat patients in the field—for example addressing injuries while extricating a patient from their vehicle after an accident.

Some injuries are permanent. Dr. Girling warns of dangers with snowblowers.

“Do not unblock a clogged snowblower with your hand—use a clean-out tool, a stick, or a pole,” he urged. Even with the engine or electric motor turned off, a stationary auger and impeller can still have significant tension. “Fingers are lost every year.”

For those who prefer shoveling instead, the American Heart Association cautions that the physical activity places extra stress on the heart, especially if you do not exercise regularly.

“Cold air that constricts blood vessels, plus poor circulation due to standing still, and then lifting heavy loads with your arms—shoveling snow is incredibly demanding on the heart,” said Nicoleta Daraban, MD, medical director and chief of Cardiology at Saratoga Hospital. “This is compounded in people who have heart disease, those with sedentary lifestyles, smokers, or those with obesity or high blood pressure. It’s important to listen to your body, pace yourself, and take breaks. If you start to experience chest pain, lightheadedness, or heart palpitations, stop immediately.”

If resting doesn’t cause relief, she said seek medical attention.

While shoveling, it is also important to be mindful of your exposure to the cold: frostbite can occur quickly.

“The combination of lower temperatures, higher winds, and time can hit a threshold that the skin can no longer tolerate,” said Dr. Uhl. Uncovered skin is most susceptible—fingers, toes, ear lobes, and the nose. Smokers have an increased risk, and alcohol can also cause problems—particularly if someone over-imbibes and falls asleep outside.

“The good news is that you can get some pretty bleak-looking frostbite and end up doing pretty well,” he said. To treat frostbite, you want to warm the extremity as quickly as possible, but within the limits of pain tolerance. “You have to wait and see how the body responds. Sometimes you do end up losing fingers or toes.”

While snow clearing and winter recreation can cause injuries, Dr. Girling cautioned, “The biggest culprit in winter injuries is a slip on the ice.”

Falls can result in broken wrists, collar bones, and hips. Dr. Girling urges people, particularly older people who may have balance issues or osteoporosis, to put cleats or spikes on their shoes. “A quick walk to get the mail can end with a life-changing hip fracture,” he said. “Simple things can be done to decrease the risk.”