Cracked Cartilage and Broken Bones, Oh My!

This article does not offer any medical advice or diagnostics, but aims to offer insight on skating injuries for interested readers. We do our best to ensure our discussion is accurate and based in research, but we are open to corrections via Twitter or Tumblr. Please be aware that we will be discussing injuries in explicit medical detail, which can be triggering to some readers.

Given the high frequency of injuries in the sport, there were many common injuries we were unable to cover in our podcast episode. This article outlines some more common ones and provides case studies as examples.

There are two basic types of injuries that skaters (and athletes in general) can face:

  • Overuse injuries, also known as stress or chronic injuries, are caused by the repetition of minor trauma, such as training jumps or throws.

  • Acute injuries are caused by a single traumatic incident, such as falling badly or colliding with the boards or another skater.

Overuse injuries are the most common type of injuries in most sports. Overuse injuries in figure skating tend to affect:

  • Connective tissue: Cartilage (stiff, squishy tissue that cushions between joints), ligaments (fibers that hold bones/cartilage pieces together), and tendons (fibers that connect muscles to bones) are all prone to injury, especially in the ankles and knees, which bear the brunt of the impact of landing a jump. For a triple or quad jump, the skater’s landing joints takes five to eight times the skater’s body weight, which is near the maximum amount of force ligaments can bear.

  • Bones: In our episode, we discussed metatarsal stress fractures, which break the bones in the middle of the foot. However, skaters can develop stress fractures in any bone throughout the body that develops microtears. Even the lower back can be damaged by skating, damaging the vertebrae (bones in the spine) or the gel-filled discs that cushion the vertebrae and nerves of the spine.

Many skaters are known for dealing with various overuse injuries, including:

  • In 2010, Vincent Zhou said he started feeling increasing pain in the back of his right knee, but attributed it to a relatively common condition called ‘jumper’s knee’ or patellar tendonitis, an inflammation of the tendon that connects the patella (kneecap) to the tibia (lower leg bone) in the front of the shin. He described it as “skating in constant pain.” After a few years of skating like this, his doctors found it was actually a bucket handle tear of the lateral meniscus, the cartilage disk on the outside of his knee. This tear rips open the interior of the meniscus, hollowing it until it resembles an empty oval, hence the name. He underwent surgery in 2016, but the tear was discovered to be too large to repair, so his lateral meniscus was completely removed.  In Vincent’s case, this injury was most likely caused by training hard at a young age, before his ligaments and bones were developed enough for them to be able to withstand the force of his triple and quad jumps.

  • Wenjing Sui has had ongoing issues with her ankles and feet. As a pairs skater, she lands with even more force than ladies’ singles skaters, as throw jumps are higher and more forceful than self-propelled jumps. Due to constant wear and tear, her right ankle ligaments had become overused, unstable and prone to twisting. In 2016, she underwent surgeries to correct her injuries, including a reconstruction of her right lateral collateral ankle ligament (the ligament that connects the protruding ankle bone to the foot and shin bones) and repair of her left ankle tendon and ligament (which hold her foot and leg muscles and bones together), which needed nails to set the ligaments as they healed. She also had necrotic (dead) bone from the inside and outside of her foot removed. Bone dies when trauma to the region limits blood flow. This procedure left her with a lengthy five-month recovery period.

  • In 2000, Tara Lipinski underwent surgery for a hip cartilage tear. At the time, a family spokesman said that “the injury is not career-threatening.” However, the injury had been ongoing for seven months, progressively worsening until she could barely walk for fifteen minutes without pain, or even get out of bed. Later, she said that she knew that her career was over when she heard the diagnosis. She had been performing multiple routines five nights a week for Stars on Ice. Less than a month after the surgery, she tried to rehearse, but couldn’t even perform the simple maneuvers. She has never admitted that she suffered any pain beyond “the norm for any athlete”, nor that her injury was due to her repeated triple loop combination practices (she was known for her 3Lo-3Lo).

  • Satoko Miyahara’s hip injury first caused her pain at the Grand Prix Final in December 2016 and supposedly required four weeks of rest initially. Her team watched her closely, and she ultimately decided not to risk further injury, withdrawing from 2017 Worlds to properly rehabilitate for the upcoming Olympic season. She spent a month in rehab, but when she resumed on-ice training in May 2017, she encountered several roadblocks: a sprained left ankle, bone bruises, inflammation in her right pelvic girdle, and illnesses. As a result, she could practice no more than 10 jumps per day. Satoko returned to competition in November 2017, when jumps no longer caused her as much pain.

  • Yuna Kim was diagnosed with a herniated spinal disk in January 2007. When a disk herniates, the membrane holding the disk together cracks, allowing the fluid filling the disk to leak out, which puts pressure on the spinal cord and causes immense pain. Prior to 2007 Worlds, she could only skate for 20 minutes at a time due to the pain. This pain lasted for years, requiring Yuna to eliminate skating elements such as the Biellmann spin and the triple loop jump to mitigate the pressure on her back. Yuna said herself that this injury was caused by fatigue and overuse, rather than one bad accident or fall.

Acute injuries often occur during a bad fall. In these instances, a single force is too much for a (likely already stressed) joint, and it gives way. Of the many examples of acute injuries, here is a short list of notable cases:

  • During a practice in September 2014, Kaetlyn Osmond swerved to avoid a collision with another skater. Her blade caught in the ice and she fell, fracturing the fibula in her right leg. She underwent surgery and was off the ice for six weeks with screw and plates in her leg, which then needed more surgery to be removed. She eventually took the whole season off to focus on intensive physical and psychological rehabilitation, and returned to competition in the 2015-2016 season.

  • At the 2016 US Championships, Nathan Chen suffered an avulsion injury to his left hip. The gala was only a few hours after the free skate, and Nathan had no time to warm up before it began. On his first jump in his exhibition skate, a triple toe, a bad takeoff injured his left hip, tearing a piece of bone away from his pelvis. He attempted to continue, but had to stop after fifteen seconds to be hospitalized and ultimately go through surgery. Avulsion injuries are more common in adolescents, whose growth spurts make bones weaker and more prone to injury, and are often associated with forceful knee extension and hip flexion, such as during a jump.

  • Alexei Krasnozhon fell on a quad salchow in his free skate at the 2018 World Junior Championships. His right foot appeared to catch on the toe while landing and he landed forwards prematurely. He was visibly limping, carrying his weight on his left leg before stopping his performance after a few seconds. He was diagnosed with a Grade 2 ankle sprain, a large but incomplete tear of a ligament in his ankle.

  • In the episode, we discussed the Dubé/Davision pairs incident, in which Jessica Dubé’s face was cut by her partner’s blade during side-by-side camel spins. The same happened to the team of Elena Berezhnaya and Oleg Sliakhov. Practicing the same move in 1997, his toe pick caught the left side of her head, cutting through two inches of her skin and cracking her skull. She needed surgery to clean her skull of bone debris, and sustained brain damage that left her with difficulty speaking and partial paralysis on her right side. This incident resulted in the breakup of her partnership with Sliakhov and led to her eventual partnership with Anton Sikharulidze.

These injuries can be devastating to skaters, hindering their progress, forcing them to withdraw from competitions, or even pushing them into early retirement. If you’re interested in the rehabilitation process after an injury, or curious to hear what we have to say about the pervasive attitudes within the sport of figure skating that foster injuries, you can find this information and more in our podcast episode from last week.

(Header image source: Kaetlyn Osmond, Twitter @kaetlyn_23)