What is better for my feet and ankles: Skiing or Snowboarding?

This is more of a question we get when we’re with family or at a party and it comes up that we know feet. While this is a more subjective question, we can use data to back up the answer. With advancement in ski boot technology, foot and ankle injuries and acute trauma are rare. If there is a fracture while on the mountain, it is likely a boot top fracture. These fractures are higher up on that tibia, above the ankle joint. Snowboarders, however, with softer boots and often higher velocity injuries, do develop ankle and foot fractures. These are usually fractures of the talus or fractures around the Lisfranc joint. On a smaller level, because ski boots are often much tighter and less forgiving, we see more chronic, repetitive trauma in skiers. This presents as nail thickening or bleeding under the nails. So, on a day-to-day basis, snowboarding is probably better, however, with acute injuries, snowboarding can lead to worse consequences.

My feet get really cold in the winter. What should I do?

Most of the time this is as simple as dressing warmer. Our body reacts predictably to cold; the small vessels of our feet and hands are supposed to close down when we are cold, to maintain our core temperature and protect vital organs. Some people, however, have more reactive vessels than others. This makes the feet more susceptible to cold injury. To prevent this, simple things like dressing warmer all over and taking a baby aspirin can help. I also recommend people avoid mild stimulants like nicotine and caffeine to try and prevent these vasospasms as much as possible.

Are hockey playing and ice skating ok on the feet?

We see plenty of injuries and chronic conditions in ice skating athletes every winter. Often, these present as pain over bony prominences, such as tailor’s bunion or arch pain. They can also cause painful nail problems, like ski boots. Feet that are in ice skates are among the most “beat up” appearing feet we see. This is usually just due to tight shoes, that should probably be worn a little bit less snug. Along with these foot problems, we can see an increase in ankle injuries because of how elevated the foot is off of the ground. It is important to strengthen the peroneal tendons, and ankle stabilizers in general, to prevent ankle sprains.

What should I do about my painful toenails in my ski boots?

Ski boots need to be tight to get the best performance out of them, but this does not mean they need to be painful. If the toenails are hurting, it is because there is too much pressure on them and you often need to be sized up to prevent long term nail damage. Keeping toenails cut short will also help.

My toe is red and infected looking after skiing. Did my boots cause this?

Ingrown toe nails are not caused by the ski boots themselves, but the problem is exacerbated by pressure from the boot on the nail. Often, this pressure causes the nail to cut into the skin, which can lead to infection. When this occurs, we will numb the toe up and remove the overgrowth of the nail.

It looks like I have blood under my nail. This isn’t a big deal, right?

Generally, no, but they can be worse than they look. These subungual hematomas, or blood under the toenail, are a sign of chronic sheer trauma from shoe gear. Most of the time up here in the mountains we see them in people with excessive tight boots or rental boots. The treatment is straightforward, where we often have to put a hole in the nail to drain the blood. This is easier than it sounds, so no need to worry. We do usually have to get x-rays too, just to rule out any underlying fracture, which could escalate the simple hematoma to an open toe fracture.