Winter Sports and Your Feet
It’s been an epic season of one powder day after another, but the mountains here in Colorado have also experienced some of the coldest days on record. With temperatures this cold, and without the proper protection, any outdoor activity can be a potential health risk. Fortunately, using some common sense and taking some simple precautions can help avoid many of the more serious cold-related injuries.
What can happen?
In conditions of prolonged cold exposure, your body sends signals to the blood vessels in your legs and feet telling them to constrict in order to preserve blood flow to your vital organs. This helps the body by preventing a further decrease in internal body temperature by exposing less blood to the outside cold. As this happens, your toes and fingers become colder and colder eventually leading to injury of the involved tissues.
In mild cases where the exposure is limited, swelling and redness of the tips of the toes may be seen. If the area remains chilled, then numbness, tingling, itching and pain may also occur. With increasing exposure to cold, frostbite may occur where regions of the tissue may appear white and frozen. After prolonged exposure the deeper tissues may be injured, and eventually all sensation is lost. Swelling and blood-filled blisters may be seen with a waxy, yellowish appearance to the skin. The injured tissue often turns a purplish blue as it rewarms and may even appear blackened and dead. Frostbite is a serious condition and anyone who develops symptoms should seek professional medical treatment immediately in order to prevent infection, gangrene and possible amputation.
Who’s at risk?
Obviously, anyone who spends much of their day working (or playing) outdoors during the coldest months of the year, is more likely to develop problems. People who have diabetes or circulatory disorders are at increased risk of developing cold-related injuries. Also, if you have had a previous cold injury, the chances of developing another injury to same tissue are increased.
For some people, the temperature does not have to drop that far in order for injury to occur. A condition known as Raynaud’s phenomenon can cause excessive constriction, or spasm, of the blood vessels in the toes and fingers, even with modest exposure to cold. Patients with the condition will notice toes suddenly turn white, then blue, becoming cool to the touch and eventually numb. As the attack subsides, usually in a warmer setting, the areas will flush a deep red and may tingle, throb or itch. In the most severe cases, prolonged disruption of circulation can lead to small, painful skin ulcers at the tips of the toes. Raynaud’s phenomenon can be related to other medical conditions, so if you have any of these symptoms consult with a physician.
What to do?
If you are exposed to excessively cold temperatures and feel that you may have suffered an injury, several steps can be taken to avoid further harm and to speed recovery. First, never rewarm an affected area if there is any chance it may freeze again. This thaw-refreeze cycle is very harmful and can lead to disastrous results. Avoid a gradual thaw; the most effective method is to rewarm the area quickly in water that is 101 to 104 F. Do not rub or massage the frozen area as the friction will only cause further tissue damage. Above all, keep in mind that the amount of tissue destruction is proportional to the time it remains frozen, not to the absolute temperature to which it was exposed. Therefore, getting to a warm area and seeking medical treatment as soon as possible is most important.
Although people don’t always acknowledge the dangers, many of them can be reduced or prevented. Dressing in layers keeps your body core warmer and helps to prevent the shifting of blood away from your extremities. Socks made of synthetic fibers such as acrylic and polyester blends are excellent at wicking moisture away from the skin. Battery powered boot heaters for ski and snowboard boots are essential for anyone with a tendency toward chilly toes. Avoid smoking, caffeine and alcohol as all of these can lead to decreased blood flow to your extremities. Supplemental Niacin, also known as vitamin B-3, causes blood vessels to dilate, increasing blood flow to the skin and may be helpful for people with Raynaud’s phenomenon. For patients with severe Raynaud’s there are prescription medications that may be helpful.
If you have to be outside when it’s below freezing because the job demands it, or because the powder is calling, taking these precautions can help you avoid a potentially serious cold injury.