One million Americans are injured due to falls each year, according to the Centers for Disease Control and Prevention, and the risk increases during the winter months. Falls on snow and ice can cause a variety of injuries, from minor scrapes, bumps and bruises to more serious injuries such as broken bones and back injuries.

Dr. Richard Wendt, an orthopedic surgeon at OrthoKansas, knows all too well that falling on the ice can cause major pain. He was injured once while walking to his car on an icy day.

“My wife had called me at work and warned me how icy it was outside, so I was being very cautious. As I got closer to the car, I thought to myself that I needed to grab hold of it so I didn’t fall,” he said. “As I reached for the door, my feet went out from under me and I landed on the outside of my hip and fractured my pelvis.”

Wendt’s fracture didn’t require surgery but he wasn’t able to apply weight on his hip for nearly three months. If he had needed surgery due to a separated joint, recovery would have taken three to six months and involved plates and screws. The possibility of long-term degenerative changes might also lie ahead.

Common fall injuries

After a fall, you might panic and brush it off, but slips and falls can be serious. Injuries commonly seen due to falls include:

• Bumps, scrapes and bruises

• Extremity fractures, including the ankle, arm and hip

• Back injuries

• Head injuries, such as concussions

“Distal radius (wrist) fractures are the number one injury I see, but people can have upper-extremity injuries anywhere from the fingertips to the collarbone,” said Dr. Neal Lintecum, an orthopedic surgeon at OrthoKansas who specializes in hand, wrist and arm care. “Anyone from children to the elderly fall and catch themselves with an outstretched hand, causing a break.”

Wendt, who specializes in lower-extremity conditions, said he most regularly deals with people who have fractured ankles and hips. Injuries such as sprains and strains may also result from a fall on the snow and ice.

“Younger people generally handle falls better than those who are older,” he said. “And of course, other issues such as ACL or MCL injuries occur, but they just aren’t as common.”

Back injuries

Back injuries, including sprains and strains, are also a common occurrence after a fall. Monica Hart, a nurse practitioner with Lawrence Spine Care, said time is your best friend with a back injury.

“While there can certainly be more serious injuries such as compression fractures or herniated discs, it’s important to know that many issues will get better with time,” she said. “If you just strain your back, meaning you have localized pain that doesn’t go down the arms or legs, you can use conservative treatments including NSAIDs such as Advil or Aleve, ice, heat and massage.”

Hart also said that movement is key. Avoiding activity may cause your pain to stick around for a longer period of time.

“You need to get up and move as soon as you can,” she said. “The less you move around, the longer you can be in pain, so it’s important to have no more than three days of bed rest.”

What to do after a fall

If you’ve just fallen, the first thing to do is compose yourself and assess your injuries. You may just be sore and need to call your primary care provider.

“If you have bruises or an extremity that’s just sore and swollen, wrap and ice the injury and call your doctor in the morning,” Lintecum said. “You can avoid a visit to the (emergency department), and that’s safe and reasonable.”

If your injury is more serious, it’s time to head to the emergency department. Emergency departments see sprains, strains, broken bones and head injuries related to wintry weather each year.

“There are definite reasons you should head to the emergency department following a fall,” said Kenna Young, LMH Health trauma coordinator. “If you can’t bear weight, move the extremity or have an obvious deformity, you need to be seen urgently. If you fell and hit your head, lost consciousness and are on blood thinners, you also need to get checked out.”

If you’ve got a bump and a mild headache, it may be best to call your primary care provider for advice. But if you experience seizures, worsening headache, repeated vomiting, blurred vision or confusion following a blow to the head, visit the emergency department right away.

Treatment

There isn’t a one-size-fits-all approach to treating injuries suffered from a fall. It will really depend on the kind of injury that occurred and its severity. A bruised tailbone, while very painful, won’t require the same level of intervention as a compound fracture of the leg. If you don’t have an emergent injury that’s caused you to head to the emergency department, start by calling your doctor.

“If the pain is more than you can handle on your own, your primary care provider may prescribe NSAIDs, a short course of pain medication or even injections to control your pain,” Hart said.

You might also be referred to a specialist such as OrthoKansas for additional evaluation. At your first visit to a specialist, expect to have X-rays taken so your provider can rule out a fracture or other structural injury.

“Soft tissue injuries, such as a ligament tear, are a possibility with falls,” Lintecum said. “We need to rule those out since they may require surgery. If we don’t see those or a fracture and everything looks good, we’ll treat your symptoms.”

The treatment course will depend on your age and a number of other factors, including the severity of the injury, activity level and other demands. Surgery to correct your injury may also be a possibility, though it’s not always the first line of treatment. It’s important to remember that your doctor will exhaust conservative treatment options, such as medication and physical therapy, before determining whether surgery is appropriate for you.

“You may receive a brace or splint and may need physical therapy, whether that’s to improve your extremity or to show you how to use them as in the case of crutches,” Wendt said.

Upper-extremity injuries that require surgical intervention or extended casting may become stiff and need formal therapy to correct. Jamie Starcevich, a certified hand therapist at the LMH Health West Campus, said it’s all about restoring functionality.

“In an orthopedic setting, we’re trying to get strength, mobility and function back for people who’ve had injuries to the shoulder, elbow, wrist and hand,” she said. “We see people who’ve had fractures, tendon injuries, localized nerve injuries like carpal and cubital tunnel syndrome, tendonitis, repetitive strain and injuries where muscles, joints or nerves have been disrupted.”

There’s not a one-size-fits-all plan for therapy patients. The length of the treatment depends on your type of injury, treatment plan and timeline for healing.

“We may see post-operative patients right away, work with them frequently as they begin to heal and wean those down as they begin to do more on their own at home,” Starcevich said. “Patients who have fractures may not be able to do as much in the beginning, so we ramp up the frequency of their visits with time.”

Preventing falls

Fall prevention is important no matter the time of year, but especially during inclement weather. If you don’t need to go out when it’s slick or icy, stay home. When you do have to venture out, be alert, pay attention and follow these safety tips:

• Don’t be in a hurry. Use caution and slow down.

• Wear shoes that fit well and offer proper traction, and consider using grips such as Yaktrax. Avoid high heels and dress shoes with slick soles.

• Sprinkle sand, salt or de-icing products on walkways that may become slick.

• Walk on the grass instead of on sidewalks. If you have to walk out to the mailbox, avoid the driveway.

“Be doubly careful if you’re walking the dog,” Wendt said. “If they take off after a squirrel and you’re standing on ice, you’re in trouble.”

It’s also important to care for your neighbors, especially those who are elderly or disabled.

“Clean their sidewalk, take the trash out or do their shopping when the weather is bad,” Lintecum said. “Help by minimizing their exposure to inclement weather as much as possible.”

— Autumn Bishop is the marketing manager and content strategist at LMH Health, which is a major sponsor of the Journal-World’s Health section.