“The disease of cancer used to be terminal,” explained Jason Chesney, director of Brown Cancer Center. “Today, most of our patients are living long lives because of the treatment we offer. It’s a dramatic change.”

The Brown Cancer Center (BCC) first opened in 1981, four years after the Regional Cancer Center Corporation (RCCC) raised nearly $12 million for its construction and operation. At the time,  took care of about 50 patients a day. Today, they care for over 500 patients per day. The number of oncologists has grown from seven in the early 1980s to nearly 80 now. As late as 1999, BCC hosted four clinical trials. In 2022, there are more than 130 open clinical trials. In addition to patient care, more than 65 University of Louisville faculty investigators conduct basic and translational research to find new and better ways to prevent, diagnose and treat cancer.

“Certainly, much has evolved in the science and technology of cancer treatment after 40 years, and I’ve enjoyed seeing the depth of talent develop in many specialties of oncology,” said Henry V. Heuser, Jr., an RCCC board member who helped lead this effort alongside several other architects of change, including Lt. Gov. Wilson Wyatt.

The Brown Cancer Center offers dozens of services, including treatment for breast cancer, endocrine cancer, gastrointestinal cancer, lung cancer, bone cancer, skin cancer and more. In 2021, the Brown Cancer Center expanded its services to UofL Health – Medical Center Northeast and UofL Health – Mary & Elizabeth Hospital, further opening up access to treatment for patients.

Forty years ago, the Louisville community came together to ensure local cancer patients did not have to travel to get the best possible cancer treatments. In a state with some of the highest rates of cancer and cancer deaths, Kentuckiana made a considerable investment to create an academic cancer center that would lead the charge in the war on cancer and educate the next generation of oncologists and cancer researchers.

“The Brown Cancer Center has a remarkable legacy but, most importantly, it is positioned to dramatically shape the future,” said Tom Miller, UofL Health CEO. “Of all the cancer teams I’ve worked with across the country, this group of clinicians and researchers is the most dedicated I’ve seen. When a cure for cancer is discovered, and I believe the cure will be discovered here, it will because of the collaborate and compassionate dedication of all those at our Brown Cancer Center.”

Since opening the doors in 1981, the BCC has been the site of significant research breakthroughs and groundbreaking treatments.

Major cancer research discoveries at the Brown Cancer Center include:

• Development of the first anticancer drugs that inhibit cancer cell metabolism
• Discovery and first in world trial of anticancer DNA aptamers (AS1411)
• Creation of the world’s largest nonprofit computer grid in Kentucky High Schools, already used to discover more than 20 new anticancer drugs
• The first clinical trial of cancer metabolism, following the date of glucose at the ATOMIC level
• The discovery of a novel population of multipotent stem cells called Very Small Embryonic-Like (VSELs).
• Development of the first stem cell vaccine to prevent cancer
• Clinical trials of beta-glucans as immune-stimulants in combination with therapeutic monoclonal antibodies

The Brown Cancer Center’s milestones in the clinical arena include:

• 1990: Creation of Kentucky’s first mobile mammography program to reach underserved communities providing access to advanced cancer screenings
• 2002: Dedication of the Molecular Imaging Research Center, housing Kentucky’s first positron emission tomography/computed tomography (PET/CT) scanner and a Nuclear Magnetic Resonance (NMR) suite that serves as a catalyst for advanced cancer research
• 2010: The Multidisciplinary Breast Cancer Program became the first in Kentucky to receive full three-year accreditation from the National Accreditation Program for Breast Centers.
• 2017: The first melanoma patient undergoes TILs procedure
• 2019: Creation of a Good Manufacturing Practices Facility and the Dunbar CAR T-Cell efforts where the patient’s white blood cells are re-engineered with a chimeric antigen reception (CAR) into the T-cells, multiplied by the millions then infused back into the patient where they bind to an antigen on the cancer cells and destroy them
• 2021: Expanded services to UofL Health – Medical Center Northeast and UofL Health – Mary & Elizabeth Hospital, further opening access to treatment for patients

Despite these significant results, use of epidural stimulation outside a research lab setting to restore function for people with spinal cord injury thus far has been hampered by several limitations, including the use of a technology that was designed for patients with chronic, intractable pain – not those with spinal cord injury.

Applying this therapy for spinal cord injury is a big step closer to use outside the research lab thanks to a $7.8 million grant from the National Institute of Neurological Disorders and Stroke, one of the National Institutes of Health. The grant will fund work at UofL’s  in collaboration with medical device manufacturer Medtronic to develop and test software applications specifically designed for spinal cord injury that work in concert with Medtronic’s commercially-available device, Intellis, which is indicated as a spinal cord stimulator for chronic pain. The five-year project, funded through the , is focused on incorporating technology to improve control of locomotor and bladder function using epidural stimulation.

“We have seen excellent results with epidural stimulation in the lab, but these enhancements to the technology system will make it much easier to implement this therapy out in the community. Integrating multiple systems will allow people with chronic spinal cord injuries to benefit from stimulation on a daily basis by reducing the need to monitor and manually revise stimulation settings,” said Claudia Angeli, assistant professor of bioengineering in the UofL and director of the Epidural Stimulation Program at KSCIRC. Angeli and Maxwell Boakye, neurosurgeon and clinical director of KSCIRC, will lead the project.

Medtronic epidural stimulators first were used for spinal cord injury in 2009 under an Investigational Device Exemption with the FDA during research at UofL led by Susan Harkema, professor of neurological surgery and associate scientific director for KSCIRC. The epidural stimulation therapy involves implanting a neurostimulator under the patients’ skin and implanting electrodes in the epidural space of the lower spinal cord, which together deliver mild electrical impulses to the spine. 

While epidural stimulation has been proven to provide effective relief for chronic pain, there are limitations in functionality when treating individuals with spinal cord injury. For example, the stimulation settings that allow individuals with spinal cord injury to stand are different from settings that allow them to walk, while a third configuration is required to help with bladder function and so forth. The devices that researchers use today must be programmed manually for each individual function.

The goal of the new project is to develop integrated, closed-loop programming for multiple systems, specifically locomotion and bladder function, using wireless sensors to monitor the user’s condition and adjust stimulator settings as needed. Working with Medtronic, the UofL researchers will develop learning programs for the closed-loop system and integrate the programming with commercially available epidural stimulators, as an investigational use.

“This device will be customized for the needs of individuals with spinal cord injury, which will require less manual interaction and lead to more positive outcomes in both locomotion and bladder function, dramatically improving the future of neuromodulation for spinal cord injury,” said Boakye, chief of spinal neurosurgery at the , neurosurgeon with and lead neurosurgeon for implantation of the device.

During the first phase of the study, the researchers will develop learning algorithms and the closed-loop system, working with the Medtronic’s Intellis Spinal Cord Stimulation platform. This phase calls for eight individuals to receive implanted stimulators and either locomotor or bladder interventions to develop learning algorithms, which later will be integrated in closed-loop controls. Those data and technical tools then will be applied to a second group of eight individuals who have not received prior training.

“By monitoring multiple systems and enabling the controller to adjust stimulation without direct input from the user, these improvements will make this device a powerful tool for improving the lives of people with spinal cord injury,” said April Herrity, an investigator on the project.

The 2018 breakthrough was the result of years of research by the UofL team, which found that applying electrical stimulation to the lower spinal cord, combined with physical therapy, allows unexpected degrees of recovery in people with complete spinal cord injury. Research participants are able to move voluntarily, stand and take steps, in addition to experiencing improvements in blood pressure regulation, bowel and bladder function and other common health issues associated with spinal cord injury.

“One of the main obstacles to making this therapy available to patients has been the need for programming specific for spinal cord injury,” said Harkema, also an investigator on this project. “This new work will promote the safe, long-term use of the therapy in the home and community, allowing people with spinal cord injury to benefit from the discoveries we have made over the past two decades.”

“Medtronic is excited to be collaborating with the University of Louisville on research related to the use of spinal cord stimulation to improve function for individuals with spinal cord injury,” said Charlie Covert, vice president and general manager of Pain Therapies, part of the Neuromodulation Operating Unit at Medtronic. “Collaboration is vital to innovation in this space in order to meet the needs of this important patient population.”

Under the newly-formed Norton Children’s Medical Group, affiliated with the UofL School of Medicine, 21 former UofL general pediatric and pediatric subspecialist practices are now part of Norton Healthcare. Approximately 600 providers and staff have transitioned with the affiliation.

“By integrating the best pediatric providers who are committed to providing safe, high-quality care, we will make it easier for families to access comprehensive medical care for their children,” said Russell F. Cox, president and CEO, Norton Healthcare.

The UofL physicians and providers who are currently on the faculty of the school of medicine will remain in their academic role and will also work clinically within Norton Children’s Medical Group.

“UofL is committed to helping nurture healthy children and communities while maintaining our strong academic training programs and research. This agreement ultimately will translate into even better care for children,” said UofL President Neeli Bendapudi.

“Integrating allows the two organizations to move forward, capitalizing on each other’s strengths for the benefit of our patients and families,” said Steven T. Hester, MD, MBA, division president, provider operations, and system chief medical officer, Norton Healthcare.

The affiliation is designed to make it easier for patients to access outpatient care within the practices and inpatient care at Norton Children’s Hospital. Access will be improved through:

• Scheduling enhancements
• Recruiting additional providers
• Increasing the number of multidisciplinary clinics, where patients with serious and chronic medical conditions can see multiple specialists on the same day
• Using a single integrated electronic medical record, which will make it easier for patients and families to access test results and communicate with their providers

“Ultimately, the goal is to develop and deliver the best possible programs, services and patient experience for the children of Kentucky and beyond,” said Jennifer C. Evans, MD, MPH, FACOG, system vice president, women’s and pediatric services, Norton Healthcare. “Both organizations have been committed to providing a seamless transition.”

This new model also will allow the practices to enhance their focus on providing highly-skilled clinical care that is integrated with world-class medical education and research. A strong continued commitment to innovation and education is an important component of the integration. UofL’s academic and research mission is key to teaching the next generation of pediatric providers, which is essential to growing a regionally and nationally recognized pediatric program. In addition, by working together, the organizations can recruit, train and retain key talent for pediatric programs.

“Children will benefit from the strong academic training programs and research that will continue through the UofL School of Medicine,” said Kimberly A. Boland, MD, professor and chair, department of pediatrics, University of Louisville School of Medicine. “Working together will help us attract additional specialists to Louisville to care for children with the most complex medical issues. We look forward to seeing what great things we can accomplish together, not only in clinical care, but also in educating future pediatricians and making new discoveries in the field of child and adolescent health care.”

The transition of ownership from KentuckyOne’s parent company, CommonSpirit Health, to the university’s UofL Health affiliate is effective Nov. 1. Some 5,500 former KentuckyOne employees have now joined UofL and UofL Health, which has assumed management of the assets.

“This is an exciting and historic day for the University of Louisville,” said UofL President Neeli Bendapudi. “This acquisition enables us to ensure access to quality health care for our entire community, and it strengthens our School of Medicine and our Health Sciences Center campus by allowing us to offer more training opportunities for our students and more research capacity for our faculty. It also saves thousands of jobs that could have been lost if any of these facilities closed.”

UofL is acquiring the KentuckyOne assets with the promise of a critical $50 million, 20-year loan from the Kentucky Economic Development Finance Authority. Half of that loan would be forgiven if the university meets certain criteria in terms of employment or service to underserved areas. The Jewish Heritage Fund for Excellence and the Jewish Hospital and St. Mary’s Foundation also are investing in the deal, contributing $10 million and $40 million, respectively.

“We owe such a debt of gratitude to our partners—Governor Matt Bevin, the leadership of the House and Senate and these foundations—for making this transaction a reality,” Bendapudi said.

She also thanked the Sisters of Charity of Nazareth and leaders of the local Jewish community for the legacy of care they have created over more than a century of work in the Louisville community.

The purchase includes:

• Jewish Hospital, including the Outpatient Center, Rudd Heart and Lung Center, offices and parking garages;
• Frazier Rehabilitation Institute;
• Sts. Mary and Elizabeth Hospital;
• Our Lady of Peace;
• Jewish Hospital Shelbyville;
• Jewish Medical Centers East, Northeast, South and Southwest;
• Physicians groups affiliated with KentuckyOne.

All of the assets will be rebranded under the UofL Health umbrella.

“Today marks an important moment for the future of health care in the Louisville community, and I want to thank everyone who contributed to the successful completion of this transition,” said Larry Schumacher, senior vice president of Operations, Southeast Division, CommonSpirit Health. “As we transfer the ownership and operations to UofL Health, I am optimistic that these facilities will continue their legacy of excellence and innovation led by the outstanding employees and providers.”

Among the most immediately visible changes will be modified names and signage to reflect the new ownership under UofL Health, the historical legacy of the communities that surround the hospitals and medical centers and the traditions of the faith organizations that were the foundation of many of the facilities.

“I want to thank the Sisters of Charity of Nazareth, the Louisville Archdiocese, the Jewish Heritage Fund for Excellence and our larger Catholic and Jewish communities,” said UofL President Neeli Bendapudi. “Health care in Louisville has grown because of the commitment made by these organizations to improve the health of patients throughout the greater Louisville community and the passion they have to serve with excellence and compassion.

“The University of Louisville and UofL Health will build on this foundation, to improve wellness for our community, by building a regional academic health care system based on treatment innovations, leading-edge research and patient-centered care.” 

Because the hospitals will no longer be operated as Catholic facilities, the Archdiocese requested that the names of Sts. Mary & Elizabeth Hospital and Our Lady of Peace be changed to no longer reflect a Catholic affiliation. Upon the closing date, they will become UofL Health – Mary & Elizabeth Hospital and UofL Health – Peace Hospital. Crosses adorning the outside of the buildings will be removed, but the hospitals will maintain their chapels, including the iconic Sky Chapel at Mary & Elizabeth, and many other artifacts that reflect the legacy of the Catholic faith and the rich heritage of the hospitals.  

As is the case at UofL Hospital, people of all faiths are encouraged to use the chapels as they choose. Chaplains are on staff to support and honor the many different faiths and traditions observed by patients and employees.

“I am encouraged that University of Louisville Health desires to continue to honor the spirit of the Church’s healing ministry as it acquires these former Catholic facilities. I once again want to extend my gratitude to the Sisters of Charity of Nazareth for their long legacy of care and compassion, beginning with the founding of Sts. Mary & Elizabeth and Our Lady of Peace Hospitals. I appreciate the University of Louisville’s stated intention to respect the history of the Sisters’ health care ministry, and I am pleased that the University will seek to maintain health care for underserved areas of the city, serve the poor and vulnerable and preserve employment for many loyal employees,” said the Most Rev. Joseph E. Kurtz, Archbishop of Louisville.

UofL Hospital – Jewish Campus

Jewish Hospital and UofL Hospital will become one united hospital with two locations. The two locations will have a unified leadership team and direction to better support and restore the services, research, employees, physicians and programs at Jewish Hospital. In addition, it will further strengthen UofL Hospital and the teaching and research programs of the UofL School of Medicine located at both locations. The newly unified hospitals will be highlighted through the new name, UofL Hospital – Jewish Campus. The name respects Jewish Hospital’s history as a leader in cardiovascular services, neurosciences and transplantation while also preserving its legacy of serving the community. UofL Hospital’s name will not change.

“We appreciate the care that everyone at the University of Louisville and UofL Health has shown in working with the Jewish Heritage Fund for Excellence Board of Trustees to make this transition,” said Jeff Polson, JHFE executive director. “We are certain that the traditions, culture and history of Jewish Hospital will continue to be honored at the new UofL Hospital – Jewish Campus alongside our legacy of excellence in health care.”

“We worked with leaders across the system and with the Archdiocese and JHFE to develop the new names for the hospitals,” UofL Health CEO Tom Miller said. “The hospitals have a rich culture and a time-honored heritage associated with many traditions. UofL Health is committed to honor this rich history and to support the hospitals, their employees, physicians and communities in keeping the traditions that make them unique and special.”

The rest of the KentuckyOne Health system

Throughout the rest of the former KentuckyOne Health system, names will be modified as follows:

• UofL Health – Frazier Rehab Institute
• UofL Health – Rudd Heart and Lung Center
• UofL Health – Shelbyville Hospital
• UofL Health – Medical Center Southwest
• UofL Health – Medical Center South (Shepherdsville)
• UofL Health – Medical Center East
• UofL Health – Medical Center Northeast

Physician practices, currently part of the KentuckyOne Medical Group, also will be renamed under UofL Physicians brand to reflect new alignment with UofL Health.

“UofL Health welcomes the teams from all these locations and, most importantly, we welcome the patients and families served,” Miller said. “We are excited to bring this larger system together, share best practices and extend The Power of U to more communities.”

Sign changes will begin this week, but will be a gradual process over the next several weeks and months.  UofL Health will assume ownership of the facilities on Nov. 1. While these changes are being implemented, there should be no interruption or delay in care.

PCMH recognizes primary care practices with a team-based health care delivery model that provide comprehensive care to patients and are dedicated to continuous quality improvement for health outcomes. Designated practices put patients at the forefront and create strong relationships between patients and their clinical care teams.

UofL Physicians – General Pediatrics has clinics at the Novak Center for Children’s Health in downtown, Sam Swope Kosair Charities Centre on Eastern Parkway and on Stonestreet Road in southwest Louisville.

“Following the PCMH model provides a very structured way to deliver coordinated care,” said Amanda Cagle, RN, practice manager for Downtown and Stonestreet sites. “It provides a high level of standardization throughout all three clinics, which follow the same policies and procedures. We are continuously monitoring different aspects of patient care in order to improve the care we deliver to our patients.”

Research shows that PCMHs improve quality, the patient experience and staff satisfaction while reducing health care costs, according to the National Committee for Quality Assurance.

A requirement of earning PCMH designation is using care coordination, the intentional organization of patient care among providers working with a particular patient to provide optimum health services. Through care coordination, providers share important clinical information, work together to keep patients and their families informed and ensure that effective referrals take place.

“We’ve changed policies, procedures and day-to-day functioning to accommodate patients in every way we can,” said Melissa Hancock, MD, UofL division director of general pediatrics. “All of our providers and staff are invested in our patients’ primary care. This is where they’re going to get their comprehensive health care needs met.”

The LOI allows the organizations to explore a more meaningful partnership as the organizations work toward a definitive agreement later this summer. 

The goal is to further align strategic, operational and financial interests to support pediatric care, teaching and research.

“We want to ensure we continue to promote healthy children and communities while maintaining our strong academic training programs and research, which translate into better care for children,” said UofL President Neeli Bendapudi, Ph.D. “We’ll do that by leveraging the strengths of the UofL School of Medicine, ULP – Pediatrics and Norton Healthcare.” 

“For many years, Norton Healthcare and Norton Children’s Hospital have worked closely with the University of Louisville through our academic affiliation,” said Russell F. Cox, president and chief executive officer of Norton Healthcare. “Each day, dedicated providers from both organizations work together to deliver quality care that children and their families need. Together we have grown specialty services for children in the important areas of heart, diabetes and cancer care. With this new initiative, we expect this type of growth to continue, and we are committed to identifying even better ways to meet the health care needs of children and families.”

Doctors found she had not one, but three. Robert James, MD, a neurosurgeon at , treated two of her aneurysms with minimally invasive stents, but the location of the third, at a juncture of arteries, was not conducive to stent treatment.

In January, the U.S. Food and Drug Administration approved the WEB Aneurysm Embolization System for treating this type of aneurysm, and on Feb. 13, Steinhilber was one of the first three patients in Kentucky to be treated with the device at .

An aneurysm is an enlarged, weakened area of an artery that results in a bulging or ballooned area in the artery. Untreated, an aneurysm in the brain may rupture, causing severe disability, cognitive loss or death. The WEB system, James said, provides a new, minimally invasive option for treating wide-necked bifurcation aneurysms, which occur at the juncture of two arteries. In the procedure, a mesh basket is placed inside the aneurysm, allowing blood to bypass the opening, which seals itself off over time, creating a permanent cure.

“If we can fix the aneurysm before it bursts and cure it, then the threat of this aneurysm bursting and the patient dying from it essentially goes away,” James said. “The WEB device is a game changer for the minimally invasive treatment of aneurysms.”

Steinhilber is grateful to have more advanced options for treating her condition. Two of her sisters were treated for aneurysms in the past. One required re-treatment and another was unable to be treated for one aneurysm due to its location. A third sister died suddenly from what may have been a ruptured aneurysm.

“Seeing the history of my sisters, I feel very good about what the UofL doctors are doing here,” Steinhilber said. “It’s wonderful to see the progress made in treating aneurysms.”

As many as 6 million people in the United States are estimated to have an unruptured brain aneurysm. Coils and stents have provided minimally invasive options for some types of aneurysms, but James explained those options have limitations in their use, and may have negative features.

The WEB (an acronym for Woven Endo-Bridge) device is approved for treating wide-neck bifurcation aneurysms, which may account for 35 percent of all brain aneurysms. James completed the first three procedures in Kentucky with the device since it received FDA pre-market approval on Jan. 7. He had previous experience in performing the procedure, having participated in the device’s clinical trials.

During the WEB system procedure, a small catheter is threaded from the groin area through the patient’s artery to the aneurysm site. Using fluoroscopy imaging, the surgeon deploys the WEB device into the “sack” of the aneurysm, where its flexible mesh conforms to the aneurysm walls, minimizing blood flow inside the aneurysm. In most cases, over time, the body seals off or occludes the neck of the aneurysm, essentially curing it.

In clinical testing, the WEB system was shown to be highly effective and safer than other options. In addition, the minimally invasive nature of the procedure means most patients, including Steinhilber, are able to go home the next day.

In addition to unruptured aneurysms, the WEB system may be used in some cases in which the aneurysm has already ruptured, providing more desirable options for treatment.

“This device also gives us the ability to use flow diversion in already ruptured bifurcation (branch point) aneurysms to prevent them from re-rupturing, which we have never been able to do before,” James said.

The WEB system, marketed by MicroVention, Inc., a U.S.-based subsidiary of Terumo and a global neurovascular company, has been used safely in more than 6,000 cases outside the United States as well as clinical studies here and abroad.

Black and other University of Louisville medical students cut their hair or underwent complete buzzes during Tuesday’s RaiseRED Shaved Heads at Kornhauser Health Sciences Library, an event that is part of the UofL campaign to support the clinical practice and UofL researchers developing pediatric cancer treatment therapies.

In addition to raising money, Black and some of the other participants will donate their locks to create wigs for children who have lost their hair from chemotherapy.

“I’ve heard so much about what a great initiative this is, so last year I decided to grow out my hair to donate it,” said Black, a second-year medical student. “We study so much, but it’s important to see the human side of medicine. This is why I want to be a physician.”

The Shaved Heads event raised more than $3,600 for RaiseRED, and fundraising will continue through Feb. 23 when the campaign culminates in an 18-hour dance marathon. RaiseRED has contributed more than $1.8 million in five years to improve the lives of children and families affected by pediatric cancer and blood disorders.

Carlos Lynes, a fourth-year medical students who had his hair buzzed on Tuesday, said he gained a better understanding during clinical rotations of what pediatric cancer patients and families endure.

“It’s very easy to shave your head when it’s an option, as opposed to what children with cancer undergo,” Lynes said. “When you’re working with these kids who are sick, it adds a whole new layer of commitment and emotion and attaches you more to this cause.”

To donate to the UofL School of Medicine’s RaiseRED total, visit  and click “pledge support.”

, is chief of Sports Medicine and an orthopedic surgeon with , and an assistant professor at the . A former football player and athlete himself, he specializes in sports injuries, and says it’s not uncommon for weekend or holiday warriors to end up in the emergency room after a fall on the slopes. But that doesn’t mean it can’t be safe, and there are ways to minimize your risk.

He said the biggest thing is to be realistic about your abilities, and not get overconfident. “People try to ski above their level. They get brave on the bunny slopes, then they think they can head for the Black Diamond,” he said.

For the uninitiated, Black Diamond slopes are difficult with steep gradients, and they are often full of bumps. A Double Black Diamond is the most difficult rating and should be skied by experts only. If you get on one of these and you’re not an expert — well, you were warned.

According to a review article published in a January 2018 issue of the Journal of the , the number of skier and snowboarder injuries continues to rise. The U.S. Consumer Product Safety Commission estimates more than 140,000 people were treated in hospitals, doctors’ offices and emergency rooms in 2015 for skiing and snowboarding-related injuries.

“It might seem like common sense, but don’t ski above your level of comfort, and wear proper safety equipment, such as a helmet, gloves and goggles,” Douglas said. “Always the helmet.”

A broken wrist or twisted knee can most likely be fixed, but a brain injury is much more serious.

The American Academy of Orthopaedic Surgeons says taking lessons is especially important for new skiers, and learning how to fall correctly can reduce the risk of injury.

Douglas said it’s also best to pick a time of day to ski when it’s less crowded, if you can. “It has happened on crowded slopes where a skier has been struck by someone else moving much faster than them.”

Common injuries

A wide range of injuries can occur, with injuries to ligaments more common than fractures. Douglas said the majority fall into two groups: Knee injuries, particularly to the anterior cruciate ligament due to twisting; and because skiers and snowboarders often put their arms out to break a fall, a broken wrist or shoulder injury such as a fracture, separation or dislocation. A separated shoulder is an injury to the ligaments that hold your collarbone to your shoulder blade.

Douglas said injuries to the upper body can be worse as that part “has an extra second to accelerate before hitting the ground.”

Skiers who fall on an outstretched hand while holding a ski pole can get “skier’s thumb,” an injury to the ligament that connects the bones of the thumb together.

Snowboarding injures tend to be more common and severe than skiing injures, Douglas said, as ski bindings are designed to come loose in the event of a fall, with the skis flying away, while a snowboard remains attached. With the snowboard strapped on, those who fall often suffer twisting or rotational injuries to the knees, as well as a broken wrist or separated shoulder. He said snowboarding injuries are more likely to require surgery or hospitalization.

Injuries to novice skiers also tend to be less severe than for those who are more advanced, Douglas said. “More experienced skiers are also less likely to take a doctor’s advice.”

Whether novice or experienced, the American Academy of Orthopaedic Surgeons recommends the following to stay safe on the slopes:

Proper preparation

• Maintain fitness. Be in good physical condition when you set out. If you are out of shape, select runs carefully and gradually build your way up to more challenging trails. Many ski injuries happen at the end of the day, when people are tired and try to get in one last run.
• Warm up. Research has shown cold muscles are more prone to injury. Warm up with jumping jacks or running or walking in place for 3 to 5 minutes. Take a couple of slow ski runs before moving on to something more difficult.
• Drink water. Even mild levels of dehydration can affect physical ability and endurance. Drink plenty of water before, during and after.
• Know safety rules. Understand and abide by rules of the ski resort. Know general safety rules of skiing, such as how to safely stop, merge and yield to other skiers.
• Learn ski lift safety. Before your outing, learn how to properly get on and off a lift.

Ensure Appropriate Equipment

• Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body’s constantly changing temperature.
• Boots and bindings. Buy or rent boots and bindings that have been set, adjusted, maintained and tested by a ski shop that follows American Society of Testing and Materials (ASTM) standards.
• Check the binding of each ski before skiing. Bindings must be properly adjusted to your height, weight and skiing ability.
• Safety gear. Wear appropriate protective gear such as a helmet and goggles. Helmets are sport-specific, so do not wear a bike helmet on the slopes. Ski helmets should be worn.

Ensure a Safe Environment

• Stay on marked trails and avoid potential avalanche areas.
• Watch out for rocks and patches of ice on trails.
• Pay attention to warnings about upcoming storms and severe drops in temperature. Make adjustments for icy conditions, deep snow, powder and wet snow.

Prepare for Injuries

• Ski or snowboard with partners and stay within sight of each other. If you get ahead of your partner, stop and wait.
• Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help if injuries occur.