While competitive figure skating is an art that captivates and mesmerizes its audiences, there is a dark side that many spectators do not realize as they watch these elite athletes perform.
So said Dr. Robert Monaco, an orthopedist with Atlantic Health System who served as team physician for U.S. Figure Skating in the 2022 Beijing Olympics.
“Oftentimes, figure skating is looked at as more artistic, but it’s really a combination of athleticism and of all the sports I deal with,” he said. “It is one of the most challenging for athletes to really master a whole set of skills, both athletically and artistically.”
Monaco has seen his share of injuries.
The grueling nature of training, and commonly sustained injuries and medical treatment, plus rehabilitation efforts for elite athletes, take a toll. But, Monaco said, with proper training and monitoring, the amount of injury and stress to the body can be lessened.
“The unique demands on figure skaters make it one of the most taxing events in the Winter Olympics, as it works nearly every muscle group in the body,” he said. “Sprains and fractures from impact with the ice can be a common occurrence. Figure skating blends the demands of middle-distance track running with the athletic and flexibility requirements of an Olympic gymnast.”
The fractures, ligament ruptures and sprains plaguing athletes in multiple sports during the 2022 Winter Olympic games were on par to match, if not exceed, the number of injuries from the 2018 Winter Games in PyeongChang, South Korea, when 12% of the 3,000 athletes in attendance sustained at least one injury.
Monaco has served as director of sports medicine at Rutgers University for more than 20 years. His current practice is Atlantic Medical Group Sports Medicine in Bridgewater. His own son, Antonio Monaco, is currently training in the Junior Olympics and hopes one day to qualify for a chance to go for gold.
“There is a lot of dedication and challenging work that goes into training for skaters — both on ice and off,” he said. “Individuals need to put in at least four hours a day on ice, plus a variety of other training that involves ballet or gymnastics — endurance training and lots of core work.”
Most injuries he sees come from overtraining and are caused especially because of overuse.
“Most skaters and coaches don’t spend enough time on the fundamentals — strength training, mobility and flexibility. That is contributing to the rate of injury,” he said.
Monaco said there are a few key principles the athletes are always supposed to follow in order to have the best chances at avoiding injury. From warmup exercises to speed training, balance, flexibility, strength and cardiovascular, off-ice training is one of the best ways to improve on-ice performance as well as prevent injuries.
“Good coaching is also key,” he said.
Knowing that a coach and a trainer are the people who spend the most time with the athletes, Monaco said they should be in tune with what each individual is going through.
One way he believes this is feasible is through monitoring a body’s load management — the amount of load an individual places on the body. He said it is crucial to monitor. In fact, it is most important because the majority of injuries occur from overtraining or doing too much too soon.
“We like to track the individuals with wearables or other items that can tell us how much work they’re doing,” he said. “We monitor things like heart rate, and how much impact a certain jump might have on their body. The devices we use look at the total amount of workload they put on the body, which helps us to determine if they can handle more, or if they need to cut back — all in an effort to avoid overdoing it.”
It is really about managing the load and the techniques so that an athlete does not get too far ahead.
When asked if some of the techniques and jumps are getting too advanced for the competitors at the Olympics, Monaco still relied on proper form and training and monitoring.
“These upper-level jumps are very demanding on the body, and certainly on those learning them,” he said.
“A lot of falls and injuries can come from these jumps, but, with the right techniques and the right coaches, these things can be executed correctly in the right amount of time. Slowly. It is a long-term process. Not one perfected overnight, because it is big load on a developing body.”
Monaco said a lot can be done right in a doctor’s office, especially things such as evaluations, ultrasounds and X-rays. Other special techniques or custom braces, if necessary to get over injuries, can also be prescribed in-house, and his practice offers services that can maximize rehabilitation and human performance for these elite athletes to enhance the medical treatment.
“We can deal with things from top to bottom, starting with prevention to injury management, evaluation, as well as well as overall looking at their system and then directing their care depending on a problem,” he said. “We pride ourselves in being able to do everything.”
