Winter in Ontario means ski hills, outdoor skating rinks, toboggan runs, and snowboard parks. It also means sprains, fractures, concussions, and cold injuries. Knowing basic first aid can make the difference between a manageable injury and a complicated one — and the single most useful skill is knowing that a first aider cannot reliably tell a sprain from a fracture, so both are treated the same way.

This guide covers the most common winter sports injuries, how to provide first aid on the spot, when to head to the emergency room, and how to prevent injuries before they happen.

The Most Common Winter Sports Injuries

Wrist and Arm Fractures

The most common snowboarding injury — and very common in skating — is a wrist fracture from falling on an outstretched hand. When you slip on ice or catch an edge on a snowboard, the instinct is to break your fall with your hands. The force travels straight through the wrist bones.

First aid:

• Immobilise the wrist and arm. Use a sling (a triangular bandage, a scarf, or even a jacket tied around the neck) to support the arm against the body
• Apply a cold pack wrapped in cloth for about 20 minutes of every hour (up to 48 hours) to reduce swelling — keep a barrier between the ice and skin, and don’t rub the area
• Do not try to straighten a visibly deformed arm or wrist
• Because a first aider cannot reliably tell a sprain from a fracture, treat it as a fracture and seek medical attention for an X-ray — fractures are not always obvious from the outside

Source: Canadian Red Cross 2025 (treat any suspected bone/joint injury as a fracture; cool ~20 min of every hour, up to 48 h, with a barrier).

Knee Sprains and Ligament Injuries

Skiing is particularly hard on knees. The twisting forces that occur during falls, especially when a ski does not release properly, can stretch or tear the anterior cruciate ligament (ACL) or medial collateral ligament (MCL). A classic sign is a “pop” felt in the knee followed by immediate swelling and instability.

First aid (RICE method):

• Rest — stop the activity immediately and avoid putting weight on the knee; don’t move or straighten the injured part
• Immobilise — only if you must move the person or help is delayed, support the joint in the position found
• Cool — apply a cold pack (wrapped in cloth) for about 20 minutes of every hour, up to 48 hours, to reduce swelling
• Elevate — keep the leg raised above heart level when possible, but only if it doesn’t cause pain

Source: Canadian Red Cross 2025 RICE guidance. Note: for ankle sprains, ILCOR (2025) considers a compression wrap optional — the evidence is neutral — so the priority is rest, cool, elevate and protect.

Concussions

Head injuries are a serious concern across all winter sports. Falls on ice, collisions with other skiers, hitting a tree or fence post while sledding, and hockey impacts can all cause concussions. A concussion is a brain injury — it does not require loss of consciousness to be serious, and its effects can appear or worsen over the hours that follow.

First aid for suspected concussion:

• Remove the person from activity immediately — do not let them “play through it.” When in doubt, sit them out (Canadian Red Cross / ERC 2025; Parachute Canada)
• Refer them to a healthcare professional for assessment — a first aider cannot diagnose a concussion or clear a return to play
• Keep watching them, and get medical help urgently if any red flag above appears, because symptoms can evolve over hours (Canadian Red Cross / ERC 2025)
• For headache, acetaminophen is generally preferred; some concussion guidance advises avoiding aspirin and ibuprofen (NSAIDs) early on — follow the advice of a healthcare provider (Parachute Canada concussion guidance)
• Follow your healthcare provider’s return-to-activity guidance — returning too soon increases the risk of a more severe second injury (Parachute Canada / Rowan’s Law, Ontario)

Source: Canadian Red Cross / ERC 2025 (recognise, remove, refer; “when in doubt, sit them out”); Parachute Canada and Ontario’s Rowan’s Law for concussion management and return to activity.

Ankle Sprains

Common in skating, where the ankle can roll inward during a fall or an awkward stop. The ankle swells, bruises, and becomes painful to bear weight on. Treat with the RICE method described above and seek medical attention if the person cannot bear any weight at all, as this may indicate a fracture rather than a sprain.

Shoulder Injuries

Dislocations and separations can occur from high-speed falls on the ski hill or collisions during hockey. A dislocated shoulder looks visibly deformed and is extremely painful. Do not try to pop it back in — immobilise the arm against the body with a sling and get to the emergency department.

Sledding Safety: The Overlooked Risk

Sledding is often treated as a casual winter activity, but it sends thousands of Canadian children to emergency rooms every year. The combination of speed, lack of steering control, and hard surfaces (frozen ground, ice patches, trees, fences) makes it riskier than many parents realise.

• Always sled feet-first and sitting up — headfirst sledding dramatically increases the risk of head and spinal injuries (Canadian Paediatric Society)
• Choose hills that end in a flat, open run-out area — avoid hills that end near roads, parking lots, fences, trees, or bodies of water
• Wear a helmet — a multi-sport, ski, or hockey helmet reduces head injury risk (Canadian Paediatric Society; Parachute Canada)
• Avoid inflatable tubes and saucers — these reach higher speeds and are harder to steer or stop
• Supervise young children at all times — young children should ride with an adult

Building a Winter Sports First Aid Kit

Keep a compact first aid kit in your car or backpack whenever you head out for winter sports:

• Instant cold packs (2 to 3)
• Elastic bandages (at least 2)
• Triangular bandage for a sling
• Adhesive bandages, sterile gauze pads, and medical tape
• Pain relief such as acetaminophen (age-appropriate doses)
• Hand warmers
• Emergency space blanket
• Whistle (for attracting attention on a ski hill)
• Fully charged mobile phone

Prevention: Reducing the Risk Before It Happens

• Helmets for everyone — for skiing, snowboarding, skating, sledding, and hockey. A properly fitted helmet is the single most effective injury prevention measure
• Wrist guards for snowboarding and skating — especially for beginners who fall frequently
• Proper equipment fit — ski bindings should be adjusted by a certified technician to release at the right force for the skier’s weight and ability level
• Lessons for beginners — learning proper technique reduces falls and teaches safe stopping
• Know your limits — fatigue is a major risk factor for injuries. Take breaks, stay hydrated, and call it a day when tired
• Watch the conditions — icy conditions, poor visibility, and overcrowded slopes all increase risk