By Dr. Jeff Daniels EBS Medical Columnist

At the Medical Clinic of Big Sky, we look forward to opening day at the ski resort every year. It’s when we open up our mountain clinic and start seeing more trauma cases, which generally is a lot more exciting than giving flu shots or treating colds (we still treat colds and other medical problems as before).

This year, the weather wasn’t very cooperative in terms of producing November snow, or giving Big Sky Resort cold enough temps to make snow, so that only the lower half of one run was available on opening day. But it was better than most Western resorts, like Jackson Hole that couldn’t open as planned on Thanksgiving Day. So there were plenty of revved-up skiers, anxious to get some runs in after a long hiatus.

The line to the Explorer chairlift looked like it was going to back up all the way to the clinic on Thanksgiving Thursday. There were enough icy patches to cause a couple of accidents, mostly resulting in shoulder injuries. We had several AC separations (where the clavicle separates from the scapula) and broken clavicles, and one dislocated shoulder. There were no knee injuries treated, but a Nordic skier from West Yellowstone came in with a thumb injury. We’ll have to wait for a few more trails and lifts to open, as well as an influx of tourists, before we start getting busy.

Traditionally, the beginning of the ski season—during the first half of December—is relatively quiet on the hill, and subsequently very quiet in the clinic. Then, Big Sky will start filling up for the holiday season, and in the previous 22 years that I’ve been in Big Sky, we will be set to experience the busiest week of the entire ski season just after Christmas. Also in those 22 seasons, the snow after Dec. 15 has typically been wonderful, despite early season conditions.

As the number of skiers increase, so does the activity at the medical clinic. No one can be sure how many injuries to expect coming off a ski hill in a given season, but I’m convinced that out of every 1,000 skiers, there will be at least 20 significant injuries. Not everyone will come to the clinic; some people will try to walk it off. Others will go directly to the hospital, either by private vehicle, ambulance or helicopter. And some will wait a day or two before seeking medical attention.

My best guess is that for every 1,000 skiers we see at the clinic, we’ll treat between five and eight injuries—none of them life-threatening, but possibly vacation- or season-ending. By the end of the ski season, we’ll probably see about the same number of shoulder injuries as knee injuries. Thumb injuries on the hill are the most common—the leading cause of surgery required after a ski vacation is to fix the so-called “skier’s thumb” injury, which is a torn ligament in the hand that, if not fixed, can lead to chronic arthritis at the base of the thumb.

But most skiers—and it can happen in snowboarders too—who incur these injuries don’t feel that bad, so they won’t seek immediate medical attention. A week after they get home, when their thumb hasn’t improved, they may get it checked out and referred to a hand surgeon.

I could write a book on all the different types of ski and snowboard related injuries that we’ve experienced here over the past 22 years. My collection of interesting X-rays is almost overflowing the memory capacity of my computer!

I hope you have a safe and successful ski season.

Dr. Jeff Daniels was the recipient of the 2016 Big Sky Chamber of Commerce Chet Huntley Lifetime Achievement Award and has been practicing medicine in Big Sky since 1994, when he and his family moved here from New York City. A unique program he implements has attracted more than 700 medical students and young doctors to train with the Medical Clinic of Big Sky.