Ben Habenecker directs the Ski Patrol at Alyeska Resort in Girdwood, Alaska, He estimates his 56 paid patrollers and 67 volunteers need their sleds “20 to 30 times a week” to assist injured skiers and riders.

The most common damage they deal with has affected “knees, shoulders and wrists, especially knee strains, and sprains.”

I recently visited Alyeska, and one of my friends suffered a shoulder separation, although he did not require a sled ride.

He said he caught an edge. After the fall, “I knew what I had done,” he said, because he had incurred a similar separation on the other side.

He skied down to the Ski Patrol office, and pronounced the attention he received there “wonderful,” as was the subsequent assistance from Alyeska hotel personnel. “The guy took my boots off for me. No one else has ever done that.”

He chose to use the Girdwood Clinic, rather than go to Anchorage, about 40 miles north.

He was pleased with his care there, and came away with a sling and a T-shirt proclaiming, “I got fixed at the Girdwood Clinic.” (If you haven’t been hurt, you can buy one for $12.)

His other option was “Orthopedic Physicians Anchorage,” which operates an “injury walk-in clinic, open seven days a week.”

This group is a sponsor at Alyeska. Their card is available in the concierge’s information rack, along with brochures for dog-sled rides and flight-seeing trips.

In a “Notice to Injured Guests,” the doctors’ group notes, “Hospital ERs, clinics and urgent care centers appropriately refer most non-life-threatening muscle, bone, and joint injuries to orthopedic specialists. Avoid significant unnecessary services, expenses, waiting, parking hassles, and appointment delays by going directly to them."

Dr. Williams Mills, one of the seven orthopedic surgeons there, told OnTheSnow that just about everyone they treat who was hurt at Alyeska has “come a long way. Seattle and Portland are three-and-a-half hour flights,” and almost anyone else will be in the air longer to get home, even “14 or 15 hours.”

Mills said, “I worry about crowds in the airport (jostling someone unfamiliar with) crutches or a walker, and blood clots.”

He continued, “We try very hard to get someone into a more comfortable seat, whether first class or a bulkhead.”

The doctors also stress to an injured skier or rider flying home that “muscle work helps prevent blood clots. Aspirin is not really proven. The most effective thing is to move more,” although a cast and crutches, for instance, makes that difficult.

Even in those circumstances, however, Mills said, “Pump your calf. Rotate the other ankle. Squeeze a tennis ball or some putty. (Blood circulation) is a closed system. Any muscle work is helpful in getting your blood to circulate more.”

Mills said Orthopedic Physicians Anchorage always writes a letter to the airline for the patient, even explaining why a patient missed a flight. “We usually get pretty good results.”

Skiers and riders should consider traveling with contact information for an orthopedic surgeon at home they use, and, wherever they are treated initially, arrange to get “clinical notes, reports or X-rays or MRIs, and operation notes. The most important thing is our talking to the doctor at home.”

Dr. Frank Cordasco is a sports medicine and shoulder surgeon at the Hospital for Special Surgery in New York City who had replaced my left shoulder, damaged in a mountain biking accident at Loon Mountain, N.H.

He sees the folks who return to NYC from Alyeska or Loon or anywhere else with a mountain-related injury.

Cordasco said, “The biggest concern regarding a flight after a lower extremity injury is the potential for a deep venous thrombosis (DVT). This can lead to a fatal pulmonary embolus. This may occur as a result of immobilization of the leg and the effects of a pressurized cabin. Many of these skiing or riding injuries involve the knee. The athlete has often been immobilized in a brace with the knee placed in extension (straight).”

Cordasco and Mills agree, “In general the individual should try to obtain a bulkhead seat or preferably one in business or first class. It would be best to perform some ankle flexion and extension exercises to keep the blood flowing from the leg back to the heart and less likely to form a clot in the leg. Thus, sleeping for the whole flight should be avoided.

“Medications that compromise platelet (factors in the blood that cause clotting) function such as aspirin are recommended as well,” Cordasco said. “If the injury is one where increased bleeding is a risk, the use of these medications should be discussed with the doctor beforehand.

“The risk of DVT is also present with upper extremity injuries such as a shoulder fracture or dislocation, but to a lesser extent. The recommendations above apply.

“The athlete should certainly see an orthopaedic surgeon within one or two days of arrival home.”

Kelly Titus, the medical records manager for Orthopedic Physicians Anchorage, has advice for skiers and riders headed to any snow, a day trip, a weekend, or longer. “Patients should know about previous surgeries.”

Riders and skiers treated away from home should consider waiting 24 hours before heading there after treatment, to collect “a CD of images (from X-rays or MRIs), and doctors’ notes.”

Titus said the thumb drive another colleague at Alyeska carries on his key-ring (he’s had heart problems) may or may not be helpful

Another skiing friend hurt herself at Creste Butte, Colo.

Here’s her account of what happened:

“My Crested Butte accident occurred on snow while skiing first tracks on a beautifully groomed intermediate cruiser. A dusting of fresh snow must have provided ideal cover for the snow snake that tripped me up and threw me into a tumble that resulted in a compression fracture of my right thumb and a separated left shoulder. I refused the sled-ride-of-shame and managed to ski back to the base, where I made a bee-line for the clinic.

“After a few x-rays, the folks there trussed me up like a Thanksgiving turkey and started me on some pills that turned me into a grinning, drooling bean bag. I spent the rest of that day propped up in a chair with both arms in crisscrossing slings.

“Thank goodness I was traveling with friends who let me jump the line at the airport and helped me with my luggage. The thing I found most humorous was when I went to check my carry-on bag and the woman behind the counter snapped, ‘That’s going to cost extra, you know.’ I just looked at her, motioned to my crisscrossed slings and asked, ‘Do I look like I care?’ She waived the charges and dismissed me.

“I had surgery to put the thumb back together with pins that they removed after 10 weeks in a cast. The separated shoulder was never quite the same and always acted up a little when I overused it gardening or raking snow off my roof. Now I guess it will really give me some trouble.”

Another woman I know had another misadventure this month in snowy Vermont, although not on the slopes. Here's her account:

“It was a Saturday night. A woman, who thought it would be fun to let her two dogs pull her along on the snow, ran into me from behind and knocked me ass-over-tea-kettle. At the hospital, the x-rays revealed that the impact of landing on my left shoulder caused the rounded top of the humerus bone to crush down on the shaft.

“The doc described it like a scoop of hard ice cream pressed too firmly on a sugar cone. I had a follow up visit with an ortho today and I’ve got to go back next week for more X-rays. If it remains stable, they’ll keep me in a sling for six weeks and I should start to be able to use it normally after about four months. They warned me that I’ll probably never regain full range of motion. I’m hoping it will improve my golf swing … not much could possibly make it any worse.”

Our friend’s accident at Creste Butte raises the issue of how airlines respond, or don’t, to cries for assistance.

American Airlines responded to our questions about serving injured travelers. Here's what they told us:

Are splints a problem? “American and American Eagle will accommodate a cast or splint made of plaster, plastic or fiberglass. Cast should be adequately designed to facilitate swelling in affected areas. Circumferential air splints are not advised in a flight environment because pressure changes can increase pressure within the splint and cause circulation problems. We have a specialized desk to handle medical acceptance cases. The customer would need to advise us of their medical condition when making their reservation and a specialist at the airline (special assistance coordinator) would contact them in advance of the flight and advise medical acceptance requirements.”

What about changing a reservation, either missing a flight, or heading out early to get medical attention from a hometown bone doc? “ Tickets can be re-issued by visiting AA.com or call AA Reservations. Additional charges may apply for fare difference and ticket change. “

How about luggage an injured person can’t manage? “Checked bag charges are applicable based on the type of ticket issued. “