Two-time Olympic gold medalist Mikaela Shiffrin suffered an abdominal puncture wound during a crash in a giant slalom race in Killington, Vermont, on Saturday. And as you can imagine, when you hear the words “abdominal” and “puncture” next to each other, the next set of words is typically not, “just walk it off and you’ll be fine.” Such injuries can be very, very serious—like life-threateningly serious in some cases—depending on where and how deep the puncture went and in all cases require immediate and appropriately thorough medical evaluations.
The crash occurred when Shiffrin was close to the finish line and caught an edge in a manner that sent her tumbling into the safety netting. Following the crash, Shiffrin reportedly said that she “just can’t move” and felt that “something stabbed me.” The 29-year-old U.S. skier remained down on the side of the course quite some time, before being “taken down by sled and transferred by ambulance to be evaluated at Rutland Regional Medical Center,” according to the following tweet, X or whatever such posts are called these days from the U.S. Ski and Snowboard Team:
Another way of saying abdominal puncture wound is penetrating abdominal trauma. It encompasses any situation where some kind of foreign object has gotten through the skin covering your abdomen. Your abdominal wall should have the following layers in sequential order from outermost to innermost:
- Skin
- Subcutaneous tissue
- Superficial fascia
- Different layers of muscle
- Transversalis fascia
- Preperitoneal adipose and areolar tissue
- Peritoneum
The nature and severity of the injury depends deeply on how deep the object has gone. Therefore, whenever any type of object causes a wound anywhere on your abdomen, the first thing you want to check for is whether that object got any deeper than your skin. The likelihood of this depends on the sharpness, density, size and speed of the object. Naturally, it would be difficult for a doughnut or éclair to cause a penetrating abdominal injury no matter how fast it was traveling. However, such penetration is much more likely with something sharp like a knife or fast-moving and hard like a bullet. If the object has gotten through all the layers of the abdominal wall, you’ve got to start worrying about the underlying organs being damaged.
But just because the object hasn’t gotten completely through the abdominal wall and into the abdominal cavity doesn’t mean that you can simply say it’s just a flesh wound. The different layers have nerves, blood vessels and lymphatics running through them. So injuries to the abdominal wall can lead to, for example, severe pain, dangerous amounts of bleeding and the risk of very bad infections.
There’s also the risk of damage to your abdominal muscles. And your abdominal muscles don’t just give you your six-pack, three-pack, one-pack or whatever you happen to be sporting. Such muscles play crucial and yes, core roles in supporting your hips and spine and keeping your insides from coming outside. Based on the U.S. Ski and Snowboard Team post on X, it looks like Shiffrin did suffer severe muscle trauma. However, the nature of this trauma is currently unknown.
Unless you happen to have a CT machine attached to your Tesla Cybertruck, it can be very difficult to tell how deep the penetration may be and what may have been damaged. A person’s symptoms and pain may not be reliable indicators. He or she may feel fine initially but still be bleeding internally, for example. Therefore, any suspicion of penetrating abdominal trauma deserves prompt formal medical evaluation at a real medical facility, where doctors can use different imaging and lab tests to figure out the possible damage and deliver proper treatment.
In fact, emergency surgery may be necessary if there is a significant drop in blood pressure, sustained elevated heart rate, high or low respiratory rate, signs of any organs not getting enough blood or peritoneal signs. Peritoneal signs are symptoms that the peritoneal lining is irritated and inflamed, such as persistent diffuse pain throughout the abdomen and rebound tenderness. Rebound tenderness may sound like what happens to a very sensitive basketball player, but it’s when you first push into a person’s abdomen and then are able to elicit significant pain when you release your hand and allow the abdominal wall to bounce back into place.
At present, there’s no indication of how bad Shiffrin’s injury may be and thus how soon she may return to the slopes. The hope is that whatever caused the puncture didn’t go too deep and didn’t damage too much.
