Ski injury prevention

Your Knees and Skis

Knee

ONS sports medicine physician, Demetris Delos, MD, a board-certified shoulder and knee surgeon, offers injury prevention advice for skiers at home and before hitting the slopes.

Skiing can be one of the most enjoyable winter activities and is a great sport the entire family can enjoy.  But nothing can ruin a great day outdoors (or even the next 6-12 months) like a serious knee injury, especially the dreaded anterior cruciate ligament (ACL) tear.

Unfortunately, most of us have heard or know of someone who injured their knee while skiing (hopefully not ourselves!). Skiers, in particular, are at greatest risk to strain the ACL to the point of tearing in several ways: when they try to recover from a fall with their body weight in back of the skis; if they don’t land a jump correctly; or if improperly set ski bindings don’t release during a critical moment. ACL tears usually require surgery and a lengthy recuperation to repair.

There is nothing glamorous or exciting about a targeted conditioning program but it can mean the difference between a successful and enjoyable ski season and one that is marked by prolonged aches, pains or even more serious injuries. For this reason, training for the ski season should (ideally) begin 2-3 months before that first run.

Skiing is predominantly a lower body sport and it pays to train the muscle groups of the entire kinetic chain. This means working the core muscle groups (abdominal muscles and the low back), the hips, the thighs, the knees and the calves.  Some upper body training can also be helpful.

Six key exercises that can greatly improve strength and conditioning and prevent injury include the following:

Core:

  • Plank stabilization
    • Begin by lying on your stomach. Lift your whole body up, supported by your forearms and toes. Lift your right leg and left arm straight out. Lower back down and repeat with left leg and right arm. Repeat for10 repetitions on each side.
  • Deadlifts
    • Begin standing with weights in your hands (can start with 5 lb. dumbbells or lighter). Keep your knees slightly bent, your stomach muscles tight and your back flat. Let your arms and trunk move forward, keeping your chest up. Lift back up and repeat for 2 sets of 15 repetitions.

Thighs:

  • Double legged squats
    • Begin standing with a medicine ball at your waist. (Alternatively, you can use weights in both hands.) Lower your hips to the floor, keeping your stomach tight, your back flat, and your knees in line with your toes. Lift back up and repeat for 2 sets of 15 repetitions.
  • Single legged squats
    • Stand holding a medicine ball. Squat down on one leg, keeping your hips, back and your knee in line with your toes. Try not to lean your trunk or let your knee fall inward. Repeat for 2 sets of 15 repetitions on each leg.
  • Lateral lunges
    • Begin with a medicine ball at your waist. Take a large step to the side; sit your hips back and squat down, keeping the opposite leg straight. Lift back up, step together and repeat for 2 sets of 10 repetitions with each leg leading.

Calves:

  • Heel raises
    • Stand with your heels hanging off a step. Pick up your left foot. Standing on your right leg only, lift your heel all the way up, then back down slowly. Repeat for 3 sets of 15 reps on each leg.

Additionally, there are things you can do to condition your body before you start a day on the slopes.

  1. Warm up: Simply put, taking the extra few minutes to acclimate yourself by doing some light runs on an easy trail can put the body and mind in the right framework for the more difficult runs that lie ahead. Some light stretching can also be helpful to stimulate the muscles that will play an important role in skiing.
  2. Cool down: Stretching (preferably by maintaining a certain pose for 15-20 seconds at a time, and repeating that for 3-5 repetitions) can loosen up the muscles and prepare them for the necessary recovery after skiing.
  3. Know the risks and minimize them: Most skiers know that the risk of injury increases in the afternoon or early evening as individuals become more fatigued. So it pays to STOP WHEN YOU ARE TIRED! However, the risk of injury also increases when visibility is decreased, when a skier skis above his or her level, or when the ski conditions become very icy or very soft. When these factors are present, instead of skiing the more difficult slopes, you should consider easier runs.

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