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Preventing Knee Injuries in Skiing
By Lissa Fraser MScPT Registered Physiotherapist, recreational skier and owner of Fresh Tracks Physiotherapy
All sports and activities carry some degree of injury risk with them and unfortunately knee injuries tend to be the most common in skiing both in recreational and avid skiers. Of these knee injuries, ACL or anterior cruciate ligaments tears are some of the most serious as they often require surgery and come with a long recovery period. While not all injuries are preventable, there are some risk factors which can be modified.
- Injuries occur most commonly when skiers are fatigued so maintaining physical fitness and strength pre- and during the season as well as resting when appropriate are important preventative strategies.
- Injuries occur more often in females than males which is thought to be because landing mechanics in women tend to be more quadriceps dominant and in knee extension. Thus muscular training focusing on hamstring strengthening and landing in a more flexed knee position can also be effective injury prevention strategies.
- Although not the main focus of this article, additional effective injury prevention strategies include appropriate use of equipment (ie. correct size and fit, correct DIN binding setting etc) and good skiing technique. Receiving ski instruction from a professional is a worthwhile investment.
Neuromuscular training programs have been shown in research to reduce the risk of sustaining an ACL injury. Specifically, programs which include landing stabilization exercises (ie. drop landings, jump/hop), hamstring strength and lunges have been shown to be most effective.
As physiotherapists who ski these are some of our favourite pre-habilitation and throughout ski season exercises to reduce the risk of sustaining a knee (specifically an ACL) injury.
- Lateral Lunge
- Lateral bosu jump/land
- Step Back Lunge
- Landing mechanics
- Split squat
- Single leg Russian dead lift
- Single leg balance with toe touch
Important points to note:
- ensure good hip-knee-foot alignment (use a mirror!)
- try not to let your knee drift over your toes in squat positions, you may need to shift your weight into your heel
- don’t forget about your core – engaging your abdominals is the key to good balance
Lissa Fraser, Registered Physiotherapist, Clinic Owner
Fresh Tracks Physiotherapy
Unit 205 -1978 Cliffe Ave., Courtenay, BC V9N 2L1
p. 250.871.7177 f. 1.250.483.1991
Outsmart your ski instructor and troubleshoot your own ski technique
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Thanks for sharing this program with us! I know it is especiallly for knee injury prevention, but can you also recommend the same exercises to do after knee surgergy, as recovery exercises or is it better to find different ones? Cheers!!
Hi Ronah! Depending on the type of knee surgery the post-operative rehab program and exercises may look quite different. Most of the ones pictured here would be appropriate later in the surgery recovery process (ie. at least 3+ months post op). However, each knee surgery and surgeon will have their own protocol including exercises and timeline for performing and progressing them so it’s always best to refer to the this. Generally speaking though, all knee programs whether pre- or post-op should focus on quad, hamstring, hip strength and mobility as well as progress to neuromuscular training like the exercises above… Read more »
Thanks Lissa! 🙂
Thanks for the info. One additional thing I’ve heard is that some (a lot?) of ACL tears occur when you’re trying to save a fall. Is there any truth to this? If so, should you just go down if you’re going down, and not fight it?
Great question, although no real clear cut answer! There are so many variables when it comes to falling (ie. terrain, speed, strength/mobility of the skier, etc) but there is some truth to this. ACL tears can occur when trying to recover from a “backseat” position where the skier forcefully contracts their quadriceps to try to stand back up. This can create a forceful pull on the front of the tibia driving it forward on the femur and stretching or rupturing the ACL.That said, i’m not sure it can be recommended to allow the fall especially since falling can bring risk… Read more »
Excellent article! I guess many can benefit from practicing these exercises and strengthening these muscle groups. Thanks for posting!
Absolutely true, these exercises are not just for skiers! Neuromuscular training like this can benefit anyone looking to strengthen the lower extremities or maintain joint health 🙂
Good article, Lissa. While a knee injury can occur at any time (as competitive skiers sadly show) I tend to find I have my most alarming moments early in the season when legs are not yet strong and balance/technique is not yet up to speed.
Do you have any similar advice on hips?
Good point – early season injuries are definitely common, hence why pre-season conditioning is so important. Hip injuries tend not to be as common as knee injuries for a few reasons but mostly to do with the anatomy of the joints. Hips have a tendency toward stiffness while knees have a tendency toward mobility so you are more likely to sustain a hypermobility injury (like an ACL tear) in the knee and more likely to suffer from stiffness/tightness in the hip. That said, the hip has a huge influence on what goes on in the knee (especially in skiing) and… Read more »
Thanks for those thoughts . My most flexible days are probably a few decades back. These days I try to stay active as I can off season and then (mostly) ski longer stays – multiple weeks/months – so I can ease in to it rather than feel I need to extract value from every minute from the 1st day back on skis. My biggest issue is getting tempted on the fabulous pow days and over-indulging in the bumps. Just another few runs! Feels fine at the time but seems to take a toll in the following days. 🙁 Is there… Read more »
Depending on your issue/pain source (ie. muscular vs joint discomfort) the answer might be different but generally speaking there are a few good practices for the hips that apply to most people: 1. Do some regular self myofascial release with a tennis/lacrosse ball, foam roller or something similar. Focus on the glutes and sides of the hip and leg. 2. Establish some type of regular mobility practice to maintain range of motion in the hips – the hip is a ball and socket joint and thus has multiple degrees of motion – I believe a previous blog post about hip… Read more »
All good points. Had to google “self myofascial release” 🙂