Preventing Skiing Injuries with Physical Therapy
Skiing is one of the most popular winter sports, demanding significant strength, agility, and coordination while moving down the snowy slopes. The most common ski injury is to the knee, accounting for 30% of ski injuries and often resulting in an ACL or MCL tear. A physical therapist can help you prepare for the slopes through a customized strength and conditioning program, addressing muscle imbalances and targeting specific muscle groups to increase stability and muscle control. Should an injury, physical therapists accompany you every step of the rehabilitation process to help you return to skiing safely.
Common Skiing Injuries
Skiing is one of the most popular winter sports worldwide with nearly 15 million skiers in the United States and 200 million skiers worldwide. Downhill skiing requires high-intensity exercise with significant agility and coordination over a brief period of time while moving quickly down packed snow and ice; this makes skiing a particularly risky sport for injury.
The lower extremities, particularly the knees, are the most commonly injured areas of the body during skiing. The snow conditions when skiing can also affect the types of injuries that occur. Hard-packed, icy snow can lead to high-speed, impact injuries due to falling whereas fresh powder or heavy snow contributes to torsional and twisting injuries to the knee.
Common skiing injuries include:
Knee: Knee sprains and ACL and MCL tears account for 30% of all skiing injuries. The knee is more susceptible to injury during skiing due to the fixed ankle and foot in the rigid ski boot combined with the necessary twisting and movement of the knee when skiing.
ACL Tears: The anterior cruciate ligament (ACL) connects the thighbone to the shinbone and is a key ligament to stabilize the knee joint. ACL tears can occur in several ways: when abruptly stopping, when making sudden changes in direction, or when landing a jump on the slopes. If the skier’s body weight bears down on the back of the foot, too much pressure is applied to the calf and drives the knee into a forced internal rotation that can tear the ACL.
MCL Tears: The medial collateral ligament (MCL) connects the thigh and lower leg. An MCL tear can occur when a skier attempts to slow down or stop altogether. If the motion is abrupt, the skier can fall, twist the knee, and tear the MCL. To prevent this, ensure that your weight is balanced when in the snowplow position to stop (ski tips pointed toward one another).
Shoulder: Injuries to the shoulder account for 4-11% of ski injuries. Shoulder injuries can include rotator cuff tears, shoulder dislocations, or AC (acromioclavicular) joint separations. A shoulder injury can result from a fall on an outstretched arm or from torquing of the shoulder by the ski pole, pulling the arm back as the skier moves past the arm on the hill.
Wrist: Wrist and hand injuries most often occur during a fall on the ski slope, such as wrist sprains or fractures and skier’s thumb, an injury to the ulnar collateral ligament (UCL) and soft tissue that connects the bones of the thumb together. Up to 10% of all ski accidents are UCL injuries and occur when the skier falls with the ski pole in hand, which places too much stress on the thumb.
To avoid ski injuries, be sure to engage in a dynamic warm-up before hitting the slopes and prepare for the season by building strength and endurance with a physical therapist. Use proper equipment, including goggles, a helmet, well-maintained boots, and bindings that are appropriate to your height, weight, and skiing ability.
Physical Therapy for Skiing Injuries
Before jumping on the ski slopes this winter, check in with your physical therapist to prepare for a successful ski season. A physical therapist can help you prepare for the slopes through a customized strength and conditioning program, addressing muscle imbalances and targeting specific muscle groups to increase stability and muscle control. Should an injury occur during the ski season, physical therapists accompany you every step of the rehabilitation process to help you return to skiing safely and with confidence.
As part of the strength and conditioning program, the physical therapist will incorporate core strengthening, targeted strengthening of the quadriceps, hamstrings, and gluteal muscles, and mobility and flexibility training in the ankles, knees, and hips to reduce the risk of injury. By building a strong core, the skier has a solid stable base to control muscle movement while traveling at a high speed. Strengthening of the quadriceps, hamstrings, and glutes is essential to maintain balance when skiing and allow for control of the knee as the skier shifts weight and direction continuously when skiing.
Should a knee injury such as an MCL or ACL tear occur when skiing, physical therapy is critical to regain full function, strength, and mobility in the knee and return to skiing. ACL reconstruction surgery is commonly done for athletes following an ACL tear followed by a comprehensive rehabilitation program of at least 9 months.
After surgery, the physical therapist helps the skier manage swelling in the initial weeks after surgery and helps the athlete safely perform range of motion exercises and contraction of the quadriceps muscle to promote good knee extension and strength. As the athlete enters months 3 and 4 of ACL rehabilitation, the knee is progressively loaded and strengthened to handle stress and the athlete begins running and jumping exercises to establish good mechanics in a controlled environment. Before returning to skiing, the skier must complete a return to sport protocol to ensure they can safely return to sport.
