February is here, it’s winter in Squamish and we’re in the middle of my favorite time of year… ski season! As a physiotherapist that’s been working with skiers for 6 years people, often ask me about the most common skiing injuries I see, and what they can do to prevent them.
Although there are many different ski injuries that make their way through our clinic doors, most often I see and treat people with knee injuries. These are common after a fall on the hill, particularly if you’re skis don’t release on time, and can take weeks or months to heal.
The knee is a complicated joint with 4 major ligaments that provide stability, and cartilage in between the bones. Any of these structures can be injured with a bad fall but the MCL, ACL and/or meniscus are most commonly damaged.
Often the medial collateral ligament (MCL) ligament is stretched or torn with a fall that stretches the inside of the knee. The MCL gives the knee stability from forces that come from the opposite side. When a fall stretches the MCL it can tear partially or completely and takes weeks to heal properly. It often requires bracing and gradual strengthening to ensure optimal recovery.
Another ligament that is often damaged skiing is the ACL (anterior cruciate ligament). This is commonly damaged with twisting falls or hyperextension injuries (landing flat from a jump). A complete tear of this ligament can mean surgery and a progressive exercise based rehab program.
Meniscus is the cartilage that sits between the femur (thigh bone) and tibia (leg bone) and allows the bones to move smoothly on each other. It can be damaged skiing with a twisting fall but can also be injured if the MCL and or ACL are damaged. This may heal very slowly but sometimes requires surgery to repair the damaged area.
These knee injuries are serious and reading about them can be enough to keep anyone off the slopes. But there are things you can do to prevent injury!
- Strengthen– The best way to avoid an injury on the slopes is to boost your fitness with strengthening exercises. Leg and core exercises can help prevent injury by improving muscle strength, endurance and your bodies overall reaction to steep, deep or unexpected terrain. All bodies are different, which means a personalized assessment with a physiotherapist is a good choice.
- Warmup– Before you start your day on the slopes it is important to prepare with a warm up that includes stretching and a few easy laps on the groomers before moving onto more challenging terrain.
- Proper equipment– Have your skis tuned by a professional, ensure the DIN on your bindings are set appropriately for your size and ability so it releases quickly when it should.
- Take a lesson– Improving your skills and comfort on the hill will help you react appropriately and hopefully avoid a season ending injury. Also remember to ski and ride within your ability, particularly when skiing with more advanced partners, or when the powder hungry crowd has brought your enthusiasm to a higher level than your ability!
As an avid downhill, cross-country and backcountry skier, I often ride the lift or up-track with ski partners that are having knee pain unrelated to an injury. Knee pain can also be caused by muscle imbalance. Tight strong muscles in some areas and weak muscles in other areas can create pain around the knee. Quadriceps, gluts, hipflexors and ilio-tibial bands (ITB) are often stiff and tight after long days on the snow. Having this assessed by a physiotherapist can lead to less painful powder days this season.
An effective way of addressing imbalances is body rolling. Never heard of “body-rolling”? This is the use of foam rollers and rubber balls of different sizes to do self-massage to decrease tightness and soreness of muscles such as the gluts. It’s easy to learn and can be done daily.
Get the most out of the rest of the season by keeping your body strong and injury free this year!