Hitting the slopes this ski season? Whether you’re a seasoned pro or gearing up for your first alpine adventure, preparation is key to staying safe and making the most of your time on the snow. Mr John Dabis, Consultant Orthopaedic Surgeon at New Victoria Hospital with extensive experience in treating knee sports injuries, shares expert tips on how to avoid injuries, optimise recovery, and enjoy a worry-free ski holiday.
Skiing is a truly exciting recreational activity, being one of the fastest non-motorised sports on land. Sliding on the snowy mountains with beautiful winter scenery is an unparalleled experience. Although skiing is widely seen as a hazardous sporting activity, the statistics indicate that it is a relatively benign sport to indulge in. However, like any physical activity, it does carry a risk of injury, and surprisingly, the rates of knee injuries suffered by skiers have been on the rise. As skiing uses movements that are not as natural as walking or running, you must get used to a different way of moving.
Common skiing injuries
Shoulder injuries are the second most frequently reported among skiers, but it is the knees that bear the brunt of the sport’s physical demands. Twisting motions, awkward falls, and the unique stress on joints and muscles make lower limb injuries account for over two-thirds of skiing-related incidents.
The most common serious knee injury in skiing is an anterior cruciate ligament (ACL) tear or complete rupture of the ligament. There are also other injuries which can be associated with an ACL tear, such as a tibial plateau fracture, or multiple ligament injuries within the knee, such as a medial collateral ligament injury.
When the knee twists, there is an audible pop at the time of the injury. This is usually followed by immediate swelling and instability when attempting to bear weight. Pain and difficulty straightening the knee are also common symptoms.
The second most common ski-related knee injuries involve damage to the medial collateral ligament (MCL). These typically occur due to excessive force applied in the snowplough position. Symptoms include pain on the inner side of the knee, often accompanied by local swelling.
If you experience knee pain, swelling, or instability after a fall, stop skiing immediately! Apply the RICE method (Rest, Ice, Compression, Elevation) in the first 24 to 48 hours after an injury and seek medical attention promptly.
Risk factors on the slopes
Skiing injuries don't just happen by chance – they're often the result of avoidable factors. Understanding the key risks can help you take proactive steps to stay safe on the slopes. There are several factors which can influence the injuries most commonly seen in clinical practice:
- Poor physical conditioning
- Improper equipment setup
- Collisions or improper landing techniques
- Environmental conditions
- Fatigue and overexertion
Preparing for the slopes
Research has shown that pre-season conditioning exercises significantly reduce ski-related injuries. Skiers should focus on targeted exercises to strengthen key muscle groups and improve flexibility in the weeks and months leading up to the ski season. This preparation will not only enhance your performance and prevent injuries but also ensure a more enjoyable and stress-free ski trip.
"Pre-season preparation is critical and, in my opinion, one of the most important and effective ways to prevent injury. Prevention is always better than cure."
Mr John Dabis
Strengthening exercises
- Squats, lunges, and Romanian deadlifts: Strengthen the lower body and posterior chain – the muscles from the back of the head to the heels – essential for balance and a quick change of direction coming down the slopes.
- Single-leg exercises: Correct muscle imbalances and improve coordination between your ears, eyes, joints and muscles.
- Core stability exercises: Such as planks and rotational movements will help build a strong foundation for balance and control.
Flexibility and mobility
Stretching keeps the muscles flexible, strong, and healthy, which is necessary to maintain a range of motion in the joints. Stretch major muscle groups regularly, focusing on:
- Hip flexors and quadriceps
- Hamstrings and calves
- Iliotibial (IT) band
- Ankles
Choosing the right equipment
Ill-fitting boots and skis dramatically increase the risk of falls, collisions and knee injuries. So it is important to ensure all your equipment – including boots, skis, and bindings – is properly fitted. Current ski bindings are specifically designed to address and minimise lower leg injuries, and decades of product improvements have significantly reduced tibia fractures and ankle injuries.
Bindings
Ensure they are set correctly based on your weight, skill level, and skiing style. Bindings designed to release during falls help minimise lower limb injuries.
Boots
They should fit snugly without causing pressure points and provide appropriate flex for your skill level. Misaligned boots can increase the risk of knee injuries.
Regular equipment checks by professionals can help ensure safety and performance on the slopes.
On-slope techniques
Good skiing technique can prevent falls and injuries:
- Maintain a hip-width stance with skis parallel.
- Keep knees flexed and aligned over your toes.
- Position your upper body slightly biased downhill with arms relaxed and weight centred over the skis.
But if you do fall, and let’s be honest – even the best of us will:
- Avoid tensing up and fighting the fall – resisting can lead to more severe injuries.
- Instead, try to relax and roll with the fall.
- Let go of the poles, but do not stick your arms out.
- It’s best to fall sideways, rather than forward or backwards, to minimise impact.
- Keep the skis together if possible, preventing them from crossing or getting too far apart.
Terrain management and risk awareness
Skiing can range from tranquil coasting through quiet, flat forests to adrenaline-pumping racing down steep slopes. Selecting the terrain that matches your level of skill and capability, while keeping environmental factors in mind, is crucial for both safety and enjoyment. This is especially important for piste enthusiasts harbouring an old or lingering injury, who may not have completely recovered before returning to the snow trail.
- Start with gentler slopes to warm up and ease into the day.
- Gradually challenge yourself with more demanding runs.
- Steer clear of icy patches, areas of poor visibility, and overly crowded slopes.
- Keep an eye on snow conditions as they change throughout the day.
And remember, while alcohol may seem tempting as you conquer the peaks, it can impair your judgment and dehydrate muscles. So it's best left for après-ski!
Recovery
Fatigue is a major risk, with many tumbles happening during those ambitious final runs of the day. While pre-ski preparation is key, post-ski recovery is just as important to keep you feeling strong, minimise soreness, and avoid landing on your backside or worse!
- Take breaks and allow adequate rest between ski days to give muscles time to repair and prevent overexertion.
- Perform post-ski stretches and use recovery tools such as foam rollers.
- Maintain proper nutrition and hydration on the slopes and between days.
- Replenish glycogen, your body’s energy fuel store, with a mix of carbohydrates, protein and nutrient-dense foods.
Skiing is an exhilarating sport that combines physical skill, breathtaking views, and a dash of adventure. With the right preparation, equipment, and awareness, you can significantly lower your risk of injuries and make your ski holiday safer and more enjoyable. Should an injury occur, timely medical attention is vital for optimal recovery.
If you’ve suffered a skiing injury this or previous seasons, or want professional advice on how to stay injury-free, contact New Victoria Hospital’s Orthopaedic Surgery Consultants today on 020 8949 9020 or:
