The Stats: It is estimated that each year more than half a million people injure themselves on the slopes.
Knee injuries make up more than 1/3 of these and are twice as common in women, making them the number one reported injury on the mountain (3). Often these injuries happen at the beginning of the season when skiers are less strong and fit or learning the sport for the first time without prior conditioning.
This blog will outline two of the most common ski-related knee injuries and three exercises you can do to help prevent knee injuries during the ski season ahead.
Two of the most common ski-related knee injuries we see in the clinic:
1. MCL tear:
The Medial Collateral Ligament, commonly referred to as the MCL, is one of the most commonly injured ligaments in the knee, particularly with skiing. It is located on the inside of the knee, bridging the femur and tibia, the two major bones that make up this joint. It’s role is to prevent the knee from falling inwards, and is most commonly injured with abrupt turning, cutting, or twisting, as well as from a direct blow to the outside of the knee(2). This ligament is almost never surgically repaired when torn or sprained, therefore the treatment is conservative.
2. ACL tear:
Another major stabilizing ligament of the knee is the Anterior Cruciate Ligament, or ACL. Like the MCL, it is one of the most commonly injured structures that support the knee(4). It’s key role is to stabilize the knee by keeping your shin from sliding too far forward relative to your upper leg(1). It is most commonly injured during the act of landing a jump, or with a sudden change in direction, both common activities on the slopes.
To prevent these two common injuries, focus on simple exercises that will create stability and strength in the muscles that surround and support the knee. Research shows that strength of both the hamstring and quadriceps muscles are extremely important in preventing ACL and ligament injuries, particularly using eccentric strength(1).
Eccentric strength: The ability to lengthen an active muscle with control while it is under load or resistance
Here are three exercises I suggest to help prevent ski-related knee injuries:
1) Eccentric hamstring curl using a Swiss ball
- Start lying on your back with hips flat on the floor and both feet up on an exercise ball
- Bend knees and roll ball in toward your buttocks
- In this position, engage your core and lift your hips keeping both feet firmly on the ball
- Slowly and with control, roll the ball out with your feet, extending your hips and knees
- When you’ve reached full extension, with your legs straight out in front of you, slowly lower your hips to the floor
Repeat for 2 sets 10 reps.
2) Lateral drop squat
• Stand on a small block or box
• Step sideways off the bock landing with both feet about hip width apart with your knees slightly bent and lower into a squat slowly with control
Repeat for 2 sets of 10 reps.
- With an “X” outlined on the floor, stand in the centre in a single-leg stand position
- With knee slightly bent, lower into a single leg squat and hop to one corner of the “X” in front of you.
- From here, on the same leg, jump back to the centre.
- With each hop be sure to land with knee bent, lowering comfortably into a single leg squat
- Repeat this process until you have jumped to and from every corner of the outlined “X”
Perform this entire exercise twice on each leg
Repeat for 10 reps.
Looking for more? A thorough physiotherapy assessment can help to identify your specific weaknesses and strengthening goals to develop a more extensive program to help prevent ski injuries.
Get strong and stay safe out there. Happy skiing everyone!
Troy Clare, Registered Physiotherapist, MPT.
1. Posch, M., Burtscher, M., Schranz, A., Tecklenburg, K., Helle, K., & Ruedl, G. (2017). Impact of lowering ski binding settings on the outcome of the self-release test of ski bindings among female recreational skiers. Open access journal of sports medicine, 8, 267–272. doi:10.2147/OAJSM.S151229
2. SHIOTANI, E., KURIYAMA, S., AMEMIYA, R., & INAGAKI, K. (2018). Recent Trends in Ski-related Injuries. The Showa University Journal of Medical Sciences, 30(1), 113-122.
3. Naqvi U, Sherman Al. Medial Collateral Ligament (MCL) Knee Injuries. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431095/
4. Koller, A., Fuchs, B., Leichtfried, V., & Schobersberger, W. (2015). Decrease in eccentric quadriceps and hamstring strength in recreational alpine skiers after prolonged skiing. BMJ open sport & exercise medicine, 1(1), bmjsem-2015-000028. doi:10.1136/bmjsem-2015-000028