Given the current global circumstances, many of those reading this blog will be thinking ‘will I ever make my beloved ski trip this season’?! At the time of writing this blog Northern Hemisphere ski slopes have been back open for a little over a month. Despite this, Brits have been unable to visit popular French ski resorts due to travel restrictions. Fortunately, France have just announced a reduction in travel restrictions, so things are looking more hopeful! With any luck we’ll be able to dust off our ski boots and get back out there soon, but in the mean time I thought it would be a great opportunity for our readers to brush up on common boarding and ski injuries, and more importantly- find out how to prevent them!

Let’s face it, waiting in anticipation for the trip of the year, a chance to visit the slopes for an amazing week of skiing with friends or family, then getting injured on the last run of the first day is less than ideal. You spend the remainder of the week tucked up in a French hospital bed, or sat on your balcony dreaming of what could have been.

In this blog we’ll discuss at a few things that can influence this sad possibility, and hopefully stop this from happening to you!

• Common ski injuries
• Reasons why these happen
• What role physio can play in prevention or rehabilitating these injuries

Common Injuries

Skiing is a physically demanding sport and has the potential to put lots of stress through different joints and muscles in the body. Even for those who choose to pootle down the green slopes and spend most of the day sipping rosé in the sunshine, negotiating the après bar stairs in ski boots can bring its own risks!

The knees can often take the brunt during twisting injuries of the legs, and the shoulders need to withstand a lot of force when you catch an edge and have a traumatic tumble. Below are some of the key snowboarding and ski injuries we see on the slopes:

• Ligament injuries- primarily around the knee, such as the ACL (anterior cruciate ligament), PCL (posterior cruciate ligament), and the two main stabilising collateral ligaments on the inside and outside of the knee joint- your MCL and LCL.
• Meniscal (cartilage) tears in the knee
• Hand and wrist injuries from falling onto the piste- thumb ligament damage and wrist fractures being the most common. One injury involving a ligament in the thumb is even nicknamed the ‘skier’s thumb’!
• Shoulder joint fractures and dislocations
• Head injuries

So how do we prevent these?!

There are many snowboarding and ski injuries that we can’t prevent which are just down to bad luck and being in the wrong place at the wrong time. However, the good news is that many injuries CAN be prevented:

• General fitness– A significant chunk of ski injuries occur at the end of the day when you’re tired. Regular cardiovascular exercise can make your organs, muscles and blood more efficient at transporting, storing, and using energy. This means that the freshly baked pain au chocolat that you’ve eaten that morning will go further. The altitude may not play as much of an impact on your fatigue levels if you’re familiar with exercising regularly before your trip too. Consequently, improving your cardiovascular fitness is a really great step in the right direction towards reducing injury risk, needless to mention the countless other benefits this will have on your physical and mental health.
• Hydration– The tissues in your body need fluid to work as efficiently as possible. Staying hydrated will keep your muscles and other structures working better for longer, and reduce how quickly you get fatigued.
• Muscular Strength– Your muscles play a key role in dynamically stabilising the joints in your legs. The pivoting movements required in skiing place a lot of stress on these joints and muscles, but if your muscles are strong, they will be able to withstand this force better. Strengthening the muscles in your legs (especially your hips, thighs and calf muscles) with resistance training will make them more prepared for the powerful movements required with skiing or snowboarding, and help to stop them fatiguing as quickly. A small twist that may not cause any problems on the first few slopes of the day can easily turn into a mechanism for injury on the last run, as the muscles aren’t able to tolerate this force as well. More stress is placed through the passive stabilising structures in the legs, and this can lead to knee ligament and cartilage injuries. Overuse injuries around the knee joint and kneecap can often get worse as a result of muscles in the thigh and hip becoming tired too, so there are multiple benefits in getting stronger!
• Neuromuscular control– It’s all well and good having strong muscles, but if your body can’t coordinate the way in which they contract and work as a team, you won’t have an efficient system to stabilise your joints. Movement patterns are a combination of different muscles contracting at different times, and at varying magnitudes. This system is primarily controlled by your nerves, and regular movement patterns are stored in a certain part of your brain. Performing exercises that promote ‘good’ movement patterns that replicate skiing like single leg squatting and lunging can make these pathways more efficient. Improving your neuromuscular control is a bit like upgrading your bicycle for a car on your daily commute. You need to do some extra work to earn the money to buy the car (doing your exercises), but once you’ve bought it, you can get from A to B quicker (nerve signals are more efficient), more comfortably (better stability at the joint), and with far less effort (reduced fatigued). Your muscles and nerves work in a similar way to this. Doing these types of exercises makes the whole system of muscle contraction quicker and more efficient, which in turn provides extra stability around your joints, reducing your risk of injury.

Where does physio come into this?!

By this stage, you may be thinking ‘why do I do this to myself?!’ Well, the good news is that some of these factors can be improved in as little as a few weeks. Completing a programme of exercises to improve your neuromuscular control and strength is a great way to prepare your body for the demands of being on the slopes, and reduce your risk of injury!

If you’re reading this sat on your resort apartment balcony, beer in hand with your knee in a brace, you’ve probably been unlucky enough to have sustained one of these injuries! It’s important to follow a graded rehabilitation programme to reduce any pain at the area, and ensure the structures damaged can heal in the best way possible.

Come and visit us in clinic or book in with one of our physiotherapists using the below link to create a bespoke ‘pre-habilitation’ plan ahead of your trip to the slopes, or to rehab your injury back to full health!

https://www.agiletherapy.com/booking-online/

Written by Jonny Harper
MSK Physiotherapist BSc Hons MCSP