With the skiing season upon us, this is the time of year when many people return from their holidays with ligament injuries, fractures, sprains and painful swollen knees.
Skiing is demanding. You may spend most of the year sitting at a desk, then suddenly spend several hours a day on the slopes. Your legs, core, balance and reaction time all have to work hard.
Snow conditions matter too. Fatigue matters. Technique matters. You cannot remove every risk, but good preparation can reduce your chance of getting injured and help you enjoy your holiday.
What are the most common skiing injuries?
The most common injuries depend partly on the snow conditions and how you fall.
In icy conditions, it is harder to slow down. Skiers often fall onto an outstretched hand, so wrist, hand and shoulder injuries become more common.
In softer snow, knee injuries are often more common. The anterior cruciate ligament, or ACL, and the medial collateral ligament, or MCL, are two of the knee ligaments most commonly injured while skiing.
These injuries can happen when the ski twists away from the body, the knee rotates awkwardly, or the lower leg stays fixed in the boot while the body keeps moving.
Who is most likely to get injured skiing?
People who are least prepared for the physical demands of skiing are often more likely to get injured.
Going from an office environment to several hours a day on the slopes can be a big change for the body. Skiing needs leg strength, core control, aerobic fitness, balance and proprioception. Proprioception means your awareness of where your body is in space.
If your fitness, balance or body control is poor, it becomes harder to stay in a good position when you are tired. Your technique may break down, your reactions may slow, and a simple turn or fall can become an injury.
This does not only apply to beginners. Experienced skiers can also get injured if they are tired, underprepared or skiing in conditions that are more difficult than expected.
When do skiing injuries usually happen?
The most dangerous time is often halfway through the holiday, especially in the afternoon.
By then, fatigue has started to build. Muscles are tired. Reactions are slower. Concentration is not as sharp as it was earlier in the day.
It is tempting to keep going because you want to make the most of the trip. But stopping before you are exhausted can help prevent injuries. A rest day can also be sensible if your legs feel heavy after the first few days.
Why are knee injuries so common in skiing?
Orthopaedic surgeons often see more knee injuries during the skiing season.
Several factors may explain this. Modern curved skis tend to carve through the snow rather than drag across it. This can steer the ski away from the body and twist the knee.
Modern ski boots also protect the ankle and shin well. The trade-off is that more force and rotation can travel up to the knee.
Preparation matters too. Skiing is becoming more popular, with an increasing number of people skiing who have little recent training or limited previous experience. If the body has not prepared for repeated turning, stopping, balancing and twisting, the knee can become more vulnerable.
How can I reduce my risk of skiing injuries?
Start preparing at least 6 weeks before your skiing trip if you can.
Focus on core strength, leg strength, balance and aerobic fitness. Swimming, cycling and using a cross trainer can be a good start. Exercises that build control around the hips, knees and ankles can also help your body cope better with skiing.
If you are new to skiing, take lessons. Good technique helps you ski more safely and reduces the chance of falling awkwardly.
Listen to fatigue. If you feel exhausted after a few days, take a rest day or finish earlier. Muscle fatigue can build over the holiday and affect balance, control and reaction time.
Avoid alcohol at lunchtime. It increases your confidence and decreases your reactions, which is a perfect recipe for an injury.
What should I do if I injure myself while skiing?
Make sure you have adequate medical insurance before you leave home.
Most ski resorts have excellent medical facilities and are very experienced at treating skiing injuries. If you injure yourself on the slopes, get assessed properly. Do not try to ski through significant pain, swelling, weakness or instability.
Seek urgent medical help if you cannot put weight through the injured area, have severe pain, see obvious deformity, have numbness, feel very unwell, or think you may have broken a bone.
If you fracture, or break, a bone, it may make sense in many cases to have it treated before you fly home, especially if you need surgery. The safest option depends on the injury, local medical advice and your travel plans.
If you injure your knee but do not have a fracture, you can often arrange treatment once you return home. ACL injuries are among the most common knee injuries in skiing. In my opinion, if an ACL injury needs surgery, it is usually better to deal with this once you are home rather than operating very soon after the injury while the knee is swollen and stiff.
In the first few days and weeks after an ACL injury, the priority is often to reduce swelling and restore the range of movement in the knee. Surgery can usually be performed safely weeks or months after the initial injury, depending on the injury and your individual situation.
Prepare well, ski sensibly and have fun
The most important thing is to prepare for your skiing holiday, enjoy yourself and have fun skiing.
Skiing will always carry some risk. But many injuries happen when fitness, fatigue, snow conditions and technique work against you.
Prepare your body before you travel. Take lessons if you need them. Rest when your legs feel tired. And if you do get injured, seek proper medical advice rather than pushing through.
A little preparation before the holiday can save you a much longer recovery afterwards.
About the author
Mr Deepu Sethi is a Consultant Orthopaedic Knee Surgeon specialising in sports injuries, complex ligament repair and reconstruction, meniscal surgery, joint preservation surgery, and partial and total knee replacement. He qualified from University College London Medical School before completing specialist orthopaedic training in Oswestry and Birmingham, followed by subspecialty fellowship training in knee sports injuries and joint reconstruction in Australia and the UK. Mr Sethi is the lead surgeon for knee and joint replacement surgery at Homerton University Hospital, where he is also an active surgical trainer and educational supervisor. He has a strong interest in improving surgical outcomes and registers patients on the National Ligament Registry, which supports research into cruciate ligament reconstruction.
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