As summer turns into fall and we start seeing the first signs of snow in the mountains, ski season is upon us! Skiing and snowboarding is one of the biggest pastimes in Colorado that natives and transplants enjoy alike. But with the start of ski season, we also see an increase in injury rates.
The most common ski and snowboarding injuries
Most of the injuries caused by skiing and snowboarding are acute, meaning they happen quickly due to a bad fall or a turn that goes wrong, and are in the lower extremity. The two most common acute injuries in the leg are ACL tears and MCL sprains.
On top of the acute injuries that skiing and snowboarding can cause, there can also be a flare up of old injuries. This is often patellofemoral pain, ankle discomfort from an old sprain, and hip tendinopathy. The good news is that the solution to preventing acute injuries and mitigating old injuries in the lower extremity is the same: a focused strengthening program.
Why is strengthening helpful to prevent ski an snowboarding injuries?
ACL tears and MCL sprains have the same mechanism of injury and occur when the knee collapses inward, or goes into knee valgus. The goal of a strengthening program to prevent these injuries is geared towards strengthening the muscles that cross the knee joint as well as the muscles that prevent knee valgus.
The quadriceps, hamstrings, and calf are the muscle groups that cross the knee joint and help provide stability at the joint itself. The gluteus maximus and gluteus medius are the muscles responsible for preventing knee valgus.
Strengthening the glutes, even though they are in the hip, is key to preventing knee injuries. I often tell my patients, the pelvis and hips are the pedestal that our core and legs rest upon. If you have an unstable base at the hips, the rest of your body follows suit. Our glutes are directly responsible for pelvic stability and preventing knee valgus. Weakness in the glutes often results in the inward dive of the knee relative to the hip and ankle, which is the position we want to avoid to protect our ACLs.
Exercises for strengthening and injury prevention
Below are two exercises to strengthen your gluteus maximus and gluteus medius and protect your ACLs for ski season. As mentioned before, these exercises are also great for preventing anterior knee pain, hip pain, or ankle instability while on the slopes.
The ACL prevents forward translation of the tibia and excessive rotation in the knee. The muscles that directly complement to also help decrease these movements in the knee as they cross the joint are the quads, hamstrings, and calf. Strengthening these muscle groups evenly is important to take some of the stress off of the ACL.
The balance of quads and hamstrings
What often happens is people tend to be very strong in their quads but weak in their hamstrings and glutes. This creates a muscle imbalance across the knee and not only puts us at risk of a ACL tear, but also patellofemoral pain and hip tendinopathy.
It’s important to train the quads and hamstrings/glutes evenly to provide balance in the knee. Below is a great single leg quad and glute med strengthening exercise as well as a hamstring eccentric!
Last but not least, our core is also very important for lower limb stability. There is a direct correlation between increased core strength resulting in a decrease in lower extremity injuries. The core is responsible for the more dynamic movements that we make in skiing and snowboarding during turns, stops, and jumps.
It helps keep our spine and pelvis aligned which in turn will keep our hips and knees better positioned. Below is my favorite core progression exercise for skiers and snowboarders!