Hi everyone and welcome to the first of a series of articles attempting to keep all of you healthy and injury free. The snow is back with hopefully plenty more on the way and I thought it appropriate to take this opportunity to discuss injury prevention on the hill. It seems appropriate to once more divide the skiers from the snowboarders and discuss each sport separately since they each have unique ways of injuring themselves.

The biggest injury we see with skiers is the Anterior Cruciate Ligament (ACL) injury occurring at the knee. Your ACL prevents forward movement of your shin away from your thigh and unfortunately being locked into a ski boot increases the force put through this ligament. Also the forces needed to cause injuries in skiing are less, due to the large lever forces that come with having skis on your feet in the first place.

The most common way to injure this ligament is by the “Phantom Foot Scenario.” Sounds creepy, but there has been a lot of research done on this subject. The worst thing about an ACL rupture is the six to 12 months you will have off after you injure it. This fall occurs by having six things happen after you get off-balance, which will look familiar since you see it occasionally at the hill.

1) Your uphill arm usually flails backward

2) The skier is off balance to the rear

3) Hips are now below the knees in a full squat

4) Your uphill ski becomes un-weighted as you try to regain balance

5) You put your weight on the inside edge of your downhill ski tail

6) Your body keeps facing forward

All these things result in your ski boot going forward while your body weight goes backwards loading up and twisting your knee causing an ACL injury.

The second most common way to cause an ACL injury is coming off of a jump (big or small, it doesn’t really matter) and landing with your weight shifted back too much on your heels. The compressive force of the landing combined with your weight transferring backwards causes the ski boot to provide enough force to rupture your ACL.

Now that you are able to recognize the worst ways to fall, the best way to fall is to keep your knees slightly bent, arms forward with hands over skis, and with skis kept together. One of the major issues is people trying to recover from a fall. Once you feel yourself getting into an awkward position just commit to falling as safely as possible onto your side without putting your hands out. Get up, laugh it off and keep going.

Snowboarders tend to suffer fewer knee injuries than skiers but have a higher risk of upper limb and head injuries from catching an edge and getting whipped like a fly swatter. So for head injuries, please wear a helmet; it’s common sense. There is not much else I can tell you other than to protect it, we all catch an edge sometime. But for wrist injuries, we see the majority of snowboarders coming in from falling on an outstretched hand. It only takes a minimal amount of force to fracture the wrist so even beginners going very slowly can get into this situation.

The best way to avoid a broken wrist when you catch an edge is to land forward onto your forearms if you catch a toe-edge, or to tuck your chin and land on your back if you catch a heel-side edge. This takes practice; because everyone will immediately put a hand out to stop a fall so try it out a couple times first to teach your body to react quickly when it only has a split second to do so.

After these injuries we see shoulder dislocations, separated shoulders, tibia fractures, compression fractures and whiplash, but there is not really any solid way to prevent these injuries other than staying on your feet and riding within your abilities. To increase your body’s ability to stay on its feet you can do some pre-season training. You want to focus on strength, balance, and endurance and so targeting your quadriceps, hamstrings, and glutes will help accomplish this. Some easy exercises to target these muscles would be squats, lunges, deadlifts, box jumps, etc. Balance reactions and stability can be trained using bosu balls (the blue half ball you see in the gym), wobble boards or modifying your squats and deadlifts to doing them on one leg. Stability is enhanced with core and abdominal work which we will cover in another article.

Lastly, endurance is trained by slowly increasing your time on the hill and the intensity that you ski or ride at, but know when to call it quits. Do you really need to hit that last kicker at the end of day? You can train endurance outside of the hill using cardio machines or going for a cross-country ski that will push your lower extremity to fatigue.

With all training programs I always recommend consulting a health professional before you start a program to ensure it is appropriate for you.

If you have any pain or abnormal symptoms with exercise please see a doctor, physiotherapist or chiropractor before you continue.

Thank you for reading and if you have any questions please feel free to call me at 780-852-2262 or email me at jasperphysio@telus.net.

Sean FitzGerald MScPT