Orthopedic surgeons at The Center in Bend see an increased number of knee injuries and fractures during the months when people are skiing the slopes regularly. Unfortunately, it’s not uncommon for powder days to end on a painful note for some skiers who can experience a torn ligament in their knee. While all injuries can’t be avoided, there are some ways to help prevent knee injuries from skiing.
The knee is made up of four main things: bones, cartilage, ligaments, and tendons. A ligament is a short band of tough fibrous tissue that connects bone to bone. The four primary ligaments in your knee hold the bones together and help stabilize your knee. Ligaments can become easily injured because the knee joint relies just on ligaments and surrounding muscles for stability. Skiing often requires rapid change in direction and hard muscle contraction, which are movements that can cause ligament damage.
Two of the ligaments that are commonly damaged from skiing are the ACL and MCL. These types of injuries account for 20 – 33% of all skiing related injuries.
Types of knee pain from skiing
Anterior Cruciate Ligament (ACL) Injury:
The ACL is a ligament in the knee that helps stabilize and control the movement of the joint. ACL injuries are quite common in skiing, often resulting from a sudden twist or change in direction.
Medial Collateral Ligament (MCL) Injury:
The MCL is located on the inner side of the knee and is susceptible to injury during skiing, especially when the skier experiences a force from the outside of the knee.
Posterior Cruciate Ligament (PCL) Injury:
The PCL, located at the back of the knee, can be injured when there is a direct impact to the front of the knee or when the knee is forcefully hyperextended.
Meniscus Tear:
The meniscus is a cartilage in the knee that acts as a cushion between the femur and tibia. Tears can occur when the knee is twisted while weight-bearing, which is a common scenario in skiing.
Patellar Dislocation:
The patella (kneecap) can sometimes be forced out of its normal position, leading to dislocation or partial dislocation (subluxation). This can happen during a fall or sudden change in direction.
Patellar Tendonitis:
This is an inflammation of the patellar tendon, which connects the patella to the shinbone. Overuse or repetitive stress on the knee, as well as improper skiing techniques, can contribute to this condition.
Iliotibial Band (ITB) Syndrome:
The ITB is a band of tissue that runs along the outside of the thigh and can cause pain on the outer side of the knee. It may result from the repetitive motion of skiing.
Fractures:
Fractures of the bones in and around the knee, such as the femur, tibia, or patella, can occur in skiing accidents, especially in high-impact collisions or falls.
Those at higher risk:
- Females
- Those with little core strength
- Overweight individuals
- Beginner skiers
Other factors such as trail and mountain conditions, quality of equipment, and prior ligamentous injury can also increase the risk of a knee injury.
How to treat knee pain
The treatment for knee injuries sustained during skiing can vary depending on the specific injury, its severity, and individual factors. It’s important for individuals with knee injuries to consult with your doctor for a proper diagnosis and personalized treatment plan. However, here are some general approaches to treating common knee injuries from skiing:
Rest and Ice:
Rest is often crucial in the initial stages of injury to allow the tissues to heal. Ice can help reduce swelling and inflammation. Applying an ice pack to the injured knee for 15-20 minutes at a time, several times a day, can be beneficial.
Compression:
Compression, through the use of a knee brace or bandage, can help control swelling and provide support to the injured area. However, it’s important not to wrap it too tightly to avoid compromising blood circulation.
Elevation:
Elevating the injured leg can also help reduce swelling. Keeping the leg elevated, especially when resting or sleeping, can assist in minimizing fluid buildup.
Physical Therapy:
Physical therapy is often recommended to rehabilitate and strengthen the muscles around the knee. Therapists can provide exercises to improve flexibility, stability, and range of motion.
Pain Management:
Over-the-counter pain medications (e.g., acetaminophen or nonsteroidal anti-inflammatory drugs – NSAIDs) may be recommended to manage pain and inflammation. Prescription medications may be necessary for more severe pain.
Bracing or Splinting:
In some cases, a knee brace or splint may be prescribed to provide additional support and restrict certain movements during the healing process.
Surgery:
Depending on the severity of the injury, surgical intervention may be necessary. This is particularly true for injuries like ACL tears or significant meniscus tears. Surgical options may include ligament reconstruction, meniscus repair, or other procedures to address specific injuries.
RICE Protocol:
The RICE protocol (Rest, Ice, Compression, Elevation) is often recommended in the initial stages of injury to manage pain and swelling.
It’s crucial for individuals with knee injuries to follow their provider’s advice and adhere to the prescribed treatment plan. Rehabilitation and recovery times can vary, and returning to skiing or other activities should be done gradually to avoid re-injury. Seeking prompt medical attention and adhering to a comprehensive rehabilitation plan are essential for the best outcomes in recovering from skiing-related knee injuries.
If the injury is not responding to rest, ice, compression, and elevation, an orthopedic specialist should be seen as soon as possible. If you hear a “pop” have significant pain or swelling, or sense instability in the knee, make an appointment or use The Center’s NOWcare walk-in clinic, open Monday – Friday, 8 a.m. – 4 p.m.
Proper preparation is key to avoiding knee injuries from skiing.
Consider the following to help avoid injury and knee pain: Strategies for preventing knee injuries during skiing
- Strength training exercises and focus on flexibility
- Learn correct ski technique by taking lessons from the professionals
- Weather and mountain conditions can play a big factor in injuries. Keep up-to-date on the latest snow reports and consider the conditions before you go.
- When on the mountain, be mindful of your body and how you are feeling. Rest to keep your body from fatiguing, which can increase your likelihood of injury.
- Evaluate your ski equipment, which should fit properly and be appropriate for your height, weight, and ski level.
- How to fall correctly – As a highly experienced skier and coach, JD Downing has perfected various techniques that new skiers commonly struggle with. “When you go cross-country skiing, eventually you’re going to take a fall.” – JD Downing Here are the things you will want to think about first so that you don’t injure yourself while falling or getting back up.
Beneficial exercises that can help build core strength and knee stability include:
Strength training before and during ski season can make a significant difference in injury prevention. Before beginning a training program, it’s suggested to modify exercises according to age and ability, and to always check with your doctor.
- Double leg squats
- Single leg squats
- Side to side skaters
- Side plank or leg lifts
- Hamstring curls
- Deadlifts
- Modified wall sits
Practice these exercises regularly, along with proper body alignment, balance training, stretching, and warming up before heading to the mountain.
