Ski injury prevention: beware the 5 B’s

Skiing is often thought as a highly risky sporting activity – something about sliding down a mountain at great speed strapped to two boards – but in an evaluation of most dangerous sports, Forbes magazine found that skiing fell significantly behind a whole host of other pastimes. Furthermore, technological advances and the use of helmets has meant that ski injuries have declined in recent years.

However, even with this decline, the knee is still very prone to incurring trauma when skiing, accounting for a third of all ski injuries. The most common cause of these knee injuries is rotation and I have identified the five Bs to watch out for:

1. Bindings

The introduction of bindings – the device that connects the boot to the ski, which releases when certain force limits are exceeded, such as a spill or collision – was a huge development in on-piste safety which addressed the two main dangers of the era: ankle injuries and lower leg fractures. The ‘downside’ of that was an increase in the rise of anterior cruciate ligament injuries and the knee sprain becoming the most common injury in skiing.

So, what have bindings got to do with knee injuries? Well, a common occurrence is when someone is travelling too slowly for the bindings to release, and falls – resulting in the ski going one way and the body weight going the other, resulting in an unnatural rotation of the knee. This incident is usually prevalent amongst beginners, but more experienced skiers can come a cropper when they set their bindings too tight.

2. Bad snow

Snow quality is a huge factor in skiing injuries and for obvious reasons: if it’s too hard-packed or icy, it’s harder to grip the surface with your ski edges and can cause more severe injuries if you take a spill. On the other hand, if the snow becomes sticky and slushy, the danger of slow-turn injuries and failures in binding releases increase dramatically.

Make sure you keep tabs on the quality of the snow as the day wears on, and adjust your style accordingly – or call it a day if you’re not comfortable with it. Early season skiers usually encounter more hard and icy surfaces: late season skiers are usually forced to contend with slushier snow. Wherever you are, it makes sense to consult local knowledge and weather reports. Here’s a more detailed guide to the complexities of snow quality.

3. Bottom of the run

By this, I mean towards the end of the day, when too many skiers are more fatigued than they realise and start to lose concentration and consideration for others.

Obviously, unless you happen to live in the Alps, skiing is not a hobby one can pursue whenever you like, and the whole point of your holiday is to get on the slopes, but there’s a fine balance between getting the ski time you desire and giving your body the chance to recover for the next day. After a day on piste, you are strongly advised to partake in a ten-minute cool-down session (simply walking on the spot will suffice), followed by a routine of stretching exercises, such as lunges, calf raises, and groin and calf stretches.

4. Boredom

It can’t be stressed enough: not only is skiing an incredibly strenuous physical activity, it’s also a hugely taxing mental experience. Furthermore, the short and exciting bits are punctuated by queuing for ski-lifts, dealing with skiers of varying experiences and skill levels, and distractions such as low sunlight.

Simple solution to this: if you feel your concentration waning, remember the latter half of the words ‘skiing holiday’ and do something else that you’d normally do on a break. Which leads to the fifth ‘B’…

5. Boozing

There’s no getting around it – the temptation to push the boat out in a nearby chalet bar and get stuck into the Glühwein can be overwhelming, but there’s a price to pay when you overdo it. The dulling of reactions, loss of concentration and the removal of inhibitions can be a recipe for disaster when on skis and the French have recently introduced stiff penalties for those caught drunk skiing, claiming that one in five ski accidents in France are due to drinking.

Surgery is not always necessary after a knee injury – modern skis can allow the recreational skier to continue their favourite pastime. My rule of thumb is always whether the patient is willing and able to adapt their lifestyle to the reduced capability of their knee joint or if the knee needs to be adapted to suit their requirements.