Skiing is widely – and mistakenly – seen as one of the most dangerous sporting activities in the world, but the truth is more complicated. Skiing injuries have halved since the 1970s, thanks to the huge advances in skiing equipment technology. But while bindings, boots and ski have dramatically improved over the years, the human body is pretty much the same.
While head injuries are still seen as the most perilous injury a skier can sustain, for obvious reasons, the most common area of the body susceptible to injury on the slopes are the knees. No real surprise for that: the unnatural position that the pursuit forces skiers into puts an exaggerated amount of weight and pressure on the knee for extended amounts of time.
Equipment – however good it is – can play a part in knee injuries as well. Bindings – the device that connects the boot to the ski, which releases when certain force limits are exceeded, such as a spill or collision – have been a major contributor to the decrease in ankle injuries, but they also gave rise to the prominence of knee injuries. If you’re travelling too slowly for the bindings to trigger when you run into difficulty, meaning that when you fall your skis will cause a knee twist.
‘Bad’ snow – whether too hard or icy, or sticky and slushy – can be another cause of knee injuries. So can fatigue, loss of concentration, and the temptations of the off-piste bar. So the dangers are still there – they’ve shifted towards the knees, with one third of all skiing injuries being inflicted on that area.
The most common knee injuries are:
Medial Collateral Ligament Tear
MCL tears account for a staggering 20-25% of all ski injuries, and for good reason: winter sports consist of a string of small and large shocks, and the ligament is subjected to a very large amount of stress whenever the knee is twisted. If you’re not landing correctly each time you go airborne – however slight – an awkward landing can tear the ligament. Stopping in the ‘snow plough’ position – by turning the skis inward to form an upside-down ‘V’ shape – can also cause an MCL tear, especially if the inner edge of the ski catches on something. And if you ‘catch an edge’ and your lower leg is suddenly thrown outward, that’s a risky situation as well.
Anterior Cruciate Ligament Tear
In layperson’s terms, the ACL stops your knee from rotating too much and helps keep the shin in place. It can be torn over time by repetitive turning and changing direction, but it can also be instantly damaged by any violent twisting or impact on the knee. It’s under most danger on the slopes when landing jumps, skiing over moguls, and twisting during a fall – and it’s particularly susceptible to a binding-related accident.
Symptoms of an ACL tear include mild to severe instability, painful swelling and a long layoff from physical activity. Treatment depends of the severity of the injury: recovery ranges from rehab exercises and wearing a brace to allow the tear to heal to ACL reconstructive surgery. Depending on the nature of the injury, it could take up to a year before you’ll be fit to ski again.
However, there a lot of things you can do to keep yourself AC and MCL-proof. Conditioning and strengthening exercises of the quad and hamstring areas are your best defence, along with upping your stretching regime – particularly in the quads, hamstrings, hip, back and shoulder areas. And don’t neglect your gear, either: keep your kit in the best condition possible, and check your bindings aren’t set too tight.
Our knee specialist surgeon Mr Jonathan Webb is passionate about taking to the slopes himself and has treated fellow skiers of all levels, from the enthusiastic amateur to GB-level athletes. To arrange a consultation, call 08450 60 44 99 for his Bristol clinic or 020 3195 2443 for his London clinics.