Category Archives: Injury Prevention

learn why skiers are prone to knee injuries and how it is preventable

There are several factors that play a role in knee stabilization. The four ligaments of the knee (the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and the lateral collateral ligament (LCL)) are the static stabilizers which hold the knee in the correct position.

ImageEach ligament has a specific purpose to prevent certain movements of the tibia in relation to the femur.  For example, the purpose of the ACL is to prevent anterior translation and medial rotation of the tibia.  Damage to the ACL is often correlated with the tearing of any or all of the other ligaments in the knee.  The muscles and tendons which surround the knee joint are called dynamic stabilizers.  Together they unconsciously flex and extend to control and stabilize the position of the knee joint.

To jumpstart this article, I’d like to start off with some fun facts to get your brain pumping.  According to the Journal of the American Academy of Orthopaedic Surgeons and the UCSF Departement of Orthopaedic Surgery (http://orthosurg.ucsf.edu/patient-care/divisions/sports-medicine/conditions/knee/anterior-cruciate-ligament-injury-acl/ )

  •  200,000 ACL tears occur annually in the U.S. and roughly 100,000 of these knees are reconstructed.  This amounts to billions of dollars per year
  • 70% of these injuries occur through non-contact mechanisms such as environmental, anatomic, hormonal, and biomechanical.
  • Women are three times more likely to have ACL injuries than men (in soccer women are eight times more likely) due to hormonal differences on ligament strength and stiffness, neuromuscular control, lower limb biomechanics and fatigue.
  • Women have a smaller ACL compared to men
  • Women do not activate their hamstrings as much compared to men during certain movements, causing less stability in the knee joint and more frequent ACL injuries.

By Including neuromuscular training, proprioceptive training and flexibility into your workouts/warm-up, you will directly decrease the risk of anterior cruciate ligament (ACL) injuries.   Your workouts should be performed at least 2-3 times a week prior to and during the ski season.  Be sure to include a warm-up,  stretching, strengthening, plyometrics, and agility.

And if worst comes to worst… just be glad we don’t live in the 1960’s anymore.ACL surgery humor

Three most common skiing injuries and how to prevent them

As everyone already know, skiing is a sport that doesn’t come without a risk factor. I’m here to tell you exactly what that risk factor is and how to prevent it from happening to you.

Today, the most common injuries are thumb injuries, head injuries and lastly of course knee injuries (account for 40% of ski related injuries).

Image
Skier’s Thumb- damage to the ulnar collateral ligament (UCL)

1) Skier’s Thumb: Occurs mostly to the UCL (ulnar collateral ligament) of the thumb.  This injury often occurs when a skier falls without releasing the pole from their hand.  This results in significant bending stress to the thumb.  Partial tears to the UCL can be treated with a splint but a complete tear requires surgery.

Prevention: Letting go of your poles when you fall or choosing poles that you can easily let go of can minimize your risk. American College of Sports Medicine (ACSM) supports the use of poles with straps rather than the fitted grip as these are associated with fewer injuries.

2) Head Injuries: Travelling at high speeds beyond one’s ability and not being aware of the surroundings are two main causes of head injury.  Of course, even the most experienced skiers can get unlucky with the conditions leading to a serious concussion or even fatality.

Image
Nik Zoricic, member of the Canadian Ski Cross Team, died following a severe crash during the eighth-finals of a World Cup event in Grindelwald, Switzerland.

Prevention: This one is a no brainer…. Wear a helmet.  Luckily up to 40% of skiers wear helmets which has significantly reduced minor head injuries since 2000.  Unfortunately there is no evidence they reduce skiing related fatalities.   The main reason for this is probably because helmets are designed to only withstand impacts up to 23 km/h (14 mph).  Also, snow conditions make a big difference between the severity of the injury.  Ice versus powder can make a big difference when a head hits the ground….

Before I go onto the last common injury, let’s put things into perspective.  According to the National Ski Areas Association, in the year 2009…

35,900 Americans died in motor-vehicle accidents.

5,300 pedestrians were killed.

8,600 died from unintentional public falls.

4,500 died from unintentional public poisoning.

2,400 people drowned while swimming in public areas.

800 died while bicycle riding

41.5 died skiing or snowboarding (average deaths over a 10 year period)

So don’t get too worked up about skiing risk factors… just wear a helmet!

Image

3) Knee Injuries- Damage and stress to the medial collateral ligament (MCL) ccur commonly with slow twisting falls or in the ‘snow plow’ position.  The other common knee injury is damage to the anterior cruciate ligament (ACL) which occurs in a variety of ways such ‘as catching an edge’ or falling backward as your feet go forward.

Prevention:  Fortunately, most MCL injuries can be managed with a brace and limiting range of motion.  However, damage to the ACL often requires extensive surgery and a long (6-12 months) recovery.  The trick to preventing knee injuries is to go into the season physically fit with ultra strong quadriceps and hamstrings.

Image
Okay, maybe not this ripped.

Fortunately, research shows ski injuries have dropped by a whopping 50% over the past 40 years.  Advancements in equipment can be thanked for that!  Soft leather cut boots have turned into mid-calf plastic boots that support the lower leg and ankle. Ski resorts continue to improve slop safety/maintenance and advancements in binding design continues to reduce lower leg injuries.