Miami Herald (Sunday)

Going skiing? Exercises can prevent vacation-ending injuries


If you’re planning a winter ski trip, you have probably given plenty of thought to the warm clothes, the gear and the lodge. Now it’s time to plan for injury prevention.

A common ski injury is a tear to the anterior cruciate ligament (ACL). It happens to an estimated 120,000 recreation­al skiers worldwide every year and usually ends the weekend or vacation on a ski patrol sled.

Despite the prevalence of ACL injuries in recreation­al skiing, little has been done to prevent them. A recent editorial in the British Journal of Sports Medicine noted that specialize­d injury prevention programs are very successful in ball sports, but they haven’t been utilized in recreation­al skiers.

“Research has found considerab­le benefits, more than a 50-percent ACL injury reduction, following specific ACL injury prevention programs in ball sports,” says Martin Burtscher, the lead author of the editorial and a professor at the University of Innsbruck.

“Why should this not work in Alpine skiing?”

When an ACL tears on a soccer or other sports field, it’s often because the body twists and the foot doesn’t, transmitti­ng that torque to the knee. But snow and skis make for a different equation, says Tim Hewett, professor and director of research at Marshall University’s Department of Orthopedic­s in Huntington, West Virginia.


Understand­ing the position of the body when these injuries are most likely to happen can help people lower the risk. There are three main ways people tear their ACL while skiing.

The slip-catch: This typically happens during a turn when the outside ski loses contact with the snow and the skier attempts to regain contact in a more vulnerable, extended-knee position.

The dynamic snowplow: This occurs when the inside ski loses contact with the snow during a turn and re-engages with the snow in a snowplow position. This causes the inside knee to twist.

Backward fall: An out-ofbalance backward fall can happen when the skier sits on the back of the ski. It also occurs when the skier hits the snow with the

backs of the skis while the legs are very straight.

Not all of these risky situations can be avoided, especially since they involve unanticipa­ted movements, but some can. That’s why prevention programs for recreation­al skiers can be effective, Burtscher stresses.


While it’s best to start a training program a few months before your trip and maintain it throughout the year, you can still benefit from training even if your trip is weeks away. Matthew Jordan, former director of sport science/ sport medicine for Alpine Canada, said injury-prevention training programs should focus on the following areas:

Core strength:

Exercises that build your core will help maintain a stable position on the skis. Try a plank (hold a push-up position with straight arms or resting on your forearms) or a bridge (lie on your back with knees bent and feet flat; use glutes to lift hips up).

Knee and hip control:

Exercises that develop dynamic strength and balance can help in situations when the snow is suddenly icier, bumpier or when another skier runs into you. Try standing on one leg with the knee slightly bent and back straight. Lower the torso so it is parallel to the floor. Or try lunges on a balance pad.

With one foot on a balance pad or disc, step the other foot back. Now lower the back knee to the floor.

Hamstrings and quadriceps: Strong legs act as a brace for the knee, and balanced strength between the quads and hamstrings is an important factor when skiing. Do squats. Keeping your back straight, bend your knees and hips to 90 degrees.

Lower limb asymmetry: Exercise one leg at a time. This helps maintain the ability to stop and make turns in each direction, especially while fatigued. At the gym, do single-leg presses on each side. Or do a series of squats or calf raises while standing on one leg, and then switch sides.

Dynamic movement:

These exercises can improve power and explosiven­ess, which is important as skiing involves quick contractio­ns of muscles to turn, stop and jump. Try jump squats, broad jumps (jumping forward) or skater jumps (jumping from side to side, one leg to the other).


One such prevention program, which focused on competitiv­e high school skiers in Sweden, reduced ACL injuries by 45 percent compared with injuries of skiers who didn’t take part in the program. The study, conducted over a 21-month period with more than

400 adolescent Alpine skiers, emphasized core strength, jumping and squatting movements.

A similar prevention program involved a group of 184 teenage competitiv­e Alpine skiers in Switzerlan­d. The group followed a once-a-week, 20-minute injury prevention program that consisted of hip and leg strengthen­ing and core stabilizat­ion training. The result was a decrease in the rates of all traumatic injuries by 34 percent and overuse injuries by 30 percent.

How well these prevention efforts would translate to middle-aged recreation­al skiers isn’t known, but experts are optimistic. They might even be more effective, hypothesiz­es Hewett, since less trained individual­s typically respond to training interventi­ons more readily than elite or highly trained athletes.

“If you have a recreation­al athlete who hasn’t strength trained in a long time, and you give them even a basic strengthdy­namic balancing exercise, they are going to get better at that a lot in a very short period of time,” Hewett says.

 ?? KIM HAIRSTON Baltimore Sun/Dreamstime/TNS ?? A common ski injury is a tear to the anterior cruciate ligament, or ACL. It happens to an estimated 120,000 recreation­al skiers worldwide every year.
KIM HAIRSTON Baltimore Sun/Dreamstime/TNS A common ski injury is a tear to the anterior cruciate ligament, or ACL. It happens to an estimated 120,000 recreation­al skiers worldwide every year.

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