Ski

The three main ski injuries are ACL, MCL, and meniscus tears.

Anterior Cruciate Ligament Tear

The cruciate ligaments are in the front and back of the knee making an “X”, connecting the thigh bone (femur) to the shinbone (tibia), and work to limit forward and back motion of the tibia. The anterior cruciate ligament is in the front of the knee joint limiting the tibia from sliding too far forward and providing rotational stability to the knee. With skiing, an ACL tear can occur from a traumatic force being applied to the knee in a twisting moment, causing forceful hyperextension. Skiers are particularly susceptible to these type of strains when landing jumps, skiing moguls or during twisting falls. Two common ways skiers tear their ACL is from landing a jump in poor form or when the “phantom foot” phenomenon occurs. When skiers land from a jump with their weight back, the back of the boot pushes the calf forward and can tear the ACL. Along with the stiff back of the boot, the tail of the downhill ski acts like a “phantom foot” in a backwards fall. The “phantom foot” phenomenon happens when skier’s try to reach back with the uphill arm, sit down to break a fall, or stand up to prevent an unavoidable fall. As the skier falls, all the weight goes on the outside of one ski, and the arms and trunk rotate away from that leg. This landing position can tear the ACL. Tips to avoid an ACL tear include progressing from simple to more difficult jumps landing on both skis with your weight forward and never try to stand up during a fall. Skiers are recommended to “go” with the momentum of a fall, keep arms forward, feet together, and hands over the skis while trying to control the fall and not fight it. Falling forward or to the side is preferable to falling straight backwards.

Medial Collateral Ligament Tear

The collateral ligaments are on either side of the knee, connecting the femur to the tibia, and work to limit side-to-side motion. The medial collateral ligament is on the inside of the knee and aids in stabilization of the knee joint. When the knee dives in excessively, this motion can cause an abnormal amount of stress and stretch to the MCL resulting in a sprain or tear. With this injury, a person will feel discomfort on the inside of the knee, possible swelling around the knee, and a feeling of the knee being unstable at times. In skiing, the MCL can tear when the “snow plow” position to stop is used. With the front of the skis pointed toward one another, the MCL is susceptible to tear if the inner edge of the ski catches and suddenly forces the knee into a further knocked knee position. The MCL can also tear when the lower leg catches an edge and is unexpectedly thrown outward. The stronger your core and hips are along with all the muscles around your knee joint, the better you will be to avoid an MCL sprain by keeping your knee more aligned with your foot. Also, performing quick directional changes, pivoting, and shifting with your training can better prepare you for reactionary countermovements that may help you avoid a tear.

Meniscus Tear

The meniscus is a piece of cartilage that provides a cushion in the knee joint between the femur and the tibia. There are two menisci in each knee, one of each side of the knee joint. The menisci act as a lubricant for the knee joint, absorb forces that the knee joint is subjected to, and help keep the knee stable. These cushions can be damaged or torn during skiing when the foot is in a fixed position wearing ski boots and rotation at the knee occurs from either a direct trauma or sharp twist. If there is a tear in the meniscus, the individual will often feel pain in the joint or back of knee, stiffness, and a limited range of motion, and or “catching” in the affected knee. Poor positioning of the knees during skiing and overusing muscles that aren’t conditioned for skiing can make one more susceptible to meniscus tears. A good strengthening program for the core and lower body can help prevent meniscal tears.