Skiing and knee injuries | All you need to know about prevention and treatment

Saket Tibrewal Saket Tibrewal Consultant Trauma & Orthopaedic Knee Surgeon
On the slopes, knee injuries are a constant threat. They make up around one third of all injuries and can result in serious ACL and MCL damage. Consultant Trauma and Orthopaedic Knee Surgeon Saket Tibrewal explores prevention, treatment, and why knee injuries specifically are becoming more and more common.

Key takeaways

  • Every year more than half a million people will injure themselves skiing
  • Around 1/3 of all skiing injuries affect the knee
  • The two most common knee injuries whilst skiing are ACL and MCL injuries
  • Modern equipment design has potentially amplified injury risk
  • Avoid excessive alcohol consumption on the slopes
  • Take skiing lessons if you need and prepare for the strain of intense physical activity

What are the most common skiing injuries?

The knee is the most commonly injured joint on the ski slopes. The vast majority of injuries are to the anterior cruciate ligament (ACL), the medial collateral ligament (MCL) and the menisci (cartilage).  

Injury typically occurs after a fall where the ski binding (the mechanism that connects your ski boot to your ski) does not release. Falling can cause the knee to twist, forcing and straining the joint into an awkward and painful position.

Why are knee injuries so common?

Skiing is a fast-paced activity that can put people in potentially dangerous situations that they’re not familiar with.

When you start skiing, you may move slowly or clumsily as you make your way down. This can result in heavy movements, falling over a lot, and putting undue stress on your ankles and knees. 

Activities that involve a lot of falling over will generally see more knee injuries because of the amount of twisting and impact involved.

What are we seeing more knee injuries?

Knee-related skiing injuries are on the rise. There are a few reasons for this, including:

Ski design

Modern skis are more curved and tend to ‘carve’ through the snow. While this enhances performance on the slopes, this design can ‘steer’ the ski away from the body and cause the knee to twist.

Boot design

Modern boots do a very good job of protecting the ankles and shins, but this can result in more force being transmitted to the knees.

Poor preparation

Skiing is growing in popularity. This means that more people who are poorly prepared and lacking the adequate fitness to ski are damaging their knees on the slopes.

When do most injuries occur?

Most injuries occur in the afternoon, particularly towards the end of your holiday week. 

This is likely because fatigue has really started to set in at this point which makes your knees more vulnerable to injury.

What can I do to prevent injuries?

Prepare your body physically

It is difficult to go from a relatively sedentary environment to spending several active hours each day on the slopes. 

The physical aspect of skiing requires a combination of core strength, aerobic fitness, dexterity, and balance. In order to achieve this, it’s essential to train properly prior to your holiday and understand your limitations when you’re on the slopes.

Start your physical preparation at least 6 to 8 weeks prior to your trip. Ensure you work on your core muscle strength and aerobic fitness. Regular swimming, cycling and using a cross-trainer are all good options. 

There are also ski-specific preparation programmes available through physiotherapists.

Include a rest day

Taking a rest day away from the slopes helps reduce muscle fatigue, which reaches its peak 48 hours after you start skiing. 

If you start to feel the fatigue after a few days, then take a rest day and enjoy some time away from the slopes.

Avoid excessive alcohol consumption

Avoid drinking alcohol at lunchtime!

As tempting as it may be to have a drink on the slopes, it increases your confidence and decreases your reaction speed, making a perfect recipe for injury.

If it’s your first time skiing…

If you are new to skiing, take lessons. 

Good skiing technique will minimise your risk of injury and add to your enjoyment when you’re on holiday.

What should I do if I injure my knee?

When you book your holiday, make sure that you have adequate medical insurance. This is essential if you injure yourself on the slopes and require any sort of medical attention.

Most ski resorts have excellent medical facilities and are very experienced at treating ski-related injuries. If you are unlucky enough to break a bone, in most cases it makes sense to have treatment (and if required operated on) before you fly home.  

It’s important to remember that a normal x-ray does not exclude other injuries within the knee. If you are concerned, then see a specialist knee surgeon when you return home for a proper assessment and further imaging (MRI scan) if required.

What are my treatment options?

Anterior cruciate ligament tears are the most common knee injuries. In general, they should be treated once you have arrived home, with the gold standard being the reconstruction of the ligament. 

Operating on a swollen stiff knee very soon after a knee injury may result in a poor outcome. In the first few days and weeks following an ACL injury, the priority is to reduce the swelling and increase the range of motion of the knee. 

Surgery can be safely performed weeks or even months, after the initial injury. A simple brace and crutches should be enough to help you on your journey home.

About the author

Mr Saket Tibrewal is a Consultant Trauma & Orthopaedic Knee Surgeon at Nuffield Health Brentwood Hospital and is solely dedicated to treating knee problems. He has extensive experience and one of the highest volume clinical practices, which covers all aspects of knee surgery and sports injuries. 

He specialises in Total Knee Replacement, Unicompartmental (Partial) Knee Replacement, Knee Arthroscopy (Keyhole Surgery), ACL Reconstruction, Multiligament Knee Reconstruction, Knee Osteotomy, Knee Preservation, Cartilage Regeneration, Patella instability, Biologics, Sports injuries, and Trauma.

Last updated Friday 8 March 2024

First published on Friday 8 March 2024