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Health & Exercise Forum

Prevent Ski Injuries: Part 1 of 2

Nov 26, 2012

Prevention of Ski Injuries Requires Conditioning, Good Judgment, Equipment Checks, And Good Technique!

Dr. Mackarey's Health & Exercise ForumPart 1 of 2



Like many in NEPA, I love winter in great part due to my love for downhill and cross-country skiing. NEPA is home to many great family ski resorts. Although, I don’t remember when the half-way-house was the main lodge at Elk Mountain, I have been skiing at Elk since 1970 and consider it an important part of winter, even today. However, I have also had the opportunity as a skier and orthopedic and sports physical therapist to witness and treat a variety of ski injuries. As a result, I am keenly aware of the need for safety and conditioning to prevent serious injury.

Not surprising, 75% of all ski injuries occur due to falls, 20% due to collisions, and occasionally some injuries occur on the ski lifts according to the American Journal of Sports Medicine. Knee injuries such as ligament strains or tears are the most common injuries. The medial collateral ligament (MCL) is more commonly injured in beginners twisting the knee at slow speeds. The anterior cruciate ligament (ACL) is commonly injured when a skier catches an edge and hyperextends the knee.

Leg fractures occur from violent falls or high-speed collisions. This is more common in very cold, icy or hard-pack conditions. Upper limb injuries also occur in skiing. Shoulder dislocations, thumb sprains, and wrist fractures are common arm injuries. Head injuries account for 10-15% of all ski injuries. Fortunately, helmets are becoming increasingly popular.


1. Pre Season Conditioning – (Described in Detail in Part II – Next Week)

    • 6-8 weeks before ski season
    • aerobic exercise such as elliptical, stepper or bike, to improve lower body endurance (See Photo Below)
    • Office Squats - begin by performing squats throughout the day for 2-3-5 minutes at a time and maintaining the skiing position (See Photo Below)
    • weight training with high repetitions for strength and enduranc.Cconcentrate on quads, hams, calfs, gluts, hip abductors and adductors
    • stretch/flexibility for arms, legs, back/torso
    • balance/proprioception
    • lunges, step-ups, wall slides

 2. Technique

    • keep knees flexed to ski and during a fall
    • relax with a fall, don’t try to stop it or get up
    • slide with a fall, on your back, feet first
    • don’t take jumps until you learn how to land – knees flexed, both skis equal, tips up, lean forward

3. Equipment

    • Helmet – protect head
    • Bindings- check for wear and working properl. Adjust for weight, height and skill level
    • Edges – keep sharp to turn well
    • Clothes – layer warm to protect skin from frost bite
      • Hand/toe warmers are good
      • UnderArmor – warm & keeps sweat off skin

4. Judgement

    • Stop skiing when you’re tired. You’re at risk when tired
    • Keep watch for terrain – grass, rocks, sticks, ice
    • Keep eye on other skiers – when passing yell on your right or left
    • Know your limits – ski slopes at your level and ask ski patrol about slope difficulty and conditions
    • Don’t drink alcohol and ski – slower reflexes and poor circulation in cold
    • Learn to use the lifts – ask lift attendant or read instructions
    • Prepare for high altitude skiing (Rockies, Alps)
      • don’t push yourself the first day or two
      • adjust to altitude – rest often, drink fluids

Visit your doctor regularly and listen to your body.

NEXT MONDAY – PART II – PREVENTION OF SKIING INJURIES THROUGH CONDITIONING! Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in the Scranton Times-Tribune.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is an associate professor of clinical medicine at The Commonwealth Medical College.