Knee injuries Skiing

Five recommendations to protect your knees this ski season and what to do if it all goes wrong

Being a specialist sports knee surgeon, each winter I see lots and lots of patients who seriously injure their knees when skiing or enjoying other winter sports. There are a number of common themes when dealing with winter sports knee injuries and there are certainly a few tips that I can give in order to try to make sure that you don’t get injured yourself.

  1. If you are skiing, make sure your equipment has been checked and most importantly that your bindings are set correctly for you. One of the most common serious knee injuries is rupturing the anterior cruciate ligament (ACL). This nearly always happens when a person falls and twists around their ski but the ski bindings don’t release.

If the ski bindings are sufficiently loose that your ski pops off, then it is very unlikely you will seriously hurt your leg. If the bindings are too tight and the ski doesn’t come off then something further up will break. This is usually your cruciate ligament, or sometimes your bone! If you’ve got your bindings right your skis might come off once or twice during the day, and although this is frustrating, remember this is saving you from a horrible injury. All bindings have a DIN rating from 0 to 10, 10 being hardest to release and 0 being easiest to release. The correct setting is best determined by a ski shop and depends on your height, weight and experience, but there are good online calculators too. It is surprisingly easy to alter this yourself with a screwdriver at any ski lift and not a bad idea to wind it back half a turn for the first day or so whilst you get used to skiing again.

  1. Don’t ski in bad conditions. Many people who I see who have suffered serious skiing injuries do so when visibility is really poor and this is definitely a risk factor for injury. Skiing in a whiteout is not much fun, and puts you at risk. If the conditions are poor, consider finding a run lower down the mountain, or sitting things out for a while. You will spare yourself some less enjoyable skiing, getting frozen, and may well avoid serious injury!

  2. Don’t ski when drunk: Quite a number of the skiing injuries I see are alcohol-related! You wouldn’t dream of driving your car at 50 miles an hour when drunk or riding a pushbike at 50 miles an hour when drunk and yet many people think it is fine to do this on skis. It takes a lot of concentration and muscular control to ski well and avoid collisions and injuries. Having a boozy lunch puts you at increased risk of hurting yourself. Keep the drinks for the evening rather than halfway through the day!

  3. Beat the crowds: A lot of the time winter sports-related injuries are due to collision with other participants, or somebody distracting you and throwing you off course. The runs closest to the towns are often the busiest, but therefore also the most hazardous. Often the snow is in worse condition and if you don’t venture further afield then you are more likely to hurt yourself. Consider being a little more adventurous and try to get away from the crowds, where you will have more piste to yourself, better snow, and less chance of getting seriously hurt.

  4. Consider having some instruction. For a lot of us we only ski once or twice a year, and can get quite rusty. There is a big increase in incidence of injury on the first day of a skiing holiday and on the last day. The injuries which take place on the first day are due to people finding their ski legs again. Consider having a morning lesson at the start of the holiday to refine your skiing and enjoy the rest of the week more, staying injury-free.

The last day phenomenon is probably people being tired and fatigued, and perhaps being a little too adventurous and tackling conditions which are beyond their ability. Don’t fall into this trap! If you are tired, simply ski more gently and avoid getting hurt, Otherwise you could ruin your summer of sport for that one last run of the holiday.

If the worst does happen, what should you do?

If you hurt yourself on the mountain, it can be a very distressing experience, and I speak from personal experience having had snowmobile and helicopter rides off the mountain with a broken back.

You will get cold very, very quickly, lying in the snow in agony so send someone for help right away. Don’t underestimate how hard it is to get yourself home safely, quickly and comfortably. Mountain Rescue will usually get you back to resort or to the hospital promptly and it is what you pay that expensive lift pass for!

If you’ve had a minor injury, usually the resort medical centre will see you, x-ray you and provide a brace and crutches for a knee injury, then recommend you seek help when you return. It is well worth arranging the appointment promptly if you can, and many people book to see me whilst they are still in their ski resort so they have an appointment in place on their return. Knee surgeons get busy in the winter! If the injury is serious, you will probably be taken to hospital and be seen and assessed there.

Medical care varies from country to country, and some places are very eager to operate while you are still on holiday, others simply patch you up without really knowing what is going on and send you on your way. If you have had a serious injury it is always sensible to seek a sensible opinion from a specialist sports orthopaedic surgeon promptly when you return home. If you have had surgery overseas then definitely get checked up as soon as you get back!

If you need surgery

Rupturing the ACL is the most common serious skiing injury that I see. If you want to ski again, this often requires surgery. The surgery takes about one hour and can be done on a day-case basis (no overnight stay in hospital). Using the latest surgical techniques you can be back on your feet really quite quickly, and usually back fit to ski the following season. It is middle sized surgery and if done with care and skill it should not be too big a deal!

Posted on Jan 19, 2017

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