By: Laura Wenger, PT, DPT
One of the common questions that I start to get from patients this time of year is, “Will I be able to ski when the season starts?”, which of course has a varied answer depending on each person and their type of injury. As our thoughts turn to snow, it’s important to think about readiness to ski whether or not you are being treated for an injury. Last year, in my pre-Rakita Tomsic PT days when I was an orthopaedic resident at the University of Utah, I was lucky enough to be an instructor in a fun, dynamic, and challenging ski fitness and conditioning class. I was able to learn a lot as an instructor for that program, mostly in what types of activities are necessary to be adequately prepared going into the ski season.
An injury to your anterior cruciate ligament (ACL) of your knee is one of the more common snow sport injuries. In fact, there are estimated to be more than 20,000 ACL injuries each year in the US that are associated with skiing and snowboarding.1 Because the incidence of this type of injury is so high, there has been a lot of research devoted to prevention. This research has been a great help in the world of physical therapy so that we can provide accurate and effective guidance on how to prevent an ACL-injury if you haven’t had one (or prevent re-injury or injury to the other leg if you have already torn your ACL!).
One of the things that interests me most is what type of elements are essential for a quality injury prevention and conditioning program. Based on the research, here is a breakdown of what types of exercises should be included2,3,4:
• Aerobic Activity: this includes anything from cycling, running, rowing, stair-climbing, and swimming. Basically, anything that gets your heart rate and breathing rate up to a good, aerobic level.
• Strengthening: it is important that all target muscle groups in the upper and lower body are addressed with strengthening exercises. This doesn’t necessarily mean that you need to be on the machines at the gym, as there are many ways to effectively strengthen your muscles at home without any fancy equipment.
• Core Strength: the “core” is a group of muscles from your pelvic floor and hips up to your diaphragm at the bottom of your rib cage. Strengthening of all of the muscles (and not just your “six-pack”!) is an important component of ski conditioning.
• Plyometric Exercises: jumping, jumping, and more jumping. Plyometrics are a dynamic form of exercise that focuses on all types of muscle contractions in order to build more strength and power.
• Agility Training: quick movements and adjustments are crucial for improving your reaction time, especially when you are on the slopes.
• Balance Activities: try standing on one leg in a safe place, first with your eyes open and then with your eyes closed. For most people, this is not quite as easy as it sounds! The nice thing about balance is that you can train it, but it does require a lot of practice on your part.
• Flexibility: don’t forget about your stretching! Different types of stretching before and after activities are another effective component of a good ski training program.
• Education: this one is the easiest, because you are doing it right now! Education on the things you can do to improve your readiness to ski this season is one step in the right direction toward an effective injury prevention program. Further education on alignment principles and other tools you can use to incorporate all of the other components of a well-designed injury prevention program is where physical therapy can enhance this even further. We would love to see you in the clinic to assess your current conditioning program and further educate you on what you can do to make it even better in order to effectively prevent an injury this ski season.
1. Vermont Ski Safety. Tips for Knee Friendly Skiing. http://www.vermontskisafety.com/kneefriendly.php. Accessed September 16, 2013.
2. Bien D. Rationale and Implementation of Anterior Cruciate Ligament Injury Prevention Warm-Up Programs in Female Athletes. J Strength Cond Res. 2011; 25(1):271-85.
3. Myklebust G, Steffen K. Prevention of ACL injuries: how, when, and who? Knee Surg Sports Traumatol Arthrosc. 2009 Aug:17(8):857-8.
4. Sadoghi P, von Keudell A, Vavken P. Effectiveness of Anterior Cruciate Ligament Injury Prevention Training Programs. J Bone Joint Surg Am. 2012; 94:769-76.