Winter Skiing Tips to Help Keep You Injury Free with Dr. Gina Fick, PT, ScD Skiing_mixdown: You’ll be surprised at how much lower you can set the bindings than the ski shop actually sets them, and how rare it is to actually come out of your bindings. That’s important because by doing this, you really dramatically lower your chances of. Ligament, uh, injury, especially the ACL injury.

Welcome to the PT Rebels Podcast.

This is the place to learn how you can become a PT rebel and take charge of your own health and wellness. We will help you find answers to your questions about pain, injury, and the path towards healing in the most efficient and effective way possible.

I’m your host, Dr. Gina Fick.

On today’s episode, I wanted to talk with you all about skiing injuries, how to prevent them, the most common types of injuries, and what to do if you become injured before hitting the slopes. It’s really important to consider the condition that you’re in and what you’ve done to prepare for ski season. Strengthening is an important way to prepare for ski season and to pre prevent injuries. We recommend that patients train. The quadricep muscles for skiing and snowboarding. Common exercises would be squats, Bulgarian split squats, lunges, deadlifts, hex bar deadlifts, split stands or single leg deadlifts, those types of exercises. One of the most important things that you can do for skiing is to warm up on the day that you’re going to hit the slope. So if you have access to a stationary bike or elliptical, if you could do 15 or 20 minutes. On that stationary bike, just repair for the skiing day. Also, make sure that you’re hydrated. A lot of people come to Colorado from out of state, and so the elevation can be tough to adjust to, so making sure that you’re well hydrated, nourished prior to hitting the slopes is really important in order to make sure that your body is ready to go through a full day of ski. One of the best things that you could do too. Is, prepare for your day on the slopes. Try to get to know the mountain. Make a decisions about what slopes or runs that you’re going to go down. Don’t ski over your ability. Don’t let a friend talk you into going down a run that you’re not prepared for. Physically or mentally. Make sure that you’re making smart choices and decisions about the route or the runs that you go down that day. Poorly fitting boots tend to lead to poor foot mechanics and foot pain. And one of the most common mistakes that we see with recreational skiers is that their boots are too stiff or too narrow. Boots used to be very stiff when they were needed to add pressure to the longer straight skis in order to make a turn. But these days, modern skis are shaped to turn easily, so stiff boots aren’t necessary anymore. They should opt for a softer flexing boot. Both the forward and backward plane, which is ideal for initiating and completing a turd, the most common error that we see with bindings that they’re set too tight. So almost everyone thinks that the tighter they set the bindings, the less they are to come out of those bindings prematurely, and the less likely they are to hurt themselves or or their knees. And really the opposite is true. There’s something called pre-release, and that’s important when skiers start down a big hill. Sometimes you can come out of bindings due to the force, um, exerted on the ski and binding, but a few people come out of their skis due to a binding set too low. So if you go to the ski shop, they should be able to carefully set your bindings based on your height and your weight and the skiing ability. You should keep lowering the ski binding setting until you find the lowest level that you can ski at without coming out of the binding. You’ll be surprised at how much lower you can set the bindings than the ski shop. Actually sets them and how rare it is to actually come out of your bindings. That’s important because by doing this, you really dramatically lower your chances of ligament, uh, injury, especially an ACL injury, possible that you’ll increase your chances of coming out prematurely and falling. But the worst case scenario is most falls after release from the binding just end up in, um, a minor fall and not, uh, knee ligament injury. There’s no data used to compare binding quality from one brand to the other, but it is really important that you are visiting the ski shop and making sure that those bindings and boots fit correctly and are set with the maximum amount of safety. Another thing you wanna do is just watch your ski width. If the skis are too wide, it can become more difficult to make the turn and guide through the slopes. And they’ve actually found that skis with wits in the 80 to 90 millimeter width range are far easier to turn with less effort than, uh, skis over a hundred millimeters wide. So just make sure that you pick the right, correct width of skis, especially for your skill that you can make those turns correctly. Ski tuning also makes a big difference in the ease of making a turn. So make sure if you do own skis that you’re taking those into the ski shop to be tuned up. They need to be tuned after every five to seven days of skiing. Not once a year, so make sure that you’re tuning up your skis and being diligent with that. One of the most common injuries that we see is a tear of a ligament around the thumb, and that usually happens because skiers lock their hands tightly into the straps around the ski poles. Which makes it impossible for the pole to release when they fall. So they fall with the outstretched hand and thumb, and that leads to the tear of that ligament called the ulnar collateral ligament at the base of the thumb. And the chance of this happening is really decreased significantly by not using those ski pulse straps. So during a fall, if you’re not using the straps, the pole can come out of your hand, but if you do have your hands strapped around the strap. It actually can be more dangerous. So just a little tip there. Another really important thing is to wear a helmet besides ACL injuries or fractures. We also see a lot of head injuries from skiing, and unfortunately, sometimes those can be fatal. We recommend a lightweight, well fitting helmet and avoid heavy helmets to reduce the, the swing of the weight on the top of the neck, wear a helmet and make sure that size correctly. In females, the most common ski injury is the ACL injuries. The anterior cruciate ligament or ACL is a knee ligament that helps prevent forward translation of the lower leg bone called the tibia, and that is the most common. Injury that we see in female skiers. The most common injury that we see in, in males is actually, um, lower fractures. So males tend to be a little bit more daring or risky on the slope, so they actually have a higher risk of sustaining a fracture. Um, but the other common injuries that we see are pet injuries, like I mentioned earlier, and that’s why it’s so important to wear a helmet. If you do sustain a head injury, get that checked out no matter what. Because over the last few years I have heard of cases where. People sustained a head injury, didn’t think it was bad as they thought they were sent home, and actually had a brain bleed and died over the next day or two after that injury. It’s really important to make sure that you’re getting checked out if you do sustain any type of head injury on the, it’s really important that be conscious and aware that you’re in an environment where. It can be very cold. Uh, sometimes the ski conditions aren’t optimal. It can be cold, foggy, it can be snowing. The snow can be more icy, especially in the spring. And so all those things play into potential knee injury risks or lower extremity injury risks or head injury risks. And it’s just really important that you don’t underestimate the sport and the difficulty of the sport. And also the fact that sometimes these e slopes are really busy. So around the holidays, we see a big increase in the number of people that are going up to ski here in Colorado. It’s really important that you prepare yourself and it’s important to take some ski lessons if you haven’t skied much, and make sure that you ski within your range so that you don’t put yourself in a bad situation up at the top of the mountain. I know that happens a lot. It happened to me when I was in college. I was a college basketball player, a pretty good athlete, so I thought I could handle it. I got up to the top of some of these mountains and I honestly, I don’t even how I got down safely. I think it’s just more common than not. Put yourself in a situation your friends talk you into, and you get up in a situation where you’re not really prepared. And then that’s when these injuries happen. And unfortunately, injury like an ACL takes about nine to 12 months to, uh, return to sport. And so that’s a significant cost and time away from sport or activity, and also a difficult rehab process. So taking all those things in into account, it’s really important that you, um, adequately pre prepare in terms of training. One thing that we recommend here at Vic Physical Therapy and Sports Performance is that you come see us for a preseason ski assessment, where we’re looking at your strength motor control, single leg stability, your ability to produce. Observe course through each leg to determine if there’s any asymmetries. We’ll talk to you about your past injury history and we’ll test your ligaments. We’ll test your range of motion. We’ll go through a full functional strength assessment and mobility assessment to just make sure you’re ready for hitting the slope. If you do become injured on the slope, one thing I would recommend is that you call us so that we can do an injury evaluation to determine the extent of your injury. We can write imaging referrals so that you can go in and get an X-ray or MRI to rule out any more significant injury such as a fracture or ligament injury to your knee, wrist, and hand. If you do feel like you’d have sustained a head injury. Or have or concussion following follow on the slopes, please see your doctor immediately. That’s not something that you wanna take lightly. Just schedule a time with us. Uh, we’re happy to take a look and see, uh, maybe where your deficits lie, and then program some strength training for you so that you can be well prepared to hit the slopes this winter.