SKIERS KNEES – GET PRE-SNOW HOLIDAY READY
As we welcome in 2020 and our Australian Summer heats up, many of us may be thinking about heading overseas to the snow and going skiing (or snow-boarding). As with any sport, preparation is key, and it’s best to prepare before heading into the pow so you can make the most out of your snow time. This blog will provide some more information on common causes of injury and ways to prevent knee injuries that occur in skiers.
The ACL (anterior cruciate ligament) and MCL (medial collateral ligament) are two ligaments in the knee that often get injured whilst skiing, in fact approximately 60% of knee ski injuries are ACL injuries. To help avoid these injuries, you want to strengthen your quadriceps, glutes, hamstrings and calf muscles prior to going on your holiday. An ACL specific training program could also be hugely beneficial in reducing your risk of injury.
With the advancements of binding technology, many lower leg fractures have been reduced however the incidence of knee ligament injuries has increased. Female recreational skiers have twice the knee injury prevalence of male skiers, with ACL risk being three times greater for females (Posch, M et al). Failure for the ski binding to release prior to accident has been shown to be a contributing factor. Before you go skiing, check that you are able to self-release out of your binding. If you can’t, your risk of knee injury goes up considerably. The international standards organisation (ISO) accepts a lowering of the binding by 15% upon request of the skier. Lowering this setting has been shown to decrease knee injuries. If you still can’t self-release out of your binding, or don’t know how to, seek guidance from an experienced physiotherapist, if you still can’t release out of the binding then you will probably need to strengthen the muscles around the knee.
In general, there are several underlying reasons that cause exercise-induced muscle fatigue, however all mechanisms ultimately result in a reduction of muscle strength (Wan et al., 2017). Studies show that just a single day of skiing leads to a significant decrease of concentric and eccentric quadriceps and hamstring strength (Haslinger, S et al). Consequently, reducing muscle fatigue might be important in preventing fatigue-related injury. An increase in the number of injuries after 2-3 hours of skiing has been attributed due to fatigue (Meyers et al., 2007). In addition, Kahn et al. reported that day 3 showed a significant decrease in the max contraction of knee extensor muscles. A study by Nygaard et al. also showed a dramatic depletion of glycogen (muscle energy storage) within the muscles during skiing that was not restored from day to day during the several day trips of a group of recreational skiers.
IN SUMMARY TIPS
1) Have a pre-ski training program
2) Strengthen your quads/ hamstrings and glutes
3) Check your bindings
4) Stay hydrated, have rest days and listen to your body
5) Wear a helmet, have fun and enjoy the mountains!
If you want further information on how to prevent ski injuries prior to your holiday visit us at Ferry Rd Physio. We have Physiotherapist’s who take a special interest in ski injury prevention who can help take a look at your bindings if you already have your own equipment.
By Erica Doenau (Physiotherapist)
Posch, M., Burtscher, M., Schranz, A., Tecklenburg, K., Helle, K., & Ruedl, G. (2017). Impact of lowering ski binding settings on the outcome of the self-release test of ski bindings among female recreational skiers. Open access journal of sports medicine, 8, 267–272. doi:10.2147/OAJSM.S151229
Wan, J. J., Qin, Z., Wang, P. Y., Sun, Y., & Liu, X. (2017). Muscle fatigue: general understanding and treatment. Experimental & molecular medicine, 49(10), e384. doi:10.1038/emm.2017.194
Haslinger, S., Blank, C., Morawetz, D., Koller, A., Dünnwald, T., Berger, S., … Schobersberger, W. (2018). Effects of Recreational Ski Mountaineering on Cumulative Muscle Fatigue – A Longitudinal Trial. Frontiers in physiology, 9, 1687. doi:10.3389/fphys.2018.01687
Tesch, Per & Larsson, L & Eriksson, A & Karlsson, J. (1978). Muscle glycogen depletion and lactate concentration during downhill skiing. Medicine and science in sports. 10. 85-90.
Spörri, J., Kröll, J., Gilgien, M., & Müller, E. (2017). How to Prevent Injuries in Alpine Ski Racing: What Do We Know and Where Do We Go from Here?. Sports medicine (Auckland, N.Z.), 47(4), 599–614. doi:10.1007/s40279-016-0601-2