“Snow” need to worry about a niggly knee this ski season!

Thinking of warming away the winter blues with a bit of Alpine Sun? Concerned about an injury? Fear not, Vitality Physiotherapy is here to help!

The most common injury sustained on the slopes, is an ACL tear. The Anterior Cruciate Ligament (ACL) is located within the knee joint and connects the tibia (leg bone) to the femur (thigh bone). It is an important stabiliser of the knee joint. The ACL is commonly ruptured as a result of quick decelerations, hyper extension or excessive rotation.

Skiers tend to sustain this injury when landing from jumps, or from falls. Novice skiers will often rupture their ACL when their bindings do not release. Often, there is an audible sound or pop at the time of injury, and trying to stand up may be difficult as the knee feels unstable. Thereafter, the knee usually becomes swollen and painful.

Many people function fully on a daily basis with an ACL tear. However for complete ruptures that occur amongst sporty people (who isn’t these days?) many clinical experts recommend surgery.

Your physiotherapist or Orthopaedic Consultant can do a few special tests on your knee to test the integrity of your ligament. Should a tear be suspected, this can be confirmed by an MRI scan.

Surgical reconstruction is a common procedure, which involves harvesting either the hamstring tendon or patella tendon to replace the ruptured ligament. This is followed by a course of physiotherapy, initially to control pain, swelling and improve range of movement, and later to gain strength, power and flexibility. Depending on your sporting abilities and requirements, focus in late stages of rehab may involve bounding, hurdles, jumping and box drills and other types of plyometric training.

Should you not require surgery, physiotherapy will help to strengthen your knee, improve your balance and resume normal daily activities and low impact sports such as golf or swimming.

Here are a few useful tips to help prepare you to hit the slopes confidently, and minimise your risk of an ACL injury:

  • Improve your general fitness by doing controlled and prescribed cardiovascular exercise
  • Conditioning and strengthening exercises for your quadriceps, hamstrings and glut muscles
  • Balance Exercises
  • Core stability Exercises- strong core, strong back = stable base of support.
  • Flexibility training


  • Use well maintained kit that is well serviced. This will minimise the risk associated with tightening of the springs though accumulation of salt, rust and dust.
  • Carving skis should be easily available from ski rental shops. Their shape and improved design have helped reduce the number of falls whilst skiing.  It’s unusual to find old fashioned skis to rent.
  • Avoid walking around excessively in your ski boots. Remember that the sole of your boot needs to fit snugly into the binding plate. If your sole wears out, the fit may not be accurate and the binding connection may be compromised.
  • Check your bindings for release tension. Do not set them too tight!

If you are concerned about injury, or have previously sustained an injury whilst skiing, or just have a little niggle, why not come in for an assessment?  We have been treating skier’s injuries for many years at Vitality Physiotherapy, Waterloo and can help you as you prepare to hit the slopes.


Picture credit: Skistar Trysil http://www.flickr.com/photos/trysil/