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KNEE INJURIES & HOW TO PREVENT THEM

Updated: Sep 29, 2023



Knees take a pummelling when skiing and knee injuries are, unfortunately, not uncommon.

The most common knee injuries in order of prevalence are:

  • Ligament injuries, involving the ACL (Anterior Cruciate Ligament) and/or MCL (Medial Collateral Ligament).

  • Cartilage or meniscal tears within the knee joint itself.

  • The Kneecap, where it joins with the upper leg bone.

  • Muscle tears involving the largest calf muscle that crosses the back of the knee.


First of all, if you have any issues with your knees (or any other part of your body) please go and see a medical professional/physiotherapist for a proper assessment of the possible causes and a specific treatment/rehab programme.


Often knee injuries result from sheer bad luck. However, there are a number of things we can focus on to minimise the risks even when bad luck plays its hand.


So what can we do?


A lot of knee injury prevention come from general strength, fitness & preparation before you hit the slopes, which is essential for everyone. Focussing on leg strength, core strength, posture/alignment/proprioreception, balance & flexibility. START EARLY - DON'T LEAVE IT UNTIL THE WEEK BEFORE YOUR TRIP! But this is not all and there are also some things that need to be kept in mind during your holiday and while on the slopes.


Read on to find out more!


PRE-HOLIDAY


Leg strength.

Here we need to consider the muscles that support the knee (quads, glutes, hamstrings) & ensuring they re as strong as possible.

In strength training, the main goals are threefold

  • to increase strength in different muscle groups

  • to minimise strength discrepancies between muscle groups in the same leg

  • To minimise discrepancies between the strength of each leg.

We all have a dominant leg, but we want to be aiming for minimal strength discrepancy between the two. Then, we want to eliminate major discrepancies between the different muscle groups (quads, hams, and glutes). In this way we can prevent certain muscles becoming weak and lazy, other muscles overcompensating for the weaker muscles and one leg compensating for the other. If a muscle group becomes weak and another group of muscles, or the other leg, compensates for it then this will lead to imbalances and lead to a greater likelihood of injury.


Core strength.

Your core is extremely important to help with balance, especially as you ski over varied terrain. It is crucial to focus on the deep abdominal muscles that hold you upright and support dynamic movement, the “six pack” muscles won’t help you maintain core tension through your turns. Think about the muscles around the whole midsection, including the obliques. If you’re sloppy in the core, you can’t expect the rest of your body to respond how it should down the line.



Keep good posture & alignment.

You need to learn how to move, automatically & without thinking, with good alignment so you can protect your knees. Working on your proprioreception (your body’s ability to know where its different parts are in space). Good alignment requires your hips to be stacked over your knees & your knees over your ankles. Never let your knees collapse inward. By focussing on quality rather than quantity you will train with good form and train your body to favour this position. Perform a variety of drills slowly until the movement patterns are second nature and you don’t have to think about it - start slow and then as the movements become automatic you can up the pace & any weight you might be using.


You need to develop strength in your hips and thighs as well as developing body awareness and balance to support your knees and ankles. If you train with good form you will train your body to maintain this form whatever it is doing and you will exhibit that form when things get dicey on the hill.


Balance.

Skiing is not a predictable sport - you are on a pair of slippery planks, on an equally slippery surface that keeps changing under your feet and gravity is also helping you along your way. In addition, more often than not we are balanced on one leg more than the other & our centre of gravity is outside our base of support. And yet we need to be able to stay upright at all times!


It is difficult to mimic this at home/in the gym but by using a balance/wobble board or cushion when performing your strength training you will go some way to helping replicate the unpredictability & instability that can be encountered underfoot when skiing.


Also try to include some unilateral (one legged) work. This will help with balance as well as ensuring that, if you do have any strength discrepancies between your two legs, the stronger leg cannot compensate for the weaker one and thus helping increase the strength in this weaker leg and stop it relying on the support of its counterpart.


Remember to focus on your form and alignment as well (as explained above) to ensure you are training your body into good habits and increasing your prorioreception. As previously mentioned, core strength will also help a lot.


Keep body mobile & flexible.

A flexible body is a healthy body and flexibility will help in all walks of life. Maintaining good flexibility will help when making movements to keep good alignment by allowing your body to move in the way that you want it to. Good flexibility will also help if (when!!) you fall, as stiffer limbs, joints & muscles will be more prone to damage when adverse forces act on them.

So make sure you don’t skip your warm up/stretching before/after exercising. Including some pilates and/or yoga into your week can also be an extremely useful addition.


So, that covers the issues you can address before you head to your mountain destination. You’ve done the work and are ready to hit the slopes. What do you need to think about whilst on holiday?



ON HOLIDAY

Warm up each morning

Some warm up exercises will help ready your muscles for the day ahead. Ensure that the movements are dynamic and not static stretching. Focussing on the muscles that you will be using during your day on the slopes - arm swings, hip rolls, leg swings, body weight squats, side lunges & good mornings are all good options to include.


Ski within your limits

There is no need to keep up with your more experienced or more courageous friends. Taking calculated challenges is a good thing to help your skiing progress but don’t take this to the extreme as the risk of injury will be significantly greater. Start on easier slopes and improve your skills gradually. Take a lesson to help you progress at your own pace in a safe, planned environment.


Fall the right way

If you feel yourself falling try to relax and go with it rather than tensing up and fighting it. If you can, draw your limbs into your body to help shorten the “lever” making it less likely to be twisted in a wrong direction.


Listen to your body

Injury rates increase with fatigue so listen to your body. Some days you may feel more energetic than others so go with the flow each day and take breaks as necessary. Better to be sipping that apres beer on a sunny terrace than taking that “one last run” straight to a hospital bed.


Have good ski technique.

Take a lesson!

Drop me an email or give me a call to find out how I could help you on this one!

clareangus@live.com

+33 6 20 17 33 56



My knees have taken some blows over the years and recently a dormant issue has reared its ugly head which has led me to really do my research & really up my strength and training game. Guided by my brilliant physio Ginny www.actionsportivephysio.com I have had a number of appointments to assess each aspect of my biomechanics to find the imbalances, particularly focussing on leg strength and the important knee stabilising muscles. We have been working on reducing the discrepancies between the strength of different muscles in my “good” vs “bad” leg as well as on overall balance/stability and explosive movements to ensure that I can keep going with all the activities I love!


I have learned a lot over the past few months and I will be bringing you a blog on ski fitness preparation very soon because we all want to be able to hit the slopes with aplomb when we finally get the chance next winter!


IN CONCLUSION - INJURY PREVENTION


Pre-holiday exercise & training - ensure you focus on all aspects of strength, agility, mobility, balance, alignment. Include cardio fitness too to reduce fatigue, which can make you ski a little sloppier and be more likely to sustain an injury.

Warm up before hitting the slopes for the day - ensure these are dynamic, rather than static, movements.

Ski within your limits - you don’t have to “impress” your friends or keep up with more experienced skiers, sensible challenges only.

Make sure your equipment is suitable for your ski level - especially binding settings. Leave this to the professionals.

Fall properly - go with it rather than stiffening up.

Listen to your body - some days we feel stronger than others, work with that and take it easy/rest as necessary. Injury rates increase with fatigue.

Stretch after exercise and your day on the slopes.

Good technique - take some lessons with a professional instructor to learn proper technique and practice it/challenge yourself in a safe way!




DISCLAIMER

If you have any niggles, previous injuries or concerns then I would highly recommend you book an appointment with a physiotherapist who can offer a full body once over and, often, a biomechanical assessment to ascertain any imbalances that need to be addressed as well as a personalised programme to help you reach your goals.


This blog post may offer health & fitness information which is designed for educational purposes only. The information in this post is not meant as an alternative to seeking professional medical or training advice. Please know that performing any exercise or programme is solely at your own risk. If you are new to exercise or planning to embark on a new fitness programme you should seek professional face-to-face advice to tailor any programme to your own specific requirements.





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