Common Ski Injuries and How to Prevent Them

The ski conditions in New England this season were less than ideal, and could’ve contributed to more injuries to those hitting the slopes. In this Q&A, Elizabeth Matzkin, MD, FAAOS, Co-Chief of Women’s Sports Medicine at Mass General Brigham, sat down with us to discuss common ski injuries, and her top tips for staying safe on the slopes.

Dr. Matzkin, what is your experience with skiing personally?

As well as seeing many ski and snowboard related injuries, I personally ski and snowboard. I also work at the Stratton Mountain Urgent Care Clinic.

What kind of injuries are most common during ski season?

In general we see a lot of skiing injuries starting in early November to the end of April. The majority of ski injuries are lower extremity. We see more upper extremity injuries in snowboarders, but knee problems are also extremely common. I have had an explosion of ACL tears this season, as well as MCL injuries, meniscal injuries, and fractures of the tibial plateau. Concussion is also a common injury. For the upper extremities, when skiers are holding their poles and they fall, they can get what we call a skiers thumb. We also see a lot of humerus fractures and rotator cuff tears.

How do most of these injuries happen?

The most common way skiers are getting injured are from stopping or turning and catching an edge of their ski. This twists their knee, and goes into what we call a valgus position, which is the most common way to injure your ACL or MCL. Most of the time it is people going off a little jump, going through moguls, catching a patch of ice, and twisting and falling.

What kind of surgeries may be needed for these injuries?

It’s usually the ligamentous knee injuries that require surgery, so the ACL, PCL, MCL, and LCL. Sometimes the fractures we see will need surgical fixation. As for shoulder injuries, the rotator cuff tears and proximal humerus fractures may need to be fixed. Sometimes the skiers thumb injuries may also require surgery.

Do you have any top tips to stay safe while skiing?

Skiing takes a lot of work. You need to be in shape and have excellent proximal muscle strength. Hip flexors, abductors, quads, are all really important to protect your knee when you are skiing. Make sure that you are fit and ready to ski, and also make sure that you have the appropriate equipment. Your boots, skis, and bindings should be adjusted properly and so that they can release if they need to. Know when you are fatigued and take breaks when needed. It is also important to try to avoid having alcoholic drinks while skiing.

Did the less than ideal ski conditions this year cause more injuries?

I definitely think that the icy conditions led to increased injuries this year. There were more than usual ACL injuries, as well as ski related injuries altogether. I also saw skiers that were injured skiing out west, because they were maybe not as well prepared because of the conditions on the east coast. Anything can happen on the mountain. Most people come in and say that they were injured on their last run of the day or last day on the mountain. Clearly fatigue plays a role in these injuries.

What can people do in the offseason to get their bodies prepared for ski season?

Appropriate fitness is really important. A lot of my high level skiers will work on their proximal muscle strengthening that I mentioned. You have to be doing side to side movements to make sure that your abductors and adductors are ready for skiing. So mimicking some of those movements leading up to ski season can be important. Also, just making sure that you have the endurance to ski all day. A lot of us aren’t out hiking 8 hours a day or working out 8 hours straight, so you can’t necessarily expect to hit the slopes for 8 hours a day.

Is there anything else you’d like to add that is important for skiers to remember?

Just be prepared for the conditions with appropriate clothing, appropriate equipment, and staying hydrated. Also, don’t ski alone. You never know when something can happen, and you want to have someone there with you.