Health and Fitness

Injuries And Ski Fitness

Mike Nixon is an Osteopath working in the city of London, but before he moved back to practice in the big smoke he spent a few years running a bar in Tignes, also treating the numerous professional skiers and borders in the area. As a result he has built up a comprehensive and specific knowledge of the strains and stresses the human body can be put under on the slopes, whether it be gunning a couloir or practicing your snow plough on the blue runs. More recently, Mike has teamed up with personal trainer, Peter Banister and together they have devised a training program for skiers which they will be bringing exclusively to SkiUnion throughout the winter.

“They’re funny things accidents, you never have them till you’re having them.”

When it comes to skiing accidents they more often than not result in injury, not least because if the speeds and awkward motions that the body is under at the time. If you spend a lot of time on the slopes, whether as a regular holiday skier, seasonaire or Pro, then inevitably at some point you will get it wrong, or someone else will to your detriment! Given that, it seems a good idea to be armed with a little knowledge that may help you spend more time on the slopes: my last two seasons were cut short with low back problems that eventually required surgery!

Taking leaps of faith might end up in some form of detriment to yourself, either then and there or later on in life. There are ways though, to minimise the effects of this sort of larking about...

Over the course of the coming season then, i will be outlining some of the basics regarding ski fitness, reducing the risk of injury when skiing, injury aids and treatments, and how to get you back skiing should you hurt yourself. Fot the moment, i will be outlining some of the most common injuries to occur whilst skiing, and what you should think about in order to minimise your rik of having them.


Every sport throws up injuries that are common to that discipline, for example marathon runners tend to get wear and tear type problems due to the repetitive weight-bearing nature of the sport. Snowboarders get upper limb or shoulder injuries falling on an outstretched hand and are especially vulnerable to wrist and collar-bone fractures.

As far as skiing goes I’ll divide the types of injury into acute or chronic. Acute injuries are usually the result of trauma i.e. a fall or collision, whereas chronic injuries usually occur as a result of overuse over a period of time e.g. cartilage wear and tear in the knees. A previous acute injury can also result in a chronic problem if severe or mismanaged, I’ll try to explain this in more detail at a later stage.

You might think the fact this on the left came out of that on the right, is both 'Acute' and 'Chronic'...It is though an 'Acute' Injury that could lead to some form of 'Chronic' condition further on in all sounds very confusing, but it's not really!


Of course there are numerous and varied ways to hurt yourself but for now we’ll look at knee ligament injuries as they are among the more common serious ski injuries. The two ligaments most often hurt are the Anterior Cruciate ligament (ACL) and the Medial Collateral ligament (MCL).

These knee ligaments are especially vulnerable due to the fact that, unlike snowboarders, each ski can move independently of the other. If the skis go in different directions to each other, or the skiers body and the skis go in different directions these ligaments are in danger. To add to that with the skiers ankle rigidly fixed in a hard boot any rotation from a twisting ski is taken up directly by the knee joint.

The ACL runs from inside the knee joint from the front to back connecting the upper and lower leg. It prevents the lower leg shifting forwards on the thigh. A classic way to snap the ACL is for the skier to fall backwards while his skis shoot out in front, stressing the ligament. Landing a jump backseat or a beginner sitting down coming off a chairlift are other typical instances leading to ACL injury, (if you’ve heard one snap they sound like a gun going off).

The MCL runs vertically along the inside of the knee joint connecting the upper and lower leg. It’s vulnerable if the ski twists out as can happen if you catch an edge. Its more common to strain this ligament but you can rupture it as well.

The Anatomy of the knee.

The main work you can do conditioning-wise to reduce your risk of knee ligament injury involves strengthening the muscle surrounding the knee joint, the Quadriceps on the front and the Hamstrings on the back of the upper leg, and ensuring the correct balance of power between the two muscle groups. I’ll discuss this in detail over the next few months when we talk about conditioning and pre-season fitness.


Chronic injuries are injuries that occur over a longer period of time, examples would be wear and tear in the knees and lower back from repetitive shock absorption. Previous injury has a significant effect on whether a problem becomes chronic, for example if you’ve had previous knee surgery then the subsequent rate of wear and tear in that joint is likely to increase, giving secondary osteo-arthritis.

MRI scanning is a superb noninvasive way to take pictures of the knee joint and surrounding muscles and tissues in order to determine all sorts of injuries. Eventhough you may think your're looking at the scary rabbit head from Donnie Darko, a radioligist can spot all sorts of health issues in there...can you tell which is which?

Osteo-arthritis ( OA) is basically wear and tear of the joint, you might see signs of it on x-ray in a 40-50 year old in the low back and knees, if s/he had skied for many seasons he might have signs of OA in his late 20’s! Therefore loosing some function in a joint due to previous injury, say some loss of strength or flexibility, will result in that joint coping less well with stresses and strains in the future perhaps leading to re-injury and then a chronic injury. This highlights the importance of correct treatment and management of acute injuries so that the same problem doesn’t come back to haunt you.


So, with all this talk of injury what can you do to get the odds back in your favour? Well getting in some sort of shape pre-season or holiday is a good idea but conditioning needs to be specific to the demands of skiing and also the demands of the skier. A professional hitting the big kickers in the park will have different physical demands to a novice trying to hold a snow plough. You will get greater benefit by targeting your exercises to the demands you’ll put on your body, having said that there are basics of strength, flexibility and balance co-ordination that are required whatever your level.

There are of course, some things that are completely beyond our control. Different people with the same injury can react differently. My dad has a badly arthritic knee, (secondary OA from a previous operation), but still goes running 3 or 4 times a week. I’ve treated people with less knee joint degeneration who have to use a walking stick. Differing physiques mean some people are more prone to certain injuries than others. Someone with a long spine may put more stress on their low back than someone with a more compact shape, and someone who is overweight will be putting a lot more strain on their knees. Knowing where and why you might be prone to certain injuries could prevent future problems.

The use of protective equipment such as helmets, body armour, and wrist braces has risen in recent years. We’ll look at what works and also how some equipment can cause injury!

Hmmm, one of these guys is more appropriately dressed for skiing than the it Chuck Norris on the left, or Michael Schummacher on the right?

I’ll examine all the topics I’ve brushed over in more detail in the build up to the season until then if there’s anything of particular interest you’d like to discuss feel free to let me know. (You can leave comments and queries below and Mike will get back to you).

Mike Nixon works at City Osteopathics
Peter Banister is a personal trainer, based at LA Fitness at the Waldorf, London


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