To avoid ski injuries, start training before it snows

If this winter is anything like the last, about 66,000 skiers will end up seeking medical attention for an injury.

And that actually is the good news. Skiing injuries have plummeted in the past half-century, thanks to advances in equipment, increased helmet use and better slope maintenance. In the 1960s, nearly one in 100 people skiing a full day were injured. Today, for skiers as well as snowboarders, that number is down to about one in 1,000, according to ski patrol data.

Still, there's no way to guarantee you won't get hurt on the slopes. The same things that make snow sports thrilling — carving down a steep run, plowing through powder or catching air — also make them risky. Add to that the sudden shifts in weather, unexpected ice patches and out-of-control skiers.

Experts say you can hedge against these dangers with things like flexibility and balance training. But for the best odds of staying safe, you need to build strength — especially in the legs, hips and core — before the season, said Bob Poehling, director of high performance for U.S. Ski & Snowboard.

"Strength is the biggest preventive measure against injury," he said. "It's pretty astonishingly above everything else."

Today's stiff ski boots and quick-release bindings have led to a dramatic drop in tibia and ankle fractures compared with the leather boots of the past. But this technology has made skiing harder on the knees. Knee injuries, such as a torn anterior cruciate ligament or medial collateral ligament, account for about a third of total skiing injuries, according to a 2019 review.

Injuries to the shoulder, wrist and lower leg also are common, as are tears of the thumb ligament, known as "skier's thumb," said Dr. Jim Lubowitz, an orthopedic sports medicine specialist who serves on the medical staff of the U.S. Ski and Snowboard Team.

"When snow is soft or deep, there are going to be more twisting injuries" such as ACL tears, Lubowitz said. "When the snow is hard, you see more fractures."

"Skiing is unique in that you have a massive lever on the end of your foot, and it just creates a huge amount of torque around the knee, Poehling said. Once you get into a compromised position, like sitting too far back and catching an edge of your ski in the snow, it's difficult to correct.

The goal, Poehling said, is to stay out of compromised positions.

Lubowitz said he's seen many ACL injuries occur in people who were falling slowly and attempted to fight it: "They try to stand back up while still moving, the ski shoots out from under them, and it takes their knee ligament with it."

If you fall, he said, let yourself come to a complete stop.

"You wouldn't see as much bad stuff on crazy runs because people there are really focused," he said.

Save the gnarliest double black diamond for when you have the most energy and focus, whether that's in the morning or after lunch when you've had a break, Poehling said.

"Be smart when you take risks," he said.

Be smart about your gear, too. Make sure your bindings are properly tuned so they release during a fall, said Rick Shandler, director of the National Ski Patrol Safety program. People often tend to overestimate their abilities at the ski shop, he said. Don't.

"You want to make sure they're adjusted to reality, not your aspirations," he said.

Lubowitz believes that some of the protective gear worn by professional skiers will become as ubiquitous as helmets someday. Before he hits the slopes, he zips on what's called a downhill jacket, which has protective shells over the spine, chest, shoulders and elbows. He also wears padded shorts and kneepads.

And don't overlook the protection that comes from being physically fit.

Skiing requires a tremendous amount of leg strength, said Matt Jordan, an exercise scientist at the University of Calgary, whose research focuses on ACL injuries. The hamstrings, he said, may be the most important muscles for stabilizing your knees, and people with weak hamstrings and strong quadriceps are especially prone to ACL injury.

A little strength training can improve your odds considerably. And the benefits go well beyond skiing, improving balance and risk of age-related injuries, Poehling said.