• Dr. Karma Patel, D.C. B.Sc (Hons)

Train your knees for your skis.

Elite alpine ski racing is a physically demanding sport imposing large external loads on the lower limbs while travelling at high speeds in an unpredictable environment. The extreme demands of the sport result in a high risk for lower body injury, particularly to the knee joint. In a competitive season, knee injuries account for over 30% of all alpine ski racing injuries.1 Anterior cruciate ligament (ACL) rupture is the most common form of knee joint injury in ski racing. Most ACL tears occur when pivoting or landing from a jump.1

In three consecutive World Cup Alpine Skiing competitions (2006 -2009), there were 20 cases of ACL injuries. The main mechanism of ACL injury was a “slip-catch” situation where outer ski catches inside edge, forcing the outer knee into internal rotation & valgus.2

Normally, a “pop” will be heard or felt, the joint will give way, and the knee will feel dislocated. Following the injury, the knee will swell significantly and the loss of stability will become debilitating. A sports-oriented healthcare practitioner (physiotherapist, chiropractor, orthopedic surgeon, or physician) should assess the severity of the injury as well as any structural or functional impairments that may impede full recovery. Most ACL tears do not necessarily require ACL reconstruction surgery.

A comprehensive Knee Training & Rehabilitation Program is a great way to strengthen your knees and avoid ACL tears. The program should include:

  1. Leg strengthening (quadriceps, hamstrings, calves, hip & pelvis musculature)

  2. Neuromuscular training

  3. Proprioception and high-level balance training

  4. Sport-specific agility

Elite alpine ski racers are recommended to assess and train their quadriceps and hamstrings for maximal strength and explosive strength.1 Furthermore, core strength is a predominant risk factor for ACL injuries in young, competitive ski racers.3

References

  1. Jordan, M. J., Aagaard, P., & Herzog, W. (2015). Rapid hamstrings/quadriceps strength in ACL-reconstructed elite alpine ski racers. Medicine & Science in Sports & Exercise, 47(1), 109-119.

  2. Bere, T., Flørenes, T. W., Krosshaug, T., Koga, H., Nordsletten, L., Irving, C., ... & Bahr, R. (2011). Mechanisms of anterior cruciate ligament injury in World Cup alpine skiing: a systematic video analysis of 20 cases. The American journal of sports medicine, 39(7), 1421-1429.

  3. Raschner, C., Platzer, H. P., Patterson, C., Werner, I., Huber, R., & Hildebrandt, C. (2012). The relationship between ACL injuries and physical fitness in young competitive ski racers: a 10-year longitudinal study. Br J Sports Med, bjsports-2012.

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