8 Tips for Skiing and Riding Safely

A helpful Q&A with one of our sports medicine surgeons.
Alpine skiers ski down the mountain in winter

Nate Endres, MD, is an orthopedic and sports medicine surgeon at The University of Vermont Medical Center. Dr. Endres is also a lifelong skier.

Meeting new people may be his favorite part of his job, but Dr. Endres says he understands why the feeling may not always be mutual for his patients: No one likes being sidelined by injury from doing what they love.

Here he offers some tips to help snow-sports enthusiasts stay on the slopes and out of his office.

1. What are the most common ski and snowboard injuries you see in your practice?

The most common skiing injuries involve the knee, specifically knee ligament injuries to the anterior cruciate ligament (ACL) or the medial collateral ligament (MCL). I also see shoulder injuries, including clavicle fractures, AC joint sprains, shoulder separations and dislocations -- and rotator cuff tears.

2. What are the most common causes of ski injuries?

Skiing too fast or skiing beyond your means. Sometimes conditions play a role, and sometimes we see people get injured getting on and off the lift. That can happen especially with snowboarders who have one foot attached to the board and one foot off.

3. Do injuries vary depending on snow conditions?

They do. If it’s a hard, icy surface, we see more fractures. With powder, or heavy or wet snow -- we tend to see more knee injuries. Particularly with skiing, a ski can get caught in that heavy snow and cause a twisting effect on the knee, causing a ligament injury.

4. What can people do in advance of heading to the mountain to help prevent injury?

Cardio training in the weeks before an outing can help get you in good shape. It will help prevent aches and pains after your day on the mountain, but the gradual ramp-up in activity can also prevent more serious situations, like heart attacks.

You’ll also want to do some stretching. General stretching around the knee -- hamstring and quadriceps stretches -- could certainly be helpful, and maybe some Achilles stretching as well. We do see Achilles tendon injuries even in a ski boot.

Finally, make sure your equipment is in order. First and foremost, wear a helmet. It’s been shown to reduce the risk of head injuries. And make sure your equipment is properly adjusted and fitted.

5. Speaking of equipment -- does equipment quality play a role in injury prevention?

Quality of equipment does matter, and I would recommend that before each season, you make sure that your equipment is fitting and working properly. Skiers should have your bindings checked at a shop every season. You should also make sure you have the right length skis and properly fitting boots. Particularly if it's icy out, it’s also a good idea to have your skis tuned, so you have a good edge on your skis to help prevent falls.

6. What about “day of” tips? How can people stay safe on the mountain?

Know your limits and ski within them. Be aware of the conditions. You don't want to ski too fast, especially on the side of a trail where you could quickly go off-trail and get hurt.

And this may sound difficult, but it’s also important to learn how to fall. One injury that’s common is called skier’s thumb. It happens when you fall and you hold onto your ski pole. While you may not be able to think of it quickly enough, if can help to throw your pole while you’re falling.

Also, when you fall and you’re sliding, keep going. As long as you're not going to slide off the trail, or off a cliff, or into trees, it's better to just keep sliding than to try and suddenly stop yourself. Easier said than done. But if you can understand how some of these injuries occur and learn how to fall in a safer fashion, you might actually be able to prevent injury.

7. Do you recommend taking over-the-counter painkillers before or after an outing to prevent discomfort?

If you have a chronic condition -- such as knee arthritis, for example -- it might be beneficial in terms of symptom relief to take an over-the-counter pain reliever, like acetaminophen or ibuprofen, before a day of skiing. It might make the day more enjoyable. Afterwards, pain relievers can also be helpful, along with icing any sore or swollen joints.

8. How can someone differentiate between a minor strain or sprain and a more serious ski injury that requires medical attention?

If you’ve hurt yourself on the slopes, some red flags would be severe pain, an inability to bear weight, an inability to fully bend or straighten the affected joint, visible swelling, or a sense of the joint feeling unstable or “giving way.” Any of those symptoms should prompt a medical evaluation.

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