As U.S. Freestyle Ski Team physician, Dr. David Goltz sees his share of ski injuries. For the team’s mogul skiers, the biggest nemesis is the anterior cruciate ligament (ACL) tear in the knee. On the aerials side of the team, a crash landing is the obvious danger. Of course, recreational skiers don’t push themselves as hard as Olympic athletes, but Goltz emphasizes that strength and conditioning preparation is important for anyone.
Start with your core
“If you can only do one part of a full strength and conditioning program, the one thing I would do would be core strengthening,” Goltz says. “Ski-specific muscles would be the next thing: lower extremity muscles like quads obviously. Then I would add some amount of balance training to it like one-legged squats or two-legged squats on an uneven surface.”
ACL injury prevention
Differences in physiology between men and women do make female athletes more susceptible to ACL injuries in variety of sports. Again, strengthening exercises can mitigate the risk.
“We’re learning that when people do an athletic-landing type of maneuver, if your knees kind of bulge in toward the midline—a valgus collapse we call it— it increases the strain on your ACL. If you strengthen your hips, you can diminish the valgus collapse and decrease your chance of ACL injury,” says Goltz.
Also an orthopedic surgeon at Marin General Hospital near San Francisco, Goltz says surgery techniques for ACL reconstruction have advanced in the past five years. Although the surgery has improved, recommendations regarding recovery time have actually slowed.
“In the recovery process, there was a time that we thought the more accelerated the recovery process the better it was, but I feel like the pendulum has swung a little back in the last couple years,” Goltz says. “We’ve learned in dealing with elite skiers that returning them to competition too soon has a lot of negative effects.
“We tell most patients that it’s about a year’s journey when they tear their ACL. At the elite level, it can be a two-year journey. They’ll be back skiing in a year, but there is increased chance they’ll hurt the other knee in that first season back. The message to most people should be to not push your return to skiing if you have an ACL surgery.”
While ski-team athletes generally wear a knee brace for a year following surgery, numerous studies have shown that the brace does not necessarily reduce the risk of reinjury.