Winter Knee Injury and Prevention

Winter is upon us, and hopefully bringing more snow and the outdoor activities we enjoy doing this time of year. For many of us living in the mountains, winter means alpine and backcountry skiing, snowboarding, and cross country skiing. Other activities include ice skating, hockey and snowshoeing. Accessing outdoor activities during the pandemic is more important than ever - not just for our physical health, but for our mental health as well. With these outdoor sports comes the risk of injury and one of the most vulnerable joints to these injuries is the knee. Some injuries are unavoidable but others can be avoided and risks can be minimized with proper preparation. Preseason conditioning is imperative in decreasing your risk for injuries.

A consistent cardio and strengthening program starting 6-8 weeks prior to winter is important. Good exercises to increase your cardio include cycling, walking, hiking, rowing and running and these should be done 2-3 times a week at a moderate pace. Strength training that focuses on the large muscle groups like the quads, the hamstrings, the glutes and the core will help build endurance for skiers and snowboarders. Just as important for getting yourself in shape is making sure your equipment is good to go for the season as well. Whether on one “plank” or two, make sure skis and snowboards are properly tuned and also make sure the bindings are appropriately set to your skier level. These adjustments should be done by someone who is knowledgeable, preferably by a technician at one of our local ski shops if available.

Winter sports are no different than other sports in that warm up prior to the activity is key to success. A good stretching routine both static and dynamic prior to hitting the slopes can warm up the muscles and prevent injury. Start slow and start on an easier type of terrain initially to allow the body and mind time to adapt. It is also important to know your limits and to be honest with yourself about what level skier or snowboarder you are.

Most injuries occur because the person is skiing or snowboarding beyond their skill level. In general, beginner skiers want the bindings set to a lower number to allow the ski to release easier while a more advanced skier wants to have the binding set to a higher number to prevent the ski from releasing on steeper and more difficult terrain. Along those lines, make sure to know the snow conditions. Snow conditions change from day to day and even hour to hour, so it’s important to have gear that can take on current conditions. Icy conditions require sharp edges to maintain control while on warmer days the snow requires a different wax to prevent the ski or board from sticking.

Remember that the majority of winter sports are done at a higher altitude causing an increased demand on our bodies. Proper hydration should be a priority and at higher altitudes more water is needed to maintain baseline levels. There is less oxygen in the air so muscles fatigue quicker which means more frequent breaks should be taken to allow muscles to recover. Make sure proper nutrition is being maintained. All these activities burn calories and when it is cold extra calories are needed to maintain core body temperature. Lastly, avoid excessive alcohol intake as it impairs decision making and emboldens the person to take more risks.

Many winter sports injuries are preventable with proper preparation, knowing your limits, maintaining proper hydration and nutrition and making good choices. However injuries do occur even with the best laid plans. With regards to knee injuries, they range from a simple sprain to a severe fracture. Majority of injuries can be treated without surgery but some do end up requiring an operation and therapy. Things to be mindful of if you do sustain a knee injury is swelling, pain with motion, pain with weight-bearing on the affected leg, and a feeling of instability.

If you do injure yourself, seek medical help. It is important to see someone with experience so appropriate treatment can be done to get you back on your way to recovery and back to enjoying winter activities we are so fortunate to have around us.

Kyle Swanson, MD, FAAOS is a Tahoe Orthopedics & Sports Medicine physician at Barton Health’s offices in South Lake Tahoe, CA, as well as Zephyr Cove and Carson City, NV. Safe, accessible care is available through Barton Health to reduce pain and help you enjoy favorite activities. To make an appointment or virtual visit, call 530.543.5554. For more information on expert orthopedic shoulder care and complementing therapies, visit BartonHealth.org.