How to get your knees ready for skiing (and what to do if you hurt one)
How to get your knees ready for skiing (and what to do if you hurt one)?
Ramp up strength training for your quadriceps, glutes, tibialis anterior, and core rotation, and if you haven’t started — START! Prevention has always outperformed treatment. A bolus of strength work 6 to 8 weeks before your trip will improve your strength and endurance, putting you in a better position to handle the demands of skiing. If you are unlucky enough to twist your knee and feel a pop, rapid swelling, or the knee giving way, stop skiing that day and get it properly assessed when you're home. Unless it’s a fracture or a locked knee, it’s unlikely to need surgical intervention while you’re away.
Why skiers hurt their knees?
As I prepare for my ski season, which is an extremely busy period in the orthopaedic knee clinic, I am left reflecting on why skiers hurt their knees. The knee is the joint most often injured in skiing, and the ACL is the ligament most often torn. Your boot covers and immobilises your ankle, so when a ski catches, or you fall backwards, the twisting force skips the ankle and goes straight to the knee. Anecdotally, 4 in 5 ski injuries have a rather mundane story; for instance, they result from a slip, twist, or fall that happens when stationary or getting off a ski lift. Only a few come from the action of skiing itself. However, these mundane events often happen after an extremely demanding week or two on your knees, and better strength and endurance may help.
Two patterns cause most ACL injuries:
The backward twisting fall: you sit back, the downhill ski catches its inside edge, and the knee twists inward.
The bad landing: landing a jump or bump with your weight too far back, so the boot pushes the shin forward.
Tired legs make both more likely. Injuries often happen on the "one last run" of the afternoon, when your thighs can no longer hold a good position.
What the evidence says
Good evidence shows that structured warm-ups involving resistance exercises and jumping/landing drills reduce soft tissue injury incidence in sport. Furthermore, greater strength is linked with reduced injury risk and increased performance in many sports, which is why strength and conditioning is a mandatory feature in ALL sports — even curling! (Herman et al., 2012; Lutz et al., 2024). Less research exists on skiing, but the same principles apply: strong, well-controlled legs cope better with increased load demands. Correctly set bindings also matter, as they release the boot before the force reaches your knee.
From my clinic
I am still working with a number of skiers from this time last year, so the ripples of a moment in time go a very long way. Some have had surgery with great effect and some with tragic effects; some have avoided surgery altogether. Some happen because a stranger clips your skis, others from getting off the ski lift (again), and some from a loss of control on the slope.
The only thing better than a comeback story is a never-stopping-in-the-first-place … story. So treat the 6-12 weeks prior to skiing as your bolus period.
Your 6-week home pre-ski plan
Do this 2 to 3 times a week. Build from 2 sets to 3 to 4 sets as it gets easier.
Exercise | Why | Dose |
Wall sit | Builds the thigh endurance that keeps you in position on long runs | 3 x 30 to 60 s, add time weekly |
Squat (goblet or barbell) | Leg strength | 3 x 8 to 10, add weight weekly |
Bulgarian split squat | Single-leg strength and control | 3 x 8 each leg |
Single-leg Romanian deadlift | Hamstrings, which help protect the ACL | 3 x 8 each leg |
Lateral bounds with a held landing | Teaches the knee to land over the foot | 3 x 6 each way |
Side plank | Trunk control so you don't sit back | 3 x 30 s each side |
Swap in your own preferred exercises or link to your exercise videos. Click here to download a more specific ski prep leg programme.
While your on the slopes
Get your bindings set by a ski technician for your weight, height, ability and boot.
Do a warm-up as pre-activation for the first run, not just a coffee.
Stop before you're exhausted. Notice when you start to fatigue and be cautious of the accumulating effect this has on your nervous system
If you fall, don't fight it. Keep your arms forward, hands over your skis, and don't try to stand up while still moving.
If you hurt your knee on the slopes
Stop skiing for the day, even if you can stand on it.
Ice, elevate and rest the knee for the first day or two. Use crutches if walking hurts.
Notice what happened: a pop, swelling within a few hours, or the knee giving way all point to a ligament injury.
Keep any scan reports or letters from the resort clinic, and check your travel insurance.
Book an assessment in your first week home. You don't need to wait for the swelling to go down.
When to get seen urgently
Go to A&E if you can't take four steps on it, the knee or leg looks deformed, your foot is numb, cold or pale, or the knee is hot and red, and you feel unwell.
Book an acute knee assessment if you felt a pop, it swelled quickly, it gives way, or it locks or catches.
Next step
Hurt your knee skiing? I keep Monday evening slots for new knee injuries in Bury St Edmunds. [Book an acute knee assessment] or [book a free call] if you're not sure.
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