The Winter Olympics make skiing, snowboarding and ski jumping look effortless. Athletes fly through the air, race down mountains and land at incredible speeds, often making it all look surprisingly graceful.
Behind every smooth performance, however, is an enormous amount of strength training, movement practice and injury prevention work. Winter sports place huge forces through the body, and the knees are often right in the firing line.
Research examining recent Winter Olympic Games has found that some of the highest injury rates occur in:
• Freestyle skiing
• Snowboarding
• Alpine skiing
• Bobsleigh
• Ice hockey
Across Winter Olympic sports, the knee is the most commonly injured body region, accounting for approximately 16.5 per cent of reported injuries. The back, wrists, hands and fingers are also frequently affected.
In snow based sports, ligament injuries, joint sprains and dislocations are especially common. Ice based sports tend to involve more muscle and tendon strains.
The risk is not surprising. These athletes are dealing with speed, uneven surfaces, sudden changes in direction, challenging landings and unpredictable contact with the ground, equipment or other competitors.
The anterior cruciate ligament, commonly known as the ACL, is one of the key structures that stabilises the knee.
ACL injuries often occur during movements involving:
• Sudden stopping
• Rapid changes in direction
• Pivoting or twisting
• Jumping and landing
• High force falls
These movements are common in many winter sports, particularly alpine skiing, freestyle skiing, snowboard cross and ski jumping.
Fixed object sports involving high impact rotational landings have been shown to carry particularly high rates of ACL injury. This includes activities where the foot is secured to equipment or the ground while the body continues to rotate.
In skiing, the boots and bindings can hold the lower leg in position while large twisting forces move through the knee. If these forces become greater than the ligament can tolerate, an injury may occur.
Research suggests that female athletes experience higher ACL injury rates than male athletes in several types of sport, particularly contact sports and sports involving high impact rotational landings.
Winter Olympic injury data has also shown a slightly higher overall injury rate among female athletes compared with male athletes.
There is no single reason for this difference. ACL injury risk is influenced by a combination of anatomy, hormones, strength, movement patterns, training exposure and sporting demands.
Some anatomical differences may influence how force travels through the knee.
Women generally have a larger quadriceps angle, which may affect the direction of forces acting around the kneecap and knee joint.
A narrower space within the femur may also increase the chance of the ACL becoming compressed during certain movements.
The slope of the top of the shin bone can influence how easily the shin moves forward underneath the thigh bone. A steeper slope may increase forward shear forces through the knee and place more strain on the ACL.
These factors cannot be changed, but understanding them can help guide appropriate strength and movement training.
Hormonal changes throughout the menstrual cycle may influence collagen production and ligament laxity.
Some studies suggest that changes in oestrogen and progesterone may temporarily affect how stiff or flexible the ACL is. This does not mean women should avoid exercise during certain stages of their cycle.
It does mean that injury prevention should take a broad approach rather than focusing on one single risk factor.
Training history, fatigue, recovery, muscle strength and movement control are still extremely important.
The muscles surrounding the hips, knees and ankles help control force during landing, turning and stopping.
The hamstrings are particularly important because they help limit forward movement of the shin and reduce strain on the ACL.
Some female athletes may rely more heavily on their quadriceps during jumping and landing while activating their hamstrings later. This can increase forward shear forces through the knee.
Strengthening the hamstrings, glutes, calves and trunk can improve the body’s ability to absorb force and maintain control.
This is why elite winter athletes spend so much time in the gym. They are not only building muscles for performance. They are building the capacity to tolerate enormous forces safely.
Winter sport preparation should begin well before the first day on the mountain.
A quality program may include:
• Squats and split squats
• Deadlifts and hip hinge exercises
• Hamstring strengthening
• Calf strengthening
• Single leg balance exercises
• Jumping and landing practice
• Agility and direction change drills
• Core and trunk control
• Cardiovascular conditioning
The goal is not simply to lift heavier weights. Athletes need to produce force, absorb force and maintain control while tired.
For recreational skiers and snowboarders, this may mean completing a structured strength program for several weeks before a trip.
A few wall sits the night before heading to the slopes probably will not undo eleven months of avoiding leg day.
Strength training is important, but equipment setup also plays a role.
Ski bindings are designed to release the boot when forces become unsafe. The release force setting needs to be appropriate for the skier’s height, weight, ability, boot size and skiing style.
A setting that is too loose may release unnecessarily. A setting that is too tight may fail to release during a fall.
Some newer binding designs allow additional sideways movement at the heel, which may help reduce certain twisting forces through the knee.
Bindings should always be checked and adjusted by an appropriately trained ski technician. Borrowing someone else’s skis without checking the settings may save a few minutes, but your knees may not appreciate the shortcut.
Not every winter sport injury involves the knee.
Snowboarding is commonly associated with ankle injuries, while cross country skiing also places significant demands on the feet and lower legs.
Research involving elite cross country skiers found that foot and ankle injuries made up a large proportion of lower limb injuries. Many injuries also occurred during training rather than competition.
This is an important reminder that injury risk is influenced by overall training load. Athletes can become injured while preparing for an event, particularly if training volume or intensity increases too quickly.
Not every injury can be prevented, but risk can be reduced.
Effective ACL prevention programs usually include:
• Lower limb strength training
• Neuromuscular training
• Balance and stability work
• Jump and landing technique
• Change of direction practice
• Progressive exposure to speed and fatigue
• Appropriate equipment setup
• Sensible management of training load
Consistency is the key. A prevention program completed once is unlikely to make a meaningful difference.
Regular training allows the muscles, tendons, ligaments and nervous system to adapt gradually.
You do not need to train like an Olympic athlete to benefit from winter sport preparation.
A physiotherapist or exercise physiologist can assess your strength, balance, mobility and movement control before you travel. Testing may identify side to side differences or areas that fatigue quickly.
Your program can then be matched to your sport, experience level and injury history.
Preparation is especially valuable if you:
• Have experienced a previous knee or ankle injury
• Have not skied or snowboarded recently
• Are returning after surgery
• Feel unstable during jumping or single leg tasks
• Become fatigued quickly
• Are planning several consecutive days on the snow
Winter sports are demanding, exciting and occasionally unforgiving.
The best time to prepare your knees is not halfway down the mountain. Building strength, control and fitness before your trip can improve performance, reduce fatigue and help your body tolerate the forces involved.
At PhysioHealth Corrimal, our physiotherapists and exercise physiologists can assess your movement and develop a personalised program to prepare you for the slopes.
Because your first run of the season should be spent enjoying the snow, not wondering why your legs already feel like jelly.
