How to Prevent Ski and Snowboard Injuries

Learn how to reduce the chance of knee and hip injuries when you hit the slopes.

Skier skiing down a ski trail

Each year, nearly 10 million people in the U.S. ski or snowboard. And while being active is good for one’s health, those who hit the slopes are at risk of knee, hip, elbow, ankle, wrist, and other injuries.

With some preparation, though, many of these injuries can be avoided.

“It’s important to know what you’re getting yourself into,” says Dr. Jakub Tatka, a seasoned skier and an orthopedic surgeon at NewYork-Presbyterian Lawrence Hospital who specializes in hip and knee preservation and reconstruction. “Being prepared for the conditions, both with your own physical fitness and making sure you have good equipment, can go a long way in preventing injuries.”

Here, Dr. Tatka, who is also a former ski racer and ski instructor, and a team physician for the U.S. Ski and Snowboard Team, offers advice for skiers and snowboarders on what you can do to help avoid injuries.

What can you do to prepare your knees and hips before hitting the slopes?
If you regularly ski or snowboard, getting back into those sports is like riding a bike. You get on the snow and you feel great, but those muscles that you used from the previous season may have atrophied a little bit. Go to the gym a few weeks, or even a few months, before hitting the slopes and get some general mobility back. The stationary bike is excellent because it’s very effective in strengthening ski- and snowboard-specific muscles like the quadriceps and hamstrings, and the gluteus complex, which make up the buttocks and are the most powerful muscles around the hip joint. The stationary bike is low impact on the joints, which is healthier for your cartilage. It also gives you a cardio workout, which helps prepare you for long days skiing or snowboarding.

What are some exercises a person can do at home?
One of the most effective moves that people can do at home is stretching the hamstrings, which is good for protecting the lower back. Easy ways to stretch your hamstrings include sitting on a mat or carpet and reaching to your toes, or standing with one leg up on a low table and reaching for your toes, while keeping your knee on that same leg straight. One of my colleagues, Dr. Elan Goldwaser, an osteopathic physician at NewYork-Presbyterian Lawrence Hospital who is a non-operative sports medicine specialist, says it’s also important to stretch and strengthen the abdomen and lower back, often referred to as the core. Dr. Goldwaser, who also works with the U.S. Ski and Snowboard Team, recommends yoga and plyometrics (“explosive” movements improving muscle speed and power) because it helps tremendously with flexibility and strength. We also recommend abdominal “plank” exercises, which involve maintaining a position similar to a push-up for the maximum possible time.

Can equipment help you avoid injury?
Yes. The most important piece of equipment you can bring with you skiing or snowboarding is a helmet. Unfortunately, we have seen traumatic brain injuries from people going at a high speed and hitting someone or something. We have a saying in orthopedics which is, “We can fix broken bones, but we can’t fix scrambled brains.”

I also advise people to make sure their equipment is up-to-date, properly set up, and well-tuned. For example, make sure the edges of your skis and snowboard are properly sharpened, which prevents them from sliding on icy slopes. Ski bindings must be properly calibrated so skis come off safely during a fall, saving your knees and other joints. Borrowing a friend’s piece of gear could save some money, but get you into trouble because the size of the skis or snowboard may not be right. For example, if you have skis that are way too long or too short, too stiff, or too soft, you may have difficulty safely maneuvering them, which puts you — and the people around you — at risk of a fall or injury.

What are some common injuries for skiers and snowboarders?
Injuries around the knee are common, and they are often equipment-related. Skiers need to have the right-sized boots. One of the most important things to keep in mind is how your boots connect to your skis so that if you do fall, your ski equipment comes off properly and safely. If someone falls and the ski doesn’t come off, their leg may twist, potentially resulting in a variety of injuries. These include a meniscal tear, ligament contusion or ligament tear, or even a fracture. For snowboarders, common injuries involve the wrist, elbow, or ankle.

Another, more serious, injury that could occur is an anterior cruciate ligament (ACL) tear. This is more common in aggressive skiers who go down a hill while maneuvering around a series of bumps or moguls, or speed down the slopes.

Portrait of Dr. Jakub Tatka

Dr. Jakub Tatka

Why are wrist and elbow injuries more common among snowboarders than skiers?
When skiing, people typically fall to their sides, while snowboarders generally fall forward onto their wrists with their arms straight out. Usually when people put their arms out in front, the wrists hit the ground first with a lot of force going into the relatively small joints of your wrist or elbow. Sometimes it’s better when you’re on a snowboard to fall on your elbows or shoulders because the wrists are a little bit more susceptible to injury. Falling is a part of snow sports, and it’s important to learn from a trained professional how to fall safely.

If someone has arthritis, what can they do to comfortably ski or snowboard?
Physical therapy, focusing on the knees and hips, can be very helpful. Patients can also use skis or snowboards that are softer, which makes it easier to turn, or avoid trails that have more physical impact on the joints, like mogul runs, jumps, or rough snow conditions. Strengthening the muscles around painful joints can oftentimes relieve a lot of joint stress. For instance, good knee exercises are short arc heel lifts, where you sit with your leg extended, place a rolled towel under your knee, and raise your foot off the floor to straighten the muscles supporting your knee.

What are treatment options for someone who injures their knee or hip while skiing and doesn’t need surgery?
When you come into our practice, we evaluate why your knee or hip is bothering you. Often we start with some small doses of anti-inflammatory medications and/or give some physical therapy regimens. There are several paths you could take in terms of strengthening muscles, so we provide some of these regimens depending on the needs of each patient and communicate with the physical therapists to fine-tune things before considering surgery.

One of the best things about the orthopedics department at NewYork-Presbyterian/Columbia University Irving Medical Center is we have a whole team of sports medicine experts to assess and treat your injuries, from physical medicine and rehabilitation doctors who help patients with exercise regimens and rehabilitation to orthopedists who treat some of the most serious injuries with procedures.

Learn more about NewYork-Presbyterian’s sports medicine programs and procedures.

Jakub Tatka, MD, is an assistant attending physician at NewYork-Presbyterian Lawrence Hospital and an assistant professor of orthopedic surgery at Columbia University Vagelos College of Physicians and Surgeons. He is a traveling physician with the U.S. Ski and Snowboard Team who specializes in complex adult hip and knee reconstruction and hip preservation.