Bend the knees

It’s the start of the skiing season which means one certainty – an avalanche of knee injuries.

Accidents can’t be avoided, but being fit and ready for the slopes could reduce the chances of this happening to you. Experts at Spire Gatwick Park Hospital have come together to give their top tips to guide you round the moguls and pitfalls of skiing and bring you safely home.

Before you go:

• If you own your skis, get them serviced. Check the bindings release quickly – if you have an accident on the slopes, a delay in releasing the bindings can make the injury worse.
• Think of your skiing trip as a week-long workout as well as a holiday and start an exercise programme six weeks before you go. Look out for specific ski exercise classes at your local gym, or start a home workout to stretch and strengthen the key muscles that are involved in skiing. These are the calves, quadriceps (front of thigh muscles), hamstrings (back thigh muscles), back and gluteal (bottom) muscles.
• Key exercises include squats, calf raises and wall sits. Warm up muscles first with a gentle walk or jog on the spot. Do this daily, building up progressively to 3 x 10-20 repetitions.
• Eccentric resistance training strengthens muscles making them ski-ready. Use the stairs to strengthen quadriceps muscles, lowering first one leg, then the other, to the step below and back up again.
• Don’t forget to strengthen the arm muscles as these will be put to the test when using ski poles – use a rowing machine at the gym, or do press ups, tricep dips and bicep curls.
• You will have altitude to cope with so boost your overall fitness levels with regular cardiovascular exercise work - that is, any exercise that increases your heart rate such as swimming, rowing, jogging, cycling or hilly brisk walks. Aim to exercise 2-3 times a week for 30-40 minutes each time.
• Increase your coordination levels by side stepping on and off a low step or platform.

On the slopes:

• Eat a hearty breakfast to maximise energy levels for the day ahead.
• Walking to the ski lifts will warm up the muscles. Try jogging on the spot once your skis are on.
• After you have warmed up, do some leg stretches for calf, hamstring, thigh and groin muscles, holding each for 20-30 seconds, repeating three to four times. For example, lean forward in your boots to get a nice calf stretch, or bend your knee behind you so the tip of the ski is in the snow and stretch out the thigh muscle.
• Check your bindings every day to ensure they release quickly and easily.
• Avoid alcohol at lunch time as this will increase tiredness levels.
• Take a snack with you to boost energy levels and aim to drink at least two litres of water a day.
• Fatigue can kick in after lunch – if you’ve had a successful morning skiing, stop in the afternoon if you’re feeling tired. Tiredness can cause accidents.
• Wear a safety helmet.

Après Ski

• Remember to do cool down stretches after you’ve finished skiing - these are the same as your pre-ski routine.
• Eat protein foods in the evening such as meats and pulses to repair and rebuild muscle tissue.
• Keep alcohol to a minimum – hard to do when you are on holiday, but be aware that excess alcohol can lead to dehydration and tiredness the next day.

Skier’s knee:

These days, ski boots are more advanced and the ankles are supported better, so knee injuries are the most common, such as anterior cruciate ligament injury.

Symptoms may include sudden pain in the knee joint at the time of injury with an audible pop or crack and a feeling of giving way. It will swell and feel warm to touch.

You will need immediate medical attention involving clinical examination to determine the extent and nature of the injury.  Self-help measures will include the RICE principles - rest, ice, compression and elevation.

If you are unfortunate enough to sustain an injury on the slopes, we have a dedicated team of specialist orthopaedic consultants, on-site physiotherapy and state of the art imaging services.