October 4th I woke up to snow on the ground. Snow. Yeah snow! I was excited. I love the change of seasons and I am a fan of winter activities such as snowshoeing and skiing. Then I started wondering how I could get myself ready for ski season, and if my patients were getting ready.
Here’s why I was wondering: One week in December, I did six evaluations on patients with recent ACL reconstructions. They all tore their ACLs – a primary stabilizer of the knee. They tore them early in the ski season and had the surgery over Christmas break. I saw them for PT before the New Year. PTs see this all the time. We joke about when the post-operative ACL’s will start rolling in and it is predictably in late December and early January.
As much as we love our patients and love the business that ski season generates, we would rather you didn’t have to go through the pain and hassle of a major surgery. So how can ACL tears, as well as other ski injuries, be prevented?
Most ACL tears result from what we call a valgus collapse. This means that when you land from a jump, or ski the bumps or simply hit an uneven patch of snow, your knees come together in a “knock-kneed” posture. This bent and slightly twisted form wreaks havoc on the ACL and can cause it to snap. In an instant, you are facing major reconstructive surgery and months of rehabilitation.
You can avoid this, but it starts now.
Now, before you strap on your skis and hit the slopes. Avoiding the knee injury has very little to do with your knee and a whole lot to do with your glutes and core. Your glutes are powerful external rotators and are extremely effective in avoiding the dreaded valgus collapse.
If your glutes are strong and prepared for an unexpected or awkward landing, your ACL will be protected. So how do you strengthen your glutes? The ever-popular clam exercise is a good start. But there’s more . . .
Beyond the Clam
Any weight-bearing exercise where you focus on proper knee alignment will help you avoid valgus collapse.
- do squats
- do squats on a Bosu ball
- do squat jumps
- do single leg squats
- balance with one leg on a stack of pillows
The list goes on. But when you do these exercises, keep your knees aligned over your toes. Do not let them fall in. Tie a band around your knees to prevent them from pointing inward.
Do all these things, every day, before you put on your skis. Early in the season, your glutes are not strong the way they will be by March (if your ACLs make it that long…). Your ACLs will be vulnerable. Do the work before the season starts so you can ski the whole season injury-free.
ALTA can help. In fact, we just might be the best place to start. In one session, we can give you an exercise program with exercise progression that you can work on to prevent skiing injuries. We can evaluate your susceptibility to an ACL tear and give you individualized exercises to keep you healthy. We can get you into a Pilates class that will kick your butt (pun intended!), prevent injury, and be fun. Doing ski season “pre-hab” is a no-brainer. Doing it at ALTA is the best decision you will make all winter.