How to Prevent Ski Injuries: A Physiotherapist’s Guide to Staying on the Slopes

Skiing is physically demanding, unpredictable and often performed under fatigue. While crashes can never be fully eliminated, many ski injuries are not simply bad luck. They are the result of insufficient physical preparation, poor fatigue tolerance and reduced neuromuscular control, particularly around the knee and trunk.

The good news? Most common ski injuries are modifiable and preventable with the right preparation.

This blog outlines the key evidence-based strategies to reduce injury risk and help you ski with confidence all season.

Why Ski Injuries Happen

Injury risk increases when the physical demands of skiing exceed the body’s current capacity. Common contributing factors include:

• Insufficient single-leg strength

• Poor lateral and rotational control

• Reduced proprioception and balance

• Fatigue late in the day or week

• Returning to skiing after a long off-season

Unlike many sports, skiing places sustained eccentric load on the quadriceps, rapid valgus and rotational forces through the knee and continuous trunk control demands, often for hours at a time.

The Most Important Injury Prevention Principles

1. Build Single-Leg Strength and Control

Most ski injuries occur when weight is predominantly on one ski, particularly during turns or when catching an edge.

Key focus areas:

• Single-leg squats and step-downs

• Split squats and rear-foot elevated work

• Controlled deceleration drills

Strong legs are important, controlled legs are essential.

2. Train Lateral and Rotational Stability

ACL and MCL injuries commonly occur when the knee collapses inward under rotational load. This is rarely due to weakness alone; it is often a coordination and timing problem.

Effective training includes:

• Lateral lunges

• Skater jumps with controlled landings

• Anti-rotation trunk exercises

These drills teach the body to manage force in the planes skiing actually demands.

3. Prioritise Balance and Proprioception

Skiing requires continuous micro-adjustments at the ankle, knee, and hip. Poor proprioception increases the likelihood of delayed reactions and awkward falls.

Examples:

• Single-leg balance with movement

• Unstable surface work

• Eyes-closed or perturbation-based drills

Balance training should be progressive and task-specific, not random.

4. Prepare for Fatigue, Not Just Strength

Many injuries occur late in the day, when strength is still present but neuromuscular control declines.

To address this:

• Perform strength work under mild fatigue

• Use ski-specific circuits

• Maintain technique quality under load

Being “gym strong” does not automatically translate to being fatigue-resilient on snow.

5. Respect Load and Recovery During Ski Trips

Consecutive full days on snow create cumulative load. Ski fitness must account for volume, not just intensity.

Practical strategies:

• Gradually build ski days early in a trip

• Maintain hydration and nutrition

• Use recovery strategies between days

This is especially important for skiers returning from injury or long breaks.

Who Should Be Most Proactive?

Injury prevention is particularly important for:

• Skiers returning after knee injury or surgery

• Recreational skiers who train inconsistently

• Athletes transitioning back to snow after other sports

• Older skiers with reduced strength or reaction time

A tailored approach makes the biggest difference.

Final Thoughts

Ski injuries are not inevitable. With appropriate preparation, progressive loading and intelligent recovery you can significantly reduce your risk of injury and ski with greater confidence.

Injury prevention is not about avoiding skiing hard, it’s about giving your body the capacity to handle it and Return to Play safely and sustainably.

References

1. Bere, T., Flørenes, T. W., Krosshaug, T., Koga, H., & Bahr, R. (2016). Mechanisms of anterior cruciate ligament injury in World Cup alpine skiing: a systematic video analysis of 20 cases. American Journal of Sports Medicine, 44(7), 1709–1717.

2. Haaland, B., Steenstrup, S. E., Bere, T., Bahr, R., & Nordsletten, L. (2016). Injury rate and injury patterns in FIS World Cup alpine skiing (2006–2015). British Journal of Sports Medicine, 50(1), 32–38.

3. Hébert-Losier, K., & Holmberg, H. C. (2013/updated evidence referenced in later reviews). What are the exercise-based injury prevention recommendations for alpine skiing? Sports Medicine, with subsequent consensus updates informing current practice.

4. Spörri, J., Kröll, J., Gilgien, M., & Müller, E. (2017). How to prevent injuries in alpine skiing: what do we know and where do we go from here? Sports Medicine, 47(4), 599–614.

5. van Mechelen, W., Hlobil, H., & Kemper, H. C. G. (2015+ applied framework). Incidence, severity, aetiology and prevention of sports injuries. Updated injury prevention models applied in modern ski research.