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How to Save Your Knees

Mitigating risk of ACL injury on the ski hill
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By DAVE JACK  |  Moonshine Ink

There are over 350,000 ACL surgeries performed every year in the United States, and 20 percent of those patients endure re-injury after only two years. With ski season around the corner, it’s time to get ready for the snow and prepare against ACL injury by following these guidelines.

Check in regularly

Perform ongoing assessments to ensure you are moving properly, both when you’re fresh and while fatigued. Basic assessments like the overhead squat, single leg squat, or landing error scoring system are great for checking kinetic chain alignment around the ankle, knee, and hips. If you find that either knee wants to turn inward, focus on mobility before adding weight to your strength exercises. Knee valgus (knee caving in) has been shown to be a predictor of noncontact ACL injuries. Making sure the groin, quad, and hip flexor muscles are mobilized while the gluteus medius and maximus are activated will help to create proper balance and function to the hip and knee. Keeping the lower body kinetic chain aligned will help take strain off the ligaments and redistribute it to the muscles.

Include dynamic stretching and warm up

Don’t just stand in line waiting for first chair. Loosen up and get the blood flowing through your joints to increase range of motion as you raise your heart rate so that you’re not going from zero to hero. Going straight from standing in line, or sitting on the cold chair, to charging straight down the mountain is asking for injury. Incorporate leg swings, lateral lunges, and opposite hand to toe touches on the mountain to get your body ready for the intensity about to come.

Two more, skip the last

Know when to stop. Fatigue is one of the top reasons most injuries occur. When your muscles become fatigued you will compensate with improper movement that adds strain to your ligaments. Don’t let the last run of the day be the run that ends your season. Stop before it’s too late.

Strengthen your legs and core

Incorporate functional lower body movements such as squats, lunges, and deadlifts in your weekly routine. Start your workouts with lateral band walks to get your hips and core activated and stabilized before performing your workout. Squats and lunges will strengthen your quads and VMO. The VMO is located on the top, inside portion of the knee and it is the patellar stabilizer. Keeping the VMO strong will help prevent knee injury. When performing squats ensure that the knee is tracking well over the foot and not turning in (when in doubt, drive the knees out). With lunges, be certain your forward knee tracks over the ankle and does not come forward of the toe. The back knee should drop to just below the shoulders. Deadlifts will strengthen the posterior chain glutes, hamstrings, and lower back. Keeping those strong will protect your back from injury and balance the strength between your hamstrings and quad so your knee can function efficiently.

Mixing in variations of all three of these exercises is important for developing balance around the muscles. Try unilateral exercises such as the single leg Romanian deadlift or the Bulgarian split squat. This will ensure both legs are working equally so that imbalance doesn’t develop. Lastly, think to load the muscle eccentrically by giving a few more seconds as you lower the weight into the squat, lunge, or deadlift. Muscles gain the most strength by focusing on the eccentric phase of the exercise.

Plan your training around your sport

Don’t hit legs and core really hard the night before you plan to be on the slopes all day! Your muscles will not have recovered and will be too fatigued to withstand the intensity, therefore leading you to susceptibility of injury. Give your body rest to recover so you can hit the slopes feeling fresh. Focusing a higher volume of training in the off season to get ready for ski season will prepare you best without compromising risk of being overly tired from a high-volume training session. When ski season arrives, focus more on corrective exercises with decreased volume to maintain the muscle you worked so hard to build, yet keep you limber and strong for the energy you plan to put on the mountain.

Have the right equipment

Make sure that your bindings are set properly. Wear the necessary braces to keep compression around joints that are already weak. Have insoles made for your feet that keep you in the proper position. Getting these all dialed in specific to you and your style of riding will give you the optimal stance, comfort, and safety.

Time is running out before the snow falls. Start following these guidelines to avoid injury so you can get out there and shred the slopes all winter long!

 
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November 8, 2018