Have you ever injured your knee while skiing?

We hope your answer is "no".

If you have hurt your knee while skiing, or at least have seen someone injure their knee then you will lean more about what happens in these injuries in this article.

When a person gets into an accident on the slopes and it involves their knee, chances are that this person has injured either their MCL (Medial collateral ligament) or your ACL (Anterior cruciate ligament). Knee swelling can result with this kind of injury, and if left untreated this can be a real problem. We will give you some useful information here regarding these two knee injuries; describing how they can occur and some ways to help avoid a knee injury occurence.

Medial Collateral Ligament Sprains

A MCL injury is the most commont type of alpine ski injury. It accounts for nearly one quarter (1/4) of all injuries in this sport. Usually, it will affect the beginner and low-intermediate skier.

Often times, people suffer an MCL injury while in the beginner's snowplough position. This means that the front of the skiis are pointing toward eachother. (The technical term for this in the medical field is that your legs are in "valgus".) Essentially, when their is too much valgus force being applied to your knee joint an MCL injury can occur. If your skis criss cross awkwardly, or the snowplough stance develops into a fall, this could be the force needed to cause the MCL injury.

If you have a grade one or two sprain, many times a person will be placed into a splint that holds their leg(s) in extension. These will be worn, at least until the pain and swelling diminish. A grade three tear may require surgical repair and the use of a substantial knee brace to help provide support.

If you wish to prevent such an occurence, it is a good idea to to do some preseason conditioning. Strengthening your quadriceps will help prevent an MCL injury. Strengthening workouts should always be coordinated with the guidance of a health care professional. Performing maintenance for correct binding and release settings are suggested.

Anterior Cruciate Ligament (ACL) Sprains

ACl injuries account for approximately 10-15% of all ski injuries, depending on the study you cite (sometimes the numbers are higher). Often times, when this ligament is injured, the MCL will also be injured.

The "phantom-foot" and the "boot-induced anterior drawer" scenarios can predispose an ACL injury.

Approximately 66 - 70 % (nearly 2/3) of all ACL ruptures are thought to be caused by the Phantom Foot mechanism. The P.F. mechanism involves the simultaneous combination of: (1) an inward twisting of the knee and thigh relative to the foot; (2) abduction (the foot moves away from midline, relative to the knee) (3) your weight line is posterior to (behind) your knee. It is not necessary to be going fast down a steep slope to suffer this kind of injury.

Boot induced anterior drawer

The acronym (BIAD) refers to the boot induced anterior drawer mechanism. The BIAD occurs when a skiers lands occurs when someone is trying to do a jump, but the skier lands off balanced to the rear. The skier may try to counter act this force moment and straighten their legs fully. After landing on the tail end of the ski, the boot presses against the posterior calf, thus pushing the tibia forward in relationship to the person's femur. Essentially, your tibia is pushed forward (excessively) in relationship to your femur (bone above your knee). This can result in an ACL tear.

In order to help avoid knee injuries, it is recommended that you land with your knees flexed (avoiding knee extension). In addition, if you are still sliding, do not try to get up until you stop. Keep your arms up and forward, so your weight does not fall backward. Land on both skis as well; this will help avoid injury.

The potential protective role for knee braces.

In the American Journal of Sports Medicine entitled "Effect of Functional Bracing on Knee Injury in Skiers With Anterior Cruciate Ligament Reconstruction - A Prospective Cohort Study". In this particular study, 257 skier-employees with ACL reconstructions wore knee braces and 563 skier-employees with ACL reconstructions did not. As a result, it was noted that sixty-one subsequent knee injuries were identified, 51 of which were in the non braced group and 10 in the braced group. It was noted that the non braced skiers were 2.74 times more likely to suffer subsequent injury than were braced skiers. The authors of this study noted that functional bracing for skiers with anterior cruciate ligament reconstruction should be recommended after seeing this data. They did point out that the data could not necessarily be transfered exactly to other sporting activities.

[Reference - American Journal of Sports Medicine 1 October 2006; Vol. 34, No. 10]

Ettlinger CF, Johnson RJ and Shealy JE. A Method to Help Reduce the Risk of Serious Knee Sprains Incurred in Alpine Skiing. Am J Sports Med 1995 23(5) 531-537