Downhill skiing is a fun and exhilarating sport that millions of Americans (including me and my family) enjoy each winter. But traveling down a snowy and often icy mountain at speeds exceeding 25mph comes with risks. Head injuries, broken legs, twisted knees. Over the last 10 years, the introduction and increased use of ski helmets has reduced the incidence of head injuries while skiing by 25%. But the rate of knee injuries including Anterior Cruciate Ligament (ACL) tears has remained steady over the same time period despite improvements in skis, bindings, and lessons.
Having to be taken down the mountain in a sled after tearing a ACL is not the way you want to spend your ski vacation.
Researchers at the University of Vermont School of Medicine estimate that 17,500 skiers tear an ACL every year skiing, which accounts for about a third of all skiing injuries. While changes in ski technology and trends (hour-glass shaped skis which allow skiers to go faster and fat skis which increase knee torque) might play a role in knee injuries, I think the biggest factor has nothing to do with expensive ski equipment.
Michael Decker, a biomechanical engineer at the University of Denver, said that asymmetry between the left and right leg may be a factor in ACL injuries.
“You are seeing big differences in right and left legs,” Decker said. “What we are finding is the non-dominant leg has been injured, especially the ACL, much more than the dominant. Females have two times the rate as males of the non-dominant leg.”
“You are seeing big differences in right and left legs,” Decker said. “What we are finding is the non-dominant leg has been injured, especially the ACL, much more than the dominant. Females have two times the rate as males of the non-dominant leg.”
 Woman with good postural alignment and balanced leg strength which would help prevent an ACL tear while skiing. |  Woman with imbalanced posture which would put the non-dominant leg at increased risk of an ACL tear while skiing. |
Postural imbalance causing knee injuries including ACL tears is something I have talked about before and think is the number one factor in why these injuries happen.
Look at the image above left which shows a woman with good postural alignment and balanced leg strength. You can see that both her feet point straight ahead as do her knees and her hips and shoulders are level. This means when she repeatedly squats while skiing, her ankles, knees, and hips will work together as a team distributing workload throughout all the lower body muscles and avoiding excessive strain on any ligaments, cartilage, or other connective tissues in her body. This means she is very unlikely to tear her ACL while skiing.
Now look at the image above on the right. Notice how her feet turn out at different angles. Her knees also point in different directions and her hips and shoulders are not level. Since we know that how we stand is how we move and bad posture equals bad form, there is no way her body will move or ski in a balanced and even way. She will end up overloading her dominate side while collapsing on her non-dominate side. This is a recipe for injury including an ACL tear - whether it happens while she's alpine skiing, playing soccer, returning a tennis serve, or jumping up and down during a bootcamp workout.
Look at the image above left which shows a woman with good postural alignment and balanced leg strength. You can see that both her feet point straight ahead as do her knees and her hips and shoulders are level. This means when she repeatedly squats while skiing, her ankles, knees, and hips will work together as a team distributing workload throughout all the lower body muscles and avoiding excessive strain on any ligaments, cartilage, or other connective tissues in her body. This means she is very unlikely to tear her ACL while skiing.
Now look at the image above on the right. Notice how her feet turn out at different angles. Her knees also point in different directions and her hips and shoulders are not level. Since we know that how we stand is how we move and bad posture equals bad form, there is no way her body will move or ski in a balanced and even way. She will end up overloading her dominate side while collapsing on her non-dominate side. This is a recipe for injury including an ACL tear - whether it happens while she's alpine skiing, playing soccer, returning a tennis serve, or jumping up and down during a bootcamp workout.
 | Here we see the same woman from above right walking down a flight of stairs. Notice how her right knee is collapsing inward (valgus knee stress, internal femur rotation, foot abduction) and her upper body is offsetting to the right as compensation. The same thing will happen as she skies downhill making turn after turn. As her muscles fatigue they will allow even more collapsing and twisting of her right leg possibly leading to a torn ACL. |
If you have a dominant or stronger leg or notice your feet or knees don't both point straight ahead I would highly recommend you seek professional help in correcting these imbalances from an Egoscue University certified Postural Alignment Therapist and Advanced Exercise Therapist to address your imbalances before you get in injury. As they say, an ounce of prevention is worth a pound of cure.
I would be happy to offer anyone who is seriously interested in correcting their imbalances to prevent injury a free posture evaluation and consultation. I would also offer the same to anyone who has suffered a torn ACL or other skiing injury and would like help getting back to 100%.
I would be happy to offer anyone who is seriously interested in correcting their imbalances to prevent injury a free posture evaluation and consultation. I would also offer the same to anyone who has suffered a torn ACL or other skiing injury and would like help getting back to 100%.
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