Knee Ligament Injuries in Skiers and Snowboarders
Rick Weinstein, MD, MBA Director of Orthopedic Surgery Westchester Health Associates
As of the writing of this article in mid-January, New York has had almost no snow. Despite this, I have already seen several injured snowboarders come to my office. Snow enthusiasts are willing to travel out West or North to find powder. However, when conditions are bad on the mountains, injuries are much more common. This has to do with the sudden starts and stops that occur when snow quality is not ideal. While gliding on snow, when you suddenly hit a brown patch, your body continues forward and your skis and feet stop. The force of your body weight and forward momentum will all go through your knees, hips or lower back. If your knee is pointed to the side and you pivot on it with the sudden stoppage, you can tear your ACL or MCL.
The anterior cruciate ligament (ACL) connects the femur bone above the knee to the tibia bone below the knee. We often hear about this ligament because when it is completely torn, it never heals. Athletes, or even non-athletes, who want to go back to pivoting activities will need this ligament reconstructed. The medial collateral ligament (MCL) also connects the femur and tibia but is on the inside part of the leg. This ligament is even more commonly torn and sprained than the ACL, but unlike the ACL, when it tears, it will heal without surgery.
Surgery for the ACL takes typically 1-2 hours when done by an experienced surgeon, but the recovery is at least 6 months to return to sports. My best advice is not to get hurt! Prevent the injuries by making sure that before you hit the mountain you are in good enough shape. For weeks to months before going, your quads and hamstrings need to be strengthened, as does your core. It is extremely important to make stretching part of your routine and to warm up before you actually head down the mountain.
In this winter of warm to cold days, you need to know the condition of the mountain you are skiing on. Look out for the brown patches, but also be cognizant that the snow may freeze suddenly and become very icy, especially at the higher altitudes. Check conditions of the trails you are going to go down. Most injuries occur at the end of the day when your muscles are fatigued, so if your legs are feeling tired give yourself a break or stop for the day so you don’t end up stopping for the entire season. If you do get hurt, immediately put ice on the injury. If you suspect a fracture, get an x-ray ASAP. If it is a possible ligament injury, call me or your local orthopedic sports specialist and get it checked out. In my practice, I see emergencies the same day, and you should expect the same treatment from your sports doctor.