Ski Injury Rehab: The Road to Recovery

Gravity and speed are a wonderful combination, which is why skiing is so damn fun. Unfortunately, however, when gravity and speed result in impact, the human body doesn’t agree.

In my 20-plus years ski patrolling, I’ve seen and stabilized all kinds of injury—and even suffered a few myself. Nowadays, in my role as a physical trainer,* I spend more time with skiers working their way back from injury than I do hauling them off the hill. If (or when) it happens to you, here are a few pointers to speed your rehab and get you back on snow as quickly as possible.

Be patient. You'll get back on snow!

The most common injury skiers face is to knee joints (like an ACL tear), so that’s what we’ll focus on in this article. Once the doctor has done a successful repair and a physical therapist has helped with joint mobility and muscle flexibility, I work with people to restore function; restore muscle strength, power, and endurance; and help them return to sport.

Before we begin, a quick note: Take it slowly. To avoid re-injury, start small and focus on technique and form. Don’t push extra weight until you have restored a full range of motion and are mostly pain free. Speaking of pain, rehab often is uncomfortable, but there is a difference between being sore and causing yourself harm. I see a lot of tough folks set themselves back months or weeks by doing too much. Know your thresholds and understand the line between strength gain and reinjury.

Expect to start small. Even bridges can be hard at first. Photo: Jake Hutchinson

Once your doctor and PT has cleared you to begin training, start with the stationary bike, because it encourages full range of motion, is low-impact, and, as muscle endurance returns, resistance can be added to begin increasing strength. I make everyone with knee problems start and finish each training session on the bike. Every warm-up should include 10-20 minutes at a vigorous enough pace to break a sweat but not to the point of fatigue. The goal is to get the blood flowing, loosen up the knee and leg muscles, and “prime the pump” so the body is ready for the real work.

Next, start building strength with bodyweight-only exercises like air squats, wall squats, lunges, and single-leg box squats. This phase may last for days or weeks depending on progress, pain, and swelling. Don’t push it, and listen to your body. The recovery (ice, rest, etc.) each day is as vital as the work itself.

With time, we gradually add weights and power movements to the workout. I like to continue with the same exercises but add dumbbells or kettlebells to the equation to increase strength. At this point, I recommend lighter weights with more reps per set, like 3 to 5 sets of 7 to 10 reps of each exercise, with appropriate rest (1.5 to 3 minutes) between sets. The key here is to be as pain-free as possible. We don’t want to do more harm!

At some point, you'll start dynamic movements with weight. Photo: Jake Hutchinson

After this phase, we can start thinking about how to train the knee for the stresses it will encounter while skiing. How do we do this without reinjury? One way is to pick up weight and move in all planes and all directions. Weighted carries, step-ups, and lateral hops are all great. Avoid movements that focus on muscle isolation, as the body rarely, if ever, works any muscle in isolation. For example, it makes no sense to focus on the quad and neglect the hamstring and glute, as the quad will overpower the hamstring and cause imbalance and ultimately re-injury. 

These weighted exercises build strength, but what about power? Strength is defined as max force production, like pushing a truck across the parking lot, whereas power is defined as the rate of force production, i.e. jumping or sprinting. For power work during knee rehab, start with box jumps, seated box jumps, and broad jumps. This also helps to stress the knee in various directions and begins to mimic movements that will translate to skiing strength.

Once sufficient strength and power have been developed, it’s time to focus on restoring function. Walking without assistance or even a limp is a huge step forward, but it’s a long way from skiing. A huge part of my philosophy is that training is only preparation for the real thing. Specifically, to prepare for skiing, we need to work on all the important muscles and muscle groups involved—not just the legs—and work on mobility so the entire body works in unison. 

You'll be at whole-body workouts before you know it. Photo: istockphoto.com

Mobility is different than flexibility, and it’s critical to understand the two. Flexibility is defined as the ability of a muscle or muscle group to lengthen passively through a range of motion, whereas mobility is the ability of a joint to move actively through a range of motion. Mobility also takes into account the component of motor control within the nervous system. 

As we begin to restore function, I add complex movements that require these muscle groups to engage simultaneously, the way they were designed to do. I introduce deadlifts, GHD extensions, kettlebell swings, sprints, and bounding. I complement with core work, including planks, hanging knees to elbows, and mountain climbers. I encourage single-leg work for balance and to build trust in the repaired joint.

At this point, it may be time to add weighted overhead lunges and additional weight on the single leg box squats. To keep my mobility game strong, I also turn to yoga. In addition to improving flexibility and balance, it’s a killer core workout and helps to keep the lower back strong.

Yoga has some major benefits for skiing, including core-strength training and balance. Photo: istockphoto.com

At the end of the day, it’s really hard to replicate the forces created by high-speed downhill travel over varying terrain with a five-foot plank clamped to each foot. But by strengthening the muscles that support the joints, we set ourselves up for a solid return to the slopes.

* Jake Hutchinson not a doctor or physical therapist, he's a talented personal trainer. Be sure to start any injury rehab discussion with the appropriate medical professionals.

Interested in learning more about ski injuries? Check out these articles:

Injury Prevention
NSAIDS and Injury Recovery
Next Level Skiing Podcast with Tom Hackett

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Article by Jake Hutchinson

Jake has spent more than 25 years working as an avalanche professional. He is currently a lead instructor for the American Avalanche Institute, an avalanche dog handler and trainer and an avalanche safety consultant to the resort and rescue communities. Off the snow, Hutchinson is a Certified Instructor and former Head of Instructor and Seminar Development for Gym Jones in Salt Lake City. He is currently involved in private personal training with an emphasis on high level functional fitness for mountain and military athletes.