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How to help prevent ACL injuries while skiing with 8 exercises!

The previous Backcountry blog post discussed the process of recovering from a major knee injury and how to recover and return to the slopes after such an occurrence. Let’s take the time now to work on avoiding the whole thing from the start! While sometimes ACL injuries may be nearly unavoidable (example: if an out-of-control skier or boarder crashes into your knee), there are things you can do to prevent excessive load being consistently placed on your ACL. We are going to look at positioning, quad strength, rotational hip strength, and hip flexibility.

When you learned how to ski, you probably quickly heard that you should be leaning forward in your boots. Keeping your weight shifted forward gives you better control over your skis so you can make that quick turn when you need to avoid a rock. It also takes stress off of the ACL. When you lean backward, the pressure of your shin bone is shifted forward in comparison to your thigh. This pressure is absorbed by the ACL to keep the shin from moving any further forward. The most effective way to maintain this position is to keep your knees and your hips bent to keep the weight shifted appropriately. To be able to keep this position for long periods of time, your quad muscles are going to need to be in top shape with great endurance! This leads into the next part of the discussion….

The quads sit on the front of your thigh. There are four parts (thus the name “quadriceps”) and it all begins at your pelvis. The muscle attaches just below your knee. Therefore, the quads actually cross both your hip and your knee joint, making them involved in the actions of both joints. To stay in the optimal position for your weight placement while skiing, the quads need to be able to hold their position for an extended period. Here are some ideas on how to help make that possible.

  1. Squats: Stand with your feet shoulder-width apart. Drop your hips slowly back as if you were about to sit in a chair. Let your hips and knees bend. Keep your back straight. Try to get your thighs parallel to the ground. Then return to standing.
  2. Wall sits: This will focus a little more on the endurance portion of your training. Place your back against a wall with your knees bent and thighs parallel to the ground. Hold as long as you can. See if you can get to 1-2 minutes and beyond!
  3. One-legged stance: Stand on one leg with your knee bent about 30 degrees. Hold that position for as long as you can. This will again force your quads to hold you in a stationary position. Once this becomes easier, you can challenge yourself by standing on a foam pad and/or adding in arm movements.

In addition to the quads, we need to focus on muscles around the hips as well. The hips play a MAJOR role in keeping the knees in a good position. This is because the hips have so much freedom to move in different directions and control where the rest of the leg goes! I am going to cover a few exercises that will focus on a rotational component of hip movement.

  1. Clamshells: Lie on your side with both knees bent. Make sure your hips are stacked on top of each other and that they stay that way throughout the exercise. Do not let your hips roll to either side. Place your back against a wall if it becomes too difficult to not let your hips roll. What you will do for this exercise is keep your feet together while your knees move apart. This creates a rotation movement, and you will feel muscle activation in the area of your glutes.
  2. Reverse clamshells: As the name suggests, this is more or less the opposite of the clamshell. You are set up in the exact same position, but your knees stay together while your hips rotate so that your feet come apart from one another. Add a resistance band around your feet (for reverse clamshells) or knees (for clamshells) to get an added challenge!
  3. Tipping bird (AKA single-leg Romanian deadlift): This movement training exercise targets the hamstrings and glutes, but will also incorporate rotation strength by forcing you to keep moving in a straight line without rotating one side or the other. While standing on one leg, hinge at the hip with your back straight to reach toward the floor. The leg that is not on the ground will be reaching straight backward. Return to start position in a controlled manner. The whole time there needs to be an emphasis on keeping your hips and trunk parallel to the ground. Do not twist toward either side.

It’s not just the strength of the hips that is important, but the range of motion of the hips as well (are we getting the idea yet of how important the hips are when it comes to your knees?!?!). To put your knees in an optimal position, the hips MUST be able to move into a position that lets the knees be there. If the hips are turned in or out, the knees will not be centered and extra stress will be placed upon the ligaments! I’ve got a couple of stretches that will be able to help. In general, I often recommend 30-second holds for stretches.

  1. Figure 4 stretch: Lay on your back with one knee bent. Cross the other leg over it so that the foot of the other leg is at the knee of the bent leg. Place your hands around the back of the thigh on the bent leg and pull it toward you. You will feel a stretch along the buttock.
  2. Butterfly stretch: Sit with both knees bent and bring your feet toward your body. Let your knees drop out to the side. Place gentle pressure on the inside part of your knee pushing toward the ground.

That’s the quick rundown on how to care for your knees and lower the risk of the dreaded ACL injury. Incorporate these activities into your routine and know your limitations on the slopes. Nobody wants to miss any powder days due to an injury! Make sure it’s not happening to you! If you are unsure about anything you read in this post and want more info, email me at scott@backcountry.physio or reach out on Backcountry Physical Therapy’s social media pages. Be sure to check back on the website for more blog posts and follow us on social media for ideas on how to keep yourself pain-free!

a man standing with his arms crossed in front of him.
AUTHOR

Dr. Scott Runyon

Backcountry Physical Therapy

We Help Mountain Athletes Not Only Recover From Injuries, But Build Them Back Stronger Than They Were Before, So That Injuries Are Less Likely To Happen Again!
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sudchai dupreez
sudchai dupreez
2022-12-14
I can't encourage Scott Runyon/Backcountry PT enough! I have a torn labrum in my hip and was set to go to surgery. Going to Scott was my last ditch effort to push surgery back and he did it! I have a very active job and I feel stronger now then I did before and Scott got me back to play again. What I really appreciate is that no matter what physical issues that arise I can go to Scott and he always finds a way to get me back in the game! Thank you Scott!
Joel Fraser
Joel Fraser
2022-12-08
Scott has been an integral part of my continued success in my career and in my training! He has been there for every step helping me through all the aches and pains that come with my occupation. If I didn’t have Scott in my corner I’m pretty sure I’d be dealing with multiple surgeries and missed opportunities. Can’t recommend him enough. Thanks Scott!
Wendy Spillar
Wendy Spillar
2022-12-06
I've been working with Scott for over a year on my hip and back pain. I'm a fitness trainer and a caretaker and I'm very interested in staying as joint healthy as possible without surgery and Scott is helping me with this goal. His creative techniques and strategies are A+, highly recommend!
DyVonne Thornton
DyVonne Thornton
2022-12-06
Scott is an amazing person and knows what he is doing. I am a professional MMA fighter and Backcountry PT is a big part of it! I absolutely would recommend Backcountry to anyone struggling with injury.
Mike V
Mike V
2022-12-05
I had a couple of injuries in rapid succession that resulted in some significant quad issues. Scott helped me rehab the quad through a mix of visits and at-home workouts. I have opted for a monthly maintenance plan to keep me out on the trails. I highly recommend Scott.
Evan Canfield
Evan Canfield
2022-06-20
Scott has been an absolute life saver for not only my body but my career. I cannot recommend Backcountry enough. Scott's attention to detail and commitment to each and every patient is unparalleled. Thank you Scott for not only helping me get back to my old self but motivating me to come back better and stronger.
Adam Schwerdt
Adam Schwerdt
2022-04-28
Can't go wrong seeing Dr. Runyon for your outdoor adventures and activities! He will ensure all your needs and concerns are addressed not just for your current injury, but also to help get you set up for the long term. As a colleague who is also a PT there are few other PT's I recommend in the Springs and he certainly makes the cut!
Mehdi Shelhamer
Mehdi Shelhamer
2022-04-20
I highly recommend Scott. I say this both as a patient and a fellow healthcare worker. He is very attentive, listens well and devises an appropriate treatment plan. But better than that, he is constantly assessing your progress and tweaking the plan as needed. Additionally, his use of technology is very helpful with a phone app that keeps you in line. He is also very quick to respond to any questions. Yes, you can find less expensive physical therapy options, but with Scott, you get what you pay for.
matthew stempson
matthew stempson
2022-02-19
I had a shoulder injury and had been dealing with the pain for about a year now. In just three sessions I have learned many excercises and stretches to help me on my road to recovery. I am already seeing a good amount of improvement. He is very knowledgeable and is great to work with. Thanks Scott!
Bobbi Rocco
Bobbi Rocco
2022-02-02
I fell snow skiing. Scott helped me by showing me how to do some exercises right away so I would not develop frozen shoulder. My range of motion improved. His expertise and knowledge has helped and I hope to be able to resume all of my sports soon.