STEAMBOAT SPRINGS, CO, UNITED STATES, October 24, 2023 / — Autumn’s chill is soon to be followed by frigid temperatures—and, for ski enthusiasts, snowy slopes. But avid skiers need to prepare early to ensure their mountainside adventures don’t lead to knee injuries, says orthopedic surgeon and sports medicine specialist Dr. Alexander Meininger.

Worldwide, several hundred million people enjoy downhill skiing each year, making it one of the most popular winter sports. But it does present a few downsides. Knee injuries remain the most common ski-related injury, accounting for about one-third of all injuries among recreational downhill skiers, according to a 2021 study in the journal Knee Surgery, Sports Traumatology, Arthroscopy (
Why are the knees so vulnerable while skiing? Many factors are at play, including changes in snow and ice conditions, binding release failures, or falling awkwardly or abruptly.

“All of these situations and more cause the knees to twist unnaturally, which can lead tendons and ligaments to tear,” says Dr. Meininger, a founding partner of Steamboat Orthopaedic & Spine Institute, based in Steamboat Springs, Colorado. “In the most serious cases, skiers’ knee joints can dislocate and they can even break bones.”

Common knee injuries among skiers

What types of knee injuries happen most often while skiing?

A torn anterior cruciate ligament (ACL)—which maintains the knee’s rotational stability and prevents the shinbone from slipping in front of the thighbone—is the most common knee injury among alpine skiers. ACL tears are often prompted by skiers trying to prevent a fall and twisting in the opposite direction or landing a jump poorly, Dr. Meininger notes.

But those ruptures almost never happen alone: Other knee joint structures are typically also injured at the same time, according to the 2021 research in Knee Surgery, Sports Traumatology, Arthroscopy (

These structures include the medial collateral ligament (MCL), which runs along the inside of the knee from the upper shinbone to the lower thighbone. It’s often torn when skiers’ knees are overstrained to the side – like when a tip catches the snow or the knee buckles inwards—and they fall, Dr. Meininger says.

“Preventing injuries can happen in two places: on the slopes and off the slopes,” he says. “Doing so on the slopes is challenging but doable. One of the key ways is to remember to practice proper form and technique—keeping your hands and weight forward, legs parallel, and hips, knees and ankles flexing equally.”

“Beyond that, avoiding injuries while skiing also relies on making smart choices,” Dr. Meininger adds. “Skiers should stay on marked trails, avoiding potential obstacles such as trees and rocks that can easily contribute to knee injuries.”

Prevention tips

Much knee injury prevention happens long before skiers hit the slopes, however. Since the sport depends on a healthy knee joint and surrounding muscles, Dr. Meininger offers these preparation and training tips before strapping on a set of skis:

• Gather the right equipment. Make sure ski boots fit, bindings are properly adjusted and that ski length is appropriate for height and skill level.
• Get moving. A person’s knees can’t be strong unless their body is strong overall. Several weeks before hitting the slopes—if not longer—start aerobic training, such as walking briskly, jogging, using an elliptical machine, or cycling.
• Strengthen your muscles. Strengthening and stretching the muscles that support the knees make it more likely skiing will be injury-free. Target muscles such as the quadriceps (front of thigh); hamstrings (back of thigh); abductors (outer thigh); adductors (inner thigh); and the gluteus medius and gluteus maximus (buttocks). Daily exercises designed to condition the knee area should include squats, thigh contractions, straight leg raises, heel and calf raises, hamstring curls, and leg presses.
“With careful forethought, skiers can spend their time joyfully whooshing down the mountain instead of coping with knee injuries that can cut their ski time short,” Dr. Meininger says. “It’s worth an ounce of prevention to maximize skiers’ enjoyment this winter.”

Alexander Meininger, MD is a board-certified orthopaedic surgeon and a specialist in sports medicine whose practice focuses on the treatment and repair of knee, hip, and shoulder injuries. He is a founding partner of Steamboat Orthopaedic & Spine Institute.