What are the most common injuries for skiers and snowboarders?

Tom: The main one, for me, is knees. I see knees all day, every day. Lots of people that have gone on ski holidays and they come back with a torn ACL or they might have seen a surgeon who recommends coming to a physio before their op.

Charlotte: I tend to see more upper limb patients. So that’s shoulder dislocations from people who’ve had a fall, or maybe skier’s thumb. That comes from holding onto the pole, they plant it and then they injure that thumb.

How can people mitigate injury risk on their winter sports holiday?

Tom: Often patients will come to us and o, ‘my surgeons told me I shouldn’t have gone skiing, or I shouldn’t go again. I really that. As physios we’re in a lucky position where we try to get people back to their sport. That’s our goal, that’s our aim. That said, there’s a few things I’d recommend.

Go and have a few sessions before you go on a ski trip. Have a few lessons, it will make a world of difference. Get used to being on the ski and turning again.

The second thing is to do a bit of pre-emptive exercise. Build your strength and conditioning. Third, make sure you have the right equipment. Simple things like having the right din settings on your skis. You want to be able to come out of your skis and not twist or injure your knees.

Charlotte: Take it at your own pace. A lot of beginners, especially if they’re sporty, think ‘Oh I’ll be fine on skis when I get there’. It’s totally different. It doesn’t matter if you’re really good at football or netball, you will be like Bambi on ice once you’re on the slopes.

Don’t push yourself too hard. If you’re in a big group, go at your own speed. Stick to blue runs to start with, and then gradually, as you feel comfortable, progress.

This should be a fairly obvious one: don’t drink too much alcohol. Drink fewer beers on the mountain. That will have a massive effect on mitigating injury.

How might an MDT treat a serious knee injury like an ACL tear

Tom: This is a massive injury to deal with. It can take a lot of time, particularly from a rehab point of view.

From an MDT perspective there’s a huge opportunity to work with quite a lot of different colleagues. We work closely with orthopaedic colleagues, our strength and conditioning guys when the patient is ready to get going.

Ideally, that would involve a three month ‘prehab’. You want to give the joint time to settle. It will be swollen and stiff, it will be really painful. I’ve actually had a number of younger patients that have completed that stage and said, I’m feeling confident that I can do day-to-day stuff without the need for surgery. You can actually be a bit more flexible, depending on the needs of the patient.

How would an MDT approach a skier’s thumb?

Charlotte: We have a specialist hand team. You might go to them for a splint to strengthen the thumb. Again, we might refer you to a strength and conditioning specialist, and there’ll likely be some soft tissue therapy, especially if the thumb feels tight. If you require surgery, you might need some scar mobilisation, and again, we’d probably refer the patient to a a strength and conditioning specialist.

How can a strength and conditioning programme help people prepare for the slopes? Are there specific exercises or muscle groups they should target?

Charlotte: I think it’s absolutely essential to prepare. Give yourself the time to build a regimented strength programme. We have excellent strength and conditioning courses here, and the can design a programme to improve your performance.

You need quads of steel. You’re almost always in a squat position. To hold off back pain or stiffness, having strong back extensors helps because you’re also in a hip hinged position. Generally, upper body strength, particularly your shoulders, is important because you’re carrying your skis from A to B.

You need a well rounded programme. Strength and conditioning is the first thing I’d advise, but you also need aerobic exercise. Elevate your heart, whether that’s running, cycling, or swimming.

Tom: How often do you get on that ski holiday, and you wake up to think ‘my legs are in absolute bits’. In order to really maximize and enjoy your ski holiday to the fullest you need to do some training. It’s a physical demand on the body.