How to Prevent Knee Injuries when Nordic Skiing

Nordic skiing is not only fun but also a great way to exercise. However, accidents do happen, most of which can be prevented. Knee injuries are quite common in Nordic skiing especially in beginners and sometimes even in pros. The good news is that you can prevent knee injury – better to be safe than sorry.

You can prevent a knee injury by warming up before hitting the track. Also, prepare your body for a couple of months with exercise that focuses on your core muscles. Polishing your skiing skills is also crucial to prevent injuries as you can injure your knees by a bad landing, collision, or fall.

Causes

When you do cross country skiing, your knees are under constant pressure due to the long squat positions. Furthermore, your leg muscles put pressure on your knees while absorbing the ground force. And if that was not enough, your hips exert pressure on your knees to stay aligned and keep a balance, so you do not fall. As a result, you ski downhill, but your knees take a lot of pressure.

If you have strong knee muscles and have warmed up before hitting the tracks, your knee muscles may be able to withstand all the motion.

If you are planning to do Nordic skiing, make sure you keep yourself safe from all kinds of possible injuries, especially the knee injury. You can injure your knee by doing some of the following activities:

  • Incorrectly landing after a jump when your body weight is drawn towards the back instead of going forward.
  • The snowplow position where you point your skis inwards to turn or stop.
  • You undergo collision while skiing or fall hitting your knee directly on the ground.
  • When you go down a slope, you may throw your lower leg outwards. This may result in your knee getting injured.

It is important to know a little bit about your knee’s anatomy to understand how it functions and how our certain actions result in disrupting this functionality. Our knee is made up of 3 bones: femur, tibia, and fibula. The femur is our thigh bone, the tibia is the shin bone, and fibula is the smaller bone at the outer side of your lower leg. Four ligaments hold this bone together. These are:

  • The 2 anterior and posterior ligaments that prevent your knees from hyper flexing and hyperextending (bending too forward or too far back in the wrong direction).
  • The 2 collateral ligaments that prevent your knee from moving to extreme sides.

When you ski, you perform repetitive movements involving these ligaments and focusing on your knee muscles. One bad landing or slip can result in a knee injury.

Cross Country Skiing

Some of the most common knee injuries in Nordic skiing include the following.

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome is not a new term among cross country skiers. It mainly affects sportsmen such as skiers, cyclists, and runners – those who indulge in activities that involve a lot of running or jumping. In this syndrome, the area around the kneecap is affected in the form of tissue damage, inflammation, or strain. As a result, the skier undergoes pain.

Symptoms

The prominent signs and symptoms of Patellofemoral Pain Syndrome include:

  • Shooting or dull pain around the skier’s kneecap.
  • The kneecap does not move as it normally does and trying to move it results in more pain.
  • When you put a little pressure on your knees or try to flex it, the pain increases.
  • When you move your knee or walk, you hear a cracking or snapping sound.
  • You may experience slight swelling around your kneecap.

Treatment

If you experience Patellofemoral Pain Syndrome, your doctor may suggest you to limit your activity level and rest your knee as much as you possibly can. Also, elevating your leg and icing the kneecap region may help relieve pain.

Your doctor may also advise on compressing the affected knee. This is done by providing some external supports like a knee-compression band, brace, or footwear specially designed for this condition.

For getting rid of the pain and reduce swelling, the skiers going through Patellofemoral Pain Syndrome are often prescribed anti-inflammatory medicines.

To pace up the healing process and your body’s mobility, you may be recommended using physiotherapy sessions.

In rare conditions when the medicines and therapy do not work, the doctor may recommend a surgical procedure. There are different kinds of surgeries involved in Patellofemoral Pain Syndrome and your doctor will recommend one after closely examining your knee. Some of the commonly done surgeries include smoothing out the damaged cartilage (or removing it if need be), arthroscopy, and re-aligning or adjusting the kneecap for reducing pressure on the knee.

Runner’s Knee

Although a large number of athletes have heard about Runner’s Knee and many of them go through it, there is no exact diagnosis of this condition.

Runner’s knee is quite common among sportsmen and health enthusiasts that do a lot of bending and straightening of their knees. This includes runners, cyclists, cross country skiers, football players, as well as handball players.

However, the exact reasons, symptoms, or conditions of all these people who get a Runner’s Knee may be different from one another. This is because Runner’s Knee is rather an umbrella term that covers pain around the knee or kneecap area.

Some doctors believe that Runner’s Knee is caused by a thick band of tissue (known as tractus iliotibialis or the iliotibal band) that lies on the outside of the hip. The iliotibal band is attached to the knee. When a skier bends and straightens his/ her knee too many times, friction is created inside this band and this leads to irritation in bursa, which is a tiny sac filled with fluid. The result is severe pain. Although no one knows for sure what happens, some doctors dismiss this theory. No matter what the real cause is, one this is for sure – the Runner’s Knee causes knee pain and with the right kind of treatment and care, you can recover from it.

Symptoms

The primary symptom for Runner’s Knee is severe pain on the outside area of the knee. The pain increases with time and/ or when the concerned person uses the knee frequently including skiing downhill.

Treatment

Your doctor will take your medical history and conduct a physical examination of the area around your kneecap. The doctor will also check for any kind of swellings around kneecap. He/ she may refer you to a physiotherapist or may ask for a knee scan (though imaging is seldom required).

To get rid of the acute pain, you can put ice-packs on the knee, or do some gentle massage around your kneecap. Compression may also help reduce pain.

The most important treatment is to figure out what caused the actual problem and not to repeat it (or overdo it) in the future. You may think about taking help from a trainer that may help you with your posture and load management techniques.

There are instances when a skier goes through Runner’s Knee by either training too much or skiing without proper rest. Cross country skiing is a strenuous activity and your body needs ample amount of rest and sleep.

How to Prevent

To prevent knee injuries when enjoying Nordic skiing, you need to keep in mind some precautionary measures. Clearly, you cannot leave skiing as it is an important source of recreation as well as a physical workout. However, your knee joint takes a lot of pressure when you twist it during cross country skiing while taking turns and going down the hill. Also, your knee absorbs the ground impact of your ski jumps, and putting constant pressure on it in a semi-squat position is not easy on the knees.

Consider the following factors to prevent knee injuries during cross country skiing:

Do a Pre-Season Training

One thing many novice skiers (and often experienced ones too) do is that they stay away from all kinds of exercises throughout the year and when winter arrives, they jump into their skis. Sitting all day on your chair and doing office work does not prepare the body for any kind of strenuous activities that Nordic skiing offers.

If you do not exercise regularly, you are bound to get tired on the slopes, resulting in shorter skiing experience and more frustration. But what is more dangerous is the chance of hurting your back and especially the knees after a year-long idle position and posture. To avoid all kinds of injuries, especially your knee injury, you need to indulge in pre-season training.

Pre-season training does not mean that you try to ski on grassy slopes. It means you keep your body in shape and your muscles need to be used to what winter will bring in. For this, you need to ideally do a combination of cardio and weight training. For strengthening your core, Pilates is a great summer workout that you can sign up for.

If you are interested in doing yoga, it is a great way to loosen up those stubborn muscles and increase your strength. When the weather is too hot in the summers, you can go to the gym and do a regular workout involving a treadmill, elliptical, and cycling – or even swimming.

All these workouts focus on strengthening the muscles that you will be requiring during Nordic skiing. These workouts will strengthen your lower back, quads, glutes, and hamstrings. As a result, your body will distribute the weight and the sudden jerks evenly while you ski, instead of channeling out to the knee.

Don’t Forget to Warm-up

Even if you have been quite regular in hitting the gym for the rest of the year, doing a warmup before you put on your cross country skis is crucial.

Do a bit of stretching followed by a combination of light movements including lunges, arm circles, and lunges, all for about 15 to 20 minutes. It is like waking up all your muscles and warming them up for the big day – a day skiing at the slopes.

It is hard for your cold muscles to show a hundred percent activity level when directly exposed to an exhausting workout. If you cannot do light exercise, you can go for a walk that moves your muscles and keep the heart pumping.

Stretching increase your mobility and range of motion. Heading towards the snowy hills without a warmup is calling for trouble. For this reason, a pre-ski warmup is highly recommended.

Practice, Practice!

Practice makes a (wo)man perfect, and this holds true in the world of cross country skiing as well. The more you practice your skiing skills, the better are the chances for you to avoid slopping mistakes that lead to knee injuries.

To differentiate between the correct and incorrect skiing posture, it is important to know the difference yourself. So that when you spot someone with a bad skiing technique, you can either help them out (to avoid them from getting injured) or remind yourself not to do that.

In cross country skiing, you must keep your hips above your waist, arms forward, and maintain full control over your body by balancing it. All skiers fall, and as weird as it may sound, there is a right way to fall and a wrong way too. The right way to fall will keep your back and knees safe whereas if you fall down the wrong way, you may end up injuring your knees (or other parts of your body) and may even have to say farewell to that season of skiing.

To make sure you fall correctly, you should consider the following factors:

  • Flex your knees while you fall and keep them flexed until you stop sliding. A mistake that skiers often make is to stiffen up their bodies in a straight posture when they are falling.
  • In order to protect your face and arms, bring them towards your core while you are falling and sliding.
  • Do not attempt to stand up while you are still sliding down as this will increase the chances of injury. Wait for the sliding to finish (by making sure your hands and face are centered towards the core) and then once your body stops sliding, try to regain your control.

What Should I do?

It is better to check the trail maps or go for a familiar terrain if you are skiing after a long time. Knowing the easy trails from the difficult ones can help prevent injuries especially if you are a beginner. Although the chances of very serious injuries during Nordic skiing is quite rare, yet falling on icy grounds can cause sudden jerk and pain to your muscles, especially the knee joint. Make sure you know what you are doing and have to take ski classes if you are new to this sport.

Still, accidents can happen anywhere. If you accidentally fall or collide with another skier, you must get up and check if you are fine or if any part of your body (particularly the knee or back) hurts. Do not ignore a hurting knee.

Consider the following cases when you injure your knee while cross country skiing:

Acute Care

You may experience sore knees after a day-long ski session, or after a slight fall or collision. The best way to help your knee is to rest your knee. This includes no movement (no walking or flexing).

Ice is also good for the sore muscles. Use an ice pack around your knee for 15 to 20 minutes. Repeat after every two hours.

Elevating your knees can also help reduce the pain and irritation. Do not ignore any kind of prolong or unbearable pain, swelling, and stiffness. Observe your knees for 24 and up to 48 hours if the pain is bearable and improving. If you feel the pain is not completely going away, or there is some increased swelling around your kneecap, it could be because of sprained ligaments of the knees.

Turn to a Specialist

If you have sprained your knee muscles, getting treatment sooner is better than later. Once you have done acute care and feel that even after 24 to 48 hours of observation (this includes elevating your knee, resting, and applying ice) the problem is still there, consult a doctor.

Your doctor or a specialist will look into the knee injury, observe the swelling rate, and may prescribe you a pain killer medicine. If your specialist thinks the fall or collision has a serious impact on your kneecap, he/ she may ask for imaging to get a clear picture of what is causing your bones and joints to cause pain.

In some instances, physiotherapy sessions work wonders. However, if the specialist suspects anything serious, he/ she may suggest you for a surgical procedure. In cross country skiing, the chances of serious injuries are quite rare, and a lot of times the skiers get back on their feet (and knees) by being careful on the slope.

Conclusion

In order to prevent knee injuries while Nordic skiing, you must make sure you have the proper skiing gear and know what you are doing. If you are new to skiing, it is better to take classes or accompany your trainer.

Do not forget to indulge in an exercise routine in summers so that your body is ready to ski in the winter. Also, do not over-do skiing, as prolong skiing may put a lot of pressure on your knees.

Just like any other workout or sport that requires your body to warm up first before indulging in something strenuous, you need to warm up your body and awaken your muscles before going for cross country skiing.

Lastly, preventing a knee injury while you fall is crucial. As a skier, you cannot prevent falling, but you can prevent knee injuries. After all, you wouldn’t want to have an injured knee and miss out on all the Nordic adventures, would you?