The arrival of snow and cold weather signals the start of the alpine skiing season. However, practicing this sport—sometimes extreme—leads to numerous injuries each year, affecting both beginners and experienced skiers. Whether traumatic or caused by repeated irritating movements, these injuries can abruptly end your season or significantly reduce the enjoyment of skiing.

These injuries involve both the upper and lower body in fairly equal proportions and are most often traumatic, mainly caused by falls.

 

1. Fractures

This type of injury represents 20–40% of all alpine skiing injuries, due to the speed at which skiers descend the slopes and the high risk of falling. Obstacles such as trees, ditches, bumps, ice, and other skiers increase the risk of serious injury.

Most common fractures

• Wrist (radius and scaphoid): often caused by falls onto the hands. This injury is even more common among snowboarders due to the absence of poles and the tendency to fall forward.
• Leg (tibia and fibula): often caused by collisions with terrain, obstacles, or other skiers.

Signs that may indicate a fracture

• Deformity of the limb
• Severe pain increased by weight bearing, palpation, or pressure on the painful area
• A cracking sound at the moment of impact
• Redness, warmth, and significant swelling

Fractures require proper medical management. It is important to consult a physician quickly or go to the emergency department to receive appropriate care.

 

2. Ligament Tears / Sprains

Thumb (Skier’s thumb)

A partial or complete tear of the ulnar collateral ligament of the thumb’s metacarpophalangeal joint. It usually occurs during falls or collisions while holding a ski pole, which forces the thumb outward and places excessive stress on the ligament.

Anterior cruciate ligament (ACL)

A very common skiing injury. A partial or complete tear typically occurs during falls or collisions where the tibia twists relative to the femur. This often happens when a ski catches on an obstacle while the binding remains attached to the boot.

Collateral ligaments of the knee

Less common than ACL injuries but occur in similar situations. Fortunately, they often have a better prognosis because they are more frequently partial tears rather than complete ruptures.

Signs and symptoms of sprains

• Swelling, redness, and warmth around the joint
• Painful joint movement
• For leg injuries: difficulty putting weight on the affected limb

 

3. Dislocations

Dislocations occur when the two bones forming a joint lose their normal alignment and contact. They are most commonly seen:

• At the kneecap (patella) during twisting knee movements
• At the shoulder during falls on outstretched arms

These injuries are usually very painful and often require hospital transport for joint realignment under anesthesia.

 

Signs and symptoms

• Visible joint deformity
• Feeling that the limb is “out of place”
• Severe pain

 

4. Concussions

Speed, ice, and obstacles create the perfect conditions for head injuries. Concussions may occur during falls or collisions with rocks, trees, or other skiers. If not properly managed, they can lead to significant short- and long-term consequences.

 

Symptoms to monitor after an impact or fall

• Headaches
• Dizziness or balance problems
• Nausea or vomiting
• Changes in vision or blurred vision
• Increased emotional reactions, irritability, mood swings
• Significant fatigue
• Sensitivity to light and/or noise
• Sleep disturbances (insomnia or excessive sleepiness)
• Difficulty concentrating, attention problems, anxiety, mental fog
• Confusion or memory loss

 

Symptoms requiring immediate emergency care

• Severe neck pain (possible spinal fracture)
• Double vision
• Loss of consciousness
• Seizures or convulsions
• Repeated vomiting
• Severe or worsening headaches
• Weakness, tingling, or numbness in the limbs

Source: Concussions: Symptoms and Treatment – Government of Canada

 

Non-Traumatic Injuries

 

5. Knee Pain

Knee pain in skiers is often caused by patellofemoral syndrome, a condition involving improper alignment between the kneecap and the femur. It can occur during repeated activities involving knee flexion, such as skiing downhill or descending stairs, or even during prolonged sitting when irritation is more severe.

Common causes

This condition is usually related to muscle weakness or poor motor control in the lower limbs. The muscles most often involved include:

• Quadriceps
• Gluteus medius and gluteus maximus
• Foot muscles responsible for arch support

 

This explains why all joints and muscle groups of the lower limb influence knee injuries.

If left untreated, knee pain tends to worsen during ski outings and daily activities. Fortunately, this condition is often effectively treated in physiotherapy through a personalized exercise program, symptom management strategies, and a progressive return-to-sport plan. Manual therapy and taping techniques may also be beneficial.

 

6. Back Pain

The slightly flexed skiing posture can lead to lower back pain in some skiers. These symptoms are often (but not exclusively) caused by weakness in the core stabilizing muscles and glutes, or by disc-related issues.

As with knee pain, lower back pain may require physiotherapy management for optimal recovery. Because many factors can contribute to back pain, individualized exercises and personalized advice are generally the most effective treatment approach.