SKI/SNOWBOARD SAFELY THIS WINTER!

How can you be healthy, fit and ready to ski safe this winter, whether downhill, snowboarding or x-country?

Note: Please click on the words in bold italics to see the treatment technique info or video of the exercise being described/referenced

If you haven't been very active the last few months due to COVID limitations, the first step is to perform a self assessment of both your musculoskeletal health and your fitness before starting to exercise again, especially if you are planning on going skiing. Our Prepare to Compete(R) system (PTC) can help you with this assessment and with a plan to fix problem areas and get in shape to ski injury free!  And if you are not a skier, the advice below still is valuable to help you prepare for any sport or activity.

As with all sports, there is a base level of healthy joint/muscle function and fitness necessary to ski with less risk of injury. The PTC system has three steps:

 1) Assess your "Present State"- posture, range of motion, stability and movement control.

2) Correct any imbalances with home exercises and office treatment if needed.

3) Train for general fitness and sport specific fitness and participate/compete in your favorite activities. Continue to self monitor with the tests from step (1) to maintain normal muscle and joint function with self-care and office care if needed as in step (2).

If you haven't had a general cardiovascular exam recently, or you are over 50 or have a family history of heart disease, see your doctor before beginning this or any exercise program.

 Ski Readiness Step 1: Key area to assess for skiing: How are your hips? Everyone knows the knees are at risk of injury when skiing, and they should be in good shape locally regarding range of motion and strength, however the hips are where the attention is often needed, and a key area to assess in the PTC system. Hip problems often cause knee problems.

Internal rotation, lateral or "side to side" motion and flexion/extension of the hip all must be checked and are necessary for proper turning and to take pressure off of the knees. These motions are "closed chain", meaning they occur with the feet on the ground (on the skis actually in this case) and must be evaluated while standing as well as improved if necessary with standing exercises. Non-weight bearing exercises also can be done but progress must be made in the standing, functional position for full ski readiness to occur. For internal rotation, the hip on the "downhill" ski side is where the rotation has to occur for the body to turn "around" the hip. At the same time, the pelvis must move side to side and the hip lets this happen through abduction and adduction. And finally, to power us down the mountain with controlled speed, the hips also flex and extend along with the rotation and side to side movement.

To see these three motions in action, look at these series of pictures showing a parallel ski turn progression- note how the skier's thighs are parallel of course the entire time, but see how in the 2nd photo he is more flexed at the hips and there is more space between his thighs, and then gradually through the photos he extends at the hips while the left hip rotates internally, and then as he finishes the turn his hips start flexing again, yet his thighs still remaining parallel. The ski edges are used to create the turn along with the hip internal rotation and pelvic movement opposite, to the right. The internal rotation occurs along with the hip extension (coming out of the more squatted position) which makes biomechanical sense as our hip joints rotate internally easier when in extension than in flexion (they externally rotate more easily with hip flexion).

·     To self-assess your standing hip internal rotation, stand and bend one leg at the knee while centering your body over the standing hip and leg (you can maintain balance by holding onto a wall or doorway frame if needed). Next, while maintaining a neutral spine and upright torso, rotate your torso towards the standing side. The normal range should be at least 45 degrees (your torso will be facing the side you are testing). A restricted side may feel "jammed' at the front of the hip or groin tightness might be felt.

·     To self-assess for standing lateral/medial, meaning the "side-to-side" hip motion, perform the standing lateral lunges in both directions, laterally out and across. Evaluate by comparing left vs. right sides for both directions for both range of motion and how smooth or controlled the movement is.

·     To self-assess for standing hip flexion and extension, perform the standing lunges as shown in these videos: Forward and Backward. Again, evaluate by comparing left vs. right sides for both directions for both range of motion and for how smooth/controlled the movement is.

Ski Readiness Step 2: Corrective exercises for hip range of motion restriction: Self myofascial release and specific stretches.

·     Muscle tightness in the outer hip muscles (gluteals, TFL, piriformis/hip rotators) as well as the adductors (inner thigh) and hip flexors can cause restricted hip motion. Rolling the hip flexors and gluteals, piriformis and TFL is essential here for self care. *Also, we must remember to check key "myofascial" areas. Connective tissue called "fascia" wraps our muscles and connects them up and down the body and can tighten in one area and then cause tension or weakness in another. Thus, foam rolling or other self massage should also focus on the arch of the foot, the calf, the ilitotibial band, the latissimus dorsi, and the upper back.

·     After the muscles/fascia are loosened with rolling, perform both active and passive stretching. Isolated hip flexor stretching should be done along with standing functional movement. This standing movement activation exercise works both the lateral hip movement and rotation described above as well as some hip flexion/extension. Also, the same test movements described above in step (1) can be used to improve mobility and movement control. And strengthening exercises for the hip extensors should be performed.

·     Finally, basic core strength and pelvic alignment exercises may need attention, as well as office care including both manual myofascial release such as ART (Active Release Technique) and spinal/extremity adjustments. Hopefully any restriction felt in the self-tests described above is muscular and not an "abrupt" hard stop with pain at the front of the joint or into the groin. The later could mean you have some degree of hip joint degeneration or impingement, which should be assessed for treatment as well.

Ski Readiness Step 3: Train to gain fitness to ski and then...ski! Enjoy the winter activity at your chosen intensity level while maintaining health by using recovery self-care and treatments. Train for both general fitness and ski specific fitness, ideally starting a few months before your first ski day, building up workout intensity gradually and then maintaining fitness between skid days/trips as the season progresses. See the paragraphs below for a sample program. Also continue to measure your present state (repeat Step 1 a few times per week, even daily as part of your warm up) thus self-monitoring for the earliest signs of Injury.

Ski Fitness: All sports require a combination of cardiovascular endurance (aerobic fitness), muscular strength and endurance, agility/balance and range of motion.

Cardiovascular endurance of course is needed and developed by x-country skiing, but is also needed for downhill skiing to help you recover between runs and deliver oxygen to the working muscles efficiently, especially if skiing at altitude!

·     If you haven't been active the last few months, take at least a few weeks to get back in a routine before hitting the slopes: Indoor cycling, running/fast walking at least 3X/week can help develop basic cardio fitness.

·     Start with 20-30 minutes and build up time gradually.

·     Once you establish a new "base" of fitness, you can increase intensity and progress to short, intense interval workouts that will more closely mimic the "bursts" of exertion followed by rest periods that downhill skiing involve as you do run after run or take breaks during longer runs.

For strength and agility, a body-weight exercise routine including squats, lunges in multiple directions (lateral and rotational motion strength and stability is key with skiing), push up variations and pull ups and/or elastic resistance band standing pulling exercises can be effective. Holding a medicine ball during your lunges and squats raises the difficulty level.

·     These exercises simultaneously work your core, and if you move quickly between exercises you can also train the cardiovascular system at the same time.

·     However, as noted above in step (2), if your core is very weak you first may need to also perform floor core stability exercises such as "Dead Bugs" and "Bird Dogs" to ensure proper form with the standing exercises. Or, on the other hand, if you are already very fit and want an more advanced ski prep workout, jumping (plyometric) exercises such as Front and Side Jumps can be added.

Finally, before you ski, check your gear! Make sure your ski/snowboard equipment is in good shape as well. If you own your own skis, check your boots for wear and tear at the buckles, and have your skis professionally tuned up so that the bindings are aligned properly with correct tension.

Following these steps can make it more likely that you enjoy safe skiing at any age and also gain and maintain fitness through the winter months!

***For guidance on implementing the above advice, feel free to contact Dr.Bochner at ptcompete@gmail.com or call the office at (212) 688-5770 to set up a check up appointment and also to gain access to the full library of self-assessment tests and self-care exercises and tests on traininghistory.com. For those working at home outside of NYC, or who no longer in the NYC area, Virtual Visits are still available.