Ski season is upon us! We spoke with Elise A. Hiza, MD, a board certified orthopedic sports medicine surgeon, to discuss the most common injury she sees, prevention, and getting back on the slopes.
Skiing: Knee Injury Season
Knee injuries are the most common injury Elise A. Hiza, MD and her team see during the winter months in Colorado. “In most other places that don’t have skiing and mountains, Fall is the ACL season, with football and soccer, and we definitely
see plenty of that here, but it really ramps up during the winter,” says Dr. Hiza.
Skiers are susceptible to injuries of the knee due to scenarios innate to skiing that place great torque on the knees. Often what occurs is a skier catches an edge (of their ski), causing their knee ligaments to twist and stretch under great strain and
force, ultimately causing the ACL to rupture.
Treatment and Recovery Time
An ACL rupture requires surgery. The ruptured ligament needs to be replaced with a new one. Dr. Hiza speaks to her approach saying, “I utilize a cutting edge technique that involves taking the quadriceps tendon from above the kneecap that recreates the ACL.” This is a minimally invasive procedure that only requires a 1 cm incision. This surgery typically takes 1-2 hours with patients going home the same day.
Following surgery and physical therapy, you can expect to be back on the slopes in 9-12 months. Studies show that the risk of reinjury is higher in returns to
sport in time periods less than 9 months. Dr. Hiza sympathizes with individuals eager to return to the activities they love, but wants to ensure her patients’ sustained health and well-being. “If you are rehabbed appropriately, my hope
is that you are back without ever thinking about that again [the injury] and enjoying a good ski season, a good hiking season, a good climbing season, and everything that you want to do afterwards,” says Dr. Hiza.
Prevention
A combination of strength, coordination and balance is integral to ACL rupture prevention. Our muscles help stabilize and protect our joints and the ligaments that hold those joints together. This is why strengthening the core, hips, quadriceps, and hamstrings is really important.
In addition to strength, a mind to muscle connection is instrumental in ACL injury prevention. “You need to have the correct brain to nerve to muscle signaling pattern to contract muscles when they are supposed to be contracted,” says Dr. Hiza. Performing exercises that focus on strength training while challenging your balance attunes your brain’s ability to sense where your body is in space, also known as proprioception. This equips your body with the brain to nerve to muscle signaling pattern that is essential for joint protection, not only in your day to day activity, but in scenarios of high stress for your joints and ligaments like a black diamond run.
A great example of training this mind to muscle connection are single leg squats. This combines the strength training of traditional squats with the added challenge to your balance of executing the reps on one leg. A standard progression for this exercise is advancing to single leg squats performed on an uneven surface such as a bosu ball. This will strengthen muscle groups that protect the knee and help build your brain’s awareness of your knee’s movements in space.
Click to learn more about Dr. Hiza and her team at CU Medicine Orthopedics Broomfield and CU Medicine Orthopedics - Longmont Specialty Care Center.