Guest Post by:
Shane K. Woolf, MD
Associate Professor of Orthopaedics
Chief of Sports Medicine
Medical University of South Carolina

With New Year’s here, avid skiers and snowboarders are eager to enjoy time on powder in the coming months. The snow base is growing at many resorts around the country, which means alpine athletes will be flocking to their favorite slopes to enjoy the thrill and freedom of gliding down a mountain. For many, just taking a vacation week every year or two is the extent of their time on skis or snowboard. Others are fortunate enough to get time on the mountain regularly. In either event, avoiding injury is the best way to maximize your powder days and to make the best of your cherished opportunities to enjoy the mountain each year.


Off-season conditioning

One of the most important things to consider prior to a planned ski/snowboard trip is being prepared medically and physically. Chronic health conditions like hypertension, diabetes, and cardiopulmonary issues should be assessed and optimized by your primary care provider to assure safe participation. Conditioning begins with a dry land training routine. This should include cardiovascular work like running, cycling, or elliptical and should be performed at least three times per week for 30-60 minutes. Weight training for power and muscle stamina/control is also necessary. Hip, core, quadriceps and hamstring strengthening are each important and should include some negative (eccentric) strengthening work. Additional power work including isometrics and box jumps will be beneficial for those long days on the mountain in different terrain. While preseason exercise does not prevent injury or lower risk significantly1, it is essential to make your trip pleasurable, to ensure that you don’t wear out as quickly, and to reduce soreness and fatigue in subsequent days.


Slope Side Preparation

Sunscreen and eye protection are often neglected during trip preparation, but are imperative to reduce the risk of UV light injury to the corneas and skin. Most people forget that the impact of UV light can be heightened at altitude, by reflection off of the snow, and also by concurrent wind and cold damage to exposed tissues. Applying sunscreen to exposed skin through the day and wearing UV protective sunglasses or goggles can help avoid painful burns. Helmet use may reduce the risk of traumatic head injury2,3,4,5, which can have grave consequences. Brain injury can occur whenever the skier/snowboarder’s head impacts the ground, another person, trees/rocks, lift towers, or other exposed objects. Neck injury is not necessarily reduced with use of helmets and is more common with more aggressive activity, such as off-piste and glades.5 Other important equipment related factors include proper fitting for your skis or snowboard and making sure bindings on your skis are properly adjusted (DIN) to suit your size, skiing style and skill level.


For those visiting the mountains of the western US or Canada, altitude can also affect breathing, hydration, and recovery from exertion. Be cautious with alcohol consumption, maintain adequate water intake, and, if you experience issues with breathing at altitude, consider going down to the base lodge or even further down the mountain until your breathing recovers. High altitude pulmonary edema (HAPE) can occur at the higher altitude resorts, particularly when visiting from a sea-level hometown. This condition can fatally impair breathing and oxygen exchange, but is remedied in its early stages by simply getting oneself to a lower altitude.


Skiing vs Snowboarding Injury

Chest and abdominal blunt trauma, including splenic injury, are more common in snowboarders but usually these are nonoperative problems. Wrist and upper extremity injuries are substantially more common in this group. Skiers, conversely, are at greater risk for lower extremity injury, often involving the lower leg and knee. Head and spine injuries tend to be evenly distributed among the skiers and boarders.6


While injuries can certainly occur during a skiing or snowboarding outing, simple preparations and precautions can make your trip safer and more comfortable.  If you do experience an injury, or have an existing problem you would like to have assessed before a trip, contact a sports medicine specialist like those in the MUSC Health Sports Medicine program today.




1 Johnson et al, Sports Health (2009)

2 Sulheim et al, JAMA (2006)

3 Levy et al, Journal of Trauma (2002)

4 Hagel et al, British Medical Journal (2005)

5 Mueller et al, Epidemiology (2008)

5 Haider et al, Journal of Trauma and Acute Care Surgery (2012)

6 Sacco et al, Journal of Trauma (1998)