Column: Winter knee injury and prevention

Winter weather is upon us, and for many of us living in the mountains, it brings alpine and backcountry skiing, snowboarding, and cross-country skiing. Other activities include ice skating, hockey, and snowshoeing. The importance of outdoor activities increases in winter — as getting outside not only has a profound effect on our physical health, but our mental health as well.

With outdoor sports comes the risk of injury, one of the most vulnerable joints being the knee. Some injuries are unavoidable, but the risk of others can be minimized with proper preparation. Preseason conditioning is imperative in decreasing your risk for injuries.

A consistent cardio and strengthening program starting 6-8 weeks before engaging in winter sports is important. If you’re reading this thinking, “I missed that window,” the next best time to start is now.

Good exercises to increase your cardio include cycling, walking, hiking, rowing, and running. These should be done two to three times a week at a moderate pace. Strength training that focuses on large muscle groups like the quads, hamstrings, glutes, and core will help build endurance for skiers and snowboarders.

Just like other sports, warm-up before winter activities is key to success. A good stretching routine, both static and dynamic, before hitting the slopes can warm up the muscles and prevent injury. On your first couple of times out, start slow on an easier terrain to allow the body and mind time to adapt. It is important to know your limits and to be honest with yourself about what level of skier or snowboarder you are. Most injuries occur because the person is skiing or snowboarding beyond their skill level.

Just as important for getting yourself in shape is ensuring your equipment is ready for the season. Whether on one “plank” or two, ensure skis and snowboards are properly tuned and your bindings are appropriately set to your skill level. These adjustments should be done by a skilled technician — there are many available at local ski shops.

Along those lines, make sure to know the snow conditions. Snow conditions change from day to day, and even hour to hour, so it’s important to have gear that can take on current conditions. Icy conditions require sharp edges to maintain control, while on warmer days, the snow requires a different wax to prevent the ski or board from sticking.

At higher, mountain altitudes, the demands of our bodies change. Drinking water is key as it takes more effort to maintain baseline hydration levels. There is also less oxygen in the air, so muscles fatigue quicker, which means more frequent breaks should be taken to allow muscles to recover. Activities burn calories, and when exposed to cold, extra calories are needed to maintain core body temperature. Lastly, avoid excessive alcohol intake as it impairs decision-making and emboldens the person to take more risks.

Knee injuries range from a simple sprain to a severe fracture. A majority of injuries can be treated without surgery, though some do end up requiring an operation and therapy. With a knee injury, be mindful of swelling, pain with motion, pain with weight-bearing on the affected leg, and a feeling of instability.

If you do injure yourself, seek medical help. It is important to see someone with experience; appropriate treatment can get you back on your way to recovery and back to enjoying the winter activities we are so fortunate to have around us.

Kyle Swanson, MD, FAAOS is a board-certified orthopedic surgeon with Tahoe Orthopedics & Sports Medicine. He is a sports medicine specialist treating knee, hip, and shoulder conditions in Carson City, Zephyr Cove, and at the Barton Center for Orthopedics & Wellness in South Lake Tahoe, CA. Dr. Swanson performs knee replacements with Mako SmartRobotics™, which enables surgeons to have a more predictable surgical experience with increased precision and accuracy for total knee, total hip, and partial knee replacements. For more information, visit BartonHealth.org.