It’s that time of year — the snow is flying and Holiday Break is in full swing, and that means one thing: ski season is officially here!
If you’re lucky, you’ll head out West to the mountains or up north to Michigan’s beautiful ski resorts. For the rest of us, it might mean carving out a Saturday afternoon to visit a local Southeast Michigan ski hill. No matter where you ski or snowboard, one thing is true: it’s thrilling, it’s great exercise, and it’s one of those rare “life sports” that people of all ages can enjoy.
But whether you’re cruising down a mountain or navigating an icy slope on the side of a landfill (yes, we all know the one), there’s always risk. Most skiers have heard someone talk about “blowing out” their knee — usually meaning a torn ligament. Unfortunately, knee ligament injuries are very common in skiing. Just ask the patients I’ve seen over the last couple of weeks whose ski trips ended much earlier than planned.
Understanding the Knee Ligaments
Before we go any further, let’s take a closer look at the ligaments that keep your knee stable. The knee has four major ligaments that provide stability:
1. ACL (Anterior Cruciate Ligament)
Located in the center of the knee, prevents the shinbone from sliding forward.
2. PCL (Posterior Cruciate Ligament)
Also in the center of the knee, keeps the shinbone from sliding backward.
Together, the ACL and PCL form the “cruciate” ligaments — they cross each other in the knee’s center.
3. MCL (Medial Collateral Ligament)
Located on the inner side of the knee; provides side-to-side stability.
4. LCL (Lateral Collateral Ligament)
Located on the outer side of the knee; also stabilizes side-to-side motion.
These ligaments work together to stabilize your knee — especially when skiing, snowboarding, or moving quickly downhill.
ACL Injuries in Skiing
The ACL is one of the most commonly injured ligaments in skiers. Because your ankle is locked tightly in your ski boot, your knee absorbs most of the twisting forces during a fall. “Catching an edge,” wiping out, or landing awkwardly can result in:
- A popping sound or sensation
- Immediate swelling
- Pain or difficulty standing
- Instability or the knee “giving out,” especially when changing direction
The ACL also plays a role in protecting the meniscus, the “bumper cartilage” in the knee. Without a functioning ACL, additional cartilage damage can occur.
Diagnosis:
A combination of medical history, physical exam, and often an MRI.
Treatment:
- Partial tears may or may not need surgery.
- Complete tears do not heal and often require ACL reconstruction, especially for active individuals.
- Surgery is typically arthroscopic and uses a tendon graft from the patient or a donor.
- Rehabilitation is essential for restoring strength and stability.
- Some less active individuals may be treated conservatively if the knee remains stable.
PCL Injuries
PCL tears are less common than ACL tears and often result from a direct blow to the front of the knee or significant twisting. The knee may “sag,” and patients might notice discomfort or instability.
Unlike the ACL, many PCL injuries can be managed with a structured rehabilitation program. Surgery is considered when pain, swelling, or instability persists.
Collateral Ligament Injuries (MCL & LCL)
The MCL is commonly injured during skiing due to force applied to the outside of the knee. The good news: the MCL has a strong ability to heal on its own.
The LCL is rarely injured.
For MCL sprains and most other soft-tissue injuries, remember RICE:
Rest, Ice, Compression (or bracing), Elevation — followed by a rehabilitation program.
Tips to Avoid a “Blow Out” on the Slopes
- Have your bindings checked to ensure they release properly
- Warm up and stretch before your first run
- Start on green or blue runs and progress gradually
- Avoid skiing aggressively when fatigued
- Pay attention getting on/off lifts
- Begin downhill runs only when the path is clear
- Consider an off-season strengthening program, which has been shown to reduce knee injury risk
Snowboarding Injuries
If you snowboard, your knees might be safer — but other parts of your body are not. Because both feet are attached to the board, knee blowouts are less common. However:
- Wrist fractures
- Forearm fractures
- Shoulder injuries
- … are much more common.
Snowboarders should:
- Wear wrist guards
- Always wear a helmet
- Ride under control
Be Safe and Have Fun This Ski Season
There you have it — the inside scoop on the ligaments inside your knee and the injuries we commonly see in skiers and snowboarders. Skiing and snowboarding should be a blast, not a blowout. Know your limits, play smart, and use common sense to stay safe.
For more information on orthopedic injuries, prevention strategies, and treatment options, visit www.miorthosurgeons.com. If you get injured after hours or on the weekend, our UrgentOrtho clinics are ready to serve you, located in Shelby Township and Royal Oak!
About Dr. Joseph Guettler, MD
Dr. Joseph Guettler, MD is an orthopedic surgeon specializing in sports medicine, including surgery of the knee, shoulder, and elbow. He is also a proud member of Michigan Orthopaedic Surgeons.