How to avoid injury when hitting the ski slopes

While many people worldwide think of California for its warm, sunny climate, it’s easy to forget the state is also a winter sports paradise. February and March mark the peak of ski season, with families flocking to the mountains from Big Bear and Mammoth to Tahoe.

Skiing and snowboarding are exhilarating sports, and overall, they are remarkably safe. Yet from the perspective of Dr. Richard Santore, an orthopedic surgeon affiliated with Sharp Memorial Hospital, understanding when and why injuries occur can help skiers and snowboarders avoid becoming patients.

Modern equipment, improved slope design and widespread helmet use have reduced injury rates over the decades. Fatal accidents are rare, and when they do occur, they are most often associated with high-speed collisions, severe head trauma, falling into a tree well or avalanches.

While risk is low, the popularity of snow sports means doctors treat a steady stream of winter injuries every season. Dr. Santore points out that skiers are most likely to suffer lower body injuries — particularly knee injuries, such as ACL sprains and tears, as well as lower leg fractures — while snowboarders tend to have more upper body injuries. Wrist fractures and sprains are common, as the hands are used to break a fall, while shoulder separations are also seen.

“Fortunately, there are some simple steps you can take to help avoid injuries on the slopes,” says Dr. Santore.

Know your body

Many ski and snowboarding injuries are caused by people pushing themselves beyond their limits. One consistent trend in ski patrol and emergency department data is the so-called “last run” effect.

Injuries increase in the afternoon as fatigue sets in. As muscles tire, coordination and reaction time decline. Balance becomes less precise, and skiers may move faster than their reflexes can safely manage. “That final run — when legs are burning, and light is fading — is often when preventable falls occur,” says Dr. Santore.

Alcohol also contributes to injury risk. A beer at lunch may be part of mountain culture, but alcohol impairs coordination, judgment and reaction time — effects that can be amplified at altitude. Trauma data consistently shows that alcohol is involved in a disproportionate number of skiing injuries, particularly collisions. “It’s pretty clear that even a small amount of alcohol and downhill speed are a dangerous combination,” points out Dr. Santore.

Experience level also plays a role. Beginners account for a significant proportion of injuries, particularly in snowboarding. Overestimating one’s ability, skiing terrain beyond one’s skill level, and traveling at speeds inappropriate for snow conditions all increase the likelihood of injury.

Prepare for your trip

The encouraging news, according to Dr. Santore, is that many ski injuries are preventable. Experts from organizations like the American Academy of Orthopaedic Surgeons and the National Ski Areas Association emphasize that preparation begins well before arriving at the mountain.

“Getting into shape early is key,” says Dr. Santore. “You should start training about a month before your trip, especially if you haven’t skied or boarded in a while.”

He says strong legs, core stability and good balance are most crucial. Exercises such as squats, lunges, planks and balance drills should be incorporated. Building strength and flexibility — particularly in the quadriceps, hamstrings and hips — can significantly reduce the risk of common knee injuries, such as ACL and MCL tears.

Once you do arrive for your day on the slopes, don’t just throw on your gear and rush for the nearest lift. Dr. Santore says it’s important to take just a few minutes for warm-up exercises before starting your first run. “Some leg swings, jumping jacks and jogging in place will get your blood flowing and ensure the right amount of oxygen is getting to your muscles,” he advises.

Equipment also matters, especially the bindings, which connect the boots to the skis or board. You should make sure your boots fit well. Additionally, have an expert from a ski shop double-check that your bindings are set properly before your first run. If not, they may not release during a fall, which could lead to serious injury.

Enjoy the benefits

Skiing and snowboarding offer tremendous physical and mental health benefits, and the vast majority of participants enjoy the season injury-free.

Yet predictable factors — deconditioned muscles, fatigue, alcohol use, excessive speed and inexperience — account for many preventable injuries each winter. A thoughtful approach to preparation, pacing and personal limits can make the difference between finishing the season strong and spending it in rehabilitation.

“I know the joy of skiing firsthand from trips with my wife and children over the years,” says Dr. Santore. “But as an orthopedic surgeon, I know the risks involved and always ski defensively. As my fellow orthopedic surgeons like to say, the best injury is the one that never happens.”

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