The truth about knee pain and skiing, it’s not what you think

ski racing
Image: Shutterstock

I just got back from a week up at the snow with my dad. My dad is 67 years old, a self confessed snow addict, and has been eagerly awaiting old age for one reason alone. His favourite mountain (Mt Hotham, Australia), offers free season ski passes to over seventies*.

So once he hits the ripe old age of 70, it will be free skiing all day, every day for the entire winter season.

But there’s just one problem. His knees are getting sore and as we all know…skiing is bad for your knees. But is it?

Dads’ backstory

In his early twenties dad first discovered the joys of snow skiing. He made sure to get his yearly snow fix from then on, scheduling annual holidays at various ski resorts in Australia or internationally. 

However in his late thirties he had a skiing accident which resulted in a torn meniscus (cartilage that protects the bones in the knee from rubbing) in his left knee. At this time it was standard to “scrape out” (Dads words) the cartilage in the knee during surgery as treatment. In contrast to modern treatment which aims to preserve as much of this protective cartilage as possible. 

me and dad at hotham
The author and her father at Hotham.

These days, Dad loves telling anyone who will listen about the disastrous results of this surgery and how he has struggled with knee pain ever since. But the truth is, he doesn’t have knee pain all the time. In fact he very rarely had any knee pain until a few years ago. That means that for at least 20 years following the surgery it wasn’t an issue. 

So what’s the real problem here? 

1. Poor rehab

Back in the day (20+ years ago), when dad had his knee surgery, there was little emphasis on post-op rehab. Dad was still fairly young and the expectation was that after surgery pain would settle and life would continue without too much fuss. Luckily he was still quite active back then which meant his strength improved to a degree and skiing was able to continue without issue – although he never did make it back to footy.

After any injury or surgery there is always some loss of strength as our body goes into protective mode and avoids use of the muscles in the area due to pain. New research has shown that this strength rarely returns to “normal” (within 5% of the other side of the body), without some targeted strengthening exercise. 

So it makes sense that since he never had a targeted strengthening rehab program, this side remained slightly weaker. Over time, this weakness will have slowly worsened. 

2. Decreased strength and fitness with age

Who remembers life as a school kid and the amount of incidental sport and activity that filled our weeks? I remember days when I would play sport at lunchtime, have a school PE class, and then follow my school day with yet another sport training session or game.

As we age our lives become filled with the extra pressures of work and family, often leaving us with less and less time for sports and exercise. This results in decreased muscle strength and endurance, and we fatigue more quickly. 

Not only this, but as we start to edge towards middle age our bodies slow down in their ability to recover and to maintain muscle strength and condition. This means slower return to fitness after any breaks, and less ease in building strength and endurance.

3. Changes in load

Everyone loves a good holiday. Relaxing by the pool in Bali, or sampling the amazing foods of Europe.

However you may have noticed that once back home and into the normal routine, you initially feel worn out at activities that would usually be easy. A few weeks off from gym or netball or even your weekly walks and healthy diet makes an impact in a very short time.

On the other hand, sometimes it can be the holiday itself that causes the increase in load. I want you to imagine your usual weekly schedule. Let’s say you work 5 days a week, 8 hours a day, and you spend majority of this time sitting at a desk. You still make sure to get to the gym for one hour 4-5 days per week and you’re in pretty good shape. 

Now imagine that after doing this for almost 12 months consistently, you decide to head off on an epic ski holiday where you sub out the 8 hours of sitting and instead endeavour to ski for 8 hours per day.

How many sports involve 8 hours straight of the activity? Very few.

And how well have our bodies and muscles prepared for this sudden launch into pro-athlete level sporting demands?? Not well at all.

So when we think about this massive change in load over such short period, it makes sense that our bodies may struggle to keep up. 

The verdict

Skiing is not bad for your knees. Weakness and lack of activity is bad for your knees. Knee pain is caused by muscle fatigue and poor tracking of the knee cap not by skiing.

It’s like saying exercise is bad for your body. It’s not. Unless we do too much. Moderation is key. The right amount of exercise keeps your muscles strong, joints lubricated and body healthy, but too much exercise (like anything), causes overload and inflammation. 

So the same principal applies to skiing. Provided you are strong enough prior and not overloading, skiing is a fantastic form of strength and fitness, that like any other exercise, is only bad when you push too far past your limits to the point of overload and injury. 

*update: The Hero Pass (Hotham) has been usurped with the Epic Pass since Vail Resorts purchased Hotham and Falls Creek. Over seventies can now pay $199 for unlimited access to Hotham, Falls Creek and Perisher throughout the season.

Whip it good! Neck injuries and pain on the slopes

Kristina is a physiotherapist based in Melbourne between Invigour Physio in Camberwell, and Evolutio Sports Physio in Richmond. A self confessed winter addict, Kristina has strong experience treating snow-sports injuries across multiple winter seasons. She has worked internationally at resorts in Japan, Austria, NZ and Australia.