Common Injuries in Cross-Country Skiing and How to Prevent Them
Welcome to the first installment of our blog series leading up to the Edmonton Birkebeiner Cross-Country Ski Races, presented by Leading Edge Physiotherapy. In this series, we’ll cover common injuries, preventative and rehabilitative exercises, and the importance of posture, range of motion, and training for a successful race. Our goal is to provide helpful tips to ensure you get to the Birkebeiner races healthy and perform at your best!
Living in Alberta’s cold winters, we’re always looking for ways to stay active. It’s no surprise that cross-country skiing has exploded in popularity in recent years. With its low-impact nature, flexibility in location, and the fact that it’s often “free” to participate, it’s become a favorite activity for many. However, don’t be deceived by its low-impact reputation—injuries can still occur, especially for those pushing themselves in races like the Birkebeiner.
In today’s blog, we’re diving into the most common injuries associated with cross-country skiing and offering strategies on how to prevent them. At Leading Edge Physiotherapy, our goal is to help you enjoy this amazing sport safely, with full preparation for race day.
While reliable statistics on skiing injuries are scarce, studies show that approximately 75% of skiing injuries are atraumatic (overuse-related) and 25% are traumatic (due to falls). Most overuse injuries develop gradually, with common problem areas including the lower back, knees, Achilles tendons, shins, shoulders, and elbows. Traumatic injuries, such as muscle strains and ligament sprains, often occur in areas like the ankle, knee, groin, wrist, and thumb, typically because of falls.
The good news is that overuse injuries are often preventable. By focusing on strengthening, endurance, and mobility exercises, as well as progressively building up to the Birkebeiner race distances, you can minimize your risk. Let’s take a closer look at the most common areas of overuse injuries and how to prevent them.
1. Knee Injuries
Knee injuries are one of the most common concerns for cross-country skiers, especially given the repetitive knee motion involved during the push-off and glide phases. Patellar (kneecap) pain, cartilage wear, and ligament sprains are common. One overuse injury we see frequently in the clinic is Patellofemoral Pain Syndrome (PFPS), which occurs when there’s irritation in the groove where the kneecap sits, causing inflammation in the connecting tendons and joint. PFPS is often caused by muscle imbalances in the hips, thighs, knees, and ankles, which lead to poor stability and skiing technique.
Prevention Tips:
- Warm-up properly: Always start with dynamic movements, mobility exercises, or even a light jog to prepare the knees for the stresses of skiing.
- Strengthen key muscles: Focus on strengthening the quadriceps, hamstrings, hip muscles, and calves, which help stabilize the knee. A physiotherapist can assess your muscle imbalances and design an appropriate exercise program.
- Use proper technique: If you haven’t had any formal training, it’s a good idea to invest in lessons. The Birkebeiner offers training sessions—check their website for more details.
- Adjust your bindings: Incorrectly set bindings can stress the knee joints. Consult a qualified technician to ensure your bindings match your skiing style and skill level.
2. Shoulder Injuries
Shoulder injuries, particularly involving the rotator cuff muscles, are common in cross-country skiers. These injuries often occur from repetitive poling motions. They are more prevalent in skiers who have poor technique or overtrain too quickly. In the clinic, we most often see rotator cuff strains and tendinopathies.
Prevention Tips:
- Warm-up your shoulders: Use your ski pole to move your arms in different directions, preparing the shoulder muscles for the upcoming activity.
- Strengthen shoulder muscles: Focus on strengthening your rotator cuff, deltoids, biceps, triceps, scapular musculature and upper back muscles to enhance endurance and reduce strain on the shoulder.
- Use proper equipment: Ensure your ski poles are the correct length for your body and skiing style. This can reduce the load on your shoulders.
3. Lower Back Pain
Lower back pain is common in skiers due to the bending and straightening motions involved in propelling forward and poling. Overuse of the low back muscles can lead to strains. The main risk factors include poor technique, poor flexibility, and core weakness.
Prevention Tips:
- Core strengthening: Incorporate core, hip, and back-extensor exercises into your off-season training to improve endurance and posture. This helps reduce strain on the lower back muscles.
- Stretching and mobility: Focus on stretching the back, hamstrings, and hip flexors. Consider yoga or Pilates for a more structured mobility routine.
- Maintain good posture: Avoid hunching over or leaning too much during poling, as this places additional stress on your lower back.
4. Other Overuse Injuries (Elbows, Achilles, Shin Splints)
Other common overuse injuries in cross-country skiers include lateral and medial epicondylopathies (tennis and golfer’s elbow), Achilles tendinopathy, and shin splints (medial tibial stress syndrome). These injuries often affect new skiers who push themselves too hard without adequate rest or cross-training.
Prevention Tips:
- Rest and recovery: Take regular breaks during training and allow rest days between sessions. Even elite athletes need recovery time for muscles to repair and grow.
- Gradual progression: If you’re new to skiing, start slowly and gradually increase the intensity and duration of your sessions.
- Listen to your body: Pay attention to aches and pains, and don’t push through discomfort. Early treatment often leads to quicker recovery.
Final Thoughts
Cross-country skiing offers immense cardiovascular and strength benefits, along with a deep connection to the winter landscapes. It’s a low-impact way to stay active during the winter months—provided you’re prepared and mindful of your body’s needs. By understanding common injuries and following the tips above, along with using proper technique, you can reduce your risk of injury and confidently enjoy cross-country skiing.
The key to injury prevention lies in preparation, listening to your body, and ensuring you rest when needed. Stay safe, ski smart, and enjoy the trails!
And remember: Life shouldn’t hurt!
Your friend in health,
Ryan Agopsowicz, PT
Leading Edge Physiotherapy Capilano
www.leadingedgephysiotherapy.com