The most common knee problems related to skiing

-and how to solve them

Below are some of the most common knee problems that skiers experience. The list is intended to be an explanation to people who are bothered by minor knee pain when skiing.  You should always consult a physician to get a proper diagnosis.  Especially if the pain is accompanied by swelling or if you had a bad crash or twist in the knee.

When I talk about weakness it is in relative terms. Compared to other muscles or compared to what you want to do.If you want to ski moguls and powder or you want to ski fast, then you need to be stronger than if you just want to cruise down the groomed runs. 

Patellar pain 

Ski related: This pain usually comes when skiing too much in the back seat or when skiing a little stiff legged (not absorbing bumps etc.).Make sure you balance your weight along the whole foot and not just on the heel when skiing.

Conditioning: Improper conditioning of the thigh muscles can cause this type of knee pain. Make sure you do get those legs going before season start. One-legged standing exercises are the most efficient.

Pain on the inside of the knee at the joint line

Ski related:  This pain can arise from forcing your turn too much when skiing.That is, if you don't trust your skis will turn when you go on edge and push against the snow, but you try to force the skis around by pivoting your knee and ankle.

Conditioning: Weakness of the vastus medialis (the muscle to the inside above the knee).Reverse step-ups are great to fire up this muscle.If the knee tends to lock, have the meniscus checked by a physician.

Pain on the inside of the knee cap

Ski related:  This is not really related to a specific ski situation. 

Conditioning: It is often a symptom of an imbalance caused by a weak vastus medialis and a strong vastus lateralis and tight IT-band that pulls the knee cap laterally.Strengthen thevastus medialis (reverse step-ups is my favorite) and stretch the IT-band to rebalance.

Pain below the knee on the inside 

Ski related: If you ski with your weight equally dispatched on the two skis you may experience the sensation of having two drivers.This puts the adductors to work to avoid the skis spreading too far.If you have more weight on your the ski to the outside of the turn, this will be the one driver and the other ski will follow more naturally.

Conditioning:Work your adductors by doing lateral some leg exercises.

Pain behind the knee

Ski related: Skiing is about balance and stability.If you have a poor balance on your skis or you challenge it by going in uneven terrain such as skied up off piste and moguls you may experience some soreness behind the knee.

Conditioning: Behind the knee we have the popliteus muscle and the attachments of the soleus muscle.By incorporating proprioceptive aspects into your training (exercises that challenge your balance), you can prevent some of this soreness.

Pain below the knee on the outside

Ski related: When trying to avoid a crash forward, for instance if you ski into a slower surface and your upper body wants to continue while your skis are going much slower, your hamstrings and the muscles of the lower leg have to react fast to prevent your legs from overstretching and to keep your hips fairly extended.It can generate a soreness at the attachments of these muscles just below the knee.This pattern often happens in slushy snow.

Conditioning: Make sure to strengthen the posterior chain of your legs in skirelevant positions. After skiing it is a good idea to strecth the hamstrings and soleus muscles.