The benefits of Prehabilitation, especially before ski season! by Caitlin, our Sports Rehab therapist. For 6.4million people in the UK, that first frost, and the feel of the cold on your face, can only mean one thing – ski season is approaching. Typically, ski-season doesn’t start until after the Christmas blow-out, where that extra mince pie, slice of Christmas pudding and the stuffing and turkey sandwiches have slowly wreaked havoc on your training regime. I don’t know about you, but that first training session back after the holidays is always the toughest for me, with the body fatigued and less conditioned. Now imagine if instead of that gym session or swim, you suddenly introduce your body to three or more days out on the slopes. That is a significant increase in load on your body, and something for which everyone needs to prepare. A sudden increase in training load can raise your injury risk. If you have had, or currently have an injury, this risk is even greater. Even the smallest of injuries, if not correctly managed, can lead to short and long-term imbalances and altered body kinematics. So what does that mean? As my old lecturer would describe it: ‘your bones move and your muscles react.’ Humans are incredibly intelligent and adaptable, and we have developed numerous mechanisms to manage our niggling injuries. This means our bones and muscles may react and align themselves in different ways to try and make us as efficient as possible under the circumstances. However, in the long-term, this can lead to the development of secondary pathologies, and with skiing, can predispose you to some very common injuries. According to research, injury rate on the slopes has plateaued in the last ten years at 2-3 injuries per 1000 skier days, with lower extremity injuries continuing to dominate the statistics. Knee pathologies alone account for 20-30% of skiing injuries, with ligament tears leading the pack. These types of injuries can take up to 1-12months to heal fully, depending on the grade of the sprain. This can set anyone back significantly. The aim of our prehabilitation programme would be to make sure you have sufficient muscle control at the knee to cope with any sudden movements on the slopes. We would also identify and work on any weaknesses, such as strength differences and gait asymmetries, that may increase the likelihood of these common injuries. Upper extremity injuries such as shoulder dislocations/subluxations, rotator cuff tears and collarbone dislocations are also common in skiing. This is usually caused by a sudden load on an outstretched hand, a common reflex we make to break a fall. Our prehabilitation programmes would focus on improving stability at the shoulder joints by improving range of motion and by incorporating neuromuscular control and rotator cuff strength training to protect you as much as possible in the event of a fall or blow. Unfortunately, we can’t stop people getting in your way, or stop your skis from embedding into soft snow, or teach you how to get off that ski-lift elegantly, but we can prepare your body as well as possible for the little challenges you may face. This is why prehabilitation is so important before you head out on that long-awaited ski-trip. It is our job to identify the most common injuries in your sport, understand the mechanisms behind them and then assess for any weaknesses you may have that predispose you to them. It is a detailed injury-prevention programme, tailored to you, which could save you time and money (and suffering!) in the long-term.

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