Skiing To Your 90s

Skiing is a fantastic sport that no one would do if they knew how dangerous it was. But what other sport can you do with your family and friends from morning until late afternoon? What other sport has you outside in the cold yet feeling warm, excited, tested, and stimulated in a hundred ways? Where else can you go fast or go slow, and still have the same outcome: a huge smile?

Pictured: ACL Reconstruction Patient Kiersten S. Skiing Less Than One Year After Surgery

Skiing, in all its forms—whether alpine, cross country, or uphill with skins on the bottom of your skis—provides the winter thrill of exercising on the snow. It is so much fun and so invigorating that it is loved despite its dangers, though needs a little caution. 

We see many athletes who prepare for skiing and do it well, along with those who don’t and get injured more often. Here (with a focus on alpine) are the preparations that make a difference:

1. Tune your gear both before and during the season. Sharp edges and smooth bottoms permit carving turns and control.
2. Ski bindings have not evolved very much over the last few years, but they have changed. As long as the design captures both the toe and the heel there will never be a truly safe binding. This is because if the capture force is strong enough to prevent premature release (coming out when you don’t want to), it will sometimes be too strong when you need to be popped out of the binding to avoid knee ligament tears. Ski gear manufacturers have, however, modified the binding and boot interface and introduced so-called “grip walk” designs. But when there is a mismatch, between older boots and the newer bindings, the release settings will be wildly inaccurate. Wise skiers update all of their gear together and check the releases in the shop before they go skiing.
3. The mind game matters. For years, orthopaedic surgeons, physical therapists, trainers, and coaches have preached about fitness: strength, flexibility, mobility of the joints, balance, coordination, cardiovascular conditioning, and other factors that make a skier ready for ski season. Yet injuries to the strong and the fit still occur. The most common reason I see such injuries, especially in skiing, is mental errors: The athlete’s mind wasn’t in the game, and a bad decision was made. It is almost always “I was going too fast; I reached out when I shouldn’t have; I didn’t see the other person…” So if you can leave the distractions at home (the phone, the work obligations, the social obligations) and really be in the moment while you are skiing, your time in my office will decrease.
4. Warm up before you go. The hot tub, shower, and stretching in the morning not only loosen up your tissues but permit you to center, focus on the sport ahead, and be ready for the mental and physical exertion to come.
5. Arthritic joints should not prevent older skiers from enjoying the sport. Joint injections of lubricants (hyaluronic acid) and growth factors (PRP) have made an enormous difference for many people with worn-out joints. I have many patients who come in just before ski season—with X-rays revealing bone-on-bone in their knee, hip, and ankle joints—and say, “Doc, that injection got me through the ski season last year—Let’s do it again. I am not letting you operate on my joints until they don’t work.” 
6. Meanwhile, biologic joint replacement procedures have advanced to the point where a new meniscus, combined with cartilage regrowth techniques, can often keep people skiing for years.
7. When we do have to do artificial joint replacements, the computer-guided robotic techniques have gotten so accurate that we can very often permit our patients to return to full sports (if they and their surgeon plan for it). 
8. Respect the adage of “skipping the last run.” When you sense you are tired, as the snow conditions change later in the day, and the light dims, everything is conspiring against you. Your fatigue kicks in, and taking that one final run often leads to an avoidable injury. 
9. Take a lesson. Even those of us who have been skiing for 60 years are shocked to find out that we could be skiing so much better if we only had modern instruction to go along with the new skis, boots, and gear that we so proudly wear. Old habits simply don’t keep up with how the sport is enjoyed today.
10. Laugh—a lot. The sport of skiing can produce the most fun moments of anything you might do this winter. Don’t take yourself, or the sport, overly seriously. Think pleasure, practice safety, and you’ll participate in this terrific sport well into your old age. 

How to Ski Forever: One Patient's Quest to Extend the Life of His Knees & His Skiing Years

For more on how skiers can play for a lifetime and avoid knee pain after skiing, be sure to check out all Dr. Stone's blogs on skiing injury prevention and recovery.