24 Days till Ski Season: Get Slope Ready

Nothing is worse than ending your ski season early due to injury. Most injuries in skiing/snowboarding occur at the end of the day. What does this mean? As we fatigue we become more susceptible to injury. Those 160cm or greater boards and skis we have attached to our feet transmit a lot of force and specifically torque though our legs. As we fatigue we struggle to control that force and that is when injury occurs.

Some injury facts: (compliments: Karen E. Crummy, Denver Post)

  • 600,000 people are injured skiing/snowboarding each year
  • About 2 injuries for every 1,000 skier visits is the national norm, this is a 50% decrease in injuries since the 1970s
  • Snowboarders have twice the injury rate of skiers

Snowboarding/skiing has turned into an interval sport. We ride 100, 2500 or more vertical feet at a time and then stand in line to ride a lift for another 5-10minutes. So we need to train the same way. When we shred the pow we are working somewhere between 60-80% of our maximum heart rate. That is a heavy load.

Nobody wants to end his or her season early so what can we do to better prepare? Start working out like a crazy person? That might be effective but there is a more efficient way.

Certain muscles don’t get used when we sit at our desks from 9-5 Monday – Friday. These muscles are the ones we need to get back in shape so we can ride better, feel stronger and ski longer.

Gluteus Maximus and Medius

  • Mini Bridge
    • Single leg Bridge
    • Side squat
  • Clamshell
    • Lateral Band

Hip Stability

  • Single leg stand
    • Single leg unstable surface
      • With reaches

Trunk stability – core

  • Transversus Abdominus
    • marches
    • BKFO
  • Quadruped
    • Alternate arm leg lift
    • Opposite elbow to knee
  • Advanced
    • Plank
      • On Elbows
      • In push up position
    • Side plank

Quadriceps, hamstrings

  • Squat
    • Squat with weight
  • Drinking bird
    • GB bridge curl

Combined – Leg and stability

  • Squat hold
  • Single leg mini squat
  • Lunge with rotation
  • Double leg side to side hops for time
  • Single leg side to side hops for time


  • 2-3x per week
  • At least 20 min
    • Bike
    • Swim
    • Walk
    • Elliptical
    • Stairmaster
    • Run – if you must

There is no guarantee that performing any exercise will stop you from getting injured. These will help decrease your chances and make you look good in the hot tub at the end of a long day on the slopes (no guarantee on the looking good part).

As a Physical Therapist working in a sports medicine setting, I see my fair share of running injuries and lately the question about the pros and cons of barefoot running inevitably comes up.

The most common reason for runners to change running style or footwear is an injury or pain. Pain during or after running is usually caused by poor mechanics, overtraining or a combination of both. A study in the Journal of Sports Medicine revealed an increase in running injuries with the growing popularity of running and tri-athlon’s, rating the incidence of injuries anywhere between 37% and 56% annually. (These are only the injuries reported. For some, unknown reason, a lot of runners and tri-athletes think it’s perfectly normal to hurt while running and don’t even consider the fact that they may be injured or injuring themselves).

Most injuries seem to be caused by cumulative microtrauma or overuse. Several risk factors have been identified as predisposing athletes to their injuries and intrinsic as well as extrinisic factors have been reported in studies (such as the 2006 edition of the American Journal of Sports Medicine: “Interaction of arch type and footwear on running mechanics”). Some of these factors include arch type, running mechanics, type of running shoe, surface run on etc. The running shoe provides a unique interface between these intrinsic and extrinsic factors and should not automatically be blamed for all break downs.

A recent study from the University of Delaware showed that athletes who run with a natural midfoot strike pattern have lower loading rates then habitual rearfoot strikers, but the key difference may be the stride length! They found that trying to tell the runners to run consciously with a midfoot strike pattern did not seem to reduce loading rates but shortening their stride did. Other gait studies have shown that barefoot runners who land on their forefoot produce smaller peak impact forces than rearfoot strikers wearing running shoes. Barefoot running has also been shown to decrease joint torques in the hip, knee and ankle joints, however, running shoe compliance may offset the increase in torque.

Just like changing the tires on your care may or may not improve the performance of your car, changing shoes, or getting rid of them all together, may or may not improve the quality and ability of your body to withstand the forces of running. The only agreement you’ll find in all the literature about barefoot running is that it works for some and not for others. Going barefoot has to be accompanied by a change in running mechanics or your body will break down. For some this will come naturally while for others it will never come.

So, if you’re going to change your running mechanics anyway, why not keep your shoes on and focus on your mechanics! I realize that this is easier said than done but it will in the long run be a much more durable and appropriate solution for most.

Some alternatives to consider are barefoot training in small doses, which will also decrease the worry about the running surface. You can do your barefoot training on an indoor or outdoor track, not having to worry about glass or nails causing injuries. There is also a running technique described as “chi-running” which combines the benefits of Tai-Chi and running and is a method of focusing on stride length, cadence and running mechanics. For more information go to:

If you are considering going the “barefoot route” due to persistent or nagging injuries, consider having your injuries and their cause evaluated first. See your running coach or go to a running store for a proper gait analysis or see a trained Physical Therapist with expertise in running and gait analysis.

Solving your biomechanical problems first will solve your pain and this will lead to the most effective and efficient running style for your feet. Be it barefoot or with wooden shoes!

Proper shoulder function depends on intricate relationships between muscle groups, tendons, bone structures and more. Comprehensive shoulder assessment and treatment should focus on the Thoracic Spine, Scapula, Rotator Cuff and the Gleno-Humeral joint while also addressing posture and energy transfer throughout the entire kinetic chain.

Thoracic Spine:

If an athlete has limited mobility in the thoracic spine, the scapula will not have a sound foundation from which to operate. Thoracic extension and rotation are frequently compromised due to kyphotic posture with typical forward head and rounded shoulder position. This can result in an anteriorly tilted and abducted scapula and subsequently a poor foundation upon which the humerus has to move. Furthermore this creates compression in the sub-acromial space, resulting in typical shoulder pathologies such as impingement, bursitis and Rotator Cuff tendonitis.


Altered position or movement mechanics of the scapula affect shoulder stability and mobility. Common pathologies include labrum injuries, MDI (multi directional instability), tendonitis and elbow injuries. Trying to throw or hit with an unstable scapula is like trying to shot put while balancing on a gymball. Transferring forces up the kinetic chain from the legs through the hips, pelvis and spine into an unstable or poorly positioned scapula is a recipe for injury. Force couples, mobility and stability all help maintain instantaneous center of rotation (ICR) of the humerus in/on the glenoid surface. Having an ICR helps to ensure proper bio-mechanical function of the joint, which helps avoid labral tearing. When the joints are centered, they perform optimally and injury risk is reduced.

Gleno-Humeral joint:

The gleno-humeral joint is subject to tremendous acceleration, deceleration and distraction forces, creating stress on the joint surface, the joint capsule and the rotator cuff. Gleno-humeral Internal Rotation Deficit (GIRD) is one of the most common adaptations that can affect throwers or hitters. GIRD develops due to the great deceleration forces placed on the posterior capsule and RTC, causing shortening of the muscles and tightening of the posterior-inferior capsule and a shift of the gleno-humeral rotation point. This migration and changing of the capsule contributes to decentration, or loss of the ICR.
GIRD leads to an increase in total range of motion of the dominant vs. non-dominant side though with an increase in external rotation and a loss of internal rotation. Some of this can be explained by “retroversion” or bony change to the humerus but it’s mostly caused by shortening of the posterior capsule and the RTC.

Most of us remember the pain of stretching and still use it during our warm up routine. But is it really beneficial or even necessary? It is a common misunderstanding that in order to prevent injury we must turn ourselves into contortionists. Out of habit, many athletes perform static stretches during their warm –up. But this can actually cause tiredness and decrease coordination, thus increasing risk of injury!

Is stretching beneficial in preventing injury and does stretching improve flexibility and performance?”

Static vs. dynamic stretching

A conventional definition of flexibility is the range of motion available at a particular joint while the body is at rest. But during activity or competition this is not relevant, since the athlete’s body is not at rest. Instead, flexibility during movement must be viewed as a dynamic controlled quality: it allows the joint to go through as large a range of motion as can be controlled. The controlling nature of flexibility involves the range of motion used in skill performance and the length of the movement available for force production/reproduction. The opposite of dynamic flexibility would be instability: which is any degree of mobility that cannot be controlled.

Flexibility for sports is more than maximal lengthening of soft tissue; it is not a posed static position. It is about movement and control of multiple positions that must occur rapidly to meet the demands of an athlete’s sport.

Sport- specific flexibility requires an integrated expression of joint stability, strength, movement awareness and soft tissue extensibility. Dynamic range of movement expressed in sports movement is significantly greater than can be expressed statically. This is due to the elasticity of the involved tissue and reciprocal inhibition, which allows the opposing muscle to relax. This is why a pitcher can externally rotate beyond 90 degrees when pitching but statically may not be able to get within 10-15 degrees of that dynamic range!

Quote: “While there is no proven connection between joint looseness and overall athletic performance, too much looseness can be a real liability in sports that require rapid changes of direction and acceleration, such as basketball, tennis and soccer, while too little of it would seriously restrict a gymnast or figure skater; and so the quality of joint looseness is largely sport specific.” (Arnot & Gains, 1984).

Evaluating flexibility

It is important to assess flexibility through observing athletes in their respective sports. Is the athlete smooth in his/her movement, can he/she get in the required positions dynamically? Has there been a pattern of injury?

More detailed functional assessment should be dynamic and intra-individual! Results are highly individual and therefore should NOT compare flexibility norms. It is a mistake to have norms set that make inter-individual comparisons on this highly individual physical quality.

Now what does this mean for rehabilitation and our patients/clients? They should be allowed the same intra-individual flexibility assessment. DO they functionally require a Straight Leg Raise past 60 degrees?! We should not use the standardization of norms set in a “laboratory setting” to justify continued stretching/mobilization in order to achieve a pre-determined range.

When do we stretch?

Too many people still equate stretching to warming up. However, strtching is NOT the same as warming up. As a matter of fact, you would have to warm up in order to effectively stretch and gain flexibility. Static stretching before warming up or competition can lead to fatigue and decrease in coordination, leading to possible injury. It is not logical to use static stretching to prepare for dynamic action.

The optimum time to develop flexibility is post workout! The proper way to warm up is to engage in sport-specific movements or conditioning while gradually increasing the intensity level. This could include 5-10 minutes of jogging, 10-15 minutes of dynamic stretching followed by 10-15 minutes of general and sport specific drills.

Dynamic stretching must include multisegmental and tri-planar movements against gravity with neural excitation. For example with running: stretching must include joint movement even when the muscle is lengthened because that is how they function during running activity: muscles are stretched to provide eccentric segmental stabilization long enough for forward momentum and concentric muscle action to create segmental mobility elsewhere in the body.


To go back to the question posed at the beginning of this article: “Is stretching beneficial in preventing injury and does stretching improve flexibility and performance?”.

Stretching can be beneficial in preventing injury if done properly. It should be done dynamically and sport or activity specific. Stretching is more than just “warming up” and vice versa, warming up is more than just stretching.

It is important to relay this message to clients, patients and athletes alike. Being able to touch your toes does not make you “stiff or flexible”. Spending 10 minutes performing static stretches prior to a work out does not warm you up nor will it prevent injuries from occurring.

Flexibility is more than just loose or long muscles. It incorporates strength, coordination, balance and dynamic stability. Ultimately it is about control: the ability to control an action or activity will significantly reduce injury and improve performance.

Overuse Injuries or Cumulative Trauma Disorder

A study reported in The Journal of Orthopedic and Sports Physical Therapy follows 131 tri-athletes before and during their competitive season. 50% sustained an injury in the 6 months pre-season, 37% during their 10 week competition.
Out of these injuries, 68% of the pre season injuries were related to overuse compared to 78% of the injuries during competition.

Factors that play a roll include: years of experience, high running mileage, history of previous injury and inadequate warm up or cool down.

Most common overuse injuries for tri-athletes per event:

Swimming: impingement syndrome, due to multi directional instability of the shoulder (“loose shoulders”) as well as poor posture

Biking: IT-band cross friction syndrome at the knee as well as Patello-Femoral syndrome (irritation of the knee cap)

Running:Plantar Fasciitis, shin splints and stress fractures.

One of the most common causes of cumulative trauma is the inability to control pronation. Pronation is a normal movement pattern that takes place in the body as it stores or absorbs energy. It occurs at every joint in the body, but particularly in the feet. The inability to properly absorb load in the foot joints will lead to excessive forces elsewhere, usually in the joints closest to the foot: the knee and hip. “Easy” fixes such as new or better shoes, over the counter inserts or custom orthotics don’t always cure the problem: driving around with a bad shock can wear the tire on your car. Buying a new tire will not fix your shock!

A functional evaluation of your body will establish if you are pronating and are unable to control it properly. The evaluation takes about 1 hour and looks at all the joints in your body, the way they interact or not and how you compensate for this.

The most common weakness in the link of joints and muscles lies in the hips. Very few athletes will specifically train their hip muscles, especially the smaller rotators. These muscles play an important roll in stabilizing your thigh bone (Femur) and the ability for your feet, ankles and knees to absorb shock. A few simple exercises can assist you in preventing a break down in this chain.

Remember that most overuse is cumulative, not from running too much or too long, but from running consistently with an improperly balanced body. Not from swimming too many laps, but from swimming without proper stability. Not from biking too long, but from biking without the right mechanics.

As a well conditioned tri-athlete, you have the ability to continue training and racing by compensating for a very long time. But sooner or later this will lead to a break down i.e. overuse injury of which the origin can be difficult to track down, especially if it has been masked for a long time. The eventual complaint or break down may not be the actual cause of the problem.

If you experience excessive fatigue, chronic pain or soreness that does not improve with rest, you may be setting yourself up for cumulative stress disorder or overuse trauma. Listen to your body and don’t be afraid to stop training and ask questions.