Every winter we see a similar pattern in The Physio Box clinic.
Someone comes back from a ski trip feeling great… apart from the knee that started hurting on the third day, the shoulder that hasn’t quite felt right since a fall, or a back that tightened up at some point during the trip.
Skiing is an incredible sport, but it places unique demands on the body. Long days on the slopes, repeated knee bending, sudden changes in direction and the occasional fall can all put muscles and joints under pressure.
The good news is that many of the injuries we see after ski trips are preventable, and when they do happen, the right rehabilitation can help you recover properly and return to the activities you enjoy.
Why many ski injuries happen later in the day (or trip)
One pattern we often notice is that ski injuries rarely happen on the very first run of the morning.
They’re much more likely to occur later in the day when the legs are starting to tire and reactions slow down slightly. By that point, your muscles have already spent hours controlling your speed, navigating the uneven terrain, and stabilising your body through every twist and turn.
Skiing keeps the knees bent for prolonged periods, while your legs, back, and core muscles work continuously to keep you balanced. Over the course of several runs, those muscles gradually get tired.
When that happens, the joints themselves can start to take more of the load. A small loss of control on a turn, an unexpected patch of ice, or a slightly awkward fall can then place far more stress on the knee, shoulder or back than it normally would.
That’s why so many ski injuries happen on the last run of the afternoon or towards the end of a week-long trip.
The most common ski injuries we see
The ski injuries we treat most often as physiotherapists include:
Knee ligament injuries
The knee is the joint we see injured most often after a ski trip.
It usually happens during a fall where the ski stays attached but the body twists in a different direction. The forces involved can put a lot of stress through the ligaments that stabilise the knee, particularly the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL).
Your knee may start to swell if you have this kind of injury, sometimes in a matter of hours. When you try to stand or walk, it might also feel unsteady or painful.
Not every ligament injury requires surgery, but rehabilitation is almost always part of recovery. Physiotherapy focuses on rebuilding strength and stability around the knee so you can move confidently again, whether that means everyday activities or returning to the slopes.
“Skiers’ knee” and front-of-knee pain
Not every knee issue starts with a fall.
Skiers often develop pain around the front of the knee, particularly towards the end of a long day or after two or three days on the slopes. People describe it as an aching or burning feeling that builds up gradually.
This tends to happen because the quadriceps muscles are working constantly to control the slightly crouched position used in skiing. Once those muscles begin to fatigue, the knee joint itself can start to take more of the load.
Physiotherapy usually focuses on improving strength and control through the quadriceps, glutes and hips so that the knee is better supported during activity.
Shoulder injuries
Falls often result in shoulder injuries, particularly when people instinctively reach out with an arm to break the fall (that snow isn’t always as soft as it looks!).
The rotator cuff muscles or the ligaments surrounding the shoulder joint can be strained by landing on an outstretched hand or by clumsily catching a ski pole. This may occasionally result in a partial dislocation of the shoulder.
After this type of injury, you might experience discomfort when lying on that side, weakness when reaching overhead, or pain when lifting the arm.
Physiotherapy helps restore strength and movement, so the shoulder feels stable again, both in everyday life and when you return to sport and exercise.
Thumb ligament injuries (“Skier’s thumb”)
This is one of the injuries that’s specific to skiing.
Skier’s thumb typically occurs when a person falls while holding their ski pole. The ligament on the inside of the thumb joint may be stretched or torn if the pole pushes the thumb back.
Gripping objects like a water bottle or zip can suddenly feel surprisingly difficult, and the thumb becomes swollen and tender.
Milder injuries can sometimes settle with splinting and physiotherapy, while more significant tears may need surgery followed by rehabilitation.
Lower back pain
Many people develop lower back pain gradually during a ski trip.
This can be caused by a combination of factors. Long journeys to the resort, carrying skis and boots, and then several full days of activity can all add up. The slightly forward skiing posture can also place extra strain on the lower back if the supporting muscles start to tire.
Physiotherapy can help reduce stiffness, restore mobility and build the core strength needed to support the spine more comfortably during activity.
Why many ski injuries are preventable
One of the most common things we hear in the clinic is, “I thought I was fit enough”.
The problem isn’t usually general fitness. It’s that skiing demands extremely specific strength and control from the body.
If the muscles around the hips, knees and core aren’t prepared for those demands, you’re your joints that can end up absorbing the extra strain. That’s when injuries or pain start to appear.
A little preparation before your trip can make a dramatic difference.
How to reduce your risk of injury on the slopes
Skiing will always involve some level of risk. You’re moving at speed on snow and ice, often for hours at a time.
That said, there are things that can proactively influence how well your body copes with the demands of the sport. Most of them come down to preparing your muscles and joints before you go.
1. Build leg strength before your trip
Your legs do a huge amount of work when you ski. The quadriceps, glutes and hamstrings are constantly controlling your position and helping absorb the forces that travel through the knees.
Exercises such as squats, lunges and step-ups are particularly useful because they resemble the positions your body moves through on the slopes. Single-leg exercises are also worth including. Skiing often loads one leg more than the other during turns, so having strength and control on each side makes a real difference.
2. Work on your balance
Balance is something most of us don’t think about until we lose it.
When you ski, your body is constantly making small adjustments to keep you upright as the terrain changes. Good balance allows those adjustments to happen quickly and smoothly.
Simple exercises such as standing on one leg, balance board work or stability drills can help train this control. It doesn’t need to be complicated. Even five minutes at the end of a workout can be useful.
3. Keep your joints moving well
Mobility often gets overlooked, but it plays a vital role in how comfortably you can move on skis.
If your hips, ankles or mid-back are stiff, your body may compensate by putting extra strain through the knees or lower back. Over several days of skiing, this can start to add up and feel uncomfortable.
Gentle mobility work before your trip can help your joints move more freely and allow your body to adopt stronger, more efficient positions on the slopes.
4. Don’t forget the muscles along the back of your body
When people train for skiing, they often focus on the quadriceps at the front of the thighs, but the muscles along the back of the body, sometimes called the posterior chain, are just as important.
This includes the glutes, hamstrings and lower back muscles. Together they help stabilise the hips and support the spine while you move.
If these muscles are weak, or if they tire quickly, the lower back and knees can end up taking more strain than they should. Strength exercises such as deadlifts, hip hinges and glute bridges are particularly helpful for building this support.
One experienced skier recently wrote about how focusing on these muscles helped resolve his long-standing back pain and allowed him to ski more than 100 days without injury. It’s a good reminder that sometimes the areas we overlook make the biggest difference.
5. Pace yourself during the week
Another factor we often see is simple fatigue.
It’s very tempting to ski from the first lift in the morning until the slopes close in the afternoon, especially if you only get away once a year. But the body can struggle if the increase in activity is too sudden.
Many injuries happen on the last run of the day or towards the end of the week when muscles are tired and reactions are slower.
Building up gradually, taking breaks and listening to early warning signs from your body can help you enjoy the whole trip rather than pushing too hard on the first few days.
When it’s worth seeing a physiotherapist
Sometimes aches settle within a few days of returning home, but if something still doesn’t feel right, it’s sensible to get it checked.
It’s particularly worth seeking advice if you notice swelling around a joint, pain that isn’t improving, reduced strength or movement, or a feeling that something is unstable.
After a ski injury, early assessment can make a significant difference to recovery. Our team provides specialist ski injury physiotherapy, helping identify exactly what’s been injured and guiding you through the right rehabilitation plan so you can return to activity with confidence.
Book your ski injury assessment
If you’re preparing for a ski trip or recovering from an injury on the slopes, our specialist guidance can help you make a safer, more confident return to this amazing activity.
Book your first visit today and start your journey to ski injury assessment.