Ski survival: How to return from the piste in one piece

Planning a weekend on the slopes? Before packing the salopettes and ski gloves, it's worth remembering that skiing is responsible for an alarming number of injuries. As Britons escape the office and head to the mountains, many of them leave their common sense at home – and return with some very nasty souvenirs.

"Skiing is a strange sport which requires no intrinsic strength or skill – anyone with a credit card can walk into a ski hire shop and hire the kit," says Steve Bollen, president of the British Orthopaedic Sports Trauma Association and an orthopaedic surgeon at Bradford Royal Infirmary. "Then they set off down the hill, and if anything goes wrong they may not have the strength or fitness to do anything about it." Tiredness, lack of fitness and a desire to fit in as much time on the slopes as possible – plus the rise in popularity of weekend ski trips – are all reasons why Bollen says he is seeing more knee injuries than ever before.

"Skiing is designed to rupture knee ligaments," he says. "Your lower leg is fixed in a rigid boot which is then attached to a 6ft lever arm. It doesn't take much imagination to realise what forces are applied to the knee if the ski is twisted and the bindings don't release – the result is an audible snap, immediate swelling and another victim tobogganed off the slopes."

Damage to ligaments – the connective tissue that holds the knee together – is painful, can require surgery and can damage joints permanently if left untreated. After studying more than 200 patients with anterior cruciate or medial ligament injuries in his clinic, Bollen says that the number of those injuries caused by skiing has increased from 9 per cent in 1996 to 28 per cent in 2004. "I have seen three ruptured anterior cruciates from skiing this week."

According to research carried out by the Ski Club of Great Britain, the vast majority of skiing trips are for seven days or less, and 28 per cent of skiers describe themselves as "beginners". And with more than 1.3 million Britons taking to the slopes on skis and snowboards last year, it seems likely that the problem will worsen. Even experienced skiers need to be wary of what Bollen calls "half-term syndrome": people who aren't as physically fit as they could be going skiing without prior preparation and spending too long on the slopes without a break.

Helen Sellings was keen to make the most of her ski trip to Austria last year, and after 15 injury-free years of skiing Sellings felt confident enough to go out in bad weather. "I was skiing slowly when I hit something," she recalls. "My left ski came off and I ended up going down the piste on my back. My right ski got caught and twisted my knee, and I ended up with a fractured head of tibia and ruptured all of the ligaments in my knee."

In her haste to make the most of her holiday, Sellings believes, she made herself more vulnerable to injury. "It was the second day of our holiday and there was the dilemma where I was thinking about how I'd spent quite an amount of money to go skiing and felt more pressured to go out even in inclement weather."

Both Bollen and Carrie Hainge of the Ski Club of Great Britain say it's vital to remember that skiing is a sport, not merely a holiday. "You'll get the most out of your holiday if you start exercising at least six weeks before you go," says Hainge. "Improve your cardiovascular health by running and cycling, and if you're a member of a gym, cross-trainers are a good idea too."

It's also important not to try to ski beyond your ability, and to stop when you are tired rather than squeezing in "one more run" at the end of the day when accidents are most likely to occur, says Bollen.

"It is easy to forget just how physical a whole day's skiing can be," says former British ski champion Graham Bell. "An average day on the slopes will deliver between four and six hours of sustained physical activity." Take regular breaks throughout the day, he advises. "Ski lifts give you a chance to recover, but the higher the altitude the longer that will take. And you do need to recover, because skiing hard works you at an intensity that can only be sustained for a couple of minutes before the legs start to burn with the buildup of lactic acid."

For safer skiing, Bell recommends following a training programme over at least six weeks leading up to a ski trip. "You need to create a programme that includes endurance, strength, balance, co-ordination and flexibility." And remember: accident insurance covers you abroad, but stops when you cross back into the UK. Not only might an injury cost you your holiday, it could cost you an arm and a leg on your return.

For more information on specific exercises to follow in the weeks before a skip trip visit www.skiclub.co.uk

Staying safe on the slopes

* The most likely time to be injured is in the second afternoon of a six-day ski holiday, which is when fatigue levels are at their highest.

* About 25 per cent of ski injuries are caused by a collision with a tree or other obstacle, or another person.

* The number one skiing injury is the knee ligament sprain which normally happens with beginners who twist a knee at slow speed or from "catching an edge".

* The popularity of snowboarding has led to an increase in broken wrists and collar bones, and head and neck injuries.

* Ideally, you should start training for a skiing holiday six weeks in advance, so if you're heading to the slopes for Easter, now's the time to get going.

* Endurance levels are key; running, swimming, cycling are all great cardio vascular activities to build up stamina. In the gym, pay particular attention to the lower leg muscles through leg presses and extension exercises.

Kate Proctor

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