By Allie Epstein Poalino EBS COLUMNIST
Sponsored Article
It’s November, temps are dropping, and the stoke for ski season is in full swing. As we look ahead to the 2025-2026 ski season here in Big Sky, you might find yourself daydreaming about those bluebird powder days, geeking out on snow cycles, updating to some new gear, or planning those fun ski trips with friends and family.
One of the very last things we tend to think about when leading up to our winter adventures, however, is injury risk. Unfortunately, knee injuries alone account for upwards of 30% of all injuries that occur in downhill skiers and snowboarders.
As physical therapists, we are often asked, “What can I do to prevent a knee injury?” or “I’ve had a knee injury or surgery in the past, how can I reduce the chance of getting hurt again?”
As health care providers who live, work and ski right here in Big Sky, we get it. We’ve seen firsthand what it takes to stay healthy out there, and also what it looks like when the worst things happen. At Lone Peak, we are committed to helping you ski stronger, recover faster and stay on the mountain all season long. In this article, we will pull back the curtain on knee injuries in skiing, share the hard truths about what you can control, and what you can’t and guide you through the process of exactly what to do about it.
What you can control, and what you can’t
Let’s jump right into the top three risk factors for knee injury in skiing and snowboarding that are, for the most part, outside of your control.
Variable conditions: Low visibility or flat light, icy patches, changing snow textures or hidden obstacles like buried rocks and stumps can quickly catch even the most experienced skier off guard.
Gender: Research shows that female skiers are more susceptible to knee injuries than males. This is due in part to anatomical differences where typically women tend to have a wider pelvis, known as a higher Q-angle, which creates more torque at the knee joints.
“Getting in the backseat”: As fatigue sets in toward the end of the day, it’s easy to fall into a “backseat” position where your hips are behind your feet, your knees are flexed and your quads are overloaded. Even the best ski boots or knee braces cannot counter the forces placed on your knees in this position. This is where ligaments and tendons are under their greatest stress and at their most vulnerable.
While the majority of these risk factors may be largely out of your control, there are proactive steps you can take to offset their effects and reduce your overall risk of knee injury. The key is focusing on what is within your control—how you prepare your body, and how you recover.
Active recovery: How you treat your body after matters
What you do after skiing is just as important as what you do before. Prioritize recovery by:
- Hydrating well throughout the day and evening.
- Gentle stretching and mobility work post-ski.
- Elevating your legs above your heart for 20 minutes to improve circulation and reduce swelling.
- Eating enough protein to promote muscle and tissue recovery.
- Bonus points for ending your day with a hot tub soak, Epsom salt bath, or 15–20 minutes in a sauna.
Dryland training: Symmetry and strength
Preseason and in-season conditioning make a huge difference. If you notice one side of your body feels tighter or weaker, that’s your sign to address it. Imbalances can lead to increased stress through the knees and hips.
A targeted dryland training program can help:
- Build symmetrical strength and stability for both sides of your body
- Improve joint mobility and neuromuscular control
- Reduce the risk of “backseat” fatigue late in the day
- If you’re female, place extra emphasis on core and hip strength to help offset the effects of the increased Q-angle we discussed earlier
Be proactive: We can’t stress this enough!
If you notice persistent aches or pains in your hips, knees, feet or low back, please don’t ignore them. These small warning signs often appear before bigger injuries develop. A quick assessment and intervention from a physical therapist can keep you on track and prevent something minor from becoming a season-ending situation.
We’ve got you covered
No matter your skiing background, experience, age or style, we all take on risk when we are getting after it on the mountain. The whole point of living here is to enjoy everything the mountains have to offer, and we are here to help you do exactly that.
At Lone Peak, we will stop at nothing to help you get back on, and stay on, snow as fast as possible. Our very first clinic was founded 25 years ago right here in the heart of Big Sky. Since then, we have built the best team of providers and use top of the line equipment, complete highly specialized certification courses, and use the most advanced technology and treatment methods to help speed up recovery, including:
- ASTYM® soft tissue therapy
- Blood flow restriction (BFR) training
- Neuromuscular electrical stimulation
- Dry needling with electrical stimulation
- 1080 Quantum Testing and Training
- Baseline concussion testing and PCS treatment
Whatever aches, pains or problems you may be facing, we’ve got you covered. If you have any questions or want to talk with one of our experts, call or text us at either our Big Sky + Performance or Bozeman + Performance location anytime!
Allie Epstein Poalino is a passionate and dedicated physical therapist at Lone Peak PT and has proudly served the Big Sky community for the past decade. Our entire team has advanced training and high-level expertise in biomechanics, movement analysis, and performance testing, and provides an unparalleled physical therapy and sports rehabilitation experience. At Lone Peak PT, we are passionate about helping our patients recover faster and empowering them to excel in their rehabilitation journey and confidently return to doing what they love.
