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Big Sky's Most Common Ski Injuries and How to Prevent Them


Since moving from Hawaii last June to practice at Big Sky Medical Center, Kirk E. Weber, MD, FACEP, has made a few observations regarding ski injuries as the Emergency Department winds down its first full season of operations. Dr. Weber shares his thoughts:

Lesson #1: Get a good helmet that fits and wear it when skiing.

Wearing a helmet while skiing is often lifesaving. We have treated multiple closed head injuries this first season. Most are minor concussions, thanks to the large percentage of skiers now wearing helmets. I am almost certain that many of these injuries would have been much worse if it were not for wearing a helmet.

Often the ski patrollers, paramedics or patients themselves bring the helmet in, which is badly damaged but the patient has only a minor concussion. Although the need for a helmet may seem obvious, I have also spent my first season skiing at Big Sky and am surprised at how many skiers I still see not wearing helmets, including expert skiers or even ski patrollers.

Back in Hawaii, it was not part of the local culture for most bike riders–especially children–to wear helmets. I saw a fair number of tragic head injuries in children– totally preventable if they had been wearing a helmet. To encourage helmet use, I would go to schools to illustrate their effectiveness by dropping watermelons from standing height. One without a bike helmet would crack and splatter; the other inside a helmet would bounce and be totally fine. I tell kids your brain is like the watermelon: please put it in a helmet so that it will be ok when you crash on your bike. I think the illustration applies to ski helmets as well.

Lesson #2: Well-functioning bindings go a long way to preventing knee injuries. Make sure yours are working well and at the lowest setting possible during normal skiing activity.

Knee injuries are very common in skiers. The knee is by far the most common body part we have seen injured at Big Sky Medical Center this ski season. These injuries range from fractures and ligament injuries requiring surgery to minor strains requiring rest and rehabilitation.

I have thought a fair amount about measures we can use to prevent these injuries. One observation I’ve made is that a fair number of knee injuries occurred when bindings did not release during a wipeout. Personally, I have been gradually cranking down my bindings to reach the lowest setting possible without having my skis come off during normal skiing. I want to keep my skis on my feet, but when I crash, I want the weak point to be the connection between boot and ski, not the ligaments in my knee. Also, I had my bindings serviced prior to ski season and plan to do so before each coming season.

Lesson #3: Ski within your ability. Physical conditioning goes a long way towards injury prevention. It is a very good idea to stop when you are tired.

We have seen a variety of other ski injuries affecting ribs, clavicles, backs, spleens, etc. Of course, many skiers who end up injured are not doing anything crazy– they just catch an edge or hit a rough spot or lose concentration for a minute. However, there is a disproportionately high percentage who crash for one of two reasons.

Reason One: They are skiing terrain above their ability, either going off a jump or down a steep slope or through thick trees before their skills are ready for it, often because they are encouraged by their friends.

Reason Two: They suffer from lack of physical conditioning and fatigue. People on vacation try to get their money's worth by skiing long hours for which they are not conditioned. Many injuries occur when skiers are tired late in the ski day. Our volume of patients dramatically increases in late afternoon, the last hour or two the ski hill is open. This has been true almost every day throughout the entire ski season.