Skilates: The Core of Ski Conditioning and Injury Prevention
By Samantha Schoeneman, PT, CPI
As seen in the Fall 2007 Balanced Body Pilates COREterly
Our physical therapy clinic – Alpine Physical Therapy – is housed in a health and fitness center in western Montana. As you can probably guess ski season is a big deal in these parts. And each year as the snow begins to fall folks start to kick up the workouts in preparation for the upcoming season. It is about this time that I notice a lot of people performing typical plyometric and power lifting exercises at the club. These exercises can increase speed on the slopes but usually the form is faulted, and injuries and compensations are observed.
As an avid skier myself, I felt it would be important to educate and instruct the skiers in the area on proper core stabilization (recruitment of the transverse abdominus), the importance of stability of pelvis/neutral spine with dynamic activities - whether training in the gym or skiing in deep powder - and on key muscles in skiers that tend to get tight, improperly used, or overused due to other muscle imbalances.
So, along with Certified PSIA Ski Instructor and clinician Dudley Improta, we began Skilates - a ski conditioning and injury prevention class using Pilates-based ski/snowboard specific exercises and apparatus. Both the exercises and instruction within the class focus on principles of ski and snowboarding form, technique, and demands, as well as providing important muscle coordination and strengthening to prevent compensations and injuries.
Skiers and Knee Injuires
Skiers run the risk of many different injuries. In particular the knees, where I’ve seen a lot of tears of the anterior crutiate ligament (ACL), medial collateral ligament (MCL), and the meniscus. Pilates helps skiers really focus on a dynamic and full range of motion and the strengthening of the hamstrings, which can help balance overused quads as well as serve as back up support for the ACL. Exercises that emphasize the adductors can help a skier’s recovery from catching an edge or keeping the skis under the center of the body, thus reducing the stress on passive structures such as the MCL.
In addition, closed chain exercises (where the foot is in contact with bar/strap/board/floor) can help simulate proper muscle recruitment and timing as well as provide functional applicable movements for skiing. Using specific exercises to focus on VMO (vastas medialis oblique of the quadriceps) and glute medius are important for proper patella (knee cap) tracking and stability of the knee and hip joints.
Skiers and Lower Back Injuries
Another area I see injured or overused a lot in skiing is the lower back. Injuries here often occur from form fatigue and poor core stabilization. Often the hip or lower extremity moves and then the pelvis and lumbar spine follow, increasing the stress on the spine as well as causing unnecessary muscle imbalances, compensations, and ultimately injuries. This increased motion of the trunk requires increased energy as efficiency of movement is lost, speed of fatigue is gained. In the Skilates class I help teach individuals to gain control of trunk stability to maximize extremity mobility and effeciency, which is taught by proper abdominal recruitment.
The following case study illustrates how Pilates can help skiers recover from an injury.
“Mary” is a 49 year-old female, whose ski edge hit the medial side of her knee resulting, initially, in a sore inside knee. However, two to three days later she noted increased pain on the lateral aspect of the knee. Mary reported limping for 3-5 days, then felt it was improving until she attempted to run and had sharp pain in the lateral joint line. Upon physical therapy evaluation, she presented with poor patella tracking (knee cap glided to outside), excessive tightness of the iliotibial band, and weak and poor recruitment of VMO and glute medius on the involved side. In conjunction with some manual techniques to address soft tissue and joint mobility, Mary was instructed on the Reformer and given stability exercises on the Pilates Chair in order to re-educate appropriate timing of gluteal and quadriceps. These exercises included basic footwork with specific cues for proper muscle synergy, side lying single leg foot work, single leg cross over hip work, forward lunge on chair, and skater series. We also used foam roller for stretching the IT band.
Once initial irritation and inflammation was addressed, Mary was able to key in on specific muscle recruitment patterns for regaining appropriate timing and strength to the knee joint. As she built up this strength and regained proper muscle balance she was able to gradually return to higher level activities such as running and skiing applying the new strength and balance for decreased pressure and irritation to the knee joint.
SAMANTHA SCHOENEMAN, MPT, CPI, is a Partner of Alpine Physical Therapy (www.AlpinePTmissoula.com) and the owner of Clinical Pilates Approach, Missoula, MT,. She is also a Comprehensive Certified Training Pilates Instructor through Body, Arts, and Science International (BASI) Samantha’s professional practice belief is that everybody deserves to move, function, and breathe with efficiency, awareness, balance, and control.