Knee pain after skiing: common causes and treatment

Skiing is a full-body workout that engages your knees to help you turn and glide down winding slopes. This also means that “skiing offers a unique challenge for your knees, boosting their strength and flexibility,” says Courtney Fitzpatrick, PT, DPT, a physical therapist at Hinge Health. 

Your knees are strong and can help you stay steady and in control on the slopes, but sometimes, you can experience some discomfort after a day of skiing. Oftentimes knee pain after skiing isn’t a sign of anything serious — it usually just means your body wasn’t as prepared to do those movements. Usually, conservative treatments like physical therapy and targeted exercises can offer relief. You can also have knee pain from an injury, like a big fall or crash. It's important to know the difference between soreness and a more serious injury so you can get the appropriate treatment.

Learn why your knees may hurt after skiing, plus tips on how to prevent and treat it, especially with exercises recommended by our Hinge Health physical therapists.

Why do my knees hurt after skiing?

Knee pain after skiing often means your body is adapting to the sport’s unique movements. Previous knee issues might resurface temporarily, but that doesn’t mean you have to stop enjoying the slopes. By preparing your body beforehand — and having well-fitted gear — you can manage and prevent discomfort after skiing.

• Doing too much, too soon. “Many people who ski infrequently try to hit the slopes for the entire day, even if they haven’t skied in months or years,” says Dr. Fitzpatrick. While it’s tempting to maximize your ski day, it’s important to listen to your body and take breaks as needed. Choosing terrain that matches your current comfort and fitness level helps your knees feel better.

• Lack of preparation. “Skiing asks a lot from your knees,” says Dr. Fitzpatrick. Since these movements aren’t ones you typically use during everyday activities, getting your body ready for ski season can make a big difference. In the weeks leading up to ski season, conditioning your knees for these dynamic moves (such as turns and rotations) can help them feel more comfortable and less fatigued or achy after a day on the slopes

• Skipping a warm-up. It’s easy to head straight for the chairlift and start skiing, but without warming up, your body might not feel as ready. Taking time to warm up can ease the stress on your knees, making your skiing experience more comfortable and enjoyable.

• Wearing ill-fitting gear. Having boots that fit well, skis that are the right size, and bindings that are adjusted correctly can greatly enhance your skiing experience. When your gear is suited to your body, it supports natural movement and keeps you comfortable on the slopes.

• Tweak your technique. Try to avoid locking your knees, shifting your weight back on the skis, and letting your knees roll inward as you navigate the slopes. Keeping a gentle bend in your knees as you ski can reduce stress on your knees. 

• Having muscle imbalances. You use all the muscles around your knees when you ski, such as those in your thighs, calves, hips, and core. If some are weak or tight, your other muscles have to pick up the slack. This can lead to muscle soreness and knee pain.

• Dealing with past knee injuries or other conditions. If you’ve experienced a knee injury in the past or have other knee problems that cause discomfort, like osteoarthritis, skiing may bring on symptoms. But that doesn’t mean you have to sit it out in the lodge or start your aprés early. Taking extra time to warm up and recover can help reduce knee pain. 

Knee injuries from skiing

Serious knee injuries while skiing aren’t very common, but they can happen. Research suggests the knee is the most frequently injured part of the body when skiing. But remember, your knees are strong and resilient, and your body is designed to help injuries heal. The most common knee injuries from skiing include:

1. Ligament injuries. One of the most common injuries from skiing is a ligament sprain. Your ligaments — ACL, MCL, PCL, and LCL — support your knee. They are resilient, but wiping out or sudden changes in direction can injure them.

2. Meniscus tears. The meniscus is a rubbery c-shaped piece of cartilage that cushions and supports your knee. A quick change in direction or a fall can sometimes lead to tears.

3. Skier’s knee. Also known as runner’s knee or patellofemoral pain syndrome, this overuse injury involves irritation in the front of the knee, where the femur bone in your thigh connects with the patella bone in your knee.

4. Patellar tendonitis. This type of tendonitis causes discomfort in the tendon that connects the front thigh muscle (quadriceps) to your shin bone. The demands of skiing can put extra pressure on this area, leading to inflammation and irritation.

5. Knee bursitis. Bursa are small, fluid-filled sacs that help cushion the joints. Sometimes, the intensity of skiing can cause irritation and discomfort in your bursa, which is why your knee may swell with bursitis.

6. Patellar dislocation. Sometimes, the kneecap can shift out of place over the knee joint. Dislocations usually result from a direct trauma, like a fall or collision, or another accident that forcefully twists your knee.

7. Tibial plateau fracture. This happens when the top part of your shinbone near your knee gets impacted, like during a hard fall on the slopes. This can lead to swelling and discomfort, making it difficult to move around easily. 

These exercises stretch and strengthen the muscles surrounding the knee to relieve pressure, lubricate the joint, and increase blood flow to reduce pain. You can do these movements before you ski to warm up or afterwards to cool down.  

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for knee pain after skiing

Most mild to moderate knee pain can often be treated with conservative treatments like physical therapy and gentle movements. But if you think you may have injured your knee, have severe or ongoing pain, swelling, instability, or other concerning symptoms, it’s best to see a doctor to get your knee checked out.

• Try physical therapy and targeted exercises. Targeted exercises can help strengthen the tissues in and around your knee so that they are prepared for all of the dynamic movements in skiing. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Keep moving. While it’s ok to rest your knee for short periods of time, movement will help you recover. Doing low-impact cardio, such as swimming and cycling, increases blood flow, which helps to heal the area while increasing mobility. Strength training is also essential to prevent muscle imbalances and injury. Doing gentle exercises can help alleviate tightness from muscle guarding, which occurs when your muscles protect the hurt area.

• Apply ice. Using ice or cold therapy can help reduce inflammation, reducing muscle soreness and swelling. You can apply ice for 10 to 15 minutes at a time as needed, Dr. Fitzpatrick says.

• Elevate your leg. Raising your leg above heart level can help fluid move away from your knee. This can bring down swelling and alleviate discomfort and pressure.

• Use compression. Wearing a brace or sleeve can make it easier to do your strengthening movements, by keeping the muscles around your knee warm and secure. 

• Get enough sleep. “Sleep helps you recover after physical activity,” says Dr. Fitzpatrick. “Your body releases hormones during sleep that help repair soft tissues, which include your muscles, ligaments, and tendons.” Getting between seven and eight hours a night can help ease knee pain after skiing.

• Eat a healthy diet. Consuming plenty of lean protein can help your muscles repair after a long day on the mountain. Eating healthy fats can also help combat inflammation.

• Stay hydrated. Water is essential for getting nutrients into muscle cells to help them recover and rebuild — even in cooler temperatures where you may not feel as thirsty. Hydration is also important for keeping joints lubricated so they can move smoothly as you ski. 

How to ski with knee pain 

Knee pain doesn’t have to stop you from skiing. You may just need to change how you ski. “Some knee pain is normal at the start of ski season, because your knees have to adapt to the movements again,” says Dr. Fitzpatrick. If you’ve injured your knee or experienced any of the following symptoms, you should check with a doctor or physical therapist before returning to the slopes.

• Difficulty bearing weight on the affected leg

• Severe, sharp pain with bending or twisting

• Swelling

• Bruising

• Locking sensation

• Reduced range of motion

• Worsening pain

If your knee pain is mild to moderate — and a doctor or physical therapist has said that continuing to ski is safe — here are strategies to help manage discomfort.

• Warm up. Performing dynamic moves to warm up your body can help prepare it for movement. Warmups increase blood flow to your muscles, which can relieve tension and increase range of motion in your joints. This can help reduce stress on the knees and injury risk. Continue your warm-up on the slopes by doing a few runs on easier trails before you hit the more challenging ones. 

• Adjust your routine. If you have some knee discomfort, consider exploring gentler trails, allow yourself more time to relax between runs, or finish your day a bit earlier. Enjoying skiing in a way that feels good to your body is what matters most.

• Listen to your body. If your knee starts hurting, pain worsens, or you feel tired, consider taking a longer break or calling it a day. Pushing through pain can make you more prone to injury.

• Engage in recovery methods. “After a day of skiing, do some gentle stretching, foam rolling, use a massage gun, or get a massage to help reduce tightness and improve comfort in your muscles,” says Dr. Fitzpatrick.

Tips to prevent knee pain after skiing

Knee pain after skiing isn’t inevitable — prevent it with these strategies:

• Do pre-season conditioning. Building leg and core strength through exercises like squats, lunges, and planks can help prevent knee injuries and pain. The earlier you start training for ski season, the more comfortable your knees will feel when you hit the slopes.

• Have a professional check your gear. An expert can help make sure you have the right skis for your skill level and terrain. They can make sure the bindings are set for your height, weight, and skill level.

• Take lessons. Mastering certain techniques, like how to keep your weight over your skis, can take pressure off your knees — and may help you prevent a fall. If you do take a tumble, knowing how to fall properly can reduce your injury risk. 

• Know your limits. Even if you’ve tackled more challenging slopes before, beginning ski season with blue squares or easier trails, especially after a long break, can help your body ease back in. Skiing above the level your body is prepared for can make you more prone to a fall or injury.

• Avoid alcohol. It’s called aprés ski for a reason — it’s meant to be enjoyed after shredding the slopes. Staying clear-headed helps reduce the risk of accidents and enhances your awareness on the slopes. 

• Skip the last run. As you become fatigued, your muscles may not be on their A-game, which could lead to a tumble. If you’re feeling tired, it’s wise to skip that last challenging run. As the day goes on, temperatures go down, which can make the terrain icy and slippery. Finishing earlier in the day can keep your skiing experience safe and enjoyable.

PT tip: Pace yourself

“Set a plan for yourself,” says Dr. Fitzpatrick. “For example, maybe start by skiing for an hour, including the time spent on the chair lift. Then, take a break and see how you feel and make any adjustments.” Planning how long you’ll be on the slopes for, what types of runs you will do, and when you will take your breaks can help set you up for success and reduce discomfort. If you’re doing a week-long ski trip, consider making your first day a bit shorter or taking a rest day away from the slopes in the middle of the week.  This way, you can ease into it and conserve energy for the upcoming days. Also, communicating your plans and intentions with the people you’re skiing with can help you stay accountable.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Skiing Injury Prevention - OrthoInfo - AAOS. (n.d.). Www.orthoinfo.org. https://orthoinfo.aaos.org/en/staying-healthy/skiing-injury-prevention/ 

2. Subaşı, İ. Ö., Gür, V., Subaşı, İ. Ö., & Gür, V. (2023). Recreational Skiing- and Snowboarding-Related Extremity Injuries: A Five-Year Tertiary Trauma Center Cohort. Cureus, 15(7). doi: 10.7759/cureus.42688

3. Cherpitel, C. J., Meyers, A. R., & Perrine, M. W. (1998). Alcohol consumption, sensation seeking and ski injury: a case-control study. Journal of Studies on Alcohol, 59(2), 216–221. doi: 10.15288/jsa.1998.59.216 

4. Health Tips | Tips to Prevent Skiing-Related Knee Injuries. (2018, September 30). Choosept.com. https://www.choosept.com/health-tips/tips-exercises-prevent-skiing-related-knee-injuries