I hear a loud pop as I crash, and my skis pin my legs underneath me in the snow. My left knee definitely should not be twisted in that direction. After my friends dig me out of the snow, I hobble 2 miles back to our van at the trailhead. The next day, however, I can’t walk. It feels like the top and bottom of my leg aren’t connected. Two doctors and one MRI later, I hear the bad news: I have a partially torn ACL.
Skiing is a common Colorado way to tear up a knee, but any activity that involves speed, running, and quick stops and changes of direction can cause trouble. Think sports such as soccer, football and lacrosse.
“Some of the most common outdoor related traumatic injuries to the knee are ACL, MCL and/or meniscus tears, and they usually happen during high-speed activities such as skiing or mountain biking accidents,” says Dr. Jeremy Snyder, physical therapist and owner of Rocky Mountain Rehabilitation. “Repetitive strain injuries like tendinopathy usually occur with running or hiking and are associated with rapid change in training load.”
Women are particularly vulnerable—four to six times more likely to tear an ACL during the same athletic activity as a male, according to research published in the North American Journal of Sports Physical Therapy. Women typically have wider hips than men, which increases the Q angle, or quadriceps angle, the measurement of alignment between the hip and femur to the knee. “As that angle increases, the tension on the knee increases,” says Angela Liddle of A. Liddle Physical Therapy. She adds that women’s hamstrings tend to be comparably weaker than their quadriceps, causing an imbalance in strength that can lead to injury.
But there is hope for both women and men to avoid knee injuries. “Some of the best prevention exercises for the knee involve making sure the lower body is strong and balanced,” says Snyder.
Strengthening the glutes, hip abductors, quadriceps, hamstrings and ankles can build healthier knees and help prevent injury. “The stronger those can be, the better off your knees will be,” Liddle says.
Here are Snyder’s three favorite basic exercises to get you started. Always warm up your muscles before doing strength-building exercises; five to 10 minutes of jogging in place should do it.
Kneeling Ankle and Hip Stretch
“This stretch is great for injury prevention because ankle and hip mobility issues are significant risk factors for knee injuries,” Snyder says. Kneel on one knee with your torso upright and the knee of the front leg directly over your foot. Keep the front knee aligned with the middle toe and the heel on the ground to feel a gentle stretch on the back of the calf. Hold 30 seconds. Repeat one or two times per leg.
Single Leg Romanian Dead Lift
Stand on one leg with knee slightly bent, but not in a squat. Hinge at your hip, and raise your other leg straight back while keeping your pelvis square. Keeping your trunk and back leg in a straight line, bend forward until you feel a gentle stretch on the back of the standing leg or feel like you lose form. Lower evenly to standing position. Do two to three sets of 5 to 10 reps.
Step forward with one leg and lower your back knee toward the ground. Lower your hips until both knees are bent about 90 degrees. Keep an upright trunk as you move through the motion, and keep your front knee directly over the ankle. Raise back evenly to a standing position. Do two to three sets of 10 to 20 reps, alternating both legs.
Find more knee exercises here.