Winter Sports and ACL Injuries: What Every Skier Should Know

As the Australian winter season kicks into gear and thousands of people head to the snowfields, ACL injuries become a common concern for physiotherapists, sports doctors and orthopaedic surgeons. While many people associate ACL injuries with football or netball, alpine skiing remains one of the highest-risk sports for this type of knee injury in Australia. [sma.org.au]
Whether you’re an experienced skier tackling black runs or a recreational skier enjoying a family holiday, understanding how ACL injuries occur—and what to do if you suspect one—can make a significant difference to your recovery.

Why Is Skiing Such a High-Risk Sport for ACL Injuries?
Unlike running sports, skiing introduces substantial rotational and shear forces through the knee. The ski can remain fixed in the snow while the body continues moving, resulting in excessive load on the ACL. [londoncartilage.com], [pmc.ncbi.nlm.nih.gov]

Common ACL Injury Mechanisms While Skiing

1. The “Phantom Foot” Mechanism
The classic skiing ACL injury occurs when:
The skier loses balance and falls backwards.
The hips drop behind the feet.
The ski remains planted in the snow.
The knee twists inwards while loaded.
The ski acts as a long lever, generating substantial force through the ligament. This remains one of the most recognised skiing-specific ACL injury mechanisms. [londoncartilage.com], [anatomyrehab.com]

2. Catching an Edge
This commonly occurs when:
A ski edge suddenly catches in the snow.
The body continues moving forward.
The knee twists forcefully.
Research investigating recreational skiing ACL injuries found that catching an edge was a frequent contributor to injury events. [pmc.ncbi.nlm.nih.gov], [londoncartilage.com]

3. Tangled ski’s off the chair lift
We have all done this one. Four people on a chair lift and the dismount doesn’t quite go to plan. Getting caught up with your neighbours ski is a very common mechanism for low energy falls.

4. Awkward Landings
Landing from jumps or terrain features with:
A relatively straight knee
Poor body position
Excessive inward collapse of the knee
can significantly increase ACL strain and injury risk. [now.aapmr.org], [anatomyrehab.com]

• A distinct“pop” or“crack”
• Sudden pain
• A feeling that something has shifted inside the knee [sma.org.au], [cromwellhospital.com]

• Rapid knee swelling
• Difficulty walking
• Reduced knee movement
• Pain with weight bearing [sma.org.au], [cromwellhospital.com]

• Potential ACL injury
• Meniscal injuries
• Medial collateral ligament (MCL) injuries
• Cartilage injuries
• Other causes of knee instability

• Reduce swelling
• Restore knee range of motion
• Improve quadriceps activation
• Reduce pain
• Minimise secondary complications

• Specific bracing protocols
• Structured physiotherapy rehabilitation
• Activity modification
• Ongoing clinical and imaging review

• Stop skiing immediately
• Ice the knee
• Apply compression if available
• Use crutches if required
• Avoid testing the knee repeatedly
• Arrange a physiotherapy or sports medicine assessment as soon as possible
• Follow recommendations regarding imaging and rehabilitation [sma.org.au]