by James Slauterbeck, RD, orthopedic surgeon at The University of Vermont Medical Center

Skiing is far from the most dangerous sport out there. In fact, the rate of serious injury in 2011/12 was 1 per 1 million skier/snowboarder visits (Source: NSAA Fact Sheet 2012) However, like any sport, there are some inherent risks.

As an orthopedic surgeon, I’ve seen quite a few skiing injuries. The most common injury I see is an ACL (anterior cruciate ligament) injury. The ACL runs diagonally in the middle of the knee and keeps the knee from slipping forward.

UVM Medical Center has done extensive research on ski related injuries and it shows that by following some simple steps, you can help yourself and your family prevent ski injuries and enjoy winter sports all season long – and beyond.

Mad River ski lesson JEB

Knee Friendly Skiing

We have studied “knee friendly skiing” at the UVM Medical Center for 35 years now. Our research team did a video training program aimed at decreasing knee injuries for instructors and employees at Sugarbush Resort. The program was a huge success! It decreased ACL injuries in half of those who participated. Now, the program has been adapted for the public. Here’s how it works.

The “Phantom Foot”

Our team found that many ski-related ACL injuries are caused by “phantom foot.” What’s that? Phantom foot refers to the tail of the ski, a lever that points in a direction opposite to that of the foot. Injuries occur when the tail of the downhill ski, in combination with the stiff back of the ski boot, acts as a lever to apply a unique combination of twisting and bending loads to the knee.

How to Prevent Phantom Foot ACL Injury

Fortunately, you can reduce risk and prevent injury. It’s a four-step process: 1) Avoid high-risk behavior, 2) Correct skiing technique, 3) Recognize potentially hazardous situations, and 4) Respond the right way.

Avoid High Risk Behavior:

  • Don’t fully straighten your legs when you fall. Keep your knees flexed.
  • Don’t try to get up until you’ve stopped sliding.When you’re down–stay down.
  • Don’t land on your hands.Keep your arms up and forward.
  • Don’t jump unless you know where and how to land. Land on both skis and keep your knees flexed.

_E0Q3853Maintain Correct Skiing Technique:

  • Keep hips above knees.
  • Keep arms forward.
  • Maintain balance and control.

Recognize These Potentially Dangerous Situations:

  • Your uphill arm is back.
  • You’re off-balance to the rear. (In the backseat)
  • Hips are below the knees.
  • Your uphill ski is unweighted.
  • Your weight is on the inside edge of downhill ski tail.                          

Respond Correctly To Loss of Control:

  • Bring your arms forward.
  • Bring your feet closer together.
  • Position your hands over your skis.

All of these actions will bring our weight forward.

What to do if You Get Injured on the Mountain

If the injury is minor, ski to a safe area and further assess the extent of the injury.

If the injury is serious, potentially serious or very painful, be sure to:

  • Stay put and do not move.
  • Have a friend create an “X” above you using skis to warn other skiers.
  • Flag down another skier and send them for help.
  • Contact the ski patrol for evaluation and transport.

Call the Ski Injury Hotline

In the event of a ski-related arm or leg injury, please call the Ski Injury Hotline at 802-847-2663. You may also email us at For more safety information, visit

phy001688James Slauterbeck, MD, is an orthopedic surgeon at The University of Vermont Medical Center. Dr. Slauterbeck is from the Southwest and lived in the desert for most of his life. When he moved to Vermont, he quickly learned how to cross-country ski and now he loves it. His favorite ski moment from last winter was teaching winter survival to the Boy Scouts in Vermont and New Hampshire, which included building and sleeping in a snow cave at -10 degrees!

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