Common snow sports injuries fall into a small number of recognisable patterns, from an ACL tear and MCL sprain to skier’s thumb and wrist injuries, and most are caused by falls rather than collisions.
Skiing and snowboarding are two of the most exhilarating things you can do on a holiday, but both come with a genuine risk of injury. A review of alpine skiing injuries estimates recreational skiers and snowboarders sustain between 0.5 and 1.35 injuries per 1000 days on snow.
Whether you are a first-timer strapping on a snowboard or a seasoned skier chasing black runs, the injuries you are at risk of are more similar than you might think. Here is a breakdown of the snowboarding injuries and ski injuries we most commonly see in clinic after winter trips: what causes them, what to do if it happens, and how to give yourself the best chance of avoiding them in the first place.
ACL Tear
The ACL tear is the snow sports injury that skiers dread most, and it is particularly common on skis. It typically happens when the knee is forced inwards during a fall, or when a skier sits back and catches the inside edge of their ski. The result is a sudden, often audible pop, followed by immediate swelling, pain, and a feeling that the knee simply is not trustworthy.
Snowboarders are at lower risk thanks to the fixed-boot setup, but knee injuries still occur, usually through direct impact or awkward twisting falls.
If you suspect an ACL tear, stop immediately and use ski patrol to get down safely. The temptation to do one more run is understandable, but continuing to ski or ride on an acutely injured knee risks damage to other structures that can complicate recovery significantly.
Management depends on the severity of the tear and your goals. Some tears can be managed conservatively with physiotherapy, while others require surgical reconstruction followed by a structured ACL rehabilitation programme. Either way, early physio input makes a meaningful difference to the recovery process.
For skiers, having your binding DIN settings professionally checked before the season is one of the most underrated preventive steps, as poorly adjusted bindings that do not release properly are a major contributor to knee injuries.
MCL Sprain
MCL sprain is extremely common in skiers and, to a lesser extent, snowboarders. The mechanism is similar in both: the knee is driven inward under load, overstretching the ligament on the inside of the joint. In skiing this often happens when an edge catches unexpectedly. In snowboarding it can occur during a heel-side fall with the knees splayed.
The inside of the knee is typically tender to touch, with swelling and pain on movement or weight-bearing.
MCL injuries are graded on a scale of one to three based on severity. Grade one and two sprains generally respond well to conservative physiotherapy management, including load management, targeted strengthening, and a graduated return to activity. Grade three tears may require a brace and a longer rehabilitation period, though surgical intervention is less common than with ACL injuries.
Lateral hip strength and knee control during turns are the key protective factors for this injury.
Skier’s Thumb
Skier’s thumb is almost unique to skiers, and it is more common than most people realise. The ulnar collateral ligament at the base of the thumb gets wrenched when a pole catches during a fall and forces the thumb sharply backwards or outward. Because snowboarders do not use poles, they rarely suffer this injury.
Symptoms include pain and tenderness at the base of the thumb, swelling, bruising, and difficulty gripping. In more severe cases there may be instability when pinching.
Partial tears managed early with splinting and physiotherapy generally respond well, while complete ruptures left untreated can lead to chronic instability and may ultimately require surgery. If you experience significant thumb pain after a fall, get it assessed before flying home.
The best prevention habit is to release the pole strap before a fall rather than gripping the pole as you go down.
Wrist, Shoulder and Upper Limb Injuries
Snowboarders are significantly more prone to wrist injuries. The instinct to throw out a hand to break a fall is hard to override, and the wrist takes the full force of a body travelling at speed. Distal radius fractures are the classic result.
Skiers tend to land falls differently and are more susceptible to shoulder injuries: dislocations, clavicle fractures, and rotator cuff damage all feature, particularly in higher-speed impacts.
Continuing to ski or snowboard on a fractured wrist or an unstable shoulder risks making a manageable injury much harder to treat. Persistent pain, significant swelling, or any deformity following a fall should be treated as a fracture until proven otherwise. Head to the resort medical centre rather than back to the lift.
Our sports physiotherapy team frequently manages these injuries once you are back in Sydney. For snowboarders, wrist guards are well worth using, particularly for beginners who are still learning how to fall safely.
Muscle Strains and Overuse
Quad and hip flexor strains affect skiers and snowboarders alike, and they follow a familiar pattern. Most occur in the first day or two of a trip, when the legs are not used to the demands of the sport, or towards the end of a long day when fatigue erodes movement quality and control. These muscle strains are less dramatic than ligament tears, but they can cut a trip short, and pushing through them compounds the damage.
Low back pain is one of the most common complaints we hear after winter trips from both skiers and snowboarders. The sustained athletic position across a full day, loaded, flexed, and constantly twisting, places real demands on the lumbar spine and its supporting muscles, particularly for anyone without a strong foundation of core strength. Our lower back pain physiotherapy service is a common next step for patients in this situation.
Knowing your limits, taking breaks, and calling it a day before your body makes that decision for you is always the smarter strategy. Pre-season strength and conditioning makes more difference here than anywhere else, as a well-prepared body fatigues later and holds better form for longer. Our Snow Sport Injury and Performance programme is built for exactly this, both before you travel and after you return.
On-Mountain Injury Management
Regardless of whether you are on skis or a board, the same principles apply when something goes wrong on the mountain:
- Stop immediately after a significant fall, as continuing on a fresh injury consistently makes things worse
- Use ski patrol, who are trained in on-mountain injury assessment and evacuation
- Apply POLICE principles (protection, optimal loading, ice, compression and elevation) for soft tissue injuries as early as possible to manage swelling
- Get a medical assessment before flying home, as altitude and pressure changes during flight can exacerbate swelling in acute injuries
- See a physiotherapist soon after you return, which is generally associated with a smoother, better-supported ski injury recovery
Whatever the pattern, common snow sports injuries generally respond best to early assessment rather than a wait-and-see approach.
Frequently Asked Questions
How do I know if I have torn my ACL while skiing?
A torn ACL often involves a sudden pop at the time of injury, followed by rapid swelling and a feeling that the
