Local physical therapists give rehab advice to recovering skiers and boarders
The on-piste checklist
You’re almost back in business. Before returning to the snow, here are quick rehab reminders from the experts at Howard Head.
Stay on the ground – There’s no need to leave the snow when you’re getting familiar with it all over again. It’ll take self-restraint, but the rollers, bumps and park laps can wait until January when the snow is better anyway.
Stick to a progression – Here’s another tough one: stay on green and blue groomers. After a few weeks there, branch out to more difficult and unpredictable terrain. You might even rediscover forgotten favorites.
Listen to your body – Aches, soreness and muscle fatigue are part of the healing process. But if you begin favoring your healthy leg over your injured leg, or you have difficulty getting back up after a fall, it’s time to stop for the day. You know how good you are – now give your body the chance to catch up.
Watch for swelling – Once you unbuckle and leave the slopes, watch for swelling related to the injury. If your joints stay swollen or tender for more than a day or two, call your doc, especially if the injury was surgically repaired.
Get active for apres – Of course you can have a beer (or two) on the deck – it’s arguably part of the recovery process. Still, don’t overlook your rehab exercise regimen. Working out at least two or three times per week will maintain your strength for this season and, with any luck, the next 20 seasons.
Early last April, your season came to a crashing halt.
It was mid-afternoon on Log Chute — you’d already tackled Prima and Pronto — when a slushy turn caught you off guard, tossing you sideways over your knee. Usually you’d shrug it off, then chuckle about it over a beer with friends.
Not this time. You blew out your knee and the prognosis was grim: a complete MCL tear. Luckily, few places in the world are better for orthopedic surgery and physical therapy, and there’s no better time for recovery than mud season. (The tear put a serious damper on your summertime hiking and biking, but that’s another story.)
At least you’re far from alone. For skiers, roughly half of all season-ending injuries are related to knees. For snowboarders, it’s wrists and concussions. They’re the kind of setbacks most dedicated powder hounds can overcome with the right rehab regimen, and you wasted no time hitting the clinic with a physical therapist. By now, you feel just as strong as you did on Prima back in April.
But first, the elephant in the room: What happens this winter?
Before doing anything, uh, unwise, take advice from Howard Head therapist Matt Mymern: No matter how hard you worked in the gym, returning to the snow will not feel the same, at least at first.
“Skiing is a different type of sport,” said Mymern, who manages the US Bank clinic in Vail and has traveled with the U.S. Women’s Ski Team for the past four years. “It puts a lot of demand on your body that’s hard to reproduce in the clinic, in a controlled environment. It’s like football — there’s no replicating that first hit, the ability to take a fall.”
Before the hill
The advice is hard to swallow. You don’t want to risk your skiing future for a few early turns — you’re already drowning in medical bills — but you want nothing more than to conquer the mountain.
Mymern knows this tug-of-war all to well. It’s his job to keep downhillers like Julia Mancuso and Lindsey Vonn in Olympic shape, even as both have dealt with debilitating knee or hip injuries in their careers. And that feverish determination isn’t limited to superstars. After eight years as a PT in the Vail area, he’s recognized the same kind of drive and passion in the local skiers he treats.
“I think we all have a high goal or aspiration to be the best at what we do up here,” Mymern said. “If you’re a recreational skier and want to get 100 days, you need the strength and endurance to get there. We’re all driven by that kind of motivation, whether you’re a professional or just want to return from an injury.”
Before even waxing your skis, Mymern says anyone who went through a serious injury last season should talk with their surgeon and PT. He always begins with several assessments in the clinic, going over everything from muscle strength and balance to landing mechanics and overall movement. It’s to make sure endurance and strength are back to normal, or as close to normal as they can be.
If you haven’t seen a therapist, test yourself by running through baseline exercises at the gym. Try single-leg squats for a minute on your injured leg, with no weight or rest. It’s an eye-opening test: If you can’t handle the strain, there’s little chance you’re ready for a wild, unpredictable ski run.
From there, Mymern suggests sitting at home to set a low-key plan for your first day back on the mountain. That can mean a few runs with your family or a long, laid-back top-to-bottom lap, but don’t jump straight into your old routine of front-side bumps. Mymern says recovering athletes tend to push themselves too hard when a coach or therapist isn’t nearby, and fellow Howard Head athletic trainer Mark Ryan agrees.
“Put away the performance mental game you want to play. Everyone wants to be who they used to be, and you really have to put that mindset away.
On the hill
Once the experts clear you, the battle is far from over. Much like Mymern, Ryan spent several years working with pro-level athletes before coming to the Vail Valley Medical Center clinic. His specialty was professional baseball, but no matter the sport, he says the most difficult part of returning to any activity is the same: patience.
“What people have to keep in mind, especially here in the mountains, is that skiing is a spectrum,” Ryan said.
Ryan suggests treating your first run as a “return to basics” session. For skiers and boarders, start with the fundamentals: link turns, skate on the flats, make quick stops on both edges.
Through it all, Ryan tells clients to pay close attention to their body. Like a PT session, keep track of how much time you’re on the slopes. If you reach a point where you can’t handle stopping and turning safely or confidently, call it quits for the day.
“Your body will tell you what it can do and what it can’t do,” Ryan said. “All you have to do is listen. Your body starts with a whisper, and once it becomes a scream, you’ve had enough. If your body screams and you don’t pay attention, it’ll scream louder and louder until it can’t take it anymore.”
After a few days with no pain on mellow cruisers, give yourself freedom to roam. Just avoid the urge to hit rollers and jumps for at least a month or two. As Mymern says, landing hard won’t feel the way it once did, but if you accidentally fall and can’t get up quickly, Mymern says that’s a warning to pass along to your PT.
“We need feedback from clients to help, especially when people can say their knee didn’t let them ski very long or they didn’t trust it enough,” Mymern said. “Those are things we can later look at in the clinic, fix, and it should translate on the snow.”
After the hill
Your first day back felt fantastic, but again, the battle isn’t over. If your injury causes sharp pain or swells for more than two days after skiing, notify your surgeon or therapist right away.
“We expect people to get sore after an injury and their return to sport,” Ryan said. “But I tell my athletes they should be able to go to sleep, wake up and feel pretty normal again. Just learn from what your body tells you.”
For Ryan and Mymern, missing a few powder days this season is worth staying healthy for decades into the future. Both therapists suggest building workouts around the injured body part, even after you’re back to 100 percent. In the end, it comes back to overall health: This season is critical — maybe one of the most important in your skiing career — and groomers or no, it won’t be your last.
“No one has done a recovery program without setbacks,” Ryan said. “How minor or major those setbacks are depends on how well you listen to you body.”