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Knee trouble for my wife... Ski technique part of the problem?

post #1 of 11
Thread Starter 

My wife's skiing really has improved greatly in the last three years.  ...More aggressive fall-line skiing with some more dynamic technique.  She's on some fatter skis now (Volkl Kiku - 106mm underfoot) and she handles powder days pretty good now.  I've had her on plenty of steep terrain and she handles that pretty well also.  However, her more aggressive skiing has caused some issues with her left knee and left thigh and hip muscles.  In many cases, both of her knees start to hurt.  It has really limited her capability to ski aggressively this year.  She often reverts to a conservative mode and ops not to ski aggressive because of this.  ... and it has made skiing less fun for her.  Back to back days are not possible at this time.  She's been to an Orthopedic doc and they found no structural issues with her knee.  She's been to two different Physical Therapists (and continues to work with one now).  However,she does not seem to be solving the issues.

I keep wondering if her ski technique is a possible cause.  I see plenty of imperfections in her technique, but since I am a self taught skier, it is hard for me to systematically fix these issues.  So, we are looking from so expert instructor input.  


I posted four videos on YouTube at the links below.  They are all on relatively intermediate terrain.  I do not have any videos of her on more expert terrain.  Regardless, I am hoping that these provide a good sample of her technique.


We appreciate any help you can offer.  Thank you very much.  This is such a great forum!












Warren & Karen

post #2 of 11

Have you talked to a bootfitter about this? Could be a boot issue. I'd have fun skiing with her--we ski about the same ;)

post #3 of 11

Hi Warren & Karen - Welcome to Epic,




You've got solid control of your turn shape and speed; and you are developing some nice high edge angles. You start your turns with an up motion, turn the skis to the new direction then set the edges and weight them to fnish the turn. This causes a fair amount of skidding through the turn finish. Your stance is on the narrow side with your feet close together on the left turns, but opening up into a small wedge to start the right turns. Your upper body stays mostly in alignment with the lower body.


This technique works, but you are doing most of the work. As the terrain increases in pitch and/or you increase your speed the potential for wear and tear on the body goes up exponentially. That skidding (instability) and bouncing on harder snow is definitely going to put more wear on the knees.


I do see you getting in the back seat a bit and suspect you migt need some fore/aft alignment. That's going to cause some quad burn and if you've been doing that a while, there's a good chance of muscle imbalance between quads and hamstrings. That's something the PTs can check. I do see some "A" framing of the legs. Women A framing is a typical alignment problem. I can't tell for sure if this is alignment or caused by knee tipping movements. But I see people with alignment issues often try to accomodate the problem by using a narrower stance to make both feet work together as one unit. So if you have not seen an alignment specialist, it's worth a visit.


For the technique issues we want to start finishing the turns with the skis more across the hill than the upper body. This will help faciliate a turn initiation move where the upper body flows to the inside of the new turn (instead of going up to unweight the skis). That movement will help the skis turn more on their own in the early phase of the turn, That will reduce the need to turn the skis quickly out of the fall line and then weight down hard on the skis through the turn finish. The end result is if you let the skis do more of the work for you, then there will be less wear and tear on the knees.


Where specifically is the pain (left or right side, knee cap, top or bottom)? Is the pain in a small spot (dime size) or more like 1/2 dollar size? Can you describe the pain as an ache, sharp, radiating or throbbing? Does the pain travel up the leg from the knee to the hip. When there is pain can you see any redness in the knee? Have you tried taking Naprosyn (Naproxen Sodium)? Does ice relieve the pain? Does the pain start right away or does it start to hurt after an hour or more?

post #4 of 11



When I read you description, I thought I knew exactley what I was going to see in the videos....I was wrong.



There are no major technqiue issues there that I can see that are so bad that it would cause knee/hip pain that is so bad she cant ski two days in a row.  That is not to say she cant improve...she can...but lots of people ski like that, day after day with no pain issues other then standard muscle fatigue.

post #5 of 11
TR gives some great insight. I do have a few other questions.

Where does she ski?

Did the pain begin around the same time as the switch to wider skis?

Is it worse or relieved when skiing powder/soft snow as compared to groomers firm snow?

Do you have some narrower (85-90) skis she can try and see if this helps?

Wider skis will put more strain on the knees and technique, strenghening, while helpful, sometimes are not enough to fix that extra strain.

Sad to say being overweight even a little can make such problems even worse. This season I was able to shed 5 lbs over the summer and my knees are thanking me for it.
post #6 of 11

Personal insights and testimony here: 


I've had similar hip and knee pain over the years, as well as an occasional cramp in the foot on the same side as the knee/hip pain.  I attributed all of this to aging.  I mean, we all get those kinds of aches and pains as we get older, right?  

I never really found a connection between narrower skis or fatter skis, technique or otherwise until two years ago when several things came in to play and we realized that I have a minor leg length discrepancy (about 7 mm) 

That's when we started to pay attention to when I had those aches and pains. 

If I'm skiing groomers without an adjustment, and I'm on skinny skis, my hip aches and my knee feels fatigued at the end of the day.  

If I'm skiing broken groomers on wider skis without an adjustment, I feel the aches and fatigue in a big way. 

If I'm skiing 3D snow on wider skis I don't feel much at all. 


If I'm skiing with an adjustment, which for me is a plate on my boot of 4 mm, I have no signs of aching or fatigue. 

When I ski with my side country boots, which don't have the adjustment, I pay for it at the end of the day and I have awful foot cramps on the short leg side if I do any traversing with the short leg on the down hill side. 

Something like 7mm isn't enough to show up in your day to day life, but over time it can make things like back and neck alignment an issue. 



I'm not saying that this is what's going on with her but its a possibility.  

post #7 of 11

I was wondering the same thing about the wider skis.

post #8 of 11

I get that this skier isn't doing anything that would indicate danger to the knees (eg skiing with weight primarily over inside ski while leaning back). Some things I do see:


Uneven snow, which does bump around twisting skis

Lots of pivoting/skidding


I wonder if the skier might reduce knee pain through more edging and less skidding. My premise is that twisting seems to put knees in a weaker position and involves at least some amount of torquing, and hitting uneven snow while skidding seems to increase that torque. Effective carving maintains alignment of lower joints with hopefully less torque from piles of snow. Plus the skier would be further removed from falling over the inside ski and backwards. Feel free to critique, all, as it's just an idea.


She may also be suffering from some bilateral patellofemoral syndrome which isn't uncommon among skiers. If so she would feel some pain in her leg after sitting still for extended periods of time (on an airplane or in a movie theatre). A physio can create a program of stretching/exercise to resolve. 

post #9 of 11

I'll throw something else into the pile.


from vid 2 if you use the posture at :06, :10, :12 as the position of transition, extended position, what have you and then compare the differences you can see the difference in her upper body comfort.  She seems to prefer left upper trunk rotation. In her left turns she will pull the left shoulder back, there isn't as much upper body rotation. In her right turn the right shoulder blade hardly retracts, in fact in some stills looks like it has to move more forward. It was more apparent in vid 3, compare the posture at :05 vs :07, again using the static posture from :02 as the starting point.


Be curious, have the PT she is working with, probably already happening,  look at the difference in her control of that upper trunk twist/rotation with a stable pelvis.  The other way would be to stabilize the upper trunk and feel which way she can twist her pelvis more easily. It would seem she could feel the difference in how easy she could pull the left shoulder blade back and down toward the right glute/pelvic bone vs the connection between the right shoulder blade and left glute/pelvic bone. Or, with respect to the other position, lifting the right pelvic up would maybe be easier than the left. Easy to feel lying her stomach.


If her system knows it prefers that left trunk turn, which works well in a right ski turn it will create more tension in the tissue structures that connect her left hip/lateral thigh/knee to her right shoulder blade. Every time she has to drive that right shoulder forward it is cranking the piss out of those tissue structures.


maybe. good luck

post #10 of 11

Just came across this, so thought I'd throw in my $.02.  (Keep in mind it's worth what you paid for it.)


In relation to equipment, on a relatively firm snow surface, wide (>90mm or so) skis put more torque on your knees.  This is just a geometry thing; the edge of the ski underfoot is offset further laterally from your knee.  So rather than the turn forces pushing directly up your lower leg some of it ends up pushing your knee to the side a little.  It doesn't sound like much, but I definitely notice it if I'm skiing groomed or packed snow all day on wider skis.  So on days when you're off piste but don't expect to be hitting deep untracked powder or the like, a ski in the 80-90mm range may help.  If you're on piste you can go even narrower for higher performance.


TrekChick also mentioned alignment.  Although I don't see any obvious alignment issues in those video clips, even small issues like slight differences in leg length can cause issues when you're skiing.  It's easy to compensate for a slight difference like this when you're walking around in street shoes, but with your feet buckled into stiff boots being even half a degree off between skis makes life difficult.  I don't know if the orthopedic doctor you saw looked at factors like this; if they don't do this sort of thing, he/she should definitely know someone who can.  The good news is that if you have an issue like this, a good bootfitter can tweak your gear to compensate.


The technique side gets more complicated.  Like TheRusty mentioned earlier, definitely some A-framing going on.  It's difficult to diagnose subtle movement things over the Internet, but some things I can see in those videos:


  • I'm not seeing a lot of engagement of the ski tips.  (If you look at the snow spray, it's all coming from the middle/back of the ski.)  If you're sitting back it will put more strain on your leg muscles in general.
  • There's a fair amount of upper body rotation.  That is, instead of your upper body pointing (mostly) down the hill, it's turning to the left and right along with your skis.  This shouldn't hurt your legs/knees, but it's more work in general.  As chad pointed out, this is more noticeable in turns to your right.
  • It looks like you're pushing your skis out to the side to set the edges, rather than tipping them and just 'falling' into the new turn.  This can be hard on your knees; the 'pushing' generates lateral forces that try to bend your knee in ways it's not supposed to go.


All of those are related.  You're swinging your upper body and pushing the skis out to the side to compensate for your center of mass not being far enough forward/downhill early in the new turn.  Rusty already mentioned a pretty good fix:


...For the technique issues we want to start finishing the turns with the skis more across the hill than the upper body. This will help faciliate a turn initiation move where the upper body flows to the inside of the new turn (instead of going up to unweight the skis). That movement will help the skis turn more on their own in the early phase of the turn, That will reduce the need to turn the skis quickly out of the fall line and then weight down hard on the skis through the turn finish. The end result is if you let the skis do more of the work for you, then there will be less wear and tear on the knees.


I'd recommend some lessons (but I'm biased  wink.gif).  If you ski at the same place all the time, maybe see if they have one of those 'show up every Saturday for six weeks' type of programs -- usually a whole lot cheaper than private lessons, but you're usually getting a more experienced instructor and you work with the same person and group every week.

post #11 of 11
I have 15+ year old injuries to my right knee. That being said, I had rarely experienced knee pain while skiing until I moved to Tahoe this year from the East. I 100% attribute my increased knee discomfort to wider skis on groomed or firmer off piste terrain... what a friend so eloquently describes as 2-dimensional snow. I figured I would ski my 98mm daily, just like everyone here in Tahoe does. However, I have found that my knee much prefers 80mm skis most days. Thus, I only take the 98mm out, when I know I will be off piste all day, 6"+ of fresh, or super soft snow that didn't freeze the night before... 3-dimensional snow. My neighbor had similar issues... after moving to a narrower ski, the discomfort resolved. He did not have an injury but still had pain.

I have also found that binding ramp angle matters too. Bindings that are truly flat (like my AT bindings) can cause me similar symptoms. Personally, I do better with system bindings on my everyday skis. There are ramp angle differences among standard bindings too.

I currently have skis at 80mm, 88mm, and 98mm. I found that even the 88mm (my east coast powder and backcountry ski) gave me pain when skied daily. I previously skid a 90mm powder ski without issue, but looking back... I only skied them on true powder days and in the backcountry. I have previously skied all mountain carvers at 84mm underfoot without any problem so I have personally deduced 85mm and under is essential for my everyday ski. Not having pain way outweighs the convenience of wider skis. If you ski the whole mountain in 80mm skis, it will definitely improve your skiing. If you plan to ski off piste frequently, chose an 80mm ski with an all-mountain bias, not a true carver. I found that going softer and longer worked well for me.

From the video, I see good ski technique and mechanics. Your extension could be more across the skis vs up... think of moving your nose towards the tip of the inside ski..., and you could settle less at the end of the turn... keep your movements progressive vs static. This would prevent you from getting a bit back at the end of the turn, which can put pressure on your knees. At times you also bring your downhill arm too far forward, which can delay or block the start of the new turn, enhancing the "settling" at the bottom of the turn. These items I describe are common and will resolve as your skiing becomes more progressive and dynamic. I do not see such elements of your skiing causing knee pain. Also, I would classify the terrain skied in the video as 2-dimensional snow, and thus would be 80mm ski terrain for me.

In summary, try a narrower ski for everyday skiing and reserve the 90+ mm skis for days when the snow is unquestionably 3-dimensional. You may also want to consider working with a local coach, who can help you fine tune your movement pattern.
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