How Dangerous is Skiing? Common Ski Injuries Explained

Skiing’s popularity has been growing for decades, with 10.6 million Americans downhill skiing or snowboarding in the 2023–2024 season, according to the National Ski Areas Association (NSAA), with about 8 million of those visits from skiers.

Downhill skiing has a reputation for being a high-injury sport, but all sports have the potential for injury. So is skiing really dangerous? How can you prevent common skiing injuries and have fun on the slopes?

Michael Kolosky, DO, a Mass General Brigham Sports Medicine provider and orthopedic surgeon, sees patients in Danvers, MA and Salem, NH. He specializes in sports injuries and knee and shoulder surgery. As an avid skier himself, he understands the eagerness to get on the slopes and the importance of proper injury prevention.

Common skiing injuries

“The most common injuries for skiers revolve around the knee,” says Dr. Kolosky. “Knee injuries make up nearly half of all ski injuries, predominantly with ACL and MCL tears and knee meniscus injuries.”

Other common skiing injuries include:

• Shoulder injuries like dislocations and sprains
• Head injuries and concussions
• Fractures
• Hand and wrist injuries, like skier’s thumb

What is skier’s thumb?

“Skier’s thumb is where a ligament in the thumb, known as the UCL, becomes torn,” says Dr. Kolosky. “With some falls, the ski pole can impact the thumb joint, resulting in that ligament tearing or stretching. The force of the pole hitting the ground and the leverage from the length of the pole drives the pole into the crux of your hand, putting enough stress on the joint to tear that ligament.”

According to the American Academy of Orthopaedic Surgeons, you may or may not feel pain when you first experience the injury. Symptoms of skier’s thumb can include:

• Bruising, redness, or swelling of the thumb or finger
• Pain at the injury site
• A feeling like the joint is loose or unstable
• Inability to grasp items

“Treatments for skier’s thumb range from a short period of limiting movement, to a cast or splint, to surgery,” Dr. Kolosky explains. Even if you think the injury is minor, it’s worth getting checked out by a doctor to avoid any long-term damage or complications.

What causes knee injuries in skiing?

Dr. Kolosky explains, “A good portion of the skiing knee injuries I see occur when the bindings [of the skis] don't release, or you catch an edge and there's a twisting-type movement.”

The skis themselves can often increase the chance for injury. “Because the skis are so long,” Dr. Kolosky notes, “the twist has a lot of torque on the knee, and those physics are at work in many skiing knee injuries that we see.”

How dangerous is skiing?

Every sport has its risks and dangers. So how dangerous is skiing, really?

The NSAA keeps track of skiing-related injuries and deaths each year, as well as how those accidents tend to occur.

Most deaths while skiing are caused by a collision with a tree or an impact with the snow on the ground. Though rare, falls from ski lifts or being trapped in a snow well (deep, loose snow) can also cause skiing-related deaths. The 10-year average fatality rate for skiing and snowboarding is 0.74 deaths for every million visits.

Catastrophic injuries—those that are life-altering such as a broken back, head injury, or loss of limb—also occur in skiing. The 10-year average catastrophic injury rate is 0.72 injuries for every million visits. Most of these injuries were among younger men skiing more advanced hills, and involved high speeds, collisions, or loss of control.

Dr. Kolosky says, “Each winter sport utilizes different body parts and muscle groups and therefore comes with different health benefits and injury risks. With cross-country skiing, for instance, there’s a lot of repetitive motion and prolonged, dynamic movement.”

Repetitive movements can cause tendinopathy or tendonitis, an inflammation of the tissues connecting muscle to bone.

Exercising in winter weather presents additional dangers like hypothermia, frostbite, dehydration, and even making you more prone to a heart attack, especially if you have a pre-existing heart condition.

Is skiing or snowboarding more dangerous?

Dr. Kolosky explains why snowboarding injuries may be different than skiing: “Snowboarding is a little bit different. Compared to skiing, snowboarding is easier on the knees, but there is a slightly higher rate of upper body and ankle injuries associated with snowboarding, due to the way in which the equipment is attached to your body.”

Whether skiing or snowboarding, only attempt hills that match your ability level. Skiing down a black diamond-rated hill—one of the most difficult trails—may sound exhilarating but is a risky decision if you’re not advanced enough in your skiing abilities.

Preventing ski injuries

As with any sport, wearing the proper equipment, following proper form, and taking time to warm up and stretch can help reduce injuries.

Wear a helmet

Dr. Kolosky says, “I always encourage the athletes I work with to make sure they’re wearing the correct protective gear. For downhill skiing and snowboarding, I recommend wearing a helmet. It’s a very easy way to prevent serious head injury.”

While head injuries can be catastrophic, the good news is that more skiers are wearing helmets every year—the NSAA reports that over 90% of all skiers wore helmets during the 2023–2024 season, and 96% of minors wore helmets.

Use proper, well-maintained gear

Another key component for injury prevention is proper gear and maintenance. Dr. Kolosky, as a skier himself, notes that it means “making sure the ski’s bindings are adjusted to your proper height, weight, and skiing ability, so they release when needed. And wearing warm layers of clothing serves dual purposes, providing warmth and cushioning in case of a fall.”

Winter workouts can be a great way to stay healthy all year long, as long as you take the proper precautions.

Warm up, stretch, and don’t forget the sunscreen

“If you think about when you go skiing the first time for the year, there's typically not much prep that goes into it,” Dr. Kolosky says. “We get on the chairlift and then make our way down the slopes without warming up and this really stresses the body.”

To help prevent injuries, you should be warming up. “To warmup, you should be stretching and taking the first few runs easy to get the body loosened up,” Dr. Kolosky advises. Lunges, twists, and butt kicks can help prepare your muscles for the hip, knee, and torso movements needed in downhill skiing.

After your skiing time is done, take a few minutes to stretch out your body, focusing on any tight areas. Consider using a tool like a foam roller or a tennis ball to massage your muscles to prevent soreness.

Finally, don’t forget the sunscreen. The sun reflecting off the snow and the UV rays you experience at high altitudes can be just as damaging as a sunny day at the beach. Wear sun protection like sunscreen, lip balm with SPF, and UPF clothing. Regular sunscreen use year-round can even help reduce dry skin.

Practice good form and conditioning

“Another key aspect to injury prevention with skiing is having good technique and good conditioning,” notes Dr. Kolosky. "Committing to a good strength and conditioning program to get into shape for ski season is paramount. And then, even if you’ve trained, it’s important to stay hydrated and take breaks as needed.”

Safety on the slopes and the skier's responsibility code

The National Safety Council recommends additional steps you can take to help prevent injury once you’re on the slopes and the National Ski Areas Association™ provides a list of ten responsibilities adopted by ski resorts across the U.S. These responsibilities help keep you and other skiers, snowboarders, and bystanders safe on the slopes.

Treating ski injuries

“We of course want everyone out there skiing and snowboarding safely and enjoyably. For emergencies, skiers should seek medical care at the ski mountain or go to the emergency room of the nearest hospital,” Dr. Kolosky notes. “But after any emergency has been addressed, if an injury has occurred, whether it’s severe or just a dull nagging ache or pain, our team at Mass General Brigham Sports Medicine has likely seen it before and can get you back on the slopes as quickly and safely as possible.”

Knee injuries are extremely common in skiing, and treatment depends on the severity of the injury. “With ACL and other ligament injuries, people typically feel and/or hear a pop in their knee, accompanied by immediate swelling and a feeling of instability,” Dr. Kolosky explains.

If you experience symptoms of an ACL injury, visit a sports medicine specialist. “We do a physical examination of the injured knee,” Dr. Kolosky says, “including imaging when necessary, in order to determine the extent of the injury and the damage to the ligaments.”

He continues, “If the ACL is torn, we may recommend surgical treatment to reconstruct or replace the torn ligament.”

ACL surgery is done in an outpatient setting, which means you’ll be able to go home to recover the same day you have surgery. “We’ll get you moving and working with one of our therapists within the week to get the ball rolling on recovery,” Dr. Kolosky says.

 If the injury is less severe than a full tear, for example, a sprain or partial tear, a brace and a rehabilitation program with our expert physical therapists could be all that is needed. “Full recovery time for an ACL injury typically takes about a year, so you may have to wait until the following ski season to hit the slopes again after injury,” Dr. Kolosky explains.

Other injuries like skier’s thumb, minor shoulder injuries, or muscle strains can often be treated with ice and rest. If your symptoms get worse or persist, visit your doctor. They can determine if the injury needs further treatment and can help you create a recovery plan so you can return to the slopes healthy.

“I am always looking to work with new athletes to help them heal from injury and excel in their sports, and I also am happy to consult on chronic injuries, especially of the knee and shoulder,” says Dr. Kolosky.

With proper preparation and safety tactics, you can ski safely and prevent injuries.