Watching athletes like Maí«lle Ricker and Alexandre Bilodeau zoom down steep pistes, it’s impossible not to be blown away by their speed, stamina, and fearlessness. Then there’s the sheer violence inflicted on their knees: the way those body parts get thrashed over and over again, it’s no wonder that knee injuries are the most common affliction among skiers and snowboarders alike, and the most dreaded.

“The knee is a very complex joint,” explains Doug Clement, professor emeritus in UBC’s faculty of human kinetics, former Olympic track athlete, and retired doctor. “Rotational forces can create a lot of trouble”¦.Add in aerials, and when things go wrong they go really wrong.”

Full or partial tears can happen in the C-shaped pads of cartilage called menisci that act as shock absorbers in the knee and in one or more of the four ligaments that help stabilize the joint, such as the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL).

“Two basic types of injuries can affect the knee: those due to overuse and those from trauma,” explains Carl Petersen, director of high performance and partner at City Sports and Physiotherapy Clinics and author of Fit to Ski: A Complete Guide to Fitness (BK Media, 2009). “Overuse injuries result from numerous microtraumas to the tissues when doing too much, too fast, too hard, and too soon. Trauma is caused by either collisions or falls, often with a twisting or rotational component. The damage to the knee can be compounded significantly by a ski that fails to release. Improper settings and poor binding maintenance are common findings with injured skiers.”

When an ACL injury occurs, a person often feels a “pop” in the knee, followed by sudden pain and swelling. Another common sensation is feeling as if the knee is going to “give out”.

Arthroscopic surgery involves the insertion of a small camera into the knee through a cut and the reconstruction of the ligament using a person’s own or donor tissue. Not treating a torn ACL can lead to early arthritis and tissue damage.

Ricker has a long history of knee problems, and in her 16-year career she has had eight surgeries, though none in the past four years. The Canadian ski team was plagued by knee injuries in competitions leading up to the Olympics, including ACL tears for Quebec’s Anna Goodman and Chilliwack’s Kelly VanderBeek, among others.

It’s highly likely Ricker will have one or two artificial knees when she’s older, Clement says, cautioning that knee injuries could be the least of people’s concerns, given increasingly dangerous Olympic courses. He pointed to the women’s Alpine ski course in Whistler that had to be altered for safety reasons after numerous crashes.

“We have to look at what we’ve created,” he says. “I would guess that every alpine skier and all boarders have had [knee] reconstruction. At the women’s alpine race, 10 skiers went down in a spectacular, scary fashion. There’s the ooh-ahh factor, but you fear for their life. Are we really being sensible putting people at big risk?”

Canadian Snowboard Federation chief executive officer Tom McIllfaterick notes that although knee injuries are still extremely common, their incidence has fallen drastically in recent years thanks to more research into and funding for the sport. Snowboarding only became an Olympic event in 1998, and boarders have not always had access to services such as physiotherapy, massage therapy, strength conditioning, sports nutrition, sports psychology, and rehabilitation.

“Maí«lle is in the first generation of snowboarding Olympic athletes,” McIllfaterick says in a phone interview. “We’re still learning so much about the sport. But first and foremost will always be to find ways to avoid injury.

“In the early years, we didn’t have as much information on how to train efficiently; we didn’t have resources for proper support for recovery, for guidance”¦.The Own the Podium program has allowed these specialists to work with athletes and to develop programs that are properly designed for them, to address weaknesses in their bodies or previous injuries, things that if we don’t address properly can lead to further injury.”

Prevention of injury is crucial for all snowboarders and skiers, whether they’re elite athletes or weekend warriors.

“People cannot strengthen the ligaments but they can improve the stability of the muscle groups around the core, knee, and leg,” Petersen explains.

He points to the ABCs of knee protection: alignment of the knees (improper tracking can contribute to ACL injury); balanced strength (skiers’ quadriceps tend to be more developed than their hamstrings, and muscle imbalance can contribute to injury); and core power. Developing deceleration strength, which involves learning to land softly and in correct knee alignment, is also important.

“Skiers need to work on dynamic balance and stability as well to effectively prepare the knees for an injury-free season,” Petersen adds. “Introduce new activities gradually. Always allow time in training for proper warm-up and cool-down. Ski easier at the end of the day, avoiding difficult trails when you’re tired.”

Clement echoes the need for smart training regardless of whether a person prefers green runs or black-diamond trails.

“If you’re skiing two to three times a week all the time, that’s one thing, but you need to do something in the off-season to maintain that power,” Clement explains. “You might be quite capable of high-impact sports, but not intermittently. You have to do it regularly. If you skip six months, then go again, that’s when you’re prone to injury.”