Preventing phantom foot and other ski injuries

Posted on December 3, 2021 by James Slauterbeck, M.D.
James Slauterbeck, M.D.


I spent the last 20 years working with some of the best college skiers in the United States in the northeast. The northeast skiing conditions are favored among our elite ski teams because they can practice under high-speed racing conditions. However, the conditions elevate the risk for injury when skiers get out of control. 

As a result of the high number of ski injuries “Knee friendly Skiing,” a research-based pathway to help one protect their knees from anterior cruciate ligament (ACL) injury was created. It is based upon years of research from the University of Vermont and led by Robert Johnson, M.D. 

The study involved staff at the Sugarbush Ski Resort reviewing a video-based training program aimed at decreasing knee injuries for employees at the Sugarbush Ski Resort. The program was an overwhelming success and decreased ACL injures by more than half of the instructors and employees who participated. Later, the program was adapted for all skiers.  

The “phantom foot” is one of the most common ski injury mechanisms. Loading the tail end of the ski is the essential factor for the phantom foot injury mechanism. The tail of the ski acts as a spring transmitting loads through the knee and like a lever or a rudder rotating the knee during an injury event. The 6 essential elements of the phantom foot are, falling with the uphill arm behind the body, falling to the rear of the ski, getting into a position with the hips below the knees, removing weight on the uphill ski, placing weight on the inside edge of the downhill tail part of the ski and lastly having the upper body facing the downhill ski.

A few situations innocently set up a skier up for the phantom foot injury mechanism. These are attempting to get up off the snow after falling while still sliding, attempting to make a big recovery when one is off balance or attempting to sit down on the rear of the ski when one loses body control.

Several injury prevention strategies can be used to counter the elements defined by the phantom foot injury mechanism. The injury prevention strategies are based on identifying and correcting several issues namely, avoiding high-risk behavior, correcting poor skiing technique, and recognizing dangerous situations. 

The ski injury prevention program is based on a few practiced strategies. When a skier recognizes that they are out of control or are falling they should react by keeping their arms together, placing the feet together and keeping the hands forward over the skis. When these strategies are executed by a skier the thigh will be repositioned in line with the downhill ski to reduce the twisting moment, the uphill ski will be utilized for weight transfer and body will be positioned for recovery or controlled bail out.

Skiers spend lots of time learning how to ski and ski better. Skiers also should spend time on recognizing the importance of learning how to fall, preventing one from getting into a bad situation and successfully bailing out of those situations. Therefore, one should practice maintaining balance and ski control, keeping hips above knees, and keeping arms forward. So have fun this winter… when the snow falls up north or out west and enjoy your ski trip.

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