Research & Evidence

Overview

Most ski resorts operate at elevations where altitude affects performance: 6,000-12,000+ feet (1,800-3,600+ meters). Understanding altitude physiology helps skiers arrive prepared, perform better, and avoid altitude-related illness. This is particularly relevant for sea-level residents traveling to mountain destinations.

Altitude Classifications

Typical Ski Resort Elevations

Physiological Effects of Altitude

Oxygen Availability

At altitude, barometric pressure decreases, reducing the partial pressure of oxygen:

Immediate Effects (Day 1-2)

• •Increased heart rate at rest and exercise
• •Increased breathing rate
• •Decreased exercise capacity (10-20% at 8,000 ft)
• •Faster fatigue during physical activity
• •Mild headache, fatigue (in some individuals)

Acclimatization Effects (Day 3-14)

• •Increased red blood cell production (EPO response)
• •Improved oxygen-carrying capacity
• •Heart rate normalizes
• •Exercise capacity improves (but rarely returns to sea-level capacity)

Impact on Ski Performance

Aerobic Capacity Reduction

VO2max decreases with altitude:

Practical meaning: A skier with a sea-level VO2max of 50 ml/kg/min effectively has 40-42 ml/kg/min at 12,000 feet.

Fatigue and Recovery

First Day Considerations

The first day at altitude is the worst:

• •Performance may be 15-25% below normal
• •Fatigue sets in faster
• •Risk of headache and nausea
• •Sleep may be disrupted (Cheyne-Stokes breathing)

Recommendation: Plan an easy first day. Don't attack the hardest runs while your body is adjusting.

Acclimatization Strategies

Pre-Trip Preparation

During the Trip

Hydration at Altitude

Altitude increases fluid loss through:

• •Increased breathing rate (respiratory water loss)
• •Lower humidity (typically very dry)
• •Diuresis (increased urination)

Recommendation: Drink 3-4 liters daily (vs typical 2-3 liters), more if skiing hard.

Altitude Illness

Acute Mountain Sickness (AMS)

Most common altitude illness, affecting 25-40% of unacclimatized visitors to 8,000+ feet.

Symptoms:

• •Headache (primary symptom)
• •Fatigue, weakness
• •Nausea, loss of appetite
• •Dizziness
• •Sleep disturbance

Prevention:

• •Gradual ascent if possible
• •Acetazolamide (Diamox) - prescription, works well
• •Adequate hydration
• •Avoiding overexertion first 1-2 days

Treatment:

• •Descend if symptoms are moderate-severe
• •Rest at same altitude for mild symptoms
• •Hydrate
• •Ibuprofen/acetaminophen for headache
• •If symptoms worsen: descend immediately

High Altitude Pulmonary Edema (HAPE)

Rare but serious. Fluid accumulates in lungs.

Warning signs:

• •Breathlessness at rest
• •Cough (may produce pink, frothy sputum)
• •Extreme fatigue
• •Rapid heart rate

Action: Descend immediately. This is a medical emergency.

High Altitude Cerebral Edema (HACE)

Rare but life-threatening. Brain swelling.

Warning signs:

• •Severe headache not relieved by medication
• •Confusion, disorientation
• •Loss of coordination (ataxia)
• •Altered consciousness

Action: Descend immediately. This is a medical emergency.

Training for Altitude Performance

Aerobic Base Building

A strong aerobic base provides:

• •Better oxygen utilization
• •Faster recovery between runs
• •More buffer before anaerobic threshold
• •Less relative impairment

Training approach:

• •Build Zone 2 (conversational pace) volume
• •Include 1-2 higher intensity sessions weekly
• •Maintain training 4-8 weeks before trip

Specific Altitude Adaptations

If you have access to altitude or altitude simulation:

For most recreational skiers: Focus on aerobic fitness rather than altitude-specific training.

Medication Considerations

Note: Consult a physician before using any medication for altitude.

Key Takeaways

• •Altitude significantly reduces aerobic capacity
• •First day is hardest—plan accordingly
• •Hydration is critical (3-4+ liters daily)
• •Arrive early if possible for acclimatization
• •Know the signs of altitude illness
• •Aerobic fitness provides the best non-pharmaceutical protection
• •Descend if symptoms of AMS worsen or any HAPE/HACE signs appear

References

• •Bärtsch P, Saltin B (2008). General introduction to altitude adaptation and mountain sickness. Scand J Med Sci Sports.
• •Luks AM, McIntosh SE, Grissom CK, et al. (2019). Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness. Wilderness Environ Med.
• •Chapman RF, Stickford JL, Levine BD (2010). Altitude training considerations for the winter sport athlete. Exp Physiol.

Overview

Skiing combines speed, technical precision, and calculated risk. The psychological demands include managing fear at high velocities, quick decision-making on variable terrain, and maintaining focus in cold, challenging environments. Mental skills enhance both performance and enjoyment.

Psychological Demands of Skiing

Speed and Risk

Skiing involves inherent risks:

• •High speeds (recreational: 20-40 mph; racing: 70+ mph)
• •Variable conditions (ice, powder, obstacles)
• •Terrain challenges (steeps, trees, cliffs)
• •Consequence of errors

Environmental Challenges

Unique conditions affect psychology:

• •Cold impacts focus and comfort
• •Altitude can affect cognition
• •Visibility variations
• •Changing snow conditions

Technical Complexity

Skiing requires:

• •Balance and edge control
• •Quick adjustments to terrain
• •Anticipation of conditions
• •Reading the mountain

Core Mental Skills for Skiing

1. Fear Management

Fear on the slopes is normal and often appropriate.

Understanding Ski-Related Fear:

• •Fear of falling/injury
• •Fear of speed
• •Fear of steep terrain
• •Fear of variable conditions

Graduated Exposure Protocol:

1. 1.Master fundamentals on comfortable terrain
2. 2.Gradually increase challenge one variable at a time
3. 3.Build confidence through competence
4. 4.Never jump too far ahead of skill

In-the-Moment Fear Management:

• •Breathing to reduce panic
• •Focus on technique, not the scary stimulus
• •"I've done this before"
• •Break terrain into manageable segments

Reframing Fear:

• •Some fear is healthy (keeps you safe)
• •Excitement and fear share physiology
• •Fear signals importance, not necessarily danger

2. Pre-Run Visualization

Before Challenging Terrain:

• •See yourself skiing the line
• •Feel the movements and transitions
• •Identify key decision points
• •Visualize successful completion

PETTLEP for Skiing:

• •Physical: Stand in skiing posture
• •Environment: See the slope, feel the cold, hear the sounds
• •Task: Specific run you're about to ski
• •Timing: Real-time descent speed
• •Learning: Current skill level visualization
• •Emotion: Confidence, flow, enjoyment
• •Perspective: First-person (through your eyes down the slope)

3. Self-Talk for Skiing

Technical Cues:

• •"Weight forward"
• •"Hands visible"
• •"Carve, don't skid"
• •"Commit to the turn"

Confidence Cues:

• •"I've got this"
• •"Trust your skills"
• •"Smooth and controlled"

Fear Management Cues:

• •"Breathe"
• •"One turn at a time"
• •"Stay present"

4. Attention and Focus

Broad Focus:

• •Read terrain ahead
• •Plan line choices
• •Assess conditions

Narrow Focus:

• •Immediate turn execution
• •Balance adjustments
• •Edge engagement

Switching Between:

• •Scan ahead, execute present
• •Don't get stuck in either mode
• •Fluid attention shifting

5. Flow State in Skiing

Skiing produces powerful flow experiences when:

• •Challenge matches skill
• •Clear immediate goals (line choice, turn execution)
• •Immediate feedback (balance, edge feel)
• •Full concentration required

Cultivating Flow:

• •Ski terrain appropriate to skill
• •Stay present (not thinking about last run or next lift)
• •Trust abilities
• •Let go of outcome attachment

6. Cold Weather Psychology

Cold affects performance:

• •Cognitive function decreases
• •Fine motor control degrades
• •Motivation can suffer

Mental Strategies:

• •Proper gear as foundation
• •Warm-up runs to get blood flowing
• •Mental warmth visualization
• •Break sessions into manageable chunks

Terrain-Specific Psychology

Groomed Runs

Mental Focus:

• •Carving and technique refinement
• •Speed control
• •Rhythm and flow

Steeps

Mental Focus:

• •Commitment to fall line
• •Breathing and relaxation
• •One turn at a time
• •Trust edge grip

Moguls

Mental Focus:

• •Rhythm and absorption
• •Line selection
• •Quiet upper body
• •Aggressive leg work

Trees

Mental Focus:

• •Look where you want to go (not at trees)
• •Quick decision-making
• •Speed appropriate to skill
• •Escape routes awareness

Off-Piste/Backcountry

Mental Focus:

• •Risk assessment
• •Terrain reading
• •Variable condition adaptation
• •Safety awareness

Competition Psychology (Racers)

Pre-Race

• •Course inspection (memorization, visualization)
• •Equipment check (reduces anxiety)
• •Warm-up routine
• •Arousal calibration

In the Gate

• •Focus narrows to start
• •Visualize first gates
• •Trigger word/cue
• •Trust preparation

During Run

• •Execute, don't think
• •Recover from errors without dwelling
• •Maintain focus through finish

Between Runs

• •Brief analysis
• •Reset mentally
• •Visualization of improvements
• •Maintain confidence

Injury Psychology

Fear After Injury

Common and normal:

• •Respect the recovery process
• •Gradual return to activity
• •Build confidence incrementally
• •Don't rush return

Mental Aspects of Recovery

• •Visualization of healthy skiing
• •Stay connected to the sport (watch, learn)
• •Address fear directly, don't suppress
• •Celebrate small progress

Season-Long Psychology

Early Season

• •Skill refresh
• •Patience with conditions
• •Building fitness
• •Confidence building on easier terrain

Peak Season

• •Pushing boundaries appropriately
• •Managing fatigue
• •Maintaining motivation
• •Peak performance focus

Late Season

• •Varying conditions management
• •Season fatigue awareness
• •End-of-season goals
• •Injury prevention focus

References

1. 1.Brymer, E., & Schweitzer, R. (2013). Extreme sports are good for your health: A phenomenological understanding of fear and anxiety in extreme sport. Journal of Health Psychology.
2. 2.Kerr, J.H. (1991). Arousal-seeking in risk sport participants. Personality and Individual Differences.
3. 3.Pain, M.T.G., & Pain, M.A. (2005). Risk taking in sport. The Lancet.
4. 4.Csikszentmihalyi, M. (1975). Beyond Boredom and Anxiety: Experiencing Flow in Work and Play. Jossey-Bass.

Overview

Understanding the biomechanics of skiing reveals why traditional gym training often fails to prepare skiers for the mountain. Skiing is eccentric-dominant, laterally demanding, and isometrically exhausting—a profile that differs dramatically from most gym exercises.

Force Production in Skiing

Ground Reaction Forces

During skiing, forces through the lower body can exceed 3-5 times bodyweight during turns. These forces are primarily:

The Eccentric Reality

Unlike running or jumping (where muscles contract to produce movement), skiing requires muscles to contract while lengthening—eccentric contraction. Your quadriceps work continuously to control descent.

Key insight: Concentric strength doesn't predict eccentric capacity. A strong leg press doesn't mean you can handle ski turns.

Knee Loading Patterns

ACL Stress in Skiing

The ACL is at risk when:

• •Knee flexion angle is shallow (near extension)
• •Quadriceps fire without hamstring co-contraction
• •Rotational forces combine with valgus stress
• •Fatigue reduces neuromuscular control

Protective Factors

The Tuck Position

Isometric Demands

The aerodynamic tuck requires sustained isometric contraction:

Training the Tuck

Wall sits are the gold standard:

• •Match ski position (90-degree knee angle)
• •Progress to single-leg holds
• •Work up to 2+ minute holds
• •Simulate race duration holds for competitors

Lateral Stability Demands

The Frontal Plane Challenge

Skiing involves constant weight transfer from ski to ski. During a turn:

1. 1.Weight shifts to outside (downhill) ski
2. 2.Inside (uphill) ski is nearly unweighted
3. 3.Hip abductors stabilize the pelvis
4. 4.Ankle evertors/invertors manage edge angle

Single-Leg Loading Patterns

Training Lateral Stability

Ankle Mechanics

Boot Constraints

Ski boots restrict ankle dorsiflexion to 15-25 degrees (compared to 30-40 degrees in barefoot movement). This affects:

• •Knee mechanics (knees must travel further forward)
• •Balance point (forward lean required)
• •Calf muscle function (reduced stretch-shortening cycle)

Ankle Training for Skiing

Energy Systems

Ski Day Demands

Cardiovascular Preparation

Ski fitness requires:

• •Aerobic base - For all-day endurance
• •Lactate tolerance - For intense runs
• •Recovery capacity - For back-to-back runs

Altitude compounds these demands—see altitude_considerations.md for details.

Movement Quality vs Force Production

Common Compensation Patterns

Movement Screening for Skiers

Test these before the season:

1. 1.Single-leg squat - Can you keep knee tracking over toe?
2. 2.Lateral step-down - Controlled descent without valgus?
3. 3.Single-leg RDL - Balance and hip hinge pattern?
4. 4.Wall sit - 90 seconds minimum?

Key Takeaways

• •Skiing is eccentric-dominant—train accordingly
• •ACL protection requires strong hamstrings and hip stability
• •Lateral training is essential, not optional
• •Single-leg strength matters more than bilateral
• •Wall sits and slow tempo squats simulate ski demands
• •Movement quality prevents injury and improves performance

References

• •Spörri J, Kröll J, Schwameder H, et al. (2012). Course setting and selected biomechanical variables related to injury risk in alpine ski racing. Br J Sports Med.
• •Hintermeister RA, O'Connor DD, Dillman CJ, et al. (1995). Muscle activity in slalom and giant slalom skiing. Med Sci Sports Exerc.
• •Berg HE, Eiken O (1999). Muscle control in elite alpine skiing. Med Sci Sports Exerc.

Overview

Skiing is fundamentally an eccentric sport. Unlike running, jumping, or cycling where muscles shorten to produce force (concentric contraction), skiing demands that muscles lengthen under load to control descent. Understanding eccentric physiology explains why traditional gym training often fails to prepare skiers for the mountain.

What Is Eccentric Contraction?

Key insight: Your quadriceps work eccentrically during most of a ski turn, lengthening while resisting the forces pushing you into the snow.

Why Eccentric Strength Matters for Skiing

Force Production

Muscles generate 20-50% more force eccentrically than concentrically. This is why you can lower more weight than you can lift. Skiing exploits this capacity constantly.

Energy Cost

Eccentric contractions are more metabolically efficient but create more muscle damage. This explains the unique fatigue pattern of skiing: you can ski all day but experience severe soreness afterward.

Neural Demands

Eccentric control requires different neural recruitment patterns. The nervous system must:

• •Activate motor units in a controlled, graded manner
• •Provide negative feedback to prevent uncontrolled lengthening
• •Coordinate timing precisely

This is trainable but requires specific practice.

The Eccentric Demands of Skiing

Turn Phases

Research shows that during aggressive skiing, quadriceps work eccentrically 70-80% of the time.

Moguls and Variable Terrain

Mogul skiing and variable snow amplify eccentric demands:

Force Magnitude

During recreational skiing, quadriceps experience forces of 2-4x body weight. Racing increases this to 4-6x body weight. Each turn is essentially a loaded eccentric squat performed at speed.

Training Eccentric Strength

Principles

1. 1.Tempo Training: Slow the lowering phase (3-5 seconds)
2. 2.Supramaximal Loading: Use heavier weights for eccentric-only work
3. 3.Progressive Overload: Gradually increase eccentric time under tension
4. 4.Recovery Awareness: Eccentric training causes significant muscle damage

Key Exercises

Sample Eccentric Session

Warm-up: 10 minutes light cardio + mobility

Main Work:

1. 1.Slow Eccentric Back Squat: 4x6 @ 5-sec descent
2. 2.Step-Down: 3x10 each leg @ 4-sec descent
3. 3.Reverse Nordic Curl: 3x8
4. 4.Nordic Curl (eccentric only): 3x5

Cooldown: Extended quad and hip flexor stretching

Total time: 45-55 minutes

Managing Delayed Onset Muscle Soreness (DOMS)

Eccentric training causes more muscle damage than concentric training, leading to significant DOMS.

Why Eccentric Causes More DOMS

• •Greater mechanical stress on muscle fibers
• •More microtrauma to sarcomeres
• •Increased inflammatory response
• •Disruption of Z-line structure

DOMS Management

Repeated Bout Effect

Good news: DOMS decreases dramatically with repeated exposure. After 2-3 eccentric sessions, the protective "repeated bout effect" kicks in, reducing future soreness. This adaptation lasts 6-8 weeks.

Implication: Start eccentric training early in your off-season to build protection before heavy loading.

Eccentric Training Periodization

Off-Season Timeline

In-Season Considerations

During ski season:

• •Reduce eccentric training volume by 70%
• •Skiing provides eccentric stimulus
• •Maintenance only (1 session/week if any)
• •Never do eccentric work within 48 hours of ski day

Eccentric vs. Concentric: The Research

Studies comparing eccentric and concentric training for ski preparation:

Common Mistakes

1. Too Much, Too Soon

Starting with long eccentric tempos and high volume causes debilitating DOMS that disrupts training for a week.

Fix: Start with 3-second eccentrics, 50% volume, progress over 4+ weeks.

2. Ignoring Recovery

Treating eccentric sessions like normal strength training leads to overtraining.

Fix: Allow 72+ hours between eccentric sessions initially. Listen to your body.

3. Stopping During Ski Season

Maintaining some eccentric capacity during the season prevents detraining.

Fix: One light maintenance session per week (if not skiing heavily).

4. Only Training Quads

Hamstring eccentric strength is crucial for ACL protection.

Fix: Include Nordic curls and slow RDLs in every program.

Key Takeaways

1. 1.Skiing is 70-80% eccentric - Train accordingly
2. 2.Concentric gym strength doesn't transfer directly - Eccentric capacity must be trained specifically
3. 3.Start early, progress slowly - 12+ weeks before ski season
4. 4.DOMS is normal initially - But decreases with repeated bout effect
5. 5.Recovery matters more - Eccentric training is more damaging than traditional lifting
6. 6.Maintain during season - Light eccentric work prevents detraining

References

• •Berg HE, Eiken O (1999). Muscle control in elite alpine skiing. Med Sci Sports Exerc.
• •Hortobagyi T, Hill JP, Houmard JA, et al. (1996). Adaptive responses to muscle lengthening and shortening in humans. J Appl Physiol.
• •Lindstedt SL, LaStayo PC, Reich TE (2001). When active muscles lengthen: properties and consequences of eccentric contractions. News Physiol Sci.
• •Mjolsnes R, Arnason A, Osthagen T, et al. (2004). A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. Scand J Med Sci Sports.
• •Nosaka K, Clarkson PM (1995). Muscle damage following repeated bouts of high force eccentric exercise. Med Sci Sports Exerc.
• •Roig M, O'Brien K, Kirk G, et al. (2009). The effects of eccentric versus concentric resistance training on muscle strength and mass. Br J Sports Med.

Overview

Skiing has one of the highest injury rates among recreational sports. The combination of high speeds, fixed bindings, variable terrain, and fatigue creates significant injury risk. However, research consistently shows that targeted training can reduce injury rates by 30-50%. Prevention is not optional for serious skiers.

Common Ski Injuries

Knee Injuries (Most Common)

Upper Body Injuries

Head and Spine

ACL Injury Prevention: The Priority

ACL injuries end ski seasons and often careers. Understanding prevention is critical.

Risk Factors

Modifiable:

• •Weak hamstrings relative to quadriceps (H:Q ratio < 0.6)
• •Poor neuromuscular control
• •Limited hip stability
• •Fatigue (most ACL injuries occur in afternoon)
• •Previous ACL injury (6x increased risk)

Non-modifiable:

• •Female sex (2-8x higher risk)
• •Anatomy (narrow intercondylar notch)
• •Ligament laxity

Prevention Strategies

1. Hamstring Strengthening

Strong hamstrings counter the anterior tibial translation that stresses the ACL.

Target: Hamstring strength at least 60% of quadriceps strength (ideally 70%+).

2. Hip Stability Training

Hip weakness leads to knee valgus (knock-knee position), a primary ACL injury mechanism.

3. Neuromuscular Control

Training the nervous system to respond correctly is as important as strength.

4. Fatigue Management

Most ski injuries occur when tired. Prevention strategies:

• •Stop before exhaustion - The "one more run" is the dangerous one
• •Build leg endurance - Wall sits, isometric training
• •Hydrate and fuel - Fatigue accelerates with dehydration
• •Rest days - Multi-day ski trips need recovery days

The "Phantom Foot" Mechanism

The most common ACL injury scenario in skiing:

1. 1.Skier loses balance backward
2. 2.Weight shifts to inside edge of downhill ski
3. 3.Knee flexes 30-60 degrees (vulnerable position)
4. 4.Ski acts as lever, applying valgus and rotation to knee
5. 5.ACL ruptures

Prevention: Strong hamstrings and hip stabilizers allow recovery from off-balance positions before the injury cascade begins.

MCL Injury Prevention

MCL sprains often result from inside edge catches or "snowplow" positions.

Prevention:

• •Maintain knee flexion (straighter knees = more MCL stress)
• •Strengthen adductors (Copenhagen plank, sumo squats)
• •Avoid fatigue-induced technical breakdown

Upper Body Injury Prevention

Skier's Thumb Prevention

• •Use poles without wrist straps (or learn proper release technique)
• •Practice proper pole plant technique
• •Strengthen grip and forearm

Shoulder Protection

• •Strengthen rotator cuff
• •Practice safe falling techniques
• •Avoid catching yourself with extended arm

Pre-Season Injury Prevention Protocol

12-Week Prevention Program Structure

Weekly Prevention Essentials

Every week should include:

In-Season Injury Prevention

Once skiing begins, prevention focus shifts:

Daily

• •Proper warm-up before first run
• •Stop when fatigued (not after)
• •Stay hydrated

Between Ski Days

• •Light mobility work
• •Adequate sleep (8+ hours)
• •No heavy leg training

Weekly

• •1-2 maintenance strength sessions (if not skiing)
• •Hip stability exercises
• •Hamstring maintenance

Warning Signs: When to Stop

Stop skiing immediately if you experience:

• •Knee giving way or buckling
• •Unusual knee swelling
• •Sharp pain (vs. normal muscle fatigue)
• •Numbness or tingling
• •Significantly decreased control or coordination
• •"Something doesn't feel right" instinct

Key Takeaways

1. 1.ACL prevention is trainable - Hamstring strength and hip stability reduce risk by 30-50%
2. 2.Fatigue is the enemy - Most injuries occur when tired; build endurance, stop before exhaustion
3. 3.Eccentric strength matters - Train the way you ski (absorbing forces)
4. 4.Prevention takes time - Start 12+ weeks before ski season
5. 5.Helmets work - 60% reduction in severe head injuries

References

• •Flørenes TW, Bere T, Nordsletten L, et al. (2009). Injuries among male and female World Cup alpine skiers. Br J Sports Med.
• •Hewett TE, Myer GD, Ford KR, et al. (2006). Anterior cruciate ligament injuries in female athletes. Am J Sports Med.
• •Petersen W, Braun C, Bock W, et al. (2005). A controlled prospective case control study of a prevention training program in female team handball players. Knee Surg Sports Traumatol Arthrosc.
• •Raschner C, Platzer HP, Patterson C, et al. (2012). The relationship between ACL injuries and physical fitness in young competitive ski racers. Br J Sports Med.