Either Falls Or Pre-Existing Conditions Can Cause Problems.
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Cross country (XC) skiing is a sport with a very low incidence of injuries for a number of reasons.
It’s a low impact sport with low sliding speed, plus the free heel allows twisting if you fall. The ski boot is connected to the ski binding only at the toe, and the heel is free.
On the other hand, there may be some injuries during the ski season by falls or by aggravating pre-existing conditions. Like the Maytag repairman, ski patrollers at XC ski areas are not the busiest employees because they do not have to address many serious skier injuries.
According to Sophia Sauter, a registered physiotherapist, about 75 percent of injuries sustained by XC skiers are the result of overuse due to the repetitive nature of skiing, while the remaining 25 percent are the result of trauma. Here are some common injuries and appropriate treatment.
Traumatic XC ski injuries (25 percent), for example, include ankle sprains, thumb sprains, knee ligament sprains, groin muscle strains, and wrist sprains. Upper body injuries are often the result of falling down. Since XC skiing speeds tend to be somewhat slow, the impacts are often less severe than impacts at much higher speeds. The recommended treatment for the traumatic injuries is RICE: Rest, Ice, Compression, Elevation. Then, slowly restore range of motion, strength, proprioception (such as the ability to drive using brake, accelerator, and steering wheel without looking at your arms and legs), and power. It’s suggested to see a physiotherapist to obtain a proper diagnosis and set of rehabilitative exercises.
Overuse injuries (75 percent) from XC skiing, could include knee pain, compartment syndrome on shins, Achilles tendon problems, rotator cuff and shoulder problems, and low back pain. The recommended treatment for these problems is a bit different. In these cases it’s important to correct muscle imbalance (e.g. tight/weak), equipment faults, and possible training errors. Seek medical advice from a physiotherapist or other qualified health professional specializing in injuries common to XC skiers.
Most people skip the warm up or preparing for recreational activity altogether, but the best way to avoid injury is prevention. This means using appropriate training progressions, maintaining physical strength, balance, flexibility, adopting appropriate recovery techniques, and treating any lingering individual alignment problems, weaknesses, and imbalances. It makes sense to warm up before hitting the trails.
Physiotherapist Sophia Sauter suggests a full body analysis with a professional to identify individual mechanical inadequacies. Also consider a specific core stability and functional strength program for athletes. Popular core-strengthening strategies might include yoga, Pilates, and a regular fitness regimen.
Think about getting in shape staying, warming up, and dealing with your injuries before going out on the trails and you can continue to have a great season.

What a useful article! I’ve seen so few XC injuries that I hadn’t thought this out.