Silver Star opening week: the 3 most common early-season injuries

Opening week at Silver Star is the best week of the year and the worst week for your body. Everyone has been waiting since April, the forecast finally cooperates, and the parking lot fills with people whose legs have not done anything remotely like skiing in seven months.

Opening week has a pattern, and it is not a coincidence. The same handful of injuries dominates the first days of a season, for reasons that are fairly easy to explain.

I wrote a longer guide to the full range of ski and snowboard injuries we see through the season. This one is narrower. These are the three that show up in the first week.

Why opening week is different

Three things stack up at once.

• Your legs are not ready. Whatever you did over the summer, it was not holding a flexed, loaded position down a fall line for four minutes at a time. Quads fatigue early, and a fatigued quad is slower to protect the knee.
• The snow is firm and thin. Early season usually means a mix of man-made and a modest natural base. Firm snow is fast, catches edges more abruptly, and is less forgiving on a fall. Thin coverage means more contact with what is under it.
• You are rusty and you do not feel rusty. The gap between what your technique remembers and what your body can currently deliver is at its widest on day one, and the enthusiasm is also at its peak. That combination is where most opening-week falls come from.

1. The early-season knee

Top of the list, and it is most often the medial collateral ligament. An edge catches on firm snow, the ski goes one way, the lower leg twists outward, and the inside of the knee takes the load. Tired quads make it worse, which is why so many of these happen in the last hour rather than the first.

The tell is pain along the inside of the knee, often with swelling that shows up over the next day rather than immediately, and a knee that feels unreliable on stairs.

Come in if the pain is persisting past a couple of days, there is swelling, or the knee feels unstable. Most mild MCL sprains do well with a few weeks of focused work, exercise rehab and Active Release Technique for the tissue around the joint.

Go to emergency if the knee locks and will not straighten, there is obvious deformity, or you cannot put any weight on it at all. Same if you heard a pop and the knee gave way underneath you.

2. Wrists and shoulders from the hand-first fall

This one is mostly snowboarders, and the early season is when it is most common. You fall backward or forward, the hand goes out, and the whole body weight arrives through a straight arm.

Wrists take a sprain or a fracture. The scaphoid, a small bone on the thumb side, is the one that gets broken and missed, because it can feel like an ordinary sprain for weeks while it quietly fails to heal. Shoulders either separate at the joint between the collarbone and the shoulder blade, or dislocate outright if the arm gets levered.

Come in if wrist or shoulder pain and restricted movement are not settling after a few days.

Go to emergency if there is deformity, swelling that arrives within minutes, numbness or cold fingers, or you have any reason to suspect a fracture. Scaphoid pain specifically, in the hollow at the base of the thumb, is worth imaging early rather than late.

3. The neck and upper back from the fall you ignored

The one people do not book for, and the one I most want them to book for.

Somebody catches an edge at low speed, lands on their back or their side, gets up, brushes it off, and finishes the day. Nothing dramatic happened. By Tuesday the neck will not turn properly, the upper back is locked, and a headache has arrived that was not there on the hill.

This is normal and it is not a sign the injury was worse than it looked. Soft-tissue inflammation peaks somewhere in the 24 to 72 hours after the event, and the stiffness that follows lags behind that again. The delay is the pattern, not the exception.

Come in if you fell at all, even a nothing fall, and your neck or back is talking to you a few days later. Earlier care is usually shorter care.

Go to emergency immediately if there was a head impact followed by loss of consciousness, repeated vomiting, a headache that keeps worsening, weakness or numbness in the limbs, slurred speech, or real confusion. If a head impact is in the picture at all, watch for the full concussion symptom list over the following 72 hours.

What actually prevents most of this

Not much of it is complicated, and none of it is new.

• Give your legs three or four weeks of something before opening day. Squats, step-downs, anything that loads a bent knee repeatedly. It is the single highest-return thing on this list.
• Treat the first day as a calibration day. Ski the groomers, finish early, and leave the trees for the second week.
• Stop when the legs go, not two runs after. The last run of the day, on legs that are already done, is where a lot of early-season knees happen.
• Wrist guards for snowboarders. Unglamorous, very effective.

Booking

If you picked something up in the first week, book online or give us a call. We would much rather see an early-season tweak in week one than the chronic version of it in February.

Full guide to the rest of the season: Silver Star injuries, what we see and when to come in.