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Ask a Doctor is a series of physician-authored columns offering insights and advice on common health topics. It is not a substitute for seeking medical care.
On winter weekends, the emergency department often fills with injuries. A skier with an injured knee after her first outing of the season. A child brought in after hitting his head while sledding. A teenager hurt in a terrain park after one jump too many. These are not rare or unpredictable events. They are patterns emergency physicians such as myself see year after year.
As a recreational skier and a mom of two active kids, I understand how easily these accidents happen. There is a temptation to overestimate what your body can handle, to push through fatigue or take one last run.
Winter sports are excellent for physical and mental health – and most people participate in them without incident – but they also combine speed, cold, fatigue and variable surfaces in a way that makes injury risk remarkably predictable. Many injuries are not the result of bad luck, but of common and preventable choices.
With the Winter Olympics under way, we are watching elite athletes perform feats that look effortless. What we do not see are the years of conditioning, skill progression and risk management. For recreational athletes, the gap between what appears easy and what the body is prepared for is where I often see injuries happen.
Here are some common injuries from winter sports, and how to avoid them.
Different winter sports carry different risks – but snowmobiling stands apart
One of the most popular winter sports, downhill skiing, commonly results in knee injuries, particularly anterior cruciate ligament (ACL) tears. These often happen when fatigue or icy conditions reduce control.
Cross-country skiing is also associated with knee and ankle injuries, as well as falls on uneven or icy terrain, especially when fatigue sets in.
Snowboarding carries a higher risk of wrist and head injuries, especially without protective gear.
Terrain parks deserve special mention. They inspire speed, height and repetition, often with peer pressure to attempt tricks beyond one’s skill level. The injuries they produce are often the result of higher energy impact, including spinal and internal injuries.
Accidents happen – but these five rules will help keep you out of the ER
As for ice sports, recreational hockey and shinny contribute to shoulder injuries, concussions and groin strains. Ice skating, particularly outdoors, is a frequent source of head injuries caused by backward falls, uneven ice and poor lighting.
Sledding, often dismissed as low risk, can result in serious head and internal injuries when high speeds, hard-packed snow or fixed obstacles are involved.
Snowmobiling stands apart. High speeds and limited protective equipment contribute to a disproportionate number of severe traumatic injuries; substance use is also often a factor. If there is one winter activity most likely to land someone in the emergency department with serious injuries, it is snowmobiling.
Warm up before you head out – and don’t overdo it
The timing of winter sport injuries typically follows a consistent pattern. Many occur early in the season or on the first day back at an activity, when enthusiasm outpaces conditioning. Winter sports are athletic activities, not casual recreation. They require strength, balance, co-ordination and cardiovascular fitness.
Warm-ups allow the body’s muscles and reflexes to engage progressively, helping to raise muscle temperature and activate neuromuscular pathways that prepare the body for movement. Several studies have shown that structured warm-ups are associated with reduced injury risk.
With winter sports, they may be even more important. Studies have found that in cold conditions, muscles and tissues are stiffer at baseline, suggesting a proper warm-up is key.
Fatigue is another major driver of injury, so listen to your body’s signals and know when to call it a day. Warning signs include slower reactions, numbness from cold, worsening vision or moving faster than you can comfortably control. Serious injuries often occur late in the day, on what was meant to be the final run or push.
Wear protective gear, monitor the weather and skip the bar
A well-fitted and sport-specific helmet should be considered non-negotiable for skiing, snowboarding, skating and sledding. Helmets reduce the risk of serious head injury in skiing and snowboarding, without increasing the risk of neck injury.
Wrist guards for snowboarding can also be helpful. Spine-protector vests can lessen the severity of injury in terrain parks. And goggles that improve visibility can reduce collision risk, particularly in flat light or snowfall.
Even with you’re wearing the right gear, weather conditions can affect risk. Cold temperatures do more than make winter sports uncomfortable; they limit dexterity and muscle responsiveness, increasing the chance of falls. Wind chill increases frostbite risk, particularly on exposed skin. And poor visibility in snow, fog or flat light can lead to collisions and make terrain harder to judge.
Children are particularly vulnerable, as they may not recognize early signs of injury or muscle fatigue. It’s important to pay attention to weather conditions, take frequent breaks and wear or pack adequate layers.
Finally, skip the chalet bar. Many injuries happen after alcohol consumption. Alcohol impairs judgment and reaction time, even in small amounts. Combined with speed, cold and fatigue, it significantly increases injury risk. Alcohol can also increase the risk of hypothermia.
Injury prevention is not about fear or restriction. It is about respecting the sport, the environment and your body’s limits.
Shazma Mithani is an emergency physician working with adult and pediatric patients in Edmonton. Dr. Mithani is actively involved with the Canadian Medical Association, Alberta Medical Association and Sexual Assault Centre of Edmonton. She is also co-host of The Doc Talk Podcast.