Preventing knee and ankle injuries in figure skaters

By: Paul Messner, Registered physiotherapist

Patellofemoral Pain Syndrome + Jumpers Knee

Figure Skating is a repetitive jumping sport, figure skaters endure an incredible amount of stress on their knees, especially on their landing leg. Landing a triple requires you to support approximately 3 times your body weight on one leg and about 4 times your body weight for a quadruple jump. Attempting jumps, skaters will fall repetitively on a daily basis which puts a tremendous compression force on the patella.  Management involves addressing strength imbalances and flexibility impairments of the knee musculature so the athlete can effectively respond to the repetitive forces imposed on the knee. A hands-on approach is crucial to ensure smooth and pain free movement of the patella. A physiotherapist specializing in figure skating will observe a skater’s footwork, jumps, and spins to modify components putting stress on the knee. Athletes in sports such as competitive dance, gymnastics, and figure skating tend to “over train” predisposing them to overuse injuries. A key component of the physiotherapists role is to educate the athlete on the detriments of over-training.

Ankle Sprains

Ankle injuries are a very common in figure skating. The demands of the sport require the use of a high heeled rigid boot to provide enough support to land triple or quadruple jumps on one foot. Ironically, figure skaters tend to have weak Peroneal muscles to support the ankle as they over rely on the support provided by the boot. Ankles sprains commonly occur while practicing technical skills off ice. Ankle injuries persist as skaters continue to exacerbate the injury while training on ice. Management includes strengthening weak ankle muscles, restoring ankle proprioception, and optimizing joint mobility to prevent re-occurrence. A physiotherapist specializing in figure skating injuries will analyze and correct a skater’s take-off and landing technique to address faulty biomechanics which may cause an ankle injury.

 Shoulder Tendinopathy

 Male figure skaters in ice dance and pairs figure skating have a high prevalence of shoulder injuries due performing multiple overhead lifts and throws. Highly skilled lifters will carry their partner with only one hand. Supraspinatus tendinopathy and rotator cuff impingement syndromes are a common result. Years of lifting results in an increased muscle mass above the shoulder, but the muscles below the shoulder do not develop as much. This muscle imbalance alters shoulder movement. This results in repetitive impingement which damages the muscle tendon over time. With this knowledge, a physiotherapist would ensure all male pair skaters without shoulder injuries strengthen their muscles below the shoulder to prevent a future shoulder injury. The therapist will also analyze and correct the skaters lifting technique. If the skater is performing the lift primarily with the shoulder muscles, corrections will be made to ensure the primary lifting power initiates from the legs while correcting the biomechanics of the shoulder to decrease the level of strain.

Other Skating Specific Injuries that a physiotherapist can be helpful include:

“Lace bite” is an irritation of the tibialis anterior tendon due to constant pressure and friction from the tongue of the boot. Management includes modification of padding and lacing of the boot. Malleolar bursitis is caused by friction over the ankle bone. Treatment includes having the skate punched out to avoid friction in tender bony areas.

“Pump bumps” or Haglund’s deformities occur when the heel of the skate is not properly fitted, allow excess movement of the heel within the boot. This can be managed by applying a donut shape padding to the area. The emphasis on having properly fitted skates is crucial!

Achilles tendonitis is common due to compression of the tendon at the back of the boot. Modifications of the boot are made to the boot to decrease the irritation and prevent reoccurrence.

Stress fractures of the 1st and 2nd toes are commonly caused by “toe pick jumps” as the skater propels the toe end of the blade into the ice. Stress fractures occur in the 1st and 2nd metatarsals, tibia, fibula, and navicular bones. This can be prevented by ensuring proper “picking technique” while executing jumps.

A physiotherapist may refer an athlete with chronic foot conditions to an orthoptist who will provide a specialized orthosis to wear in their skate.

Injury Prevention

 The literature indicates that 50-78% of figure skating injuries are preventable. A multidisciplinary approach involving a physician, physiotherapist, athletic trainer or kinesiologist, nutritionist, chiropodist and sports psychologist together with the skater, coach, and parents are key component to be healthy and successful in sport.

Reference List:

  • Omey, M., Micheli, L., Gerbino, P., (2000). Idopathic Scoliosis and Spondylolysis in the Female Athlete
  • Porter, E., Young, C., Niedfeldt, M., Gottschlich, L., (2007). Sport-Specific Injuries and Medical Problems of Figure Skaters.


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