Torn cruciate ligament: when can I start skiing again? Science explains how to get back on the slopes safely

Attention should also be paid to the persistence of deficits in muscle strength, power and coordination. In some studies, the ability to generate explosive strength during a jump was still reduced five years after the procedure.

And having two legs that appear symmetrical does not mean you have fully recovered: even the uninjured leg may have lost strength during the period of inactivity. For this reason, the authors recommend assessing not only the differences between the two limbs, but also overall strength, comparing it, where possible, with pre-injury levels.

One piece of advice that also applies to amateur skiers, therefore, is that before returning to the slopes, it is important to undergo a specialist assessment to evaluate the strength of the quadriceps and hamstrings, balance, the ability to brake and control movements, and the response to sudden stresses.

Another key player in rehabilitation is the brain. Following a cruciate ligament injury, changes can occur in the neural mechanisms involved in controlling movement.

And a ski slope is not a gym: you have to contend with patches of ice, drifts of snow and changes in gradient, whilst avoiding other skiers. The brain has to process information quickly whilst the legs carry out complex movements. That is why experts suggest including cognitive exercises in rehabilitation, such as reacting to unexpected stimuli whilst maintaining control of the body.

And then there’s the matter of fear. After an accident – especially a serious one – it’s normal to be terrified of falling again. There’s no point in trying to convince yourself that you can take risks at all costs; it’s better to gradually regain your confidence through proper preparation.

A return to skiing should always be gradual. The protocol proposed by the study’s authors involves starting with controlled exercises on snow, on prepared and predictable terrain, and then gradually increasing the difficulty, speed and complexity of the movements.

Put simply, for those who ski purely for fun, this means not tackling a black run or very long descents on the first day of your skiing holiday. It’s best to start on easy slopes, at moderate speeds and in short sessions, interspersed with breaks. If your knee copes well with the strain and you maintain adequate control, over the following days you can consider gradually increasing the intensity and difficulty.

It is also important to monitor how you feel in the hours following your first runs: if you experience pain, swelling, stiffness or a feeling of instability, you should not just grit your teeth and carry on, but reassess the situation.

The call for caution is also supported by the figures. In the studies on competitive skiers reviewed in this review, the incidence of a second cruciate ligament injury ranged from 19 to 47 per cent amongst competitive skiers.

And a new injury may not always affect the knee that has already undergone surgery, but could also affect the opposite one. This is yet another reason to focus on preparing both legs and not to stop your muscle-strengthening exercises once you’ve returned to skiing.

Not all anterior cruciate ligament injuries require surgery. The decision depends on a number of factors, such as the stability of the knee, any associated injuries, sporting requirements and individual characteristics.

But even in this case, an individualised orthopaedic assessment is required before returning to the slopes. A knee that gives way or fails to provide adequate control during turns is a problem in a sport such as alpine skiing.

In short, returning to skiing after an injury is not determined by the calendar, nor by friends who insist on going to the slopes, nor by the fact that you can walk without pain. Only a specialist can give the go-ahead, after confirming, through appropriate tests, that you have fully recovered. The aim is not simply to manage that first run after the injury, but to be able to enjoy many more in the seasons to come.