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Dr Jean-Marc Parisaux is a doctor of sports medicine and traumatology with expertise in manual medicine, osteopathy and rehabilitation. He is a specialist at the prestigious Monaco-based sports medicine center, IM2S, which helps world-class athletes and ordinary folk with their goals towards attaining optimal physical performance. Send your health and fitness questions to: askthedoc @

Too young to ski?

Dear Dr Parisaux,

I'll soon have my nephews for the winter school holidays. Since the ski hill is very close, I plan to take them for their first time on the slopes. They are four and six years old. My sister thinks they are too young for winter sports and is afraid they will get seriously injured. I disagree and think this is the best time to get them started before they pick up bad posture habits as teenagers. Which one of us is right?

- Lea

Dear Lea,

I think you are right to a certain extent. Your nephews are not too young for the sport. A child can begin skiing from as early as three years of age. One can put a child of that age in skis but you should be wary of actually taking the infant on the slopes too soon. Such a young child should remain in the ski resort's kindergarten.

Skiing and the first notions of balance should be acquired in the form of play. Taking a little one on the slopes, where he is likely to be cold and is unlikely to have fun, would be a disheartening experience for him. But after a three-year-old discovers the joy of skiing in the kindergarten, he can go on the slopes from as early as age four. It's not so much the age, but the child's readiness after his introduction to the sport in the kindergarten.

Two other ideas are important: all of this must be done under the supervision of a trained ski instructor, and the child needs to be wearing protective headgear.

Skiing with a bad knee

Dear Dr Parisaux,

My new girlfriend and her buddies are all skiers and I plan to join them this year. I had an ACL problem a few years ago and I don't know if skiing is safe. Do you think I should have surgery before?


Dear Chad,

Many people experience injury to the anterior cruciate ligament (or ACL), one of the most important ligaments of the knee. Not all ACL ruptures need reconstruction. Many people continue sports activities without the ACL and have no problems.

The main risk with an ACL deficient knee is that it may make you unstable on your feet, and in this case you'll have to get surgery. With a good clinical examination, your doctor will know if your knee will be able to support your skiing session or if the risk of instability is high. Moreover, your doctor can order you a good orthesis (orthopedic brace) for an ACL deficient knee if you want to be safer (but bear in mind that the best orthesis is good muscle strength). I would advise you to have an isokinetic evaluation before joining any ski party. This strength evaluation will allow you doctor to appreciate whether there is muscle deficiency requiring preventative reinforcement.

So to summarize: you can go skiing safely if your knee is usually stable, the strength of your muscle is good and your clinical examination is reassuring...but there is always a risk, even with your other knee!

Piling on the pounds for winter

Dear Dr Parisaux,

Is it true or is it just an old wives' tale that you need to eat more meat and potatoes during winter? I am on the tiny side (five feet, four inches and weighing 105 pounds) and my neighbours (who are all, shall we say, on the plump side) tell me I need to pack on more fat, especially for the winter. They warn me that if I fall ill, I'll be in big trouble. I don't mind putting on weight. Moreover I plan to go skiing and they tell me it is dangerous if I don't improve my reserves!

- Darlene

Dear Darlene,

The notion that you need to gain weight to make it through the winter is a fallacy and you should forget this idea. However, it is true that your energy needs are greater in winter than in the warmer seasons because of the cold and the activities you are likely to participate in (ski vacations for example). Proper nutrition is important when practising winter sports to ensure hydration and the optimal recharging of the muscular glycogen reserves. Eating right will enable you to fight against the cold and to avoid becoming too easily fatigued (which may make you more prone to falls and injuries). So, put aside your neighbours' advice and just know that a balanced diet will allow you to remain in shape and in good health.


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