Conventional wisdom says that when you have a broken leg and partially torn knee ligament, you’re going to be laid up for a while. But Italian ski racer Sofia Goggia doesn’t have time for conventional wisdom.
Goggia, the 2018 Olympic downhill champion and current World Cup leader in the discipline, crashed in the Cortina d’Ampezzo World Cup super-G on Jan. 23—one day after winning yet another World Cup downhill and just 12 days before the opening ceremonies of the Beijing Games.
In the crash, Goggia’s inside ski appeared to hook up on its inside edge during a left-footed turn, causing Goggia to do the splits before being tossed on her back and sliding into the gate below. While she skied down from the crash on her own two feet, Goggia was medically evaluated after the race and her team reported that she had sustained a “minor fracture” of the fibula bone in her leg plus a partially torn ligament in her left knee.
Watch: Sofia Goggia crashes in Jan. 23 Cortina super-G
But not to worry—Goggia told her fans and the world that she would be starting rehab that very same day in order to be in Beijing in time to defend her Olympic downhill title on Feb. 15. She would have to skip the women’s Olympic giant slalom and super-G that were part of her original 2022 Olympic plan—and pass her honor of being Italy’s flag bearer on to another worthy compatriot to give herself more time to recover before flying to China—but she vowed to give the Beijing Olympic downhill her best shot.
How is it possible, one might wonder, to recover from a broken leg bone and knee ligament damage and return to downhill racing—the most dangerous, physically taxing discipline—in a mere two weeks? To answer that, we turned to Dr. Matt Hastings, an expert in the PT and sports medicine field. While he’s not a member of Goggia’s medical team and doesn’t have insight into the full extent of the injuries she sustained, we asked him to weigh in on what we do know.
SKI: What details do we know about Goggia’s injuries?
Dr. Matt: I don’t have any first-hand knowledge of Goggia’s injuries so I’m just going off of what her team and the media have reported. After the crash, it was reported that Goggia partially tore a cruciate ligament and suffered a “minor fracture” of the fibula bone in her leg, plus some tendon damage. But it’s telling that she was able to stand and walk away from the crash on her own.
SKI: Knee ligament tears most commonly mean ACL tears for skiers. Can we assume that Goggia partially tore her ACL in the crash?
Dr. Matt: There are a few ligaments and tendons around the knee that she could have injured in that crash, and it’s hard to tell which “cruciate ligament” and tendons her team was referring to. It could be that she partially tore her anterior cruciate ligament (ACL) or her posterior cruciate ligament (PCL). Both ligaments—along with the MCL and LCL—serve as static stabilizers for the knee by providing stability to the joint, preventing any abnormal motion outside of the knee’s designed function to flex and extend.
Related: ACL recovery timelines for skiers
SKI: What’s the difference between a fully torn ligament and a partial tear?
Dr. Matt: Ligament or tendon injuries are typically classified by three grades. Grade I is considered a mild tear and results in some stretching or tearing of the ligament fibers, which may cause mild pain, joint stiffness, and, potentially, bruising. These are hard to detect with any manual or field testing and usually are identified with imaging studies (MRI). Most Grade I tears have minimal functional implications.
Grade II is considered a more moderate tear or partial tear with a larger percentage of tearing and separation of ligament fibers occurring. These injuries present with more moderate pain and joint stiffness as well as instability and swelling. Grade II tears can sometimes be detected during field or manual testing. People who suffer a Grade II tear are at greater risk of reinjuring the ligament if it’s not properly treated.
Grade III is considered a complete or totally torn ligament. These injuries can have severe pain, swelling, bruising, and abnormal joint motion associated with them. They are more easily detectable during field or manual testing and may require surgical intervention.
SKI: Sounds like Goggia may have suffered a Grade II tear. What about her “minor fracture” of the fibula—how do you treat an injury like that?
Dr. Matt: The fibula is the long skinny bone on the outside of your lower leg next to your tibia. A “minor fracture” is mostly a downplay on the wording of the injury and not a medical term used. But it generally suggests a tiny hairline crack in the bone which may not require surgical intervention.
Generally, if the fracture is stable and in the correct place, you would treat it by immobilizing the area to allow your body to heal or regenerate the boney structure. Complete bone healing in a healthy individual can take upwards of 6-8 weeks before the rebuilding process can occur.
Once sufficient healing is noted on imaging studies like X-Rays, you would start addressing any of the negative effects that immobilization can have. This may involve rebuilding strength, mobility, and correcting for any movement dysfunction.
SKI: Goggia doesn’t have 6-8 weeks to let her fibula heal. In fact, she reportedly started PT in a pool a day after her crash and has now already returned to skiing.
Dr. Matt: Pool therapy, also known as aquatic therapy, is a great way to rehab an orthopedic injury. The water can allow someone to be partially weight-bearing in a pool environment while offloading the joint due to the buoyancy. You can also use the resistance or drag force of water to provide a way to challenge your muscles and rebuild strength and stability in a safe environment.
And rebuilding strength will have been Goggia’s top priority after her injury if she hopes to be strong enough to tackle the Beijing downhill. After managing pain, swelling, and making sure her fracture is stable and healing, building strength and stability around that left knee as well as in the quads, hamstrings, glutes, and core will be crucial to making sure she can handle the high-level demands of a downhill racecourse.
It’s not unheard of for an athlete to compete with injuries. Slalom skier Paula Moltzan has been racing with a fractured wrist for the majority of this season. But it is risky. While Goggia is back on snow and already training in China with the intention of starting in the women’s downhill on Feb. 15, she and her team will have to decide after the official training runs leading up to the race whether or not she is fit enough to defend her Olympic downhill gold.
Dr. Matt Hastings, PT, DPT is an orthopedic and sports physical therapist at The Alpine Athlete who specializes in treating a variety of alpine sports injuries and orthopedic conditions. When he’s not helping others get back to the activities they love, you’ll find him pushing himself on his skis or bike around his home in Denver, Colo.