Dr. Collins: This contraption can be your ladder to success on the slopes

Ski season is in full swing, and with the variety of conditions out there we have to have the ability to quickly adapt as we move on the snow.

Separate strength and stamina exercises are important, but it is sometimes beneficial to combine those workouts.

One way to combine exercises that you can do at home or at the gym is to use an agility ladder.

An agility ladder is a rope ladder with wooden or PVC pipe "steps." The ladder lies on the floor in a straight or curved line and you walk, run or jump through the holes or from side to side.

This type of workout will improve your cardiovascular fitness, balance, timing and three-dimensional position perception, which will quickly make you a better skier.

The ladder looks simple, but using it can be difficult, at least in the beginning. What is impressive is how fast using it can bring your balance and your muscle power in alignment.

The main muscle groups involved in exercises with the ladder include the spine stabilizers, the hip flexors, the quadriceps and the ankle flexors. Using it is an active, balance-based exercise regimen, so you tend to bring along those smaller muscles that gym machines miss.

Before you move ahead on one of these programs, get the proper gear. If your gym shoes are worn out, do not expect them to protect you from the impact loads.

Next, it is an excellent idea to get a trainer to help you. Improper balance or positioning can quickly lead to problems, including foot and knee pain, especially around the kneecap.

Before you "jump into it," discuss with your trainer previous problems you may have had so you don't get hurt or cause pain and swelling in a joint.

Do not do too much at the beginning so you don't overstress your joints and muscles.

Start at one 5-10 minute program with the ladder twice a week. This will allow you to get your feet and other parts of your anatomy used to the impact.

After about three to four weeks, you can start lengthening the time and frequency of ladder exercises to two episodes of from 10 to 15 minutes three times a week. It is quite a workout. The good news is that most active skiers can rapidly move to this level.

As with many exercise regimens, having a partner to train with is a great way to keep it fun.

Aly Jacobs, a trainer at the YMCA, recommends what she calls the diagonal two-footed jump for alpine skiing. She has her folks jump from the outside of the ladder to the inside and then outside to the opposite side with a 45-degree angle at each side.

Jacobs says this exercise mimics uneven terrain, and that is what skiers have to master.

You can imagine the effort it takes, but in the process you learn balance, reaction and agility.

If you develop areas of pain doing ladder exercises, especially in the area of the tibia below the knee, make sure you give yourself adequate rest and recovery time.

Stress fractures from repetitive overloads can occur if you overdo it.

Your shoe condition could be as important as your body's condition, because in these exercises foot protection is important for balance. If you loose your balance, falling on an outstretched arm is a good way to get a broken wrist.

If you have a history of knee or hip arthritis, exercises can be modified to limit or reduce the impact loads, but still help with balance, strength and timing.

On those days when you cannot get up to the ski hill, you might consider this type of agility ladder training to make sure your body is ready to handle whatever nature throws at it.

Paul Collins, M.D., is an orthopedic surgeon specializing in sports medicine at Orthopedic Health Care in Boise. Collins is an avid participant in many of Idaho's outdoor activities. Send your sports medicine questions to outdoors@idahostatesman.com or to the Idaho Statesman, P.O. Box 40, Boise, ID 83707.