 Poster: A snowHead
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Just back from a week in Italy, 10 months after tibial plateau repair...did loads of re-hab and fitness work, however, knee swollen and tender, even though i took it easy when skiing and did plenty of re-hab on knee while there.
I'm now pretty sure i did not do enough muscle work...I went to the Chill factor quite a few times, with no problems, but as soon as you get on the piste it changes altogether !! (somebody else did mention this !!)
so if your going skiing after knee ops make sure the muscles are really upto it. as all the little bumps take their toll on the joint.
by the way, for the swelling i've been using apple cider vinegar..and arnica gel,, results fantastic
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| yorkshirelad wrote: |
by the way, for the swelling i've been using apple cider vinegar..and arnica gel,, results fantastic |
Rubbing custard into a swollen knee is good, followed by jelly and finish of with sponge fingers soaked in sherry.
Then throw the whole lot in a bowl, top off with cream and sprinkle on hundreds and thousands! 
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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| Quote: |
I'm now pretty sure i did not do enough muscle work.
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my knee was swollen after some hard work on the off piste course last week - partly because I spent far too much time letting the snow throw me back on my heels. But my quad muscles were completely unaffected - not even a tiny bit stiff. I'll be interested to see what comments you get because I don't think that any more "muscle work" would have stopped my knee swelling (though consistently better ski technique certainly would have).
I've been using ibuprofen and, this morning, got a steroid injection as I need a quick fix for skiing on the Birthday Bash next week. The doc also drew off 3cc of fluid so range of movement already a lot better. I've also been taking gin and tonic, internally and in moderation.
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I'm 10 years post-ACL reconstruction and my knee gets a little swollen after skiing. a bit of Ibuprofen and a few days sorts it out - it's just one of those things
by all means work on your strength but make sure you maintain or improve your flexibility too - tight muscles can increase pressure in the knee joint
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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yorkshirelad,
You may be sick and tired of hearing this advice but it is none-the-less still valid: spend 10 mins in your room sitting on the bed with some sort of compression on the knee and and ice-pack.
I'm led to believe that a lot of pro sports men/women of many disciplines sit in ice baths for 20mins after competing to aid muscle recovery as well 
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The doctor I saw this morning examined both knees and flexed the "good" leg (heel to bum) and said "Vous etes souple", which pleased me (and maybe he didn't add under his breath "for an old lady"). Don't forget the hip flexors - need to keep them stretched, not just quads and calf muscles.
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yorkshirelad, sorry to hear your knee is swollen. Even after a hard week in Val d'Isere in December where I skied and partied too hard..to the extent that I could barely walk at the end...didn't result in swelling. I did have a little sweling at the end of the week in Flachau the other week, but, as Arno says, after a bit of ibuprofen it went down in a couple of days and my strength is back to what is was before I went. I'm finding it 2 steps forward and 1 step back, but overall that means forward. I'm still doing weekly physio and gym 3-4 times a week ( now in the 7th month of rehab) and while my muscles have improved my right leg is still significantly weaker than the left.
I know you originally asked the question about a brace; I am using one because of the MCL issue, which I don't think you have. You could conisder a ski-mojo to take the pressure off your knee. Do you have any more trips planned?
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holidayloverxx, was it the skiing or the parties which left you legless? 
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pam w, seeing as I already do the pam recommended calf stretch whilst cleaning my teeth, what do you recommend for hip flexors??
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pam w, if I'm honest..it was the parties
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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holidayloverxx, well nobody can say you'd not earned that holiday!!
kitenski, there are loads of hip flexor stretches on the internet - some a bit whacky, as ever. I just do the usual kneeling lunge sort of stretch - my hip flexors suffered a lot when I spent weeks sitting around after my accident last year.
Another good hip thing, which I do every morning before getting out of bed, is lying on your back with your knees up, feet and knees a bit more than hip distance apart and dropping knees to either side alternatively. At your age they should easily go right down (ie both knees on the mattress), with no effort but sometimes older people struggle, one side more than the other if they have hip problems. Flip from side to side, keeping very relaxed, as many times as you can be bothered. You need to take the hip joints through their whole range of movement - and extend it gradually, if it's limited. Then do it feet and knees together. Then get up and make a cup of tea. That exercise was impressed on us as very important by a guy we did a stretch workshop with in London, years ago.
http://www.suppleworx.co.uk/htdocs/home.htm This guy, though his website has a very out of date look about it and he might not be practicing any more.
As you get older I do think flexibility is more important than strength. Great if you have both, of course.
Oh - I do hamstrings with the toothbrush too......
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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pam w, Martin is still going strong. I had an email announcing that he'd appointed a PR guru (!) so an update of the website might be on the way.
Did a stretch workshop with him last year which was very good
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| Quote: |
Martin is still going strong
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Arno, that's good news. He told my old man that he'd seen worse hips, and he'd seen worse shoulders, but he'd seldom seen a worse combination. He told him to do that knee swinging exercise as often as possible. We'd have seen him more often if it wasn't such a trek up to London.
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You know it makes sense.
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holidayloverxx, have decided not to go again this year, as the concentration i had to do on each turn spoiled it a bit for me, i'm not used to putting in too many turns. but glad i did go...would hated to have missed skiing...
anyway, the problem seemed to stem from the muscles not supporting the joint i think, as the ski excersizes were no problem, but when my knee was being constantly jiggled the inflamation grew more, there was a small twinging pain sometimes as well 
next year i may look at the mojo , but by then i'm hoping the knee will be far better than now.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Mollerski, TROLL and (_*_)
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Poster: A snowHead
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yorkshirelad, where are you getting the twinging pain? Because of the brace, even with the MCL issues I had no pain while actually skiing. I wonder if you do have some residual damage?
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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holidayloverxx, the twinging pain was just behind the bottom of the knee cap, where the tendons join the Tibia
not in the area the surgeon repaired.. it was not all the time though, best way to describe it is that it feels like the joint is bruised.........each day the swelling got worse until i had to miss friday..then back to it saturday but only till 2pm.
there was no need for a brace as there was no ligement damage, and i passed all the ski excersize tests
the swelling has nearly gone now, but trying to walk down a hill still causes discomfort. Once the swelling has gone i'm off to see the physio. 
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Rocker skis did not help me by the way !!!
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yorkshirelad, same here - no pain in the actual break site but a bit where you describe, as well as the MCL. The physio will see you sorted, I'm sure.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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10 months after a tibial plateau fracture is early to start skiing again. Just to have made it on to the slopes after that length of time is good going. It took me 9 months and I was not at full strength and didn't ski that aggressively all season. The season after was when I first felt I could begin to push myself. I skied 80 days that season and made really good progress.
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hyperkub, I know your right...and i did try to take it easy..honest  I only went because we had booked the holiday in the January before and it also gave me something to aim for. The friends i skied with were well impressed and stayed with me, so i mainly skiied with wife, i stopped for rests at cafes while they did some fast runs.. i thought i had put in plenty of training effort but looks like i did'nt although i was cleared by surgeon and Physio..squat jumps, side jumps etc etc. and doing 2 hours a week at the chill factor is different from going down 4K a red 
one thing i did note though, i had trouble clicking into my bindings, it seemed the muscles for that had gone between chill factor and italy
However, wife did point out that although on day one i only did 7 runs i got carried away on day two and three...not going fast but just doing too long..
day four was when we had some bad light after lunch which made it harder to ski and i ended up putting a lot of stress on the joint in a bid to get back to the hotel before the weather got worse...I caught the lift down rather than ski to base
will be ready for next season though..
I did'nt ski on the friday due to swelling !!!, as of today the knee is nearly back to how it was pre skiing, so i'll be starting my physio again. have appointment with physio on Tuesday, so we'll see what his verdict is.
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yorkshirelad, after a 4 days complete rest from skiing, the steroid injection, prescribed anti-inflammatory patches and lots of ice, my knee swelling has pretty well disappeared.
Apart from the fact that I was doing some off-piste lessons in L2A, and did the long and hard (for me) descent in La Grave, I suspect a major contributor to my knee problem was simply not skiing well, particularly when visibility and/or snow conditions weren't easy.
I am fairly confident that if I were skiing better, and not letting my weight drop back so often, my knee would be a lot less affected, though I would expect some swelling towards the end of a week's holiday. I have taken away a lot of good advice and good drills, to improve my skiing.
You did a lot of rehab/training - I'm sure there are plenty of people skiing around the mountains whose muscles are not in anything like as good shape as yours, and strengthening them further might not make that much difference. Would it be worth looking at getting some really good quality private lessons to make sure that your technique is not putting unnecessary strain on your knee? As I mentioned earlier, despite my having been sitting back too much off piste my quad muscles, which are in reasonable shape, didn't complain much and I had no stiffness in them.
Perhaps if one's technique isn't really good, it's counter-productive to strengthen the muscles so much that they will hold you up without complaint, even in the back seat? Any degree of "back seat" skiing will, after all, put unacceptable strain on dodgy knees, however clever your muscles.
Apologies if you are a really good skier with excellent posture - but for me, I think this (not using strong muscles to compensate for poor technique) is quite an important thing to think about, and work on.
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| Quote: |
the bad days make you wonder when it will ever get back to normal....
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holidayloverxx, it's a long hard slog after the severe injuries that you and yorkshire lad suffered, obviously. My problem is much less severe - a neglected ligament injury years ago has given rise to some arthritis. But the way my skiing goes to pot when conditions are bad definitely doesn't help - my knee was extremely swollen and the doctor I saw here warned me not to ski again until the swelling had completely gone. I was left in no doubt by easiski (Charlotte) what I need to do!
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pam w, I skied with an instructor all the time last week...it was a suggestion to go onto rockers and ski differently to how i normally do in a bid to help, but i struggled at low speeds on the rockers and was unable to do high speed due to the vibration through my knee and its weakness.
It was very evident that my muscles were not strong enough once i started day two,(putting ski on !!) but i have a year to sort myself out now, still might end up with Mojo
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| pam w wrote: |
You did a lot of rehab/training - I'm sure there are plenty of people skiing around the mountains whose muscles are not in anything like as good shape as yours, and strengthening them further might not make that much difference. Would it be worth looking at getting some really good quality private lessons to make sure that your technique is not putting unnecessary strain on your knee? As I mentioned earlier, despite my having been sitting back too much off piste my quad muscles, which are in reasonable shape, didn't complain much and I had no stiffness in them.
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I completely disagree with the comment that 'strengthening might not make that much difference'. The muscle wastage from a TPF is extreme and takes a very long time to get back - my surgeon told me that it would be 18 months from the date of injury until I plateaued. I'm young, do a LOT of exercise and strength training and, nine months post injury, don't believe I'm anywhere near strong enough to ski hard for extended periods of time. Getting the muscles to fire again, particularly the VMO, is seemingly very difficult after a TPF and I reckon YorkshireLad definitely needs to do more strengthening and that it will be very helpful with his skiing.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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I completely disagree with the comment that 'strengthening might not make that much difference'.
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I probably didn't explain very well what I meant - sorry. yorkshirelad had been given the go-ahead by his medical advisers, presumably because the muscles did seem to be working pretty well. But don't you think there could be a point where very strong quad muscles, precisely because they don't complain when you ski in the back seat, could allow you to put more strain than is wise on a weakened knee? When I did a ski course with Rick Schnellmann, some years ago, we did some "fore and aft" exercises where we skied two turns forward, two centred, two aft (and repeat). He specifically advised me to go very easy on the "aft" turns - because of the danger to my knees. My point was that if strong quads enabled you to spend longer in the "aft" position without those muscles complaining, it might not be good for your knees. Don't you think that's right?
Clearly, other things (like technique) being equal, it makes little sense to suggest that strength doesn't matter. Of course it matters, but I'm suggesting that good technique is at least as important. Certainly seems that way to me - my quads, last week, didn't complain, despite my spending far too long skiing in the back seat, especially off piste, to the extent that my knee became seriously swollen.
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pam w, I don't believe he's got to the stage of having strong, well balanced quads & VMOs, because it would be very difficult to have this at only 10 months post-TPF. I'm not saying that technique won't make a difference, rather that its a bit silly to think that, at this stage of a recovery, further strength training would not help.
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You know it makes sense.
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pam w, relating this to myself, for example, I have done a lot of re-hab and strength training since my TPF last April. However, my muscles can still only cope with a certain load for certain periods of time. I cycle, mainly, but whilst I can manage 1-2 hours of hard effort, 4-5 hours leaves my knee swollen. This is because the muscles still aren't strong and conditioned enough to do that level of exercise, its nothing to do with technique etc. I just suspect Yorkshire Lad's muscles are reacting similarly to the skiing load.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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My TPF was almost two years ago, but the op to remove the tibial spine growth was only in November, so I'm going to be very weak skiing next week, I haven't been able to do nearly enough exercise to return to fitness, although my surgeon has told me I can go skiing as long as I wear an ACL brace.
I'm really glad that JohnQ suggested I wear it around the house to get used to it, because I've been struggling with what to wear underneath it. My usual long johns have a side seam that was rubbing horribly under the knee pads of the brace, which I reckon would have actually broken the skin after a bit of skiing, and the tube type stocking that came with the brace is too thick and the pressure was too much. I've tried a few different things, and eventually found a pair of reasonably warm thick footless tights that work perfectly. I'm so pleased I've found all this out beforehand
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Poster: A snowHead
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pam w, sorry to hear that your knee didn't improve with rest, but you sound set up for next week, and I'm sure your G & T training will stand you in good stead. Enjoy
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| Batman_123 wrote: |
| pam w, I don't believe he's got to the stage of having strong, well balanced quads & VMOs, because it would be very difficult to have this at only 10 months post-TPF. I'm not saying that technique won't make a difference, rather that its a bit silly to think that, at this stage of a recovery, further strength training would not help. |
Totally agree with this. I will buy the champagne the day that I have strong, well balanced quads and a VMO that I can even see! I have a long time to save up.....
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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welshskier, thanks. it's far better now - I suspect the drawing off of fluid plus the injection of steroids had more to do with its recovery than the G & T.
However, I remain entirely convinced that it was poor technique, not weak muscles, which caused my problems.
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RachelQ, I am using a tubi grip bandage under my brace. I still got a bit of rubbing so put a folded tissue under it at the point where it rubbed, and it was fine therafter. I did buy the anti-migration sleeve, but the tubi grip stips it slipping.
I'd be a little wary of fototless tights as I think they will slip in action (similarly it never occured to me to put the brace over my long johns for the same reason - long johns go on top) - but you can keep an eye on that. I would suggest taking a tubi grip with you just in case.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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holidayloverxx, good advice, I'll take some tubi grip with me, thanks
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I cam imagine there is a risk to the knee if the various muscles around it are not balanced. Even when one muscle is contracting strongly the others are still working to stabilise the joint. After my TPF one problem I had was that my hamstrings were very weak. Building them up helped a lot. Basically the more strength the better, but it's important to make sure all the different muscle groups get strengthened. For that reason I have quite a mixed training programme.
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hyperkub, Agreed. My programme is very mixed. Hamstrings are improving but on the outer knee keeps tightening up.
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Having rested my knee for the week im now ready to restart my rehab.. So joined the gym and will be trying harder than before to get the knee as good as poss.
The joint feels ok, but the muscles are still tender ..so hopefully the light excersize will start doing me good
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You'll get to see more forums and be part of the best ski club on the net.
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yorkshirelad, Jolly good. Do you have a proper programme to follow? Off to the gym myslef in a minute - a busy week saw me go only twice last week and I can feel the need to get back today. I have 3 weeks till my Canada trip and need to be better than I am now...
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The better skier you are the easier time you will give your knee. Improving fitness will help as will improving technique. Maybe rather than not going again this year, find a Coach to work with and spend some time on easy slopes rebuilding your technique on some easy slopes. That way you get to ski (which will help with fitness) and stay safe.
Let me know if you need a recommendation.
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