 Poster: A snowHead
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I took a fall this morning on a bumpy piste. Unfortunately it was a slow fall into the mountain, and so my skis didn't come off, but my legs twisted around. I felt one knee 'go' and wasn't able to put weight on it. Had to wait for the ski patrol to get me down.
I've had it up with ice on it for a few hours now. It's not particularly painful or swollen.It is restricted in movement though and hurts or freezes if I over-straighten it or try to bend it very far. I can put full weight on it when it is almost straight without pain.
Has anyone else had anything similar? Do you think I've done something which needs the attention of a doctor, or do I just need to ice and rest it.
Thanks
Last edited by Poster: A snowHead on Tue 12-02-13 15:44; edited 1 time in total
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Surprised you don't have swelling from what you have said but if you are Getty locking definitely see the doctor and tbh even if not always worth it.
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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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Go to Doctor he can send you to physio If surgery is not thought needed.
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You need to Login to know who's really who.
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As above, see a doctor, there's a lot of us who probably had similar happen, but everyone's different so impossible to give advice on what...if any..the damage might be.
Sorry to hear btw.
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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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Wot t'others said, sorry to hear.
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Ok, I'll get myself off to the doc in the morning.
Guess I was hoping for someone to say they had done the same and were skiing the next day, but it's not looking hopeful.
Thanks for the replies.
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Ok, I'll get myself off to the doc in the morning.
Guess I was hoping for someone to say they had done the same and were skiing the next day, but it's not looking hopeful.
Thanks for the replies.
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janeed, good luck.
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cran
cran
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Just put ice on it and drink lots of beer. Should be fine by Thursday... 
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| NickyJ wrote: |
| janeed, good luck. |
+1
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Did you get is looked at? I had a similar fall and turned out i had injured my ACL and slightly broken the bone below the knee.
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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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Hi again,
Thanks for the advice and good wishes.
Yes, I made it to the doctor yesterday. Nothing seriously wrong according to the Xrays thankfully. He diagnosed a medial ligament strain and told me to rest (no exercise for a month), ice and wear a brace which he prescribed me. He also said to get it checked again in 8 days (very specific) and suggested I'd need physio after this.
So, I'm certainly out of skiing for the holiday, and not running the half marathon I entered in 2 weeks. But hopefully no surgery needed.
On the positive side the sun is finally out, so I'm going to find a bar in town and take Cran's advice. If I can get down the steps.......
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janeed, Sounds very positive, good to hear.
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You know it makes sense.
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X-rays don't show up an ligament damage just bone damage. Did he perform the Lachman test? There are utube videos of it if you google it.
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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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I think he did this. He certainly pulled my leg around quite a bit, and pressed on various bits to see where the pain was. When he pulled in 3 directions it was fine, the 4th made me scream, which is why he diagnosed it was the medial ligament.
The pain and swelling is still mild, but definitely on the inside/left of the kneecap as I look down my right leg.
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Poster: A snowHead
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That's good, does sound promising, best of luck.
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cran
cran
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I ripped my calf muscle (stupid slow motion [so binding didn't release] ski crash a couple of years ago in only my second ever week of skiing) and although I was able to hobble off the mountain, it took 3 months for the swelling to go down and another 3 months to get back to full strength...
So on the plus side a month isn't so bad... and it sounds like it will fully recover.
Hope it heals quickly
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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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Sounds very similar to what they said to me. I've had a variation of a sharp pain, soreness and stiffness in my knee after doing nothing outstandingly horrible to it, and my physio has said it's about 4 different things (various strains and slight meniscus damage), which is entirely different to what the doctor said before she referred me to a physio in the first place (a small tear in the lateral collateral ligament). The recovery time they advised me was 6-8 weeks which was in hindsight more like 8. I boarded on it after 5 since it was feeling a lot better, and couldn't start the second day because it simply wasn't working when I assumed the stance.
Moral of the story: give it LOADS of rest, don't walk on it too much and absolutely don't think that just because it doesn't hurt, it's fixed. It probably isn't. If you can, try and get a referral to a physio so they can do the ultrasoundy stuff, give you some exercises to do to keep the muscles going and keep manipulating it. If you have any form of health insurance through work it's worth giving them a call to see if you're covered for some sessions just to give it a go.
Sounds like you've had a lucky escape though!
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janeed, call me dave, Rule 5 and possibly Rule 17
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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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With respect, Rule 5 is why I've ended up with a repeat injury and referral to a knee specialist in the first place 
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janeed,
Get it looked at in the resort, mostly they are good at diagnosis and immediate management.
X-rays do help them be sure they aren't missing a fracture but I question the need for an MRI scan in almost all cases.
Unless you have a serious fracture or emergency be very carefull about agreeing to surgery.
In recent years there has been a trend in some resorts to try and persuade injured skiers to have urgent surgery, this seems to be particularly prevalent in Austria who have put a lot of pressure on injured skiers to have ACL surgery. There is no reason to acutely reconstruct the ACl so do be careful.
On return to UK get an urgent appointment with your local knee specialist.
Post if your have further questions
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Fortunately the doctor in resort didn't seem to think surgery was needed.
I'm now trying to get a GP appointment to start the ball rolling here. Hopefully she'll agree that surgery isn't needed, but I guess an MRI may help to check what's going on?
If I need surgery, I'm not sure what the process is, but will come back for suggestions (Manchester area).Hopefully it will just be physio, and I know a good one of those.
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| janeed wrote: |
| but I guess an MRI may help to check what's going on? |
| Jonathan Bell wrote: |
| but I question the need for an MRI scan in almost all cases. |
Jonathan Bell, out of interest, are you saying that in most cases, examination & x-rays alone are enough to give a clear picture to the extent of injury?
Jjaneed, my MRI raised more doubt than if I hadn't bothered having one, which is why I ask for the above to be clarified.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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I di something similar in valmeinier a few years back, day 2 of 5 day trip, didn't see doc, could only just walk using both ski poles, thought he would tell me not to ski and there is NOTHING to do in valmeinier for another 4 days if you aren't skiing
Skiid for the rest of the week with my normal braces on, and quite well. Still couldn't walk anywhere ! Which was only a problem at lunchtimes and toilet trips, plus the stairs in the apartments
Oh yeah, coach and plane trip home on my own weren't much fun either
Bloody good few days skiing though
Bruise appeared 1 week after I got back, went from toes to buttocks. ......... Errrrrrrrrr 
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[quote="gatecrasher"]
| janeed wrote: |
| but I guess an MRI may help to check what's going on? |
| Jonathan Bell wrote: |
| but I question the need for an MRI scan in almost all cases. |
Jonathan Bell, out of interest, are you saying that in most cases, examination & x-rays alone are enough to give a clear picture to the extent of injury?
No, I always do an MRI but I do not use MRI to diagnose the ligaments that are injured nor the extent to which they are injured. MRI is quite poor at grading injuries to ligament. It is the grade ( severity of injury) that dictates the the immediate( first weeks) , midterm ( next month or two) management. So the MRI isn't as important as a good assessment.
I use MRI to find out what has happened to the joint surfaces and the meniscus because although that doesn't influence how I mange a knee in the first few weeks ( as I'm managing the ligament injury) it helps me paint a picture of eventual outcome and whether reconstruction is going to be a great outcome or less so.
My point is that MRI is not a the best way to get a clear diagnosis and plan of treatment . One of the reasons I decided to post on Snowheads is that huge numbers are struggling without a clear plan. A treatment plan can only be arranged with a crystal clear diagnosis and advice on what to do about it.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Jonathan Bell, thanks, I really appreciate your input on SH's, I think I can speak for many of us in this respect. So if you are not using the MRI to grade the ligament injury, how do you go about grading it without surgery?
Edit, re-read... Are you saying you can tell the amount of ligament damage by assessing other damage to meniscus etc?
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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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gatecrasher,
I do all the of the following without MRI.
When I assess an injured knee I basically decide is there a medial ( medial collateral) injury and what is the grade, has the injury extended to round the back of the knee to involve the capsule ( the very strong sac around the back of the knee). Is the medial injury a grade 1 ( a minor tweak that is very painful but will settle quickly without problem ). Is it a grade two ( may take longer , may need a brace but will probably settle in a couple or three months) . The more the injury goes round the back the ,more I'm inclined to brace. Or do you have a grade three which will need bracing and involve the ACL and probably need delayed surgery ( 6 to 16 weeks post injury).
I'll then look at the lateral( outside ) of the knee and in essence do the same. I'll assess the capsule( strong sac around the knee) on the outer side and the the ACL and then the PCL ( the lig behind the AcL that is less frequently injured).
Then I look for combination injuries.
After that I decide on plan for the next three weeks. It might involve physio weight bearing and pushing hard or at opposite extreme brace, weight off it, limited range of movement or even an examination of the knee under anaesthetic ( very rare after a few years on the job
).
I don't use an MRI to decide on any of the above and in fact find an MRI unhelpful in assessing ligaments ( but invaluable in assessing meniscus and joint surfaces) in many cases. Isolated meniscus injuries are rare in skiers when compared to ligament injuries.
Instead of MRI I rely on my experience and the fairly large number of knees i have seen. I am very specialised, all I do is look at knees, every day, for last fifteen years. After a while you see patterns that frequently crop up in skiers. I stared a ski injury clinic about ten years ago and therefore see the majority of ski injuries in our area.
MRI is over relied upon, even by some doctors, but is unfortunately the only way many injured sportsmen and women feel they can get an answer when confronted by what is,at times, an indifferent attitude from the NHS. The most important step after knee injury is to get a clear diagnosis and treatment plan and MRI is just one part of that. That's why I push the concept of physio assessment / specialist over spending money on a scan.
I hope that explains .
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When my consultant got the MRI back his comment was - yep definitely ruptured the ACL but then sad "not that I needed the MRI to know that". Then he said "now I can put you on the waiting list for the reconstruction". I did think at the time so why did I need to wait for an MRI and then I see him again before I could be added to the waiting list. Though maybe that is NHS rules? Thankfully as he did it always as an over night stay op I was allowed to claim off my private health cover and got it done a lot sooner.
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You know it makes sense.
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Jonathan Bell, thanks for your detailed and informative posts.
If I have understood you correctly, I should be asking my GP to refer me to a knee specialist for diagnosis rather than directly for an MRI then. I'm prepared to make a private appointment for this diagnosis if it speeds up the recovery time significantly. Do you know a specialist in the Manchester area ?
thanks
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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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Jonathan Bell, thanks, a very clear explanation.
My own experience...
First 2, weeks, managed injury till the pain went down enough to allow it to be pulled about. (wimp I know)
Week 3, saw specialist, pulled about, said didn't suspect anything major, valgus flexion/capsular entrapment, as private was given the option of MRI or leave for another 3 weeks to see if settled to 90 percent if not, return for MRI, no brace recommended.
Hoping things will fix themselves I went another 3 weeks, didn't settle.
Week 6 return for MRI (3 pages).
Week 7 started physio, did physio for about 3 months.
Now 8 months in and it feels about 90 percent.
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Poster: A snowHead
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janeed,
Yes your priority is a diagnosis as quickly as possible.
For some more straight forward problems a physio, sports physician or more general doc may be sufficient but the problem is that you don't know whether you need that high expertise until you have been seen.
I don't know any names in Manchester well enough to recommend but the people who know best are former patients and local physios. GP's will have an idea but will may just recommend the person they have to send their NHS work.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Jonathan Bell, it's interesting to hear your thoughts on MRI and diagnosis. When I ruptured my ACL last season, I went to the A&E sports clinic here (also happens to be my GP) in France. They took an X ray and said the bones were fine, did some pulling and poking and said: fully ruptured ACL, no damage to other ligaments, meniscus in tact, no point having an MRI straight away as I would need 3 weeks of brace/rest/ice, then 20 sessions of physio first, whatever I decided to do operation-wise. Lots of people told me there's no way they could say all of that for sure without an MRI (MRI subsequently showed they were completely correct with the initial diagnosis). It's good to hear that it wasn't just a lucky guess!
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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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miranda, knee injuries were diagnosed long before MRI.
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You need to Login to know who's really who.
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gatecrasher,
V similar. I would tend to do MRI early because it can reduce number of visits to see me, because I'm private that keeps patients' costs down.
I like to get physio involved immediately as I think it can sometimes reduce length of recovery by starting early.
But the most important is the outcome, sounds like you are just about there.
One reason for that 10-20% loss can be failure to really push the strength and conditioning component of recovery that generally follows on after physio largely finished. Best person for that is a Strength and Condition coach or Personal Trainer.
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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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| Hells Bells wrote: |
| miranda, knee injuries were diagnosed long before MRI. |
But MRI should have reduced the number of arthroscopies required by allowing better clarity of the components of an injury.
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You'll need to Register first of course.
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| Jonathan Bell wrote: |
One reason for that 10-20% loss can be failure to really push the strength and conditioning component of recovery that generally follows on after physio largely finished. Best person for that is a Strength and Condition coach or Personal Trainer. |
I couldn't agree more, and need to really get off my backside to get on with this, after physio I went all out too soon and injured my Achilles so probably used it as an excuse to skip other exercises.  I really find pounding the gym on my own very boring, I need to be pushed because I'll just get lazy otherwise, my physio said I can get on with any exercises now, I've been looking into these trackbike/spinning & high intensity classes, so might give them a whirl (in moderation of course).
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All good advice. I'm going to speak to my physio today.
Gatecrasher, I used a strength and conditioning coach to help with my alignment issues last year, and it was really useful. Originally I booked a package of running coaching, but as soon as he saw dodgy knock knees and lack of strength he advised ot work on that first. It took 3-4 months to start seeing and feeling a real difference, and I feel both skiing and running improved (until this).
If you are near Manchester let me know, and I'll send you details.
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janeed, Thanks, I'm down south, hope all works out well for you!
It was running that did my Achilles  prior to knee injury, I joined the daughter on one of her race camps, probably 30/40% fitness, running, lunges, side jumps, tag rugby, ladder work, you name it..I've never been so knackered or done so much exercise in years, I really loved this team training, very similar to football training I guess, if I could find something local like this (minus the football) I'd be there....
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Jonathan Bell, Thanks enormously for your contribution here. It's a real benefit to have a experienced knee surgeon who is also a skier to provide objective and common sense advice in the soup of myth and half-remembered experience that is leg injuries. Most of us can only talk about our own experiences but you've obviously got whole orders of magnitude more experience with each type of injury.
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Gatecrasher, have you looked into cross fit or some of the military type boot camps. They sound like something you might enjoy.
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