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Sore knee

 Poster: A snowHead
Poster: A snowHead
Hello all. I have been dithering about posting about this so please be gentle with me.

I am a reasonable intermediate skier and we are going to Les Arcs at the beginning of March for a week. I've got a couple of off-piste skills clinic sessions booked with New Generation.

For about a month I have had a Bit of a Sore Knee. I don't remember exactly when it started or doing anything that might have caused it. It is intermittently sore on the bottom half of the knee cap and also around the back of the knee sometimes when I turn. It hurts a bit when I go down stairs and when I kneel on it. It has never been swollen that I have noticed. It may have been improving a bit.

For a few weeks I just ignored it assuming it would go away. Then because it didn't seem to be going away, I thought I had better find out what was wrong before skiing on it (I was worried that it might be an ACL about to go, or something - clearly I am no medical expert). I went to a GP at my practice who has an interest in sports medicine and I believe used to work for a Premier League football team. He had a look and doesn't think that there is anything about to explode, so to speak. He has referred me to a physio in the hope that an appt comes through before I go, and told me in the meantime to do leg raises and that thing where you lean against a wall and bend your knees in order to strengthen my quads, and also to take ibuprofen to reduce any inflammation. If it hasn't gone away by the time I'm back from skiing then I'm to go back and see him and he'll refer me for scans etc.

With regard to skiing, he said that it was a question of common sense, but on the basis that when skiing you need all your receptors etc to be working well, he wouldn't recommend it - more because I would be more likely to have an accident of some description than because of any danger to my knee specifically. However, he wasn't going to tell me i couldn't.

I think what I would like to do is plan to ski gently and see how I go. If it is all fine then continue with the off-piste clinic but err on the side of caution in that respect. I only get 50% of the cost of the lessons back if I cancel now, or nothing if I cancel nearer the time, but they would write me a letter to support an insurance claim. Does that sounds sensible or does anyone think I should avoid skiing altogether?

Also, I feel like I should probably tell my insurers, just in case it invalidates a claim if I do have a serious accident. Does that also sound sensible? Or OTT?

Sorry for the long post. Thanks in advance for any help.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
I think the course of action you are proposing is the one I would also take, after all you have a month to go...

Regarding the insurance company - if you tell them, they will exclude a claim for damage to that knee (but not the rest of you !!)

have you thought of buying/wearing a 'support' for that Knee? :: I have a 'weak' knee and always wear a support, even if it feels OK.
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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?
albob, the insurance could reasonably exclude injury caused by the knee too. If there is anything in the OPs notes that says she shouldn't ski then she won't be covered at all. The GP says he's not telling her she can't ski but if it was me I would want confirmation of what is in writing then make the decision on insurance (I woudld tell the insurance but want all the facts to hand - a lot of the risk assessment is about whether you are receivng treatment). The fact the OP has been referred to physio, and probably has something in the notes that says referral for a scan is a possibility, will also have a bearing. I'm not receiving any treatment now, apart fom physio (which is not regarded as material by my insurance company) and I am covered for it by paying an extra premuium on my worldwide, annual policy. works out at about an extra £16 pw

Insurance notwithstanding, if it was me I would decide whether to ski gently or off piste based on whether the pain was debilitating, or if my knee felt unstable, to the degree that my skiing would be affected


Last edited by Well, the person's real but it's just a made up name, see? on Thu 6-02-14 13:38; edited 1 time in total
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NatalieG, If you can afford it try and get a private physio appointment - they aren';t that dear. I could recommed a ski specific physio in London if you want.
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Thanks both. holidayloverxx, that's my concern. I will ask the GP to confirm what the notes say.

Without skiing, the pain is nowhere near debilitating - nothing more than a bit annoying really. As for whether my skiing will be affected, I just don't know without trying. If I hadn't been to the GP, I would definitely have tried.

Maybe a trip up to Hemel is in order so I can try it out without needing to rely on travel insurance...
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Sorry, crossed posts. holidayloverxx, yes please. That would be helpful, thanks.
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Definitely worth a support for the week. I had minor problems courtesy of a very old injury that makes skiing painful after a few long days or any significant falls, and on recent trips have used a Mueller HG80 support to help. The difference is fairly dramatic, and has avoided my knee feeling anywhere near as bad as before. I think the stability it gives to the kneecap and the hinges keeping things straight help, but speaking to a physio should help with finding the right kind of support to help the specific problem you have.
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NatalieG, OK, James Vickers (ex Team GB ski physio) - Google him. He works out of central london, sevenoaks and wimbledon. He can advise on whether to brace too.

Good idea to go to Hemel.
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NatalieG, An excellent private physio in London

http://www.hfs-clinics.co.uk/team/nick-critchley/

I assume you are taking anti-inflammatories? Good luck with your knee Very Happy
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holidayloverxx, thanks, I've spoken to his London clinic and they pointed out that private health insurance might cover some of it at least - duh. It sounds like the best way forward to me. I imagine I am less likely to get a CYA generic "better not to ski" response from him if it's not necessary than from a non-specialist physio - and if it is then I suppose I am better off listening!
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genepi, thanks. holidayloverxx's suggestion is a bit more convenient for me location-wise but I will keep yours in mind in case that doesn't work out. Yes, taking ibuprofen when I remember. It's hard to remember given how little it really hurts! Probably shouldn't have gone to the GP in the first place - I was just trying to be sensible! Thanks for everyone's suggestions. I will see a private physio one way or another and go from there.
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And love to help out and answer questions and of course, read each other's snow reports.
NatalieG, Good luck with it...and yes, do listen!
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If you do decide to ski, it's worth checking the small print in your insurance policy.

I had a twinge from my knee last week in Austria, and called my insurance company to inform them that it might need attention when I got back to the UK. They informed me that my policy only covered medical attention OUTSIDE OF MY OWN COUNTRY. Luckily the knee seems to be OK now, but I didn't have the cover I thought I had...!
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 You know it makes sense.
You know it makes sense.
Bladder, Really, you thought holiday insurance would give you medical treatment in the UK? That's what the NHS is for...
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
NatalieG , Physio will definitely help the knee but the only way you will find out how bad your knee is will be when you ski ! If I were you I would go and just try some easy runs first and take it from there . Off Piste , Moguls , steeps and hardpack are not kind to knees with problems so probably best avoided . I need a partial knee op so have only been able to ski for 1-2 hours per day this season which is very annoying but I am so pleased I decided to do it as I have had some fantastic skiing and long lunches in the mountains .
Maybe you could explain your situation to get New Generation and get them to give you some on piste technique lessons instead of the off piste ?
Good luck !
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 Poster: A snowHead
Poster: A snowHead
Quote:

Maybe you could explain your situation to get New Generation and get them to give you some on piste technique lessons instead of the off piste ?

I'd agree with this - off piste skiing will be much harder on your knee.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Bladder, think the clue is in the name, travel insurance?
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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?
It's not so simple as that... the injury (which luckily wasn't one in my case) happened whilst I was covered, and some policies do cover all of the costs of injuries sustained whilst travelling. wink
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Bladder, If you say so; I am no expert but none of the policies I have ever looked at have that cover. The most that is offered is physio if the injury was sustained during the cover. I'm genuinely interested - who provides the cover you describe?
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NatalieG,

I work with James Vickers. If physio is going to work he will sort it.

I use James at Wimbledon Clinics to help me with returning my patients to skiing.

He also has a practice in central London.

Jonathan Bell
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Thanks Jonathan Bell.
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Jonathan Bell, oh, did I consult the wrong physio at Wimbledon Clinics for my knee pain? wink
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Pedantica wrote:
Jonathan Bell, oh, did I consult the wrong physio at Wimbledon Clinics for my knee pain? wink


No, Would i try and fob you off with anything but the best advice?

Claire Robertson has done our ski specific sessions for years but has now sub specialised in dealing with Patella Femoral Pain. She does occasional ski sessions if James not available. Claire mainly does second opinion work now and will work along side the treating physio.I've used James on an ad hoc basis for skiers in past but because he was so tied up in the ski industry he was always away in winter. So NatalieG could probably see either if she wanted.

Jonathan Bell
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Jonathan Bell, thank you. I was joking. Very happy with the advice I received. Very Happy
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holidayloverxx wrote:
Bladder, If you say so; I am no expert but none of the policies I have ever looked at have that cover. The most that is offered is physio if the injury was sustained during the cover. I'm genuinely interested - who provides the cover you describe?


The Gold or Premium covers offered by some insurers seem to offer the cover I mentioned - this is based on the phone call I had with my insurer from Austria. I've done a quich search online & found a couple of insurers that provide physiotherapy after returning from a trip (e.g. Columbus Winter Sports Gold) and the Post Office seems to offer a policy that covers up to £10,000 of medical expenses in the UK.
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Bladder, yes, I got physio with Snowcard but nothing more in the UK
The Post office policy says
"Medical, Emergency &
Associated Expenses
(Cover when in UK limited to
£10,000 as a maximum)"

I take this to mean if you are on a holiday in the UK when you become injured,
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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.
brnttptr, thanks for the suggestion re switching lessons. I hadn't thought of that but I have just spoken to them and they have moved me to a technical on-piste refresher clinic which I am hoping to be able to attend (subject to physio's advice, insurance cover, etc) - certainly a more sensible approach than the off-piste anyway.
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
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NatalieG That's great news ! Look at this experience as a positive ! The better your technique on piste (and the course will be a great help for this ) the easier off piste will be next time !
Hope you have a great time!
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 You know it makes sense.
You know it makes sense.
Thanks brnttptr, not there yet though! Just spoken to the GP for a referral to the private physio and he says he would rather refer me to a knee specialist for an MRI in the first instance before physio if the NHS isn't paying for it. Got an appt at the clinic where James Vickers works in Harley Street next Monday now. This all seems massive overkill for the level of impact my knee is having on my normal life but i suspect it's going to be my only chance of getting to ski on an insured basis! Still feel a bit ridiculous though. Embarassed
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 Otherwise you'll just go on seeing the one name:
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NatalieG, Sieze the opportuntiy! although MRI isn't the the only diagnostic it's a start, and hopefully you'll get a diagnosis on the day. Let us know how you get on.

I'm seeing James next Wednesday..
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 Poster: A snowHead
Poster: A snowHead
NatalieG The upside of seeing the knee specialist on Monday and getting an MRI or Xray is that you will get the problem diagnosed quickly .Then you will know exactly what you are dealing with and will be able to work out the best way forward from there . Hope it all goes well .
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I know, it all makes sense. Just feel a bit silly about it. Especially as the people I'm seeing all seem to specialise in elite athletes - seems rather incongruous somehow! If i can't ski it won't be the end of the world of course but it will be good to feel that I've done everything I can to be able to.
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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?
NatalieG, James is working with me, and I saw others at Hemel that he had been working with...most of us were not athletic in the slightest, mostly middle aged women who ski a bit. The specialist and James will treat you just the same as any other patient - someone who has a problem that needs fixing.
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I got similar symptoms couple years ago. It was only happening very occasionally, usually when walking up or downstairs, particularly in ski boots, but again there was no consistency, and it didn't bother me at all when I was skiing (I ski mainly moguls and off-piste), and wasn't getting any worse after skiing. Really random indeed. Last season I dislocated left patella, but seem to be fully recovered, I was already skiing end of last season, albeit on piste, but after a week I could go as fast as pre-injury. I have no idea if my injury was related to pain I had previously, and it wasn't a ski injury, just a stupid walking accident. This season I am back off-piste and ski harder than pre-injury (I usually get 60 days a season, only last year it was 35 due to my injury), I started training mid-summer, lot of biking and weight training, so my legs feel much stronger. I do get intermittent pain but it's too random and never when I ski and never straight after skiing, there are weeks when I don't get it at all, not even once. I wear a brace when skiing (though my doctor told me not to bother and to "grow a natural brace") but half of the time I forget to put it on, it doesn't change anything. If it bothers you too much, I would get it diagnosed. But find a good doctor and physio, and diagnose it properly - with MRI etc. If your doctor tells you not to ski, find another doctor who has a better clue. My boss was told to stop skiing in the past, now in Switzerland he went to see the doctor in Martigny who only does knees for skiers and has been happily skiing ever since.
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NatalieG, I had the same kind of thing with my knee, got sent to a serious specialist for a Bit Of An Owie and ended up with a "well, you've got OA but nothing else really" diagnosis. All very embarassing because in certain circumstances it hurt so much I couldn't walk on it.

Frequent trips to Hemel to build up and maintain the snowboard muscles made it almost disappear, but after a day on the real mountain it still gives me grief driving home and on the plane. I don't entirely understand why.

When they say "no skiing" what they really mean is "take up snowboarding" Wink. No but really, as never summer's bosses situation shows, they don't know you, your lifestyle or your risk assessment skills so it's fair enough that sometimes sweeping statements are made and people who are capable of managing their own situation are told to stop. In the end it's how much you want to ski, and thus how much maintenance work in a dome or your living room you're willing to do to keep the muscles going to avoid it hurting.
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call me dave, I agree. I am cleared to ski..advice was it's up to you... but it does get painful and stiff at the end of the week so I'm off to the Doctors for good drugs before my next trip. I can generally manage pain during gym sessions or just because it's a bad day with an ibuprofen and co codamol cocktail
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I tweaked my knee on last day of skiing on Birthday Bash. Not sure what I've done to it yet. Anyway, I've just been to my GP who is writing me a referral letter so that I can see a specialist consultant using my work's private healthcare scheme. Can anyone recommend a good consultant for knee injuries in Central/West London?

I'm feeling encouraged by the stories from others who made full recoveries!
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After all it is free Go on u know u want to!
cat skis, Jonathan Bell - a snowhead - works out of Wimbledon Clinics
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holidayloverxx, Brilliant, thank you!
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I've just spoken to the insurance company (LV) and it seems that as long as I can get cleared to ski by the consultant, I should be ok.

Encouraging to hear that it is possible to be "cleared to ski" with a knee that does not feel 100% perfect; my lovely GP spent half an hour talking to me on the phone the other day and was very nice and helpful about referring me etc but made it clear that he thought I would be bonkers to ski with a non-perfect knee - but also that he thought skiing was in itself pretty bonkers from a risk point of view...

I'm hoping that a good MRI result plus a different outlook may result in a happy holiday. Just going by how it feels, I find it really hard to believe it will make a huge difference and if it starts getting more sore when skiing then I am always more than happy to have a break and a vin chaud! I would just like the opportunity to get on the snow, even if it is just pootling gently around for the week (my husband would say that he would struggle to notice the difference, i'm sure).
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