 Poster: A snowHead
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Any knee injury/mechanics experts out there?
1st post, help appreciated. I hurt my knee bouldering I mid October. Twisting & standing it went "click". Didn't hurt too much at the time but the next day swelled a bit, & very painful to walk on. Doctor referred my for an x ray & examination to assess (after 5 weeks) whether I merited (in a further 7/9 weeks) a scan.
In 1992 I had an arthroscopy which cleaned up a painful problem with th MCL. No problems after. I assumed from the pain I now had (principly, though not exclusively on the inside of the knee) that I had hurt the same bit.
The assessment of the injury was carried out by a physio, who after bending my leg about and looking at the x rays, told me that it wasn't the MCL, & didn't look like arthritis, but was probably a small tear to the cartilage. At the pace of a modest glacier I am waiting for referral for some physio treatment. So far, so good.
For the last 9 months I have been weight training with gradually increasing intensity (stronglifts 5 x 5). Part of making up for a whole year of virtual inactivity due to a torn rotator cuff (and I am only 55!).
The key exercise in stronglifts is the squat. You start small and build up very gradually. So, I had reached the stage of 3 x 5 full squats at 100kg. I weigh 75kg. Like anyone squatting, my knees make a bit of a noise, but did not hurt at all, at any stage. The muscles certainly did. I dead lift with a bit more weight. I don't think that this was linked to my injury, but what do I know?
The question is, what is the best exercise to strengthen/maintain the strength of the knee? 6 weeks on I am moving much more freely & climbing and exercising with caution. Crucially, I am off piste skiing with UCPA 2nd week in January with my son. I am prepared to work hard between now and then on anything that will help. In passing, the physio recommended I did knee extensions & similar things for the knee & avoid squatting. I have read a lot since which suggests knee extensions are not a good idea in any circumstances, & that compound exercises (like the squat) are preferable.
What is the best approach?
Thanks for your patience.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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HammondR, welcome to Snowheads.  There are a number of knee experts here. I'm not one of them BUT I do know that if you wait for National Heath physio treatment you will wait a long time. You need to find a good physio and do what they say. Being a little old lady I don't do weight training but personally, watching some (often fairly fat) blokes do weights in the gym I ask myself whether they are doing themselves more harm than good.
Squats can be good for knees BUT they need to be done right, and aren't deep sort of squats. Also lunges but again, only if done right - they can be bad for knees if you do them wrong. Hence the need for the physio.
You will probably get some good advice here but there's no time to waste if you are off to UCPA in January. Where do you live? somebody might be able to recommend a good physio - you will need to pay him/her, of course, but it's well 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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Oh - and if you are at all overweight the best favour you could do your knees before January is to lose weight. 
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You need to Login to know who's really who.
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Pam
Thanks for the reply. That was quick! At around 6 foot and 12 stone (& climbing 2/3 times a week since 1986) I may be many things, but fat isn't one of them! Also, though I did go on at great length, I omitted to mention that I do squat with good technique, below parallel. My eyes do bulge a bit at the same time.
I live in the Halifax area, & would be more than happy to spend on good treatment.
Overweight indeed.
Cheers.
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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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HammondR, OK, not fat, peace! Have a look at the stuff on this website. https://www.facebook.com/wimbledonclinics
Jonathan Bell is an orthopaedic specialist, posts very helpfully on snowheads, this is his clinic. With a comprehensive programme for knees.
He will probably be along to comment on your specific question before long.
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You'll need to Register first of course.
You'll need to Register first of course.
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From my experience most cartilage injuries need surgery and delaying it may cause arthritis. I was advised to only do supported squats for months after injury. I either did them with my back sliding up and down a wall or with a gym ball behind me.
You do need proper advice though and I'd be pushing for that mri.
Good luck
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HammondR, you need to be assessed bot by a specialist knee bod as well as by a good sports physio. I've had quite a lot of knee surgery and was advised against deep squats as well as squats using weights in the periods prior to treatment. Your form is so critical that repetitions using those kind of weights with poor form could be making things worse. Until you get a definitive answer, switch to maintaining muscle mass and fitness with things like cycling and swimming. I was also told to avoid any open-chain exercises until my problems were diagnosed.
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If it doesn't hurt then gnash on.
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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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HammondR, hello fatty
I agree with Samerberg Sue, you're not going to building up any real muscle at your age so better to concentrate on safer exercises that maintain the strength you have
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Do more reps and less weight. Skiing is not about ultimate 1 rep strength but some strength with speed and muscle endurance. I find doing sets of 30 squats with continuous movement the best training for skiing as it replicates as much as you can the load you will get when skiing. It really helps to build up the muscle endurance so you are not getting the fatigue and leg burn at the end of skiing a pitch so maintain form and much less likely to make a mistake and get an injury. Doing big weight and low reps will just make you slow in my opinion and also has an increased risk of injury especially if you have an existing problem.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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The thing about physios is that you will get a different story from nearly everyone. Some say squats are great, but don't go below parallel; others say, too risky to do at all; others say, the only proper lift to strengthen all the muscles around the knee is the full, below parallel squat, done systematically with progressively increasing loads. My experience is, this last approach works best for my knees (49 yrs old with 2 meniscus tears requiring trims and 1 partial ACL tear not requiring surgery) and they are by far the strongest and healthiest after a consistent period of full squatting. Personally I avoid the machines - leg press, extensions and curls, try and focus on "perfect technique" full squats supplemented with 1 leg balance work and work in my ski boots immediately before a trip. If you are full squatting without knee pain, then you are doing the best exercise for leg strength and therefore keeping your knees healthy, so keep up the good work and ignore some of the ignorant posts above, such as
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Doing big weight and low reps will just make you slow in my opinion
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- you ever see the alpine racers training? Guess what Didier Cuche squats - somewhere around 500 lbs. He wasn't too slow last time I saw!
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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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you're not going to building up any real muscle at your age
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another good one, perhaps you would like to explain how doing the most effective muscle building exercise in existence will not help the OP? or, how doing ineffective bodyweight or machine exercises will do anything for him if full loaded squats do not?
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red 27, you can build strength and muscle well into your 70's if your genetics are pretty normal. The only limitation being people telling you you can't 
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You know it makes sense.
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HammondR,
Your description of twist,swelling next day, click at time of injury,medial knee pain is text book medial meniscus tear.
Get a referral to your knee specialist.
Your excs program sounds as though it risks being very quads orientated. However it will be dependant to some extent by your technique. You don't want to be " quads dominant", it puts your ACL at risk because the quads will load the ACL un opposed by balanced hamstring strength.
Doo look at our excercise program https://www.facebook.com/wimbledonclinics but it is a bit late.
If you are fit and strong do the plyometrics element which I'm going to post today. Plyometrics very important and will help protect ACl.
Every year I send some people off skiing with medial meniscus tears with the following proviso.
1) there must not be a displaced fragment on MRI.
2) they don't ski with an effusion ( puffy knee), this can be helped by icing after skiing and anti inflammatories.
3) they accept that it probably increases risk of injury a little, though I've not ever seen it happen presumably ly because they've been careful
Jonathan Bell
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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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Another reasom why full range, deep squats work so well is that they are not quads dominant (as are partial range
squats) - they give the hamstrings and entire posterior chain a great workout resulting in the balanced strength referred to byJonathan Bell,
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Poster: A snowHead
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| red 27 wrote: |
| I agree with Samerberg Sue, you're not going to building up any real muscle at your age so better to concentrate on safer exercises that maintain the strength you have |
I beg to differ...! At 52 over the past 6 months or so I have dramatically increased my lean body mass through a combination of intake and exercise. It certainly is possible!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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ssh, Me too...at the ripe old age of 53....
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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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holidayloverxx, you go! Most excellent! I'd love to hear more about how you did it...
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You need to Login to know who's really who.
You need to Login to know who's really who.
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ssh, gym 4 or 5 times a week for 5 months (knee rehab for huge muscle loss)...squats..sumo squats. ...lunges...lateral lunges....leg press..side plank...single leg bridges... heel rsises...bike....squat jumps....step ups...step throughs....sustained hold squats....crabbing....all lots of reps/sets and building up resistance or holding dumbells...etc etc etc
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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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Thanks for the replies all.
I tried to respond Saturday but, having spent 45 minutes on Saturday (mostly dealing with red 27's misunderstanding of physical strength & conditioning) I pressed the wrong button & lost the whole lot. Age is taking an even greater toll on the brain.
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You'll need to Register first of course.
You'll need to Register first of course.
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gra,
Exactly my experience. As you rightly figured out, I recognise that it is a fantastic exercise for everything ( there is EVEN more to life than skiing, with climbing [rock & ice] & mountain biking) & the invaluble for gaining high levels of lean body mass/low fat/healthy organs, etc. I just wanted to be sure it wasn't going to make my knee worse.
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ssh, holidayloverxx, talk is cheap - photos please.
BTW at 83 am I also a fine figure of a man with an enormous chest and an enviable lower body 
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Jonathan Bell,
Thank for the input Jonathon. Having read this I will go back to my GP & request he revisits this & refers me to a consultant.
As for the squat technique, you clearly make a good point. I squat to or below parallel, concentating on good form, pushing through my heels/hamstrings/bum. Equally, I ensure no knee buckling or other wobblyness interferes.
Thanks for reminding me about the facebook link (1st sent by pam w). I will follow the knee care advice, & must pursue the best longterm fix possible. I am likely to retire within 12 months & was planning to become a mature climing/ski bum!
Regards
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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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red 27, tslk us cgeap but the £2k I have spent on rehab is nit. I dont have to prove my progress to you but today I skied for 3 hours wihoutva break, including a red run. 5 months ago I came off crutches, having been on them and mostly non weight bearing for 3 months. I have a clinical report from 8 weeks ago advising that there was significant weakness in quads vmo abductor adductor hamstrings and glutes. I have another from 2 weeks ago which reports significant improvement and clearance to ski. My glutes and hamstrings have never been stronger as I have never done exercise before. I will take that as evidence. I dont really care about anything else.
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whether you can build muscle mass, increase flexibility (equally important) etc depends a lot from where you start from. If you are a lifelong top flight athlete then yes, you are not going to be able to make yourself even more superlative at 55 than you were at 25. However, that's more possible for an idle, stiff and overweight middle aged person. Mobilising joints is as important as building the muscle, especially as most of us are in danger of joints seizing up as we get older. Flexibility helps reduce injury, too. And balance. I've had a bad cough the last week or so and found that CV exercise just made it worse (well, that's my excuse) but I have spent some time on squats, lunges and the BOSU ball and am hoping that will all help.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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pam w, with you 100%.
Reading ' Total Skiing' by Chris fellows is a fantastic book for assessing and achieving off snow a) the necessary body movement patterns (functional movement) and b) targeted ski fitness to improve your skiing. At about £10 pounds, it's given me the most unbiased objective view of my skiing i've ever had. I'm in no doubts where my short comings lay. 
I will never reach the necessary level of flexibility for a True All Mountain Expert. The truth hurts so it isn't easily spoken. I can and will improve ( even if only a little bit) i'm sure.
Last edited by snowHeads are a friendly bunch. on Mon 2-12-13 19:59; edited 1 time in total
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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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and if you're interested in improving...can i vouch for 'Ultimate Skiing' by Ron LeMaster. For me , i now understand the massive importance of 'For / Aft' dynamic balancing throughout the turn phases and , even more importantly, over / through mogul fields. Again, another £12 / 15 book that's worth considerably more. Rob of I/O S fame talks highly of it as a 'reference manual' not, skiing instruction - how to ski etc. Sorry , this was a little off topic.
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HammondR, where do you train in town?
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You know it makes sense.
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| 'Ultimate Skiing' by Ron LeMaster. |
 or Dave Pratt to his mum I'll bet
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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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Mosha Marc,
Workout Warehouse, grrr.
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Poster: A snowHead
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HammondR, Fitness First myself
You wouldn't go too far wrong having a word with Sammie Wheelwright
She and her husband Dan helped me out with dodgy knees and injuries recently. She also sorted out Tyler Harding when he had a bit of bother.
Who do you cycle with, any club?
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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 wrote: |
| red 27, tslk us cgeap but the £2k I have spent on rehab is nit. I dont have to prove my progress to you but today I skied for 3 hours wihoutva break, including a red run. 5 months ago I came off crutches, having been on them and mostly non weight bearing for 3 months. I have a clinical report from 8 weeks ago advising that there was significant weakness in quads vmo abductor adductor hamstrings and glutes. I have another from 2 weeks ago which reports significant improvement and clearance to ski. My glutes and hamstrings have never been stronger as I have never done exercise before. I will take that as evidence. I dont really care about anything else. |
I believe you. I've seen the results. Impressive recovery which would not have
Been achieved without very dedicated work at rehab . Have a great season .
Jonathan bell
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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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Mosha Marc,
Thanks for the link to Sammie Wheelright. I had not heard of her before & will be getting in touch.
I don't cycle with a club. I generally cycle alone or with the current Mrs HammondR. I am a bit of a grump & do not like cyclyng with people who cycle either faster or slower than me. I go at Goldilocks pace (not too fast, not too slow....)
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You need to Login to know who's really who.
You need to Login to know who's really who.
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| holidayloverxx wrote: |
| [b]tslk us cgeap but the £2k I have spent on rehab is nit. I dont have to prove my progress to you but today I skied for 3 hours wihoutva break, including a red run. |
Oh dear. Your slurred typing and intemperate tone suggest a spell in a different type of rehab might be wise.
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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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red 27, I seem to have forgotten to put you on ignore...
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You'll need to Register first of course.
You'll need to Register first of course.
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Jonathan Bell,
Jonathan,
I would appreciate a rough estimate, based on your considerable experience. I was a good boy & diligently followed your exercise programme suggestions. That, plus doing exactly what my physio advised was working well with stronger legs & fewer & fewer knee grumbles. As a long time coward, all of this was preferable to the thought of surgery.
Then an awkward twisting movement of my knee has set me back to much worse than square 1. January off piste is definately off. I have been barely able to walk for 3 days & it is very much worse than the original pain in October. I will be seeing my GP in a couple of days.
My question is, if I undergo surgery on what now seems like a bit worse medial meniscus tear, what is the likely recovery timescale - if I comply fully with all rehabilitation requirements? I can put the trip back with UCPA to late March/early April. Is this totally unrealistic?
Regards
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HammondR,
It depends a bit on what is found and done at arthroscopy of your knee.
A straight forward medial meniscus ( no osteoarthritis found ) & you will probably be ok at six weeks. Four will be pushing your luck a bit.
Lateral menisectomy, again no wear, think eight weeks.
Osteoarthritis much less predictable.
If you can get it to settle down quickly ( ice, compression, relative rest etc) you may get away with the trip. If you do try ice every day after skiing, the presence of swelling will increase risk of trouble.
Jonathan Bell
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Jonathan Bell,
Thanks very much for the reply Jonathan
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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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| holidayloverxx wrote: |
| red 27, tslk us cgeap but the £2k I have spent on rehab is nit. I dont have to prove my progress to you but today I skied for 3 hours wihoutva break, including a red run. 5 months ago I came off crutches, having been on them and mostly non weight bearing for 3 months. I have a clinical report from 8 weeks ago advising that there was significant weakness in quads vmo abductor adductor hamstrings and glutes. I have another from 2 weeks ago which reports significant improvement and clearance to ski. My glutes and hamstrings have never been stronger as I have never done exercise before. I will take that as evidence. I dont really care about anything else. |
Yer bum certainly displays a new and admirable level of 'pertness'
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Jonathan Bell,
Oh
I forgot to mention. There may be a spot of "displaced fragment" in there, as when I hurt the knee again (now 4 days ago), it was the fact that it locked, & I couldn't stand up under pressure, that caused it to hurt so much. I suspect that makes a trip next week even more of a risk.
Regards
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