 Poster: A snowHead
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Mrs B recently acquired a brace for skiing, to support her (slightly) unstable knee.
After damaging her ACL (and undergoing extensive rehab, but without surgery) she has skiied for 16 years without a brace, averaging 40-60 days on snow each season. She is an aggressive skier and loves off piste, steeps and ski touring. Disaster struck in April 2013, however, on the last day of a ski tour, when she injured medial ligaments in her dodgy knee. She underwent extensive rehab and physio but fell off her mountain bike in July 2013, causing the knee to collapse.
After more rehab, she made her skiing comeback (still with no brace) in December 2013, skiing 18 days over the 3 months prior to a Canada trip in Feb 2014. On the Canada trip, disaster struck on the last day when her knee collapsed sideways as she came to a stop on the first run of a heli ski day. Game over....
She then sought the advice/support of her physio, who arranged a scan. Initially she was diagnosed with meniscus damage but, after further examination of the scan, was later advised that that was not the case. In essence, the physio could not find any instability of the knee, so Mrs B skied again in Tignes (for 2 days) in August 2014. So far so good - no ill effects at all.
With the onset of winter, we were out walking in local woods when Mrs B felt her knee wobble sideways slightly. She had experienced this only once before, in Canada the day before the heli skiing, when her knee gave a slight sideways wobble (which she now regards as a warning wobble) on a steep mogul run. Mrs B therefore felt that she should buy a brace to support her knee and, as much as anything, give her the confidence to tackle steep off piste and/or to go ski touring. In essence, she was concerned about the possibility of a further collapse.
So, we went to see a physio that specialises in CTi braces. The physio, however, could not find any instability in the knee and said there was no reason why Mrs B should not ski without a brace. However, if Mrs B wanted a brace, the physio was happy to supply one - so that is the route she went down, opting for a CTi brace. The physio spent over one and a half hours with Mrs B and although we did not go for the custom fit, several measurements were taken to ensure the correct fit.
Mrs B experiences no knee problems/symptoms in day to day life; and no knee instability.
Fast forward to last weekend and a 2 day trip to the Stubai Glacier in Austria. The brace was particularly uncomfortable on day 1 and, although supportive, caused bruising and chafing around some of the straps when worn against the skin. On the second day, therefore, Mrs B chose to wear the brace outside her trousers, which were a thin Goretex shell.
She felt very confident and tackled some relatively steep off piste and powder with gusto! However, on day 2 (Tuesday) while stepping into her ski (admittedly, at a "funny angle" on a slope) she felt her knee wobble sideways again and felt some pain. Nevertheless, she skiied the remaining two hours of the day pain free.
Yesterday her knee was slightly swollen and today (back home) it looks similar, with only slight stiffness.
We will contact her physio (and brace supplier) shortly but in the meantime we are concerned that the brace allowed any sideways movement of the knee at all.
The brace appears to fit but Mrs B is wondering whether there is a problem with the fitting. In other words, should it support the knee so firmly as to prevent any lateral movement? We must admit, that we were under the impression that that was what Mrs B was paying for...
So, while the good news is that the brace seems to have prevented a bigger problem occurring should it have allowed any lateral movement whatsoever?
We are obviously very concerned and any observations/comments from experienced Snowheads would be welcome.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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I don't think any brace will support the knee so firmly that lateral movement is impossible, while also allowing the knee to bend as nature intended
Hope it clears up soon and doesn't impede her skiing too much
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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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@Bergmeister, my CTI brace does not allow any lateral movement...assuming that means the bottom half of her leg moving from left to right. It's off the shelf but was fitted by an orthotist. I wear it over a tubigrip bandage to stop chafing. I also slip a folded tissue inside the tubigrip to cover a knobbly bit of bone that gets a bit sore. I fasten the straps tightly and there is no movement in any direction apart from the knee bend. I can't imagine wearing it even over a base layer never mind trousers...I think the movement of the fabric would reduce the effectiveness of the brace
Last edited by Well, the person's real but it's just a made up name, see? on Thu 4-12-14 15:58; edited 1 time in total
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@Bergmeister, it really sounds like it would be worth seeing an orthopaedic consultant. There sounds like a lot of similarities with my issues and to what I was told by Physios, that culminated in my knee giving way while sprinting which tore my medial meniscus cartelage in such a way it locked my knee (causing extreme pain and left me non weight bearing). The MRI indicated the ACL recon (from 9yrs previously) was still intact but I found out after the consultant operated for the tear that actually half the ACL recon had been destroyed and is almost certainly why my knee wasn't stable despite feel it to me and the Physio. I have now been left with very little of the original structure of my knee (the consultants words!) that I am no longer allowed to play hockey and he was suggesting I should never ski again either.
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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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@Bergmeister,
It sounds like it is the knee not the brace that is the problem.
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Thanks All.
We are becoming confused and concerned, having been (via a short notice appointment) to see a (new) private physio 3 days ago (albeit at a clinic Mrs B had visited in the past) and having read your replies to date.
He examined the knee and (like others before him) struggled to find any sign of significant instability. Again, like others before him, he said that, in principle, there should be no problem in skiing without a brace. The knee was slightly swollen, so he did some ultrasound. He also had a look at the brace and said that it appears not to allow any lateral movement and the (new) injury was most likely caused by a slight twist.
We appreciate that there seems to be a problem with the knee but are now really unclear as to next steps - not least as the experts seem to be unable to detect any instability. Mrs B is desperately keen to resolve things but is now doubly confused. She has a further appointment with the physio on Thursday this week.
Having considered the above, it sounds like we should (belatedly) be seeking out a local orthotist.
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As I said the experts - Physio again - detected no instability, even the MRI indicated the ACL was still intact but when he went in a operated on the knee to sort out the meniscus damage caused by it collapsing on me completely unexpectedly he found that I had lost half the reconstruction - I know now that I only have half of it left and take precautions accordingly ie had to give up hockey, wearing hinged brace recommended by the Physio and most importantly exercises to keep the surrounding muscles strong enough to compensate.
Next step would be an orthopaedic consultant.... Even if like me she finds out that nothing more can be done at least know what is happening is better.
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| Bergmeister wrote: |
Thanks All.
We are becoming confused and concerned, having been (via a short notice appointment) to see a (new) private physio 3 days ago (albeit at a clinic Mrs B had visited in the past) and having read your replies to date.
He examined the knee and (like others before him) struggled to find any sign of significant instability. Again, like others before him, he said that, in principle, there should be no problem in skiing without a brace. The knee was slightly swollen, so he did some ultrasound. He also had a look at the brace and said that it appears not to allow any lateral movement and the (new) injury was most likely caused by a slight twist.
We appreciate that there seems to be a problem with the knee but are now really unclear as to next steps - not least as the experts seem to be unable to detect any instability. Mrs B is desperately keen to resolve things but is now doubly confused. She has a further appointment with the physio on Thursday this week.
Having considered the above, it sounds like we should (belatedly) be seeking out a local orthotist. |
A swollen knee can feel unstable.
You need to try and manage the swelling, you may use a knee sleeve a part of that but you don't need anything fancy.
Jonathan Bell
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