 Poster: A snowHead
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One of our group this week is out now with cruciate ligament troubles
She was on the last run of the day and tiring when into a turn lost confidence ( I was just ahead of her looking back as none of the group have skied for more than 8 days)
anyway she went back on her heels then on her but, are the binding supposed to release for that kind of fall ?
either that or the subsequent twist did the damage
by the time the medic arrived on the snowmobile to take her to the medical centre her knee had swollen to double the size
being a big on the crazy side she is now talking about getting a metal brace for her knee so she can at least venture onto the nursery slopes again later this week.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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She would certainly be crazy. The cruciates provide joint position sense for the knee and its muscles controlling it. Apart from the pain even with a brace she would seriously risk compounding her injury (Cartilage, Medial ligament) and accelerating the onset of arthritis in the the joint into her 30s or 40s, which is a bit inevitable at some point in ones life after a cruciate injury. Find her a large bottle of malt or Bailies, a good book and a comfortable viewing point. Chain her there...
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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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Well at the moment she cant get out of the chalet as she cant put weight on the knee and is hobbling between the fridge and the couch - the chalet is at the top of the village of saas fee - a windy ice filled pathway down some very steep slopes
I think she is mental that she is even considering - I have been quite lucky with my inguries over the years and it has mainly been shoulders, nose and ankles (rugby and ice hockey) I dont have any knee injury experience to call on.
She told us she was fine and that she would just walk down after a few min rest - we were about to go to a different slope when I spotted her sitting up near the top, I went back up to check she said she couldnt walk - so I got the ambulance - in broad scots german 
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Good luck - I hope she's OK. Perhaps its still the shock talking 
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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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| obelix67 wrote: |
anyway she went back on her heels then on her but, are the binding supposed to release for that kind of fall ?
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That kind of fall is the most difficult for release-bindings to cope with. (But I'm sure many of the experts on this site can give you more detail than I can. [Come in David Goldsmith])
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yeah it is one thing telling people fall sideways - sometimes you cant
I did a similar fall at verbier last week nothing happened to me, my wife did one last week and her back is still at her.....
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Those last tired runs can be nasty. Wonder if she could have a go at seated skiing as a temp leg disability? Probably even that would be too risky with her injury.
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if it were me I would be worried about the possibility of jarring - ah well that is my night at home with wife n kids over until Saturday - I am heading back up to Saas Fee now - talk to you later.
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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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obelix67, the mechanism of injury that you are describing (all your body weight behind a very bent knee) results in the thigh bone trying to move backwards accross the top of the shin bone. The cruciate ligament and the quadriceps mechanism are the principal appliers of force in the opposite direction - and since your friend was tired the quads were probably less than efficient and excess strain on the anterior cruciate - which snapped (she may tell you she felt/heard a "pop").
NO SKIING 
Unless she has had an MRI scan you do not know if other structures have been injured (especially medial cartilage and medial ligaments which fairly frequently get injured at the same time) and as Martin Nicholas, says she is putting the rest of the knee at risk until she is either fully rehabbed or orthopadiaclly repaired.
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obelix67, if she really has done in her cruciate ligaments, she will not be skiing this week has she been for physio? they'll give her an idea of what she can or can't do. from my own experience, the attitude of my physios immediately after the injury was that I'd done about as much damage as I could do to the knee so walking around on it and so on were OK. the muscle atrophied so quickly that the whole leg felt pretty unstable for a long time so i had no desire to be skiing on it
as other posters have said, the sitting back type of fall is the most difficult for bindings to deal with. you simply have to teach yourself that you DO NOT fall this way if you can possibly avoid it. as soon as you feel yourself getting in the back seat do everything you can to get forward
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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obelix67, I am not A. Surgeon, nor A. Doctor, but everything I've read about ACL (anterior cruciate ligament) injuries since 1986 suggests that the member of your group has experienced a classic ACL-spraining or (let's hope not) ACL-rupturing fall. The surgery for the latter is usually very successful, with good physio.
As snowball says, present-day bindings don't respond efficiently to this type of backward-twisting fall. Electronic bindings might do, but have never reached the market.
Nick L's advice reads true to me.
This injury was described, more than 15 years ago, by one of the world's experts as an "epidemic" within skiing. Building the strength of the muscles around the knee is - I believe - thought to be the key to protection and rehabilitation.
Best wishes to your fellow skier. Such a shame.
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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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David Goldsmith, she has almost certainly completely ruptured the ACL because of the immediacy of the swelling unfortunately. The medial ligaments and medial cartilage do not have much of a blood supply, so swelling following injuries to either of those is usually late and less (the next day usually).
The ACL however has a blood vessel running along it which ruptures (and therefore bleeds) when the ACL does.
(I tried to find a nice arthroscopic picture of a normal ACL with its blood vessel but couldn't, sorry)
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You know it makes sense.
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The review in the medical centre was that the cruciate had not torn but the medial had.
She is now thinking of giving up skiing - does boarding put the same stresses on your knees ?
This is the second time she has gone ski-ing last year on tyhe same knee she did the cartlidge.
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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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Lange introduced a boot some 3 years ago with RRS (Rear Release System) or something like that that was supposed to give some more protection from the 'sitting backwards fall' by allowing the shin bone to move backwards a little further - in theory to the point where the balance was such that the skier would end up on their back and the leverage would be instantly reduced.
I have not really been aware of any discussion on the success of these - or failure as I suspect the silence would indicate 
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Poster: A snowHead
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obelix67, have they drained the knee? If their view on the injury is purely clinical (i.e. not done and arthroscopy or an MRI) and especially if they have not drained the knee then it is really very difficult to tell at this stage.
I don't know about vulnerability of knees on boards but would imagine that it is less because the feet cannot move and twist completely independently of eachother. You are much more likely to break your wrists though
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Nick L, boards can do a lot of damage to knees, the most common being toe edge catch and smack your knee(s) straight into the piste. It's been known to split and/or displace kneecaps. You can get a lateral displacement if you slap your board's nose into a solid object.
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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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Masque, Nick L, You guys seem to know something about this so here goes: After an excellent week away in France over Christmas my grapefruit Stylee Knee doesn't seem to have gone down. Although swelling on the rest of the leg has subsided overall jus seems to be floating around, to the extent that after a recent flight back from the States my foot was completely bruised and even wearing socks causes weird Welsh mountain like appearances on my leg. Bruising also seems to be developing extremely lately. The knee remains in the same shape but without the same degree of pain as experienced whilst away. Any thoughts? Please don't tell me I have an ACL injury or that I need a knee drain, I'm terrified of needles - give me a 6ft drop any time!
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...And it goes without saying that I board!
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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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The swelling on her knee had dropped considerably by wednesday and it was the doctors assessment that is what she thought had happened - she gets the MRI with BUPA next week, we are not sure if it is from the same incident but the ankle on the same side has swollen up - could be from the metal brace - could be from going up on the cable car etc to Allalin to see the revolving restaurant - could be from not walking prooperly due to the brace.
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saxabar, just going by my own experience here, but it can take a very long time for swelling to subside. It can also move around (I found swelling from my knee slipped down to the ankle on one occasion). In addition to raising and icing the swelling, I found ibuprofen to be very good for reducing it
Impossible to tell over the internet whether it is an ACL or what - if it is an ACL, the joint will feel unstable and the muscles in the affected leg will probably have atrophied noticeably. Go and see a physio in the first instance
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Thanks Arno, I've had problems with my knee before but asides obvious bruising pain it doesn't feel like there is anything 'structurally' wrong. Liquid on my knee has moved around but I think overall it is subsiding, albeit very slowly. I'm going to book a doctors appointment this morning to be on the safe side - unlike when I'm away and go out riding with a knee I can barely fit in my trousers!
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and accelerating the onset of arthritis in the the joint into her 30s or 40s, which is a bit inevitable at some point in ones life after a cruciate injury
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Before everyone with an ACL goes out to buy their Zimmerframes in anticipation of their arthritic futures..................!!!!!!!!
Certainly ACL injuries increase the risk of osteoarthritis (due to the decreased stability of the knee joint) but does not mean it is inevitable that anyone with an ACL injury will definitely get arthritis aside from the fact that arthritis simply means "wear and tear" and as such everybody will get it sub-clinically to some extent.
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being a big on the crazy side she is now talking about getting a metal brace for her knee so she can at least venture onto the nursery slopes again later this week.
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The metal brace for the knee will match the metal brace for a leg she will require afterwards..........
Kevin 
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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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saxabar, I had one knee drained a few years ago. I am scared of needles. It's no big deal, really. I felt much better afterwards and had much greater movement in the joint.
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saxabar, Get a scan if you can to asses any ligament damage, but it may just be fluid so Ibuprofen (or Diclofenac Sodium - prescription only in the UK) will help a little but not for long term use. Draining may be a option but you DO NEED to see a doctor.
And as you and I have experienced, flying and immobility makes edema much worse to the point where it can mask a causative injury.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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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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Saxabar - If you can afford it pay to see a Phsio privately (about £30-50). I did my ACL & Lateral Ligaments about 5 years ago playing football. Went to see my GP and he gave me tablets, told me to come back in 6 weeks then put me on a waiting list to see a physio.
I paid to see the Physio from Birmingham City - within 5 minutes of examaning me knee he said he couldn't help and too put it bluntly my knee was F*cked ( I appreciated the honesty). Anyway got it reconstructed and skied 9 months later.
I ended up doing the same to the other leg, skiing (came of the first lift of the morning and fell, my own fault I shouldn't have been on the mountain as I didn't get in from the night before till 5a.m. - Red Bull and Vodka unfortunately doesn't give you wings it gives you too much confidence).
On the needle front, you get used to them I was really scared before all this but ended up having acupuncture as part of my physio (it's not too bad really and does seem to work).
If you have done it, get it sorted ASAP.
Work with the physio on your rehab and the more effort you put in the better the results.
Good Luck. 
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saxabar,
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As all needle fearing peeps, it is psychological rather than a pain thing. Perhaps sH shouldf market Snowbunnys for us to hug onto whilst being treat for injuries?
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I appreciate the thought, and I guess I would be kept quite busy 
I know a really good Orthopod in Bristol, or alternatively an Orthopaedic Physician, same place if you want the details, pm me.
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You know it makes sense.
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Needle phobia??? - as a diabetic kid I didn't like other ppl doing injections, so I did my own tetanus jab at the Dr.s. I found that slowly pushing the needle into the thigh muscle isn't really the best way to do 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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Scarpa, The more you write the more nauseous I get 
saxabar, MRI will show any damage but a GOOD knee doc probably won't need it to get the diagnosis right. There are lots of SHs who can recommend a good un and probably in your area. I've one close by but I've no idea what his list length is like.
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Poster: A snowHead
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Masque, That's a common effect I have on people
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Darky
Darky
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