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Modern knees

 Poster: A snowHead
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Is it my imagination or have dodgy knees become a far more common occurrence? And if so then why? It's not just amongst skiers but amongst 'normal' people too,knee replacement operations seem to be almost de rigeur.
And if they are becoming more common then why because I would like to do everything I reasonably can to avoid it? I'm sixty, mountain bike, trail run, walk the dog and obviously ski. So I would have thought I'm a prime candidate. Thus far though, touch wood, I've had no symptoms. Are there any common causes?
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I am sure a lot of my damage was done due to hockey moving onto AstroTurf rather than grass. Running on grass has more cushioning that on date, also when you stop and turn you tend to skid a little. Whereas running with turf trainers on Astro, you get more shock up through the knees and you can turn very quickly due to the better grip.
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It's a side effect of obesity.

They can make people feel better about being fat by reducing clothing sizes all the time, but fat peoples' knees are still not designed for all that weight.
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philwig wrote:
It's a side effect of obesity.

They can make people feel better about being fat by reducing clothing sizes all the time, but fat peoples' knees are still not designed for all that weight.


Actually yes that is also a part of mine - a good part of my time running round that pitch I was overweight, no where near obese but that also added to it. However I started having pains from my knees before I gained the extra weight and I had to switch to cushioned trainers.
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In general, today people are heavier and that is a factor and we are also far less active so muscle control and shock absorption is poorer. Our joints are the first to suffer. Eat less, play more, problem solved . . .

Fat old white guy with fer some reason, good knees . . . Everything else is f*d though Evil or Very Mad

As a sidebar, bad running technique and poor biomechanical training plays a big role in boogering oop knees.
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OK, mine are a combination of sporting injuries as a young adult, poor recovery techniques (ice...who needs ice?), a more sedentary lifestyle as I got older and the post kids weight gain - its a lethal combination for knees.
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@NickyJ, has it right I think. Ski related injuries are all to do with 1. High rigid plastic boots (mid 70s, well documented shift from broken ankles to broken ACLs) and to a lesser extent 2. Carving skis and associated torques.
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esaw1 wrote:
Is it my imagination or have dodgy knees become a far more common occurrence?

A very quick google showed a study showing a big increase in ACL's 5 to 14 year olds and a big increase in females but not easy to answer definitively.

esaw1 wrote:
And if so then why? It's not just amongst skiers but amongst 'normal' people too,knee replacement operations seem to be almost de rigeur.
And if they are becoming more common then why because I would like to do everything I reasonably can to avoid it? I'm sixty, mountain bike, trail run, walk the dog and obviously ski. So I would have thought I'm a prime candidate. Thus far though, touch wood, I've had no symptoms. Are there any common causes?

Very much doubt there is one simple cause. Artificaly surfaces get a bad rap, some top flight rugby players with knee issues refuse to play on them. But reports I've read suggest the jury is still out on whether they are direct cause of more injuries than on grass. I think in some cases athletes are over training. Obesity quite naturally puts a strain on the knees. Perhaps there is a more of a culture for going under the knife these days. Having spoken to a few people that have had knee surgery my overwhelming impression is that you avoid it if at all possible.
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Running on pavements.
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I think it is the result of 3 things:

We are living longer so our knees are wearing out.
We a active for longer. When I was young, men over 65 would stagger to the park bench sit for a while or play bowls. Now we ski, climb and do active sports. I remember being very impressed talking to some one over 65 who still rock climbed. Now my riends over 70 climb to a gigh standard but can barely walk because thir knees have had it.
We expect better. No longer do we sit by saying its just cos we're getting old but want to do something about it
Quote:

Having spoken to a few people that have had knee surgery my overwhelming impression is that you avoid it if at all possible.

I am really glad I had my ruptured ACL repaired
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esaw1 wrote:
IAre there any common causes?


As has already been mentioned
Obesity
Running on pavements
living longer


to add
Ball sports with quick changes in direction (squash, hockey etc)
Parcour (kids)
Wide skis on hard pistes

Quote:
In an article by Discovery News, Dr. LaPrade comments on the effects of fat skis on the knees. The fat ski phenomena started a few years ago when ski companies designed a wider platform to help skiers stay above soft snow and deep powder. In the Rocky Mountains, Dr. LaPrade has seen more torn knee ligament injuries as a result of fat skis. He says, “more than 75 percent of people have them [fat skis].”

“On powder days, we don’t see any injuries,” said Dr. LaPrade. “It’s usually four or five days without snow when it gets icier. I don’t see people changing over [to skinnier skis]. Most people are skiing with powder type skies. Once the snow gets packed down, then we see torn ACLs. [anterior cruciate ligament].” Using the proper skis for the terrain and keeping yourself physically fit are some ways to lower your risk of injury.


https://drrobertlaprademd.com/fat-skis-may-hurt-knees/


Your mountainbiking and walking is probably doing a lot of good for your knees i.e. exercising the muscles around the knee to make the knee more stable without pounding the knee till they break.


Last edited by snowHeads are a friendly bunch. on Mon 12-11-18 13:44; edited 1 time in total
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A lot more of the “weekend warrior” syndrome - people who run longer distances, ski more ambitiously, etc. but don’t have the muscle training to support that. I include myself in that category- three knee injuries skiing, two minor, one ACL and meniscus. You’d think I’d have figured out after the first two that something was amiss!!
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johnE wrote:
I think it is the result of 3 things:

We are living longer so our knees are wearing out.
We a active for longer. When I was young, men over 65 would stagger to the park bench sit for a while or play bowls. Now we ski, climb and do active sports. I remember being very impressed talking to some one over 65 who still rock climbed. Now my riends over 70 climb to a gigh standard but can barely walk because thir knees have had it.
We expect better. No longer do we sit by saying its just cos we're getting old but want to do something about it
Quote:

Having spoken to a few people that have had knee surgery my overwhelming impression is that you avoid it if at all possible.

I am really glad I had my ruptured ACL repaired

ACL repair is a good shout, but Surgeons are trying to avoid surgery as it has shown that surgery increases the chances of arthritis dramatically. I had my knee ops at 8, 14 & 20. Just hanging on to avoid the 4th which will do away with much of 1, 2 & 3 Laughing
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Frosty the Snowman wrote:
I had my knee ops at 8, 14 & 20.


3 knee ops on the same day must have been tough wink

Seriously 3 knee ops before you were 21? Why?
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NickyJ wrote:
I am sure a lot of my damage was done due to hockey moving onto AstroTurf rather than grass.


Actually we avoided most of the issue with that in the UK, due everyone being too cheap to lay astros for years. As a result we didn't get the turf/concrete pitches, that did for a generation of Dutch players and only saw the turf/rubber/concrete ones.

And now a little bit of TV coverage seems to mean we all have to switch to Smurf turfs and pink balls.
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 Poster: A snowHead
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Quote:

post kids weight gain

Lots of good reasons for dodgy knees given above - but "post kids weight gain"???? It's amazing the number of things people can find to account for their weight gain. The additional strain on knees from just a few kilos of extra weight is substantial - but given that men can be overweight, as can women who have never had kids, blaming pregnancies is just a cop out. rolling eyes
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Wider skis put extra strain on the knees, don't they?
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DB wrote:
Frosty the Snowman wrote:
I had my knee ops at 8, 14 & 20.


3 knee ops on the same day must have been tough wink

Seriously 3 knee ops before you were 21? Why?


Aged 8 - knelt on a sewing needle in the carpet at home, it snapped, half went into the carpet, the other half ended up in the middle of the knee joint. 2.5 hr op to remove it as they couldn't find it, a fair amount of damage.
14 - A school rugby accident, bad break of the kneecap, op to repair and remove loose bodies
20 rugby accident - The terrible triad, full reconstruction using carbon fibre (read up on that if you want a laugh) a full 24 months to get back from that, never the same though

Been putting a replacement off for the past 15 yrs. Just had a flare up and thought that was it, but it seems to be settling after a week of full bifta drugs.
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Knee problems aren’t increasing but expectations of what we can/ should be able to do on our knees has.
Patients have high expectations of what they can participate in post treatment for injuries and arthritis.

Obesity is the one area where I think we are seeing more need of treatments because of premature arthritis.

Running does not directly cause arthritis unless there are already problems with the knee.

In the past many who ruptured their ACL were told to give up all sports .

We also have new treatments when compared to 20 years ago. I’ve spent 20 years keeping the active active and have more to offer than I did when I started
Jonathan Bell
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I feel that there's scope to look at ski types with a different focus on how they build and contain loading in use to help mitigate this area of skiing.

There's some very opposing characteristics within ski performance, some of which I think should be avoided by people that have a vulnerability in this critical aspect of using them.

We were close/scratching the surface of this subject in @NickyJ, thread about ski choice, it may be worth adding to that one as it got a little dissolved in just technical semantics rather than giving a better understanding of what a ski construction can do to help in this direction.

The bindings of any type are the fuse or resettable shear coupling that caps the torque coming into the leg, but to put the whole transaction under examination it needs to understand how that torque builds in use, can it be tempered by ski design, and what you'd look for in trying to create a more balanced set of load building properties, and trying to ski with a lessened total load to contain the forces at a capacity below which it can cause damage.
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pam w wrote:
Quote:

post kids weight gain

Lots of good reasons for dodgy knees given above - but "post kids weight gain"???? It's amazing the number of things people can find to account for their weight gain. The additional strain on knees from just a few kilos of extra weight is substantial - but given that men can be overweight, as can women who have never had kids, blaming pregnancies is just a cop out. rolling eyes

Post kids isn't necessarily blaming it on pregnancies is it?
My own life style changed a bit post kids and I had less excercise and got out less.
I never was pregnant though as far as I remember. wink
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T Bar wrote:
pam w wrote:
Quote:

post kids weight gain

Lots of good reasons for dodgy knees given above - but "post kids weight gain"???? It's amazing the number of things people can find to account for their weight gain. The additional strain on knees from just a few kilos of extra weight is substantial - but given that men can be overweight, as can women who have never had kids, blaming pregnancies is just a cop out. rolling eyes

Post kids isn't necessarily blaming it on pregnancies is it?
My own life style changed a bit post kids and I had less excercise and got out less.
I never was pregnant though as far as I remember. wink


Given I'm a bloke, gaining weight after my pregnancy would have constituted a miracle of science!

Pretty much what T Bar has said - post kids I went from gym/tennis/cricket/5 a side during the week and weekends to struggling to fit in one session and still do my share of the looking after. Add lack of sleep, and the inclination to go for a run just dissipates. I admire people who can carry on much as before, sadly I wasn't one of them.
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Quote:

Post kids isn't necessarily blaming it on pregnancies is it?

I'm puzzled by what else you'd blame it on (not that pregnancy is any excuse). I had a sedentary job and did a lot more exercise at times when I was looking after the kids than when I was in the office. Running up and down stairs, taking them to parks, dashing round picking up after them, walking miles round Gatwick airport when weeks of rainy weather meant that options for excursions were few...... housework, washing, etc. Not as much exercise as a tree surgeon, or a postman, granted, but far more than an office worker.
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I would say other generations suffered from worn out knees as well. Just back then the solution was to live with the chronic pain.
We may be living longer, but most folk drive more & walk less as well as having a desk job compared to manual labour.
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pam w wrote:
Quote:

Post kids isn't necessarily blaming it on pregnancies is it?

I'm puzzled by what else you'd blame it on (not that pregnancy is any excuse). I had a sedentary job and did a lot more exercise at times when I was looking after the kids than when I was in the office. Running up and down stairs, taking them to parks, dashing round picking up after them, walking miles round Gatwick airport when weeks of rainy weather meant that options for excursions were few...... housework, washing, etc. Not as much exercise as a tree surgeon, or a postman, granted, but far more than an office worker.


I would call it lifestyle changes. These can very easily catch you out. Be they going from being a uni student who had the luxury of being able to cycle / walk between lectures and do sports activities, to working full time at a desk, to becoming pregnant where I was told to not ski or play hockey (rightly or wrongly this is what my GP told me!), to having a very young baby so struggling to adapt to learn their needs and struggling to fit in the same level of exercise, to having an injury where you are stuck on crutches. I have been caught out by these all of which has caused weight gain as I failed to reduce the amount I eat successfully to adjust for those lifestyle changes.
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Mjit wrote:
NickyJ wrote:
I am sure a lot of my damage was done due to hockey moving onto AstroTurf rather than grass.


Actually we avoided most of the issue with that in the UK, due everyone being too cheap to lay astros for years. As a result we didn't get the turf/concrete pitches, that did for a generation of Dutch players and only saw the turf/rubber/concrete ones.

And now a little bit of TV coverage seems to mean we all have to switch to Smurf turfs and pink balls.


I started playing club hockey at 13. Training was all on Astro but only playing for 3rds then meant I got to play matches on grass, only 1st’s and sometimes seconds team played on Astro. However while in my twenties we saw league rules change to say that all league matches had to be played on Astro. This caused some clubs - Persore eg to stop playing league, Upton upon Severn have to make Malvern their “home” pitch (as well as other teams) and made the game a lot more expensive. Can’t remember the exact year but that was around 2002.
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There looks to be a programme featuring a knee replacement operation tonight on Channel 5 at 10pm.
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Thanks @rjs, set to record
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Blimey, I'm watching that and it's really gruesome Shocked

Admiration for the med team, but certainly makes me move committed to looking after my own knees.
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Layne wrote:

A very quick google showed a study showing a big increase in ACL's 5 to 14 year olds and a big increase in females but not easy to answer definitively.



This is happening in Australia. The main cause is more girls playing football (soccer, but especially Australian Rules). There's been an explosion in numbers, they start playing at 12 or 13 not knowing how to bump, fall, ride tackles etc and do their knees. I'm a teacher, and a couple of girls on crutches at school at the moment for that reason.
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I watched that surgery programme last night (wincing when a perfectly good ACL was cut in half!). If I recall correctly, the stated two main causes of the need for TKR surgery (or cartilage wear and tear) were genetics and too much impact exercise whilst "young" (unspecified).

I'm not really sure that modern knees are that much more susceptible; more that when surgery wasn't available or was less common or 'easy' then people put up with knee problems and pain as inevitable consequences of age, accident or a hardworking life. They also often didn't live long enough; but perhaps now the more mature folk also expect not only a longer and more enjoyable life, but to be more active and less limited by musculoskeletal or osteopathic limitations. Not a bad expectation, btw.
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I am of a similar view to Grizzler, I suspect that dodgy knees are becoming more common due to the changes in our general lifestyles. We live longer and are very active to a much greater age than historically plus replacement surgery is now almost the norm whereas in the past you just put up with discomfort and then you died. My husbands hip replacement a year ago has been life changing and he will be back on the slopes in 2020, he never gives the new hip a second thought these days.
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Maybe you're right. People are generally a bit heavier and due to lifestyle we don't exercise as much the muscles which support the knee joint.

This book helped me get over recurring knee problems, which stemmed from overuse injuries by running: https://www.amazon.co.uk/dp/0897934229/?tag=amz07b-21

The gist is: strengthen your quads and hamstrings because they support the knee joint.
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According to inside health people who run regularly have thicker cartilage. Wearing it out maybe a function of age and inactivity rather than too much activity!
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So as someone 6 weeks away from my ski trip, lying here with a very painful knee that I can’t bend so that my heal can’t touch my butt, anyone have any suggestions as to how to tackle this?

I have an appointment with a physio on Wednesday and have a knee brace but I’m panicking a bit that I’ll not be able to ski
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@kosciosco, you are doing same as I would (have done!!!) in your situation which is see a good physio ASAP.
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@NickyJ, +1
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@kosciosco, this was my post on similar a month ahead of going skiing

https://snowheads.com/ski-forum/viewtopic.php?t=98989

Nb i did get there and was able to ski.
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