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Mild MCL sprain/pain

 Poster: A snowHead
Poster: A snowHead
I think I have a quite mild MCL sprain in my 40 year old left knee as there is a little pain there, but nothing major.

There was no accident to cause anything specific. Having had a google, it can’t really be higher than grade 1.

I think it may be caused by a bit of inward knee rotation / poor technique while I was on my last ski trip at the end of Jan.

What sort of exercises (rest first?) should I be doing to help this?

Also, going forward, on the piste is there a good drill to prevent inner rotation of the knee?

Could it also be caused (or exacerbated) by a lack of foot arch in my boot footbed? I just have this feeling that if I had more footbed arch (or maybe even if my custom liners or boot were stiffer) it would be happening a bit less, but maybe it’s just poor technique...
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I injured my MCL about 10 or 12 years ago. Once it had healed it didn't bother me for years, but over the last 2 or 3 years it has started to. I over pronate on that leg and that definitely makes it worse. I tried several insoles but the only ones that help are my ski boot footbeds, so I wear a pair most of the time. Building up muscle strength really helps too, so I get out on the bike and do quite a few squats.

Coincidentally I had an MRI scan last Saturday, so I'll know a bit more when I get the results.
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Quote:

Could it also be caused (or exacerbated) by a lack of foot arch in my boot footbed? I just have this feeling that if I had more footbed arch (or maybe even if my custom liners or boot were stiffer)

Quite likely. Especially if you have this same "feeling" of your knees having too much inward rotation...

See a better boot fitter. Or try a wedge on the big toe side of your boot (2-3 layer of duct tape would be a good start).
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Thanks. I’ll probably go and get it checked out next week if it hasn’t subsided by then. I think squats at the gym actually brought the mild pain back out! I may have been a bit eager to strengthen my legs after skiing.
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abc wrote:
Quote:

Could it also be caused (or exacerbated) by a lack of foot arch in my boot footbed? I just have this feeling that if I had more footbed arch (or maybe even if my custom liners or boot were stiffer)

Quite likely. Especially if you have this same "feeling" of your knees having too much inward rotation...

See a better boot fitter. Or try a wedge on the big toe side of your boot (2-3 layer of duct tape would be a good start).


Thanks. I’m definitely going to do it in resort next time as my friend has an excellent place in Courchevel he uses every year (he’s an instructor).

I’m also skiing a bit more aggressively and often (just over 30 days this season so far), and I feel that at 100 flex my Lange RX100 may not be stiff enough (I’m 1.76m, 67kg). I could be talking utter rubbish of course and it may have nothing to do with stiffness!

I’d say I’m at probably now around about lower advanced skier on piste, but not “expert” let’s say...
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What makes you think that it's MCL? It may just be general age (sorry Sad ), 'wear and tear', mild meniscal degeneration or something like that. Or just some general strain and irritation because your knees aren't properly aligned? Can you get a physio to check and advise?

Subject to that - would definitely recommend getting some proper custom footbeds (not just for skiing but for everyday footwear, so that you minimise ongoing strain on anything which is irritated or healing).
General attention to which way your knees and lower legs/feet are pointing should assist your brain to remember to tell your muscles not to let your knees fall inwards - be aware of them when doing exercises, walking, squatting (slowly is good) and always when skiing.
Exercises to make you aware of and strengthen the inner and outer thighs may help (? squeezing balls between thighs?)
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
The reason I say MCL is purely because of the location, but I could be wrong of course. Could also be age as you say Sad

Hadn’t thought of footbeds for shoes, but that’s an interesting idea. I’m definitely acutely aware of watching my knee rotation lately and am trying not to allow it to happen.

It was when skiing that I noticed my left knee kept wanting to rotate inward, hence the footbed question... I would consciously try and resist that.

I still think the footbed I had made as part of the boot fitting at a specialist in London could be a smoking gun in all this...
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anjunabeats wrote:
I still think the footbed I had made as part of the boot fitting at a specialist in London could be a smoking gun in all this...


Could be. I've had some really bad, useless (and very expensive) well-known make insoles 'custom made' by a 'specialist' fitter. And I've had some good ones mess up my ski boot fit because they were just a tad too long and not quite sitting right inside.
Layman's check - take them out of ski boots, put on floor and stand on them in your socks. What's knees and general support and alignment doing compared to standing without them?
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Grizzler wrote:
anjunabeats wrote:
I still think the footbed I had made as part of the boot fitting at a specialist in London could be a smoking gun in all this...


Could be. I've had some really bad, useless (and very expensive) well-known make insoles 'custom made' by a 'specialist' fitter. And I've had some good ones mess up my ski boot fit because they were just a tad too long and not quite sitting right inside.
Layman's check - take them out of ski boots, put on floor and stand on them in your socks. What's knees and general support and alignment doing compared to standing without them?


That’s a great idea - cheers!

Not sure how to post photos, but I just had a play, and a few observations taking the footbeds out of the liners:

- on both footbeds the arch doesn’t look as big/wide into the middle of the foot as my foot arch actually is. Or let’s just say I could definitely have more support and it would probably feel fine...

- the left foot (the side with the knee issue) bed arch is slightly lower than the right

- I couldn’t discern a major alignment issue from this compared to standing on the floor

Obviously feet are different so the shape difference is a bit unscientific, however, putting it them back into the Sidas liner, but not in the boot and putting my feet in:

- the foot arches feel too far back (Ie closer to the heel than they possibly should be), even if flexing the ankles forward

- generally I wouldn’t describe the foot arch as massively complementing my feet! There is a resemblance, but I just don’t think it’s right, and I would say the left is a bit worse than the right!

I’ve not been sure about my boots.

They are not terrible and the shop has offered me another go at the sidas liners as I had a problem with them (which has temporarily been improved by slightly moving the Velcro from shin pad - could this have also changed things?) hurting the top of my foot from a hard part of the foam injection molding where the foam gets cut/bunged.

I enjoy this sport so much that this test has just made me doubt them further, and I want to just start again in resort as I don’t want to mess with my knees!

The only other thing to report is I do have a Therm-IC heater on the footbed, but if anything this is adding to the footbed and doesn’t seem to be causing a problem looking at it.
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@anjunabeats, I had similar about 5 days into a week in Tignes this year. I used to do a lot of off season cycling, but have not done much the last couple of years so my knees dont have the strength.

My "injury" came after a long day on fresh snow, negotiating huge moguls and generally just a massive massive amount of strain on the knees.

I got in that evening and noticed the classic lump on the inside - but no pain at all.

I managed it on the last day by using a knee brace, pulled up as tight as poss - and as the lat day was very bright and the skiing easy, had no issues.

It has calmed down now, but will be tested in Scottish skiing a day or so next week (weather permitting).

I suspect that lots of knee work pre ski season is what I need and may also be part of the answer for you.
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