 Poster: A snowHead
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Hi all,
I hurt my knee in the most stupid way yesterday - I was offloading from the chairlift on the far right, the person next to me threw a massive snowplough on the off-ramp which I couldn’t dodge and completely wiped my left leg out. My left knee twisted in and popped really loudly. Weirdly, it didn’t actually hurt that much past the first few minutes, but when I tried putting weight on it it just buckled. Got taken down in the sled and the clinic thinks it’s probably an ACL, although I do have significant pain along the outside of my knee when it’s in certain positions too. I can’t get an MRI until I get home (thankfully I got almost the full week of skiing in before this happened). Right now I’m on crutches, less because of pain and more because my knee is really wobbly. Has anyone had a similar experience and it not turn out of be an ACL? I’m trying to stay positive at the moment (and not project too much anger towards the random stranger who didn’t know how to get off a chairlift properly  ) - but I’m going to be devastated if it’s a bad one. I lead a really active life so a long rehab is my worst nightmare really.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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That’s really bad luck - sadly your description suggests an ACL injury but an MRI will be needed - best of luck with your recovery - #come back stronger!
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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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@kfaz688, everybody's different and there are people who have run marathons WITHOUT an ACL. Mine I couls feel the instability while walking, although witb the physio leading upto the op to get full ROM back and the swelling down, it was feeling pretty good and I did wonder should I do it?
I don't regret getting it done, I was only 29 when I had the op. I have since damaged the recon so it isn't as stable as it was and have given up hockey as a result and use a hinged knee brace. I am not sure I would now go back through the rehab.
See how phsyio goes, you can achieve a lot by building up amd keeping muscles strong to make up for lack of ACL.
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You need to Login to know who's really who.
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@kfaz688, I feel your pain - I snapped mine mid April, although entirely my own fault (fell off a bouldering wall). For me it was quite an emotional roller coaster for the first few weeks, especially until I'd got the result from the MRI confirming it was snapped, which wasn't until a month after I'd had the accident. I was really trying to convince myself it wasn't going to be snapped, because it wasn't particularly unstrable, but sadly it was.
I hope you get confirmation of the damage quicker than I did, because at least once you get the result, you know what you are up against, and what the options are.
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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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 it does sound like an ACL
Hope you get the person's details to claim off their insurance!
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You'll need to Register first of course.
You'll need to Register first of course.
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Back home now and been to see my doctor - he also suspects ACL damage due to the swelling and instability, but MRI to confirm. I can’t extend or bend my knee that much at the moment, is that normal for an ACL tear? My doctor said range of motion can vary depending on what’s been damaged, but keen to hear others’ experiences
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@kfaz688, as I said above had to do a lot of physio to regain full rom. Although also possible that other damage was done when it collapsed.
ETA my consultant wouldn't operate until after I had got swelling down and regained full ROM. This was due to having no other significant damage.... that time
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| kfaz688 wrote: |
| Back home now and been to see my doctor - he also suspects ACL damage due to the swelling and instability, but MRI to confirm. I can’t extend or bend my knee that much at the moment, is that normal for an ACL tear? My doctor said range of motion can vary depending on what’s been damaged, but keen to hear others’ experiences |
depends on the swollen parts.
Any idea when your MRI is likely to be? Due to strikes/waiting lists, etc., you could ask your GP for a referral/agreement for you to self pay/fund one.
If you need surgery, it is not going to bump you up the list - but at least you will know the extent of your injury. Private MRI can be found for around £200
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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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I can't comment on the OP's situation, although it does sound from the description as text book ACL.
But I thought I'd share a recent experience with a private MRI.
I injured my knee over Christmas - no idea how and nothing to do with skiing... but I was extremely keen to know what was wrong as our ski trip is only a few weeks away. I couldn't get a rapid appointment through my health insurance so decided to research self-refer, self-pay MRI options. I was pleasantly surprised to find a firm (Vista Health) who could get me a same day MRI* for £350, including radiologist report, which arrived about 40 hours after the scan. So not quite £200, but it was same day, at Christmas, so I was pretty pleased.
In my case, the report wasn't conclusive - although it did show that I have "a degree of injury" to my ACL, which I suspect is an unrelated historic injury**. So I'm now in a position where I don't quite know what the original issue was (it's getting better of its own accord thankfully) but I now have the knowledge that I'm probably just one bad fall on the slopes from the day I hear that dreaded pop. It's focused my mind on ensuring my DIN settings are right. But I guess one should also be careful what one wishes for... I could have let sleeping dogs lie!
Anyway - my reason for posting is that they sent me the imaging files. Hundreds of .DCM images. Nothing on my Mac could read them but I found a piece of software that can (OsiriX Lite) and it is UNBELIEVABLY amazing. I think it's the tool the radiologists use and the visualisations it can produce are awesome... I can see the inside of my knee from multiple directions, can walk through the 'slices' seeing the (thin/ragged in my case) ACL appear, with the (thick/solid) PCL coming up behind it... I can see pretty much all the anatomical features of my knee. It's been an amazing learning experience... and there is a wealth of knowledge online (mostly aimed at medical students I think) explaining how to understand what you're seeing.
However, what it made me realise is that there's probably no such thing as 'an MRI'. eg in my case, the slices are 3 or 4mm apart. Would there have been an option to get them 1mm apart? Maybe not - maybe it's fixed in the machine, but my guess is it's a configurable parameter... where it simply takes more time (and energy) to do more slices. Next time I might be tempted to ask how much extra it would be.
Similarly, the literature talks about 'T1' and 'T2' imaging, which influences which types of body part appear relatively darker/brighter in the imaging. In my case, the operators had scanned all three axes of my knee with one of these types, and then also scanned one axis (sagittal) again, with the other. They know what they're doing, of course. But, in my curiosity, I'd have been really interested to see all axes in both modes. ***
Net-net... I wouldn't hesitate to do this again. It is extremely empowering to be able to see your own images, and be able to use online resources to figure out (even if at a very superficial level) what they mean.
* The machine itself was in a trailer in the corner of an Asda car park! Operated/owned by 'InHealth'. Interestingly, it also had an NHS logo on it, so I guess they provide capacity for the health service as well as to private firms and self-pay individuals?
** This is the problem with online information... it can fool you into thinking you're an expert. But, in my case, the fact there was nothing in the imaging to suggest recent injury and the fact that the report was carefully worded to leave the timing of the ACL injury ambiguous makes me suspect I'm right that we'd simply discovered an old injury.
*** I think this is an over-simplification too. The 'TE' and 'TR' settings for each of my four series were different
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@gendal,
was going to say that OsiriX will read them. I have all my MRI's & Xray's loaded into it. The Software came with my MRI scans when I requested my medical records from my local NHS trust.
I have used in-health (aka vista-health) - in a trailer! My price was £250, but would have been £230 if I was prepared to wait another 10 days & turn up at 8am!!!
They sent my results where they are viewable online & can also download the scan (to load in OsiriX). You can even share your scan with a unique password to pass on to your GP.
The online viewer allows me to set all sorts of variables including slicing down to 1mm!
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@gendal, i have seen some of my MRI scans, and I couldn't make any sense out them. My hats go off to the experts.
Also old injuries make them very difficult to read from what I understood. On my second to last knee injury / problem. From MRI it looked like ACL (reconstructed) was still intact, but when they operated (had bits of cartilage jammed into the joint) the guy reported that the recon had been damaged with only half of it left, which had left it unstable and hence lead to collapse wĥile sprinting which caused cartilage to get jammed into places it shouldn't be.
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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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| Gored wrote: |
@gendal,
The online viewer allows me to set all sorts of variables including slicing down to 1mm! |
Interesting... do you think an image actually exists for each 1mm slice? Or is it being interpolated? The image files I downloaded - and imported into OsiriX - are definitely 3/4mm apart. I guess it's possible they did take far more images but only included a subset in the download package? That would be pretty exciting if so.
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Yeah definitely going to go the private MRI route, otherwise it’s going to take weeks - I’d rather know what I’m looking at as soon as possible even if it doesn’t speed up the actual process. I can get in tomorrow with report 1-2 days after so I think I’ll do that. Thanks for the tip on the software too, I’ll be really interested in what I can see with mine.
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You know it makes sense.
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| gendal wrote: |
| Gored wrote: |
@gendal,
The online viewer allows me to set all sorts of variables including slicing down to 1mm! |
Interesting... do you think an image actually exists for each 1mm slice? Or is it being interpolated? The image files I downloaded - and imported into OsiriX - are definitely 3/4mm apart. I guess it's possible they did take far more images but only included a subset in the download package? That would be pretty exciting if so. |
no idea - maybe it is down to the parameters for the area they are scanning and what the symptoms are. For me, my issue was to do with small bones & quite a small localised area.
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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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| Gored wrote: |
| gendal wrote: |
| Gored wrote: |
@gendal,
The online viewer allows me to set all sorts of variables including slicing down to 1mm! |
Interesting... do you think an image actually exists for each 1mm slice? Or is it being interpolated? The image files I downloaded - and imported into OsiriX - are definitely 3/4mm apart. I guess it's possible they did take far more images but only included a subset in the download package? That would be pretty exciting if so. |
no idea - maybe it is down to the parameters for the area they are scanning and what the symptoms are. For me, my issue was to do with small bones & quite a small localised area. |
Makes sense. I've just checked my online version and it's definitely just 3 or 4mm. (or maybe 3mm thickness, taken 3.5mm apart?). So that would confirm my suspicion that it's very much a configurable parameter!
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Poster: A snowHead
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most MRI's are on the order or 3/4mm slices and the two types of images are done as one is better to "see" bone damage the other soft tissue. There are "HD" MRI machines (3T) that are an order of magnitude better than the standard ones but not many hospitals have them but if you can find one well worth it to accurately assess damage with a much finer slice and better resolution...
Depending on where the beam slices your ACL you may not even see the tear... But a simple Lachman test of joint mobility once the swelling is down will confirm...
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Update - MRI has come back confirming ruptured ACL and LCL
Has anyone had experience with this combination of ligaments before? Or recommendations for a good orthopaedic surgeon to get started?
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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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Update - MRI has come back confirming ruptured ACL and LCL
Has anyone had experience with this combination of ligaments before? Or recommendations for a good orthopaedic surgeon to get started?
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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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@kfaz688, Jonathan Bell at Wimbledon Clinics...also a snowhead
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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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| holidayloverxx wrote: |
| @kfaz688, Jonathan Bell at Wimbledon Clinics...also a snowhead |
+1
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You'll need to Register first of course.
You'll need to Register first of course.
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| kfaz688 wrote: |
Hi all,
I hurt my knee in the most stupid way yesterday - I was offloading from the chairlift on the far right, the person next to me threw a massive snowplough on the off-ramp which I couldn’t dodge and completely wiped my left leg out. My left knee twisted in and popped really loudly. Weirdly, it didn’t actually hurt that much past the first few minutes, but when I tried putting weight on it it just buckled. Got taken down in the sled and the clinic thinks it’s probably an ACL, although I do have significant pain along the outside of my knee when it’s in certain positions too. I can’t get an MRI until I get home (thankfully I got almost the full week of skiing in before this happened). Right now I’m on crutches, less because of pain and more because my knee is really wobbly. Has anyone had a similar experience and it not turn out of be an ACL? I’m trying to stay positive at the moment (and not project too much anger towards the random stranger who didn’t know how to get off a chairlift properly ) - but I’m going to be devastated if it’s a bad one. I lead a really active life so a long rehab is my worst nightmare really. |
I’m sorry to hear this.
I saw two identical to this yesterday.
How it happened, the pop, the swelling and the buckling make it about as certain as you can be that the ACL has been injured.
It needs lots of icing, use your crutches and possibly even commence physio now.
Your priority on return is to get it looked at by your local knee specialist who needs to examine it to determine if the ACL and other ligaments are injured.
Don’t worry about the MRI now, it is needed to assess the joint surfaces and meniscii but not immediately. The examination is more important.
The initial sense of pain and instability tend to settle quite quickly over a couple of weeks.
Jonathan Bell
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| kfaz688 wrote: |
Update - MRI has come back confirming ruptured ACL and LCL
Has anyone had experience with this combination of ligaments before? Or recommendations for a good orthopaedic surgeon to get started? |
Really sorry to hear this - I remember how I felt when my MRI came back last April and confirmed an ACL rupture as it was a bit of a surprise having had no pain or swelling, just a bit of instability post ski accident. I ruptured my other ACL 10 years ago (also skiing) and had that one reconstructed with no problems at all, however this time around my surgeon recommended no surgery due to increased arthritis risk and the fact that it was remarkably 'well behaved' with no instability a week post accident. I was very concerned about this as I had 2 ski holidays booked for this year but having read lots of encouraging posts on here from people in a similar situation, I just decided to go with it, do my exercises and see how I got on. I'm delighted to say that I'm just back from a few days' skiing and whilst the first run of the day was a bit terrifying as I wasn't sure how my knee would be, it was all plain sailing from then on and despite having no ACL in my left knee, I skied exactly as I'd always done and only thought about my knee on more difficult or icy slopes, not because there was any issue with it but just because I remembered there was no ACL in it! I've looked back and wondered now if I did need the first one reconstructed all those years ago as, like with this one, there was no swelling or pain and no instability either but that's what the surgeon recommended so that's what i did but it was a long, tough road to recovery with hours of physio to get to the position of being able to ski again a year later. I appreciate everyone is different but my advice would definitely be not to just assume you need surgery, as I'm sure many on here will agree with. Good luck!
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@bumble66, great news! Well done and keep the leg muscles strong.
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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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I always see offloading the chairlift as one of the most dangerous places on the mountain. The 6 and 8 man chairlifts always seem like a disaster waiting to happen - completely at the mercy of what the person next to you does.
Any general tips for avoiding potential carnage?
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@NBH, get on at the outside seat, get off last
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| NBH wrote: |
I always see offloading the chairlift as one of the most dangerous places on the mountain. The 6 and 8 man chairlifts always seem like a disaster waiting to happen - completely at the mercy of what the person next to you does.
Any general tips for avoiding potential carnage? |
avoid snowboarders (and i am one, so no offend to anyone)
try to avoid many people. If it is not possible always left or right.
You have to check the direction of the lift. It if turn on the mountain right, then sit left (and vice versa)
Except that you have to know where the people have to go after they left the chairlift.
If the piste goes direct left, then sit complete on the right side and go straight forward.
Better : take tow lifts or gondolas....
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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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@turms2, interesting point on taking note which way the chair/piste turns at the top - I hadn't considered that
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| NBH wrote: |
I always see offloading the chairlift as one of the most dangerous places on the mountain. The 6 and 8 man chairlifts always seem like a disaster waiting to happen - completely at the mercy of what the person next to you does.
Any general tips for avoiding potential carnage? |
I agree. The 5m at lift exit far more dangerous than any off piste I’ve skied!
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You know it makes sense.
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Offloading from chairlifts are full body contact combat skiing! Don’t be shy to fight for your space. 
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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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@abc,
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Offloading from chairlifts are full body contact combat skiing! Don’t be shy to fight for your space.
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Especially with people (mainly skiers it has to be said) standing about in the offloading area, who then complain as a boarder goes barrelling into them getting off the lift! (Rant over!)
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Poster: A snowHead
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Skiers stand and you stand a chance of sliding through them, snowboarders sit on the back bottoms, boards up and are even harder to get round or past ...
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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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| NBH wrote: |
| @turms2, interesting point on taking note which way the chair/piste turns at the top - I hadn't considered that |
yeap...as a snowboarder i sit always left or right....
taking as example the chairlift at the top turns right. I place my self always left at the first ride.
But if i noticed that exactly after leaving the chairlift everyone hat to ski left (sometimes is so) then i choose the other side for the next rides.
I put my wife (with skis) next to me so according to all these, she has enough space between myselft and the other person
the 6er or 8er chairlifts are always detachable meaning they are really slow at the top
the worst is the 4er fix chairlift which have a constant speed.
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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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@JonA,
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Skiers stand and you stand a chance of sliding through them, snowboarders sit on the back bottoms, boards up and are even harder to get round or past ...
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That's because the snowboarder has fallen over trying not to barrel into the group of skiers that was standing there not a few seconds ago! 
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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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@gixxerniknik, 
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You'll need to Register first of course.
You'll need to Register first of course.
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| NBH wrote: |
I always see offloading the chairlift as one of the most dangerous places on the mountain. The 6 and 8 man chairlifts always seem like a disaster waiting to happen - completely at the mercy of what the person next to you does.
Any general tips for avoiding potential carnage? |
Elbows out & poles at the ready to dig in. Protect your space. Leave the outside chairs to snowboarders if there is one in your surroundings.
Personally I try to aim for the outside seat to clear the whole lift area as quickly as possible.
If you are stuck next to a boarder, then note which foot they are leading with, as they are likely to turn off heel side (so leading left foot will see them turn left, if the right foot is strapped, then they will be turning right.
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| JonA wrote: |
| Skiers stand and you stand a chance of sliding through them, snowboarders sit on the back bottoms, boards up and are even harder to get round or past ... |
Harder to get around but also a better target for spraying them with snow! 
Those of us who have twin tip skis love boarders sitting in “inconvenient” spots. Smart snowboarders, on the other hand, know where to sit that are out of the way of traffic. (Two of my best ski buddies are boarders)
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Last off...............
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FAQ
