 Poster: A snowHead
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I will possibly have to ski with a knee brace next season and want some help from knee brace users. I want to know what brace you use and why you use it. ie to give more confidence in a weak joint, to prevent further or recurrence of injury, or for support. What are the short comings do they do exactly what it says on the box etc.
Basically I want to cut through the Bullsh*t and find out what I really need to know. At this point function is more important than price but if I pay alot I want one that works and will last.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Russell, I've been gven a Donjoy Armor knee brace - & its designed to be used skiing. I'll have to wait & see if it really works though. My ski boots are at our apartment at the moment, but I will try them on with the brace to see if it fits in September when we go down there.
From a support point of view though, it is great. I wore it when I started playing tennis again, & its light,gives me confidance, & the knee feels well supported in it.
My brother also tore his ACL last winter, and has been given a brace - he's a competetive tornado sailor (national level) & has been using it for that. I've forgotten which one it is, & he's away at the moment. I'll let you know when he is back in a week or so. He also rode a motor bike from Essex to Ghana six weeks after the knee injury & the brace worked well for that He's a snowboarder, & is thinking about surgery in November., but holding out on making the decision, because the brace is working for him. Also he's a GP, so a bit squeamish about letting a surgeon loose on his knee! 
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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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geri, Thanks
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Russell, Has your physio recommended a particular one?
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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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I can understand you want confidence after your injury but if you need the brace your knee probably isn't ready. None of these things should do the job of the muscles in your leg and none of them will do it as well. You should build up the muscles around the knee to such a degree - every one should this anyway - that they can support the joint. Too many peeps make the mistake of bandaging this or that because they get pain when the indicator of pain is really telling them something like the ligaments are doing too much of a muscle type job..!!
You should get a properly supervised rehab at the gym to get your muscles doing the job, the brace will be or should be psychological, I'd say
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Russell, I've just remembered - his is an Edge brace.
JT, I'm doing lots of physio & training with a personal trainer to get my knee fit for next season. And its doing well. I'm no longer wearing it for tennis - although I did tweak the knee a couple of times when I stopped wearing it. The brace certainly isnt intended to take the place of the muscles - just to reinforce them & help keep the knee stable during what is quite an intensive workout on the knee. It also helps with proprioception - & if you've never lost it, you wont know what it feels like!
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| JT wrote: |
I can understand you want confidence after your injury but if you need the brace your knee probably isn't ready. None of these things should do the job of the muscles in your leg and none of them will do it as well. You should build up the muscles around the knee to such a degree - every one should this anyway - that they can support the joint. Too many peeps make the mistake of bandaging this or that because they get pain when the indicator of pain is really telling them something like the ligaments are doing too much of a muscle type job..!!
You should get a properly supervised rehab at the gym to get your muscles doing the job, the brace will be or should be psychological, I'd say |
There is not one way that I can improve on this advice. You ever thought of being a doctor JT?
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JT, I am doing seeing a Physio every week and trying to develop muscle strength to support the joint. One problem may be that due to the injury I may never be able to lock the knee straight this is affecting the development of the muscles in my leg. The reason why I asked the question is because i want to find out all I can about the usefulness of a knee brace. I will make a decision about whether to use one when the phys show no signs of further improvement I'm 7 months on from injury but suffered a lot of muscle wastage I have been doing phys for 4 1/2 months and have been taking it seriously. I have thought about seeing a sports injury specialist to work on rehab but the hospital physiotherapist is highly recommended as well.
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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 have used a Donjoy brace as recommended by my physio after a partial ACL tear. The brace was excellent and provided good stability. Unfortunately a few years on I had a big fall and completely ruptured the same ACL.
The brace is designed to support and prevent further injury under moderate force. I don't imagine anything would have prevented my injury, such was the force of the fall.
One thing I would advise would be to get a consultation with a physio and listen to their recommendations for a brace rather than just buy one.
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Kramer,
Thanks...I'm just a good body listener and have had a few injuries...not on the scale of Russel's though.
I went to a physio in my teens when I wanted to get back into playing football and he laughed at my muscles. I've always had pretty good definition in my legs but he told me what I should do to get rid of pains in my joints... It worked and I still do those exercises for skiing to this day. Lucky I went to this wise old guy...!!
Russell,
I not trying to put a damper on this and wish you all the best. I may have this out of context but there is a world of difference between a physio trying to get you fit enough to sign off your rehab and wanting the injured knee to go skiing.
I'm no Dr or physio so take this with due reservation.. go to a sports physio and ask them to construct a regime building leg strenght, you at the very least need to be able to do squats at some time. I know what I start with and what works for me and I do this DAILY. Use a brace in the meantime to help prevent that tweak as you are still building up the muscles around the joint. Try not to concentrate of one set of muscles as these can over-power the other set. ie quads against hamstrings.... I did this last year and wondered why my calves were screaming but my quads weren't.. I'll sort that this year..
What I am saying is get a physio you trust..some work better than others... and consider what a professional athlete recovering from this type of injury would have to do Ever seen the skiinniest footballers legs..??? You might want to be on those lines with specific exercises.
I would have thought a decent physio would have said stuff like this but with a bit more authority and expertise
Sorry if you know this
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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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Very topical for me this. The results of my arthroscopy are in. Torn meniscal cartilage (Bucket handle tear) cut out and I have a torn ACL (non functioning) . The latter was only confirmed by manipulation under general anaesthetic, previous physical exams had shown good stability, presumably from muscles. My surgeon is advocating the conservative approach and wants to refer me for a custom brace. He recommends CTI over Donjoy - anyone got specific experience here.
Given I skied reasonably well for most of last season carrying the injury and even managed a couple of hours telemarking at MK last month I am inclined to go along with his approach then have a reconstruction later if necessary. Anyone want to persuade me otherwise?
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fatbob,
Probably on the lines of "if it isn't so broke, don't try and fix it. I don't know what a non-functioning ACL is but presumably it is able to
do some sort of job as its only torn and not snapped. I would think...with all the caveats above...that the surgeon is hoping that the ACL will repair itself over time and that you don't break it in the meantime, or that you will break it and recon is the only way to go. He isn't inviting work here and I guess that the NHS service could put the resource into more pressing concerns. A surgeon might be thinking I need to get this person walking and as a normal way of life as poss and others want to go skiing. The priorities and perspectives might be different. Thats why I said to Russell that he should have his own defined and specialist rehab. The NHS are probably far too occupied to be able to go there so it needs to be patient driven and probably paid for.....IMV
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You know it makes sense.
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fatbob, I'd follow his advice - go with conservative approach wherever possible.
Interestingly I bumped into one of our local orthopaedic surgeons in the gym a few days ago. He was rehabilitating his knee following a reconstruction of his ACL - he'd torn it 15 years ago, & it had been fine until it gave out a few times while playing tennis. So that was what decided him to have it done.
JT, From what I've been told, the ligaments dont repair themselves, you just learn to compensate by building up the muscles around the knee.
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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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Mine is private on insurance so NHS resource constraint shouldn't be an issue. The diagnosis is my ACL is torn such that it isn't working and will not repair itself, although it looks largely intact on scans etc. I have the option of reconstruction but if I can function without it through muscle compensation/bracing then I'm inclined in the short to medium term to try to do so. My surgeon had spent some time in Vail working with some of the surgeons there and said that the US approach was usually to reconstruct straight off the slopes but he felt this was problematic as a reconstructed joint will never have the same functionality and in some cases pain will endure. Obviously if I was a pro athlete reconstruction would probably be the only option but even then rehab takes 10 months so I am inclined to do muscle work in any event then see how it goes this winter with a brace, worst case is I build up my muscles which will prepare me better for surgery and I have to snowboard rather than ski if my knee can't take it or miss a few/all trips which I'd miss anyway if I had reconstruction. (I knew I shouldn't have booked the La Grave trip so early!!)
I am prepared to be dissuaded though by anyone with personal direct experience.
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Poster: A snowHead
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fatbob, My OH beanie, had a partially torn ACL in March 2004. Underwent an initial operation to assess the damage, had the torn ligament tidied, and still had approx 60% present. She underwent extensive physio, but the knee never became strong enough, and would regularly give way when changing directions, which caused a stir in the supermarket. 5 months later, she accepted the inevitable and underwent a full patella tendon reconstruction, and this has been completely successful, but the additional 5 month wait meant we lost another season.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Well, it's nice to see that I've finally found the "Knackered Knee" thread
I too damaged my knee last season. I had it x-rayed within an hour of the fall; was told it was ok; skied on it for 8 days and, only because things weren't healing, did I go to see my doctor.
The doctor said everything was ok, but sent me to a consultant "just in case" and because I had private cover.
The consultant said everything was ok, but sent me for an MRI "just to be sure".
It turned out that I had micro-fractures in my lower leg and a torn MCL. Depending on whether you believe the radiologist of the consultant, I also had an 80% tear in my ACL. Interestingly, because I went to a knee consultant, the MRI only covered my knee area - and so the horizontal bruise at boot line was never really investigated.
The consultant also recommended an non-interventionist approach, but it unfortunately didn't work for me and I had an arthroscopy 8 weeks ago and I'm just undergoing physio to recover the 60% muscle loss in my left quad. The arthoscopy found that I'd damaged a ligament that I'm not supposed to have in my knee. The chap even fessed up to getting the text book out.
What have I learnt through this?
- Xrays don't tell you everything
- injury is a matter of opinion until they open you up
- in hindsight I waited too long before getting them to open me up.
I'd agree with the thrust of JT's sentiments - if you have to have a knee brace then you probably shouldn't be skiing. But, let's face it, life isn't as simple as that. I'll be skiing this season, the whole season, and will be wearing a brace - at least at the beginning - to give me some added confidence.
Something I learnt is that it's not enough to find a good physio - you need to find a physio who does the sport you want to do (again). Find a physio who runs for runinng injuries and find a phsyio who skis for skiing injuries. Why? Because the first two physios I saw obviously didn't have a clue about skiing and didn't understand. One of them told me that I should probably not consider skiing again.
I've thankfully found a physio who skis - and understands that I want to ski.
If you find a physio who skis then you'll get a good brace recommendation will come with the physio.
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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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Peter B,
The changing direction thing is interesting. I had frequent tourette like outbursts swimming breaststroke when I had to suddenly change direction due to people who don't respect lanes. Breaststroke leg kick is one of the best/worst things for exposing knee deficiencies apparently.
Last edited by Well, the person's real but it's just a made up name, see? on Tue 22-08-06 12:54; edited 1 time in total
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geri,
If the case is that ligaments/tendons don't or can't repair then you'd be looking at a injury that can only degrade. I suppose your choice would be to accept the situation with the limitations that you know you can live with or go for an Op. I think Russel wants the brace because he doesn't know how good the knee will be until he tries it.
fatbob, LG will be a doodle, just a few powdery pitches...
PhillipStanton, You are right, there are surgeons and surgeons...and of course, physios and physios. I found my physio after 10 years of back issues. The best thing about her is that she talks a lot of common sense and bosses you a bit. You are under no illusion that the success or failure within the confines of your rehab ability is down to you. I guess most people don't realise how much we take for granted in the way the body works and therefore don't remember how much work we put in to get the body to do such things, and therefore how much effort it takes to recapture that.........Very simplistic, I apologise in adavance
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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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My take (as someone who has had a full ACL reconstruction):
1. If you have had the reconstruction done and have rehabbed properly and fully, you should try to do without the brace. That said, a brace can be useful for building confidence and prioproception (never know how to spell that!)
2. Russell's case is complicated a bit by the fact that it seems unlikely he will ever get his leg straight. In my rehab, this was stressed as being crucial to restoring strength to the thigh muscles. As JT says, he'd be well advised to speak to his physio about this in a specific skiing context. If he feels the advice isn't helpful, he should search out someone with skiing knowledge (preferably someone who skis to a high level themselves) and speak to them. My experience is that physios can get quite conservative past a certain point - I think some assume that everyone who skis finds themselves involved in twisting falls all the time. This is in contrast with the surgeons I have come across who see the reconstruction as a means to performing at pretty much the same level as you were at before the injury
3. Fatbob - I have skied with a couple of people who ski to a pretty high level with no ACL. Both used a brace - one certainly had one made specially for him. Both also did a lot of work off season to build up the supporting muscles. One was probably never going to get his ACL done - he was 50+ and was of the view that it just wasn't worth it. The other felt his knee go pop and was beginning to think that well timed surgery (ie right at the end of the ski season) might be worthwhile
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PhillipStanton, When I did my knee in April, I developed shocking bruising around my ankle about 4 days later! The surgeon said it was typical of a knee injury, as the blood pools! Got more sympathy for that than the knee itself almost!
I'm only seeing a personal trainer now, who doesnt ski, but is heavily into rehab. He is a martial art champ himself, so appreciates the need to regain sport specific fitness.
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[quote="JT"][b]geri, [/b]If the case is that ligaments/tendons don't or can't repair then you'd be looking at a injury that can only degrade. I suppose your choice would be to accept the situation with the limitations that you know you can live with or go for an Op. I think Russel wants the brace because he doesn't know how good the knee will be until he tries it.]
I think you 're right - hence the need to find an exercise programme that suits you to maintain quads & hamstrings.
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On the ligaments repairing thing - the ACL doesn't repair beyond very minor injuries. The MCL can repair itself (I know, I've done it) because it has more of a blood supply than the ACL
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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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Arno,
I must admit I thought I'd had minor knee ligament tweaks ( not ACL ) repair themselves, ditto ankle and achilles.
I have read somewhere that they can use these in Recon, the achilles being the strongest ligament/tendon in the body.
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JT, i met someone who had done something to his achilles and it seemed as though it was going to fix itself. Apparently a completely torn MCL can repair itself whereas an ACL won't. I believe that the favoured methods of reconstructing are using a patellar (?sp) tendon or hamstring. I had the latter. Some doctors also use replacement ligaments from cadavers - not sure I'd be too keen on that myself...
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Arno, With the hamstring reconstruction, can you kneel? I gather you cant with the patella one. This is a relevant point for my brother who kneels a lot on the Tornado.
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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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geri, My OH has no discomfort kneeling, and she had the patella tendon reconstruction, although I undersatnd that pain from kneeling is more likely with this method of repair.
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I get a lot of pain kneeling and some odd grindy/crunchy noises when getting up but my knees have been fine, should I be getting worried?
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You know it makes sense.
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I too have no ACL, also had a meniscal tear.
Skied within weeks of the keyhole op, and last season.
So far so good
The 'current' stability of the knee will be a determining factor on the rebuild.
I also have one of the Bio Skin supports from Slush & Rubble
http://www.snowandrock.com/shop/activity/ski/accessories/sports_supports.
I don't think I used it last season though.
With only 7 or 8 weeks skiing under the belt though, my skiing may not be putting the same stresses through the knee.
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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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kermit,
Skiing is hard on the knees anyway so with 7-8 weeks you may be stressing the knee more than others with more snow time so its just as relevant IMV
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Poster: A snowHead
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geri, i can kneel - the patellar reconstruction is supposed to be more likely to reduce range of movement as Peter B says
kermit, my feeling is that a less experience skier is more likely to put stress on their ACL - the usual cause of a tear is twisting the knee while skiing in the back seat. something a less experienced skier is more likely to do i would say. that said, i don't fall over too much these days, but when i do, i do tend to feel it so you may be on to something!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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JT, The reason why I can't straighten my leg is because I had a Tibial spine fracture, This is a break in the bone where the ACL attaches to the tibia this was repaired surgically with soft fixings ( some sort of stitch ) drilled thought the bone to pull the ACL with bone fragment attached back into place. This has repaired well but the bone growth around the repair is stopping the knee from locking straight. Further surgery may be an option in the future.
I don't particularly want a knee brace but I'm just investigating the what ifs if the muscle development continues in the same way its been going then additional support will be necessary because I can't walk down a slope with out the knee feeling like its about to fail and sometimes it does.
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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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JT you are, of course, right. A "no nonsense" physio is worth their weight in gold.
Russell, I forgot to say that I also used a BioSkin (when I didn't know how bad the knee was) and it was very good. (I'd bought one "just in case" a few seasons before). It's not the same league as the "exo-skeleton" type, but did a nice job of providing a tad more stability, without taking over the work for you.
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You need to Login to know who's really who.
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I had patella tendon transfers in both knees in my late teens and did my ACL in my mid 20s. I'm now in my md30s. I switched from skiing to boarding 'cos I couldn't turn in one direction (this was in the days of long skinny skis) and have had no problems boarding. I now wear neoprene supports with the patella cut out simply becuase it makes me feel more confident. I also think that my knees are more comfortable when they are warmer. It may be psychosomatic but it works. I should stress I only wear supports for snowboarding - not for cycling, down the gym or other forms of exercise.
Having said all that my snowboarding improved the most when I used a personal trainer for a few months. He identified that I was using my big leg muscles to protect my knee and the small muscles around the knee had wasted away. I had great difficulty just standing on one leg. Many one legged dips and squats later and a lot of balancing on the BOSU my knees are strong and my snowboarding technique and stamina had imporved out of sight.
Not too sure what my conclusion is - probably support is useful if it makes you feel more relaxed and confidnet but you need to rehabilitate properly and build up your own strnegth rather than rely on the support.
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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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| Russell wrote: |
| I don't particularly want a knee brace but I'm just investigating the what ifs if the muscle development continues in the same way its been going then additional support will be necessary because I can't walk down a slope with out the knee feeling like its about to fail and sometimes it does. |
It would seem to me that if this is the case, then more physio and rehab and time may be what's needed, not a brace.
I'm a GP, so this isn't my area of expertise, however I've had some orthopaedic experience in the past. My understanding has always been that braces are good for limiting a joints range of movement in normal daily activities during the rehabilitation phase, but not much use in strengthening a joint, especially in a sport such as skiing which has the potential to put additional stresses through the joint. I have also heard it said many times by far more eminent colleagues that braces may actually be dangerous, in that they give a false sense of security, and also by relying on them, you stop the relevant muscles from achieving full strength. Some people also view them as a substitute for adequate rehab.
IMV you need to get your knee to the point that you would feel comfortable skiing on it unsupported, if not then you shouldn't be skiing.
I'm hoping that there may be someone with a little more expert and up to date (<5yrs ago) knowledge on this subject.
Last edited by Anyway, snowHeads is much more fun if you do. on Wed 23-08-06 15:47; edited 1 time in total
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Going back to the analogy of footballers who have had ACL or knee surgery, how many of them do you see playing with functional (ie not the crappy neoprene things) braces - none.
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Good points Kramer - and completely agree with the point that the support isn't there to give you strength. And my no-nonsense physio from Oldham is making sure of that. Mark my words. (Any disagreement and I send her round - and then you'll be sorry...)
For me, though, I'll be using a brace at the beginning of the season just to provide me with some initial insurance against lateral "tweaks" that, frankly, are a bit difficult to train for.
Russell,
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| I can't walk down a slope with out the knee feeling like its about to fail and sometimes it does. |
If it's of any comfort, my knee was like that just four weeks ago and is now past that stage.
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Surely some of the wear it/ don't wear it debate is missing the point a bit. Motorcross riders wear knee braces routinely for prophylactic purposes on both knees as catching a foot in a rut while putting on a lot of BHP can cause severe knee injuries. I see the use in skiing as akin to this - either its protecting against further damage caused e.g. to other ligaments because part of the knee is no longer functioning or its there while you get the joint fully rehabbed but don't want to miss a season. A fully rehabbed post reconstruction knee shouldn't need a brace except for confidence building purposes. A quick trawl on the web reveals plenty of pro-skier endorsements for braces.
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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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Russell, if you go for the sports injury specialist route, let me know. Dad-in-law was a member of the Institute of Sports Medicine , and knew a lot of the guys who looked after Leeds United, and the rugby league team. Might be able to give you a suitable contact.
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Helen Beaumont, I'm going to give it another 8 weeks before I decide whether I gone down the sports injury route.
Kramer, I agree with your comments, I haven't made things clear, I have no intention of skiing until fully fit and the knee is stable thats why the EOSB looks like the earliest skiing for me at the moment. I suppose what I really what to know is can a brace prevent this type of injury in a fall I suppose thinking more as protective equipment rather than a support device. My theory based on the fact that the knee may all ways be weaker but strong enough to ski on.
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FAQ
