 Poster: A snowHead
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Question for the physios out there.
I've now got a full exoskeleton type functional brace for my ACL deficient knee. I'm not really intending to use it for any other sports as knee feels fine hillwalking, cycling etc but have been advised to use one skiing. Anything I should be looking out for when using it skiing for the first time etc? Don't want to create another problem.
I guess in an extreme it might increase slight chances of tib/fib or femur fracture if very unfortunate with a large moment applied to it at the right angle but those sort of forces would pretty much screw up a knee anyway.
Am strengthening my Quads, hammies, calfs etc as much as possible in the gym at the moment.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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fatbob,
I can't help and I can't recall which make/type my friend has ...and he REALLY needs it.
You'd have to talk to an expert physio...who knows how to use one.
I did have a chat with an gym instructor who skied a few years ago and has since done his ACL....don't know how...
and he is going back sking for the 1st time in 10 years. He will be using one but I don't expect he will be doing what you are doing. His legs are in great shape though and he thinks it will be for piece of mind mostly and maybe to prevent an over-extention. If I catch up with him again, I'll ask him.
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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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fatbob, got a personal interest interest in the answer to this question! What make is yours?
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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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Mine's a Donjoy, I liked the look of the CTi but the best looking ones were made to measure only.
My physio reckons they are fairly straightforward provided you fit it as instructed but then she isn't a big skier - searching TGR etc suggests that lots of people wear them without incident & certainly most serious moto-Xers seem to wear a pair preventively.
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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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think there are differing opinions on this one. lots of people seem to be advised to wear them to ski post-op and post rehab after an ACL reconstruction. my surgeon was of the view that if you've rehabbed properly, you shouldn't need the brace and they can allow some muscles to weaken because of the support offered by the brace
my experience is that they're very good for peace of mind but as you take a few tumbles, you feel the need for it less and less
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You'll need to Register first of course.
You'll need to Register first of course.
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fatbob, Mine too. There was a Donjoy rep at the ski show & he advised ski gently to build up confidence & get the feel of skiing in the brace for a couple of runs when I first go in Jan. Like you, I'm building up hamstrings & quads in the gym! Hoping not to need it for too long when skiing! Hope it works for you - when are you going?
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Russell, Good luck! Have fun at Castelford 
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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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fatbob, I'm not a physio but:
You mentioned strengthening of the surrounding musculature - which is good - but I hope that you are also doing loads of proprioceptive work. This will helps those newly-strengthened muscles to rptoect the knee in a co-ordinated and timely manner. There was an article about BOSU (those inflated half-ball things that you see in the gym) in the most recent issue of Ski and Board I think, and using it or smething like it will help agument and re-attune your proprioceptive reflexes.
It occurred to me that the above might be a bit full of jargon and that I ought to try to explain it a bit better!
Proprioception is the bit of the sensory nervous system that allows your brain to know where your body is, how bent a joint is, how stretched a muscle is. You can voluntarily alter this situation (contract a muscle to bend the joint more/less) but there are also reflexes (which work at a spinal level and are therefore very quick e.g. the knee jerk) and learned movements which do not need you to actively think about them (e.g. kicking a football).
"Proprioceptive work" involves your body learning/relearning these movements so that they are happening without any conscious intervention - in your case your proprioceptive sensors in your knee feeling that the top of the tibia is sliding forward on the bottom of the femur (which the anterior cruciate usually prevents) and reflexly tightening quads and hamstrings to prevent it happening.
I suspect that little tiger will be along in a minute to fill you in further.
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Nick L,
Thanks for that - no need to apologise for the jargon. I've been doing Bosu jumps in the gym (2 footed static jump on & off forwards & laterally) and have an easy wobble board at home to stand 1 footed on. To be honest my ACL must have been damaged a while as it definitely didn't just pop on my last ski trip of last season but now I know I don't have one I'm keen to protect against further cartilage tears etc.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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To those with an ACL reconstruction that are considering skiing without a brace This article suggests that skiing without a brace may increase your risk of injury. The author is a leading authority on knee injuries and skiing I believe.
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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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Good spot T Bar, but the paper is about protecting people who have had a reconstruction, which fatbob and, I think geri haven't.
However, I would say the logical inference is that there would be at least a similar decreased rate of injury by wearing a brace in an ACL deficient knee as there would be in an ACL reconstructed knee.
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I had my ACL re-constructed back in September 98, Skied with a Brace in March 99 - No problem what-so ever. Deecember 99 didn't bother with the brace after the first couple of runs.
Then bug ger me in March 2000 went and did the other ACL. Had that done and again skied the first time with a Brace (more for confidence than anything). Skiing fine now without any support.
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You know it makes sense.
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Pete1909, Thats interesting. What sort of reconstructions did you have? Did they use the patella tendon?
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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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fatbob, You could always go to see my local friendly osteo/physio here - who also skis, of course, if in doubt.
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Poster: A snowHead
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geri, did you have a patellar tendon reconstruction (it was this season wasn't it?) - I assume this was in Soton - because much more common now is a hamstring graft.
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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, 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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Nick L, No, so far I've avoided any surgery! He'll operate if it is unstable (in Soton, you're right). I've just been looking at it in case, & also for my brother, a keen dinghy sailor who needs to kneel a lot. I was told hamstring graft is more painful for kneeling.
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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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I skied with a full-on brace, Edge thingy (very not cheap) for a couple of years. I've got half my ACL left and had a meniscus tear + eye. Eventually I came to the conclusion it was more a mental than physical thing and stopped using it BUT looking back on it, I'm not sure it wasn't more a matter of confidence and also giving my muscles/tendons/ligaments etc. time to re-adjust and recover.
My only observation other that would be to get used to wearing it beforehand. Mine used to be OK for the day but by the end I couldn't wait to get it off and daft as it sounds, if you can ski when it's colder or don't ski too hard it helps because if you sweat they move about/need a little re-adjustment. Make sure you get the velcro fastenings bang in line too, otherwise thay rub and by the time you notice, it's already a problem you'll be stuck with. So that's two observaytions but who is counting, mon.
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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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geri, no I believe it's the exact opposite - don't have a patellar graft if you want to kneel a lot - there are often problems with pain at the front of the knee using that technique.
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