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"Knee friendly" skiing

 Poster: A snowHead
Poster: A snowHead
This year for the first time ever I'm having problems with my knees when I'm skiing. I've had some problems with my knees (=pain) for the last 25 years but the doctors have always said there's nothing actually wrong with them. They get sore when jogging or trekking (3-7 days with 20+ kg backpack) but both activities are totally doable. No problems with skiing, ever.

In November my left knee started swelling, something that has never happened before. No pain at all. Eventually I went to see a doctor who considered it to be "over use irritation" and injected cortisone. There was no clear relation to skiing or any other activity. I also went to a sports physio therepist who told me I stand wrong and walk wrong and that puts added stress on my knees.

After the Christmas I skied for three days and my right knee started swelling. After a week the swelling now starts to go down. At first I didn't really believe the doctor's diagnosis, I was quite sure something had to be "broken" for my left knee to swell like that but now after the same happening with the right knee I trust the diagnosis much more.

So any tips for knee friendly skiing? I've noticed carved turns are a lot better than skidded turns. And I got problems with my right knee after I got rid of my knee braces (the physio therapist said they are probably not doing much good but that it's na individual thing) so I'll probably start wearing them again. They were also great for climbing the Kebnekaise in the summer Very Happy
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Skise, I think you have to rethink your approach to sports, keeping fit and be more selective about what you do. Jogging should definitely go, you should swim/cycle instead. Skiing wise, I don't believe there is such a thing as "knee friendly" skiing. Naturally, moguls should be eliminated. But aside from that I'm not sure there's much can be done. Sure carved rather than sharp turns will help a little. But you may have to just do a couple of days at a time.

You shouldn't wear a knee brace for any length of time (unless you have a diagnosed injury and medical advice to do so) as it will simply weaken the knee.

It sounds to me that you have slightly deformed/delicate knees that require a bit of TLC but you've given them a bit of a pounding over the years. Time to ease off old man Laughing
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Skise, Have you put on weight?
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mfamily2 wrote:
Skise, Have you put on weight?


10 kgs with last 10 years but that only means I'm now 58 kg/174 cm, BMI about 19 I think.

Jogging has gone. Both the doctor and the physio therapist have told me to ski... XC. I hate it. And it makes my shoulder ache (I had forgotten that but my friend kindly reminded me, she's the one who takes me XC skiing about every 5th year).
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Are you taking Glucosomine ?

I tried it to remedy arthritic knees but within 2 to 3 weeks both knees swelled and stiffened and I could hardly walk.

It took 4 to 6 weeks to get out of my system.

Not convinced, at the time, that the swelling was caused by Glucosomine I tried it again 6 months later with the same reaction.

I haven't touched it since and have used weights etc to strengthen supporting muscles.
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Skise, What about ice pack after exercise to reduce any inflamation. I tend to get knee pain now and again and ice works for me.
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codyaitch wrote:
Are you taking Glucosomine ?

I tried it to remedy arthritic knees but within 2 to 3 weeks both knees swelled and stiffened and I could hardly walk.

It took 4 to 6 weeks to get out of my system.

Not convinced, at the time, that the swelling was caused by Glucosomine I tried it again 6 months later with the same reaction.

I haven't touched it since and have used weights etc to strengthen supporting muscles.


Wow. Shocked I am taking a product with glucosamine in it. And I did start it this autumn. Can't remember if it was before or after the first episode of swelling.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Powder is easier on the knees than hard pack. Obviously your quads need to be strong enough though.
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boris360 wrote:
Powder is easier on the knees than hard pack. Obviously your quads need to be strong enough though.

Not true, 'powder' is variable and can be incredibly unpredictable. If I am taking it easy I would much rather be on a nice groomed piste.

In general

>Good technique is easier on the knees than bad technique

>Obviously don't bomb around if you are not feeling 100% - instead ski at a canter. Much less forces acting on the body

>Taking plenty of rest is important and taking a rest day can be a very sensible decision

>use RICE treatment eg rest, ice, compression, elevation

>Try to think about what really aggravated the injury and either: don't do it or be sensible and do in moderation.

>Get in shape your and knees will thank you for it
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Go on a quiet, cold week.
Ski ealry in the morning. Gentle reds and blues, but nothing too shallow.
The above should ensure smooth pistes.

If you have been jogging for days with a back pack on then you deserve all you get wink
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boris360, er, not quite. It depends 100% on the type of knee injury. For example, I'm post ACL-op, and hard packed piste infinitely easier on the knee than chopped/powder. This is because the stress on piste is pretty much up and down, so good leg strength and training sort that out. Powder means lateral pressure on the knee, and unpredictable bumps/turns, which is exactly what I don't need at my stage of recovery.

Elston, just noticed your response. Glad we agree. Also a massive +1 for correct technique. My first days skiing since opp in December were spent focusing on technique instead of my default "bombing around". I'll be getting 1-1 tuition in a couple of weeks to brush up on knee-friendly techniques.

One last edit - WARM UP. Some basic squats, step-ups and stretches should help de-risk enormously.


Last edited by snowHeads are a friendly bunch. on Mon 9-01-12 14:57; edited 1 time in total
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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.
Skise, personally I'd go and see a sports physio for a 2nd opinion...
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Dr John, et al, you might find this book helpful. Me and the OH have got a lot of benefit out of it. It's small, easy to digest and only a fiver. Treat your own knees
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You know it makes sense.
Frosty the Snowman wrote:

If you have been jogging for days with a back pack on then you deserve all you get wink


I don't jog for days, only 3-5 km 2-3 times/week. With the back pack I walk, usually wink
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kitenski wrote:
Skise, personally I'd go and see a sports physio for a 2nd opinion...


A second sports physio?

I'm just looking at the program my personal trainer made for me. I'm so going to die... Riding, skiing (XC), swimming + gym 3x/week.
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 Poster: A snowHead
Poster: A snowHead
Skise, Do you ski fast on bumpy hard pack on very wide skis? I noticed that my knees ached more in those conditions after I moved to over 100mm under foot . . . nothing like your problems, but I'd never had any issues at all with my knees on narrower skis. Could just be getting old, all the same I'm not going back to skinnies anytime soon! Very Happy
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Obviously A snowHead isn't a real person
Quote:

This is because the stress on piste is pretty much up and down, so good leg strength and training sort that out. Powder means lateral pressure on the knee, and unpredictable bumps/turns, which is exactly what I don't need at my stage of recovery.


I'd agree with that. My knees have always been a bit dodgy, but these days one hard day will see them being hot and swollen in the evening. Not exactly painful, but uone day last week was a couple of very bumpy chopped up red runs - which I didn't ski well at all. On more predictable terrain I can get my weight well forward, which helps a lot - and my legs are in reasonable shape for an OAP. But I did notice one day last season, skiing with a couple of young Belgians, quite fast, on empty and very hard packed pistes that by around 2 pm my knees were telling me to go home - I could feel the heat from them, through my salopettes.

It's my knees which make me very nervous about powder - if it looks really easy I'll have a go, but it doesn't take long for my knees to complain, probably because I lack confidence in the powder and am in the back seat' It's better when I have a lesson in powder - because I trust the instructor, who knows me and my limitations well.

the OP is obviously not overweight with a BMI of 19.5. Mine is 22.1 - I'm not overweight either, so that's one obvious (and relatively easily remedied...) cause of knee problems eliminated.
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Dr John,
Quote:

This is because the stress on piste is pretty much up and down, so good leg strength and training sort that out. Powder means lateral pressure on the knee, and unpredictable bumps/turns

we discussed this elsewhere i recall, but you are confirming that in your rehab you didn't train for lateral / rotational forces (only flex/extension), so now it comes to ski time you're nervous about subjecting your knee to the lateral/rotational forces you will get off piste. You may think that you can't replicate the lateral/rotational forces, but with some creativity and expert advice you can go a long way to doing so and this is way better than finding out on the snow for the first time!

Also to be clear, clean carving at speed on piste introduces significant lateral forces on the body, whether this is more than off psite depends on the type of snow and turns you are making (also the skis you are on...)
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spiceman, I believe we did, and I think we also discussed relative priorities. If I earned my living in the snow I'd be there doing all the types of training with bells on (as one poster did, who was obviously a ski coach). But I don't. I work in a busy, pressure job in central London. This takes up a large amount of my time. It also allows me to spend more than the average time on the slopes each year, but still very much in the bracket of recreational skier. I also have an active social life.

Immediately after both the accident and the operation I doubted if I'd ever be able to fullt extend and/or bend my knee again, never mind ski. My aims for post-op training were simple; do enough to get me back on the slopes, which in itself is not an insignificant amount of work. Job done. If it means I have to wait until next season to hit the powder then so be it.
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Before the swelling in the right knee started going down I had gotten an appointment with my doctor but could only get it for the next week (last Monday). On Sunday I skied XC, but only for about 0.5 km because there wasn't really quite enough snow in the forest. On Monday the knee was quite good and the doctor thought it would just keep getting better without any treatment. Well, it didn't.

On Wednesday the knee was hugely swollen and by Wednesday evening I realised I probably could not work through weekend like I was supposed to. So I went to see another doctor. She took 25 ml of fluid out but it was cloudy so she didn't dare put any cortisone in. I had some lab tests done (blood and joint fluid) and she consulted an orthopedic surgeon who said that the reason for these kind of pain free swollen joints is often not discovered. It may recurr or not. Empty and inject cortisone as needed. So another 15 ml of fluid out and cortisone in. Today the knee feels great even though I was up and driving/standing/walking for 7 hours last night (the doctor told me to rest with my leg up and wrapped in cold packs as much as possible - well, it wasn't possible).

Next week I'm off to physio and gym. Next weekend skiing Twisted Evil
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Sad to hear your problems Skise, are you sure you're balancing in the right place when you ski? What many people don't realise is if you balance in the centre of your foot you'll be much more likely to avoid any knee problems. We've got a trainer called the SkiA Sweetspot Trainer which helps people do just that, and funnily enough when we showed it at the ski show in Munich last weekend a top ski physio got really excited about it. You can direct message me (top right of screen) if you'd like more details, cheers.
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So. The left knee was good for about three months, after that some swelling. Nothing horrible but it's never totally good either. But the right knee... It took 4 weeks after the cortisone injection until the knee was totally normal. And that lasted for 1,5 weeks. So a 6th visit to a doctor (a 3rd one) who said:"I wonder what really is wrong with your knees..." and referred me to an orthopedic surgeon. It took him about 5 minutes to diagnose a torn meniscus in my right knee. When the "regular doctors" have been flexing, extending or twisting my knee I've always been like:"Yea, that probably feels a little uncomfortable". He just did one specific movement and I was screaming. He thought this is probably an old injury that I already had 4 years ago when I had MRI because my knee was locking (just didn't show there) and now something has made it worse (again). Now I'm waiting for arthroscopy for my right knee. The left one was almost ok at the time so he didn't feel anything needs to be done to the left knee. We'll see...

Now I'm wondering what I should or should not do until the surgery. Any activity makes the swelling worse but I can hardly just lay on the sofa for next 4 or 6 months. And anyway I have to work (which makes the knee worse...) Ugh. This will probably ruin my summer vacation too, I'd think hiking is not good for the knee at the moment.
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Skise, You and I have a similar problem with knees for the last 10 years. My left knee has had 2 ops, , torn minuscus, confirmed arthritus, cortisone injection etc. I've tried glucosamine, condriotin but this had no noticable effect. I went through the same guessing process with no real confirmed diagnosis. To speed up the hospital process I paid for an MRI and that really defined what the issue really was. The medico's provided me co-codimol and a prescribed anti-inflmatory, these also helped. Oh, there advice was, if it hurts dont do it!
The arthritus has curtailed my hill walking and really impacted my skiing. I've had to slow down, and it's really messed with my stance, now way too upright. I deliberately choose smoother pisted areas and try slower turns. The extra rest(beer) stops are another consequence.

I've tried neoprene knee supports and they do help a little but one minor impact or bump and my skiing day's over. For the next holiday, 5 days time, i'm trying a ski~mojo and hope that will help. I now only need something to help when I'm in the hills walking!
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Skise, Just a thought, but it's worth making sure that not just your quads, but your glutes are strong too. If they are weak, your knee may be working out of alignment.
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FraserP wrote:
I now only need something to help when I'm in the hills walking!


Walking is a bigger problem because when I'm skiing at a resort I can quit any time my knees start feeling bad. If I'm in the middle of nowhere (like even 2-3 days in the middle of nowhere) I can't just quit because I have to at least walk back and I can't even rest for a longer period because then I will run out of food (and vacation time).

I do have a program from the sports physio to help with strengthening all the muscles needed for maintaining proper alignment. At the moment I can't do all the exercises but most of them are possible.
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The arthroscopy is probably either 24th or 26th of April. Way sooner than I expected. Shock I was sure they'd tell me there is a 4-6 month queue. Perhaps the summer vacation is not ruined for this year after all, I'm hoping my knees will be good enough.
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Skise, please feel free to dismiss the following heresy, but you COULD consider learning to snowboard... I've met alot of people who transitioned to snowboarding after knee problems compromised their skiing. There's alot less torsional stress on the knee...

I'll shutup now.
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Richard_Sideways wrote:
Skise, please feel free to dismiss the following heresy, but you COULD consider learning to snowboard...


Shocked

My friend started snowboarding last winter. Up she went thinking "this is not so difficult, after all I've tried this 20 years ago". Then she started down, fell and twisted her ankle pretty bad. She was fine on snowboard but it took weeks before she could ski again. I went skiing all around the resort with her husband and she was stuck with her board in the children's slope. She was extremely pissed. And more than a year later her ankle is still bothering her. Boarding is way too dangerous...
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Skise wrote:


My friend started snowboarding last winter. Up she went thinking "this is not so difficult, after all I've tried this 20 years ago". Then she started down, fell and twisted her ankle pretty bad. She was fine on snowboard but it took weeks before she could ski again. I went skiing all around the resort with her husband and she was stuck with her board in the children's slope. She was extremely pissed. And more than a year later her ankle is still bothering her. Boarding is way too dangerous...


Her attitude is a lot more dangerous than snowboarding. If you start with having lessons you will reduce the risk of getting injured. I had a snowboarding lesson 20 years ago but it doesn't mean I remember how to ride a snowboard.
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...but her knee was ok, right?

Ok, that was a flippant response, BUT you really shouldn't judge snowboarding as too dangerous by the actions of a novice with 20 years between their time on a board. Learning a new skill takes time, practice and you have to give it the respect it deserves...
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Richard_Sideways wrote:
Skise, please feel free to dismiss the following heresy, but you COULD consider learning to snowboard... I've met alot of people who transitioned to snowboarding after knee problems compromised their skiing. There's alot less torsional stress on the knee...

I'll shutup now.


I booked a snowboard lesson Shocked
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Shocked Very Happy
Congratulations!
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And I made it through 100 mins of snowboarding without hurting myself at all. I only fell once (it doesn't count that I frequently used my butt or knees to stop Laughing ). Even the ascent with the dreaded button lift went ok. Now I have to find myself boots and a board, the rentals were horrible.

Arthroscopy on wednesday so this was probably the last time on slopes this season. Crying or Very sad
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Skise wrote:
So. The left knee was good for about three months, after that some swelling. Nothing horrible but it's never totally good either. But the right knee... It took 4 weeks after the cortisone injection until the knee was totally normal. And that lasted for 1,5 weeks. So a 6th visit to a doctor (a 3rd one) who said:"I wonder what really is wrong with your knees..." and referred me to an orthopedic surgeon. It took him about 5 minutes to diagnose a torn meniscus in my right knee. When the "regular doctors" have been flexing, extending or twisting my knee I've always been like:"Yea, that probably feels a little uncomfortable". He just did one specific movement and I was screaming. He thought this is probably an old injury that I already had 4 years ago when I had MRI because my knee was locking (just didn't show there) and now something has made it worse (again). Now I'm waiting for arthroscopy for my right knee. The left one was almost ok at the time so he didn't feel anything needs to be done to the left knee. We'll see...

Now I'm wondering what I should or should not do until the surgery. Any activity makes the swelling worse but I can hardly just lay on the sofa for next 4 or 6 months. And anyway I have to work (which makes the knee worse...) Ugh. This will probably ruin my summer vacation too, I'd think hiking is not good for the knee at the moment.


I have only just found this thread, as I was reading from the top I was thinking your symptons sounded just like my knee when I tore the medial meniscus cartelidge. In fact I actualy did it just kneeling down while painting the side of our decking. Thankfully I had private health insurance, so I got the op very quickly. I can't really advice on excerise as I was told to rest it, which even for the relatively short few months it took to convince the doctors something was wrong and get referred etc I lost a scary amount of muscle strength. I did go skiing 3months after the op but it wasn't ideal I was strapped up, maxed out on pain killers and could only ski on well groomed pistes the day we had a load of fresh powder down I was in agony and gave up for the day. Good news is, that was 16 months ago, and since then I have played a full season of hockey and my knee feels good and hasn't swollen now for quite a while.

Good luck
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NickyJ wrote:

I have only just found this thread, as I was reading from the top I was thinking your symptons sounded just like my knee when I tore the medial meniscus cartelidge. In fact I actualy did it just kneeling down while painting the side of our decking. Thankfully I had private health insurance, so I got the op very quickly. I can't really advice on excerise as I was told to rest it, which even for the relatively short few months it took to convince the doctors something was wrong and get referred etc I lost a scary amount of muscle strength. I did go skiing 3months after the op but it wasn't ideal I was strapped up, maxed out on pain killers and could only ski on well groomed pistes the day we had a load of fresh powder down I was in agony and gave up for the day. Good news is, that was 16 months ago, and since then I have played a full season of hockey and my knee feels good and hasn't swollen now for quite a while.

Good luck


Well, after all it took less than a month from the visit to ortho to arthroscopy, so not bad at all, specially for public health care.

But... not good enough for skiing after three months Shocked Yikes. Although I wrote yesterday was probably the last day for this season I WAS hoping for some days in May-June. Well, it's 6 months till October, maybe I'm ok to ski then.
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I already had the holiday booked for a did my knee in. I decided that I could ski enough to go for it rather than cancel as although I could have got the money back on insurance, we had booked the cheapest week of the season and wouldn't have been able to afford to go later on. If it hadn't already been booked, we wouldn't have gone so soon after as I was still in quite a bit of pain.

The hardest thing I found getting the strength / fitness back was that I kept pulling muscles. I ended up doing a good number of aqua aerobics sessions as that meant I was exercising the muscles that I need to regain without my weight through them, that helped get me to the point where I could then get a programme setup at the gym. I then hit the same issue returning to hockey, I pulled a muscle the second session I went to. Very fustrating, but my fitness is reasonable now.
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2¢ worth and purely subjective . . . since I started telemarking my old stiff and often swollen knees have never been better and can even run on them again. I think part of it is that I'm putting wear pressure on entirely different areas of the joint and not the areas that are or cause the inflammation. I also significantly improves the musculature around the joint providing better support.
As I said, purely subjective, but may be worth thinking about.
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Skise wrote:
And I made it through 100 mins of snowboarding without hurting myself at all. I only fell once (it doesn't count that I frequently used my butt or knees to stop Laughing ). Even the ascent with the dreaded button lift went ok. Now I have to find myself boots and a board, the rentals were horrible.


Glad your session went ok. Rental boots are rarely good, so a good place to start. As you're looking after your knees, you may want to invest in some knee-protectors to take the strain of those 'unscheduled stops'.

Oh, and welcome to the DarkSide. Good luck with the op.
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Masque wrote:
2¢ worth and purely subjective . . . since I started telemarking my old stiff and often swollen knees have never been better and can even run on them again. I think part of it is that I'm putting wear pressure on entirely different areas of the joint and not the areas that are or cause the inflammation. I also significantly improves the musculature around the joint providing better support.
As I said, purely subjective, but may be worth thinking about.


I do also telemark. Badly. But at least now before the operation it has been impossible, hurts too much.
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Skise wrote:
I've had some problems with my knees (=pain) for the last 25 years but the doctors have always said there's nothing actually wrong with them.


And this was proven by arthroscopy on Wednesday. The medial meniscus was fine (as was the lateral), both CLs were fine, the cartilage was mostly fine (some softening of tibial cartilage in the lateral part of joint). The biggest problem was a plica in the front, there was also another slightly irritated plica medially. Both were taken away. More cortisone suggested for the left knee to avoid surgery. But if the right knee is great after this I'll start pushing doctors to do surgery on my left knee too...
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