Skiing Knee injuries

Winter is very much here and for many of us that means a well-trodden trip south for our annual dose of fresh mountain air, dramatic scenery and (hopefully) tons of the white stuff.  Ski season is undoubtedly a very bright spot in winters that are fast becoming wet and wild here in the UK.

For the majority it’s a special week in an otherwise bleak few months and thankfully skiing injuries are uncommon. But they do happen… The relative tight support of the ankle inside a ski boot which itself is firmly attached via bindings to ski at the bottom increases the twisting forces through our knees. The Anterior Cruciate Ligament, or ACL, is the main restraint to these twisting forces and is therefore commonly injured in skiing knee injuries.

Signs of a knee injury – The most common type of injury pattern is the knee twisting or slipping to the side. The bindings often fail to release and you may feel a pop or a clunk inside the knee. This is often followed by pain in the knee that can be intense but thankfully tends to settle after a few minutes. Often the knee swells rapidly and feels unstable. Trying to stand and confidently ski or walk can be difficult if the ACL is injured as the knee loses it’s stability especially when trying to twist or turn.

What to do next – If you are able to ski down then great but for the majority help from the local rescue team, affectionately known as “the blood wagon”, will be necessary. These guys are skilled expert skiiers and highly trained in getting you off the mountain safely. They don’t hang around either! Most ski resorts now have a medical centre either in the resort or within a few miles where you will be assessed and an Xray taken to make sure there are no breaks or fractures. A supportive brace or plaster will be applied. If there is a fracture you may need a more specialist opinion at a nearby hospital.

First aid for ligament injuries – If no fractures have been identified then you will often be advised to seek definitive medical advice once home in the UK. Not a great end to your skiing holiday but it does give you the chance to explore the other side of the ski towns or villages. Keeping your knee elevated whenever you can and icing (both front and back of the knee) for 10-15 minutes in every hour are good ways of reducing swelling and inflammation which in turn reduces pain. Some gentle range of movement exercises can be useful and putting as much weight as is comfortable should be your goal. Weightbearing is important for reducing the risk of blood clots forming in the leg, known as DVTs.

What about getting home – Travel can be awkward. You will be allowed on a plane with a knee brace or split plaster but it is always worth checking with the airline if you are flying. For those who prefer to drive or train then keeping the leg elevated (knee above the level of the hips) is the ideal position – swelling tends to follow gravity and will therefore collect in the leg (knee and ankle) unless these are elevated sufficiently. Regular icing can also be utilized as described previously; 10 -15 minutes in every hour if possible.

What to do once home – You will often have a report from the local medical centre to bring home with you. This can be presented either to your GP or your local A & E department who will be able to then refer you on for specialist help. If you are insured or wish to see a knee specialist quickly then appointments can be made with The Invicta Clinic directly on 01892 552908 or A specialist review from a sports-injury trained knee surgeon is important for any injury where the knee swells or feels unstable. An MRI scan will be arranged and you will be thoroughly assessed. A tailored plan can then be made with you.

Will I need surgery? – The problem with soft tissue injuries to the knee (cartilage, meniscus and ligaments) is that they can be very unforgiving and lead to ongoing mechanical symptoms in your knee – clicking, catching, locking and giving way. As knee surgeons we worry about these symptoms because the ligaments and cartilage layers have only limited healing potential. If treated early these structures can be repaired in many cases. A knee that has continuing instability is a concern as each “give away” can lead to further damage to the three protective cartilage layers of the knee. For this reason early an review, MRI scan and diagnosis is important.


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