At Complete Physio we are dedicated to keeping you out of pain and fully fit! This is the last of our skiing blogs providing valuable information about common injuries sustained on the slopes. This week the blog focusses on the knee and is a must read if you have sustained a knee injury. At Complete Physio we work with leading knee consultants and see many clients following injuries on the slopes. If this blog doesn’t answer your questions please email our clinic directors, David Luka directly at david@complete-physio.co.uk

I’ve even sent my own son to see the team at Complete when he badly injured his knee – and you can’t get a better endorsement than that!

Mr Ian McDermott (Consultant Orthopaedic Knee Surgeon)

The 5 knee injuries you’ll likely suffer

Knee injuries make up the largest proportion of all recorded mishaps whilst skiing, accounting for over 42% last year. The vast majority (72%) of these injuries occur, surprisingly, on-piste; terrain parks account for 19%, and the use of ski lifts 6%. Perhaps more surprisingly, off-piste is responsible for the least number of knee injuries, making up just 3% of all recorded cases.

The main issue with skiing and knees is that most people don’t realise the incredible forces that are generated at the knee whilst partaking in this enjoyable pursuit; during a regular controlled turn you will be putting at least 2.5 times your body weight through the knee on your outside leg, get some air and this doubles even on a well executed landing. If the landing isn’t so well executed, well, you can do the sums! Add the aforementioned rigid boot into the equation to act as a nice torsional lever and your knee could quickly become the weakest link in the chain.

The most common knee injuries in order of prevalence are:

  • Ligamentous, involving the ACL (Anterior Cruciate Ligament) and/or MCL (Medial Collateral Ligament).
  • Cartilage or meniscal tears within the knee joint itself.
  • The Kneecap, where it joins with the upper leg bone (the Patella-Femoral Joint).
  • Muscle tears involving the largest calf muscle that crosses the back of the knee (Gastrocnemius).

The majority of serious knee injuries will be acutely painful immediately afterwards, you may also recall hearing a loud pop or a cracking sound at the moment of injury that will usually be followed by a rapid swelling of the knee.

These more significant injuries tend to occur at moments when you’re slowing down and turning, but don’t always involve high speed.

If your knee becomes painful, especially if you find yourself unable to put your weight through it, getting an X-ray locally in the resort is advisable to rule out any bone damage. If your X-ray is normal and your knee is swollen then the best thing that you can do is take whatever painkillers that you normally would, ice the knee, get yourself a compression type bandage and rest it back at the hotel, ideally in an elevated position. You will find that the most comfortable position for resting your knee will be with it slightly bent at around 30deg. Do not get into the bad habit of resting it in a dead straight position!

The following day, if the knee remains swollen and painful and feels unstable then an MRI scan should be the next course of action. This is the best diagnostic tool available to fully assess the internal integrity of your knee. If the scan does show a ruptured ligament, then it will likely require surgery; however, there is no need to rush into this whilst you’re at the ski resort, despite what you may be told at the time! Get yourself safely repatriated through your travel insurance company and start the proceedings for getting your knee sorted once you’re back home. This nearly always results in a much better outcome.

Getting the swelling down, getting normal range of movement and restoring muscle strength around the knee are the absolute most important things following a serious knee injury. This should be done under the guidance of a suitably experienced physiotherapist who will also liaise with a specialist knee surgeon to map out your return to full function.

This time of year I see a lot of people who’ve injured their knees skiing, and we end up having to treat a lot of meniscal tears and ACL ruptures. With the work that I do as a specialist knee surgeon, my patients’ outcomes are not only dependent on the surgery that I do — indeed a large proportion of a patient’s outcome will depend upon the rehab that they do post-operatively, and here the quality of the actual physiotherapist is absolutely key. If you have an ACL reconstruction, for example, you’re going to need several months of physio rehab treatments, and you should only go back to skiing once your physio assesses you as safe to do so.

I’ve been referring patients to the team at Complete Physio for years now. I’ve never had anything but positive feedback from my patients, and the team at Complete give me total confidence that my patients will be looked after by senior experienced physiotherapists with the right knowledge and the right skill-set to ensure that the patients’ rehab is 1st class. I’ve even sent my own son to see the team at Complete when he badly injured his knee — and you can’t get a better endorsement than that!

Mr Ian McDermott (Consultant Orthopaedic Knee Surgeon)

Our 5 Tips if you get injured:

1/ Most soft tissues injuries and some breaks/fractures do not need an immediate operation. It is often best to wait, get safely back to the UK and then start investigating all the options.

2/ Call your insurance – inform them of the situation. Don’t delay or you may not be covered. Make sure your insurance has winter sports coverage in the first place!

3/ If you get X-rays, scans or other tests carried out whilst you are away – get a copy of the results. For example, if you get an X-ray take a photo of it on your phone. The more information you get the better!

4/ Get a specialist – unless it is a medical emergency you don’t want a hip surgeon operating on your shoulder or a knee surgeon operating on your wrist. Get a specialist!!

5/ Email our clinic directors at david@complete-physio.co.uk – we work with world leading clinicians and surgeons and are happy to put you in touch with the most appropriate one for you.

To make an appointment please go to https://online.tm2app.com/completephysio or email info@complete-physio.co.uk

We look forward to seeing you soon!