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Knee Pain

post #1 of 19
Thread Starter 
Hello Folks

I went skiing for the first time at the end of January - Finland - (v.nice, by the way!!)

Anyway, I've been back in the UK now for two weeks, and during my time skiing I managed to do myself an injury. Both of my knees are in excruciating pain underneath the knee-cap. I didn't really fall over when I was skiing, but I think the pain has been caused through spending most of my time in the 'snow-plough' position whilst skiing downhill!

It is so bad that I can't walk upstairs or downstairs (going downstairs is the worst), without stopping on each step. It also hurts to stand up when getting out of a chair. If I'm relaxing, or even walking on a level floor, then it doesn't really notice, but when pressure is on the knee the pain is really bad.

I've not been to the Doctor yet, as I was hoping this would ease with time. It hasn't.

Has anyone experienced this? Does anybody know what it is? Is it common...?

Cheers,

Lisa
post #2 of 19
Welcome Lisa! Please keep in mind that even a physician cannot perform a cyber-diagnosis. It's possible that you have some sort of MCL strain, which is common, but not exclusive to wedge skiers.
post #3 of 19
A lot of low-end skiiers mention this pain, and the ones who mention it are usually sitting back when they are skiing, and usually are skiing in a fairly braced, defensive snowplough. ie They are using the snowplough to slow them down, rather than turning for speed control with a more narrow wedge.

I suspect that this is causing problems with that big tendon that holds the kneecap, down the front of the leg, possible pulling the kneecap off track and causing inflammation. You should try to find a sports-orientated physiotherapist and make them your first port of call.

Sadly, this type of pain is very common with women (I have it too, but know the cause... over tight tibial band thingy down the outside quad, and not enough muscle tone in the inside quad. Causing my kneecaps to mistrack).
post #4 of 19
I had pain similar to what you describe in my left knee & was diagnosed with "patellar femoral" disorder.... but I would suggest seeing a Dr. to be sure....

And there is a strap/brace you can wear to help your kneecap "track" properly if that's what it is....

I also take Glucosamine/Chondroiten/MSM which helps me....
post #5 of 19
chondromalacia onset?

Quote:
Originally Posted by jenscats5
I also take Glucosamine/Chondroiten/MSM which helps me....
me too. I have minor arthritic spots in the right knee and the pain from those spots disappeared after 3 months on the Triple Threat joint lube tablets.
post #6 of 19
Stop snowplowing. That is one of the ski techniques that try to convert the knee into a rotary joint, which it ain't. The other main ski technique that tries to rotate the knee is steering the ski to make a turn.

So, what to do? I suggest buying this book...it is biomechanically sound.
http://www.amazon.co.uk/exec/obidos/...097603-6379062
Get the companion video, also. You'll like your skiing results.

I find that a neoprene knee brace is some help. In any case, no more snowplowing.


Ken
post #7 of 19
Quote:
Originally Posted by SoftSnowGuy
Stop snowplowing. That is one of the ski techniques that try to convert the knee into a rotary joint, which it ain't. The other main ski technique that tries to rotate the knee is steering the ski to make a turn.
It would, if steering to make a turn employed the knee, rather than the whole leg.
post #8 of 19

Knee pain and related issue.

Here is my story, I want to share it so people may find it useful.
I developed some pain in my right knee, it is kind of dull pain that was really evident after day of skiing. Most painful on the drive back when leg is in static bent position. Knee tolerated all kind of bumps, jumps and off-piste skiing approximately the same as high speed carving – that puzzled me, there are lot more impact in bumps, at least the way I ski them ) While skiing pain was mosly evident in skating moves, after skiing when sitting with leg bent or walking upstairs. Finally decides to see a sport doctor who specializes in knee problems, regular doctor could not tell me much about this about year ago.
Doctor told me that the reason for pain is that my knee cup is pulled to the side when I bend my leg. It rubs agains a ridge in the joint and gets irritated. My right leg is pronated so knee turns inward when I squat. He referred me to physical therapy.
First thing I’ve done before going to therapy – I changed canting on my right boot to bring my knee more outside. I do not think it helped my skiing but it almost immediately removed the pain! Now I can ski all day and all is fine.
There is another problem I have – my left ankle does not bend forward much because of previous injury. It does not bother me in playing other sports so I assumed that stiff ski boots also eliminate this problem, I can lean on front of the boots but do not bend my left boot much ( I did not know that until yesterday when I compared how deep I can bend each of my boots)
So I vent to see therapist, she mostly evaluated strength of different muscle groups and joints flexibility. There were no problem with strength but flexibility sucked big time, I’m stiff as board not even looking at this bad ankle. With ankle it is even worth and I think it started chain reaction that finally ended up in the knee. When I flex in both ankles my left one does not go much past vertical, right one flexes much more and this brings my right knee forward and rotate it inside. This inside position results in knee pain, also not being able to flex puts me in back seat and brings huge inside ski lead in right turns – I just can not pull inside ski back. You can see pictures in this thread

Anyhow, I just want to say that knee pain may be result of bad alignment, if you knees hurt see if they drop inside a lot when you squat, try to fix alignment problem and it may fix the pain.

Thanks,
Anton
post #9 of 19
Thread Starter 
Hi Folks

Thanks for your replies. Anyway, I've been to the Doctor, so I thought I'd let you all know what he said....

He thinks I've got Anterior Compartment Syndrome. I've done a search on the net, and this is the muscle running down the side of my shin - which he didn't mention!! I've never had any problems with this muscle? Also, I'm not having problems lifting my toes or pointing my toes which is the main symptom of that...!! The pain is only in the knee, and it's a sharp, concentrated pain.....

He tells me the inside of my kneecap (sorry, don't know the medical name for it!), is swollen and rough, and when I put pressure on it causes it to rub against the area where my upper and lower leg bones meet at the knee joint. He also tells me there is a lot of inflammation under the kneecap which is causing problems when I stand up, walk upstairs, and walk downstairs - (this hurts the most!).

Anyway, he's suggested 400mg of ibuprofen three times a day, and rest. He also tells me that when somebody suffers from this they are prone to future knee problems. This has put me off skiing ever again, which is a shame as I wanted to give it another go!! :

Hope this gets better soon - I'm catching the lift up and down one flight of stairs in work!! LOL.

Cheers,

Lisa
post #10 of 19
Oy Vay! Anterior compartment syndrome?!?! I'm sorry. I don't mean to rag on your doctor, and I didn't perform an exam on you, but nothing you have said in your history sounds anything like ACS.

On the other hand, you report the classic signs of Chondromallacia Patellae (CMP). Among the classic signs is pain when going up, and especialy down stairs. Another one is pain when standing up, especially after sitting for a period of time (called theatre sign).

You might find some great info at this site, or any one of a million other sites on the web.
http://www.sportsinjuryclinic.net/cy.../indexcmp.html

The best protocols for CMP are PRICE as much as you can. Finding the dysfunction of the quad that is usually the cause of CMP (usually a weak vastus medialis muscle, though on women -depending on age-possibly a weak v. lateralis), in order to stabilize a possible excessive Q angle, is usually the first thing you need to do. Can't stress enough prober rehab for this type of condition. Anyway, all this is in the website.

I would like to add: ibuprophen is very important, as long as you can tolerate it. Depending on your weight, you'll need probably over 1200mg/day to act not only as a pain killer, but also an anti-inflammatory. Glucosmin chondriotin, MSM etc. also work extremely well, but they don't work immediately, so you'll have to give them time. Some people don't notice a difference, so they stop taking it. It really takes a couple of months til you feel the difference. The best thing you can do is get CMP bands. They are 1 1/2" velcro bands that go under the knee cap. Once again, they don't work immediately, so some people quite using them thinking they are not working.

Just a very little bit of info.
post #11 of 19
Agree with above poster. Find a sports Dr, or a sports physio.

I had anterior compartmant syndrome in the 80s.... Shin splints! ie severe shin pain.

You need a doctor/physio who can help to fix the source of the problem, not trot out "rest and drugs". That won't fix it.
post #12 of 19
Funny my boss whos a 50+ yr old haven't ski for like 3 yrs went ski today and develop kneecap pain by the end of the day. i had to tell him to stop. I notice he was in an plowing position most of the time as well. He plow and position himself like his sitting in an invisible chair.

If u are having some much pain that u can't even work up stair normally in a few days go see a doctor.

I think we all know the good pain from the bad pain
post #13 of 19
Quote:
Originally Posted by ctown
Funny my boss whos a 50+ yr old haven't ski for like 3 yrs went ski today and develop kneecap pain by the end of the day. i had to tell him to stop. I notice he was in an plowing position most of the time as well. He plow and position himself like his sitting in an invisible chair.

If u are having some much pain that u can't even work up stair normally in a few days go see a doctor.

I think we all know the good pain from the bad pain
She did go to the doctor, and got (IMHO) the wrong dx. and therapy protocol. I think everyone needs to remember that if they have a sports related injury (or any ortho injury), they need to see a specialist. GPs are often not equiped to handle these types of injuries. And don't get me started on HMOs. And really don't get me started on SOCIALIZED medicine.:
post #14 of 19
Well, in Oz we have socialised medicine, and it works very well indeed. Thank god. Every time I come to the US, I'm reminded of how lucky lucky lucky we are.
However, for sports/movement problems, see a sports doctor.
post #15 of 19
Tor the first time in many years, I am experiencing the same pain. I did a lot of training with the patrol sled this year and a lot of that included using the the "snow plow" I was attributing the pain to "old age" and arthritis due to several old injuries. After a training session I was sore, stiff and could hardly move. It was really troublesome to have stairs around. I was always fine the next morning, and was fine when I skied just to ski.(which wasn't all that often). I guess now it may have actually been related to the training I was doing.

On the recommendtion of a friend, I tried Glucosamine Chondroitin. Believe it or not, it relieved the pain and I am now moving much better and more swiftly.
post #16 of 19
Quote:
Originally Posted by Docjoque
On the other hand, you report the classic signs of Chondromallacia Patellae (CMP).
My guess is that 9 out of 10 sports-med docs and physiotherapists in Australia would be thinking CMP straight off here. It's just so typical in
new skiers, who spend hours with tense, braced legs
energetic skiers of the old school, who use lots of flexion and extension
runners who do a lot of downhill work, esp. on rough terrain
novice cyclists whose seat posts are set too low

If you're structurally disposed towards this disorder (and it runs in families) then it doesn't take much of any of the above activities before you start getting imbalanced development in the quads, causing bad tracking of the patella.

Good news though:
bad as the pain is, there is probably no internal damage to the knee
simple physical therapy should get your patella tracking right within a few weeks = zero pain
pre-emptive exercises (the same as the remedial ones) before each ski trip should mean you don't have to go through it again
as your stance and balance on skis improve, the cause of the problem (weight back, tense legs) will be eliminated. Well, minimised.
post #17 of 19
Quote:
Originally Posted by ant
Well, in Oz we have socialised medicine, and it works very well indeed. Thank god. Every time I come to the US, I'm reminded of how lucky lucky lucky we are.
However, for sports/movement problems, see a sports doctor.
Where is Oz? Glad to hear your socialized medicine is working for you. It generally doesn't in the rest of the world. Don't want to get into it here, but if you consider getting medical care (any medical care) as working and being sufficient, then yes, it works well.

Socialized medicine is just a huge governmental HMO. HMOs suck in this country also.
post #18 of 19
Quote:
Originally Posted by teachskiljp
Tor the first time in many years, I am experiencing the same pain. I did a lot of training with the patrol sled this year and a lot of that included using the the "snow plow" I was attributing the pain to "old age" and arthritis due to several old injuries. After a training session I was sore, stiff and could hardly move. It was really troublesome to have stairs around. I was always fine the next morning, and was fine when I skied just to ski.(which wasn't all that often). I guess now it may have actually been related to the training I was doing.

On the recommendtion of a friend, I tried Glucosamine Chondroitin. Believe it or not, it relieved the pain and I am now moving much better and more swiftly.
Just curious. How long did it take for your glucosamine/chondriotin to work? Also, to help prevent further injury, you might want to wear the cho-pat bands when you're working. They work wonders.
post #19 of 19
Quote:
Originally Posted by Meganne
My guess is that 9 out of 10 sports-med docs and physiotherapists in Australia would be thinking CMP straight off here. It's just so typical in
new skiers, who spend hours with tense, braced legs
energetic skiers of the old school, who use lots of flexion and extension
runners who do a lot of downhill work, esp. on rough terrain
novice cyclists whose seat posts are set too low

If you're structurally disposed towards this disorder (and it runs in families) then it doesn't take much of any of the above activities before you start getting imbalanced development in the quads, causing bad tracking of the patella.

Good news though:
bad as the pain is, there is probably no internal damage to the knee
simple physical therapy should get your patella tracking right within a few weeks = zero pain
pre-emptive exercises (the same as the remedial ones) before each ski trip should mean you don't have to go through it again
as your stance and balance on skis improve, the cause of the problem (weight back, tense legs) will be eliminated. Well, minimised.
Great post. Wonderful info.
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