I am writing this to document my journey through a recent injury resulting from alpine skiing. I'd like to know if others have had this injury and hear about their repair/rehab experiences. I also want to be able to help others through the experience if (shudder - God forbid) this ever happens to them. Finally, I want to write this to hopefully, help me rehab my knee to the same or better condition it was in three short weeks ago.
About me:
46 y.o. male. 35 year skier. Former ski instructor at large Colorado resort for 8 years. Former ski racer. After children (2 - now young teens), moved to Idaho to get a "real job" - which involves sitting behind a desk and wishing I were out skiing most days.
Ski typically 30 to 40 days a year now - not even close to enough. Still love steeps, bumps, trees, terrain. Mostly ski at Bogus Basin near Boise, but take trips to Utah, California, Montana and Canada to ski steeps. I am a fanatic in the true sense of the word. I never, ever get enough. When I taught skiing, it was my goal to be the first person on the lift every morning of every season, and I very nearly succeeded. I would ski every day of my life if possible. In addition to alpine, I do a lot of nordic early season before terrain begins to open up.
Cycle all summer - both road and mountain. Long, long rides. I have a gang of guys my age and a little younger with whom I both cycle and ski - very fortunate that way. Also very fortunate that my wife (former ski instructor) loves the exact same activities as I. We both stay in shape, and in addition to cycling, I typically begin a lifting and conditioning program in early September to get my body in "ski shape."
Have had a previous torn left ACL approximately 5 years ago (repaired with a hamstring) from which I recovered well and have continued with my lifestyle ever since. I do have nearly constant patellar/femoral pain in both knees which I deal with through physical therapy, lifting, cycling, nordic skiing, etc.
The Injury:
The morning of Sunday, January 13, I was skiing with a friend at Bogus Basin. Having a great day - probably 4 inches of new. On about the 7th run or so, was following said friend down a steep face, making relatively high speed GS turns with a "must make" right hand turn down at the bottom onto a very narrow traverse out of an extremely steep sided, long, narrow, gully underneath a quad lift.
The "must make" turn at the bottom was perfect - beautiful, balanced, high speed . . . . until my left knee simply exploded in pain, and I went down screaming with my knee on fire. I ended up hanging upside down on my back, dangling from my left ski (which never came off), in incredible pain - looking up at the faces of numerous lift riders who were all staring back down at me (probably wide-eyed at the string of profanity I had just let loose with).
My friend came down, quickly assessed the situation, and helped me release the binding and get turned around with my good leg planted underneath me. My knee was extremely painful - absolutely on fire - and we quickly opened up the zipper on my shell pants and packed it in snow. Then, as we were in an extremely sketchy place for a rescue, attempted to get back up to the traverse (max two skis wide with a very steep drop off below) and as far down it as possible. My leg was simply unresponsive - dangling without any control at all. I hooded my pole strap into the bottom buckle of my boot, and was able to lift it and move it that way. Suffice it to say that the situation was somewhat desparate.
Patrol came and performed a rescue - while I appreciated their efforts, I was somewhat concerned for both their safety and mine. Despite a few bumps and problems, we all made it out without further injury to anybody else - I am sure it was quite a show for the fully loaded lift overhead!
The Diagnosis
Initially, as soon as I got down to town, we iced the knee and determined whether to go to the emergency room. As the pain was slowly subsiding, I determined to tough it out without paying the huge fee to have the ER doc tell me to go see the "Orthopod". Got into to see my Orthopod two days later. The knee was simply too swollen and too injured to make a proper diagnosis, although the doc suspected that the ACL hamstring graph had failed (he was really bummed as it would have been the first such repair he had done that had ever failed). He suggested that rather than getting an MRI, he should take several cylinders of blood out of the knee to get the swelling down and that I should spend money instead on PT - a suggestion that I think he later came to regret. We proceeded on the basis that we needed to get the swelling down and begin physical therapy to keep the leg as movable as possible. I agreed to come back in two weeks for further diagnosis and discussion of surgical options.
I went to PT, began building up the quad muscles through isometric and other exercises, began spending time on the bike and walking in the pool. I also used an "Iceman" (thanks John!) all night every night. However, I could never fire the quads enough to straighten out the leg, and it would simply collapse on me at any time - causing extreme agony. The PT suggested a partial tear of the patellar tendon below the kneecap.
On the second visit to the Orthopod - two days ago, he diagnosed a complete tear of the Quadriceps tendon (above the kneecap) and sent me to get an MRI to determine whether any further problems existed. There is some torn and loose cartilage floating beneath the kneecap.
He explained to me that the tendon simply "peeled" off of the kneecap under the extreme force exerted by my quads in the turn I was executing at the time. I now understood why the pain had been so incredible - 'twas nothing like the ACL injury I had experienced a few years previous.
The Proposed Surgery
The surgery is somewhat gruesome, so if you don't like blood, you may want to skip this part. First, they must open an approximately 8 - 10 slit in the leg immediately on top of the kneecap (no arthroscopic surgery for this procedure). Next, they drill four holes through the kneecap lengthwise, from the top near the femur to the bottom near the tibia. Then, he stitches a couple of pieces of permanent material into the quadriceps muscle and tendon using what he calls a "baseball stitch". These pieces of material have several "tails" each, which are then run through the holes in the patella and anchored with knots at the bottom. For a view of the surgery and a better description of the injury, see this link: http://www.arthroscopy.net/quadrep.htm
My Attitude
So, this will happen to me tomorrow morning. Hopefully I can quickly recover and begin rehab. I have a great feeling about this one - I know it will take awhile for rehab (6 months), but have done rehab before, and can do it again. Now, I can't wait until cycling season here in Idaho! I have many good friends, a great family, and am very fortunate in many other ways. The thing I keep remembering is that many, many people my age would never have this injury because they are not active enough to ever get hurt this bad. Between athleticism with an occasional injury, and couch riding without ever getting hurt, I'll take athleticism any day.
All of you with injuries, keep your chins up!
Good luck to ya!
About me:
46 y.o. male. 35 year skier. Former ski instructor at large Colorado resort for 8 years. Former ski racer. After children (2 - now young teens), moved to Idaho to get a "real job" - which involves sitting behind a desk and wishing I were out skiing most days.
Ski typically 30 to 40 days a year now - not even close to enough. Still love steeps, bumps, trees, terrain. Mostly ski at Bogus Basin near Boise, but take trips to Utah, California, Montana and Canada to ski steeps. I am a fanatic in the true sense of the word. I never, ever get enough. When I taught skiing, it was my goal to be the first person on the lift every morning of every season, and I very nearly succeeded. I would ski every day of my life if possible. In addition to alpine, I do a lot of nordic early season before terrain begins to open up.
Cycle all summer - both road and mountain. Long, long rides. I have a gang of guys my age and a little younger with whom I both cycle and ski - very fortunate that way. Also very fortunate that my wife (former ski instructor) loves the exact same activities as I. We both stay in shape, and in addition to cycling, I typically begin a lifting and conditioning program in early September to get my body in "ski shape."
Have had a previous torn left ACL approximately 5 years ago (repaired with a hamstring) from which I recovered well and have continued with my lifestyle ever since. I do have nearly constant patellar/femoral pain in both knees which I deal with through physical therapy, lifting, cycling, nordic skiing, etc.
The Injury:
The morning of Sunday, January 13, I was skiing with a friend at Bogus Basin. Having a great day - probably 4 inches of new. On about the 7th run or so, was following said friend down a steep face, making relatively high speed GS turns with a "must make" right hand turn down at the bottom onto a very narrow traverse out of an extremely steep sided, long, narrow, gully underneath a quad lift.
The "must make" turn at the bottom was perfect - beautiful, balanced, high speed . . . . until my left knee simply exploded in pain, and I went down screaming with my knee on fire. I ended up hanging upside down on my back, dangling from my left ski (which never came off), in incredible pain - looking up at the faces of numerous lift riders who were all staring back down at me (probably wide-eyed at the string of profanity I had just let loose with).
My friend came down, quickly assessed the situation, and helped me release the binding and get turned around with my good leg planted underneath me. My knee was extremely painful - absolutely on fire - and we quickly opened up the zipper on my shell pants and packed it in snow. Then, as we were in an extremely sketchy place for a rescue, attempted to get back up to the traverse (max two skis wide with a very steep drop off below) and as far down it as possible. My leg was simply unresponsive - dangling without any control at all. I hooded my pole strap into the bottom buckle of my boot, and was able to lift it and move it that way. Suffice it to say that the situation was somewhat desparate.
Patrol came and performed a rescue - while I appreciated their efforts, I was somewhat concerned for both their safety and mine. Despite a few bumps and problems, we all made it out without further injury to anybody else - I am sure it was quite a show for the fully loaded lift overhead!
The Diagnosis
Initially, as soon as I got down to town, we iced the knee and determined whether to go to the emergency room. As the pain was slowly subsiding, I determined to tough it out without paying the huge fee to have the ER doc tell me to go see the "Orthopod". Got into to see my Orthopod two days later. The knee was simply too swollen and too injured to make a proper diagnosis, although the doc suspected that the ACL hamstring graph had failed (he was really bummed as it would have been the first such repair he had done that had ever failed). He suggested that rather than getting an MRI, he should take several cylinders of blood out of the knee to get the swelling down and that I should spend money instead on PT - a suggestion that I think he later came to regret. We proceeded on the basis that we needed to get the swelling down and begin physical therapy to keep the leg as movable as possible. I agreed to come back in two weeks for further diagnosis and discussion of surgical options.
I went to PT, began building up the quad muscles through isometric and other exercises, began spending time on the bike and walking in the pool. I also used an "Iceman" (thanks John!) all night every night. However, I could never fire the quads enough to straighten out the leg, and it would simply collapse on me at any time - causing extreme agony. The PT suggested a partial tear of the patellar tendon below the kneecap.
On the second visit to the Orthopod - two days ago, he diagnosed a complete tear of the Quadriceps tendon (above the kneecap) and sent me to get an MRI to determine whether any further problems existed. There is some torn and loose cartilage floating beneath the kneecap.
He explained to me that the tendon simply "peeled" off of the kneecap under the extreme force exerted by my quads in the turn I was executing at the time. I now understood why the pain had been so incredible - 'twas nothing like the ACL injury I had experienced a few years previous.
The Proposed Surgery
The surgery is somewhat gruesome, so if you don't like blood, you may want to skip this part. First, they must open an approximately 8 - 10 slit in the leg immediately on top of the kneecap (no arthroscopic surgery for this procedure). Next, they drill four holes through the kneecap lengthwise, from the top near the femur to the bottom near the tibia. Then, he stitches a couple of pieces of permanent material into the quadriceps muscle and tendon using what he calls a "baseball stitch". These pieces of material have several "tails" each, which are then run through the holes in the patella and anchored with knots at the bottom. For a view of the surgery and a better description of the injury, see this link: http://www.arthroscopy.net/quadrep.htm
My Attitude
So, this will happen to me tomorrow morning. Hopefully I can quickly recover and begin rehab. I have a great feeling about this one - I know it will take awhile for rehab (6 months), but have done rehab before, and can do it again. Now, I can't wait until cycling season here in Idaho! I have many good friends, a great family, and am very fortunate in many other ways. The thing I keep remembering is that many, many people my age would never have this injury because they are not active enough to ever get hurt this bad. Between athleticism with an occasional injury, and couch riding without ever getting hurt, I'll take athleticism any day.
All of you with injuries, keep your chins up!
Good luck to ya!
