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Knee is hurting!

post #1 of 18
Thread Starter 
I just started skiing again and have noticed that my patellar tendon is killing me (right to the bottom of the kneecap). I'm almost certain this is because my knee is getting over/past my toes (leaning forward into the boots, putting the heel back into the boot, and thus sending my knee past the toes). I do know that to do a proper squat, your knee should not go past your toes since its puts strain on the tendon. Any thoughts? I'm not going to be able to ski if my knee continues to get worse. Thanks for any help!
post #2 of 18
You are not doing deep knee bends when skiing. If the knee gets in front of the toes once in a while, it shouldn't be a problem. You could have tracking problems with your knee cap (patella). How strong are your legs? Having stronger legs usually will help with patella tracking problems. Is there any history of tendonitis in that knee?

I have had patellar tendon ACL surgery, and have never had a problem with that. You may have a special circumstance that a Dr should look at.
post #3 of 18
Patellar tendonitis is usually associated with backseat skiing. Use ice and lots of ibuprofen, and get out of the backseat.
post #4 of 18
Thread Starter 
I've had the problem you are describing in my right knee before (tendon wasn't tracking, essentially tendon was getting hung up and snapping across, did quad work, problem went away), but this is my left knee, and my quads are fairly strong. I've also been fitted with prescription orthotics to help with allignment. I don't believe the problem is the conditioning of my leg, but I very well could be wrong on that. There is something with the way I'm skiing that is causing the problem, and whether its body positioning, conditioning, I don't know. I can probably get the knee to calm down, but I don't want it to fire up the minute I get back out on the hill.
post #5 of 18
It sounds like a typical back seat syndrome. The most likely cause is too much forward lean in your boots. I suggest you read the 'balance and alignment' thread to learn correct stance so you can ascertain whether the boot is the problem. There can be other factors but this is a good starting point.
post #6 of 18
David makes a good (and brief!) point. Too much forward lean can do it.
post #7 of 18
Thread Starter 
So my guess was correct in my original post that leaning too far forward in my boots (thus putting my knees over my toes) is the potential cause of the problem. How would I correct the boot problem? I have a high instep, wide foot, and foung the Salomon boot to fit my foot best. I bought a pair of X-Wave 7.0 boots and ski Crossmax 9's. Is the problem that I can flex the boot too far forward? Thanks.
post #8 of 18
I have empathy for you as I've been dealing with the patellar tendonisis thing myself for a while.

Have someone watch you ski while you ski first as flexed as you can, then extended as you can, then your normal pattern. Their feedback should help you determine where you both: Travel within your overall range of flexion/extension limits and where your normal skiing puts you within that range.

If you are skiing from more flexed to partially extended, and staying flexed most of the time, this would contribute to a tendonitis aggrivation. The more flexed you are at falline the longer you will need muscular engagment for support until you can start to release (stressing tendons). This stress is compounded if you are skiing with extension (up motion) prior to and thru your edge change.

If this is the case try to move up within avaliable range so that by being more fully extended you "stack your bones" for support in each turn and reduce constant stress of support on those tendons. This should involve really trying to lengthen legs in top of turn as you move body to inside after edge change. The more extended you are in falline the sooner you can "soften" muscles while turning out of it. Try to smoothly progress from max extension at falline, to relaxion/flexion thru edge change. When the turn dynamics are building thru finish, yield to allow CM to flow across edge change, don't resist, trying to extend up as forces are at maximum (it is a battle your body can only lose). Make love, not war with gravity. [img]smile.gif[/img]

You may need to adjust forward lean, boot flex, boot ramp and/or binding ramp angle to find a new stance to support a more extended and less flexed travel range for your skiing for/aft balancing needs.

I've reduced my binding ramp angle and softened my boots and I am always working on developing a smoother pressure cycle throughout the whole arc of my turns. I'm not yet ready to back off on the energy level and give up the skiing I love to do, so I continue to pursue efficiency.

Good luck,

post #9 of 18
Thread Starter 
This may help as to how I've been skiing. My calves were also killing me for 4-5 days after skiing as well. They feel fine now since it was only muscular, but may help to figure out how I've been skiing from a position standpoint. What is the optimal position/center to be skiing from?
post #10 of 18
There is no optimal "position." The optimal way to ski is "in balance," which means constantly moving to manage or balance the forces acting on the skier. You need to develop balancing skills yourself or with the help of a coach. When you do, (based on your earlier posts) you will no doubt develop a stance that is generally more forward of where you ski now. This is true of most beginner to intermediate skiers.
There are also two opinions about finding a "balanced stance." One opinion is that every variable in your boots, bindings and skis must be carefully adjusted within extremely small tolerances before you ever attempt to slide on the snow. The other extreme is that you should just go out and ski, and adjust to whatever is under your feet. There are some excellent skiers and coaches who advocate one or the other of these approaches.
The problem with the first approach is that all this "balancing" occurs in a static environment, typically on a flat floor, that is nothing like the dynamic environment we experience skiing. (For example, the maximum variation of the forward lean angle of typical skiboots is probably from 10 to 20 degrees or less, yet I ski pitches anywere from 5 to 48 degrees.) I think the principle appeal of this approach is that it promises to correct skill problems with new equipment, but you can't learn to ski just by buying equipment. Unless your boots are grossly misaligned, too stiff, poor fitting or uncomfortable, "boot balancing" will have limited impact on the problems you are experiencing.
Treat the inflamation in your knee, do careful conditioning, and work on your skills.

Good luck,
post #11 of 18
Optimum? No general answer there, optimum is very much a personal thing based on becoming more aware of how efficient, or not, your movement patterns are for your own body. It is a matter of discovering how you can get your skis to do what you want with the least wear and tear on your body. These transiitions are a process though, skiing a new or different style may initially feel less "comfortable" than ingrained habits until you find a new groove and get more efficient. Having someone (like a pro) who knows what you are trying to achieve watch you and give you feedback can help you thru the transition.
post #12 of 18
What Arcmeister said. [img]graemlins/thumbsup.gif[/img]


[ January 22, 2003, 08:03 AM: Message edited by: John Dowling ]
post #13 of 18
Making adjustments in stance/alignment through modifications of equipment isn't done for balance reasons. Those of us who advocate this are just trying to put the skier into a neutral stance/alignment from which they can move forward or back at will and with a minimum amount of body movement. This process has solved the patellar (sp) tendon pain of many students and instructors. It is from a stance of neutral alignment that skiing is most efficent.

Yes, we do the inital fore/aft alignment staticly on a flat surface but this alignment is not really affected by motion or slope and proper alignment just makes it easier to deal with the motion or slope. Also, on snow follow-up and evaluation is a part of the process.

We can make moves to compensate for being out of ideal fore/aft alignment but then we are in some way compromising our ability to move through our entire range of motion i.e. if I have to flex my ankles to comensate for being alightly aft in my alignment that is ankle flex I can't use in my skiing, this will also cause me to flex at the knee and require that I use muscle rather than bone to support my body weight.

Why should I have to adjust my stance for every ski in my quiver when I can adjust the equipment to allow me to use my most efficent stance on each ski.

An additional point. For a few people out there it is imposssible to compensate for their misalignment and some kind of adjustment in their equipment is necessary for them to ski at all.


[ January 22, 2003, 08:46 AM: Message edited by: Ydnar ]
post #14 of 18
Ydnar replied:
Making adjustments in stance/alignment through modifications of equipment isn't done for balance reasons. Those of us who advocate this are just trying to put the skier into a neutral stance/alignment from which they can move forward or back at will and with a minimum amount of body movement.

David M wrote in this thread above:
It sounds like a typical back seat syndrome. The most likely cause is too much forward lean in your boots. I suggest you read the 'balance and alignment' thread to learn correct stance so you can ascertain whether the boot is the problem.

Every time someone asks advice for a balance problem here, someone else suggests "check alignment." The reality is that (for reasons David M has described ad nauseum), we simply have a reflex to adopt a defensive, backseat posture in unfamiliar skiing activities, and learning to ski at an advanced level requires training ourselves to use new responses when skiing. No amount of equipment modification will ever change that: the defensive reflex is just too deeply embedded in our genes to be overcome with extensive training.

post #15 of 18
Thread Starter 
I'm not sure where this is all going. I guess I'm trying to figure out why my knee hurts (patellar tendinitis), and can only conclude that is is because of either 1) how I'm skiing or 2) that I'm not conditioned properly. I tend to think that it is #1, but I'm open to suggestions otherwise (I'm sure it's possible that because skiing is using muscles you don't normally use, it is causing fatigue somewhere which then results in too much strain on the tendon, but my quads are pretty strong, so not sure that's it).

As far as balance, I think I'm achieving that while I'm skiing since I'm not falling all over and I'm able to carve down the slope, but it would seem to me that perhaps it is the "how" I'm achieving the balance, the skiing itself, that has caused the tendinitis. I don't believe it is the equipment, I believe I'm doing something that is putting undue strain on the patellar (which I think is caused somehow by how I'm distributing weight or using my body while skiing).

I don't know what backseat skiing is (what is, if at all, the exact body position of that? and then why would that put strain particularly on the patellar tendon?). I can only guess that "flexed" means my quads are fired, my shins are pressing against the tongue of the boot, and my knees get over my toes; and that "extended" means straight-legged.
post #16 of 18
The more you flex your knees (while standing) the more pressure is put on your kneecap and patellar tendon. Try extending your knees while flexing your ankles to maintain contact with the tongue of your boot. That will move your hips (and your Center of Mass) forward. Leaning on the back of your boots will increase the pressure on your knees. If your boots have a forward angle adjustment, adjust them as upright as possible to minimize the strain on your knee.

Poor conditioning may not have caused the problem, but sometimes it contributes to incorrect tracking of the kneecap or to a muscle imbalance that leaves you susceptible to this kind of injury. Strengthen the front muscles of your leg when you can do so painlessly.

Hope this helps. I've dealt with a similar chronic injury, so I know what you are going through.

post #17 of 18
Ski backwards down a gentle slope
The posture adopted should be applied when skiing forward.
If you have too much fwd lean in your boot/binding, you will have your weight "back" in spite of feeling shins to boot.
Can you do a 90 degree knee bend while wearing your boots? It's OK to hold your hand fwd.
If more than 90, you may have too much fwd lean position in your boots.
If less, well, you know the drill.

If while skiing, you feel a pull on your shin, knee, or quads, do whatever you have to do to relieve the pull.
Does this change your posture? Stand up and forward?

I'm slow to warm up, first tracks in new snow KILL my front side. I know I am in the back seat. When I warm up, and relax, my weight stacks up, and I can ski all day without discomfort.

Try different things, see what it takes

Good luck

post #18 of 18
d money - I suggest going to a GOOD PROFESSIONAL BOOTFITTER and telling him/her about your problem.

If like myself you don't want to spend an extra $150 after having bought the new boots, try loosening the top buckle and the velcro strap on your boots for a day and see how it goes. Your calf muscles have been hurting you probably because you were trying too hard to lean your shins forward against a stiff boot top, and your lower legs should find a better position then.

If your boots have a forward lean adjustment (most of them do these days), try pulling them back a little bit (that should make them more vertical and prevent your knee from going over your toes).

[ February 13, 2003, 07:14 PM: Message edited by: AlexG ]
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