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Protect Your Knee in the Winter Weather
February 11, 2004
By Stephanie Riesenman for Knee1
Spring may finally be in sight, but several weeks of winter still remain and that means plenty of opportunity for cold weather-related knee injuries. Many of those injuries occur on the slopes; in fact one out of three ski injuries are knee injuries. The most common winter sports injuries are strained knee ligaments. When a ligament is damaged, a popping noise often occurs and patients feel their knee give out from under them. This is followed by swelling 2 to 12 hours later.
There are two sets of ligaments in the knee: the cruciate and the collateral ligaments. The cruciate ligaments are located inside the knee and connect the thighbone to the shinbone. They are crisscrossed and act like rubber bands holding the knee in place while bending and extending. The ligament located towards the front of the knee is the anterior or ACL, and the PCL is located in the posterior or back of the knee.
Dr. Riley Williams, orthopedic surgeon in sports medicine at Hospital for Special Surgery in New York, says ACL injuries that occur while skiing often happen when the athlete falls and twists a knee. "The most common mechanism is when a fall occurs and the binding does not release," said Dr. Williams. An ACL can also become torn when the tip of the ski gets wedged in the snow and the skier’s body keeps moving forward, but the feet stay planted.
A study published in the January 2004 issue of the American Journal of Sports Medicine found that skiers who get injured during their first day on the slopes are more likely to injure their MCL, or medial collateral ligament. The collateral ligaments are located at the inner and outer side of the knee joint. The MCL connects the thighbone to the shinbone and provides stability to the inner side of the knee. When the MCL becomes injured, patients usually complain of a sharp pain on the inside of the knee. The article in the American Journal of Sports Medicine said MCL injuries were more prevalent in novice skiers because they are more inclined to ski in the snowplough position, in which the knee is already in a valgus — or inward-turned position — which places more stress on the MCL in the event of a fall.
Dr. Williams says surgery is usually recommended in the event that an ACL or MCL tear does not spontaneously heal. Rehabilitation takes anywhere from 4 to 12 weeks. In the case of minor knee injuries, physical therapy may be enough to regain function. Another common site for knee injuries is the meniscus. This is the cushion that surrounds the thighbone and shinbone. When someone suffers a meniscal tear they usually experience stiffness and swelling in the joint, or "water on the knee."
These types of injuries are also common for city bound folks who may twist a knee when they slip and fall on ice. And while avoiding city related accidents may rely more on pure luck and caution, experts say the best advice to prevent ski-related injuries is to use the right size equipment and not to push the body too hard. They also say weight training and stretching before hitting the slopes can help. "It’s not ever been shown in a study, but most sports doctors anecdotally believe this to be true," said Dr. Williams.
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