Knee pain on ski vacation

[DeeSki]

Hello all, haven't posted here for a while but I do check in from time to see how everyone is getting on. The good news is I'm on a ski vacation in the Austrian Alps and it's dumping snow. The bad news is after one very easy day skiing - about an hour in the morning and the same in the afternoon, my knee is hurting. This is the knee I broke six years ago - tibial plateau fracture. This is my third time skiing since. First time was three very short days and no problems. Last year I skied five of six days and the knee was sore at the end. I'm fairly sure the reason for this is that I'm not in good shape. I had been going to the gym and cycling to work about 20 minutes each way until Christmas but then I got sick and spent all January coughing so badly I could do nothing. I ran a fever for 9 days in a row until two days ago and went for a 20 minute hike rather than ski yesterday because I knew I wasn't up to it. Leg muscles are obviously very week because I find it hard to even step down into my left ski.

Anyway, I have another 4 days to ski. Clearly, I'm not going to be ripping up the mountain but if anyone can advise me on what I should do so that I can ski a bit with the minimum pain possible and without causing myself further damage, I'd be really grateful. Is it too late to do a few exercises, lunges, squats etc or should I just rest? Thanks!

 

[Jilly]

You know the drill....R - rest, I-ice, C - compression - E - elevation. RICE.

So first rest and ice. Snow in a plastic bag is great. This should reduce any swelling. Keep it up too as you rest it. Then tape it up or use a neoprene brace while you ski.

I think I saw a picture of the Ski Diva's DH doing this during Diva West.

 

[DeeSki]

Thanks Jilly, I'll give the snow in a plastic bag a go! This is so annoying. My knee gives me no trouble at all except when I ski.

 

[Jilly]

Not sure if you have a brand called Zip-lock. They are the greatest.

If the knee is only bothering you when you ski, then maybe you should have a bootfitter look at it. Might need an alignment.

 

[Jenny]

Maybe wearing one of the compression knee braces would help . . .

We went through a period some years ago where it seemed part of our equipment included these, plus a prophylactic ibuprofen before every ski day.

 

[nopoleskier]

yes to all of the above and I'm a believer in Arnica (montana) cream... no heat/no smell is a homeopathic for deep tissue bruising without it I'd not be skiing as much as I do.. several Divas and their friends can attest to the quickness and help arnica has been for them.
and if you can find the "K" Tape.. it's a tape you can put on joints to give extra support :-)

I hope you feel better ASAP!!

 

[bounceswoosh]

I'm so sorry! I wonder if the nasty crud that's been making the rounds here is the same cold you had ... I was flat-out miserable for a while, and I'm out of breath now just climbing 1.5 flights of stairs for work!

 

[geargrrl]

foam roll/lacrosse ball on the bottom inside of the quad, vastus medialis area.

 

[newboots]

Is the altitude also making you weaker?

 

[2ski2moro]

As tolerated, try to work on your Glutes to build up some strength to protect your knee. Bridge. Side steps. Lunge as tolerated. Clam leg exercises (google that). Good luck.

Where in Austria? I'm going to Zillertal/Mayrhofen in 3 weeks. Can't wait.

 

[bounceswoosh]

Clamshells, omg. I have done so many of them!

 

[marymack]

While it doesn't sound like this is the issue, but maybe a ski lesson would identify issues like skiing in the backseat which could be contributing to the knee pain?

 

[DeeSki]

Thanks all for the fantastic advice. I iced with a bag of snow last night - best ice pack ever! - and it really helped. I then headed to the pharmacy this morning and got myself a compression bandage. What a difference! Wow! It really helped. I skied about 1.5 hours this morning and felt so much better. Some of it is probably in my head, but so much of skiing is in your head. My last run was a wrong turn down a black which I managed nicely. I'm slowly getting my mojo back, with a lot of talking to myself! With zero visibility, I decided to quit while ahead and am now repeating the rest, ice, elevation protocol.

Jilly, I think I do need a boot fitting. My boots are 10 years old and I was probably about 12lb heavier then and much fitter. My calves are a lot slimmer than they used to be and I'm having to tighten the buckles almost to the max. I've been putting it off because the solution will involve new boots and that's a lot of expense for a weeks skiing a year.

Definitely need to do all the squats, lunges and clamshells, I'd forgotten about clamshells. Foam roll would probably do me good. I never seem to be able to use it properly by myself so I might head for a PT session for some help. Marymack, there are definitely issues about how I'm skiing. I don't think I have the stamina for a lesson right now but I've taken a lot of lessons in the past so I know my issues. Hence the talking out loud to myself like a madwoman: pick your line down the hill, shoulders and hips pointing down the mountain, hands in front, forward over your boots, rise and turn. I'm doing a lot of the steering the car drill and I'll have to work on relaxing my shoulders later, but the first priority is not to turn my shoulders when I feel nervous.

Don't think the altitude is an issue. I'm in Galtür, near Ischgl, which is at about 1600m or 5250 feet and I'm usually good with altitude. Bounceswoosh I suspect this is global nasty crud. I haven't been sick for ages.

2ski2moro, you'll have a blast in Mayrhofen. Weather here is lousy today, rain at base and snowing with no visibility up the mountain, but snow condiditions today are amazing.

Thanks again for all the great advice. Last night I thought I'd be doing well to manage some hiking but I really enjoyed myself today.

 

[2ski2moro]

I'm glad it's working out for you. Last year in Zillertal, we had such cloudy weather on the mountain for several days. But when it was sunny, it was beautiful! Enjoy the rest of your trip.

 

[WaterGirl]

Thanks all for the fantastic advice. I iced with a bag of snow last night - best ice pack ever! - and it really helped. I then headed to the pharmacy this morning and got myself a compression bandage. What a difference!

Jilly, I think I do need a boot fitting. My boots are 10 years old and I was probably about 12lb heavier then and much fitter. My calves are a lot slimmer than they used to be and I'm having to tighten the buckles almost to the max. I've been putting it off because the solution will involve new boots and that's a lot of expense for a weeks skiing a year.

I'm glad your knee is feeling better! I can totally relate to this as I had weird knee pain early on this season, new boots with new custom foot beds resolved it instantly. For me it was over compensating with movement to maintain control in packed out boots. Perhaps the compression bandage is giving support to the muscles that are compensating for boot issues. I am wondering if you can get a new foot bed while on your trip to see if support (or taking up a bit more room in the boot) is the issue -- even the aftermarket superfeet provided the relief for the two days I skied before I could get back to have the custom footbeds made. While I agree that getting new boots can be a PITA it seems the boots on the market today are far superior as far as customizing and fit to boots of even even 5 years ago, and once broken in will make future trips that much more enjoyable. It may be costly for the amount of time you are skiing, but I think everyone will agree that boots are where the $ should be spent.

 

[DeeSki]

Water girl, that's interesting. Totally agree about the importance of boots and know that's where I'm headed. Got a few adjustments made 5 years ago and even then it was clear the technology had moved on a lot. I have akward feet - wide at the toe, narrow at the heel and ridiculously high arches. My boots actually still feel great around the feet with their original custom foot beds but they seem too wide at the calf with the result I am having to buckle them very tight. I won't make a bootfitter on this trip but I'll make it a priority next time. In my case, I think my boots are an issue but my general lack of condition is the bigger one so I'll work out harder and hopefully this will also help when it comes to picking the right boots.

2ski2moro fingers crossed for the weather. That's the mountains!

 

[WaterGirl]

DeeSki I can sooooo totally relate to your feet and I also was thinking that my old boots did fit well, but like you I had to crank the buckles. I think you will be (as I was) pleasantly surprised that even some of the lower volume shells can accommodate a bit wider forefoot yet cater to a slimmer ankle/ calf with a higher then normal instep.

 

[Obrules15]

Water girl, that's interesting. Totally agree about the importance of boots and know that's where I'm headed. Got a few adjustments made 5 years ago and even then it was clear the technology had moved on a lot. I have akward feet - wide at the toe, narrow at the heel and ridiculously high arches. My boots actually still feel great around the feet with their original custom foot beds but they seem too wide at the calf with the result I am having to buckle them very tight. I won't make a bootfitter on this trip but I'll make it a priority next time. In my case, I think my boots are an issue but my general lack of condition is the bigger one so I'll work out harder and hopefully this will also help when it comes to picking the right boots.

2ski2moro fingers crossed for the weather. That's the mountains!

If you really like your shell, you could consider an aftermarket liner like Intuition or Zipfit.

 

[COchick]

Socks are also sometimes a vastly underrated component of the boot system. It's crazy what a difference it makes going from one thickness to another. And I've often found thinner is better, which seems counter-intuitive. Since I also have knee trouble, I focus on prevention/maintenance. So when I get up in the morning of a ski day, I immediately take ibuprofen. I wear compression tights and knee braces. I take ibuprofen at lunch and at the end of the day, and RICE also at the end of the day. And a margarita. ;) Yoga stretches and a few lunges in the morning get my legs warmed up a little and the fluids moving around in the knees. If I have access to a stationary bike on this next trip, I'll jump on it for about 10 minutes to get the initial "clickiness" out of the knees. Of course that only works if your time on the hill is shortly after that, or it won't do much good. But you can always do a few squats/lunges before putting on your ski boots just as a little warmup.
If your boots fit well other than in the calf, you can always put one of those sticky wedges in and see if that helps?

 

[bounceswoosh]

So when I get up in the morning of a ski day, I immediately take ibuprofen. I wear compression tights and knee braces. I take ibuprofen at lunch and at the end of the day, and RICE also at the end of the day.

I used to be a big proponent of Vitamin I. Then it turns out I have a medical condition that doesn't allow me to use it.

But I wonder if using ibuprofen so much really counts as prevention/maintenance. Seems more like masking. I guess it depends on if you see it as serving a function similar to compression.

Even for people without medical conditions, ibuprofen is hard on the GI system.