Skiing and Arthritis

[Divegirl]

Does anyone ski with arthritis in the knees(s)? Do you have any advice?

I was just diagnosed w/ arthritis in my left knee - under the knee cap and and the inside of the joint. I had a Cortisone shot last week which helped w/ the pain and swelling and I start PT next week to strengthen my knee and hopefully get range of motion back.

Right now I am having difficulty completely straightening/extending my left knee/leg so I am walking flat-footed or on the ball of my left foot (my left leg is 1/2" shorter than my right). While I have had some mild knee issues/pain over the last few years this seemed to flared up in late August when I sprinted to 1st base playing softball and I have not been the same since.

This diagnosis hit me pretty hard as I am pretty active (or I was) - skiing, SCUBA, biking, walking, hiking, softball, snorkeling and any other activity that comes my way in addition to every day household activities.

My goal is to get my activity level back to what it was before this flared up. I have 8 weeks to get this under control as I plan to start my ski season on January 5th.

Thank you

Laura

 

[altagirl]

I do. I've had 5 knee surgeries and lost most of the medial meniscus in both knees, so they are both bone on bone in spots. Years ago, when I was hobbling around and unable to ski without pain that brought tears to my eyes most of the time, my surgeon said there was nothing to do other than wait until I'm old enough for knee replacements, and just have them scoped every 18 months or so to clean up the bits of cartilage floating around in there to keep things going. I have (our had) bone spurs all around the rims of both knees, and they blamed that for the lack of range of motion that I had then. I started doing yoga regularly and then changed my diet drastically and discovered that the swelling that was virtually constant in my knees went away when I eliminated gluten (and most sugar and processed foods) from my diet. I can still aggravate them by running on hard surfaces too much or sudden hard pivots, etc. BUT - I CAN run and ski and bike and even took up ballet and swimming recently. I couldn't do much when it was at it's worst. I do think that yoga helps dramatically - especially when done with a focus on alignment (after about 8 years, I can comfortably sit on my heels again! ). I can tell if I've been slacking. I also find it helpful to massage my own knees with arnica based salve whenever they've gotten a workout or I feel any twinges. (Hard to say if the arnica or the massage is going the good there...)

Clearly, diet stuff is individual, but I guess I'm saying to not give up hope.

 

[Jilly]

Me too. Just this summer. Right knee..cortisone and euflexx. Left knee scoped. OA brace for right leg. Physio for extension. Do those religiously! I should be able to ski opening weekend. Scope was 15th Sept. So listen to your health team.

 

[MaineSkiLady]

DH does - in fact, it pre-dates his ACL surgery by many years. DS is well on his way - wear and tear. Not sure about mine, but am sure about left hip. Can and does affect my skiing.

What’s peculiar about arthritis is its intermittent nature, in terms of how bothersome/how often. It will vary for everyone, as will best treatment. You’ll need to embark on a “personal journey” of finding what works best for you. Hopefully, you’ll be encouraged by results, after a trial and error period.

I do feel your pain, however, as most of my summer has been limited by pain that was only just diagnosed this fall. Remedial - but requires serious motivation and work.

A sad reality regarding time - and wear and tear. But NOT the end of an active lifestyle!! Just a few prudent modifications. Hang in there.

 

[Divegirl]

Thank you for the advice and encouragement.

This hit me hard for a couple reasons - my activities/exercise have helped me lose just shy of 50 lbs in the last few yrs and I still have a long way to go. Also, I recently hooked up w/ a bunch of like minded women - very active, always looking for the next activity to organize - hiking, softball, 5K walks, kayaking and so on. Just in Nov I am going to miss a 5K food pantry walk, a 7 mile hike and pick up soccer games w/ these ladies. Activities especially walking, skiing and biking are relief valves for me - to burn off stress, excess energy and get me out of the house.

@altagirl - I will keep the diet in mind and add it and yoga to my list of questions for my therapists. In the long run, it wouldn't hurt me to cut down both of those "food groups" as I have a wicked sweet tooth.
@Jilly - I have brace/support on the list of questions, currently I use an OTC support when I know I will be moving about alot. I will definitely listen to the therapists. I went to the same people for a frozen shoulder several years ago and they are wonderful. No mention anything past PT yet but I am to check in w/ my ortho PA after 2 - 4 weeks of PT. Cortisone is the only anti-inflammatory available to me as I cannot take NSAIDs or ibuprofen based anti-inflammatories. Tylenol does squat.
@MaineSkiLady - No 2 people exerience injuries and pain the same. What hurts me may not hurt the next person. Like you said - trial and error. My short term plan is getting back on track for my ski season. Long term getting as much of my activities back as possible. It may be that if I know I am going indulge in softball or another high impact sport, I back off my regular activities a day or 2 before and the day after. I am already thinking subbing in some swimming/aqua aerobics for walking and other high impact activities.

I am lucky that except for the arthritis and bone spur on my knee cap, I have no other damage to the knee - no tears or fraying of the cartilage/meniscus or to the ligaments which apparently is unusual for someone my age (early 50s).

Laura

 

[Swamp Dog]

bilat knee replacements here. I like @altagirl 's subtle advice.... eliminate gluten and processed foods and see if it helps. I wish I had done that many moons ago, may have saved myself a lot of grief and aggravation. Before knee replacements I was doing Synvisc injections about every 6 months and it helped.....until it didn't. I skied and ran and did everything I wanted to do. I still ski, but no running. Lots of hiking and walking with the dogs.

so yeah, listen to your body, and maybe ask about Synvisc or similar meds.

 

[Divegirl]

Thank you everyone. I started PT this week and they are working on strengthening my left quad and hip muscles. I still have a lot of fluid on my knee so no improvement regarding range of motion. I have to get back to the ortho PA in about 10 days to see how it is going. People seem divided on what is wrong - arthritis, the bone spur, meniscus tear. I learned that MRIs are not too accurate when there is a lot of swelling so diagnosing is difficult. I'll have to see what happens.

Since I have about a 10 degree bend in my left knee my ski boots are the most comfortable "shoes" I have put on the last 2 months. Walked all over the house yesterday w/o pain or limping.

 

[Jilly]

Just finished day 5 of 12 "rehab" work out sessions. We are really working on the extension on both knees. Also building up the muscles around the knee. Absolutely no squats though. That's what got me into trouble in the first place. Not allowed any running, never did anyways, but lots of bike and elliptical machine.

My brace is a DonJoy off loader. $ 1800 worth of brace. Thank god for insurance that covered all but $300.

 

[altagirl]

Thank you everyone. I started PT this week and they are working on strengthening my left quad and hip muscles. I still have a lot of fluid on my knee so no improvement regarding range of motion. I have to get back to the ortho PA in about 10 days to see how it is going. People seem divided on what is wrong - arthritis, the bone spur, meniscus tear. I learned that MRIs are not too accurate when there is a lot of swelling so diagnosing is difficult.

What are you doing about the inflammation?

I can't tolerate the did they usually prescribe for this, so I'm pretty good at the icing and elevating and edema massage and anti inflammatory diet routine.

 

[snow addict]

I have a damaged cartilage under patella in my left knee, chondropathy grade 4 (this is the worst it can get), the rest of the joint is fine according to MRI. I am seeing a surgeon on December 1 to discuss further options, I have just finished a course of physiotherapy, my range of motion is not affected and I am not in any sort of pain, so I am planning to ski this season as normal, thought if surgery is recommended I will probably go for it once the season is over. Will have a second opinion in any case - since I will definitely need a knee replacement in the future, I don't want to go under knife unnecessarily.

 

[brenda kelley]

Glued to this discussion ... Thanks all!! Arthritis knees starting to get way too much of my attention. I going to try the recommended change in diet. Much better than the steady current diet of Advil I am on.

 

[Divegirl]

RE: Inflammation - I cannot take NSAIDS or Ibuprofen based anti-inflammatories - I am hyper-coagulant and take blood thinners. Tylenol has done nothing even the Tylenol for arthritis. The cortisone shot I had about a month ago helped some. I ice 2x day and keep the leg elevated and extended w/ about a 20 deg bend to it per PT when I am sitting still. I am probably not resting it enough as I am a pretty busy person.

I am on week 3 of PT and so far no change - still swollen and stiff, still not walking correctly and the range of motion is not improved. The most painful part is the ball of my left foot - it is taking a lot of punishment from the difficulties walking. I will get back to my ortho PA this week and see where he wants go. I may look for a 2nd opinion elsewhere. I am beginning to doubt the arthritis diagnosis and that there is something else causing inflammation as this has now dragged on for 3 months - may be the bone spur or tears in the meniscus.

 

[altagirl]

Does self massage help any? What I was taught in PT was to do it with legs up a wall with downward strokes to bring the fluid back toward your core. I also find it helps to do massage around my joints with arnica salve. It's really thick and forces me to do a decent massage just to get it rubbed in.

 

[Jilly]

Cortisone brought mine down reasonably quickly. But I was also getting the euFlexxa shots too. Have they suggested an OA brace?

 

[snowski/swimmouse]

Yep, I definitely belong in this club. As MSL said, you have to experiment to see what works for you and your situation individually. One thing not mentioned above is that when I have swelling appear, I wear a totally soft elastic knee brace for 2-8 hours and that alone relieves much pain as the swelling goes down with or w/o ice and elevation. Swimming and biking (stationary or road) help me as does lunging on a half rubber ball device (yes, I'm sure there's a technical term, but I don't know it) that springs me back up. This week the physical therapist had me racing down a steeper ski slope than I would be racing on- on a Wii! Wild!!!

Two doctors have recommended knee replacement, but I've eight concerns about why this would not be a good idea for me at this time and they couldn't disagree with me. They're surgeons, they exclaimed!

I got my first ski day in Tuesday. Tuesday was ideal for me to test the knee after titanium rod inserted through it for shattered thigh bone. I skied two hours initially on "Easy Way" to check it all out. Getting off the lift was a little tricky. and my right turns were a little weak. But, I did graduate to the only blue slope open and did OK. I limited myself to two hours to not overdo it. No slush, no ice, no crowd (almost private slopes), so the perfect day to check me out. I'm planning to go Tuesday to opening day (always good) at Appalachian this Tuesday; I want to get 1-3 more days in before Steamboat. I definitely need to work harder on the strengthening.

Thanks for the diet tips. (I confess I'm a dark chocoholic.)

 

[pinto]

I have a damaged cartilage under patella in my left knee, chondropathy grade 4 (this is the worst it can get), the rest of the joint is fine according to MRI. I am seeing a surgeon on December 1 to discuss further options, I have just finished a course of physiotherapy, my range of motion is not affected and I am not in any sort of pain, so I am planning to ski this season as normal, thought if surgery is recommended I will probably go for it once the season is over. Will have a second opinion in any case - since I will definitely need a knee replacement in the future, I don't want to go under knife unnecessarily.

This is what I have... I'll be interested in what you hear. As others, my pain comes and goes. It's pretty good with soft snow so I think I should only ski powder. :-)

 

[snowski/swimmouse]

This is what I have... I'll be interested in what you hear. As others, my pain comes and goes. It's pretty good with soft snow so I think I should only ski powder. :-)

That's why I'm headed for Steamboat!

 

[merrydog]

I probably have something similar to you Snow addict & Pinto but it's been over ten years since I've seen an ortho as I don't want to hear about surgery.

It's pretty good with soft snow so I think I should only ski powder. :-)

That's my skiing strategy, now if I can just get copious amounts in Tahoe...

 

[altagirl]

I probably have something similar to you Snow addict & Pinto but it's been over ten years since I've seen an ortho as I don't want to hear about surgery.



That's my skiing strategy, now if I can just get copious amounts in Tahoe...

Same here. I know the backs of both of my patellas looked like spaghetti squash on the pictures from previous knee surgeries. They cleaned it up as well as they could (basically just shaving off the frayed bits), but it's not like that stuff grows back.

 

[Divegirl]

Getting info out of the ortho PA I saw has been like pulling teeth and it constantly changes - according to him, I now have the beginning of arthritis on the outside of the left knee in the femur/knee area. I also now have torn cartilage under the left patella along w/ a bone spur. I meet w/ a sports medicine/orthopedic surgeon tomorrow for further steps/options. I plan to ask him about a brace/support other than the OTC one I have.

I'll continue the PT while I get some options as they are working on strengthening my left quad and hip muscles

Electro stimulation and cold packs seem to work the best for the swelling so I have upped the icing to at least 3x per day. Massage was hit or miss - sometimes it made the swelling and stiffness worse.

I am working on cutting down on the sugars/breads/carbs anyways as they have snuck back into my diet lately.

I hope to get this straightened out before I start skiing in January. I am glad I purchase pass insurance so If I have to lose part or all of the season I can get some or all of the pass cost back or put towards next year.