Toll Free 1-877-626-4500
Quick Links Home
The Need For Speed
It is critically important to apply ice and compression immediately after an injury. Studies show that recovery from an injury is directly related to how soon ice and compression are applied. More Ice Therapy facts »
Skiing and Knee Injuries
Category: Knee Injuries
Jan 2, 2007
May your ski trip be a blast -- not a blow out
It's that time of year -- many of us migrate to the snowy ski slopes of the west, or the icy ski slopes of Michigan, to enjoy the invigorating thrill of downhill skiing. We forgo the relaxing "beach somewhere warm" and opt to tackle the mountain, hill or slope on the side of a landfill. With this choice of vacations, however, comes risk. We've all heard of someone "blowing out" their knee. Generally speaking, this refers to the tearing of one or more ligaments inside the knee. Before we go any further, let's learn a little more about the ligaments of the knee.
The cruciate ligaments are two ligaments that are located deep inside the knee joint and connect the thighbone (femur) to the shinbone (tibia). They are called "cruciate" ligaments because they "cross" in the middle of the knee. They are instrumental in providing the stability that is needed for proper knee joint movement and stability when you torque on your knees and put them to the test. The cruciate ligament located toward the front of the knee is the anterior cruciate ligament (ACL), and the one located toward the rear of the knee is called the posterior cruciate ligament (PCL).
ACL INJURIES
The ACL prevents the shinbone from sliding forwards beneath the thighbone. The ACL can be injured in several ways. Most often this involves a sudden change in direction during which the knee is twisted or during direct contact, such as during a football tackle. ACL injuries are particularly common in skiers, particularly if you "wipe out" or "catch an edge" with your ski. Because your ankle is rigidly immobilized in the ski boot, it is your knee that gets torqued, and if enough force is involved, ligament or cartilage injury can sometimes result.
If you injure your ACL, you may feel or hear a pop. The knee will swell and get stiff, and you will often feel pain when you try to stand. Over time, without a functional ACL, the knee may give out, especially when you attempt to change directions. When the knee gives way, this can lead to additional cartilage damage inside the knee.
The diagnosis of ACL injury is based on the history, a good physical exam and, often, an MRI.
A partial tear of the ACL may or may not require surgical treatment. A complete tear is more serious, and unfortunately, ACL tears do not heal on their own. Complete tears, especially in younger patients, athletes and active individuals, may require surgery to restore stability to the knee. Operative treatment is most often done arthroscopically and uses a piece of tendon, usually taken from the patient's knee (patellar tendon) or hamstring muscle, that is passed through the inside of the joint and secured to the thighbone and shinbone. Surgery is followed by a rehabilitation program to strengthen the muscles and restore full joint mobility. Complete tears may be treated conservatively in less active individuals or in individuals whose knees remain stable despite the injury.
PCL INJURIES
The posterior cruciate ligament, or PCL, is not injured as commonly as the ACL. PCL sprains usually occur when the knee is twisted or from a direct blow to the front of the knee. Without a PCL, your knee sags, and there can be increased wear and tear on the cartilage inside the knee. Like the ACL, PCL tears do not heal on their own. Fortunately, some patients with PCL tears often do not have as much knee instability as patients with ACL tears, and even high level athletes often return to their sport without significant impairment after completing a good rehabilitation program. For patients who continue to have pain, swelling, or instability of their knee, surgery may be necessary to reconstruct the PCL.
COLLATERAL LIGAMENT INJURIES
The collateral ligaments are located at the inner side and outer side of the knee joint. The medial collateral ligament (MCL) connects the thighbone to the shinbone and provides stability to the inner side of the knee. The lateral collateral ligament (LCL) connects the thighbone to the other bone in the lower portion of your leg (fibula) and stabilizes the outer side. Injuries to the MCL are very common and are usually caused by contact on the outside of the knee and are accompanied by sharp pain on the inside of the knee. The LCL is rarely injured. If the MCL is torn, is does have the ability to heal. Remember the acronym RICE: rest, ice, compression or bracing, and elevation. Most MCL tears do fine with an initial period of RICE followed by a good rehab program.