Get Your Knees Working For You

As seen in Apex Matters December Edition

Let’s talk about knees. These powerful joints cushion our turns. They are the shock absorbers. One of the most common injuries seen on the hill is a knee sprain, accounting for one third of all ski injuries.  

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Ligament Sprain. Ligaments are like the thick cord in a suspension bridge. Providing the tension needed to hold our knee joint together. The most common ligaments in the knee to sprain are the MCL and ACL. These ligaments commonly get injured when we ski above our skill level or when there is a twisting fall and the ski doesn’t pop off, thereby wrenching the knee.

 

The Terrible Triad. This is a traumatic injury to two ligaments (MCL and ACL) and the meniscus. Ubiquitous to a ligament tear is an audible popping sound and severe joint swelling immediately following the injury. Definitive diagnosis of this type of injury is found through an MRI. 

 

Osteoarthritis. This is what you call bone on bone. The ends of our bones are lined with cartilage. Joints well lined in smooth cartilage move easier and without pain. Wear and tear from years of skiing the bumps or an injury that never quite healed can lead to articular cartilage damage and this degenerative joint disease

 

Osgood Schlatter Disease.  This disease afflicts the youth especially those that do a lot of jumping, kneeling and squatting. Part of the preseason ski training drill. There is often a painful bump on the top of the shin at the tibial tuberosity. Along with this growth there is inflammation of the patellar ligament. Kids are often told to rest as the knee pain is worse with activity. Beyond conservative treatment, prolotherapy can help restore strength to this area.

 

How to best support your knees? Consider some of these tips to keep your shock absorbers working for you from first run to last.

 

Build with Glucosamine Sulfate. An essential ingredient that your body uses to build cartilage. What you are looking for here is 1500-2000mg per day depending on body weight. All too often I see patients taking too low of a dose.  This supplement is particularly useful in patients with degenerated joints as seen in Osteoarthritis.

Lubricate with Water & Oils. Your joints are bathed in synovial fluid. If you are dehydrated, all fluids in the body go down.  Add in Omega 3 oils through supplements or upping your dietary fish will reduce the inflammatory mediators and improve joint lubrication. More long term studies need to be done to look at Omega 3’s role in prevention of osteoarthritis.

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Replace ant-iinflammatories with SAMe. Both NSAIDS and SAMe reduce joint pain, yet SAMe does it without affecting the gut lining. Making it safe for the long term. Dosage to treat knee injuries is 800mg per day.

 

Relax in the Hot Tub. Hot water soothes aching joints. I am sure I don’t need to explain this one.

 

Mix it Up with some Cross training. This could mean not doing the bumps all day. Take a break with a fast groomer run or two. When you are not up the hill get in the gym. 

Strengthening hamstrings, quads, and calf muscles. How about trying out some yoga tree poses to build balance & stability of your lower body. 

 

Regenerate with PRP (Platelet Rich Plasma). Some injuries only heal so far on their own. This is where PRP comes into play. Injecting your own blood right at the site of injury creates a whole cascade of healing. Platelets are rich in growth factors and localizing the platelets to damaged tissue accelerates their repair. PRP should be considered in injuries that have not healed on their own or in degenerative osteoarthritis.

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