THE KNEE DOCTOR
with Jonathan Bell
Veteran skier and orthopaedic knee surgeon Jonathan Bell of Wimbledon Clinics launches his new Ski+board column, in which he’ll be addressing burning issues about knee health
Follow our expert’s tips to help you stay injury free
Like many, I frustratingly didn’t ski last winter for the first time in years. That aside, I have skied for over 30 years. Alongside skiing I have also been a knee surgeon for most of that time.
Skiing with my friends, family and meeting fellow skiers is the highlight of my winter.
Socially, I love to catch up with skiers, whether they be first timers or Olympians, but sadly I have also met thousands of skiers as patients. Not all have injured their knees – many have required a knee replacment after years of wear and tear in order for them to return to skiing.
Although I practise in Wimbledon, where it sometimes feels like just about everyone skis, many recreational and pro skiers have travelled from as far as the Far East for help with their knees. I run a dedicated ski injury clinic every winter to ensure that anyone unfortunate enough to be injured knows they can get seen as soon as they return from their trip.
I believe that the return to skiing (and the vast majority intend to do just that) begins as soon as we meet. For those unlucky enough to injure their ligaments we aim to have them skiing by the following season. To help those nervous about returning, I run a ‘return to skiing’ day in late November, where I take recovered skiers to the Hemel Snow Centre for a ski day with Warren Smith’s instructors – so there is no excuse for not getting back on skis.
Over the next four issues I am going to be covering everything that is knee and ski. This month we’re going to cover the crucial topic of how to avoid having to see me, of course I mean with my surgeon’s hat on!
TOP TIPS FOR AVOIDING A KNEE INJURY
On meeting people for the first time, they frequently ask me about their knee problems. Surprisingly, few ask what they can do to avoid having knee problems in the first place, which is odd as there is plenty that can be done to minimise the risk of injury to the knees.
What follows are my insider tips distilled from speaking to thousands of fellow skiers and boarders who have sustained knee injuries or dealt with arthritis. Here are three ways in which to minimise your chances of sustaining a knee injury:
PREPARE BEFORE YOUR TRIP
Try to stay strong and fit over the summer/autumn – and pre-order if you’re hiring kit to ensure everything fits correctly
If you already have knee pain or swelling get it checked out. Skiing with a knee that is already misbehaving increases risk of further injury. An arthritic knee will ruin your trip if you don’t know how to keep the swelling under control. Strengthening helps, but learning how to best use ice and anti-inflammatories is a good place to start.
Build confidence. Fear increases injuries, so have a few practice sessions or lessons on a dry slope or artificial snow slope to build confidence.
I know it’s hard to build strength and fitness, but it does reduce your chances of injury. Don’t just do quads strengthening, although that helps, also do trunk and upper body strengthening. It is easier if you kept strong and fit over the summer/autumn – try cycling, for example.
If you will be skiing at a busy time and plan to rent your equipment, be sure to pre-order so you don’t get given all that is left over when you arrive. That way you’ll be sure the skis are suited to your capability and that the boots fit!
Book in for lessons in the resort, especially if you aren’t confident – this also means you don’t end up skiing with others who are faster/better than you. I’ve met many a Dad or Mum who fears being always at the back and pushed to ski black slopes out of their comfort range.
ON ARRIVAL…
Don’t borrow kit from a friend as it greatly increases the risk of injury. If you do, make sure it is appropriate for your level and get it adjusted to the correct DIN settings. Don’t make adjustments yourself unless you are sure you know what you’re doing.
Watch out for the ice in resort – I’ve seen many patients who didn’t even get as far as the first lift due to having an accident in the car park. Use strap-on boot crampons that provide lots more grip on ice.
Consider planning a day off, or having a lighter day on day three. This is the day your muscles will be at their most stiff and fatigued during the whole week.
ON THE SLOPE…
Adapt your behaviour to the conditions. Poor visibility and heavy snow are high risk for injury. I’m not suggesting that you should not ski at all, but it might be an opportunity for a short day or checking out the spa. We all love a good lunch up the mountain, but
even a few drinks reduce your coordination and increase the risk of injury.
Pick your company carefully. I avoid groups with too much testosterone and I’m very wary who I’ll get on a chair lift with. A novice or wobbly snowboarder falling across the skis of the person next to them has ruptured many anterior cruciate ligaments.
Be very aware of those skiing above you. Every winter I see patients who were innocent victims of out-of-control skiers and boarders. For this reason, I avoid the home run; I get the lift down. Not quite as heroic as spraying everyone with slushy snow as you come into town, but at least I avoid being run down by those in a hurry to get to après-ski.
FACTFILE
Jonathan Bell is a keen skier and consultant orthopaedic knee surgeon at Wimbledon Clinics. His areas of expertise include treating sports injuries, ligament reconstruction, knee replacement and non-operative management of arthritis. Jonathan founded Wimbledon Clinics where he runs a team of orthopaedic specialists and sports injury experts offering a multidisciplinary approach to keeping the active active.