THE KNEE DOCTOR
with Jonathan Bell
Our expert gives the lowdown on what to do if you’re injured in action
Follow our expert’s tips to help you stay injury free
I’ve been an orthopaedic surgeon for longer than I care to remember, so have seen my fair share of injured skiers and boarders. Fortunately, the majority of injuries are relatively minor – with a little grit, a support and some painkillers, most travellers can ski for the rest of their holiday. However, should you or someone you’re with sustain a serious injury while on the slopes, I’ve outlined how to respond, with tips on how to navigate the system.
THE IMMEDIATE AFTERMATH
If your injury is relatively minor and you can still use the affected limb without significant discomfort, you may be able to continue skiing or boarding. Generally speaking, pharmacies in ski resorts offer more assistance with minor injuries than those in the UK, giving advice on painkillers and often selling specialist supports, bandages and ice packs.
Apply ice packs (or snow) to your injury, taking care to wrap them in a damp tea towel and apply for a maximum of 15 to 20 minutes in two-minute blocks to avoid a freeze burn.
SEEK HELP
If you’re struggling to bear weight through your leg, can’t lift your arm without significant pain and swelling is visible, consider seeing the local GP. My experience is that GP surgeries in resorts are fairly good at reaching the correct diagnosis and offering early treatment plans. Many are able to carry out X-rays on site, will fit or order a brace for you, and offer crutches.
A small number of injuries will require hospital attention and/or urgent surgery, such as fractures and dislocations, which should be addressed prior to travel. Some resorts, however, seem over-keen on performing MRI scans (paid for by your travel insurance), which are then followed by suggestions of urgent surgery, for example to the anterior cruciate ligament (ACL). The quality of these scans and surgeries is questionable and getting follow up arrangements once you’ve left the country is hard. I advise waiting six weeks after injury before ACL surgery; patients often find surgery isn’t needed and manage with physiotherapy alone.
SURGERY OR NOT?
If you are considering surgery in a ski resort, I advise talking to your insurer and seeking advice from their medical advisors. Should this not prove possible, Wimbledon Clinics is happy to provide help where we can safely do so. Should surgery be required, your insurers may choose to Medevac you out (repatriating you with medical support) so your urgent treatment can be continued at home. This can be a positive outcome as the best person to manage your post-operative care is the surgeon carrying out the surgery.
GETTING HOME
If you’re walking wounded, particularly on crutches, it’s easier to travel with family or friends on your planned journey rather than reschedule for an earlier flight home. Prior to travel, ensure you have documents stating you’re safe to travel – many airlines insist on them. Also keep your doctor’s diagnosis and treatment notes and any operation notes and post-operative instructions to hand.
Taken any prescribed anticoagulation medication before your flight to minimise the risk of developing a deep vein thrombosis during the journey. Make sure you have adequate painkillers for the journey and that you elevate your injured limb if possible. If you’ve been fitted with a brace or walking boot, loosen it while travelling. If the limb swells during the flight in an overtight brace or plaster cast, blood flow to it can be restricted.
AFTER-CARE
If possible, make your follow-up arrangements in the UK before travelling home. Your priority now is to obtain a clear diagnosis and understanding of your injury. Delays at this point can lead to increased stiffness in the limb, loss of muscle conditioning and difficulty in returning to normal day-to-day activities.
At Wimbledon Clinics, we aim to scan and provide results of possible ACL ruptures within 24 hours of attending our dedicated clinics. Clients also receive clear directions on what do over the coming days and weeks and a referral to physiotherapy where appropriate. For the unfortunate few who require knee surgery, I plan for it to be completed by mid-May, with most clients ready to attend our annual Return To Ski Day with the Warren Smith Academy in late November in order to be back on the slopes the following season.
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.