Most ligament injuries whilst skiing are sustained by falling and the ski not releasing.
MCL (medial collateral ligament) sprain/tear
Simple sprains can be managed actively with the help of a physiotherapist and early mobilisation. More major tears however require a hinged brace (splint), which needs to be provided within a week or so. With bracing most MCL injuries heal and patients make an excellent recovery. Delays in diagnosis, however, can lead to an unstable knee sometimes requiring knee ligament surgery with less predictable results.
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ACL (anterior cruciate ligament) rupture
A rupture of the anterior cruciate ligament (ACL), the most serious ligament injury, can cause the knee to become unstable particularly when twisting – a key action for turning on the slopes. Longer term, it increases the risk of the knee wearing out early (osteoarthritis). These injuries can be managed with physiotherapy alone or a combination of physiotherapy and ACL reconstruction surgery. Early knee specialist advice is critical to make the best possible recovery but beware of being pressurised into ACL surgery abroad.
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Knee Meniscus (cartilage) tears
The twisting nature of skiing falls can lead to tears in one of the two menisci (cartilages). These can vary from small tears which cause discomfort but no locking to larger tears which can lock the knee. The small tears can heal and symptoms settle down but if discomfort continues to limit activities over 4-6 weeks then treatment including knee arthroscopy (simple keyhole surgery) may be advised. ‘Locked’ knees which cannot be fully straightened require urgent assessment within a week or two and often early arthroscopic knee surgery is advised to try to save the meniscus and/or to restore movement.
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