Learning to trust the knee again
Whether you’re a top athlete or a one-week-a-year skier, once you’ve damaged your knee, stepping back out on the slopes takes more than physical strength.
In 2014, just ahead of the Winter Olympics in Sochi, American downhill skier and three-time Olympian Lindsey Vonn re-ruptured her cruciate ligament. Her journey back, not just to competition but to being genuinely competitive in PyeongChang, is what makes her a one of a kind. Yet even she has had to face one of the most oft-recurring challenges in sports recovery: how do you learn to trust your knee again?
Recovering from an ACL
The most serious knee injuries – the ones that will leave you feeling as though your knee is about to give way when you twist or turn – are anterior cruciate ligament (ACL) injuries. These are all too common across many sports, including skiing, rugby, football and netball.
Following ACL injury, there’s a period of time when the knee is unstable. For professionals (or non-professionals who are referred to Yorkshire Knee Clinic’s knee consultants quickly), this period is usually short, but can be much longer if diagnosis is delayed. The knee specialist will make a decision about surgery and, if necessary, the operation to reconstruct the ligament takes place.
Following ACL surgery in professional athletes, the knee will take around three months to recover and gain strength, and a further three months of more advanced rehab – starting to run, twist, turn step – that builds capability back into the knee, and builds confidence in its owner.
For contact sports (e.g. football, rugby), professionals will then usually begin a month of non-contact drill training, then a month of non-competitive contact training.
The biggest step
By this point in the recovery process, professional athletes are usually champing at the bit to return to full competition and are likely to be pushing their knee as far as it can be pushed to secure an early return to action. They will be able to run, swim and perform straight line activities. Many will say they can train aggressively and assume that they are ready for anything.
Yet the biggest hurdle remains. All the above activities are predictable. The knee is facing heavy loads and performing under pressure, but every action is a known. It is the unpredictable – the bounce of the ball, the mistimed tackle, the unexpected dip of the ski slope, that is likely to pose the greatest threat.
A question of trust
That’s why having confidence in the knee is so vital, and it’s the single greatest distinction between professionals and non-professionals. Of course, everyone has those key points during the knee recovery process: the morning after your operation when you’re wondering whether you can place any pressure at all on the knee. The first time you step out on ice or snow, or even wet grass. The first time your resume strenuous activity.
But for most of us, the test of whether your knee will withstand the rigours of a downhill or mogul course is not likely to be tested for months, and even then over a relatively short duration.
For professionals, trust in the knee is essential to resuming a competitive sporting career. Pushing it too far too fast can damage the psychological and physical wellbeing of the athlete. That’s why it’s essential that knee consultants and physiotherapists manage both aspects.
For athletes, the moments leading up to that professional return can be a nervous. Usually though, the moment the whistle or claxon goes, the injury is forgotten. And around one year after injury, the worry of a repeat is usually gone.
Non-athletes and a return to skiing
Let’s assume for a moment, however, that you’re not Lindsey Vonn, or any other performance athlete. What’s the position for recreational skiers? As with professionals, there is a physical and psychological element, compounded by the fact that skiing is one of those rare sports where you spend one week a year doing it intensively, while the skis stay in the shed for the other 51 weeks.
At Yorkshire Knee Clinic, we recommend it is at least eight months before you resume skiing after an ACL reconstruction. It can be tough to step back out on the slopes though, especially if your injury was caused while skiing. So to help build physical stamina and psychological confidence, our knee consultants always suggest taking a six week course of physiotherapy (once that rehabilitation period is complete) and before you resume skiing. If your reconstruction happened in January or February, for example, you should be booking a physio course for the end of the year, with a view to being ready for the following year’s ski season.
When you once again take to the snow, you’ll find you’re stronger, fitter and more agile than you were before the injury occurred. It may not make you an Olympian, but at least it will reduce your chances of further injury.
If you’ve injured your knee skiing, talk to the knee specialists at Yorkshire Knee Clinic. Please contact us here.