As we approach this year’s ski and snowboard season, many winter enthusiasts are getting ready to hit the slopes, with confidence that they have their ski legs under them. Once the snow really begins to fly, whether they’re cruising groomer runs, carving wide turns down the open bowls, seeking out powder stashes in the trees or mastering tricks and flips in the parks, people of all ages will venture out to one of our many Pacific Northwest ski areas where they will be making the most of old man winter’s opportunities for fun.
Unfortunately for many snow riders, the slopes can turn cruel, and the inevitable knee injury turns many smiles upside down.
What should I do after a knee injury?
You can minimize downtime after a minor (non-surgical) knee injury by following a few key principles.
- Pain Control
- Manage swelling
- Maintain mobility
- Regain quadricep control
- Ensure a symmetrical walking pattern
- Work on balance training
Ice for pain control after a knee injury.
Use ice for pain control, especially in the first 24–48 hours.
Keep it:
- 15–20 minutes at a time
- with at least 1–2 hours between sessions
- stop if it feels worse or overly stiff
Ice helps comfort you now without meaningfully harming recovery later.
Managing swelling after a knee injury.
Swelling can be managed with relative rest, ice, compression and keeping the knee elevated above heart level as much as possible during the first 48-72 hours after you get hurt. In addition to the RICE method, use of over-the-counter anti-inflammatories (if your doctor says these are okay for YOU) may also be helpful during this time immediately after an injury to help with swelling and pain control.
Maintaining mobility after a knee injury.
Range of motion exercises should be initiated as soon as possible while initially keeping the amount of movement in a minimal pain range (keep it at a range of 1-3/10 on your pain scale).
It is exceedingly important to maintain mobility – to be able to fully straighten the knee (extension) and to try not to favor it by allowing yourself to keep it slightly bent (usually the most comfortable position).
Sliding your heel back and forth in bed and using your non-injured leg to apply gentle overpressure or using a stationary bike to rock back and forth are good ways to maintain and gain further bending motion (flexion).
Strengthening your quad after a knee injury.
Combined, pain that causes you to favor your knee along with even minor swelling in and around your knee joint is enough to quickly inhibit your quad muscles. Even a few days of inactivity can allow your quad to atrophy, which then leads to decreased knee support. The sooner you can start activating your quad the better.
Starting with isometrics is usually best. Isometrics involve muscle activation without moving the knee joint. Holding the leg straight with a small towel roll under the knee and pushing your knee into the towel by squeezing the thigh is the most basic but necessary exercise to avoid loss of muscle mass and control.
Since your quadriceps are the muscles that support your body weight above your knee, making sure these are working properly is essential to getting around. A progression to this basic quad set is combining it with a leg raise while sitting in an upright position.
Walking with a knee injury.
Normalizing your walking pattern can be difficult if you have swelling, a loss of motion, and/or poor muscular control. Addressing those components of your recovery quickly will help you maintain a symmetrical walking pattern if you overrule your body’s natural tendency toward favoring the injured knee. Initially, crutches may be needed to keep your weight completely off the knee to avoid the pain that comes with weight bearing. But, as pain allows, it is important to start putting weight through the leg and use the crutches only as needed to give it just enough support to avoid excessive pain and work toward symmetry with walking.
The crutches will always follow the injured leg, picking up and putting down at the same time. Rather than getting rid of the crutches too soon and limping, you may need to wean to a single crutch which will stay on the uninjured side. Again, the crutch in the opposite hand will always travel with the injured leg in order to keep the walking pattern reciprocal and “normal” (when walking without an injury, our opposite arm swings forward and backward with the opposite leg). Once you can walk symmetrically without the single crutch and not favor the injury, you are ready to ditch the crutches altogether.
Balance training after a knee injury.
Just like muscles — which can become inhibited and atrophy from pain, swelling and lack of use — the nerve receptors in the knee joint that tell us where we are in space can atrophy as well. To restore their function, we must train them, too. Balancing while standing on one leg once it can be done pain-free is a simple way to work on balance. You can progressively make this more difficult by looking down, straight ahead, to both sides, up at the ceiling and then closing your eyes while maintaining balance. Allowing your knee to bend as well as standing on a pillow or cushion are good ways to increase the challenge of single-leg balance on an injured or non-injured leg.
Hopefully, you can avoid the snow snakes that try to trip you as you rip down the mountain this year. But if they manage to get you and you sustain a nonsurgical knee injury, following the above steps can make a big difference in minimizing your downtime.
It’s important after a knee injury to see a medical professional for an assessment. As musculoskeletal experts, physical therapists are the optimal choice for care after an injury to get you back to what you love as quickly and safely as possible.
Direct access means you can see a PT without a referral from another healthcare provider. If your physical therapist identifies any red flags and suspects you need treatment beyond what they can provide, such as surgical intervention, they can refer you to a physician or other specialists for further examination.
Additional resources for skiers:
Traumatic Knee Injury Recovery — Charlie’s PT Success Story
After a knee injury sidelined his ski season, Charlie’s recovery at Therapeutic Associates Bend got him back to doing what he loves most.
Skier’s Thumb: What is it and how can PT help?
Skier’s thumb is one of the most common snow-sport injuries. Physical therapy can speed recovery and help you get back out there.
Start your physical therapy journey today.
As physical therapists, we know the importance of movement for overall health and well-being. From injury recovery to achieving optimal performance, our passion is to help patients reach their goals and live active, pain-free lives. Get started with PT today!
