 Poster: A snowHead
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10 days back from Alagna (Great)
But this my 50 year old right knee felt sore and sensitive all week. Had an arthroscopy 8 years ago on a medial meniscus tear (I think the tear was removed)
My knee has stayed swollen and sore with a "hot" patch of pain on the interior -
Have tried RICE not really getting anyway - suspect the worse in severe arthritic knee but just looking for ideas really !?
cheers
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Probably not what you want to hear, but go to see a physiotherapist who specialises in sports rehab.
They can assess joint range of motion (ROM) to evaluate flexibility, stability, and function. There are numerous diagnostic tests involving manipulation of the joint which can help narrow down the cause of any swelling and inflammation. If they can't help in the first instance then they can refer you for imaging or to see an orthopod for further diagnosis/treatment.
It really isn't one of those things that can be done on a forum. Wishing you a swift recovery and return to skiing and sport.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@NoMapNoCompass, Thanks , yes physio next steps i suppose!
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Surrey Hills? Go to The Knee Clinic in Wimbledon.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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I would get an MRI first, then see if a physio if required.
Surgeons always want to do surgery. Physios think they can fix everything with a bit of rehab.
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You'll need to Register first of course.
You'll need to Register first of course.
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Generally speaking, you should see a clinician first (be that a physio or a medic) who will take a history, understand the onset of the current injury and then do a physical exam. If required imaging is the next step and will result in a report from a radiologist - it is up to the clinician to then take that report, interpret it and decide next steps.
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Go see your GP, knees are somewhat critical for mobility.
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It all depends on your funding situation and propensity to spend money to get sorted.
If insured then get a referral to orthopaedics at your local private hospital.
If happy to self fund get a private MRI first (as if it’s meniscus or something soft the surgeon won’t be able to see it on an X-ray) otherwise you will just waste your first appointment and be told to go and get one anyway.
If you want to go NHS then get a GP appointment followed by referral. Might be waiting à while though so also ask for physio in parallel or go to a private physio.
Good luck
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Got an online BUPA appointment this afternoon to start the ball rolling. I do wonder if its a pre existing condition from 8 years ago which i had done on the NHS. Not sure if there is a cut off date and you start again ?
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@norris, weird that it came on after a 10 day delay 
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@under a new name, ah no was swollen probably during the skiing ! and has continued afterwards.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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My left knee was hot and swollen after, and sometimes, during, skiing for years! Right knee not so much. In my case it started after my first ever ski trip, with the school, in the early 60s! The doctor panicked and thought it was related to rheumatic fever (i'd had possible RF as a child) and I was put on compulsory bed rest for weeks "to protect my heart". In recent years it got so hot you could feel it through salopettes and so swollen as to reduce flexion a lot, making getting up after a fall uncomfortable. Had various treatments over the years, including an arthroscopy, steroid injection, lot of NSAIDs. Some physio (including gentle squats, done with careful coaching on form from a sports physio). I figured I needed to keep my leg muscles really strong, especially the vastus medialis, but there seemed to be nothing much to do for the knee itself.
On one off-piste course I sat during the evening sessions with ice packs and goodness knows what. If I'd not been on a course I'd have stopped skiing for a few days and rested it. Should have done, really. In recent years, if I skied a harder day than usual (generally because of skiing with visitors who wanted to make the most of it) it would puff up quite quickly.
The most effective treatment so far, I'm afraid, is giving up skiing (for other reasons, but it worked!). But before that, plenty of NSAIDs, keeping quads strong and taking it a bit easy did the trick!
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Not sure I agree with you there.
After 4 arthroscopies free with a cartilage in one for meniscus I was told by my surgeon to ski blue pistes only very carefully
As a passionate of be scared this was a disaster for me and I put some considerable effort into finding alternatives. I tried Mojo's and then found an alternative called ski againers.
10 years on for my last operation I'm still skiing six to eight weeks a year mostly off pidte with my fantastic knee braces. They don't give you an excuse not to train and get fit for skiing but they do provide protection and dampening for hard impacts.
If you manage to get your issues sorted and returned to skiing I strongly suggest you look at one of these two as a Preventative option.
From my perspective the most important Factor is that they give me confidence because I know that if I hit something under the snow once I get to about 90 degrees I get a serious degree of leg support that will stop some sudden damage happening to my knee.
Wishing you the very best of luck with your recovery
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You know it makes sense.
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@norris, RICE now out of date - have you tried elevation above your heart for extended periods - eg evenings?
No NSAIDs - they appear to inhibit healing.
Alternating heat and cold - not ice - can be helpful as an addition eg cold water from shower head for 5 mins then warm then hot, repeat until bored.
After advice I have used this regime in a series of injuries and boy des it work for inflammation
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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@valais2, errr, "No NSAIDs, etc, ..."
We haven't really demonstrated support for that, have we?
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Poster: A snowHead
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@valais2, I've been lying on the sofa quite a bit ! Not tried hot/cold , just a bag of frozen peas !
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Mojo certainly well worth trying. I had a chunky knee support but I think it's role was more psychological than anything else.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@under a new name, …well…
https://journals.physiology.org/doi/full/10.1152/japplphysiol.00036.2013
And a lot more … all stating the same mechanism.
@norris, …but it does need to be above your heart. When I had a bad calf hematoma I lay on the sofa with my leg on a heap of cushions to elevate it above my heart - it worked very well. And a two month rehab become two weeks.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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@norris, ChatGPT in case you haven’t already tried…
From the description:
• inner (medial) knee pain
• swelling lasting about 10 days
• a “hot” patch on the inside
• previous medial meniscus arthroscopy
The two most likely causes in a 50-year-old after a ski trip are:
1. Meniscus irritation or small new tear
Very common after skiing, especially if part of the meniscus was removed years earlier.
Typical signs
• pain exactly on the joint line (where femur meets tibia)
• swelling that appears later the same day or next day
• pain with twisting, turning, or squatting
• occasional clicking
This does not always mean surgery. Many small tears settle with rest and physio.
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2. Pes anserine bursitis (overuse inflammation)
Often mistaken for a meniscus problem.
Key clue
Pain is slightly below the joint line on the inside of the knee (about 3–5 cm).
Typical features
• very tender hot spot
• worse when climbing stairs
• knee feels stable
• swelling usually mild
This usually improves with anti inflammatories and stretching.
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What your friend should do now
Since it has only been 10 days, most sports doctors would start with conservative treatment:
• reduce twisting sports for 2–3 weeks
• light cycling or walking is OK
• anti inflammatory gel (diclofenac) 3–4× daily
• optional NSAIDs for a few days if tolerated
• gentle hamstring and quad stretching
If swelling persists, a physiotherapist can usually identify whether it is meniscus or tendon related.
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They should see a doctor sooner if they have
• locking (knee stuck)
• inability to fully straighten the knee
• sharp pain with twisting
• swelling not improving after ~3 weeks
Those signs usually prompt an MRI.
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Reassuring point
After ski trips, medial knee pain with swelling is extremely common, especially in people with previous meniscus surgery.
Most cases are irritation or bursitis rather than severe arthritis.
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If you want, you can also tell me:
• exactly where the hot spot is (joint line vs a bit below)
• whether the knee clicks or locks
• whether it hurts more twisting or climbing stairs
Those details usually make the likely diagnosis much clearer.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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@valais2, I don't reject that there are arguments around of this, but "should ly the basis for future work" is not a definitive conclusion.
Also, "Collectively, these data do not provide overwhelming reason to avoid the occasional use of NSAIDs postexercise."
- the paper studies NSAID use for post exercise pain
- data is sparse and conflicting (actual benefits shown for older adults)
Did you actually read the paper?
"To date, there is no clear message with regards to the effect and mode of action of anti-inflammatory interventions and how they can best promote muscle healing and functional recovery."
And, one is dealing with pain, presumably reducing function and use, which by itself is likely to lead to muscle loss.
Would you be suggesting powdered opium instead? (I have some in my drugs box if OP would like).
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You'll need to Register first of course.
You'll need to Register first of course.
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@BobinCH, Excellent thanks. This is basically what my online video call with Bupa clinician told me.
referred me to a local physio
Some light cycling/walking for a while - hopefully it settles down soon, though he did say could be 4-6 weeks
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@under a new name, yes I have.
"To date, there is no clear message with regards to the effect and mode of action of anti-inflammatory interventions and how they can best promote muscle healing and functional recovery."
which is an argument against use of NSAIDs since the mechanism of supporting healing is not clear. M’lud…
BoBinCH has usefully pushed the ‘if in doubt’ button….let’s do the same for NSAIDs during post-injury phase.
Oh look….
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, and aspirin are frequently used for pain and swelling reduction in injuries, but recent evidence suggests they may have a dual role in injury recovery, potentially impairing long-term healing while providing short-term pain relief. While effective for managing acute pain, their ability to suppress inflammation—a crucial component of the initial healing process—means they may delay recovery, particularly with long-term or early, high-dose use.
PubMed Central (PMC) (.gov)
Key Findings on NSAIDs in Injury Recovery:
Impact on Inflammation and Healing: Inflammation is the body's natural response to tissue damage, necessary for the repair process. NSAIDs block the chemical signals that initiate this process, which can lead to incomplete tissue repair, weaker tissue structure, and a higher risk of re-injury.
Musculoskeletal and Soft Tissue Injuries: For acute soft tissue injuries (sprains, strains), while NSAIDs provide short-term pain relief, they may hinder the long-term, structural healing of tendons and ligaments. Some evidence suggests they might actually turn a minor injury into chronic, long-term dysfunction.
And as we know, AI is always right.
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@valais2, ??
OK, 4 weeks ago I slipped, landed on hand and have somehow damaged my shoulder.
Untreated it wakes me up 7-10 ish time a night.
Would you like to suggest a non-script treatment (I have seen my physio)?
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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OK, edited the above having read more carefully.
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"To date, there is no clear message with regards to the effect and mode of action of anti-inflammatory interventions and how they can best promote muscle healing and functional recovery."
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That seems congruent with what has been discussed. But the current situation is a short term acute one where pain relief and maintenance of normal function where possible would seem the priorities. And otherwise, there is no clear message ...
And whatever AI use of "can" should be replaced by "could" and the caveat of "no clear message".
OP, crack on with the ibuprofen.
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@under a new name, …that’s grim … and right now I have exactly the same problem. In both bloody shoulders. I’ll explain that in a minute.
But on your situation It’s very unclear what the mechanism is behind night time shoulder pain after injury. Nerve impingement can be a reason but the prevalence of nighttime pain after Rotator Cuff Tear or injury suggests it’s more than that. Lie on that side and there’s pressure on the nerve and tendons etc. lie on your back and the front and side muscles stretch when you fully relax into sleep. Lie on the other side and the shoulder blade attachments are stretched. No win anywhere. I couldn’t find any way of supporting my shoulder recently after RCT and like you got no extended sleep.
The only consolation is my injury was New Year and it’s now manageable: 3 periods of extended sleep = 7 hours in total. But waking every couple of hours is frustrating.
Paracetamol does help and I hesitate to say it but in CH two weeks ago while touring I would have a tiny tiny slug of Welsh whisky after the first wake up and that really helped me to sleep the next two periods.
In 2005 I had a full shoulder separation on the right after being hit by a motorbike coming through a red light (and a spinal fracture but that’s another story). I had a lot of physio and no surgery which followed the protocol for a lot of Canadian ice hockey players. Result was weird shaped shoulder but excellent movement no pain and good strength. So at New Year a complete twit hit me hard from behind and down I went onto boiler plate at about 20kph - onto right shoulder.
Load of tendon pains, gross movement restriction, some nerve involvement since tingling in hand and shooting pains in arm for no apparent reason, like you terrible pain at night - fine during day. And bloody crepitus - which I avoided after the shoulder separation.
So this injury joined a November smash to my left shoulder while mountain biking - fast berm left into the forest, then right, and into next 180 berm - and the sodding berm isn’t there! Some idiot had taken it out - so BANG down into hard naked trail - on left shoulder.
Good thing? Getting better with intensive physio - wall press-ups, 20 repetitions and def that whenever I have a twinge in a specific mivement - move to point of pain and repeat 20 times - constantly do this. Then symmetrical movements with both arms exercising in every mode of movement. Squeeze ball during meetings.
Still have pain at night though
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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I’m finding each morning’s regime of exercises is bringing better strength and movement after a depressing stagnation of improvement in the first month. Massive muscle wastage on rear of shoulder after two months of not properly using it. Grrrrr.
Need to do another day of splitting wood in forest…..
This is a good listen …. What’s up docs on BBC Sounds on tues on …. Shoulders!
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@norris, from my experience, Good physio first, as cheapest starting point, and they can rule out some of the major issues like ACL tear.
Depending on that, and maybe they recommend an exercise regime, an MRI would probably be next….
But the outcome from that may be surgery, so get on the medical insurance route in case it’s needed.
Not all surgeons recommend surgery, in my wife’s case the surgeon was very dissapointed he couldn’t justify the work… she just needed physio ( for which read a sustained program to develop leg muscles)
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You know it makes sense.
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@hamilton, …indeed when I had my grade 4 shoulder separation I initially was slated for surgery with a leading consultant (Ian Bayley) until I told him that I was a climber and skier. He was then disappointed not to operate but he strongly advised intensive physio and not reconstruction. I was left with very weird shaped shoulder but excellent function.
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FAQ
and sleeping on my back causes Mrs U to relocate to the spare room due snoring, although I anyway find it hard to fall asleep on my back (in bed).
