Anyone Know Knee Anatomy?

[scrapster]

After a few minor accidents (car, snowboarding), I've developed a generally bum knee that I'm trying to sort through with my physical therapist. Its my front (when riding) knee, and after a few hours on the mountain it begins to get sore and swell a bit. Both those symptoms happen primarily on the BACK of the knee. When riding this past weekend, I noticed two more things: 1.) it only hurts when I'm on heelside with my knees bent, and 2.) riding higher binding angles (over 45*) helps alleviate the symptoms.

I'm going to bring these up with my PT when she gets back from vacation, but I figured I'd throw it out here, as someone likely knows the bodily dynamics of snowboarding more then she does--and she's very willing to investigate any new leads I suggest.

Any thoughts? What's getting pressured in the back of your leading knee when you're crouching on heelside, and not on toeside?

[Buell]

A few thoughts from experience after a couple of significant knee injuries:

Cartilage damage or a location where the cartilage has already been damaged and cleaned up that is irritated by carving.

Referred pain from another spot in the knee.

Tight hamstring (or other overcompensating muscles around the knee) is a problem my bad knee causes. That then puts new pressures on the knee joint when I carve.

Scar tissue build up within the knee joint from past injuries keeps parts from flowing freely.

Carving puts significant forces on the knee joint that, if you knee is a bit "loose" could be really irritating any damage to the cartilage. I now have to ride with a brace that gives my knee lateral support when I carve. I still limp at the end of each carving day though.

Good luck.

[tdifan_2003]

well, i know a thing or two.............from Med School :). I am by no means a practicing orthopedic though.

I did have signifficant problems with my knee (front) a few years back. i could not pinpoint exactly when the problems started. A that time I was doing alot of running, preparing for marathons. Anyway, ultimately, I was not able to ride almost at all. Still run a marathon and after that went for MRI. I did have a torn meniscus and got it fixed arthroscopically. The best news - for the past two years, I have had no problems - none, nada :). Admittedly, I have cut a lot of the running, but I am able to ride as much as I want . Even thinking of trying for Chicago marathon again this year.

So, in short, probably you'll need MRI and/or ortho consultation. PTs are great, but you will get a definitive diagnosis that way. If there is no structural damage, than PT is going to be of great help.

Good luck ,

Millen

[scrapster]

Thanks Buell and Millen! I've had many of the same thoughts myself. As for the MRI, my PT did all sorts of yanking/pushing on my knee and was pretty confident that nothing was structurally unsound. Minor damage to the miniscus, something causing it to become irritated, or a very slight tendon tear are all still on the table though.

Its funny, no one has been pushing an MRI so far. (And there I was so worried that I actually needed SURGERY that I didn't go to the doc until after my riding season was almost over--denial, denial.) Luckily, I think my PT is just taking it slow, building up the knee and leg muscles. If that doesn't work within a reasonable time, I'll bring up the MRI again and I think she'll concur.

PS- Much of the damage was done when I hyperextended my knee hitting a big slush patch while riding. :(

[Dr D]

sounds like an ergonomic problem to me. Go with the simple answer and adjust your binding angles:biggthump I know personally that certain angle combos are just bad news. I would play with the splay a little as well. the general consensus around here is that 5 degrees or so difference is far enough. I have seen enough odd anatomy to confidently say that you may not be "normal";) :lol:and you should experiment with both wider and narrower angle splay. I personally know a guy who rides about 65 on the front and 80 on the rear. wierd for sure but it matches his anatomy and keeps an old man carving.

[scrapster]

Very possible, Dr. D. And it wouldn't be the first "weird" anatomical issue I've had.:p I do know that I have the knee pain at other times too, when not riding. So something is probably awry in there. Still, if the discomfort on the hill goes away at certain angles--well, that's an elegantly simple solution.

[Dr D]

check out prolotherapy as a possible alternative to surgery if it comes to that.:biggthumpquite successful and relatively non invasive

[tdifan_2003]

Thanks Buell and Millen! I've had many of the same thoughts myself. As for the MRI, my PT did all sorts of yanking/pushing on my knee and was pretty confident that nothing was structurally unsound. Minor damage to the miniscus, something causing it to become irritated, or a very slight tendon tear are all still on the table though.

Its funny, no one has been pushing an MRI so far. (And there I was so worried that I actually needed SURGERY that I didn't go to the doc until after my riding season was almost over--denial, denial.) Luckily, I think my PT is just taking it slow, building up the knee and leg muscles. If that doesn't work within a reasonable time, I'll bring up the MRI again and I think she'll concur.

PS- Much of the damage was done when I hyperextended my knee hitting a big slush patch while riding. :(

I did the same - run thru the pain the whole marathon. Didn't do the MRI before because, I would've know what's wrong and still run the marathon ;). I am not saying you certainly do have something torn/broken, but for peace of mind (now that the season is...................almost over :), you can do it. The way you are describing it, it might be a partially torn meniscus. In that case, you certainly can leave for ever without an absolute need to repair it. Keep us posted.

Millen

[skatha]

I would say it's your tendons in the back of your knee/your hamstrings. When you are carving heelsides, your extending your legs, while your knees are slightly bent and your feet are dorsiflexed. Much like the movement of engaging your clutch while driving.

[Dave ESPI]

Obvious snarky reply : RIDE SWITCH (GOOFY) all the time... dauh :rolleyes:

[BDZal]

You could try some single-leg exercises. Step-ups, rearward lunges, etc. I don't know - most of my knee pain has come from muscular hip asymmetry (and compensating for a shoulder injury). But it'd be hard to go wrong with some single-leg work if you can do it.

Also, try switching stances (as in goofy vs. regular) sometimes. Riding in the same stance every time out has some long-term effects - it will twist you around a fair bit. Not good for you... I'm not saying that it's the cause of your knee problems, but it could be a contributor. I haven't snowboarded in 3 or 4 years, and I still have issues from it. I've thought about picking it back up just so I could ride in an opposite stance.

[SWriverstone]

Aside from injuries...I actually put more pressure/force on my rear knee when carving. Maybe I'm too much in the back seat, but I don't think so. It just seems to me that even though the ideal is to have your weight perfectly balanced between both knees...I seem to have more of it on my rear knee (especially on toesides).

Maybe I better work on that?

Scott

[Transistor Rhythm]

Your toe and your heel are in different places if you look at the edge. If you're doing a toeside (regular), you need to pressure your rear toe more to get even pressure across the edge and heelsides vice versa. One of the reasons they have invented asyms I guess. With asyms your toes and your heels will always be (at least a bit more) on the same place of the edge.