This year there have been more ski accidents in Munich’s local mountains than in years – Brettl fans injure their knees particularly often. Here the team doctor of the German national ski team, Dr. Manuel Köhne, the background.
Munich – Injured skiers are currently knocking each other out in clinics and medical practices – a consequence of the Brettl boom in the first season after two limited Corona winters. “It’s going to be extreme on the slopes this year,” Felix Neureuther already analyzed in our newspaper – and ski doctor Dr. Manuel Köhne from the OCM Clinic in Munich reports: “It’s really unusual how many skiers are currently caught.” Most of them hurt their knees. The classic: a tear in the anterior cruciate ligament, the posterior is rarely affected. Instead, however, the medial ligament and/or the medial meniscus are often damaged. Doctors call such combined injuries unhappy triad. You can read more about the most common knee injuries in the article below.
Many skiing accidents: women are affected more often than men
“The ski victims are often beginners or very good skiers. Women are affected more often than men because women’s knee joints have a less favorable anatomy. They are more susceptible to cruciate ligament tears in particular, and they often have weaker muscles than men,” says Köhne.
Most accidents happen in unspectacular and apparently harmless situations. This is especially true for knee injuries. Hobby skiers, for example, rarely suffer a cruciate ligament rupture after a serious fall at high speed. Much more often they get caught on easy terrain and at low speeds. “When you lose concentration, you quickly get lost on skis. That can be enough to tear your cruciate ligament,” explains the doctor.
Ski accidents: “Especially good skiers often get injured in comparatively easy terrain”
A prime example is his patient Dr. Isabella Jacobson. The 46-year-old Munich cardiologist, who used to compete in ski races herself, was out and about in the St. Anton am Arlberg ski area – more precisely on a trail between the Gampen and the Zammermoosbahn. “Somehow I got caught in a pile of artificial snow at the edge of the piste, and it tore my skis with freshly sharpened edges.” Jacobson didn’t even fall, but immediately felt that her knee was probably injured. “Unfortunately, it was already my third cruciate ligament tear.”
Such cases are typical, says Köhne. “Especially good skiers often get injured in comparatively easy terrain, on pull trails or when swinging down in front of the lift. Sometimes the patients report that the injury happened to them practically in slow motion,” reports the ski doc. “In these situations, concentration often slacks off. In addition, when falling at low speed, the binding often does not open. The pressure on the knee is then significantly greater than when falling at higher speeds.”
Many accidents happen either early in the morning at the start of the day’s skiing or in the afternoon on the last descent. “In the morning, the muscles are often still cold, too few skiers warm up before the first descent. Your body isn’t even up to operating temperature, so to speak – and it’s already happened,” says the orthopaedist. “Sometimes the psyche also plays a role. You hit the slopes at the weekend, are still stressed out from the work week and want to go full throttle right away.
Ski accidents: the six most common knee injuries – and what helps
cruciate ligament
Signs: Swelling usually delayed, knee feels like jelly, usually only moderate pain.
Treatment: Younger and athletic patients are usually operated on in order to stabilize the knee and regain full resilience.
That’s what matters: After a serious knee injury, an X-ray should be taken quickly to rule out bone injuries. If none can be seen, you can arrange an MRI appointment in peace. Before cruciate ligament surgery, specialists usually first allow the swelling to subside so as not to put additional stress on the tissue.
How long does it take: After the operation, partial weight bearing with crutches is often only required for a few weeks, with the option of a splint. Sport again after six months at the earliest, more likely after a year.
inner band
Signs: A medial ligament tear is very painful, usually hurting more than any other ligament or meniscus injury – especially when straightening the leg. However, the swelling is usually rather manageable.
Treatment: Conservative in more than 90 percent of cases – i.e. rest, painkillers and cold pack, possibly a relieving bandage.
That’s what matters: If, in exceptional cases, an operation is necessary, the inner ligament should be fastened back to the bone very quickly – with so-called bone anchors or screws.
That’s how long it takes: If you can do it without surgery, you can slowly start doing sports again after four to six weeks.
tibial plateau
Signs: Often swelling in the knee and lower leg area, severe pain and restricted movement.
Treatment: An operation is necessary when fragments have shifted. In these cases, the bone is stabilized with a plate and sometimes with two additional screws. In the case of non-displaced small fractures, it is often sufficient to relieve or protect the leg.
That’s what matters: If you suspect a broken bone, you should have an X-ray taken as soon as possible. Because there is a risk that blood vessels could be injured. If the fracture does not heal well, there is a risk of osteoarthritis.
How long does it take: The bone grows back together in about six to eight weeks. Sport is back after four to six months.
bruised knee
Signs: It often hurts like hell immediately after the bruise, but the pain usually subsides quickly. As a rule, the knee does not become particularly thick, and its function is not more restricted either. The leg does not feel shaky or unstable – unlike, for example, with a cruciate ligament tear.
Treatment: Ice pack, rest and painkillers like ibuprofen or voltaren.
That’s what matters: The following also applies to severe bruises: If in doubt, it is better to get an X-ray to make sure that the bones and kneecap are intact.
How long does it take: Rapid recovery, usually no longer sports break necessary.
meniscus
signs: Pain is very typical when you bend over – for example when you squat down. Rotating movements can also hurt cleanly. The swelling is usually not so wild.
Treatment: An operation is necessary when a torn piece of the meniscus is trapped.
That’s what matters: Today the motto is that you should preserve as much meniscus as possible. Therefore, specialists try to sew up torn menisci. If this is not possible, the broken part is removed.
How long does it take: After a partial removal only crutches for a few days, after a suture several weeks.
capsule injury
Signs: The joint capsule, which encases the knee joint like a kind of elastic tissue cover, is often affected by overstretching or twisting the leg. Capsulum injuries without other damage do not cause major swelling. The dull, rather flat pain is usually moderate.
Treatment: It is usually sufficient to protect and cool the knee. Voltaren or ibuprofen help against the pain. A bandage for relief is also useful.
That’s what matters: Whether ligaments are injured in addition to the capsule may have to be clarified with an MRI.
How long does it take: Two to four weeks.
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