Skate safe this winter

By Mr Chinmay Gupte, consultant knee trauma surgeon, at The Wellington Hospital, part of HCA Healthcare UK.

Mr Chinmay Gupte, consultant knee trauma surgeon at The Wellington Hospital explains what happens if you have a knee injury on the ice.

Ice skating has increasingly become a staple winter activity with even the most graceful skaters needing to take care. Many injuries can occur during skating, including wrist, knee, back and ankle. The slippery surface combined with the constant turning motion can put a lot of pressure on your joints, particularly the knees. Injuries can happen when the forces overcome the resistance of your muscles and ligaments.

Winter sports knee problems can include ligament damage, cartilage injuries, and damage to the bones, knee cap and its associated structures. The most common knee injury (damage to the inner medial collateral ligament) can usually recover with bracing and physiotherapy. If the knee swells immediately and weight-bearing is impossible after the injury, it is more likely you have anterior cruciate ligament damage. An injury that seems trivial at first, but becomes more painful and swells over the following hours or days, might be a meniscal injury. Damage to the bones could be bruising or a fracture.

It is advisable to speak to an orthopaedic consultant if you suspect a serious injury, or have pain and instability that persists for more than two weeks. Your surgeon will take a history surrounding the injury and your symptoms. Your knee will be examined for swelling, tenderness, movement and looseness. Most types of knee injuries are best investigated with an MRI scan or sometimes an X-ray. MRI scanning is painless and usually takes less than 25 minutes.

Medial collateral ligament injuries generally recover without surgery, but you may need to use a knee brace and crutches while it heals. In adults, the anterior cruciate ligament generally does not heal well. If it is injured, immediate treatment should consist of ice, compression, elevation of the knee and supporting the knee in a hinge knee brace. Surgery to reconstruct the ligament should be considered if you are particularly active or have an associated meniscal injury. Some anterior cruciate ligaments injuries can be managed without operation if the knee feels stable and you avoid high-stress activities.

Meniscal injuries to the knee can sometimes heal with physiotherapy but persistent symptoms will require arthroscopy (keyhole operation). A torn meniscus can be stitched back together or the torn segment can be removed; your surgeon will discuss which option is best for you. Crutches and a brace may be necessary for recovery.

Knee cap injuries are usually managed with physiotherapy and a brace, although recurrent dislocation may require an operation to stabilise the knee cap.

It is important to keep the muscles around your knees in good condition. One of the best exercises to strengthen and condition the muscles is cycling. This builds up your quadriceps, hamstrings and buttock muscles, which are all important for knee stability. Other activities that build up the abdominal core, such as Pilates, are also useful. Balance while skating is important too so it is advisable not to drink alcohol. People with previous knee injuries may consider using a short hinged knee brace on the ice.

To book an appointment with Mr Gupte at The Wellington Hospital call 0207 483 5148