What's a normal strength quad?

[edk]

Ship4 mentioned that her surgeon said she needed to strengthen her quad more before she could ski. I'm planning on skiing in about 6 weeks and have an OS appt in about 3 weeks to get the OK. I started to have second thoughts about what if my quad isn't strong enough? What if he tells me sorry go back to the gym for a couple of months. So the question is how much is he expecting? I went to the gym and wanted to see how much I could life on the leg extension machine. My non-op knee could lift 120 lbs and and my operated knee onlt 80 lbs. I've been hesitant to do too much quad extension lifting because I'm afraid of damaging the knee.

 

[ship4]

edk,
You answered your own question. Your operated knee is obviously much weaker than the non-operated knee because it can not do equal work. They should be of equal strength to ski! Remember you are in a flexed knee position using your quads strength for balance.......
So, you need to work on that leg so it is of equal strength before you plan to head out onto the ski hill. Also, remember the most danger to you aside from being ready to ski and strong enough, is the possibility of a collision with another skier.
Best,
Crystal

 

[edk]

All that is nice theoretically. But last year I skied 37 days on sort of one leg and an outrigger. My left knee wouldn't bend past about 70 degrees with weight on it. And my
left quad and calf were starting to atrophy from disuse. So I would bet last year I might
have only been able to do only do 60lbs with my left leg and 120 with my right. Its probably been 20 years since I've had equivalent musculature. This year I have two
knees that bend and I can probably ski on both legs.

I do understand about collisions. Almost everyone I know that gets hurt ends up that way because of a collision.

 

[ship4]

Are you going to continue to use outriggers? They are a huge help. Many doctors say absolutely no skiing with a TKR......
I am fortunate that my OS office handles the first aid room at the mountain I ski, and where my husband continues to teach private ski lessons with the Snowsports School (broken link removed: https://www.loonmtn.com/winter/). I taught skiing for 7 years prior to my initial injury. I have not felt comfortable skiing for 2 years. I went out and tried the last 2 years, but my knees were both so bad I was looking for a chair to sit on early in my run down only 1/2 the mountain.
Have fun! I hope it is a go for you and you are comfortable with it.
Best,
Crystal

 

[edk]

Actually I used the term "outrigger" for my left leg. I used to ski with about
75% of the effort & weight on my right leg and my left leg would just be out there for balance.
Consequently, whenever I was at one of those places where you needed to turn
or you were in trouble, I would always start to the right and turn to the left so I would end up
with most of the weight on my downhill right ski.

I understand about surgeons and skiing after TKR. I couldn't find anyone in Central
Illinois who was willing to talk skiing after surgery. I found this odd because almost
everyone you run into on a ski hill over 65 in Colorado has one artificial joint. So
I was all set to have surgery in Denver when I found a guy in Chicago who is a snowboarder
who understands the motivation. I'm really glad I didn't do the Denver thing -
I didn't really realize how debilitating TKR was. I sort of figured I'd spend a week
in Denver and then be pretty well past it. Little did I know....

Now we are just arguing about what agressive means. He says "non-agressive"
skiing is OK. I am a non-agressive skier who likes to ski some agressive terrain.

 

[ship4]

My OS was adamant about skiing only groomed trails and not bumps. Pitch was not a factor as long as it is groomed. He also stated no skiing after lunch.........
It is scraped off and piled up and that is where you will run into trouble. Mid week skiing is the best as the crowds are smaller and since I work all week, my skiing will be first thing in the AM. Out on the slopes at 8:00 AM and back in around 11:00 to Noon.
Have fun!
Best,
Crystal

 

[Josephine]

Well, I know little about skiing but I do know about artificial knees and trust me, there's not a lot you can do to damage the actual prostheses either in the gym or on the ski slope. They tough and solid and can take some punishment.

BUT the ligaments around the joint are what are at risk. Being now rid of the pain and disability, there is a real danger you can get too enthusiastic in these early, healing days (sorry, I forgot when you had your knee done) and cause some inflammation that might take a while to settle. So on that score, I'd say try to be fairly measured in your exercise but go for it as well. You need to build up those muscles!

 

[Simon]

Well the only skiing that I have ever done is on my Nordic track ski machine. I used it as it was the only thing that did not bother my knees. I can't wait to get back to it but the PT said to hold off a bit longer as my knees are not equal in strength. Also, the nonunion fracture in my foot is just starting to fill in after 5 months of ultrasound treatments and the push off motion will put too much stress on the area.

My OS has a TKR and does ski. In fact, like Crystal his office has a clinic at the ski resorts (Killington area of the Green Mts of Vermont) and all the OS in the office ski. I think the key to if you can ski again is that you were a pretty good skiier before hand and your quads and other muscles, tendons and ligaments are strong enough.

Good luck.

SImon

 

[edk]

I was operated on 18 Mar 08.

I guess to add to what Josephine said, there is the added problem
that fractures around the prosthesis are more complicated.

That being said, I'm not planning on jumping off any cliffs til later
in the year

 

[JenniferG]

All that is nice theoretically. But last year I skied 37 days on sort of one leg and an outrigger. My left knee wouldn't bend past about 70 degrees with weight on it. And my
left quad and calf were starting to atrophy from disuse

OK Ed let me ask, how much did that hurt, skiing on a pre & needing TKR knee?!
BTW Nice knee date!

 

[edk]

You can get along on bone on bone on 10 ibuprofen a day for a while.

Actually probably the most important thing was that a couple of years
ago my left knee functioned well enough so I used it enough to keep it
in shape. The last two year I physically couldn't push with it enough
so that the muscles in that knee started going downhill.

I think that the number one mistake people do who need a TKR is to
put it off til they have no muscles left in that leg. Then they've got
a long way to come in recovery. I think this is 1. especially hard for
people with rheumatoid disease and 2. hard for surgeons who always
think people are too young.

Sorry - I know you didn't expect a soapbox speech -

What do you call us, Jennifer? Prosthetic twins?

 

[JenniferG]

Prosthetic twins, that works. Just don't call us gimpy right!?
Ah yes, mega dose ibuprophen. I would take up to 6 pills 3-4 times a day. Just to walk/hobble. Forget the knees, my stomach must be so grateful.

 

[Gretchendz]

I think that the number one mistake people do who need a TKR is to
put it off til they have no muscles left in that leg. Then they've got
a long way to come in recovery.

So very true! It sure was for me

 

[AlaskanTKR]

OK - I can live vicariuosly through you wonderful skiers this winter. I skied the last 2 years over 30 days each winter - colse to 40 last year - I think we don't count - just ski. Had to quit in late March when my buddy (9 year old daughter) broke her wrist on her heelies. Probably a good thing becuase by that time verytime we skied I was icing that night. My OS is ok with skiing NEXT season if the knees cooperate. Recreational, lower mountain terrain - groomed- no moguls. He said we will revisit it next fall. Told me to forget this year - I was hoping for the spring - but don't think I am going to chance it. Top of out mountain has 35 inch base already. Opeing will be Thanksgiving weekend. My kiddo is looking forward to skiing and I am looking forward to enjoying some wine. Keep me posted on your return to the slopes!

Marianne