Concerns over potential knee damage

TTT Yachting Medicine answer

A newly formed group of healthcare specialists, whose focus with TTT is to provide specific and appropriate advice and treatment to the sailing market. All three partners are experienced racing sailors in their own right. Timo Malinen is a qualified Chiropractor and Physiotherapist from the University of Glamorgan and Tampere College of Healthcare Finland, respectively. He most recently was the Medical Coordinator for the Volvo Ocean Race and the representive for the Medical Advisory Committee during the Race. Tim Spalding is an Orthopaedic Consultant at Coventry Hospital. This means he knows an awful lot about bones and joints and specialises in knees, a common problem for sailors. His current active research area is the prevention of offshore yachting injuries. Tim has been Medical Advisor to the Volvo/Whitbread Race since 1989. Mark 'Tommo' Tomson is a GP. He specialises in providing on board medical kits and has been Medical Advisor to top racing teams such as Kingfisher, ENZA and Royal Sun Alliance. Tommo has been Medical Advisor for the Whitbread/Volvo Race for over 10 years.

Jane Curwen asks:
My daughter has been sailing a Cadet for 6 yrs. She has had problems with her knees for a couple of years. She has seen a consultant who has diagnosed knee caps rotated by 30 degrees, together with twisted tibias. Her knees go inwards when bent, therefore she cannot bend them if her legs are together. She is having physio currently and it is believed to be a congenital problem. I wonder if it could be directly related to hiking and therefore further aggravated.


Jane,

From the brief information given you are describing a situation of knee problems which are secondary to the shape and alignment of your daughter's legs. I assume that she is aged 12 to 14 or so and that the Consultant Specialist has advised a watch and wait policy with physiotherapy muscle strengthening exercises and help with walking while awaiting further growth. This would seem a very reasonable approach.

Malalignment problems with the lower limbs would not usually be caused by activities such as hiking and are merely a reflection of patterns of growth. However, once a problem has developed with the shape of the legs then they are more likely to succumb to overload type problems as the patella or kneecap is not sitting in the optimal position. Sometimes surgical correction of alignment problems is indicated and this can either be performed before growth stops or at a later point once the so called growing area of the bones has stopped developing - usually at aged 16 or 17 in a female.

It may be worthwhile discussing the issues with your Consultant as a lot depends on the age of your daughter and the exact alignment problem. The timing for surgical correction of severe alignment problems, if indeed it is necessary at all, is a very specialised area and all the pros and cons would need to be discussed.

Thank you for your question.

TTT Yachting Medicine

Important note: This medical advice is offered as only an opinion and does not constitute a diagnosis or a recommended course of treatment. The opinion offered above is bound by the terms and conditions of www.thedailysail.com.

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