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No ACL and doing fine?

 Poster: A snowHead
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@Markhandford, that was a good trash, then! Glad that it's all seeming so positive so far and interested and pleased that even with your pro activities you have been advised and are hoping to go the conservative route.
Like you said, sometimes body things just take their own time. Hope that it works out for you. You seem to have a realistic understanding of how it may turn out. Hopefully, barring any further incidents (which could have caused injury anyway, irrespective of the past knee injuries), you'll be back out there soon.
(Only mountaineering related thing I've noticed, bar getting stamina and strength back, is a rather timid approach to ice or mud or descending polished rock. Fear of slipping and falling and reinjuring the knee. Hopefully time will prove this is overcomable.)
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 Obviously A snowHead isn't a real person
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@Markhandford, Well what a story and a rich vein of information but as you say we are all different. Its great news to hear your progress to recovery.

I like you sometimes forget I have no ACL but 7 months on the soft tissue damage still gives me slight pain and stiffness. However, its is getting better every day and with some mild easing of the knee it goes away. I do notice that the ACL deficient knee is looser when I am not weight bearing on it which is slightly disconcerting but not at all painful. Muscle mass is all but there and perhaps better than it was before, considering the amount of time I have spent in the gym it is all to be expected.

My physio is keen on running to build the new neuro pathways plus turning on a Bosu ball with my eyes closed (testing). All good stuff and new training experiences which for me is excellent and worth the effort.

Just to be safe I have ordered a CTi brace to ski. In the long run I may not need it but the thought of straining the soft tissues in my knee make the cost worth it.

Good luck and to everyone else out there. Very Happy
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Grizzler wrote:
@ItaloSkier, Good for you. As you say it's all day to day, and it takes a bit of time, but by the sound of it you'll be super strong by then and are already doing extremely well (my niggles hate you! wink ).


One can hope... I still have issues here and there but there's time to work through a good strength protocol.

@Markhandford Good to read your story and best of luck on the continued rehab.
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@ItaloSkier, my physio checked out my old running shoes and suggested I could do with a new and perhaps better pair. Prior to new shoes I had pain in front of knee, post new shoes all comfy. My pace over 2.5 km is good enough to pass the army fitness test, job done. He also put me on a negative gravity running machine, Mo uses one, to check out my running technique which proved to be ok. It might be something to check.
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Anyway, snowHeads is much more fun if you do.
I wear the infamous Vibram Five Fingers which have always served my knees very well... they have been extremely helpful in all of my rehab exercises. Its been quite some time since I've tried running on a treadmill so maybe a quick test would be worthwhile... certainly less impact versus pavement.

https://us.vibram.com/shop/fivefingers/ (my divisive but effective preference... some people hate they way they look and I get that but they work extremely well for me)
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Starting to realize that perhaps a) I don't like running which I truly don't and b) when I do, its best not done on the pavement. Kicked the ball with my son the other day on a pitch near my office... was out there practicing corner kicks, dribbling, passing etc. Plenty of running around and no pain front of knee. That seems to imply that perhaps the issue is not the running or the shoes but the surface. Need to test the theory on a treadmill.

Never been a big fan of running for distance so inability to run a 5k won't be terribly disappointing.
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@ItaloSkier, I have long struggled even walking long ways on pavement or hard surfaces, never mind running on it. Rough ground, long bumpy grass, snow, rock etc - all fine. My body just doesn't like it flat and even.
Mind you, Grizzlers are not and never have been running creatures; not even bouncy joggers. Was very happy when a specialist leg sports physio looked at my weirdly-pointing kneecaps (way before injury, just the way my lower leg bones were put together by nature) and said "I'm not surprised that you don't like running: you really aren't built for it". Quel domage... Laughing He wasn't at all bothered about it vis the ACL/MCL rehab.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Very pleased yesterday - with already tired legs, made it relatively easily (puff, pant, gasp) up Hall's Fell & Narrow Edge onto Blencathra. Fair few scrambling and easy climbing moves (or not so easy with my short little legs) and a lot of rough stony ground (as opposed to my usual very rough grassy bog) then the long 'easy' slog down the steep stony track. God, my legs have forgotten what a good ascent is! (My fault: too busy with other stuff to get out much this summer.) Tired quads, stiff hams and deep achy peroneals and upper thigh, but no knee joint problems or stiffness yesterday, just very some minor twinges today. Nothing that, hopefully, a lot of doing more of the same won't cure.
Good legs. Good knees Very Happy
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@Grizzler, well done Very Happy. Not long and you will be booking winter holidays
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@ttrucwy, Believe me, I've been looking for months! I'm just waiting for something cheap enough. snowHead
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Has anyone tried this program for ACL recovery/injury prevention? I'm going to print this out...

http://www.aclstudygroup.com/pdf/pep-program.pdf

Went ahead and committed to going back to Chamonix next March. Can't back out now.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
No ACL and doing fine - Ish Sad
One month ago the physio said sit to stand one leg with no wobble.
A month later and still can't do this due to knee pain, front of knee somewhere, and my kneecap is clicking and jumping upwards all the time, sometimes painful and definitely off-putting, so no progression yet, to allow me to go for skipping or jogging, a month behind is how I feel.

I still can't walk down the stairs normally, I thud down on to my good leg as the knee pain feels like massive pressure in my kneecap somewhere.
So a switch from 2 legged gym work to one legged gym work now.

On the plus point I have gained 1/4" size on my bad leg, that includes calf, knee and mid thigh. So the German volume training has worked somewhat over the past 5 weeks, however the bad leg can only leg press 68kg, where as both legs together I am able to do 100 reps of 143kg, so my good leg is doing a lot of work.
Over the next 17 weeks of single leg press work Im planning to get the weight up to the same as my good leg to balance it out. (edited - should say that this is not my sole exercise regime, but don't want to bore folks with what Im doing and what is working for me - Unless people want to know/compare training etc)

Also on my 'bad leg side' I have a bit of a twist in hip rotation, so more work needed on my hamstrings and glutes.

I really feel against the clock now, as 1st week in Jan that's me in the Alps for the whole of the season.
Really starting to chew that which I have bitten off! Hard work all the way folks, we will all get there in the end!
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4 1/2 months to go. You can do it.
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 You know it makes sense.
You know it makes sense.
So I have lost 5 weeks of gym work due to the demands fo the NHS physio who asked me to perform jumping lunges which caused so much pain that my MV muscle switched off and have had lots of knee pain straight away that stopped me working out. Private physio confirmed a pain response had switched the muscle off, so now back to leg extensions for isolated exercise to get it firing again- boy does it hurt though Sad Just a little peeved and now have to work even harder.
On the plus point I was put on a 'skiers edge' machine and told to go skiing indoors as I may be quiet surprised with my ability, functional strength sis good but quads still massively weak.
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That sucks... sorry to hear that. Bit by bit... you'll get there.
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 Poster: A snowHead
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@Markhandford, sorry to hear that. These injuries and rehabs are funny things. They take their own sweet time and decide their own agendas. The muscles, especially VMOs, are also very delicate little darlings prone to princess tantrums.
Some things you can do fine, maybe well before you or others think that you ought, others take a very long time. Hopefully, in the end, it all averages a positive development though.
I managed to ski indoors for 6 hours continuous recently, then set off my outer right knee pain, and a bit left, really badly just standing around on a hilltop for a day in the rain dismantling and carrying around some very heavy dry stone walling. Don't ask me how, no twist or slip, it just decided that it wanted to hurt and stiffen, exactly as it did skiing last season. The usual left mild hammy stiffness was fine... Repeated problems after several days' rest, then pain and reduced movement for 2 further days, then it finally decided that since I wasn't going to stop using it, it was being ignored so would return to normal service.
Bodies, hey Puzzled rolling eyes
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Obviously A snowHead isn't a real person
@Markhandford, so sorry to hear about your setback. However what you are doing does seem a strange thing to do. I suppose all physios are different and have their own ways. I have been doing lunges, squats and treadmill work plus lots of other stuff. Taking it slow but it’s working. Keep at it but keep off dry stone walling, that must be some peculiar Northumbrian test regime 😃
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Finding this very interesting discussion and well done to all on recoveries. I wondered if anyone here has looked at www.skimojo.com at all? It's more than a ski brace. I might be doing some work for them, so interested to see what someone who's had ACL issues thinks as they believe it's perfect for someone in this situation.
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@iainm, lots of posts about or referencing the ski mojo on the forum, some keen users also.
Not something which I personally feel of attraction or assistance as yet, and my consultant's advice was to avoid all braces and similar and just get strong enough. It's also pretty costly. That said, doubtless if it was a choice between assistive equipment (which is different from a brace and serves a different function, as I understand it) or not being able to ski or board at all (or much less and/or in more pain) then I'd be considering it. I'd also want to look at the expensive customised brace angle too, and as an alternative to the mojo. I don't see the mojo as an ACL-related knee stabilising aid per se, nor as a brace, more as an adjunct to natural strength and an aid to reducing strain for those with pain and knee joint problems. I could be wrong, and my already tired muscles might not thank me for it.
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@Grizzler, Yes the VMO is temperamental at the moment, onwards though. Good news on the indoors skiing, setting off pain can be a real head game though. I know what you mean about sudden aches for now reason, that then dissappear as quickly as they appeared, I had a 3 out of 10 pain in lateral ligament when walking up hill, one minute it was fine the next it was annoying, after ignoring it for a minute or so, it just disappeared.

@ttrucwy, The NHS physio went through the test for functional strength, which included fast jog on the spot, followed immediately by stepping each leg out to the side followed by a 'jumping' lunge with jumping change of leg forward - that is what started the knee pain. Im jogging up and down hills with no problem apart form endurance fitness, road biking and hiking - plus lots of walking lunges with weights at the gym, but jumping lunges at the time were not going to work for my weak quads - I will be highlighting this with the NHS physio at Octobers review.

@iainm, I know a few older folk who use the mojo as a supplement for their weaker legs muscles. Both my consultants have said I should get strong and that a custom knee brace is not needed, but one did say that perhaps a knee sleeve may bring some psychological help. Get strong hamstrings and quads was the message.

I don't think Im going to take the private physio advice about going to chillfactor, I think I will give it another 5 weeks of training and get this muscle switched back on getting strong first.
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@Markhandford, re Chill Factors: a difficult choice. The psychological aspects need to be addressed at some point, just knowing that you can ski again and can stop and avoid etc etc. My first time back, at 5 months, was terrifying, but although my knees ached and the quads protested and felt weird and fizzy, I was surprised that I could at least ski. OK, the race slalom skis were a bit too much for me, and I only did 2 hours, but it was a much needed getting back on the horse exercise. Maybe it was a bit early, maybe not. At that time I was still quite stiff kneed and definitely not fully recovered, though starting to hill walk longer distances. Only tried indoors once, due to house moves rather than anything else, then threw myself into UK skiing over last winter. Done some long indoor sessions since. Feels like I get stronger and more confident each time out.
Only you now can really decide when's right. Sounds like your fitness and strength are there; sounds a lot better than me now! You're always taking a chance skiing, but I reckon that you'll find it surprisingly easy as long as you take it cautiously at first. It's just this fear of falling... ( or in my case colliding). Indoors is short and won't over test you as outdoors might, plus you can see how you react to constant standing (ski down, poma up). It's also very useful to get your parallel knees back: one thing I've found is that I've lost the inner muscle control, or whatever I used, and my ability to hold skis parallel, and after years of training my right knee not to collapse in, it's collapsing in again! Can't seem to sort that with exercises, just practice and muscle memory on skis.
Good luck whenever you go.
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Quote:
I'd also want to look at the expensive customised brace angle too, and as an alternative to the mojo.

Thanks Grizzly. Can I ask what you mean by the 'customised brace angle'? Do you have a link?

Quote:
I know a few older folk who use the mojo as a supplement for their weaker legs muscles

Thanks Mark. What sort of age are the 'older folk' you're thinking of here?
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After all it is free Go on u know u want to!
https://www.firstaid4sport.co.uk/supports-and-braces-c5/knee-supports-and-knee-braces-c6/donjoy-armor-with-fourcepoint-knee-brace-p4

I ski with no ACL I use these braces on both legs only missing 1 ACL. They are brilliant. I'm an Off Piest skier. I wish I'd used them pre accident.
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Quote:

Thanks Mark. What sort of age are the 'older folk' you're thinking of here?

@iainm, Late 60s and mid 70s with knee problems but no TKR done.
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@Markhandford, bug me...I am only 58!
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@iainm, on the custom side I know of CTi and Donjoy. They also do slightly cheaper off the shelf jobbies. I should probably have said high-end ACL (and other ligament) braces rather than custom, although having tried on a standard CTi it did seem to be too long for me, and some of the custom ones are also lighter, I believe.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Grizzler wrote:
@iainm, on the custom side I know of CTi and Donjoy. They also do slightly cheaper off the shelf jobbies. I should probably have said high-end ACL (and other ligament) braces rather than custom, although having tried on a standard CTi it did seem to be too long for me, and some of the custom ones are also lighter, I believe.


I went for a fitting for my Donjoy, I asked about a custom brace but was told you only need one if you have an unusual stance or unusual sizing ect. Otherwise follow the sizing guide and order on line
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I am 69 and have skied recreationally for 30 years. I ruptured my left ACL on the second run of my holiday last December, in Austria. The insurance paid for some local treatment (ice and electrics) as well as an MRI. The local doctor suggested that I could be able to ski without surgery, following a lot of physio.
But the NHS website seemed to suggest that surgery was essential and by the time I got home, I was convinced that was the way forward, although my son who had had this surgery advised against, if at all possible.
Went to see my GP on my first day home, he is a skier, and he advised against surgery because of the long wait to let the swelling go down, followed by a long recovery time and the possibility that surgery would not improve the situation and could lead to more problems later. He advised a local (private) physio (who is also a skier) and she treated me for several months. She also said that she thought strengthening the leg, quads, glutes, lots of exercise would do the trick as long as I wore a brace and wasn't intending to do off-piste blacks (I wasn't).
In June I went to Chill Factore in Manchester and all was well for that hour, no problems at all.
I have today taken delivery of a DonJoy Armor Knee Brace with FourcePoint Hinge and will be trying it out skiing in December. Watch this space.
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 You know it makes sense.
You know it makes sense.
@NorthernLight, Well done you. That sounds like very good progress. Very Happy
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@NorthernLight,. Good for you.
I hope it works out. No 2 ACL cases are the same, just simular. The Donjoy you have is a great product. I found it takes some bedding in on the pressure pads, use something under it, I have Marino long John's under mine and Hard Shell Gortex trousers with side zips over the top. You'll find at 1st you'll have to adjust the straps a few times but after a while you won't know it's on. I've had some hefty off piest scrapes and tumbles since using them and without a doubt they've saved me from further injury. Give you great confidence. Well worth the money.
Lindsey Vonn uses one. You can watch her film on the red bull chanel just type it in Google. She starts off using the custom brace and ends up using the standard one. Good luck and happy skiing
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 Poster: A snowHead
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Huge chapeau to those preparing for the coming season with all the hard work enduring the occasional three steps forward and two back.

Having had the OP I always thought that it was nigh on impossible to ski again without the Op and no ACL* then I went in and had keyhole on my other knee to be told that at some point I must have ruptured the ACL in that knee and for years I'd be doing stuff without one and no knowledge (maybe better) of that!

For those without ACL's presume reading through most of the posts that you'll be skiing with a brace to be sure etc

Even with the op and reconstruction I skied the following season with a Donjoy and even now if my knee is sore (old age 60 this season and numerous strains) I use a mini reinforced brace.

*though think it does depend on the severity of the rupture and what other damage etc
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Weathercam wrote:
Huge chapeau to those preparing for the coming season with all the hard work enduring the occasional three steps forward and two back.

Having had the OP I always thought that it was nigh on impossible to ski again without the Op and no ACL* then I went in and had keyhole on my other knee to be told that at some point I must have ruptured the ACL in that knee and for years I'd be doing stuff without one and no knowledge (maybe better) of that!

For those without ACL's presume reading through most of the posts that you'll be skiing with a brace to be sure etc

Even with the op and reconstruction I skied the following season with a Donjoy and even now if my knee is sore (old age 60 this season and numerous strains) I use a mini reinforced brace.

*though think it does depend on the severity of the rupture and what other damage etc


That's a good question. My doctor said I should get fitted for a custom brace before I go skiing just so I have it, just in case. I am assuming insurance will pay for it but not certain. At the same time, my physical therapist, after working with me for a few months (we stopped working together in June when it was apparent the PT time was no longer necessary) looked at me and said, "you're not going to need a brace. He felt it would help me from a confidence level but it wouldn't be necessary. His comment was, "what are you going to do, tear your ACL? Its already gone". So, I don't know. I may just wear a sleeve on my knee or I may check one of the braces in my collection. There are three to choose from!? rolling eyes
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
As I've said elsewhere, my NHS orthopod consultant was very clear in his instructions that I should not wear a brace. Just get strong and you won't need one. I believe that he is of the referred injury school: knee stabilised with steel rods = next weak point to go is probably femur.
I use a couple of wraparound neoprene Velcro jobbies with springs down the sides (Boots own brand), sometimes plus tubigrip. Bought them early on for general support. Not sure that the support isn't more psychological than actual - even if they hinder more than help - but they keep things warm and remind me that my knees need thinking about (which isn't a bad thing given one's tendency to drop in if I don't hold them parallel; a pre injury issue got worse again with lost strength). I don't have them terribly tight but haven't yet got the guts to ski or board without them.
I did originally intend to shell our for 2 Donjoy or CTi braces, but couldn't find anywhere to try the former on, and they were going to cost me £1,000, so the Consultant's advice was welcome in that regard!
If I had a graft to protect, maybe I'd think differently.
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"Not sure that the support isn't more psychological than actual - even if they hinder more than help - but they keep things warm and remind me that my knees need thinking about (which isn't a bad thing given one's tendency to drop in if I don't hold them parallel; a pre injury issue got worse again with lost strength). I don't have them terribly tight but haven't yet got the guts to ski or board without them. "

Agreed. The sleeves should serve as a reminder to be smart and don't do anything stupid (not always easy for me) but I know the kind of situation that can get me in trouble. If I think of my two knee injuries, both were due to speed... one was simply catching an edge and straining an MCL and the other was two skiers (me and another skier) coming in hot into a run, colliding (the collision did not cause the injury per se) but ending up moving backwards while on my feet to the point I eventually made it to powder on the side of the run and the sudden stop in motion caused the rupture.

The things we do for the love of our sport... its a passion... exactly what the doctor and I discussed in Argentiere. When asked recovery and sports, my sole goal was going back to skiing.
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1. It will never be the same as the other side
2. You can find any opinion you want on the internet
3. Ask the expert treating you for his / her advice based on - their knowledge of the evidence, their experience of treating people like you, their understanding of your history, the examination and investigations they have performed on you as an individual
4. If unsure- which is reasonable- ask for a second opinion (from a knee surgeon- not from here) before doing anything
5. If you do have surgery it is really important that you have confidence in the person treating you

Whatever you do- best of luck, keep those thighs strong and carry on skiing. Brufen and beer help.
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A few steps backwards for me. Had a gentle limping jog on the beach for a few hundred metres, then a gentle hike up across and down a plantation. Knee was a bit swollen as I would expect, did a work out yesterday and that really increased the swelling above me knee, RICE and cryocuff didn't do much Sunday or yesterday, called GP this morning as can't bend knee past 90 degrees so back on Naproxen and Omprazol - haven't been on pills form months Sad
Obviously I have over cooked something. Sleeping with legs on lots of pillows again.
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@Markhandford, Oh dear Sad Never mind, it's all part of learning to rehab and live with it. Mine, or the attached muscles etc, are still niggly and easily tired if I do too much too often; seems like a bit too much too soon for yours. I had the same problems when first starting skiing again outdoors last spring, and in fact recently on my first attempt at really serious rock (music) dancing - don't laugh, it's good exercise! Sitting here now with sore outer joint lines and stiffening knees (hot bath beckons) after a good long all-terrain yomp this afternoon.
Rest until recovered, then try again. Rehabbing knees are a bit like dogs I reckon: slowly keep repeating the exercise, and with enough patience, rewards and pampering they'll eventually work out what you want them to do.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
@ed123, Generally good advice: though Ibuprofen down the same route as the beer would not agree with my stomach at all!
Bar some cream Ibu or Diclofenac (Volterol) - neither of which seem to do much if anything - I've not touched the anti-inflammatories (for reasons of already irritated gastrics).

Keep the thighs strong; and the hamstrings stronger.

Your rule 1 can easily be ignored: just take out both at once Toofy Grin
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Thanks for the feedback. It seems the Donjoy is popular but at the same price as the Ski Mojo, it feels you get much more back from that? Maybe it's the simplicity of the Donjoy that appeals?
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@iainm, I always thought that the Ski Mojo was not about protecting the knee like a brace, but more to help overall leg strength in the quads / calves etc
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