“The combination of knee orthosis M.4s comfort and the medi Rehab one provided optimal support after my injury!”
At the beginning of March, winter sports athlete Alexander Schmid tore his front cruciate ligament in the left knee during training in Berchtesgaden. He had to have an operation. This meant that the season ended around one and a half weeks earlier than planned for the 29-year-old skier. Shortly after the op, Alexander Schmid was fitted with the orthopaedic knee orthosis M.4s comfort and the medical compression stocking Rehab one – both from medi. These medical aids not only support the rehabilitation but also help in preparation for the new season.
Alexander, you tore the anterior cruciate ligament in your left knee about three months ago. Did you realize at that moment that it would be a protracted injury?
“Yes, I realised this immediately! During the giant slalom training, I slipped on a gate with the inside of my ski and slid down the slope. As I tried to get up, I twisted my knee. It immediately swelled and ached. Fortunately, our team physiotherapist was present during the training. He took a look at the injury right there on the slopes and then drove me from Berchtesgaden to Munich for an MRI (magnetic resonance imaging). The diagnosis: Rupture of the anterior cruciate ligament and the external meniscus. The season was over for me – instead, the clear recommendation was to operate as soon as possible.”
When did you have the operation?
"The same day, just five hours after the accident. Dr Manuel Köhne, DSV team doctor and orthopaedic specialist, removed a piece of quadriceps tendon from my left thigh and inserted it in place of the torn anterior cruciate ligament. To do this, the cartilage under the kneecap is smoothed and the external meniscus is sewn together.”
How did things go following the operation?
“The operation went without complications. When I woke up from the anaesthesia, I knew that from now on, things were looking up! Of course, it was annoying to be out due to injury so soon after my World Champion title in Courchevel / Méribel, France. Being an athlete, I’m aware that the risk of injury is high in alpine skiing. This makes it all the more important to look positively towards the future and focus on my rehabilitation. The goal is to do everything possible to get fit for the new season quickly.”
A secure feeling in everyday life with the M.4s comfort knee orthosis
What form did the therapy take following your operation?
“I had physiotherapy at the hospital as an inpatient for two days after the operation. When I was discharged from the orthopaedic surgical clinic in Munich, I received the medical knee orthosis M.4s comfort and the medical compression stocking medi Rehab one. The M.4s comfort orthosis has a rigid frame but the range of flexion and extension movements can be adjusted manually without tools – however, this should only be done by qualified personnel. It gave me a feeling of security in everyday life and protected me in critical situations. The medi Rehab one has usefully supplemented the therapy postoperatively.”
Reduction of swelling: Get moving again faster with the Rehab one compression stocking
“My knee was extremely swollen and the joint was irritated by the operation – the main goal in the early stage of the follow-up treatment was to reduce this. The compressive pressure of the medi Rehab one on the tissue has helped to reduce my swelling and get me mobile faster. Initially, I neglected the therapy a little and didn’t wear the postoperative medical compression stocking for a couple of days, because I saw a noticeable improvement. But immediately after this, I had fluid in my knee again and it became swollen again. Since then I have been wearing the medi Rehab one regularly from morning to evening. Thanks to the particularly soft merino plush, it is also pleasant to wear and the topband ensures an optimal fit on the leg.”
When were you able to begin light training again?
“It took about two weeks – the body needs time to recover slowly from the operation. Although the mechanical stability of the knee joint has been restored by the orthopaedic procedure, the knee is far from being stable in its movement. Therefore, in the first few days the focus was on reducing the swelling and slowly increasing the mobility in the knee joint. I tried not to use my knee and raised it; regular cooling also helped to reduce the inflammation further. I also received manual lymph drainage every day. Fortunately, our team physiotherapist lives next door to me. Unfortunately, my muscle mass reduced really quickly, owing to the fact that I was lying down a lot. That is why it is essential to become active and restore muscle strength as well as mobility and proprioception (depth sensitivity). Immediately after my operation I had physiotherapy and about 14 days later I started with small mobilization exercises myself.”
Can you describe them for us?
“You tense the muscles on the thigh briefly and loosen them again – and repeat this several times during the day. I also regularly raised the operated left leg slightly up and down. To regain the mobility of the patella (kneecap), it is important to move it and carefully shift it with your thumb and forefinger several times a day. You need to exercise caution here, however – if you experience pain, it is better to wait with the mobilization.”
What did your training plan look like?
“After the inflammation in the knee had noticeably subsided, I started doing exercises in water – simple bends and stretches of the knee in the swimming pool. As a small increase, I then started training on equipment, for example, leg stretches on the bench in a prone position or lateral leg lifting. I also used a passive movement splint three to four times a day for 30 minutes at a time, plus a device that stimulates the muscles by electrical impulse. All this in order to improve mobility, prevent stiffening and support the healing process – with the least possible strain on joints and tendons.”
Five hours a day for rehab
How much time do you invest daily in your therapy?
“I work actively on my rehabilitation for about five hours a day. Of course, I am aware that due to my excellent medical care, I have a lot of therapy options that others may not have to the same extent. But the most important thing, in addition to expert care, is to become active yourself and find out what you need to do.” Without this personal sense of responsibility, cruciate ligament rehabilitation is slow and returning to sport would be reckless – both for competitive and amateur athletes.
Are you and your team satisfied with the progress you are making?
“In principle, yes! However, in the meantime, my knee got warm again several times, after it was placed under strain, and the inflammation flared up. That's when I realized that I need to reduce my training workload so as not to delay healing. To be honest, it bothered me that I was unable to implement the specifications of my doctor and therapist as planned. But it helps to talk about it with the team and my family. We need to accept the signals that the body sends to us, about what is feasible and what is not. In the meantime, I no longer have time requirements, but we are talking about stages and what requirements must be met in order to tackle the next stage. And things have been going better since then! I am glad to have such excellent care and a great team around me that takes care of me fully and supports me. And the support from the association is also unique. This feels incredibly good.”
From May to the end of June, you will be doing rehabilitation in Chiemsee. How does your therapy programme there differ from your first two months at home?
“There are three points of focus. Firstly, to build up the muscle strength; secondly, to improve my coordination skills; and thirdly, to slowly get back to my normal training routine. For example, I have started cycling on the ergometer.”
Are you wearing the medical knee orthosis M.4s comfort and the medical compression stocking medi Rehab one at the moment?
“In consultation with my doctor and physiotherapist, I wore the knee orthosis for the first six weeks after my operation. This gave me a feeling of security that my recommended movement restriction was being adhered to and that the surgical result would not be jeopardized by careless movements – this was also a great advantage from a mental point of view. I also found it great that the range of motion could be adjusted individually. After six weeks, I took it off to learn how to put weight on my knee again and to regain my old mobility, as much as possible. I am still wearing the medical compression stocking."
Rehab one raises your awareness of the injury, without restricting you.
In what way?
“On the one hand, the compression raises my awareness of the injury; on the other, it gives support without restricting me. And it prevents swelling – I have clearly noticed that! For me, the combination of the M.4s comfort knee orthosis and the medi Rehab one provided optimal support after my injury! I am convinced that this will allow me to return to full mobility faster.”
When do you think you will be able to stand on a pair of skis again?
Six months after the operation would be perfect, i.e. at the beginning of September. My team will then be training in Argentina. I will probably fly to join them and then stay longer to catch up on the time I have missed. The alternative would be to remain in Germany. But we will decide this at the last minute, depending on my physical condition.”
How come you are training in Argentina?
“The association introduced overseas training a few years ago. In Germany, we are very limited in the summer and can only train on glaciers, which unfortunately have been declining faster than expected in recent years. When it is summer in Europe, it is winter in Argentina and the conditions are better. From wet to winter-hardy to soft snow, they have everything in the ski resorts. This allows us to ski in varied conditions and train our skiing style accordingly as well as test our equipment. Further advantages: They have wind and plenty of altitude differences there, plus the ski resorts have good snow reliability.”
Realistically: Will the shortened preparation time for the coming season be enough for you, or is it a clear disadvantage?
“It’s difficult to say! On the one hand, I don't have the usual training scope and will need to start cautiously with ‘rehab skiing’ – time trials won’t be possible at first. On the other hand, I don't need extensive training to perform well. I will go into the training much more concentrated and motivated, use every single day of skiing perfectly and train more consciously.”
Have you set yourself clear goals for the 2023/2024 season?
“Most of the time, I get in my own way when I’m making plans. I’m all the more disappointed when it doesn't work out. I will work on my rehabilitation step-by-step. It would be a huge highlight if I could be present for the start of the season in Sölden at the end of October and hopefully be in a position to attack again! If this isn’t possible, I’ll remain very pragmatic. The main thing is to be pain-free and get my ‘ski feeling' back, so that I can test myself to the limit and rev up the power again.”
Alexander, we wish you every success! Thank you very much for the interview and good luck during the coming season!
Would you like more information about the knee orthosis M.4s® comfort? Find out more here:
How does a cruciate ligament ruptured occur? Everything on causes, types and therapy options.
Medical compression stocking for the treatment of postoperative and posttraumatic oedemas
Athletes rely on medi both while training and competing
medi Rehab® one is a round-knit medical compression stocking for compressive care of the lower limbs, mainly for prevention and treatment of postoperative and post-traumatic oedema and general swelling.
M.4s comfort is a brace with a frame that is intended to reinforce and stabilise the knee joint using limitation of extension and flexion.