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Managed to get the crank over a few times yesterday - old hardtail MTB on one of my son's trainers. Not smooth or effortless by any means, but it's a start. My regular 170mm cranks but seat height is 1.5cm lower than my road position.Quote:
Originally Posted by smooth operator
Good luck on the recovery. Listen to your PT and you will be back next season.
I tore both of my ACLs on Mt. Hood so I feel your pain.
So true. I never felt like my recovery was on the speedy side compared to others. Then about 2-3 months in I started having weird, shooting nerve pain in my knee when weighted--not every step, like 1 out of 10 but enough that I was always in fear of it. Both my doctor and PT seemed somewhat unsure what was causing the pain. They never said anything like "Oh everybody goes through this" so I knew it was unusual. Just the looks on their faces told me that. But the pain was real and when it came it hurt like hell, like made me gasp.Quote:
Originally Posted by Djongo Unchained
Just had to deal with it though. My chiropractor is trained in ART and he massaged the nerve entrapments all up and down my leg to loosen up the nerves and ease the irritation--that helped a ton. My PT was awesome with soft tissue work as well and her massaging helped, plus she worked wonders with K-Tape and that really helped support and keep weight off the knee for a few weeks when it was bad. Eventually it just went away. Huge relief. I definitely remember some down days wondering why this shooting nerve pain was happening to me but not to other people. Just took time to heal.
Hey all, thanks for the stories and tips, there's some great info on here - joined the club after a couple spills and one gnarly tomahawk out in Revy in Feb. Doc back home on the east coast confirmed it was torn beginning of March, I was lucky to be strong enough to cruise groomers so he gave me the green light to take it easy and finish out the season.
Went in for surgery last Weds. 5/15, was off the narcs by Sunday and have been taking only asprin and CBD oil since. First PT sesh was Saturday, second one this morning (Tues.) - swelling has gone down significantly, and I've got about 100* ROM so far. Been able to put some weight on the leg with crutches as an aid, feeling pretty good for ~1 week out. PT mentioned they might try to get me on a stationary bike on Friday if all goes well at the post-op follow up tomorrow.
Sending positive vibes out to you all, hope everyone heals up well and gets back in action by next season.
My doc has me doing home/self PT for the first month then sending me to an actual Physical Therapist, 4 weeks post op.
My Ortho guy works at the Meadows clinic, and specializes in sports, and had good recs from other skiers. Odd that most others are getting a PT so early, (my son had the same surgeon do an ACL in 2014, skis like a champ now).
Question for those doing PT by week 2; what kinds of exercises are you doing?
Today was 14 days post surgery and I saw my PT this morning.Quote:
Originally Posted by k2skier112
Session involved several stretching exercises for the hamstrings and various walking exercises, including balancing drills on one leg. As my doc and therapist explain it, the joint is plenty strong vertically but not strong rotationally or with a lateral stress on it. Also did some time on the stationary bike. Amazingly the repaired knee felt really good during some of the one-legged balance exercises.
Also got the OK to go without the Donjoy lockable brace unless I'm in a crowd (or on my feet for a long time and get tired). Entire session today was without brace (last week was mostly with brace on). PT stressed not hyper-extending the joint (or forcing flexion past about 110 degrees) and not putting rotational force on the repaired knee.
My PT started 5 days after surgery. It was not intense but did help me get the ball rolling. The ladies took it easy on me and in retrospect, that first week might have been premature. Not due to pain but that my leg in it's entirety, didn't fully reawaken for another week.
Now I feel improvements almost daily: more stable, less sore, more flexy, etc.
Don't feel like I'm racing along but plenty quick enough. I think my downtime from accident to surg was a negative. The leg atrophy is amazing. Not totally gone but damn; Sore from disuse...becoming my #1 impediment but working thru it.
My first PT session was 7 days post-op, and was also pretty mellow, though it sort of blew me away they had me walk without the brace.Quote:
Originally Posted by Djongo Unchained
For me it is more about setting guidelines at each stage: "Go ahead and put all your weight on it" "Keep every thing linear when you do this" "Don't bend past XX degrees for now" and explaining why. Doc said the PT timeline is very specific to the procedure(s) performed, they might well have gone slower if I'd had more or different things done.
My surgeon literally had me in PT the day after surgery. That was his thing. Not sure it was necessary, although it did give me some moral support just to talk to the PT. She kind of moved the knee around, did some flexion tests, I think she might have changed my bandage? Can't recall, I was pretty fogged out. She made encouraging noises and that seemed to help.
Yeah the atrophy is astounding. 30+ years of climbing and skiing and hiking just melts away, it's not fair. I had like a month delay before surgery (long story but I initially went to not the right place for treatment), but in retrospect I think surgery right away makes more sense simply because less time to atrophy. It's not always possible though.
Anyway, vibes to you guys, keep on truckin'.
Thanks for the replies.
My home PT is pretty much the same thing. Easy moving, stretching and mild strengthening.
I was walking without my brace about 9 days after, easily (ish) walking without brace now, 20 days after. Improvements keep me motivated.
I told my doc my goal was to be playing a mellow game of golf by the end of August and to be skiing by 1-1-20. He said if I keep up my PT, that it was a realistic goal. Fingers crossed!!!
Yea for me its about the same with the early PT, first two weeks are easy movements and stretching. The original plan was to wait 2 weeks until the post-op but after several conversations with close PT friends it seemed like getting started sooner rather than later was the best bet. I'm happy I was able to get moving early on as well, it's day 8 and they've cleared me to unlock the brace and put tolerable weight on it around the house. Agree that the atrophy is the worst part, still very stiff getting out of bed in the morning's as well. Awesome to hear they've got you setting some goals to work towards, all about creating that positive mindset.
One thing I used a lot doing PT at home were those ankle weights with the 1-pound sandbags that you can keep adding up to like 5 pounds per ankle. I got them at Walmart pretty cheap. Did a zillion leg lifts with those things, lying on my back, my side, and my stomach. Those weights, along with a recumbent exercise bike I got for $100 on Craigslist, were my primary home PT exercises for the first few months, along with the usual exercises assigned by my PT (squats, lunges, wall sits, etc.).
Last week in PT my flexion was up to 115* then up to 117* on Friday. Then I got the bicycle pedal over the top and pedaled slowly for about 10 minutes, so that was kind of a milestone. Life is returning to my leg. It's weak...ready to start working it out.
Awesome. It seems to come back pretty fast - I'm 4 days into the bike, doing about 15 minutes twice a day slowly (i.e. cadence ~ 50) with very little load, and my quads have gone from being a quivering mass of jelly to pretty firm already.Quote:
Originally Posted by Djongo Unchained
^^^^had to laugh about the atrophy thing. That has become my only real issue, getting it to turn on. Once it does, things come back pretty well so far.
Flexion to 120* today. Another goal met. Go to doc tomorrow for my 4 1/2 week post op checkup.
Gotta buy my pass by Friday. $1479 includes a mt. collective 1/2 price tickets deal and a base Ikon pass. That means free skiing at Alpy next year. FKNA, I am Ikon. Oh yeah, there's a full season pass to JH included in there. So I got that going for me, which is NICE.
1st PT visit, 4 weeks post op. Still -5* extension. 120* self flexation, 125* with manual help. Repaired knee is still 2 cm larger than good knee, about normal swelling he said. Getting around ok with no brace or crutches. I'm jonesing hard to swing a golf club, may go and putt just to get a fix.
~2 months post opp, starting to strengthen, but still working toward full flexation but I'm walking down stairs with a bit of discomfort. My knee constantly feels tight, or pressurized for lack of a better explanation. Worse in am, but never great. Is that normal? Thx
At 5 weeks that's about what I'm felling more of, tightness and puffiness, especially in the morning. Ice, elevate then stretching PT seems to help, plus not standing for more than 2*2.5 hours at a timeQuote:
Originally Posted by PhishingME
add-my 2nd PT today, first real PT work out. My PT said the tightness and puffy feeling may not go away for 3-5 months
Tomorrow is 6 weeks from surgery. Things seem to get better by a tiny increment almost each day. Tiny, I said.
Flex is about 125/7 with a nudge. Extension is at +1 still. Hard to get the last few points and doc said because of an incision point for scope, it's a normal challenge. Using a crutch mostly but can motor around without for awhile.
AM still is stiff and a few little pains. Not righteous enough to bust a move on, but nothing unbearable. Almost no swelling as it's smaller than my other knee today. Was noticeably swollen a few days ago though.
Pressurized is a good way to explain my sensation. Less so when it loosens up. Stairs are still testy but I've been going up and down them since the first day as my room is on another floor; wanted to sleep in my bed not the La-Z-Boy. 3 nights sleeping with the immobilizer brace was enough.
I am not the best on my own recognizance with my PT homework. Staying active doing stuff but not great with sets of stretches, heel slides, etc. Only wear my sport brace when I have an extended outing or sketchy walking. Almost zero pain medicating, not even Ibuprofen. Haven't used the ice machine for over a week, maybe 2.
Some other things - Man, the crutches have kinda wreaked a little havoc on me. Get the right size...My first set was a hair too tall which fucked up my back. Had to go to a massage therapist twice and the Chiropractor a few times too to get it back to functional. Lucky to have an MT/friend who cranks me for 1.5-2 hrs for $80 at the drop of a hat. I have one of those percussion massage tools, it helps a bit too.
Trying to be careful not to want perfection too early. I want this to be a non issue by ski season. Feeling real good about the pace, wish it were a little faster but PT gals and Doc say I'm doing great and right in the sweet spot for healing.
Knock on wood, my insurance has so far kicked ass on this. Finally got the bill for the hospital portion of this gig. $31k and change. Bill for Surgical assistant - $2300; Still gonna be about $7k for the surgeon(his pre-surgery quote). My outlay - $1100, my max out of pocket. I upgraded my coverage last fall to a 20% copay with an 1100 max. Glad I did that now.
Hey Mofro, How you doin?
Exactly what I am feeling - like someone put a piece of tape over my kneecap or my skinny jeans are too tight, though all I wear is shorts. Worse in the morning and after long periods on my feet, good after massaging it or riding the bike or flexing the joint in a hot bath. Seems like it will take some time.Quote:
Originally Posted by PhishingME
Walking up stairs is OK, but going down only works if the knee is "warmed up."
PT showed me how to massage the incision area and scarred tissue around where the drain tube was without putting lateral stress on the sub-dermal sutures, trying to get the skin to move more freely over the patella and getting the patella to "float" over the joint, seems to help quite a bit.
11 week update:
Still not "as good as new," but pretty damn good. Doc says one more week and we can start on more serious strength training and some jumping - weeks 6-12 is a "danger zone" when you start feeling pretty good but the new ACL has actually lost strength from necrosis and needs to re-establish a blood supply to bulk up again.
Back on the road bike, started commuting to work again last week, ~90 miles total. Walking 2-3 miles on rolling terrain around the house. ROM is 0-130 degrees. Still some "tingling" around the kneecap as sensation returns and scar tissue is absorbed, not really pain but feels strange.
Walking is pretty much normal, including up and down stairs. Starting to dream about skiing.
4 month check up was good. Full extension, and 140* flexation. No pain, been golfing for 7 weeks now. PT was pushing me hard, getting stronger feels good. I'm going on my own at a gym for a few weeks then maybe 2 a month with a PT to keep on schedule to make turns this winter
Sounds like y'all have good, strong repairs. If I have any complaint about mine it's that it was never tight like you describe even from the start. At 1 week I had full extension and flexion. It was a lot more stable than it was before but never was as stable as the other knee. Probably gone again as it feels even looser after hitting a tree three years ago but it still works for skiing. My Lachmann test makes people cringe when they see me do it myself.
had my 5 month check-in with the Ortho on Monday, he's pretty happy with the progress overall. I've had full extension since the beginning of the rehab, nearing full flexion by doing lots of stretching and some yoga. Have been keeping up with my exercises 2x per week but still need to regain more strength in the effected leg. Have been road biking a ton, and even got out on a few hikes lately, jump squats and other plyos started a few weeks back so it's been nice to mix in some new workouts.
Unfortunately the doc wants me to wait a full 9 mo's before getting back on the slopes - so call it mid-February before any turns will be made. I was kind of expecting that time frame but I was really hoping I might get the okay a bit sooner (end of Dec./early Jan.). Somewhat bummed about missing the beginning of the season but I guess I ought to be thankful I'll be able to ski at all and just try my best to be patient.
Positive healing vibes to all, keep up the hustle gettin' strong for the season.
8 month check up was good. Gonna hit the mountain Sunday, most likely Monday for the first time since Feb 13 2019.
Feeling strong and ready, about 80% of new.
How'd it go?Quote:
Originally Posted by k2skier112
X2?Quote:
Originally Posted by yeahman
As for myself I've been skiing at about 75% for about 30 days at the village.
Knee feels tight and stable. Leg strength is not back to normal. Yet. It has increased noticeably since getting out daily.
Having some serious bootfit /cramping issues though. I suspect both feet changed slightly since spring so I need to remold my liners methinks.
My plan is to ski safe, not push the knee to it's limit and charge next year. Which makes for some kinda boring skiing right now. Like skiing with an intermediate all day every day, but it's me.
Actually my skills feel more solid than my head wants to believe. I could mach the groomers more, but worry about a high speed digger; which rarely happens IRL anyways.
Overall, pretty psyched about my outcome so far.
Attachment 309454Quote:
Originally Posted by Djongo Unchained
Pretty much mirrors my experience, but not many days on snow so far due to the late season in the PNW. I think my surgery was about 2 weeks after yours. Knee feels stable, no real pain, but it's still a little tight and the strength/confidence is only at about 80%. Rolling the groomers trying to be conscious of basics while trying to watch out for obstacles isn't all that fun, but it feels good to be back. My doc came in last week to get boots for his kids and approved of the conservative strategy for this season, saying I won't even think about it next year.Quote:
Originally Posted by Djongo Unchained
^^^^^Thanks, that's encouraging.
I got motivated this morning and caught my first early tram for a 1st tracks OB run. Boottop for about 4k vert over 4-5 miles, pretty awesome.
I've been keeping the off piste to a minimum. Solid storms are starting to flatten the underfoot terrain. Mini-dumps in the 6-16" range are getting the hard pack to finally go away and fresh lines are soft and light. temptation is rising.
On my second run, I took a middlin' digger and tweaked the knee; only a 1 on the scale but my first real kerplunk this year. Skied about 10 moar runs w/a friend and called it. fatigue is my foe right now. Maybe a tiny bit of stiffness setting in, to be expected.
Training for Alpental.
Little less than 20 days so far, all with fairly conservative skiing for me. Was really diligent with rehab up until mid-Sept when I started a bathroom remodel and slacked on my preseason training all fall, so also feeling closer to 80% than back at full tilt. Got a bad case of empty nest syndrome so went to Utah before Xmas to ski with the kids and sort of got the legs back at Soli and Alta, but I've been little more apprehensive starting this year out knowing I could have done more to get strong. Mostly trying to ski as conservative as I did when the ACL was missing, shin on boot tongue and balance 100% dialed.
Pretty solid day of skiing on the Alpental opener, soft snow sure feels good.
Sounds like we're all in the same boat - we know how to ski balanced and conservatively, work on fundamentals, etc. but it gets old after about 3 runs. I supposed I could be a bit further ahead if I hadn't spent September in Europe eating, drinking and not rehabbing, but I did. Hopefully it snows a bunch and the spring touring season is a gem.
glad to hear everyone is doing well thus far, I'm at 7 months out now with hopes to be back on skis in mid-Feb. I have a final strength test at the end of January where I'm hopeful they'll give me the green light. Plan is to ski conservatively for this season and come back strong next year. Weather here in the east has been funky so at least I haven't been feeling like I'm missing out on too much yet
Curious to know, what's everyone's thoughts on braces? I've had friends who've gotten them and used them, and other's who haven't worn one at all. Doc said its up to me, I'm thinking about getting one now and having it on hand rather than not getting one and wishing I did.
I wore a Don Joy brace first year back, most of the second year too. Eventually I could just tell I didn't need it anymore, but continued to wear it on deep, heavy days for another season, when the knees really get tweaked around. Psychologically it was helpful, but also physically. I could really tell the few times I forgot it that my knee was way more sore at the end of the day. I never had the illusion it was going to prevent another ACL tear if I hyperextended. It's more for support, just takes some of the strain off the knee and allows the muscles to get stronger. Eventually, though, if you continue to wear it, it will start to prevent the muscles from gaining that last 10-15% of strength. You'll know when it's time to ditch the brace.
I was given the Donjoy Fourcepoint carbon fiber behemoth and have cumulatively put about 4 hours in it.
Didn't risk much early on and was very careful. Very.
At 7 months I got the go ahead to ski. And without the brace. Promised to ski wisely and feel I have.
First 8 weeks was PT 3 days a week for an hour, pared down a bit at the end.
Then worked a small remodel for about 5 weeks and a few projects until late Oct. Not really exercising on the finite stuff, just getting ladder exercise, etc. for the bigger muscles.
Visiting family in Florida for a month was my chance to catch up a little.
Put on my Dad's fitbit and started walking about 5-8 miles a day and maybe an hour at the gym doing light leg work and stair stepping.
That really helped and my performance for the strength test was better than before I'd left.
(My doc sets in the rolling chair and says lift the leg and push me backwards; I'm sitting on the exam table. Good leg sends him across the room, even with 2 hands. New ACL - couldn't hardly push the one hand back. Neither of us were too happy.)
So the exercise helped as I could push much harder at 7 months.
Skied 33 days so far, 2-4 hrs. a day. Lotsa low angle but ramping up a bit now. A few JH expert runs lately. Normal, everyday lappage for me but looking at it thru a new lens for sure. Kinda weird after being in the same lane for so long.
Been using a cheap Ace knee sleeve, open patella and 2 plastic strips on each side for a wee bit of rigidity. Mostly for the compression benefits. Feels good but I don't rely on it to save my ass.
Also, I turned my DINs down to 7.5 to start. Moved up to 8 the other day as I'm pushing a little now, combined with deeper snow. Had a double heel release today.
Full over the handlebars sitting upright landing.
The nanosecond of focus on my knee was obvious. Then I knew it was fine. Sat in the pow, Cleaned my goggles and was glad to have done it. Some positive feelings after a fall, as that has been my main headgame, Don't Fall.
I waited until Thursday the 9th to break in my knee, wanted easy conditions. Ortho said my knee felt strong enuf for no brace, he wasn't suggesting braces as much anymore, depending on the patient of course. Was stiff at first being over protective, felt great, got to the point where I was venturing to ungroomed for a softer turn. Still want to avoid deep snow until I get a few more days and strength backQuote:
Originally Posted by yeahman
Just saw this thread.... a few comments about ACL repair in general.
1) Choice of graft is still mostly surgeon dependent. It seems possible that the strength of repair options may be patellar tendon > hamstring autograft > cadaver allograft, but the absolute risk of re-rupture is low enough for all the graft choices that the side effect profile of the graft harvest is probably just as important. The risks of chronic anterior knee pain with BTB patellar tendon harvest and lifelong small but measurable hamstring weakness with semi-T autograft harvest should be discussed with your surgeon.
2) Patient demographics matter. At least where I work, if you are younger, male, or pushing it harder, the surgeons often opt for a hamstring autograft. If you are older, female (women tend to have smaller hamstrings that are less ideal for ACL repair), or not pushing it, they will often steer you towards cadaver allograft. If you are over 40-50 yo and not pushing it at all, they will likely recommend not repairing the ACL.
3) Concomitant injuries matter. If you have a significant meniscal injury and/or MCL tear in addition to your ACL, your level of pain/instability will be greater than someone with an isolated ACL injury. Your rehab will be slower and harder too.
4) Do your PT! Control your swelling or you won’t get your range of motion back. Use a custom knee brace if you are going to ski within the first year of your repair.
I had mine repaired in Oct 2018, along with my MCL and lateral meniscus. I was having a midlife crisis period and skied on it more than I should have in 2019.
If you can, hold off for one season! If you can’t... well, I hope your season looks something like this.
https://vimeo.com/331146090
My surgeon, a skier with kids who race, doesn't recommend knee braces much anymore. Luckily I didn't have any meniscus damage and stayed strong thru rehab. Skied 5 times so far, no pain, no brace just mental in not trusting it. Skiing more aggressively than I should I'm sure but without pain
Crushed my final strength test last week and got back on the slopes for the first time this weekend. A little past the 8.5 month post-op mark, and have been working really hard on getting into solid ski shape lately. I ended up getting a Don Joy brace from the Doc and rocked it on the mountain. It felt good, not too restrictive or anything, and was definitely nice to have as a confidence boost mentally. The majority of my runs consisted of riding the lower mountain lifts, just cruising around the greens. There was about an inch of new snow on top of fresh corduroy and I had the goofiest smile on my face. I took it very easy overall, skied for about 3 hours, slow and cautious but stoked to be back in action!
Right on, man. I remember the same feeling when I started skiing 8 months after surgery, just being happy af to be skiing groomers and be on the mountain. I still think that in a weird way the whole injury gave me a renewed appreciation for skiing that lasts to this day. Like anything, when it gets taken away, you realize how much it meant to you.Quote:
Originally Posted by Boosh
Agree with pretty much everything you said in this post. I tore mine on my 50th bday in the terrain park. Doh! The surgeon recommended hamstring for me, that was his favorite graft to do, and for me the appeal was minimizing the chances of arthritis and achy knees later in life. But no question it comes at a cost in hamstring strength down the line. Doesn't stop me from doing anything, but I do notice it. Still, I feel lucky regarding the outcome as a whole. Enjoyed your video too, that was cool.Quote:
Originally Posted by DGamms