ACL Class of 2013

Got out on a backpacking trip this past weekend with Mrs. Splitter. Happy to report all went well with the knee. First time carrying weight for her since surgery. She is coming along nicely with her recovery. 18 weeks post surgery for her and she says she doesn't even feel like she had surgery. Little pains here and there and certain motions cause minor discomfort. Especially on the downhill but doing well. Strength still isn't 100% but we are getting there. Stoked to get back on snow here in another month or so.

Mrs flounder is doing well. Physical therapist kicked her out since she was progressing so well. She was to have her final check up with the surgeon on Monday but his wife had a baby and he had to cancel. The PT told her he expected her to be cleared for all activities but nowhere has to wait a couple more weeks for the all clear. The mystery pains and numbness seem to have gone away.

Shes still been limiting her activity and mostly just road biking. Still has an issue of lack of strength on the hill climbs but the average speed keeps increasing each ride. Hopefully she will get the all clear to get at least a couple of days of climbing in before winter.

I had my 6ish month checkup yesterday and got cleared by the Doc to start returning to pivoting sports. I still have some knee cap pain with certain motions but neither the doctor or the pt are concerened about it. Both are of the opinion that it will go away in the next few months with continued strengthening and stretching.

I've been religiously going to the gym 3-4 days a week and biking/hiking 2 to 3 days a week for the past 3 months. I'm probably in the best shape I've been in in about 10 years.

My plan is to continue strengthening and healing and get back to skiing at the beginning of January.

Wildman, he told me to wear a brace this winter while skiing and next summer if I'm doing pivoting sports and then I shouldn't need it.

Keep at it pesto - the slight pain will go away, I had the same thing. I'm a little over 3 years since my surgery and I still have some popping but virtually pain free besides when it is strained, usually from climbing on my mountain bike.

Been a while since I checked in. 18 weeks post op now (hamstring graft).

Had some swelling that we couldn't shake that held up my clearance for plyo's and running, and was causing some pain at the top end of one leg squatting motion. religious icing finally put an end to that and allowed me to push much harder on the strength training.

Strength feels great now (PT thinks I am at 80-90% of my good leg) and ROM is completly back (well, about 1 degree short of my other leg in both flexion and extension). The first week of plyo's and running feel absolutely great.

I'll 2nd pesto's comment above, feel like overall I'm in the best shape I've been in a while.

So psyched to start getting some mountain biking in before ski season rolls around.

New to forums but I tore mine in January racing in a slalom course on a 300 foot hill. I thought I was 20 again. :rolleyes: Just over 7 month post op using patella tendon to reconstruct. Strength is getting better. A little minor pain especially if I go hard on the bike. Starting cyclocross practice now and it was a little scary getting off the bike the first few times. I think the next few months will require more strength obviously, but also getting over some metal hurdles. I really do not want to go through this again.

I am planning a ski trip to Utah right now so I have to be ready. :)

Looking for some advice on an ACL brace. This will be my first season back on snow :biggrin: after I took out both my ACL, and MCL. I was in the class of 2012 for the injury, and then 2013 for my repair - 11 month waiting list in Canada! Everything has been going reasonably well although I wish I hadn't taken out the MCL. Glad I had it fixed but it's definitely slowed my recovery compared to a 'simple' ACL.
My surgeon (Dr Mark Heard) recommends a brace for the first year or two which I'm happy to comply with but I was wondering what recommendations everyone else has been given, and whether there is a brace out there that's better than the rest. From what I can tell Donjoy seems to be one of the bigger names. Never had a major injury that's required bracing so not sure how I'll adjust to having it on. Managing to do every other sport (biking, and running) without a brace although I used a pretty basic neoprene one at work up until a couple of months ago. Not sure whether I really needed it, but did give me some more confidence I guess.

I highly recommend this http://www.ossur.com/pages/13230. I've been using it for a couple months and it's the only knee brace my doctor gives to athletes

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Originally Posted by bilkovet

Looking for some advice on an ACL brace.

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I just had this conversation w/my surgeon who is very conservative (no running until 6 months, no contact/twisting sports until +10month). His feelings were that a brace is for peace of mind and confidence to ease back into sports, or if I were adament about returing to sports/skiing at 6 months post surgery. But otherwise unnecessary if I feel emotionally comfortable/confident skiing without a brace. A repaired, fully healed ACL is stronger than the natural one.

After reading through everyone's, I figured I should put in my two cents.

ME: 25
WHEN: Complicated; ACL tear was in February of 2012, medial meniscus tear was in May of 2013
WHERE: Steamboat(ACL) and soccer field(menisucs)
WHAT: See above
HOW: Trying to impress a guy and was skiing too fast. Not even a cool yardsale, just a regular old fall.

So long story short, I didn't realize I had a torn ACL. Continued to ski on it the next day and for the rest of the season and the next. Played two soccer seasons and then this past spring, I finally tore my meniscus badly enough that I couldn't walk.

WHERE I'M AT NOW: As of today I am 16 weeks and one day out of surgery. PT let me "light jog" on Monday for 5 minutes which kicked my ass, but felt great. My gait is still a little wonky since I am having trouble getting my knee completely straight. I do squats and other leg strengthening exercises to get some of the muscle back that I lost.

I'd say if you are going into your first surgery or just out of it, be patient. Everyone told me this and it was still hard. Heck, I still get misty eyed when I think about not being able to ski until Christmas, if I am lucky. Have someone you can call and bitch to about being stuck on the couch. Because it is going to suck. But it will be worth it in the end.

Oh and ice the hell out of it. I was really good about it and my PT was impressed. It will also help when you first start being able to do therapy.

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Originally Posted by bilkovet

Looking for some advice on an ACL brace.

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My surgeon reccomended the Breg fusion. FWIW, I probably don't NEED a brace but I prefer to follow the ACL recovery protocol set forth by Dr.

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Originally Posted by Wildman

My surgeon reccomended the Breg fusion. FWIW, I probably don't NEED a brace but I prefer to follow the ACL recovery protocol set forth by Dr.

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Thanks for all the replies. I've just been fitted for a Breg Fusion which is what my surgeon recommends. I still notice my knee, especially when I'm doing more strenuous activities so I'm happy to have it. I spent some time looking through all the research and it appears skiing is probably the only activity where a brace might actually make a difference in terms of re-injury.

Knock on wood... I've never had a knee injury, but the place I work out at is Mike Boyle's gym, the strength and conditioning coach for the Red Sox. Someone else on the forums recently posted about PT and getting back to skiing. I talked to some of the coaches there about advice for people doing their own training after PT and they said a complete training program is obviously best, but the best single exercise you can do is (light weights in the hands stretched out in front make it easier)
http://www.youtube.com/watch?v=XWeXisjUnBs
"This is the best ACL prevention and ACL rehab exercise ever however you need to progress to it. In fact this is our standard "return to play" test. If you can't one leg squat as illustrated you are not strong enough and risk re-injury in competition. This applies to males and females regardless of size."

How many people perform athletic movement holding weights to help with trunk control?

you can't do that without weights, your not organized enough to do the exercise. Enjoy the knee tendinopathy.

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Originally Posted by kingdom-tele

How many people perform athletic movement holding weights to help with trunk control?

you can't do that without weights, your not organized enough to do the exercise. Enjoy the knee tendinopathy.

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Every skier?

But without going through all the pre-parallel progressions, they generally go light weights, no weights, then increased weights to add resistance, I've seen some athletes go north of 100# of vests and weights.

But, huh? You think that holding 5lb weights which allow you to get your butt back and help with balance is going to cause patella tendonitis?

So are you against using sl squats as a resistance exercise?

not against the exercise at all. it is a great functional movement.

but if you need weights to maintain your balance your ignoring the reasons why you can't balance to begin with, cart before the horse.

I don't really care, I get that people want to feel strong and they measure themselves by weighted vests, hand weights, score cards, phone apps, etc, but if someone is out to get good at a single leg squat thinking that is the preventative measure they are misguided. A squat is only as good as your ability to reverse the movement at any time, which means you need good trunk dynamic control and sensory ability to know when you left that quality behind. kind of like skiing.

you ski with hand weights?:)

I asked this question in the 2012 thread, sorry for the re-post but... I got my custom fitted brace...but was instructed NOT to put a baselayer underneath it (so the brace should sit directly on the skin). Does anyone know of a "baggy" baselayer that i could wear over the brace?

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Originally Posted by Wildman

I asked this question in the 2012 thread, sorry for the re-post but... I got my custom fitted brace...but was instructed NOT to put a baselayer underneath it (so the brace should sit directly on the skin). Does anyone know of a "baggy" baselayer that i could wear over the brace?

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I don't want to give contrary advise ... but I used a custom fit Donjoy brace, they told me the same thing but I ignored it. my ultra thin polypro was not an issue.... thicker stuff may be a problem. I had an issue with a few pairs of thick high socks.

The few time I put a base layer over top of the brace, I found it difficult to adjust in the field.

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Originally Posted by Wildman

I asked this question in the 2012 thread, sorry for the re-post but... I got my custom fitted brace...but was instructed NOT to put a baselayer underneath it (so the brace should sit directly on the skin). Does anyone know of a "baggy" baselayer that i could wear over the brace?

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In the past I've always worn a base layer under braces. In fact, Donjoy and others sell "sleeves" to wear under their braces to prevent chafing. I can't see how wearing a base layer under the brace is any different then wearing one of these sleeves.

Example: http://www.betterbraces.com/knee-bra...e-cotton-lycra

Back to your original question... I have a pair of REI expedition weight long underwear that are pretty baggy. They might be worth a try.

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Originally Posted by kingdom-tele

you ski with hand weights?:)

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That's my pet name for poles.

I'm still not completely following you and I know you do this for a living and its just an interest of mine. But wouldn't performing single leg squats in the progressions (maybe I should have posted the full progressions but was trying to make this simpleish) help develop the dynamic trunk control? I always thought that part of the benefit of doing single leg exercises is the increased demand it places on your "core". Most people when they start these exercises can't get close to parallel, so they go to a bench, using weights, then eventually get to parallel with a touch to a box, then get rid of the box, get rid of the weights, then add resistance. So wouldn't progressing this develop trunk control.

I'll ad the caveat that obviously no one exercise is good enough on its own to do everything and a total body workout that encompasses movement patterns, plyos, strength, and conditioning is best.

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Originally Posted by cmcrawfo

I don't want to give contrary advise ... but I used a custom fit Donjoy brace, they told me the same thing but I ignored it. my ultra thin polypro was not an issue.... thicker stuff may be a problem. I had an issue with a few pairs of thick high socks.

The few time I put a base layer over top of the brace, I found it difficult to adjust in the field.

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Good info as I am in the same boat.

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Originally Posted by neufox47

That's my pet name for poles.

I'm still not completely following you and I know you do this for a living and its just an interest of mine. But wouldn't performing single leg squats in the progressions (maybe I should have posted the full progressions but was trying to make this simpleish) help develop the dynamic trunk control? I always thought that part of the benefit of doing single leg exercises is the increased demand it places on your "core". Most people when they start these exercises can't get close to parallel, so they go to a bench, using weights, then eventually get to parallel with a touch to a box, then get rid of the box, get rid of the weights, then add resistance. So wouldn't progressing this develop trunk control.

I'll ad the caveat that obviously no one exercise is good enough on its own to do everything and a total body workout that encompasses movement patterns, plyos, strength, and conditioning is best.

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I had to do 10 single leg squats before being cleared for running (among other things), and it was a bitch. Residual patella pain from the graft being the worst. They only had me go to about 90* per squat. Bowler squats helped me get there, as well as heel touches on an 18" box. I'm about 5 months removed from surgery and am in much better shape then I was pre surgery, and am 25lbs lighter, but I'm still nervous about getting back to action.

Quote:

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Originally Posted by neufox47

That's my pet name for poles.

I'm still not completely following you and I know you do this for a living and its just an interest of mine. But wouldn't performing single leg squats in the progressions (maybe I should have posted the full progressions but was trying to make this simpleish) help develop the dynamic trunk control? I always thought that part of the benefit of doing single leg exercises is the increased demand it places on your "core". Most people when they start these exercises can't get close to parallel, so they go to a bench, using weights, then eventually get to parallel with a touch to a box, then get rid of the box, get rid of the weights, then add resistance. So wouldn't progressing this develop trunk control.

I'll ad the caveat that obviously no one exercise is good enough on its own to do everything and a total body workout that encompasses movement patterns, plyos, strength, and conditioning is best.

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what do snowboarders do? Would craig kelly have benefited from hand weights?:)

It is an interest of mine to, we are the same.

What is dynamic trunk control? strength, ability to heft weights, etc. The funny part about squatting is it demonstrates little about the condition of the knee other than the ability of the tissue around the joint to absorb the forces. Someone who can't squat because of decreased mobility somewhere else is on a fast track to knee strain. Answering the question why you lose your balance is more important before you start making modifications so you can balance.

Why is balance so important, why is reversibility so important, they both demonstrate motor control, don't got it, you can adapt, but it shows up in strain related issue in the limbs that are compensating for the loss of mobility somewhere else.

read this...
http://graycook.com/?p=35
relate it to your own movement issues

we are horribly impatient, realizing your soleus is so tight you can't squat and maintain spinal muscle balance, and that it may take 2+ months to address that issue is not good enough, we rush, we strain, we adapt our environment to fit our needs. often to regret.



there is nothing wrong with SLSquats, but its not what you do, its how you do it.

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Originally Posted by kingdom-tele

read this...
http://graycook.com/?p=35
relate it to your own movement issues

we are horribly impatient, realizing your soleus is so tight you can't squat and maintain spinal muscle balance, and that it may take 2+ months to address that issue is not good enough, we rush, we strain, we adapt our environment to fit our needs. often to regret.

there is nothing wrong with SLSquats, but its not what you do, its how you do it.

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I agree with everything you are saying, except that it is a bad thing to use hand weights to stabilize the SL Squat, or that if you can't do it without hand weights you are more likely to develop patella tendonitis or that your calfs are too tight. Using myself as an example, I can execute a SL squat to parallel without weights, but I have to extend my chest forward and get my knee about 2-3" out in front of my toes, and if I go below parallel at all, I tuck my butt. Add in 10lb hand weights and my form is almost perfect. Is this really a trunk stability issue, or is this because my chest is really big and I'm top heavy?

Also, wondering if you realized that the guy Gray mentions and credits as being partly responsible for the content in the article you linked is Mike Boyle, the guy who is responsible for the video and quote I originally posted.

the calf issue is only one possibility, that was my intention including the article. Just as altering the orientation of your rib cage is an option. All of us will have different motor plans to complete the task. They are not wrong or right, but if it is your only choice it will lead to something burning up (knee tissue as one potential). In the context of a SL squat, relying on weights to hold form is a compensation, especially considering if your training for a function that has no weights.

If you have access to Mike Boyle, you should ask him how what he contributed to the article would apply to your findings in your SL squat. Issues in trunk stability(control) are equally related to loss of mobility as they are to hypermobility(the article's POV)

FWIW, we all have to tuck our tails with deep squats(below 90*) :)