Hi all,
When I next check this I'll be coming round from an ACL reconstruction.
I'm sure many of you have been through this, any tips??
One day we'll ski again!
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Hi all,
When I next check this I'll be coming round from an ACL reconstruction.
I'm sure many of you have been through this, any tips??
One day we'll ski again!
Sent from my Pixel 3a using Tapatalk
First tip would be to post in Gimp Central.
Actually the first step is to read the fucking stickies
Like this one
https://www.tetongravity.com/forums/...HE-RIGHT-PLACE
Agreed with the above.
And don't get behind on your pain meds when your nerve block wears off.
I had not found the Gimp section yet...
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I hate oxycodone and went easy the day of, the next morning was hell...truth^^^Quote:
Originally Posted by pfluffenmeister
Gimp Central!
But seriously, good luck. Go easy with meds if you have an addictive personality. Seen it put some people thru the wringer personally and its not fun.
Crush the rehab and you'll be good to go. Most people I know ended up in better shape, healthier eaters and loved getting back into things they hadn't done in ages.
Regarding meds and addiction, I agree; stop using as soon as you can.
But post-op my cutter told me start them as soon as you can start to feel your foot, and them set an alarm (mine was every 4 hours) so you don't get behind the pain.
And then kick them to the curb ( and crush your rehab, I did funny walks up and down my driveway forever).
You'll be good, I skied (lightly) 6 months to the day after surgery.
Thanks guys, had a good read of the gimp central during my sleepless night.
First experience with Oxy, i dont think they're spoiling me with them (insert Swiss German joke here).
Edit - just had the drains out - man that makes a difference!!
Edit edit - managed to convince them to stop giving me the Oxy and just have an ice pack instead - very proud of myself...
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Good luck with your rehab. Work hard, and be patient. It takes time. Even for the pros. Some people get there faster, but for most it takes a year or two after surgery to return to the level where you were before your injury.
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Good call on quitting the oxy if you can handle it; I went 4 days on them and had a shitty time getting the flow going. Not sure what the equivalent in SUI is, but the DonJoy Iceman I used (recirculating icewater machine) was a big help for swelling.
Find a PT who understands what you want to achieve, and do what they say without fail - sometimes it's hard to believe them, "Really? Do that on one leg?" My guy is a skier and cyclist, and also knew when to back off for a few days. Like the others say, it takes a while, and your knee has its own timetable. Be patient, I overdid it a few times and set myself back each time.
My recovery went something like this: easy biking on smooth pavement @ 3.5 months, commuting ~100 miles per week at 5 months, skiing at 7 months (only on smooth groomers, turned DIN's down by 1), easy touring at 9 months. I'm currently at 11.5 months and pretty much doing everything, starting up on a hill/bumpy descents on the MTB and landing/bumps on skis still hurt. Estimate my strength in the repaired leg is at about 93%.
I would say that the advice I got from other veterans is pretty much on the mark so far - "You'll do everything OK the first year back, but you won't feel 100% - second season you won't even think about it" - hoping the last part holds true.
I'm resigned to next season being focused on walking up rather than on hitting epic cliffs and straight lining Bec's.
Thinking of selling the big ass pow skis that did it and picking up some skimo race ones over summer...
Greg - think I've been lucky as it was a pull apart rather than a smash together so there is relatively little other damage but I will take onboard what you say and take it steady. 3 laps round the clinic on crutches already! Whoop, that's going on Strava!
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Good call again. I tried to ski on it twice more (yes, once should have been enough) after blowing the ACL, subsequently tearing the MCL and damaging the meniscus on both sides. 1,000 gram boot and 1050 gram ski combination has been working well for me this spring; lighter is a little sketchy even with two good knees.Quote:
Originally Posted by ddraver
yeah, i was walking and skinning before the Op (bit of a big guy so I have chunky thighs, which seemed to help) and skiing down very carefully so let's see!
A very cute physio has to teach me to do steps today!
Consultant today was talking about skiing 6 months to 1 year after Op if I bought a 2500CHF brace...
I haven't seen anyone else mention that level of brace. Is this more for pro's desperate to get back as soon as possible?
(That's a whole new touring set up!!)
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Possibly. I just used the one they gave me in the hospital. Certainly helped from a psychological perspective. With a good op result and disciplined rehab there’s no reason you shouldn’t be skiing by start of next season. I had my op on 1st May 2018 and skinned up Mt Gele at the end of November. You’re welcome to the brace if you need one.Quote:
Originally Posted by ddraver
I talked at length to a ski bud about knee braces, I didnt even realize he had knee probs or wore a brace but he has had knee issues for decades but skis well, teaches skiing & tours.
He has 4 knee braces of various price & quality, sez he is probably going to drive 13hrs to Calgary to get a custom made brace which is gona cost twice what the 2500CHF will cost and he sez its all about the fit, putting the brace on and the brace staying put
I'm still waiting to hear from the surgeon NO idea when they will get back to doing surgery and i'm classed as not urgent, at least it doesnt hurt my knee brace buddy said if yer not hurting you are really lucky !
My Ortho, a sports and shoulder/knee specialist doesn't recommend braces for skiing much anymore. If your knee is strong and you rehab properly, he didn't see much benefit. Skied about 15 times since my surgery this season with no brace. Landing about 2-3 foot drops with no pain and full control. Bumpy chattery conditions cause a little discomfort. 1 year surgery anniversary is May 3rdQuote:
Originally Posted by ddraver
Yeah, that sounds more in line with what others are saying.
Next Winter will be an easy one (if it happens), By spring, I'll be able to be more adventourous.
Sounds acceptable under the circumstances. I suspect braces may be in my future but not while I'm still young (ahem)
Xxx-er, from what I've heard if you do it properly - snap it completely - there's not a lot of pain as there's nothing else to snap... I was lucky too, I had a month at least being able to get out and about a bit.
Thanks Everyone.
I heard 2 pops, complete tear. Only pain was from bone bruising. I got up and skied 6 more runs, then 3 days later at BBI19 I made about 10 runs on chair 2...BIG mistake.
Wow, sugar!
I felt the pop but couldn't hear anything due to the clatter of ice and rocks that were hidden under the snow (and caused the fall. Bob - opening Cathedral Couloir, just below the little wind lip). Got up and 'skied' down but only with a lot of side slipping and traversing.
By the bottom my knee was a bit sore but both my calve muscles were screaming for 2 days!
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After the big pop I skied out on the run, easy right turn was ok, did an easy left, no support at all so went down instantly, the GF seen it from behind and thot oh shit .
so i slid it out on one ski to the bar, I haven't tried skiing and i really can't see any skiing being a good idea
A little biking is OK
the good news is that BC is 3 weeks ahead of Canada on Covid, the cases have peaked and we are on the DH side SO maybe they can open up surgeries I can get some !
My surgeon and PT were both in the same camp. Said if I applied myself to PT I should have a pretty good idea if I can ski and how hard to push it; brace is mostly for psychological support rather than physical. Congrats on your 1 year anniversary, mine is next week. Started skiing December 30th 2019, 29 days on snow so far doing pretty much everything (but bumps and chattery ice are not ideal). Touring has been good, the warmup before every run helps.Quote:
Originally Posted by k2skier112
On the other hand, a friend who has the same doc has had repeated problems with more or less the same surgery going on 20 months and the surgeon ordered a fancy custom brace for him recently . . .
seems that surgery ain’t the only option anymore…
“A torn ACL can heal itself, new study shows. Surgeons disagree.
The finding that surgery may not be needed for ACL injuries could redefine future treatment and suggests that the knee is more resilient than previously believed”
https://wapo.st/3XvDelP
of course the surgeons disagree.
PT is the most important part of rehab for sure. If you slack on that the problems will persist longer. I give a ton of credit to my knees doing as well as they are, to Iriponsnow for an awesome PT regiment.
to follow up on this thread I had surgery sept 29/ 2020, so it took almost 9 months in the Canadian system to get surgery during which I could mtn bike but it hurt, so I ended up skipped a ski season, 9 months of not being an idiot to let the surgery heal up and then nothing was firing well the next ski season, I would check in with the PT once month but really it was all bout me getting my ass to the gym so 120 days on the weights
PT said its gona be 3 full years to recover and it was 2.5 yrs post surgery before I could ski rough groomers without pain and i could say to myself " OK this has worked and i can still ski " I think maybe a lot of people go back too soon and wreck the surgery, personaly I was a very good boy so didnt fuck anything up and I would say its now really good but still needs to get stronger
The thing about letting an ACL heal itself is you don't know if its gona heal, you don't know if you will ski again in fact you don't know SFA so I would opt for the surgery
As for a brace the surgeon ( skier who had his acl done ) said " if I did this right you shouldn't need a brace " so I never got one,
"Reviewing scans from the first 80 patients for the new study, Filbay and her colleagues noted healing — which they defined as MRI signals indicating tissue was bridging the torn edges — in 90 percent of the knees. None were fully healed, according to a standard, 4-point scale of ACL health, which scores a total tear of the tissue as a zero. But 50 percent now qualified as grade 1 injuries, showing some entwining of the torn ends, 40 percent achieved grade 2, and 10 percent were at grade 3, representing a nearly intact ACL."Quote:
Originally Posted by m2711c
I can't say I find that particularly confidence-inspiring, though they are interesting preliminary findings. Needs more follow-up at 6/12/18/24 months since 3 months is pretty short. It does seem plausible that the bracing protocol should be first-line treatment for most ACL tears in people who aren't competitive athletes. If nothing else that will give you a good indication of how compliant patients will be with post-surgical PT if they end up requiring a reconstruction. There's not much point in reconstructing someone's ACL if they're not going to do the post-op PT.
Anecdotally, I've had a ruptured tendon heal spontaneously. I ruptured the EPL tendon in my thumb skiing. Saw a hand ortho who confirmed a full rupture ("Well, that thing's completely gone"). He recommended not operating since I still had shockingly good function. Over the next 6-12 months I was amazed to see it grow back on its own. However, it's not as thick and tight as the EPL on my other hand so there may be limitations to this approach.
Timeline sounds really odd to me...did you have a lot of other damage? 3x ACL reconstruction for me, six months is the longest it's ever taken me to be back to skiing, and it was probably a week or two (at the outside) after the six months before I was skiing again at essentially 100% of pre-injury (and while the second two injuries were almost entirely just the ligament and some meniscus damage, the first one featured some other nastiness--shattered condyles and such). I really thought that 6-9 months of solid PT was the accepted amount of time before return to activity--I've heard that it can be a year+ before the new ligament returns to what might be considered full strength, but my surgeons/PT's never made me wait that long.Quote:
Originally Posted by XXX-er
I only really wore a brace following the first reconstruction, for maybe a few months. It sucked and I don't think helped me at all--received a better brace after the third one, it sucked a little less but I ditched that one too pretty quickly. The fact that neither brace worked well with the top of my ski boot certainly didn't help, but I'm extremely skeptical that at least for my injuries any brace would have had a meaningful effect (IMO braces might help prevent other kinds of knee injuries but probably don't do much for your ACL--I'm not an ortho and don't even have Holiday Inn credentials, so don't take that as advice or anything, but I do recall reading some expert opinion that questioned effectiveness of braces at helping prevent ACL injury).
The surgeon actualy said from looking at the MRI I have a great knee joint other than the ACL was completely seperated, he said that he used a brace his first year back skiing and he didnt think I would need one
first time skiing at about 15 months was so bad I almost gave up skiing, I wonder if the leg just deteriorated more with all the waiting in the Canadian system and old age doesnt help
You could have worn a brace and kept up with your activity and you wouldn’t have had as much wasting. A friend of mine blew her acl halfway through the season and kept skiing with a brace until the season was over. I know it’s anecdotal but so is every post in this thread.
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I got a friend who blew her knee same time as me, she has had the MRI/ done a consult with the same surgeon so its just a matter of her not being a chicken and booking the surgery , instead she is still ski coaching with a Donjoy brace and she sez it doesnt hurt
So i know this now but i didnt know it then, acess to sports med is not so great up here but also i blew it right at the beginning of Covid lockdown so not only was there was no skiing
there was no nothing
probably the worst possible time to be kacking an ACL,
Sounds like you're in the know so I'll ask my question & hopefully you see this....Quote:
Originally Posted by Dexter Rutecki
Wife blew her ACL and a lateral meniscus tear, what is your opinion on donor vs patella graft? thank you in advance.
There’s a more active acl injury thread.
ACL Class of 2017
https://www.tetongravity.com/forums/...d.php?t=309811
Donjoy makes a lot of clinical-based claims about the support that their fancy braces provide. https://www.djoglobal.com/our-brands/donjoy/acl-bracing
My surgeon, who's done a lot of them, says the vast majority of "repairs" he does are donor grafts, the strongest option by far is patellar tendon bone-to-bone. He used to be the team physician for the San Diego Chargers, FWIW. Hamstring was his #2 option.Quote:
Originally Posted by PowerWhore7
I've had two hamstring autografts and have good outcomes.
My cutter said that pateller autografts have patients reporting more pain the joint after recovery vs. that of a hamstring autograft.
But I just break 'em
PS Annoyingly, every time I type in autograft I have to override the damn phone which thinks it knows what I'm trying to say.
Professional sports team doctors pay for the privilege of being a team doctor. Take that as you will.
Bone tendon bone acl grafts have a much smaller cross section than a hamstring autograft or a quad tendon allograft.
All grafts have initial good strength but it’s during the remodeling phase weeks after surgery when they are weakest and most vulnerable.
There is some weakness reported after hamstring autograph but there is evidence that hamstrings regenerate.
Most pain from patellar tendon autograph is associated with the donor sites on the patella and tibial tuberosity.
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Wife is 45 and prehabing now, she has minimal symptoms now but there is enough laxity that she's gonna need the surgery. Well regarded female Ortho here who does a to of women athletes recommends Quad tendon , her reasoning is that the retear rate is lower than donor graft, she can get a bigger stronger graft than a hammy, and that possible hammy weakness post op is more problematic than the quad b/c quad dominance and weak hamstrings are a contributor to ACL injuries.Quote:
Originally Posted by PowerWhore7
She also said for high level younger athletes she recommends the bone to bone patellar graft bc it's the absolute strongest one, but that it has significantly more annoying symptoms going forward (pain squatting on knee, kneecap pain, etc)
Duff, That’s a good run down. Funny how quickly this all evolves. A decade or 2 ago, seemed like donor grafts were the popular option because they were the ones perceived to be stronger.
The quad theory makes sense. First I’ve heard of that option though.
My impression is all the grafts have pros and cons, and a successful reconstruction can be done many different ways. Best bet is to find a surgeon with a good track record and discuss why they pick the method they prefer to use.Quote:
Originally Posted by mcski
The biggest advantage to a donor graft that I can see is no residual compromise in the strength of the hamstring or quad. I had hammy and for me it is noticeable. It doesn't affect anything I do, but it's still noticeable. If I did it again I would consider donor for that reason, even if it means greater risk of failure in later years.
One thing I am very grateful for is no lingering pain or arthritis, as seems to be more common with the patellar graft. I absolutely did not want to risk knee arthritis.