Busted ACL question

[Mrs Roo]

To all of you who are skiing again despite a busted ACL I have a question (or several).

A friend of mine tore hers this year in Morzine. I've been talking to her about coming skiing with us next year but she seems to think that her skiing days are over. I think that is often the attitude in England.

Those of you who are back skiing, how long did it take? What did you have to do to get back? Do you ski in a knee brace? How does it feel now when you ski? Has it made you more apprehensive?

BTW she's doing really well with her rehab but they are still undecided whether or not to reconstruct it.

Cheers!!

[basom]

from what i understand from my doctor, people forgo the surgry and still ski. i dont think you'll find many people reccomend this. she would absolutely need a brace. if she skies novice terrain and doesnt crash there is little chance she would further injure the knee.

[altagirl]

If you ski without reconstructing it, you risk further damage, so her first step would be to get it fixed.

I had mine reconstructed several years ago via hamstring graft. My doctor was pretty conservative and insisted that I wait a year before skiing again - I think I would have debated this, but I had my surgery in late October, so by the time my knee was feeling strong enough for me to really think I could ski the season was over. But it did turn out well with the extra waiting - it felt fine when I did get back to skiing. I was pretty cautious the first couple days, but by mid-way through that first season back, I was skiing better than I ever had before. (I was skiing a lot more than I ever had before too, so that helped...)

I did end up tearing my meniscus last spring, which required a MUCH easier surgery, and after that I do now wear a knee brace for skiing (Donjoy Defiance). It's comfortable and I generally don't notice it at all when I'm skiing (or telemarking).

Anyway, there's no reason you can't get back to skiing after a reconstruction. It does take a little time to get your confidence back, but it does come back. And while she probably won't feel like her knee is totally perfect ever again, it can definitely be good enough to get back to doing whatever she wants to do. I feel a few twinges and get a little stiffness or soreness after an exceptionally hard day - but it's never even anything worth taking a pain killer over. I can't complain.

edit: guess I'm one of those people who don't recommend skiing on no ACL. I had to wait about 6 months to get mine properly diagnosed (so I kept skiing on it, which would be fine some days and it would collapse other days). By the time I had the surgery my knee would collapse from the pivoting motion of just walking around a corner carrying something. Not good. I say get it fixed unless you're going to severely limit your activities.

[StormRider]

I blew mine in January ’93 and had it reconstructed within a few days. I made a couple runs that March but they were on East Coast groomers. I was cleared for full activity after 6 months. By next winter I was good to go. I used a brace for most of the season even though the doc said I only needed it to one year after the surgery date. It never bothered me until I partially tore the MCL of the same knee in ‘03
Post op Rehab is the key. If she sticks to her rehab schedule she should be OK to resume her regular life.
I think foregoing surgery is just setting yourself up for more problems down the line.

[lph]

Originally posted by basom
from what i understand from my doctor, people forgo the surgry and still ski. i dont think you'll find many people reccomend this. she would absolutely need a brace. if she skies novice terrain and doesnt crash there is little chance she would further injure the knee.

I think that is mostly correct.

There are some really good knee surgeons in this country who will only do an acl reconstructions on people over 35 if they can prove they need the acl and they will do the rehab. obviously, everyone on this board would fit this category, regardless of age.

there are certainly different degrees of instability of the knee after a complete tear, some people have very little change in stability and will never have their knee 'give out'. others will have a very unstable knee. The hamstring muscles can certainly help provide stability to a knee that has a complete acl tear. that in conjuction with a brace and the OK from the doc, should allow her to ski mellow terrain at slow speeds.

having a terribly unstable knee predisposes you to further cartilage and meniscus damage and premature arthritis (not a good thing). However, I have seen young people who have an ACL recon and still gone on to develop horrible premature arthritis. This is probably due to the damage done to the cartilage at the time of initial injury.

It is alot to consider, especially if her mindset is ' i won't ski again' but certainly roo can testify to the many people on this board who have had an acl and come back to ski again and again and again.... you get the point.

[natty dread]

Originally posted by Mrs Roo
I've been talking to her about coming skiing with us next year but she seems to think that her skiing days are over. I think that is often the attitude in England.
BTW she's doing really well with her rehab but they are still undecided whether or not to reconstruct it.

Show your friend some pics of altachic skiing this year. That and tell her about the time ac hit 70 mph. And she did both her ACL and MCL last year.

[Theodore]

I went skiing about 2 years after my surgery to repair complete ACL, LCL and hamsrting tears. I always wear a brace and I'm doing just fine. My repaired knee actually feels sturdier than my OEM knee. I was a bit apprehensive at first, but now I'm more worried about my 'good' knee than my 'bad' one. Make sure she gets the surgery, does ALOT of therapy and just keep the muscles that support the knee strong.

Ted

[Mrs Roo]

Thank you all for your feedback. I've shown this to my friend and she also appreciates your info.

That's why I love this board

[Big E]

Keep up the PT religiously, don't try to do stuff too soon, and she'll be fine. I did my right knee about 5 years ago, and was back on skis the next season (surgery in February, skiing in December). It has never really bothered me and in fact I ski much harder (and better) now than when I hurt it.

Course, I did my other, previously-good knee this past December and had surgery the end of January. Coming along well so far.

No ACL almost guarantees the onset of arthritis, since the biomechanics change slightly and end up wearing away the meniscus.

[powderboy]

I'd have to agree with what everyone has said... if you stick to rehab, you'll be back out skiing in 6 months.

I tore mine in March 97 and was back out skiing in November 97 with a brace. I skied the entier 97-98 season with a brace and didn't mind it at all. After a season of 60+ ski days that year, I'd have to say my knee was as good as new.

I haven't used a brace since that first season back and I don't think about it much. I'm still a bit cautious when skiing crusted windpack (which is what did me in), but other than that, I'm just fine.

Get it fixed, keep up the rehab and go out and ski.

[nancie2k]

i totally tore my acl 8 or 9 years ago-did not ski for one year,did not have the surgery,just did physical therapy for a while then did my own exercising. i have been skiing since just wearing a brace i got out of a ski catalog. i use ankle weights and work out pretty regularly. i have skied 68 days this year, mostly killington, and 8 days in utah. no pain, no scar.
i love to ski!!!!!

[basom]

just a few questions here nancie. do you ski bumps? do you ski fast? did you take any falls this season? or are you super careful not to fall? any swelling recurrance?

[nancie2k]

i am learning to ski the bumps better- i tore the acl in snowbird on a bump run
i AM a bit careful, but there is nothing like letting it go on a great run

no pain, no swelling.
sometimes i wonder if i really did tear it, but i had the mri done that many years ago.
and, yes, i do fall!!!!
(but not too often)

[basom]

Originally posted by nancie2k

sometimes i wonder if i really did tear it, but i had the mri done that many years ago.

from what i understand they can be inconclusive. its great you have been fairly unaffected if it is gone or even torn.

[lph]

Originally posted by basom
from what i understand they can be inconclusive. its great you have been fairly unaffected if it is gone or even torn.

If the MRI shows a 'Complete Tear' then it is almost definitely a complete tear or very close to a complete.

Occasionally, an MRI will show an ACL injury, and in these cases the ACL may actually be completely torn.

Obviously, it is also dependent on whom is reading the MRI.

nancie, shows that you can live without an ACL and ski. Nevertheless, I would have the surgery if it were me.

[basom]

i'm me and i'm having the sugery. trying to avoid degenerative knee thingy at all costs.

[nancie2k]

that first year skiing after injury was very tentative-i figured if i hurt myself again then i would submit to the knife. but here i am years later,skiing happily with no pain.
i would not give up on my muscle building exercises,tho.
i think that is what keeps me okay.
just got back from riding my bicycle!!!!

[nancie2k]

best of luck on your surgery,by the way!

my girlfriend tore all 3 ligaments and the meniscus on a fall on a cruisin blue. she had the surgery and is skiing fine now.
just make sure you do the rehab work

[Mrs Roo]

It's my friend who's hurt her knee but I'll send your wishes on to her. She's got a good PT and is working really hard with her rehab. The only thing is in England it can take an age to get the surgery done and they haven'y decided if they are going to do it.

Goddamitt we both work for the health service so I think we should start leaning on a few folk.....having a few words in the right ears.....giving the odd cheeky back hander......mailing a few dodgey photos...sending the boys round...nudge, nudge, wink, wink. Raise a glass to free National Health!

[maddog]

I tore my right acl in 1978 and never had it repaired. I've been skiing ever since, but do get sore and swollen after a hard day. Rest, ice and asprin are my good friends. Tore the left one in 1999 and had it repaired via hamstring graft. I sat out one season and now it works pretty good. Lots of swimming and bike riding help keep to keep the muscles strong and the joints loose. I don't wear a brace because the one I had for my left knee kept smacking into my right knee causing bruising and such. I recommend the surgery and hard rehab work. Remember... Pain is part of the fun of growing up - - and life just gets more and more fun!