If you've torn one, will you tear the other?

[orangey]

My PT told me that if you've torn one ACL, chances were good that you'd tear the other due to structural and mechanical issues that were present in both knees, especially for women. Any truth to this or vicious rumor?

[drmark]

The rumor is not a rumor. It is a fact.
It can be modified by a neuromuscular reeducation program.

[seldon]

neuromuscular reeducation program.

Do they shine bright lights in your face for days on end and make you confess to crimes you didn't commit?

[Stymie]

I tore both.

[khakis]

my experience and casual observations suggest that if you've torn one you will tear the same one at least once more

[Young Yeezy]

My doctor (who works with the MN Vikings and Wild) told me that... Then I tore my second the next year... I've worn two knee braces ever since.

[orangey]

Okay, I'll bite. Would this reeducation program involve anything different than gaining even and appropriate strength in the knee's supporting muslces? My hammies are and have always been strong and flexible while the quads aren't what they used to be. If I get my quads back, will my reeducation be complete? Or, should I just do something crazy to tear the other one and get it over with?

[Vinman]

It is not all that different. But it does involve more than just strength training. It will include balance/proprioception, plyometrics, instruction in proper jumping and landing mechanics.

I do some team training, especially with female high school athletes. I teach them how to jump and land to reduce the stress on the knee joint, improve their balance, improve how they recover from unexpected positions and address any strenght imbalance I see. The last part includes hamstring, core strenght as well the hip strenght.

[orangey]

I tore my ACL jumping and intend to continue jumping so I probably need to learn how to jump. Can I do this on my own or should I seek professional help. I did the PT thing and don't want to revisit. Will a certified personal trainer/certified athletic trainer do the trick?

[Vinman]

It all depends on who you go to see but I would say a certified athletic trainer or a physical therapist. Tyr to find one that specifically does ACL prevention/ neuromusc. re-ed... etc

[Dexter Rutecki]

If my experience means anything you tear one, then you tear the other, then you tear the first one again...I hope that's where it ends.

[Vinman]

as with anything in life there are no gaureentees (sp?). But there is an incr. risk of having a second tear if you've already done one.

I've had 2 ACLR on the L knee.

[FreakofSnow]

Yes...it just is a matter of how much time will be b/t the two.

[Woodlandclown]

doh! why do I keep opening this thread??!

[cold_smoke]

I just confirmed the theory...

And proprer quad to hamstring strengh does play a major role. If one is considerably stronger then the other chances of an ACL tear increase significantly. Quad stronger then hamsting is probably worse then the other way around however.

[Sinecure]

I tore my right one in 1986 at Jackson Hole and my left one in 1987 in Flaine, France.

Now I ride/ski with two knee braces and try to do some pre-season exercise.

[Mofro261]

1-R
6y
1-L
12y
2-L
1y
3-L

[Toadman]

I was trying to think of someone I know who had torn an ACL that then didn't end up tearing the other one. So far, I only know one individual who didn't tear the other one. Mostly because they did specialized therapy and toned down their activity.

What kind of hammy exercises would you recommend? Dead lifts? That's about all I do for my hammys these days.

[drmark]

Nowadays, good docs put thier post op ACL patients, and teenage school athletes on a program of neuromuscular retraining such as to prevent a second injury to the same or opposite knee.

After such a program is completed, then the chances of another injury (on what ever side) are greatly diminished.

[Vinman]

I just confirmed the theory...

And proprer quad to hamstring strengh does play a major role. If one is considerably stronger then the other chances of an ACL tear increase significantly. Quad stronger then hamsting is probably worse then the other way around however.

your quads will always be stronger than your hams and it should be that way. The hams should be about 65-75% as strong as your quads.

The problem comes when someone is quad dominant, meaning they have either very weak hams or they have a hard time recruiting them properly during dynamic activity.

[Vinman]

I was trying to think of someone I know who had torn an ACL that then didn't end up tearing the other one. So far, I only know one individual who didn't tear the other one. Mostly because they did specialized therapy and toned down their activity.

What kind of hammy exercises would you recommend? Dead lifts? That's about all I do for my hammys these days.

In no particular order

squats
lunges
dead lift
russian hamstring
hamstring bridges
hamstring curls
balance squats/etc on discs/bosu

Out of all of those the hamstring curl is prolly the least useful.

[cold_smoke]

your quads will always be stronger than your hams and it should be that way. The hams should be about 65-75% as strong as your quads.

The problem comes when someone is quad dominant, meaning they have either very weak hams or they have a hard time recruiting them properly during dynamic activity.

Thanks for the clarification. I had much more quad strength when I was younger as compared to hamstring (I guess as compared with 'normal' ratios) after Cybex CT2000? testing (basically 20 quad extension/hamstring curls as fast and powerful as possible) and was directed to strengthen my hamstrings which I focused on. I think I may physiologically be quad dependent which lead to my ACL tears.

While we are on the subject...tore my other one about a month ago and I have been in the gym getting strong. Between gaining confidence and the strength I have gained, my skiing went from super conscious and low confidence in the knee to feeling pretty solid and not noticable in most cases. Anyway Vinman or anyone...Do you have any advice on exercises I should be doing and those I should shy away from. My doc said the hammy is the main stabilizer that accounts for the lost ACL so I have been doing a lot of hammy exercises as well as lots of overall leg exercises. Low weight, high reps one leg at a time for the most part. Any advice on what to do as well as a brief description would be greatly appreciated...things like russian hamstring seem extremely burly bu mean nothing to me ... More importantly I am curious to know any specific machines/exercises that are no bueno to do sans ACL....

Oh yeah and any further info (or link) to 'neuromuscular retraining' would be greatly appreciated.

[GoNads]

Did both my ACL's 2 years apart from eachother. Been fine so far... but I think they're both stretched beyond functionality, seeing as any GP who tests them thinks they don't exist.