Wasatch 24/25-Stoke, Conditions, and general debauchary

[Shaaarrrp]

I may be misunderstanding you, but it seems like youre saying the ACL is isolated system only affected by what the lower and upper leg does and is not affected by how the entire body is positioned or what its doing. The function of holding the lower leg to the upper is an important part of a much larger chain designed to support our entire being. Its orientation in space, connection to other muscles, amount of work required of it, and how energy is exerted, held or absorbed will inherently change as we introduce varied degrees of movement and forces in different directions. A simple way to feel this is to flex your toes upward; you will feel the tension in your knee because it's hugely affected by how the foot is oriented. If you push it down, the knee is serving a very different specific function and will be pressured in a different manner. If you twist your leg it's yet another plane of energy a knee is being tested. https://chatgpt.com/share/6868a37d-b...f-dac488968f56

[Shaaarrrp]

Absolutely — here's the updated, concise forum-style post including the ankle-related muscles and how they tie into ACL injury risk:??????? Preventing ACL Injuries in Skiing – Key Muscle Weaknesses to WatchACL injuries often happen when the body can’t properly control force, rotation, or alignment — especially in high-speed sports like skiing. Weakness or tightness in the following muscles can seriously increase your risk:?????? Glutes (Gluteus Medius & Maximus)Control hip and knee alignment. Weak glutes = knees collapsing inward (valgus), a major ACL risk factor.?????? Hamstrings (Biceps Femoris, Semitendinosus, Semimembranosus)Help stabilize the tibia and counteract quad force. Weak hamstrings = more forward tibial movement = more ACL strain.?????? Core (Transverse Abdominis, Obliques, Multifidus)Poor core stability throws off body alignment, increasing stress on the knees during turns or landings.?????? Quadriceps (esp. Vastus Medialis Oblique – VMO)Needed for knee control, but imbalances (strong outer quad, weak VMO) can destabilize the joint.?????? Calves (Gastrocnemius & Soleus)Assist with shock absorption and dynamic balance. Weak calves = more force transferred to the knee.?????? Ankle Stabilizers & MobilizersMuscles:Peroneals – lateral stabilityTibialis Posterior – medial arch supportTibialis Anterior – ankle dorsiflexionFlexor Hallucis Longus / Flexor Digitorum Longus – stability on uneven terrainWhy it matters:Weak or stiff ankles (especially poor dorsiflexion) force poor mechanics up the chain — leading to knee valgus, rotation, and ACL stress.?????? Highest Risk Combo:Weak glutes + hamstrings + core + ankle instability = high chance of ACL injury under load or fatigue.? Prevention Tips:Train single-leg glute/hamstring strengthStrengthen ankle stabilizers and improve dorsiflexionWork on landing control and proprioceptionBalance quad/hamstring strengthPrioritize mobility + strength throughout the chainStay strong, mobile, and in control — your ACL depends on it.

[EWG]

I’m not sure landing flat from 40 feet in ski boots and tearing an ACL had much to do with ankles in this particular case.

MRI seems to indicate a partial ACL tear. So that’s why the first doc wants to see how it heals. He’s able to do anything linear right now no problem and no pain. But anything serious and sideways hurts pretty bad. First doc thinks thats the bone bruise. Wants to let it heal and see if it tightens up - thinks swelling is making it loose.

Cooley looked at the MRI but mostly checked stability. It’s been two months. Knee is loose. That was enough for him plus at least partial tear showing up on MRI. I think everyone is starting to accept that he needs it put back together.

[Shaaarrrp]

I think that makes sense. But the effectiveness and speed of any recovery/rehab will certainly be affected by the ability of a patient to retrain the ACL's connection to the ankle/glutes and other muscles which it relies on to function properly. And the amount of energy being transmitted in the body is absolutely affected by the bodies ability to carry oxygen in all the ways we ask the body part to move (which is much more complex than generally described). An example would be that you might use your knee joint for the following action (this is just a small part of a massive list) Pushing down to stay straight Pushing down to lean back Pushing down to lean forward Pushing forward pulling with the foot relaxed pulling while pushing the foot down pushing + pulling with ankle extended pushing + pulling with ankle flexed Literally every single one of these actions requires a different expression of the ACL or connecting muscles and how it handles force. In my body I have found that each needs to be specifically focused on.

[Shaaarrrp]

Another thing that can happen is that when one part of the body is injured, it forces connecting ones to pick up the load. These could be muscles that need to be relaxed for whatever got injured to handle force freely. And if we never give those muscles that used to relax the chance to relearn how to do it, injuries will keep occurring in whatever needs it.

[Shaaarrrp]

AI so take it fwiw:The knee joint is designed primarily for flexion (bending) and extension (straightening) movements, acting like a hinge. Lateral (side-to-side) motions, such as abduction and adduction, are limited in the knee, especially when it is extended. While the ACL is a crucial ligament for preventing excessive forward movement of the tibia (shinbone) relative to the femur (thigh bone) and controlling rotational stability, it doesn't directly cause sideways movement. Instead, the muscles around the knee joint work to control and limit these sideways movements. The gluteus medius, a hip muscle, is particularly important in resisting excessive knee valgus (knock-kneed position), which is a common mechanism for ACL injuries. It does this by acting as a hip abductor and controlling movements that could put stress on the ACL. Other muscles like the hamstrings also contribute to knee stability during activities that involve sideways motion. In summary, the primary role of muscles in relation to sideways knee movement is to control and stabilize the joint, preventing excessive or potentially harmful movements that could strain the ACL.

[Dantheman]

Cooley looked at the MRI but mostly checked stability. It’s been two months. Knee is loose. That was enough for him plus at least partial tear showing up on MRI. I think everyone is starting to accept that he needs it put back together.

This would clinch it for me. MRIs aren't perfect and palpable instability is a problem. I once heard the legendary sports medicine doc Andy Pruitt make the case that, for these kinds of injuries, a physical exam by a trained practitioner should be considered just as if not more diagnostic than imaging. The MRI is for the patient so the doc can put a picture up on a monitor and say, "Yep, there's the tear."

[Shaaarrrp]

If medical professionals fully understood the human body, why are injuries like torn rotator cuffs and resultant surgeries like Tommy John, increasing in performance sports?
Why is life expectancy and overall well being decreasing in society?

[Shaaarrrp]

I just experienced what to me is a clear example of how body parts very far from what you think is being worked are highly important in what is actually happening.I used to play very competitive soccer. Recently I have gotten back into it and am working on regaining the strength in kicks and shots.Today I was really going at it, kicking the ball as hard as I could in succession.To some people, all they see is my knee articulating to create speed.After a particularly hard kick with my right foot/leg, I felt strain in my left foot. This is because the way to generate maximum power with my right knee/entire chain is to create as much stability as possible with the left foot that is supporting the entire thing. And that's not even accounting for what I am doing with my ankle flexion in the kicking leg to increase power. Because of this feeling, I stopped playing for the day. Because in order for my right leg to improve at its fully dynamic potential, my left foot requires rest to repair and strengthen itself.

[Dantheman]

If medical professionals fully understood the human body, why are injuries like torn rotator cuffs and resultant surgeries like Tommy John, increasing in performance sports?

Why is life expectancy and overall well being decreasing in society?

I never said medicine fully understands the human body. But, a physical exam to diagnose an ACL tear or similar hardly requires fully understanding the entire human body. Also, I can think of a lot of reasons why sports injuries and orthopedic surgeries would be increasing that are completely independent of medical knowledge or even the result of improved medical knowledge.

Overall well being is not really the purview of medical professionals.

Life expectancy at birth in the United States is declining because people die young from poverty-related infant mortality, gun violence, and drug overdoses. If you live to 65 life expectancy in the US is the highest in the world.

[altacoup]

Sharp, your arguments simply aren’t valid regarding an ACL tear and wanting to return to high level skiing. I tore my ACL going 40’ to a flatish landing in low light. Complete tear. Very little pain as the nerves were totally severed from the impact. I had great stability even after a complete tear. Had I opted to not have surgery I would’ve done much further damage to my knee by continuing to ski at a high level. The ACL is crucial for dynamic athletic movements. TFW’s son Jonny is as fit as it gets and has had 4 surgeries. Shit happens when you’re really going for it, no matter how dialed you are physically and no matter how much breath work you do. While breath with is greatly beneficial to health it can’t stop the physics of motion that occur in a high impact situation. Without an ACL it’s simply impossible to ski at a very high level. Your chances of not making a turn and injuring yourself worse than an ACL tear or dying are greatly increased without on ACL. I’ll take tearing an ACL over missing a turn and going over a cliff or into a tree or rocks at high speed any day. These days the surgery is so dialed and if a patient puts in the time doing PT, which can include breath work, they chances of a full recovery and return to high level skiing are very high.

[Yukonrider]

Looks like things are back in order here?

For the bird folks who don't check their email bird just extended their early bird pass deal (including freeloader and free shoulder season night at Cliffs) until Sept 24th.

I will have a freeloader pass if someone would like to purchase it.

[Shaaarrrp]

Thank you for sharing your thoughts and experiences. I will use it to reanalyze my beliefs. I understand and accept the portrayal of physical examination of a tear but I cannot accept that any repair of the body which is attempting to create future dynamic movement can be comprehensive without fully considering the entire chain and not only repair the injured area, but consciously spend time reteaching the body parts which are involved in movements, even if far away from the injured area.I understand the ACL is crucial for movements. But I do not agree that it is an isolated system which can be analyzed in a vacuum. The body will always compensate and if you keep pushing it, the body part which felt fine will eventually have to work hard and break down, sometimes in no way because the body part is injured, but because something else lost its ability.Yesterdays soccer session is now being felt in my lower leg and leg pinkie toe. If I had kept going at it, I see no way my right ACL wouldn't have felt the need to compensate and overwork itself because my left foot lost its ability to be full in the chain.

[Shaaarrrp]

Just to throw it out there, I believe that always wearing a tough guy label and pushing thru pain without being willing to rest, can be destructive to our bodies.

[efbride]

Lost my ACL to a snowboarder completely slamming me broadside on 1/1/2000. Waited a year to repair cause of insurance not allowing second opinions. Got fixed. Did lotsa rehab and it still works. Don’t like stiff alpine boots, would rather ride comfy tele boots. Been dropped a knee since early 80’s and still my weapon of choice. But if you run with a young kid crowd, you gotta lock um down. As we get older, wisdom tells us what we can and can’t do. Healthy is good. Chasing our kids is good. Live for the next adventure and enjoy the ride. Bumps happen, so we adjust and keep chasing !

[telefreewasatch]

Got one guy recommending no surgery, another one (Cooley - US Ski Team and Collinsons doc) saying for the level of free skiing he s doing he needs to get it cut. Third opinion on Tuesday. Surgery Wednesday by Cooley unless minds are changed. Thanks for all the suggestions. Lost seasons suck.

Well?
Inquiring minds want to know...

[EWG]

Well? Inquiring minds want to know...

He decided it just wasnt stable. Cancelled the third opinion appointment. Wrote a big check to the facility today, will be there to get sliced tomrrow by Cooley at 7:45 am. The reality of a lost season is starting to hit and its tough to watch. Hes super posisitive and super motivated though so itll be all good once he gets on the other side, I hope.

His goal is to heal fast enough and strong enough to attend the Frank on skis in April, even if hes just tooling around. 9.5 months. We shall see.

Wish us luck. Hes a great guy and truly one of the best skiers in that canyon. In the 5 seasons he's been there hes gone from really good to breathtaking. Skiing with him at that mountain is bizarre - the deference and respect he gets from all these hot shit young guns is wild (and then they look at me and try to figure out why HE is sking with this old guy - I guess Im old to a 20 something haha.) Hilarious.

I am, quite frankly, terrified of the idea he might not get it back. I will do everything I can to help him. I know you've been down this exact road Telefree - only for your guy it is also his profession. Makes it even tougher. Sorry you had to feel all this stuff Im feeling. Thanks for letting me vent, and wish us luck.

And truly, toi all of you - thanks for all the help. Tough enough when its you going under the knife. Even tougher when its your kid and its impacting their favorite thing in the whole world, and something that they are great at.

[telefreewasatch]

That kid has a great dad.
Know that. I think he does...
Patience is a virtue, practice it if you can. Found seldom in a woman and never in a man.

[efbride]

Our kids keep us young. They also scare the shit out of us cause their shenanigans are so much bigger. It’s a beautiful day and I’m not gonna let it slip away.

[EWG]

All done. Successful straight forward surgery we are told. He just had to do the ACL, nothing else was an issue. Everything looked great he said. Now comes the fun part.

Thanks again for everything Mags.

[muted reborn]

If it was a straightforward surgery there's no reason he can't be back to 100% or nearly 100%. I wouldn't worry to much.

[telefreewasatch]

Agree.
No miniscus damage is huge...
Whew!

[Dantheman]

Agreed, the future is bright, even if he doesn't do any breath work

[Shaaarrrp]

You and your son are in my prayers, EWG.

[Trackhead]

EWG,

Best wishes for your son. He’ll recover fine, I’m sure. And soon “this too shall pass”.