This is a thread that will hopefully help a few people who might well end up doing their ACL this coming season. By far the greatest % of ACl injuries happen to beginners, for me it was just tough luck.
After you've done one, you end up trawling the Internet to find out as much information as possible, some of it really freaks you out, some of it is typical US type bull, and in between it all are some good nuggets of helpful information.
By far some of the best help comes by way of mouth, or in my case email.
So I thought I'd highlight what I've done to date, in that I'm now as I commence this thread six weeks post operation and it's going to be touch and go whether I make it back on skis this year, as recovery can be anything from six to nine months after the operation - and as you get older so things take longer to heal.
I know I'm not the only one on here who has done an ACL and hopefully they too can add to this thread their own experience.
You know when you've done an ACL but the sickening noises / pops that come from your knee and in the instant pain. Usually it's when your ski does not come off and your leg rotates pass a given point as the ski digs in the snow and the momentum of your body twists your leg, it's then that the ACL that holds your chin bone and thigh bone together breaks under the pressure.
And the reason why ACL injuries are so bad is that it does not heal again once broken / ruptured - the only way is surgery to "make" a new one!
Now top pro athletes and the like, when they do their ACL's are quite often operated upon immediately and then they undergo intense physio on an hourly basis as money and resources is not an issue, however for the majority the time from the accident to the being back on skis can be long.
It can be easier if you have private health insurance, but if you're on the NHS (like me) it can be a bit of a nightmare, that said I have a few pointers to help you!
Now some people can carry on without an ACL and can ski, in fact I met a BA pilot recently who lives in Chamonix who manages to run and ski without one, but he knows he might be doing long term damage to his knee.
Six weeks after doing my ACL I was back on the bike cycling without any pain, and I carried on racking up substantial 160km rides - there was some logic to this - however windsurfing was out as I could not twist my leg without it giving way - so without the operation skiing and windsurfing and any aggressive sports would be a NO NO.
Plus it's quite common when doing your ACL that you also trash other elements of the knee such as the meniscus and in some cases the MCL.
So to it.....
As a few on here may know I did my ACl back in March - the 22nd to be precise!
As a point of interest, the heli was at no cost - as when away from the pistes it's like here in the UK, in that it is treated as Mountain rescue and you are not charged.
The heli flew me the ten minutes or so back down the valley landing on the helipad atop Briancon Hospital. From there I was stretchered off and down into A&E. I had all the right cards and docs (E111 & Insurance details) with me so they could see I was covered. Then had a wait while a skier was brought in after me but was in a much worse condition after a collision on the piste..
Eventually I was taken up to X-ray and then the Doctor had a quick look only to advise me of what I'd already diagnosed that I'd broken various crucial ligaments and that I'd eventually need surgery.
The only way to confirm a ACL rupture is by an MRI scan, and normally you have to wait at least 15 days for the trauma to recede before an MRI scan to see what has actually happened in the knee.
I had to wait longer as I was still out in France for another three weeks.
Once back in the UK, as I mentioned I do not have private health care insurance so I was facing going down the NHS route and I knew that would take a fair number of months.
To leap frog the system as it were, I suggested to my GP that I pay for an MRI, to do that he had to refer me, he thought that was a good move saving at least a couple of months as the NHS process would be, GP referral to Muscular Skeletal (3 or 4 weeks), who would then see me, only to refer me to Orthopaedics (3 or 4 weeks) who would then say I need an MRI (another 3 or 4 weeks).
Vista Diagnostics in London charge £200 to £300 depending on how flexible you are, the Radiologists report is then sent to your referring GP though you get a copy of the disc with 144 images of your knee!
GP then four days after rang me up to tell me the results, I then had to go and see him and we decided that I would pay to go to see the knee consultant, again jumping the system as it were.
I went (privately) to see top knee guru James Lewis (who just happens to practice 3km from where I live at Goring Hall Hospital) and he confirmed that I had torn both by ACL and Meniscus as well as the posterior aspect of the tibia stretching across the tibia from medial to lateral, almost what is known at the Unhappy Triad.
I happened to know that James Lewis* also does NHS operations, so in my discussion with him I asked if it was possible to go NHS as I didn't relish the prospect of shelling out some £5K to have it done privately.
He said he'd write to the relevant person at the hospital to organise that - he then mentioned to me that the relevant person was actually himself!
Timetable to date was
22nd March - accident
10th April - arrive back in UK
14th April - see GP for MRI referral
20th April - MRI in London
4th May - GP to discuss MRI & referral to Consultant
12th May - meet with Consultant to confirm injury
28th May - confirmation of operation date July 14th Bastille Day!
So reading the above time-scales were pretty good.
However the operation was put back twice and it ended up being September 3rd - those six weeks could well be crucial in my attempt to get back on skis.
Trouble is I suffer from severe white coat tension, in that put me near a blood pressure monitor and it goes through the roof, which it did in my pre surgery assessment, so they had to write to my GP for him to confirm this, hence that was probably the reason the op date was put back, so can't blame the NHS.
In the meantime I had received various emails from people who read my daily blog (I run a big windsurfing / kitesurfing site) who had also done theirs, and some of their advice was great.
I'm not going into the pros and cons of the various ACL surgical procedures - there are two main types advocated - first ( which is what I had) is the hamstring graft, where a sizeable length of hamstring is taken from the same leg through an incision a couple of inches below your knee - if you want to really be put off go to Youtube and do a search for ACL / Hamstring graft operation.
What they do with the hamstring is make a new tendon by folding the graft a few times and then drilling through the front of your chin bone and back of your thigh bone and putting it in place with a couple of screws by drilling into your bones - now you see why the rehab is so long - as it can take 12 weeks or so post op for the graft to take, and in that time you loose strength etc in your legs.
The other method is that of taking a chink off your patella and make a ligament from that - in the States the hamstring is often taken from cadavers, but the body can reject them even after a year evidently.
In advance of the operation prehab is really crucial, in building your legs up to be as strong as possible in advance of the operation. In my case that was miles of cycling. When my operation was postponed I then went back out to the Alps for a weeks cycling, my first ever trip to the Alps in the Summer and we stayed at our friends in La Grave and I cycled all the famous Cols, such as Izoard, Galibier, Alpe D'HUez and Sarenne - more on that http://www.anotherharddayattheoffice.co.uk/lagravecycling.html here
I also bought a brace and a Cryo Cuff which is basically an ice bucket that feeds a knee wrap with cold water to help reduce the swelling.
Day of the OP
The nurse took my blood pressure and again, it was something like 185 over 120 - so again I was worried that they would say it was too high. She said the anaesthetist would come to see me and discus. Once he showed up I was a little more confident that the op would actually happen after we'd discussed things, I did in fact tell him that once I was out the my BP & HR would probably drop like a stone, mind you it was not until I was in the actual theatre (08:45) being given the drugs that I was confident all was about to happen.
When I came to just after Noon I was naturally all over the place, so my memories are not too clear. When they (anaesthetic staff) eventually were happy that I was ok I was wheeled back up to the ward. What was then quite ironic was that all afternoon they were a tad concerned that my BP & HR were too low!!!
As the drugs wore off so the pain came through, I tried to last out, but in the end I had to ask for something to relieve the pain.
The physios came round and showed me how to hobble around on crutches, again all a tad ironic after the last couple of years with my various incidents. Tried to have a pee but was not happening. I sort of told a white lie how I had managed to pee so I could go home, however it was only after I had rung the wife to come and get me did I suss out how stupid that was. The anaesthetic can affect people so they might feel that they want to go but they can't, and yours truly had quaffed a whole load of water, if I did discharge myself I could well be in the situation of having t o go to A&E later on with a full bladder but unable to go!
So when Elaine did turn up (did try calling her) I had to explain so she had to go home and come back later. I eventually made it home at 20:30.
That first night's sleep was good and I was not in too much discomfort. The next day I was surprised at how mobile I was and I even made it to the pub in the evening. The weekend also saw me out and about as well!
In advance of the operation I managed to find on Ebay a Donjoy Post Op knee brace - this is so much better than a normal Velcro splint as you can adjust the angle of flexion and extension, so much easier to sit down. I also bought on Ebay an Donjoy Arctic Flow Knee Cooler and iced my knee three times a day. The other great bit of kit as a pair of baggy MTB cycling shorts (minus the pad) these go over the brace and have loads of pockets for carrying various stuff around the house. Also have my back pack for carrying the ice cooler to and from the kitchen.
In terms of pain I was only taking two coadamol twice a day and the anti inflammatories, after four days I weaned myself of them, though did carry on with the anti inflammatories as the swelling was quite severe.
Pretty well from as soon as being on crutches I was been able to put all my weight through the bad leg, and managed to hobble around ok. I am surprised how mobile I was initially having read various horror stories, though the swelling was quite intense - maybe I over did it a little.
Two Weeks Post OP
Did feel a bit sorry for myself a times thinking was it all worth it as I lay awake at night with my knee feeling uncomfortable, and thinking how people commented "Jeees Gav you've aged" or "You look really tired". But then I put a reality check in place and thought how stupid I was, being as there are people far worse off than I!
I was hobbling round the house without crutches, I did the previous week have some really intense pain around the bottom of my shin and nearly took myself to the Doctor, but after some Googling found out that it was fluids and blood from the swelling that had run down (via gravity) into the bottom of my leg, damn painful when standing up, getting out of bed. So been more of the same using the Cyro Cuff three times a day to reduce the swelling, and doing some light exercises to increase ROM (range of movement).
I had my first Physio session after two weeks which was a wee bit frustrating in that I still had yet to see my consultant so I was none too sure as to what I should exactly be doing as different Doctors determine their own rehab procedures. So she gave me more exercises to do, and measured that I have 80 degrees of flex - so not too bad, but I was none too impressed by the physio rehab procedures
Sept 19th - went back to the hospital to see what I thought would be the surgeon, it was one of his minions who took a brief look and said seems to be healing ok and we'll see you in three months!!!
I then went back to see the NHS physio and again did think that I might be at a disadvantage - having in the past a fair amount of experience with previous injuries so use to various techniques to reduce swelling, increase movement etc etc and with the dear old resources of the NHS this was not going to happen.
So thought about this and came to the conclusion that I should try and see my Consultant by going private to see what he thought of my progress - that could have been an issue as once you've been operated on in the NHS you then can't go outside of it, however I booked the appointment as a follow up to my initial appt with him back in May - so "got" around that!
Saw him Monday (Oct 3rd), and he confirmed that I did need more physio to get the knee more flexible. The dear old NHS resources are just not up to focusing on that type of rehab, which does seem crazy in that they do not follow up on the investment of the operation as it were.
In that week I had two sessions with Sarah Jeremy who James Lewis referred me to who specialises in ACLrehab based at the Esporta gym in Rustington, so clinical rehab along with gym work, which when you think about it is so much better than just seeing a physio is their own clinic.
I've joined join the gym on a monthly basis so I can carry on in my own time the exercises she has given me and use the static bikes as I'm allowed to do loads of cycling, in fact have also upgraded my turbo at home, so now do 20 mins in the morning and evening and 45 mins in the gym mid day.
My real issue was that I could not get full extension of my leg and she explained that was critical as if I'd left if any longer then scar tissue would have built up around the graft and I would have probably have to had surgery to the leg - after two sessions and loads of exercises and within four days we'd sorted it!
So long term is that as I get stronger so she will get me running in the pool doing loads of pool exercises which is meant to be excellent in all round strength and not too damaging on the ligaments and aggravating swelling again, though that will happen for a long time to come.
Then when I'm allowed it will be more resistant work on the machines such as leg presses and curls etc to really strengthen the leg.
My quad is probably 20% down compared to my good leg, what we have to work on this week is the huge chunk of muscle / swelling behind my knee / top of the calf muscle, going to be interesting to see how she can budge that!
So I'll do more updates as and when.
Was up at Edge and Wax yesterday and Scott there who is three weeks post op (though not as serious as ACL) was raving about a great piece of kit that helps the quad post op not waste away, the kneehab - see http://www.neurotechgroup.com/uk/products/kneehab-xp must work as he's planning to be skiing mid December ![url][/url]
Last edited by Poster: A snowHead on Fri 14-10-11 11:10; edited 2 times in total
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Or you can simply got to www.kneeguru.co.uk and read the information posted there by world class expert surgeons and physios (Information Hub) and join in the banter on the Knee Geeks Forum (www.kneeguru.co.uk/KNEEtalk/ )
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Sue as I mentioned, there is a tremendous of US centric bull out there, and knee guru was one of the places where I found most of it, even though it is a co.uk
My thread is there to help UK centric skiers who might find some of the information helpful, re leap frogging the NHS system etc, and who know that the info is from trusted posters, and is relevant to their UK focused predicament - for instance Knee guru posts mention cadeaver grafts, something that is not than common here, especially in the UK.
Weathercam, it is not US centric and the ACL procedures included in the articles posted are written by specialist from the UK as well as North America. The list of surgeons and specialist Knee Clinics covers the whole world and is peer reviewed, not pay for placement.The very detailed rehab protocol for preparing for and recovering from ACL injuries/ops was written by the Senior Physiotherapist at the Droitwich Knee Clinic. As it includes video demonstrations of each exercise, it is an invaluable resource for anyone recovering from an ACL reconstruction.
Allografts are used in the UK however not as widely as in Norh America
If you pulled in your neck a wee bit and were not so full of anti American bile, perhaps you would have learnta wee bit more.
On all English speaking forums there is quite often a lot of BS, be it American or other, however that does not prevent you from sorting out the chaff.
Have I merely ruffled your ego a wee bit, by suggesting a more authoritative alternative to one persons personal blog?
Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Samerberg Sue wrote:
Weathercam, ....Have I merely ruffled your ego a wee bit, by suggesting a more authoritative alternative to one persons personal blog?
Quite the reverse, as I was thinking exactly the same when I read your two line little quip (though I didn't state that and let it go) in that you must some how be associated with knee guru to post such a put down after my marathon essay that was only trying to help people on here rather than they too having to wade through hundreds of irrelevant posts
My post was aimed more at the process, such as playing the GP (NHS) vs private card and then my subsequent experience - again think I said as much "I'm not going into the pros and cons of the various ACL surgical procedures".
Others on here who have done their ACL will hopefully add their own experiences / timescales (rather than just be negative).
And I did state at the beginning that "you end up trawling the Internet to find out as much information as possible, some of it really freaks you out, some of it is typical US type bull" so apologies I didn't mention KneeGuu then!
As I do a fair amount of cycling I did find on various cycling forums a few ACL related threads and they were far more helpful in obtaining an insight into recovery / rehab for cycling as opposed to reading threads from obese hamburger munching mid western lard back bottoms who are not exactly biased to doing anything remotely physical in the first place
Hence thought it would be a good idea to have a similar thread for skiers, again sorry for attempting to steal your pedastol
Weathercam, my my I have tweeked a nerve haven't I
No I am not associated with the site other than being a long term user. I find the Cruciates Board an invaluable resource and learnt from the information there and in the Information Hub why my ACL reconstruction rehab was not going to plan. A lot of the information on the Cruciates Board is by skiers, as is the information on the Tibial Plateau fracture section. The point being that each and every ACL injury, reconstruction and rehab is unique to the person concerned. Having a multitude of resources available under one web site, means that mastering the simple search engine, helps you to find blogs and reports on similar cases and injuries
I just do not see the need to re-invent the wheel, unless of course you are holding yourself up as a Knee Guru
Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
No nerves tweaked have enough of those going on at the moment in my quads.......
So what you find useful I found a PITA
I think it was on the these forums that someone mentioned Vista Diagnostics who do MRI's and a reasonable cost - that helped me tremendously at the beginning - rather than going down the private route - so hopefully skiers on here who may have the misfortune to do their ACL might glean some helpful information.
Like you say rehab is going to be different for every one, if someone has not been use to the discipline of "training" prior to the op be it putting the miles in on the bike, running, swimming or any other sport then they might well find the rehab protocol more difficult.
I know at my age, that my body takes a damn site longer to heal, and that's going to be my Achilles as it were - I'm quite happy sitting on a bike, swimming, running but my body might object.
It's a shame you can't see the benefit of passing on your experience to other Snowheads on here rather than merely direct them to yet another forum, which you happen to think is the dogs bollox whilst I happen to think it's populated by people (US centric) who talk bollox
After all it is free
After all it is free
Weathercam, I do pass on my experiences when appropriate and when it is asked for. Whether or not it is of benefit to them only they can say. A number of people here have asked, I just don't make a big song and dance about it!
Those who know me know my knee history as well.
I credit people posting here to be largely capable of sifting through the chaff to find the useful stuff, I don't assume that they are incapable of using a simple search engine or index either!
You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
Samerberg Sue wrote:
Weathercam, my my I have tweeked a nerve haven't I
No I am not associated with the site other than being a long term user. I find the Cruciates Board an invaluable resource and learnt from the information there and in the Information Hub why my ACL reconstruction rehab was not going to plan. A lot of the information on the Cruciates Board is by skiers, as is the information on the Tibial Plateau fracture section. The point being that each and every ACL injury, reconstruction and rehab is unique to the person concerned. Having a multitude of resources available under one web site, means that mastering the simple search engine, helps you to find blogs and reports on similar cases and injuries
I just do not see the need to re-invent the wheel, unless of course you are holding yourself up as a Knee Guru
Thankfully I have no need to go on to a specialist website for knee injuries. But I found his post generally quite useful.
When I have an specific injury I will go on sites like the one you mentioned but I would not bother otherwise.
Ski the Net with snowHeads
Ski the Net with snowHeads
I'm nearly 4 months post op on a left knee acl repair using a hamstring gracilis graft, and a meniscus trim. Sue's right in that everyone's experience is unique and am actually very grateful to her for the support and encouragement she gave me through the Knee Geeks site. It is an incredibly useful resource and whereas there are some US users, the majority of posters I came across were UK based.
I'd like to add something about the NHS experience, as I want to encourage anyone with acl problems to persevere and press for the kind of support I got - and am still getting here. Maybe it helps that I work for the NHS but I'd like to think that the resources are available to anyone who knows how to work the system.
I had my acl accident in the late season bash last year, end of April. I had two MRIs, one at the hospital, one ordered by my GP because I wanted a copy and the hospital wouldn't give me one!. Both led the surgeons to conclude that my acl was gone and there was a probable torn meniscus.
Initially there was reluctance to do a surgical repair. I'm collecting a bus pass next April and the NHS NICE guidelines reckon that outcomes for older people (anyone over 40!) are ambiguous and that most get by without surgery. What I read on KneeGeeks plus a further skiing fall in March this year which led to my breaking a shoulder persuaded me to go the surgery route.
Initially I was offered physio and fortunately we have a very good 3 days a week, hour long acl clinic at my local hospital (Whipps x, Walthamstow, London). This is not unique as there other acl clinics run in East London. Your GP should be able to refer you to any of these so it is unnecessary to pay for private rehab. Before going skiing again last September, the PT referred me for fitting a brace and I asked for and was given the Townsend Rebel. This was OK but I didn't enjoy using it but did so twice more. In January, I slipped on ice while using it at Les Gets and it did not prevent me pulling my hamstring (same knee). It also didn't help when I couldn't complete a turn in March at Tignes and crashed into an icy mogul breaking my shoulder in 3 places. I still can't figure that one but suspect that my leg wasn't working as it should. Anyway, as the 6 hour shoulder op putting in 3 titanium screws to secure the ball and socket meant I would be off for a few months, I had the acl done 2 months after the shoulder. The surgeon agreed after I insisted that I really wanted to continue skiing and that I needed the confidence of a fully functioning knee. My PT also supported that referral - she was crucial in getting me in to see the best surgeon locally - up to then I'd seen a variety of Registrars.
He did a beautiful job, and I walked out at the end of the day. I had 6 puncture holes around the knee as there is nothing to beat arthroscopy to diagnose problems. Contradicting the MRIs, the acl was actually intact but lax to the point of useless. Up to to then I'd thought that the hamstring graft would mean a hole in the crook of my knee. Was surprised that they actually take it from the front. Given the trauma (well described by Weathercam above!), I was also surprised by how easy it was to walk on it. The amount of pre op rehab certainly improves outcomes. Although given crutches, I really didn't them. Rehab subsequently has been relatively straightforward, apart from again slightly pulling my hamstring while putting on socks!
Bruising and swelling for 4-6 weeks is common but I was amazed to see a Chinese woman 2 weeks post op who had neither. She put this down to taking Arnica which is known to aid healing and reduce bruising.
Looking head, I hope to be fit enough to ski again come Feb / March, Having had two major falls I'm not in any hurry, but equally haven't been put off. The shoulder op was far worse than the knee and rehab on this to regain full functioning will take longer. My PT says it will be a year before the knee feels normal again. The shoulder probably two!
snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
Bust my right ACL (+ grade 2 MCL) in Jan. Lucky to have medical cover with work so got to see Dr Jonathan Lavelle at the Lister immediately on return. Had surgery as soon as practicable 4 weeks later (hammy graft). Mahoosive post-op brace and 2 weeks on the sofa, twice weekly physio for 3 months. Been full running in the gym for 2 months now. Got fitted with CTi this week (also bought a spiffing Patagonia jacket as an incentive, but I digress).
Got a long weekend in Schladming booked in December, and hopefully a mate will be getting a season let so intend to take full advantage of it.
And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Just as a footnote, we now ARE about to be Kneehab stockists. Not a money maker for us, but I have used the product and believe it REALLY helps especially with patella stability and muscle wastage recovery times, my physio rates it highly and recommends it to others, and Kneehab have kindly said they will supply us rather than having to order from them in Ireland. So if you want to buy from somewhere that has knowledge of using the system in a winter sports/rehab scenario then that'll be us from next week
Keep twitching,
ScottyDog
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
Weathercam, out of interest, did you get your bindings checked at all, or was it just an unlucky fall where they failed to release?? I remember the months of physio, dragging my back bottom around a wooden floor with my heal post my femur break!!
You know it makes sense.
You know it makes sense.
forwood, that sounds like very bad luck to have so many damaging falls. Did you slip on ice on skis or walking around the village???
Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
kitenski, mine was an innocuous fall on a blue run, specifically Leissieres in Val d'Isere. Particularly annoying because we'd been thrashing the powder and steeps all morning. I'm convinced that if I'd have been going faster, instead of a gentle cruise, it wouldn't have happened.
Poster: A snowHead
Poster: A snowHead
kitenski, stand back whilst I open a huge can of worms!
If you read about the day I did mine, (see link above) it was a big ski touring day, and we did around 1,500m vertical with the last 400 being very technical.
So maybe a little tired perhaps - descent was a classic in great powder, I then came out of the shadows and hit the plateau / run out where the sun had been at the snow for a fair bit longer, going from superb powder to spring sludge in around 2 seconds and caught a tip, like I say I might have been tired - as it was really just a simple low speed fall that I should not do!
That's all I've really said up to now about the "event" - deliberately not mentioning the bindings. Reasons being that when you use those bindings you tend to be of a certain standard possibly, and people don't fall. It certainly is something that can sometimes be in the back of your mind especially when skinning up as if an avalanche were to hit, you have to be pretty damn quick to take your bindings off, for the simple reason that Dynafit Touring bindings do not really have a front quick release mechanism* - there I've finally said it!
It's not something you really want to broadcast, for me even more as I've skied ski toured with Mr Dynafit and his son so I feel I have a certain allegiance to him and his brand.
You use Dynafit bindings to save weight and hence some sacrifices are made - and they are a superb piece of kit. Dynafits release laterally at the heel which is meant to be similar to releasing at the toe.
However the big question will obviously be will I use them again in the future, the answer if I were to get back on skis at all next year is a big NO NO - I'll use my Dukes on a very low din setting.
Thereafter I don't know, will all come down to how confident I'll be feeling and how much vertical we'll be doing, and whether it's only a day tour or longer hut to hut tours.
My mates with me on that day also asked the same question, if I for instance had the Dukes would they have released - we all seem to think that maybe not, but who will ever know.
As a postscript one of my mates is selling his touring skis with Dukes and has gone for the new Dynafit for next season - so didn't affect his thinking.
Physio gave me a hint of optimism today about March, but obviously still a very long way off. I really have till the end of Nov to make the call on whether I buy a season pass for March / April - just that if you buy the pass before Dec it's almost the same price as two weeks with all the discounts plus you get various days to other resorts - decisions, decisions..............
Sorry should explain the above, we go for five to six weeks - I'd already said to the Mrs I'd go anyway taking my bike, plus I have my ski du Fonde kit and I at least should be fit for some of that, and was not really thinking about the piste but physio seemed to think could just be possible...........
What will be will be
*When climbing you actually lock them in to even more of a non releasing position
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Kitenski - hamstring was around the village; shoulder was relatively easy red (and actually skied home same day and went out for a couple of hours next - it was the op that near killed me! acl was a brutish off piste road - churned up and icy. But all told, b unlucky!
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Weathercam, the way I see it, there are two main physical factors that should determine the time table regarding return to skiing
1- muscles/leg strength/physical ability
2- internal healing of knee/body's incorporation of new ACL
#1 is relatively easy to measure and test
#2 is not so clear cut with many differing opinions. While I think the patient and doctor might be able to assess it to some extent, I think there is a lot going on that you can't readily feel or measure.
I've had 2 ACL reconstructions exactly 2.5 years apart Nov 08 and May 11 (with about 180 days skiing in between). Both allographs (cadaver) in the US. 1st was a double bundle, 2nd, by a US Women's ski team doc, was more traditional single bundle.
Both rehabs went well for me and I did some limited skiing March-May 2009. In hindsight, I could have waited longer after the 1st surgery as the knee continued to improve between month 6-18 post op, but don't think I did any damage with my spring 2009 skiing. Was living in Summit County CO and was happy to do a few hours of skiing about 1 time per week.
1st Doc initially said that with double bundle, I could get back to skiing sooner than 6 months (originally said 4-4.5 which he revised to 4.5-5 months while I was a patient and may have revised further since). 2nd Doc told me that while they originally thought 6 months was ok, for allographs, he now used more of a 9 month protocol as there is some evidence it takes longer to go through a ~ metamorphism and incorporate fully. He also said that while double bundles sound good in theory, the practical outcomes have been as good, or better with the single bundle. As I am in France currently, I plan to do an email/phone consultation shortly as part of my 6 month follow-up when he said we would "talk" about skiing this season. He initially said that he has "no problem if I don't ski this year" but sounded relatively optimistic when I saw him for my last follow-up (and said he was more concerned with my repaired meniscus than my ACL at that point).
I also got somewhat mixed messages from my two main PTs. For my 2nd go around, my PT said I could skin up and do easy ski downs from the start of the season, but she thought that I would be better off waiting until month 11 rather than 9 to push things with alpine/downhill. Part of her reasoning involved the extensive meniscus repair I had. My first PT told me recently that at least one study shows higher re-tear rates 8 months post op and it is believed that the graph (auto or allo??) may hollow out at this point as part of a rebuilding process. He said that there is a good bit of guessing going without being able to perform autopsies on ACL patients at various stages in the recovery process.
Long winded way of saying my situation is different than yours, but my advice would be not to plan to ski every day during an extended Spring trip. My philosophy with most activities is to start slow and work into it while giving the body time to react to/recover from the various stresses. One of the reasons I like living in the mountains is so I don't have to feel like I have to maximize my time on the slopes in the same way a guy on a week vacation does.
Ultimately it is up to you to weight the risks and decide.
Yesterday went in for keyhole on the other knee (right) to clean up the meniscus tear – and he found at that at some point in time I had ruptured my ACL in that knee too!
Now this came as quite a bombshell when I came round to be told that - as with that knee I never had any severe problems or sudden pain comparable to what I went through with my left knee, so all very bizarre - and I have been very active on it over the years - it was only after I had torn the meniscus that I thought it to be wise to use a brace as it did not feel right - maybe I tore the acl then, but the surgeon inferred it was a while back - but think I'll be wearing two braces now for a while!!!!!!!!!
The video is really interesting with the running commentary – if you get bored skip to 05:10 when he has a look at my ACL !!
I've recently had two acl opps and before I was a frequent skiier haven't had the bottle to go skiing again I've got a knee brace and help which could ensure my knee stays fine while on the slopes and what could I do to improve my chances of getting back to full fitnes again, I don't want to go on a slope and my knee pops out of place, any info/help would be great
I did read a lot of sites, and My UK surgeon was quite belittling of the US methods and seemed to think what he was doing was more than a little bit more advanced.
I now still ski without any brace or support...and sometimes get a tad of swelling, but my repaired knee skis everything my other one does loved it.
Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
lampbus, thanks for that link. I'm circa 14 weeks now and progressing ok, though have ripped my back doing lunges so that has held me back a little.
Do the gym three to four times a week, bosu ball, leg press etc stair master etc. Have not seen physio for a couple of weeks as I thought I'd be more laid up after the key hole, but that was not the case, but have been sort of following a sensible regime.
Hope to up it to more dynamic exercises soon with her ok, but I'm prepared to be patient.
Went for a very gentle twenty minute jog yesterday as my legs felt good and knee was quite sore today, so maybe too soon just yet, though did have keyhole on the other knee only two weeks ago! Contradicting the above paragraph
Been cycling hard on the turbo and am now cycling outside and first time on the road felt so good just to be out in the fresh air!
Negative is the back and an osteopath mate gave me a right going over today, saying how tight my hamstrings were and how I have no power in my glutes and various other issues.
So out to the mountains for the new year where I hope to do some hiking, and hopefully ski in March which will only be six months post op.
Seeing my consultant next week about progress on both knees, then will be in regular contact with him as I'm going to be doing a couple of projects with him all to do with knees!
More about that later as & when.
So lampbus what was your timing again from op to being back on skis?
After all it is free
After all it is free
Weathercam, i cant exactly remember, but it was before fully discharged that i bimbled about for a couple of days on a pair of 140cm planks set to silly low DIN...then at the start of the next season I just threw my knee down anything, including massive mougls...on wide long powder planks. Yes, I like 'challenge'.
Remember that people ski without ACLs and their muscles do their thing and it is mostly OK, but a freshly repaired ACL will bear too much load if you have insufficient muscles and the correct response trained into them; or if you fall and go all floppy and rely on the ligaments to hold together.
Obviously, people skiing without ligaments are mostly fine, but risking nasty mashing up if they fall or execute an unexpected/untrained manouver.
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You'll get to see more forums and be part of the best ski club on the net.
First test of bionic knee coning up on Saturday in Schladming. I've decided against taking my Missions, going to hire some piste skis instead. Mainly because I'll only be doing gentle pisted runs and want something very nimble & manoeuvrable (missions are quite long & can grab if you're not firm with them), also because I have a 3 hour lay over in Munich and can't be arsed to lug them around.
Wish me luck!
Ski the Net with snowHeads
Ski the Net with snowHeads
lampbus, you 'bimbled' in Wengen I think? So it was probably March.
snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
Hells Bells, just looking back at the thread...I did it over 4 years ago...surgery late Sept 07...bimble march 08...about5.5 months postop.
And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
lampbus, was it really that long ago now? A long time since that MSB.
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
lampbus, interesting........
My op was Sept 1st and be back in Serre March 10th
But still a long way to go rehab wise from the feel of things.
Just under three months to go!
And best of luck Dr John
You know it makes sense.
You know it makes sense.
lampbus, interesting........
My op was Sept 1st and be back in Serre March 10th
But still a long way to go rehab wise from the feel of things.
Just under three months to go!
And best of luck Dr John
Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Weathercam, and by bimbling he means knocking about on the nursery slopes rather than anything more interesting. Friend had op August 2010, he did ski last winter,with a short break in Dolomites in January, and trip to Banff in late March, but I was surprised he made it, and he was still complaining during the summer that certain things he did, his knee didn't feel right (couldn't walk up a steep hill properly).
Poster: A snowHead
Poster: A snowHead
After all my BOSU ball balance stuff etc in the gym this morning did half an hour on the treadmill - walk / run at an incline of 10-12 got quite a sweat going and really had to concentrate so as not to fall off - oh should add that I was doing it backwards
lampbus, and Dr John, how much did you push yourselves - prior to you injury did you train a lot and a what sort of intensity, do you use HRM's etc etc ?
Just that I was pretty fit / strong prior to me doing the ACL - I was not in the elite athlete category as I still like my food n'drink but I would still do quite a few hours of intense training a week and then long rides and or runs with the occasional race often in the top 10% for my age top 20% overall.
So currently be it on the stairmaster or bike in the gym I'll be working damn hard as well as back home on the turbo - doing Tabata intervals (google that if you don't know what it is) but all the time aware of the knee(s).
Then three times a week leg presses etc pushing a fair stack of weight - though on some machines my acl leg is so much weaker compared to the other one.
Then I come home wipe my shoes on the door mat in a sort of backwards dragging motion and can feel that all is still not right
Suppose the point I'm trying to make and to make me feel better, is that hopefully I'm coming at rehab with maybe an above average better base to build upon, plus the amount of stuff I was doing after I did the ACL and prior to the Op was pretty full on such as cycling in the alps this summer..........
Oh well wait and see
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Weathercam, I did pretty much sod all before the injury. I'm a lapsed sportman (rugby for 20 years, occasional footy & cricket), so not a complete stranger to a workout, but nothing regular. I wasn't a fat b@astard, but not exactly trim either.
Post-injury/pre-opp I did what I was told about keeping it active in a gentle way; walks around the block, putting weight on it, straight leg lifts from a laying position etc. Post opp I was off work for 2 weeks, after that I was seeing physio twice a week and doing more gentle exercises. Progresses to x-trainer & free-weights/balance stuff in the gym after about 2 months, progressing to gentle running after about 4. Been full running (treadmill) since August-ish, going until my knee hurt. Last couple of months the knee has been fine, and general fitness has been the thing stopping me.
I have a CTi brace, and playing with it around the house it certainly gives a huge amount of support in the bent knee with inward pressure "inside edge" sort of movement that I was concerned about. Surgeon and two physios say I should be fine, take it easy at first etc. According to the chaps I've been seeing modern ACL jobs (hammy graft) are "bullett proof" and I have as much chance of popping my good one as my repaired one. Still nervous though. See what happens at around 10am Saturday morning when I put my first turns in.
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Dr John, be thinking of you Sat Am !
Hopefully the one thing I might have going for me is my sport fitness then but that is probably offset against my age and subsequent speed of recovery, or lack thereof.
And your comment about chances of popping your good one vs your repaired one being about the same is what I'm going to be worried about, having been told three weeks ago after keyhole to my other knee that I don't have an ACL in that one does not feel me full of confidence!
We were talking about braces today, watching some mates windsurf ripping the beautiful waves up, and I said what can really go wrong if you have a brace on?
Then I added knowing my luck I'd then rip my hip socket out instead
Cheers mate. I'll post an update if I'm not broken and depressed.
Be aware the brace won't stop a re-occurrence in the even of a similar fall/twist, but it will help stabilise in normal skiing movements and provide psychological assistance. I chose the CTi because two friends use them for surfing, wake-boarding and snow boarding. CTi also seems to be taking over as the default heavy-duty brace over DonJoy.
As a mate of mine said, with my run of bad luck over the last couple of years (broken ribs, sprained wrist and the ACL), my knee will be rock solid but I'll dislocate a shoulder.
Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Dr John wrote:
Be aware the brace won't stop a re-occurrence in the even of a similar fall/twist...........
Aaaaaah that's news to me, I thought it would prevent it as the brace extends down from thigh to calf and over the knee etc - I actually bought a brand new Donjoy ACL Armor brace on Fleabay for £125 so quite a bargain!!
Welllll, Weathercam, sounds like you are doing it all wrong.....what the heck are you doing Tabata things for? (I had to google it) ... looks like thats some fancy complicated way to get people into a gym to loose weight....if you are fit then you dont need to burn fat !
Stop going to the gym !
As I understand it, people damage their ACL partly because their leg muscles dont know how to respond to the unexpected, and the only way of teaching them that is to do the unexpected...which never happens using machines in a gym.
Machines just strengthen individul muscles.
I go out on brisk walks on uneven paths and through woods where agility is as important as strength. Almost all the work I did before and after surgery in the hospital gym used stairs (and I still do stair calf raises and stepdowns at off times like waiting for trains). I did much agility stuff - standing, knee bent on wobble boards (one or both leg) catching beanbags thrown to me by trinee physios....
Also using a large excercise ball in various wobbly ways...
Yes, I get sweaty sometimes, but it is far more important to be doing those unexpected moves. thats why I dont need a brace now.
Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Oh yes, you comment about backwards dragging on the doormat.....you are training the mscles on the bck of the leg arn't you ? the hamstrings. Pushing weights, squats, lunges etc will only sort the front groups. To train your hamstrings you need to be pulling....
My hospital gym had a wheeled stool (like a office chair without back)...sit, pull yourself along one leg at a time with your heel...I thought 'easy, its got wheels on' but they wernt very good wheels and after 10 lengths of the gym I could feel the quads. It works because of the swivelly-ness. You are not just pulling, but all sorts of muscle groups are firing to keep you going along the 'route' and like most shopping trolleys, the castors on this stool had a mind of their own that needed fighting...all good stuff.
After all it is free
After all it is free
lampbus, do the tabata stuff after all the other bollox to keep cardio levels on trac, well that's the theory!
Did barefoot pose running (another one for you to google ) today on the tread mill and calves did not like it, nor the knee as I sit here typing this!
Was with Nick Baker today, ex world champ windsurfer talking about rehab & injuries as he was digging me out for not having seen me on the water recently as he was unaware of my present situ, and he was going on about hyperbaric oxygen therapy which he swears by as he has fecked himself quite badly over the years!
So there's yet another method operandi to consider!
I've always said that before I put skis on I have to feel confident running down a slippery chalk bridle path on the Downs, and that's what I'm aiming for, that hopefully starts in the new year outside, meanwhile all the gym bollox!
You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
I have googled some of those, and it amazes me how much guff is talked in order to separate people from their cash and/or in the name of ego and fashion
I just go skiing, and I have decided to call it the revolusi training systems approach which research has shown may (or may not) be 9.12 percent better than competitve approaches. Also it is fully natural and organic. You can buy my book about it, and attend a course at reasonable prices...
Anyway, I hope that whatever you are doing to recover, that you get back to enjoying skiing soon.
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Poster: A snowHead
