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Skiing after ACL tear poll


I have (medically) confirmed ACL tear and
WITHOUT ACL reconstruction I ski as aggressive as before (moguls, off piste, backcountry, freeride)
29%
 29%  [ 14 ]
WITHOUT ACL reconstruction I ski but only on piste and easy (blue - green) lines only
4%
 4%  [ 2 ]
I did NOT have ACL reconstruction and I've stopped skiing
4%
 4%  [ 2 ]
After ACL RECONSTRUCTION I ski as aggressive as before (moguls, off piste, backcountry, free skiing)
58%
 58%  [ 28 ]
After ACL RECONSTRUCTION I ski but only on piste and easy (blue - green) lines
4%
 4%  [ 2 ]
After my ACL RECONSTRUCTION I had to stop skiing
0%
 0%  [ 0 ]
Voted : 48
Total Votes : 48

 Poster: A snowHead
Poster: A snowHead
Hi all,

as many of you I've also done my ACL and I'm now reading trough articles and forum posts.

There are many references to people who ski without ACL (or with a severe ACL tear) - without reconstruction, some with some even without brace.
I was wondering what is "really" % of people who do not have reconstruction and still ski aggressively and without constraints.

p.s. Please answer for your self not for someone you have heard about...
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
So I did my acl in 1994, had it repaired in 1995, started skiing in 2008, and ski everything I can. The limit isn't my knee. The whole point of the reconstruction is to return as close as possible to full function.
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 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?
I need a button between:
After ACL RECONSTRUCTION I ski as aggressive as before (moguls, off piste, backcountry, free skiing)
After ACL RECONSTRUCTION I ski but only on piste and easy (blue - green) lines

I had mine done in 1982 using carbon fibre, before the day of grafts. My main reason for having the re-build was to play rugby, which I did for another 12 years. It was never as good as before the op with restricted movement and restricted training periods due to swelling and pain.
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I tore my left Cruciate and a small cartilage tear a few months back. According to the MRI scans the Cruciate has completely gone. Been in the gym since Christmas trying to build up my thighs. I have ben given a pair of very light and expensive knee braces from my NHS consultant. Off to Tignes next week and hope I can ski OK. Time will tell. Having discussed with several other snow heads quite a few people manage without the cruciate. Having blown the right knee a few years ago I don't want to have the same op on the left knee.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
I was skiing to the level I was before destroying my ACL after the reconstruction. Now I have subsequently damaged the reconstruction (apparently half left) and had a lot of my cartilage removed, I am planningon skiing in April with a brace I will probably fall into the sticking to blue runs (anything being better than nothing).
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Ruptured my ACL in 2002, had the repair done using my patella. With marriage, and kids, I had about 11 years off before returning to skiing last year. I am loving it again, and do not feel hampered by my knee. Even had another op back in September to repair a bit of damage to the meniscus from bowling (cricket). I am constantly pushing myself well beyond my capabilities, and its felt okay so far. Fingers crossed!! I also play squash and feel that could be worse on the ACL then skiing?
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Hi, thanks for replays and votes.

On two forums (the other is at epic ski.com) we have 10 out of 16 votes for "After ACL RECONSTRUCTION I ski as aggressive as before" and one "skiing the same without surgery" (thanks newfydog).

V.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Hi,
I ruptured my left ACL, tore the meniscus and cracked the cartilage, while skiing New Year 2012. I skied for 12 days after that in 2013 with knee brace, I would say I was cautious. But da brother reminds me I skied the 3 valleys escapade and took 12 hours of lessons with ESF in one week.
I had the ACL et al replaced with patella tendon graft April 2013. I have skied 12 days, in the skiwelt, this year with a knee brace, I find I am more cautious but it is a mental thing, and I think it is gone now.
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You'll get to see more forums and be part of the best ski club on the net.
I carelessly left an ACL on the mountain on my first ever ski trip... Did not have reconstruction and have continued skiing. I'm not good/brave enough yet to go off-piste, but can ski anything I want to on piste. Only problem I get is when putting skis back on on steep sections - the ACL deficient knee has to be "uphill" for that.
So, that said, I could actually say "I ski better than pre-ACL"!
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A button that says ' I have not torn my ACL' would be good too, it would be nice to be able to see the results.
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I've blown the ACL in my right knee twice playing football, the second time 2 months into the season after having the first reconstruction (patella) 12 months earlier. I decided on balance not to return to football after the second reconstruction (Hamstring) so I could continue skiing every year. I ski now more aggressively than ever. I don't give my knee a second thought these days as I keep fit and my legs strong. I get a little swelling after an aggressive days skiing, but that's probably to be expected as I had to have a lot of cartridge chopped out. A bit of RICE soon sorts it out. I don't use braces or any knee supports, that is the reason I had the ops in the first place so i could continue life normally and never have to use my knee as an excuse for not doing something.
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 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.
Hells Bells wrote:
A button that says ' I have not torn my ACL' would be good too, it would be nice to be able to see the results.


I assume what is behind the post is trying to decide whether to reconstruct or not.

In answer to that question though is a very personal one and shouldn't really be guided by peoples responses, though i suspect they are reassuring, I would suggest that people who have had to give up skiing after an ACL injury may not be frequenting a ski forum, hence these results are going to be skewed.

In my case my knee felt unstable just walking down the corridor, I could literarlly feel it doing a figure of eight movement inside the knee every step I took. I was able to run on a treadmill (nice even surface) but it was most definitely the right course of action to me.

I have a friend to rupture their ACL tried to take the build muscles up to compensate route, and carried on with skiing and hockey He eventually got an ACL recon, and was recommending I do when I did mine, as he said he caused himself so much more damage by not getting it done earlier, and once he had it done his skiing felt much better and easier.
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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
HI NickyJ, I also expect that there will not be any reply "I quit skiing" on this forum, I've left the answer in anyway and I've also intentionally left out those who did not injure their ACL - I hope there are more than injured ones Smile

Yes, this kind of injury is really personal and I've seen a couple of surgeons in after my injury but without conclusive answer to what to do... My case is not as clear as yours NickyJ and even as I'm more stable I'm afraid I'll do more damage if I tray to continue with my activities. And I also hate the idea of months of rehab only to figure out next season that I'll need the op anyway and loose another season (or two)...

My idea was to see how many "real copers" are around - people that ski backcountry, deep snow, ski touring and maybe some more serious coluars without ACL reconstruction and knowing that their is raptured completely. And capture some of their responses...
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 You know it makes sense.
You know it makes sense.
vasja,

The stats are as follows:-

Approx 10% will have a great knee.
The rest won't.
15% will experience some form of instability on day to day activities.
Of the remaining approx half can manage by adapting( by giving up sports that make the knee give way)

The literature talks about copers and non copers.
There are varying definitions of a non coper but anyone whose knee gives way after say a week is a non coper as every episode if giving way risks tearing the medial meniscus
Non copers have been shown to have clearly defined changes to their movements patterns.
If you do a non op programme with physio alone it will be three months of rehab, at least.

Osteoarthritis

Untreated most will get osteoarthritis.
Untreated virtually everyone will tear their medial meniscus by ten years. ( it may have been torn at the time of injury in about a third.)
The medial meniscus tearing has now been shown n many studies to be strongly correlated with osteoarthritis. In other words if it is intact it is probably worth protecting with a reconstruction, particularly if the joint surfaces are healthy.

I do manage Anterior Cruciate Ligament rupture non operatively. The ones who have non op care are those with limited aspirations for sports(especially pivoting sports), those who are,or seem, unlikely to commit to the rehab and those, of course, who would like to try non op care.

I am open with patients who are young, have healthy meniscii and joint surfaces that I will gently put a bit of pressure on them to have it done.

It is not a perfect operation but when carried out well should in most cases do well, but the rehab is lengthy.


Jonathan Bell
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
vasja, I don't quite fit into any of your categories. I've torn my ACL & it hasn't been reconstructed, but I never skied aggressively moguls, off piste, backcountry, freeride, before I injured my knee. I'm happy on the blues/reds & some blacks that I was happy on before. It is a bit unstable still though, & it collapsed on me a couple of days ago while vacuuming rolling eyes
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 Poster: A snowHead
Poster: A snowHead
Thanks all for feedback.

Jonathan Bell, are there any more ways to predict who might be candidate for being a coper? Anything that can direct after (5-6) weeks after injury in less clear situation - where there is no clear sign of instability.

I should be in La Grave, skiing some couloirs and powder, this and week. Of course I've had to canceled and I'm afraid that if I want to only postpone to next year reconstruction is the only realistic option...

and yes, I know this kind of poll can not be any base for decision in individual case, but it's still interesting to see: in both forums there are 9 copers and 18 who had successful reconstruction. No vote on less successful reconstruction or partial coping. on epicski.com its 50/50 on coping and op...
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 Obviously A snowHead isn't a real person
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vasja, I don't know if this helps you or not? However I voted as skiing as aggressively as before as I was after the recon, however in march my weight came down wrong during hockey training and after hobbling off the pitch and seeing a Physio (she thought it was an MCL sprain as testing it, felt stable and it felt stable to walk on) however after what I thought I had recovered fine, I went back to hockey training and within 20mins my knee collapsed from nothing, I was stuck on crutches for over two months with a locked knee until I could get the surgery - the meniscus cartilage had torn folded over locking the knee. After the operation I was told that during the arthroscopy to remove the cartilage tear he also found my ACL recon was only half intact. My best guess is that in march I partially tore my reconstruction but the half which was left and functioning leaves my knee feeling stable but it isn't. Sad. Know I will be skiing in April but keeping it very easy and braced up.
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 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?
vasja,

A partial coper is someone who gives up things to avoid surgery.

You could push through with a physio programme but you are unlikely to get an answer before three months.

I agree you wouldn't go off piste skiing in Le Grave without an ACL.

If you are proposing to do so you need to be very carefully assessed.

Jonathan Bell
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thanks Jonathan Bell, I've figured that out already and I'm getting assessed and trowing in some second opinion too... Unfortunately I've blocked out Jan and Feb for skiing so now I have all time on my hands to read and surf Smile

As my primary interest is off piste and ski touring I'm leaning in direction of reconstruction ASAP (Feb, March, also at 42 I'd rather do that sooner than later) - and intensive rehab afterwards (as much as business allows), start season in late December and than hopefully build up for La Grave & Cham in March/april 2015.

NickyJ, I'll keep my fingers crossed for your great April skiing!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
vasja,

It sounds like the correct decision.
Keep in touch as I take my own ACL patients back skiing in early winter to ensure the " nerves" and conditioning are completely recovered.

Jonathan Bell
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vasja wrote:
thanks Jonathan Bell, I've figured that out already and I'm getting assessed and trowing in some second opinion too... Unfortunately I've blocked out Jan and Feb for skiing so now I have all time on my hands to read and surf Smile

As my primary interest is off piste and ski touring I'm leaning in direction of reconstruction ASAP (Feb, March, also at 42 I'd rather do that sooner than later) - and intensive rehab afterwards (as much as business allows), start season in late December and than hopefully build up for La Grave & Cham in March/april 2015.

NickyJ, I'll keep my fingers crossed for your great April skiing!


Thanks and the best of luck. Really working hard on the Physio several times a day really makes quite a difference.

I was chatting to a colleague of ruptured his ACL while posted in the states and he had the recon there. He said he had a cadaver ACL reconstruction, and was saying how quickly he recovered, vs my hamstring reconstrcuction, mi presume this isn't available in the Uk? As I hadn't heard of it before.
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NickyJ,

Caderveric tendon is readily available.

It is expensive and more likely to fail than your own tendon. There is a very small risk of disease transmission.

I use it rarely, and definitely, not for a first time reco. Some surgeons have used because they don't do many

reconstructions and taking the graft is a fiddly part of the op.

I've also seen problems ( in females) from a graft that is too big.

Jonathan Bell


Last edited by Then you can post your own questions or snow reports... on Fri 7-02-14 22:20; edited 1 time in total
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After all it is free Go on u know u want to!
NickyJ, I was offered it in Southampton, but declined it for squeamish reasons. Very interested therefore to see what Jonathan Bell has to say about it
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Well, after seeing 3 surgeons they all have the same recommendation: "go for reconstruction if you intend to do any 'extreme' (e.g. off piste) skiing".


First possible date is next Saturday as I'm supposedly already fit for op after 6 weeks post injury with full ROM and 20% weaker injured leg (compared to good one). I need to decide by tomorrow or wait until end of March and ... well, I'm leaning for Saturday.

NickyJ, they also do cadaver around here (Slovenia), but at less than 5% ...
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vasja, best of luck. I only know one person who had the cadaver reconstruction, but was mentioning partly as it wasn't even mentioned when my ACL was being reconstructed (that and hearing how quickly he recovered) sounds like it may not be as good as it originally sounded.
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vasja, Good luck! A friend had his reconstructed in May 2011 and was back on skis December 2011, he skis hard and fast and only off-piste unless he is teaching. He got injured in January 2011 but could ski lightly in March. There is no reason to think that you won't get your form back after surgery.
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 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.
I ruptured my ACL and tore cartilage skiing. Had 2 ops - I for the cartilage and then the ACL reconstruction using a tendon. I took I year off skiing then was back with avengeance. I wear a neoprene brace with side supports for skiing and all is good - I don't think I really need the brace, but I wear it as a bit of a confidence thing. I do a lot of gym work and running and suffer no ill effects at all. As part of my rehab, to strengthen the knee, along with the usual wobble boards etc, I did a lot of indoor rowing on a Concept 2 - that really helped.
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 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
Just got back home from the reconstruction - 5h post op...
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 You know it makes sense.
You know it makes sense.
vasja, well done, hope it goes well. Work hard at the Physio.
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
NickyJ, +1
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 Poster: A snowHead
Poster: A snowHead
vasja wrote:
Just got back home from the reconstruction - 5h post op...


Rehab after anterior cruciate reconstruction: the first three weeks. Recovery from an ACL is like a hurdle race where each hurdle has to be cleared before the next.

1) Your first is to get full extension ( straight) get someone to help by steadily applying their weight on the leg to stretch it straight two or three times day.

2) Your second is to ice, ice , ice as it is imperative you get the swelling down as quickly as you can. You will help to achieve this with crutches to part weight bear for three weeks. Avoid going out and being up on the leg for too long or you will see the knee swell quite quickly. Elevate where possible and apply compression. Getting swelling under control helps to maintain the extension by helping the muscles fire up. It also plays into the next goal.

3) Your third is to try and walk without a limp so you cannot tell, when watching you walk, which side had the op. To achieve this requires full straightening, heel strike( back of heel makes first contact with the floor, not flat of foot) and good muscle control. Try to make everything you do,when you move, symmetrical .

4) Bending the knee. At least 90% by 3 weeks if a hamstring graft , full flexion of a patella tendon. Bending will not come if the knee is very swollen.

That's your first three weeks done.
Good luck

Jonathan Bell
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Hope it's not too painful vasja

I'm just back from a week's skiing exactly a year after a nasty complex partial ACL tear (the unhappy triad) and it's probably the best skiing I've ever done. So glad I listened to the friendly orthopaedic surgeon who told me I was too old for surgery (at 45!) as he threw a brace at me.

It took the full year, I was away in December and it wasn't as good as this week. I couldn't get much past 90 degrees for months, and couldn't squat equally until a couple of weeks ago, but this past week I managed blacks, off piste, etc without any problems - even moguls accidentally when I'd planned not to, but I forgot.

I'm thinking if it goes completely or I can't ski I'll get it fixed or if it's gone already and I'm managing then I won't.

Hmm - better go again next month just to test it again Smile
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Well, the person's real but it's just a made up name, see?
Pending, what sort of brace were you given?
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Donjoy, a fairly basic model, with the advice to get a stronger one if it wasn't enough, but it seems to be doing the job

http://www.djoglobal.com/products/donjoy/reaction-web-knee-brace
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Pending,
Quote:

So glad I listened to the friendly orthopaedic surgeon who told me I was too old for surgery (at 45!)

Whaaaat - I was 54 when I had my reconstruction, and age never really came into question with my OS: we felt it was more important to get it fixed so I could continue to lead a pretty active lifestyle.
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geoffers wrote:
Pending,
Quote:

So glad I listened to the friendly orthopaedic surgeon who told me I was too old for surgery (at 45!)

Whaaaat - I was 54 when I had my reconstruction, and age never really came into question with my OS: we felt it was more important to get it fixed so I could continue to lead a pretty active lifestyle.



I don't know why there is such nihilism about being over forty with an ACL rupture. Its not just general orthopaedic surgeons . One local " knee specialist" told a 42 yr old to give up skiing, which seemed odd to her as she owned a home in a ski reort. There are a number of studies that demonstrate results of reconstruction are as good, if not better, than younger age groups.
I've helped many over 40's get back to a good / high level of sport ( including skiing) with reconstruction. They recover just as fast as under 40's. I think many surgeons think skiing is,universally, an extreme sport!

Jonathan Bell
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Flawed poll - won't let me answer for both before and after recon.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Jonathan Bell wrote:

I don't know why there is such nihilism about being over forty with an ACL rupture. Its not just general orthopaedic surgeons . One local " knee specialist" told a 42 yr old to give up skiing, which seemed odd to her as she owned a home in a ski reort. There are a number of studies that demonstrate results of reconstruction are as good, if not better, than younger age groups.


Glad you said that - wanted to chip in with a comment but was younger when I had my reconstruction done and obviously know nothing about the medical side of things… but 45 seems pretty young to me and, as the injury took a full year to recover from and still requires a brace, I couldn't quite work out what the benefit of NOT having the op was…?
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Jonathan Bell, I think it was said somewhat tongue in cheek really, he was a friend/colleague and a mad skier himself, so he'd have done whatever it took to get me back on skis, but in the end he was right - the conservative approach was the best option for me (so far, anyway). I'll be coming over to you when I need the replacement though wink

I wouldn't have taken the slightest bit of heed of anyone who wasn't a skier - imagine that advice to give it up!! Completely nuts. When I was away one of the group I was skiing with had just recently had her hip replaced, and by recent I mean 3 months, and she had already been skiing for a month! I have to say we all cringed every time she took a tumble, but she seemed grand. She said her surgeon was a skier and so long as she knew and accepted the risks he was ok with it. And that's the advice I give to skiing friends regarding injuries - go and get seen by someone who skis!
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Summer 2012 ruptured my left ACL, skied twice winter 2013. Knee did give me a lot of grief (swelling and pain) but didnt stop me going where and as hard as i wanted.
Just got back from a week in Austria, and my knee didnt even twinge. I only wore a elastic support but feel that is only a placebo.
Feel like i should go for a recon but i am a big baby.

Background, 43 YO male 19 years skiing.
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