 Poster: A snowHead
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I thought I would run a little occational blog on here - please comment, or just hide behind the sofa.
Having destroyed my ACL in March in Wengen (at least it was the last day of a wonderful powder week) I have been to weekly physio to keep the joint supported an control the swelling and omprove the range of flex.
(For those who dont know, ACL is the Anteriour Cruciate Ligament - an important bit of the knee that helps hold the top half of your leg to the botom half. Part or total snapping is a very common sporting injury)
I totally snapped mine, but was lucky not to damage the other ones too mutch, or the meniscus - the softer material that acts as a bearing surface for the bones as they slide when you bend your knee.
The bad news is that the ACL will never regrow - the torn ends just flop around in the joint.
Now I could live with the 'instability', learn to adjust by not loading and twisting my knee. The ACL particularly prevents the lower leg twisting out and it was the weird way my ski waggled out during my little incident that told me all was not well. THe incident was a classic ACL tearing slow rearwards twisting fall, no collision, just ridiculiously simple.
The moral is - train yourself to ski properly weighted - be vary careful about keeping out of 'the back seat'.
But, with the joint flapping around I was heading for arthritus, and would never ski again anyway.
On tuesday morning I got up rediculiously early and my father took me up to Wansbeck hospital for my reconstruction operation. Under a general anesthetic the surgeon uses his keyhole tools to gain access to my inner knee. (I am anethtesised, not the surgeon, thankfully)
First, he 'harvested' a length of the tenon from my hamstring and removed it for preparation.This narrows the hamstring tendon but it will eventually recover some width.
An alternative method is to use part of the patella tendon - from the kneecap to the shin keeping bits of bone on the ends, which is stronger but this has other problems. Trials have been done with goretex and other man made materials, but they dont last and can stretch and weaken. Or I could have a donor transplant from a dead person.
He then set to work with a grinder to remove the remains of the snapped ACL where it connects to the bones top & bottom. With the joint tidy he can then set about installing the 'new' ligament. So how does he do that ? theres not a lot of room in the joint so he simply drills some holes in my bones 
The first one, from the shin up into the joint and the next one through the upper leg bone (cant remember what it is called) emerging at the back.
The harvested tendon is folded twice and looped onto a bit of nylon cord with a steel 'blind fastening' on the end. this is then inserted up through the two holes and the fastening pops out at the top, twists and locks in place against the bone. Neat.
At the bottom, the tendon (now a ligament! I dont know why they have different names) is secured with a screw in the hole and a staple into my shin 
Apparently not enough metal to set off airport security, but i am now part 'bionic'. Or anderoid. Or terminator. Or not.
Over the next 6 weeks, the new ACL will die and get weaker. But being a part of me and not man made, it will gradually grow a new blood supply and become stronger and solidly attached to the bones where the holes fill in. Give it 6 to 9 months and it should be as good as the one I broke.
Skiing ? not next season, but 2008-2009 I will be back in the bindings.
Bindings - theres a question. I have marker bindings on my Volkl 5*, which have always been set to DIN 7 or 8 and have a cunning toe release to help prevent ACL damage. I was not using them on the day of my incident - I was on wider off piste hired skis. The same afternoon I took the hire skis back to the shop and had them tested with my boots on their electronic machine - no problem, but the rental bindings didnt have the marker toe lift feature. How many times had I got away without damage in the past ? Impossible to tell realy, but its worth learning to ski defensively no matter what the bindings are.
Time to put the bag of peas back in the freezer and to some more physio - I am meant to be doing excercises every hour - even when asleep I assume cos the form I have been given just says every hour!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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the tendon (now a ligament! I dont know why they have different names)
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A tendon connects muscle to bone and a ligament bone to bone..useless info but true..
I hope it all goes well and keep up the physio..
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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?
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I had a reconstruction two years ago using the Patella tendon graft.
It's fine now but a word of warning - Don't push it too far too early or you'll delay recovery. I did.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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LONG TERM LOCAL EFFECTS OF CARBON FIBRE IN THE KNEE
J A Fairclough; U K Debnath; and R L Williams
University Hospital of Wales
A radiological and histological analysis of five knee joints after a minimum of 15 years following the implanting of carbon fibre which had been used as a treatment for knee instability was undertaken. All patients underwent Total Knee replacement for secondary osteoarthritis.
Ah how times have moved on. 25 years since I had mine carbon implant done, and still skiing - Bucking th trend big style......or living on borrowed time.
As said elsewhere, all the best for a good recovery lampbus
Last edited by You need to Login to know who's really who. on Thu 20-09-07 15:58; edited 2 times in total
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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ACL recon is in my future as well.
Done 3 trips skiing on it so far, still doing Judo-esque type stuff with it. So far it has been pretty stable, but I have fairly strong legs to help it.
May look to getting it done next Spring....
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You'll need to Register first of course.
You'll need to Register first of course.
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great stuff Lampbus keep it up, let us know how you're going, and while you're at it (and a bit 'trapped') why not find some pix - it would be very interesting to many of us! 
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easiski, I will, but a picture of a bandage is a bit boring (and my camera is at home currently - I am staying at my parents till this evening) but I get the dressings done tomorrow PM so I will take my camera!
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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.
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lampbus, I like your blog, it's quite fascinating, please keep it going, illustrated preferably. Best wishes for a full recovery. 
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| RachelQ wrote: |
| lampbus, I like your blog, it's quite fascinating, please keep it going, illustrated preferably. Best wishes for a full recovery. |
Ditto, ditto!
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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lampbus, would you consider going to snowblades (with release bindings) or some other skis adapted to have significantly shorter tail levers, as a first stab at optimal balance after recovery?
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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.
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My friend was advised not to ski at all after her reconstruction, but told to take up snowboarding instead. A bit OTT I think, but it was the surgeon at Wansbeck who told her (could be a different one of course).
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Helen Beaumont, I seem to have randomly acquired an earlier model of these, should be interesting.
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You know it makes sense.
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comprex, blades? I think would rather Board !  Actually, my balance is usually rather good but I will be trying to develop an automatic response to avoid repeating the incident as basically, there is no time to think so it must all be muscle memory type responses.
Helen Beaumont, My surgeon is a Mr Muller - a keen skier himself who positively encouraged me to o for it to ski again - unlike my GP who said he would just give up, but he is a non skier.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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I'll be following with interest so as much detail as possible of the rehab process please.
I fear this is in my future as I have a completly torn ACL. Managed over 50 days skiing and snowboarding on it last season though but as anyone who saw me on a bad day when I was limping around after a day's skiing might testify its not without cost.
Time to get down the gym and commence my pre season single leg presses etc.
Good luck
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Poster: A snowHead
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fatbob, ok, I have just done another set of excercise and my bum is realy hurting ! My physio concentrated on the rear muscle groups - hamstring and calf. THese involved dragging yourself around on a wheeled stool with your heel to build the hamstring, and putting your toes on a step, lowering the heel and pushing up again to strengthen the calf.
I did lots of others too, balance on various wobble boards, lifting myself by pressing my heel on a big ball lying on my back, lunges, lying on back and walking the ball up the wall.
THe reason is - the ACL prevents your shin bone moving forwards relative to your upper leg - and these rear muscles need to be strong to pull it back.
Quads are minor in this - they even pull the shin forwards as they lever round the kneecap onto the front of the shin. So make sure the rear muscles are strong enough to balance the quads.
Last edited by Poster: A snowHead on Tue 13-12-11 16:09; edited 1 time in total
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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I know PSG (BASI trainer) totally ruptured his ACL in Jan 2006. He had the operation to repair it on the same day (lucky he was it St Anton), and skied again in April of the same season. This was the fastest recovery I have ever heard of. To be fair, it was probably not wise, but as far as I know he has skied since with no problems.
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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?
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lampbus, yeah also stuff like the ball thing strengthen the core... and lunges require stabilisation so recruits small muscles that you do not use when on a machine....
My sports medicine doctor hates leg curl machines with a vengeance... and loves lunges and squats.... and the trainer from the AIS that does ski stuff loves the ball hamstring exercise and also a similar curl to each side...
Another one is walking backwards up hills... which gets you looks like this  but is apparently good for skiers legs...
and then deceleration training is good - the jump boxes and catching medicine balls on landing one is an example... this helps decrease risk of knee injury...
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You need to Login to know who's really who.
You need to Login to know who's really who.
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lampbus, If I have time at work tomorrow I'll try to get a pic of the knee from Anatomy Online which I currently have access to. Can't promise if today was anything to go by, but it's really interesting. You can strip bits of the body layer by layer (or build from the skeleton up). 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Mmmmmmm... knee sex 
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You'll need to Register first of course.
You'll need to Register first of course.
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All the best Richard
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lampbus, I wish you a full and speedy recovery.
Was there a physical reason for the delay betweem March and the September operation ? Was there a specific purpose to the physio before the operation? It just seems a long time to be coping with a missing ACL.
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| lampbus wrote: |
unlike my GP who said he would just give up, but he is a non skier.
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Those non-skiers just don't understand do they?!  All the best with the rehab.
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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.
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lampbus, All the best for a speedy recovery - did they give yu a video of the op?
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lampbus, Wishing you a complete recovery - although as you say it will take some time.
You mentioned the possibility of a donor transplant from a dead person - if you had gone that route wouldn't you need you to take anti- tissue rejection drugs on a permanent basis? Perhaps some medics can comment 
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| geri wrote: |
| lampbus, did they give yu a video of the op? |
Why do you want to know? Do you want to borrow it?
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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.
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geri, I watched a video of my bro-in-law's gall bladder operation recently. It was fascinating!
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You know it makes sense.
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And this week on through the keyhole....
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Hurtle, I can't imagine anything worse . I bet you used to watch, "Your life in their hands" too!
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Poster: A snowHead
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maggi,
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I bet you used to watch, "Your life in their hands" too!
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You bet! - with my dad, who was a surgeon. The one thing I didn't like, and even he was not that keen, was eye surgery. For some reason that makes me feel distinctly squeamish. Also, I turned out to be squeamish when being operated on myself: I was offered the option of watching my carpal tunnels being operated on and, after the first incision, decided that that definitely was not for me!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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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?
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Just think - there was a time I wouldnt even wear shorts in public, now I post pictures of my legs on the Internet !
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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lampbus, i still think the leg needs waxing!!! 
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You'll need to Register first of course.
You'll need to Register first of course.
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easiski, ill pack my shorts - the scars I will carry as a badge of honour.
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lampbus, Maybe you could show them in the 2008 calender 
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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.
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FAQ
