The snowHeads ACL rehab club !

A snowHead

Just gone under the knife for the 2nd time to clear out some scar tissue getting in the way of full extension following an ACL reconstruction in January. Already feels better! Will find out in the morning how long the recovery. Guessing Verbier opening on 31st October might be pushing it...

A snowHead

@BobinCH, best of luck. How did you know that you had scar tissue?

Well, the person's real but it's just a made up name, see?

Couldn't get rid of discomfort on full extension despite a lot of effort. MRI scan showed some extra tissue around the ligament which seems to be the cause

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Hi all,

I'm going for the results of an MRI scan next week with suspected ACL damage.

Would people to be kind enough to share which surgeon etc they used? All I know so far is if I need surgery I won't be going to my local hospital as the orthopaedic department does not have a good reputation.

I'm up in the Lake District but willing to travel.

Thanks in advance.

Anyway, snowHeads is much more fun if you do.

@Grizwald, Sheffield Hallam has had a good reputation in the past, I'm not up-to-date but it may worth asking around.

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@Grizwald, Ian Fyfe in london. Absolutely fantastich. http://www.spirehealthcare.com/bushey/our-facilities-treatments-and-consultants/our-consultants/mr-ian-fyfe/

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@barney2, Your leg currently isn't supporting your weight. When you are rowing the weight of your leg is causing it to fully extend but the muscles can't support it. Cycling and swimming are both exercises at less than body weight. The good news is you are getting the sensation because your swelling is minimal.

So you need to be moving onto exercise at body weight when your physio says so of course. It sounds as though you suspected that from your comments about walking. Make sure you are consciously pushing through the leg when walking to really straighten it and get to a step for good old 90's style step class action (head band obligatory). It really works. Start each day with a few squats with your arms in front of you, ideally with a bit of weight to get the core properly engaged as again, cycling and swimming do not need the same level of engagement.

Sounds as though you're doing well and are where you should be. A cross trainer could also be beneficial for introducing your leg back to body weight without impact.

After all it is free

@22 dropout, Thanks for that - Not sure about the headband though?
I was pleased to pass the 3 month mark as I was thinking about you having to go back in and get your knee bent at this stage - I take it that you can bend it OK now and are back on track?

@barney2, no looking back after the manipulation. 10 days walking in the Alps really helped in month 5. But not all plain sailing. Running induces swelling and hamstring strength still less than I would like. But I will be skiing in December despite some apprehension. Hard to believe just 7 weeks to go!

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I had the worst confirmed today ruptured ACL and tears to both meniscus. The chap today wasn't a knee specialist but assured me that two very good consultants were available locally. Including this guy http://www.williamhage.com/index.html

I'm not committing to surgery with anyone in particular as yet so time to do some investigating.

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@Grizwald, sorry to hear that. Best of luck!

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@22 dropout, Snap! I will also be skiing in December - Yep - hard to believe only 59 weeks to go

Can I ask those prior to surgery were doing exercise wise? I need to do something or I'll be 10 stone heavier by time I get it sorted- so was thinking of swimming?

You know it makes sense.

@Grizwald, I would seek advice then make up your mind what suits you - But for me - static exercise bike - swimming but not breastroke -least not the injured leg - I also used a Compex Fit 1.0 to try and help build up my quads before the op.

Otherwise you'll just go on seeing the one name:

I concentrated on building muscles.as much as I could, not on weight loss per se. Most importantly, do something regularly. I couldn't run due to swelling. Work in the water is best for swelling but I don't see many slim people in the pool. Rowing is best bang for buck for aerobic and all round strength work. I worked upnto loads of lunges as probably best all round for the muscles that support the knee.

Basically, do whatever you want unless in discomfort or advised not to. No twisting, sprinting sports of course.

A snowHead

@barney2, how are you doing? Week 17 for me and it is ok. Never has my leg wobbled. I am working hard at the gym when life doesn't get in the way. I have worked my dog( the one who took out my ACL) at discover dogs ( golden retriever display team if you are interested on YouTube) have been on a cruise and walked the legs off of my husband, and although the knee tells me when I have overdone it, it's ok. Interestingly when I showed my physio the footage of DDogs she picked me out straight away by my walk, so I am not perfect yet.Have been discharged from the hospital physio, and just visit my local one. Going to Ischgl next month, husband skiing, hotel has a gym. Guess what I am doing? Do get the odd pain, sometimes quite intense and still have my numb bit.

A snowHead

It takes a long time to stop yourself limping when you don't realise it! Have you been set a wobble board yet? Funny thing now is I have been "told off" so many times for limping I can't help notice when colleagues to it, and have to bitey tongue not to do the same.

Well, the person's real but it's just a made up name, see?

I have been told to walk with my left hand up in the air( left leg operated on) to stop the limp. I could not see the limp on the video myself. I thought I had done well!

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@margaret, Sounds pretty good to me - going to Ischgl may be a bit frustrating? But I bet you won't be tempted to stick a pair of skis on!
Limp - Well I think I am now a professional limper! seems to be my default setting! Always getting told off by my wife and the physio- Walking backwards on the treadmill to try and overcome this - though increasing the speed button behind e is intersting.
Hand in the air? I think you will get some funny looks if you walk around everywhere with your hand in the air - make it easy to spot you though.
Now passed 4 months stage and i think that I remember Jonathan Bell saying previously that this can be a challenging time with rehab and yeah I agree - Progress seems 2 steps forward and one back? NHS Physio has examined the knee and said it is stable - rowing machine can do no harm - So tried again at the gym- 10 mins in - same thing - only this time had it happen again while cycling back home afterwatds - which was a bit of a sod as I have always been great on the bike. Physio said that I have one of the most looked after ACL reconstructions she has worked with -(not sure if this was a compliment) Now needing to push a bit more = so I will just have to have a word in my knee dept.
@NickyJ, _ Went to a private physio for sports massage - certainly felt good afterwards but don't know yet if it has helped.
@22 dropout, Your suggestion around lack of power was right - Physio confirmed this with my jumping - Though I have stopped this exercise for now as I think this coincided with problem.

Anyway, snowHeads is much more fun if you do.

@barney2, not tempted at all to put on skis in Ischgl, there is absolutely no snow. Husband could be in the gym with me Toofy Grin

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@barney2, glad you You found the sports massage helpful.

Once I progressed so far with rehab I switched from walking backwards on the treadmill to the cross trainer - alternating forward and backwards.

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@Jonathan Bell, Hello, I just joined this group after attempting to find info on which knee replacement make and model is best for skiers. In several of your posts, you talk about taking those w/knee replacements skiing. What is the make / model of the knee replacement they are using? Also can you tell me what some good ski exercises would be? I appreciate any info. I have 1 knee injury from when I was active duty military and just (in June 2015) had to have meniscus surgery on the other knee. Now they are talking total knee replacement as the 1st knee has gotten worse.

After all it is free

@barney2, I discovered the imbalance when I got access to a Watt Bike. It gives a real time graph and % split of the power you are applying in each leg whilst cycling. It was eye-opening. To achieve a 50:50 split it felt like 80:20 effort through my weak leg. But once I found that I realised that I wasn't getting the full effect of the cycling as my good leg was doing more work. So, if you can get access to a watt-bike, even just once a month they are great for assessing progress, and in any event put more effort into your bad leg and less into your good and you will see the progress quite quickly.

Like you, I tried getting onto jumps etc at four months and pulled back as it was too much too soon. Are you able to do much on your hamstrings yet?

I remember the phase when the knee was very clicky. The good news is, that means there isn't much swelling and the leg is extending nicely. It's just not firing well. Balance the cycling as above. Going into a pool in chest deep water and jogging, building up to sprinting, is an excellent exercise for this as it is getting you to push off, straighten the leg, use the VMO but not at full weight.

good luck.

Back on skis and while I get a few twinges it's going better than expected and have been able to get back into the off piste. However, have been using the knee brace for security. Is this prudent for a few weeks while building up the ski specific muscle strength or best to ditch and ski without?

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@22 dropout, Hi-You must be very close to being back skiing for the first time??? Bet you are watching all long range forecasts - !!!!!!
Yeah I can see where you are coming from with the watt bike - good idea I will look into it for sure.
I blamed the rowing machine for the clicking - clunking - grinding or whatever - but it wasn't the case - It has just got worse and I am just coping with it - massaging the knee whilst biking seems to help whatever it is to locate better - still very much under light loading and with knee bent at around 90 degrees - It will either get worse or improve-
Funny enough I have been running as fast as possible in the swimming pool - bet it looks as stupid as the six million dollar man scenes if anyone is old enough to remember.
Ham string work with elastics still - and moved onto weights ( well my ski boot actually) bending up behind-
Squats now I can do with a back pack full of books-
Walking is getting better for sure - and driving doesn't bother the knee as much
Back to physio in about 2 weeks as she wanted me to have time to make a bit of a step foward - (no pun intended)
But month 4 I think was probably the most difficult one to date - But for sure we are getting there - All downhill now?
Appreciate your tips - thanks

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@BobinCH, I have no idea as about a season behind you - But sounds to me like you answered your own question - If the brace gives you some confidence and security then sounds good to me.

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Bit of an update on my injury.

I finally saw a knee specialist, unfortunately he was the first one to pick up on the MRI that some cartilage is where it should be and that's stopping me from getting a full range of movement back. It's to the extent I can bend my leg much at all (still can't get in the car!)

So I'm going to need an op to remove this (they have a good look at the same time) then wait another however many weeks-months? To strengthen the leg back up etc and he'll do the ligament reconstruction. I also had a fracture that was no picked up on initially but has healed.

I've been told I'm on the wrong side of 30 to probably attempt cartilage repair so he may not bother-is this normal or should I be seeking a second opinion? I want to return to skiing and other sports.

You know it makes sense.

Otherwise you'll just go on seeing the one name:

@barney2, yep, skiing next weekend. Back to the place where I did it… I reckon I've done everything I can physically. Mentally is a different matter. Every year I head out to Chamonix doubting whether I can remember how to ski in any event. There is a part of me that is intrigued as to what I will find in terms of responsiveness, muscular control etc as a result of the op. The real test will be a fresh snow fall. Will I be able to resist it? Should I resist it? Surely one little gully won't do any harm...

You seem to be doing well for four months so don't get down about it for too long. I couldn't do any hamstring work until about 6 months (it just swelled up), and any work on speed responsiveness until 6-7.

I know what you mean about the pool. When I started doing it a young boy said to his mum "what's that man doing". She replied, don't stare dear, I don't think he can swim"!

Just stay in the zone.

A snowHead

Hi all, I snapped my left ACL on a black run 8 yrs ago after mis-judging some ice, had the full hamstring (not patella)reconstruction and have since climbed Kilimanjaro 4 years ago so I know my knee and leg muscles are relatively strong - I'm due out to les arcs end of Jan and wondered whether I should invest in some knee supports??? started doing all the quad strengthening exercises and calf stretches etc but is there anything in particular I could do with doing prior to skiing??? (my DR was rubbish with advice so thought I'd refer to the experts) and pretty sure i'll remember how to ski but my confidence is rock bottom so would you suggest private lessons? or a group ski school? need to go at my own pace but similarly might need the encouragement of others to get me going - Thanks Very Happy

A snowHead

Well, the person's real but it's just a made up name, see?

Ok. So, 10 months after the op and 8 months after getting on a bike I went back to skiing. I have since skied about 15 days and have done everything that I used to do. But, it wasn't the same…

In response to @vickylouise, my first time back was a private 1:2 lesson. I treated it like learning to ski again. I was unsure whether I would struggle on my reconstructed (right) side. I found that I could not do anything very quickly or aggressively and which made me very nervous of other skiers. It didn't help when a teenage girl was straight lining, realised she was out of control and went over the back of my skis. I have chosen to wear a brace this season. I probably won't next but, as @Jonathan Bell says, it does give a psychological boost and in the case of my Ossur some reassurance in a hyper extension scenario.

The good news was that there was no obvious difference turning in either direction, but when the terrain got bumpy I could feel it in my right knee. My physio later told me that this was from my hamstring not engaging quickly enough to hold the patella properly in small rapid compressions, reminding me that it is not just strength, but reaction times that are important when doing rehab.

By the end of the first week my knee was sore, but I was doing good broad turns on skied offpiste and the soreness over ridges had reduced. Short turns and pivoting was more of a challenge and would remain so for a while.

After a break of a couple of weeks I did 9 days skiing in 3 blocks of 3. I have found that after three days my knee is a little tired and aching. This especially shows when putting on skis, when my “stamp” with the right leg gets weaker as the leg gets tired. During that time I gained in confidence and was lucky enough to have fresh snow. I progressed from piste, to offpiste, to deep (very deep) powder, to wind-blown crust, steep and then to trees. Conifers are not my comfort zone in any event and they caused me some issues.

It was not always pretty. Just like learning how to ski again, each progression was with a degree of trepidation, and highlighted what I either wasn’t doing well or what I was not capable of doing. In short, I was struggling to make my turns shorter (a limitation in trees especially) and I struggled in the slab. I fell a few times, felt it in my knee a little but nothing that I will worry about. Then I realised that I was not releasing the pressure as well as I thought I was. Rather like when doing the rehab, I had to make the effort more conscious. Once I did this I gained more control of the skis, could spend more time in the turn and could tackle the harder terrain.

I now feel back to normal. It was enlightening. There is no substitute for doing the activity you are training for as it will sharpen the muscles up. But, they will not respond initially the way you might expect them to so exaggerate what you need them to do to retrain them before you get into a difficult situation. Then, provided you know your exit, don’t be afraid of progressing.

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@22 dropout, Good to hear that you got on pretty well by the sound of it - and sounding confident - Great news.

Anyway, snowHeads is much more fun if you do.

@barney2, thanks. How are you getting on?

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@22 dropout, Pretty crap really - Its been the mental aspect of the injury rather than the physical -which I know probably sounds bizzare - 2016 hasn't been a good start - But on a positive note - my walking is now pretty much there which is really good -
At the moment I am thinking next season we may have an extended time in Scandinavia and do some cross country - skate ski-ing - May be the best option to get back onto the snow and winter sports and build strength and confidence back - Still one day at a time -hey ho.

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@barney2, are you about 6 months now? My physio said a few choice things to me. The first was that the only objective test is at 9 months. Up until that point everyone is different and there is no comparative progress. And you know, she was right. I had the flexion issue, my hamstring was really shot - slow, swelled up quickly and is still a bit sluggish but I got to my 9-moth goal at 10 months. At 6-7 months I got to a low point when I didn't think it would be possible. So don't give up. The other is that only at around 15 months do these reconstructed legs feel normal. I guess she will be right about this as well. For me, the big thing has been exercises that compare the two legs and enable to work the new one to even it up, and to back off into the pool to control swelling to get the most out of the exercise I do.

But you're right, it is a much longer, harder road than it seemed all that time ago.

After all it is free

@22 dropout, Thanks for the advice - yep 6 months since op - - sure to keep improving as we progress into spring and more time outdoors - unbelievable that it is now 12 months since I fell over - Asked the French doctor at the medical centre if he had some crutches I could borrow for a few days - funny now when I look back.
Challenge for me is what was such a simple fall has knocked all my confidence for six - I drove our motorhome back from the French Alps the day after - no problems. - Just need to rehab my mind/brain and get my mojo back - Sure it will come.

@barney2, there will be a point in the next few months, when you suddenly realise that you are moving without thinking about it. You will trot down some stairs, run up them, just cross a room and some time after you will realise that normal things are just that, normal. That's not just based on my experience, but the many people for whom 9 months is a magical average milestone. Scandinavia is a good goal. Having spent a year there it has a special place in my heart. The light is amazing. The way of life and access to the backcountry fantastic and what an opportunity to do something different?

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Guys has anyone ever invested in one of those electronic muscle stimulator things? If so are they worth it? Any ones to recommend stay clear of?

I've now not had full use of my leg since the end of September and have another op to go so need all the help I can get!

Help!!

The snowHeads ACL rehab club !

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