 Poster: A snowHead
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@legalista, four weeks sounds right. I took three, wouldn't have wanted to return sooner. When you return to work it is much harder to control swelling, take it easy, ice etc., so the longer the better.
O/T What area of law do you practise?
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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After having a meniscus repair before Christmas I have my ACL reconstruction scheduled for early March-just hope the Jr Doctors planned strikes don't push it back.
My main problems have been not being able to use it for the best art of 6 months so it's a bit bent and getting strength back into it my leg has been difficult.
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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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@Grizwald, the only thing my surgeon worries about is straightening the leg. He has me placing my hands just above my knee with my leg out in front of me and pushing down as hard as I can for a count of 10 with my leg straight three times, twice a day. He reckons that not fully straightening the leg after surgery os the biggest cause of knee problems in later life.
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You need to Login to know who's really who.
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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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@22 dropout, flying to Canada and then doing a drive around - probably ski somewhere in Vermont, just going to see what takes our fancy and what the weather does. Probably visit Monte Sainte Anne or Mont Tremblant and then Calabogie before heading back.
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You'll need to Register first of course.
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| Grizwald wrote: |
After having a meniscus repair before Christmas I have my ACL reconstruction scheduled for early March-just hope the Jr Doctors planned strikes don't push it back.
My main problems have been not being able to use it for the best art of 6 months so it's a bit bent and getting strength back into it my leg has been difficult. |
I would not do an anterior cruciate ligament reconstruction on a knee that did not have full movement.
You may never get the knee straight again.
If it is unable to fully extend at 6 months you need some help.
It may turn out that you just need physio, especially if you didn't do any after you ruptured the ACL and had the meniscus repair.
That is the simplest reason for your stiff knee.
If physio didn't help other things need to be considered like:
A displaced meniscus tear ( bucket handle tear )
A build up of scar on the stump of the ruptured ACL ( cyclops lesion)
Scarring to a minor Medial collateral ligament injury that has healed too tight.
Internal scarring of the knee ( arthrofibrosis)
The above list is in order with most likely at the the top.
I suggest that you go back to the surgeon asap and find out what is causing the block
Jonathan Bell
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Hello everyone,
having had a read through all posts since my accident last week I have now officially joined this club with my MRI confirming:
full rupture of the ACL, tear of the outer (lateral) ligament (Grade 2) and also of the meniscus (it can apparently be stitched together thanks to location of the tear yet this will be painful).
I have been lucky to have some private cover and was able to see a consultant at the the Saint John & Saint Elizabeth Hospital who is also associated to the Wellington - they seem to be very experienced.... ?
I am however wondering whether I should get a second/ third opinion just to get some further confirmation of treatment and outcomes as my consultant thinks it is unlikely for me to ski next season?! Something I had assumed should be possible yet as the outer ligament seems very loose it might also need to be replaced along with the ACL as otherwise a loose lateral ligament can negatively impact the reconstructed ACL.
The consultant does around 20-30 ACL reconstructions a year- is this a lot?! How do I know about success rates in the long term- he mentions 90% chance of getting back to all sports yet unlikely that it will be all back to how it was before the accident?
As I am based in North London could I arrange an appointment to discuss the MRI with Dr Jonathan Bell for a second opinion?
What experience do others have? Has by any chance someone got experience with Dr Chinmey Gupte?
thanks all already for sharing your experiences and comments as reading these thus far has been great!
Nadja
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Hi NadjaD
Sorry to hear of yet another member - Luckily I am not too experienced in these things (yet). As I had to go through NHS things went slowly -
about 5 months to operation and now 7 months post op - No way could I have been back skiing this season - But - everyone's injury and recovery time is different - I am not so young and things just took their time -Others seem to have got back much quicker - others seem to manage OK without an ACL -
If you have the option for a second opinion - then why not?
Best of luck getting it sorted
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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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@NadjaD, I was back skiing with the blessing of my surgeon 5.5 months after an ACL reconstruction revision that also included resetting on my fibula head and an LCL reconstruction during an op that took over 6 hours according the operation notes I was given. By the way that operation took place in August 2008 when I was a lively 57! So age is not necessarily a good pointer one way or the other. It is the attitude of ALL concerned as well as how much you personally want to get back to it. My surgeon's first question was "What do you want to achieve if we go ahead with this?" He is also a keen skier as were all my therapists (most of them ski tourers but they warned me off that!).
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thanks for your encouraging words!
@SamerbergSue - do you mean in general no more ski touring as this is certainly what my ultimate goal would be again- happy to do next year (not this season anymore) on blue and reds with the children but ultimately would like to get back to pre-Op... I think the concern I do have is that to any non-skiers it seems like throwing caution to the wind if we want to get back up on a mountain as quickly as possible
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@NadjaD, happy to help if you want.
Recovery depends on a number of things. It can be variable between individuals. Although we can give rough estimates of the time to recovery I generally aim, in skiers, to try and get you onto the Return From Injury Ski day in November at Hemel Hempstead. This gives the best chance of getting you skiing next season. You would, however, be carefully monitored throughout to give the best possible chance of that. I have a physio at every follow up to assess your progress so we can proceed at the best rate for your knee. We would not advise you go back onto skis until we feel you would be safe which means strong enough. It's is very important to ensure that we do not put people at risk of damaging their graft just because a certain amount of time has lapsed since surgery.
Treatment of lateral ligament injury depends entirely on how bad it is. The scan cannot assess that. A good old fashioned examination of the knee is the best way to assess it.
Jonathan Bell
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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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@Jonathan Bell, thanks so much for your comments I had send an inquiry to the Wimbledon Ski Clinic last week for an appointment so is it best to give them a call and try and arrange an appointment- i would really value your opinion and of course being able to join the 'Return from Injury Ski Day' sounds brilliant along with assessments as I go along.
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@NadjaD, The return to ski day is great. I was coming back after tibial plateau fracture and a bit of soft tissue damage. Jonathan's physio is excellent - very tough but worth it.
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You know it makes sense.
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@Jonathan Bell, and the rest, thanks for the advice.
As it was I had a break and a good lump of meniscus had become dislodge and was preventing me from getting a full range of movement back in the leg. As the knee would never function properly without this being resolved he opted to do the surgery in two sittings. My injured knee is getting better everyday and is just about straight now.
I've been going for long flat-ish walks and doing physio exercises, I've only been off crutches since the meniscus repair a few weeks.
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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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@NadjaD, sorry to hear about your injuries. I doubt it is appropriate for anyone to talk about medical professionals on this forum even though it feels like a huge decision. What I would say is if it was me (and not so long ago it was), I would make sure that my consultant and physio had a good understanding of the sport I was doing and my ambitions.
Very unscientifically, I would say you should be back at 90% or more of your previous proficiency by next season. The last 10% is a combination of preparation, conditioning and confidence! That means that, if you are an experienced tourer, then touring will present little challenge.
As an exampe, this was my wife following me in Kiroro last week when I was 11 months post-op.
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Poster: A snowHead
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There was a brief piece on Inside Health on Radio 4 tonight about skiing injuries. An orthopedic surgeon suggested there was a 1 in 70 chance of coming back from a week's skiing with a serious injury like a busted ACL. He has several cases right at this moment.
http://www.bbc.co.uk/programmes/b071lcrz
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@altis, Interesting. It's probably right over the last decade or two skiing has really opened up to the masses, so lots of people with poor fitness, conditioning=lots of injuries. It's quite a unnatural movement that's difficult to replicate other than actually skiing.
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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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Whoops - hadn't realised we had gone on to another page! Welcome to the club Nadja D - but commiserations, too. 22 dropout - family law is my speciality. At the moment, the OS is talking about doing both ops at once - the meniscal tears I think are the main reason to get on with it, but knowing that I'm keen to get on with the ACL surgery has said he can do this at the same time.
I'm still on crutches and using leg brace due to instability. I'm working hard on range of movement with the exercises and also using the exercise bike. It was scary how I couldn't even get my leg round a complete revolution when I started but I now can and am very slowly increasing the time and there is definitely progress.
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You need to Login to know who's really who.
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@legalista, who knew you bend your leg so much when cycling until you can't?
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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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@legalista, The static exercise bike was very good for me - first thing I did really and for sure it helped with movement - whilst not weight bearing - I think it was good for building some confidence and seeing progress.
Good luck with op in April - least you now have your first goal to work towards.
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Did your knee extend forwards when it collapsed after the fall and has it now gone the size of a football? If not it may not be so serious. Obviously out for this season but you may be walking on it again in a couple of weeks. I did mine in Jan and was hobbling around the village the next day with the leg brace, am now running slowly on a treadmill. MRI will show if the ligament damage is very bad and needs an op or less bad and needs gentle exercise.
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@andyg9053, Its definitely not balloon size or even that swollen at the moment and I was mooching about in Centre waiting for a friend to come and get my skis and boots from the med centre for a coupe of hours (sat for some of that, leaning for most and some walking around very gently).
The injury was a sideways motion as my knee was slightly bent due to trying to get up. It doesn't feel as bad as he has suggested but its only been 8 hours, so am hedging my bets and being immobile for tonight. Will do a little bit of walking with the brace on tomorrow then more rest (can't sit/lie in the apartment for too long without going stir crazy).
Took 2 x 500mg paracetamol and that seems to have reduced the pain a bit (unusual for me as generally not much works in pain relief, I usually resort to co-codamol, but haven't needed to yet). Just going to walk gently and little and follow instructions for physio and see how it goes. With luck it won't 'balloon' too much, even though it felt like a chicken leg dislocating!! And I have a promise of Genepi tomorrow lunchtime - genepi treats everything!! 
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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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@chaletgirl,  Hope you have a speedy recovery.
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Chalet girl - oh dear! Ice is the way to go here, I would recommend . It helps both with pain relief and with getting any swelling down, but it's a great sign that it's not swollen up too much at this stage. Let's hope you get away with it, but commiserations if you don't and it is an acl tear. Welcome to the club in any event.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@chaletgirl, Sorry to hear this. Have to say I've seen/heard of too many injuries that have happened when inexperienced people have picked or try to pick up fallen skiers from a awkward position. Witnessed first hand a ruptured ACL after someone tried to pick someone up on a steep gradient.
Mine wasn't skiing but swelled up massively, as if I'd somehow swallowed a melon and it became lodge in my knee! 
Quite a few lads who I play rugby with have done there's and kept running after hearing a pop.
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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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@Hurtle, @legalista, Thank you. Sadly, the little bit of sun seems to have melted the snow on the balcony! (not that I am sure I'd have been able to bend down to put it in a bag!!). Ice pack in the freezer and freeze gel liberally applied!
@Grizwald, I 'think' the instructor was telling the other students not to do that afterwards - it was in French, so not 100% sure as wasn't listening closely, but am pretty sure he was pointing out that the damage was due to being pulled up. I didn't know that could happen to be honest but then have never tried, I always take my skis off and get up then start again. We were in powder but it wasn't that deep! (Just off piste).
Still no swelling and looking at 9 hours now. I was pretty active between getting let out of the med centre and going home (well, gentle walking, leaning and sitting. Had to walk to the telebus and then from there to home, so for the injury, quite active I guess?).
I physically couldn't keep going as when I tried to use that leg for skiing or walking it collapsed on me But I plan to do a little bit of walking each day with the full leg brace on for a while until it (hopefully) feels better and I get to do physio.
Thanx for the comments and support xx
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When I eventually saw physio he was pleased as I hadnt sat with my leg straight for 3 weeks, I found night was worse, extra pillow for your knee and definitely wear brace in bed. Within about 2 days I was hobbling around in the hotel room without brace but put it on when I went out. When I got home a week later I didnt wear brace in house. Do very gentle stretching exercises.
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You know it makes sense.
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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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@chaletgirl, what did your doctor say about crutches to take some of the weight off of the injured leg? Also ibroprufen for swelling (can be taken with paracetemol)?
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Poster: A snowHead
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| altis wrote: |
There was a brief piece on Inside Health on Radio 4 tonight about skiing injuries. An orthopedic surgeon suggested there was a 1 in 70 chance of coming back from a week's skiing with a serious injury like a busted ACL. He has several cases right at this moment.
http://www.bbc.co.uk/programmes/b071lcrz |
Not sure where that statistic came from.
1 ACL in 70 trips of six days is approx 2 per thousand skier days.
I think there may be some confusion with numerous studies that put ALL injuries requiring medical attention at about 2-3 per 1000 skiers days.
I'll see 5 ACL ruptures some weeks from skiing but there are huge numbers of people skiing in our area.
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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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@chaletgirl, If it's giving way on you it would suggest a rupture but I know nothing I'm not a doctor can just share my own experience and what my consultant has told me. Have they scheduled an MRI or do you need to wait until you're back in the UK? My consultant told me that MRI's are 90% successful for diagnosis so 1 in 10 will miss.
I called my consultants secretary this morning and gladly she confirmed my operation will still take place this Thursday despite the junior doctors strikes! Good news, I was convinced it would be cancelled.
The NHS is a wonderful thing BUT having never had any health issues before it has certainly highlighted how stretched it is. Although this wasn't a ski related injury it has made me reassess what provisions I have in place health insurance wise in the future. I've been off work a lot but I'm lucky to have good T&C's and paid sickness.
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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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@Grizwald, I'm not planning on returning to the UK until late April, so anything that needs doing will probably happen here as long as my season insurance allows it! When I see the Doc again on the 15th I'll ask about an MRI and surgery. Given the amount of these injuries that are seen in these areas, I'd be quite happy to have any surgery done here. And there seems to be much less waiting time for things like MRIs (the Xray I had on my lungs was a case of walk in and have it done, take the X-ray back up the mountain to the doctor!).
Just going to have to deal with it for another 9 days until I see the doctor and get more answers.
I'm going with his diagnosis until he sees it again. Its still not as swollen as I'd expected and definitely not as painful as I expected. Both good (to me) but no idea what that mean about the injury! Just got to be patient (not exactly my forte!!)
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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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@chaletgirl, what country are you in? Not Scotland I presume  . There are people in here with experience of medical treatment overseas that might have some useful advice. Get an MRI as soon as possible though if you can and try to be accompanied. My recollection is that there is was lot of information and too much going on in my head. An extra pair of ears is really useful.
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@chaletgirl, do you have carte neige?
I had to wait quite a while for an MRI in Annecy as there were apparently loads of these injuries around the same time. It just confirmed exactly what the doctor who'd wiggled the knee about a bit had said - full rupture, everything else fine. He also specifically told me to sleep with the brace on for the first couple of weeks even though I didn't want to.
If you do need a reconstruction and you have it in France, I absolutely recommend my surgeon in Annecy.
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@chaletgirl, sorry to hear about your injury. A useful reminder about the need to avoid hauling people to their feet. 
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@22 dropout, I'm in France, La Plagne. A friend here was treated for a shoulder injury that involved surgery and was impressed with the system and quality. Also, I'm intending to move out here from next winter, so might as well find out how it all works! Don't know whether it will help to go to the doctor before the 10 days he requested but if it doesn't swell any more, I might ask someone to come with me for an early check up and request an MRI. And, whatever I do, I will try and get someone to come with me for future appointments, like you say - so much information and when you are emotionally involved (its your own knee!) its much more difficult to remember stuff
@miranda, I do have a carte neige. That just got me off the mountain. I also have Seasonnaire Insurance so need to ring them tomorrow and sort out letting them know and finding out what they will allow me to have done here. The doctor definitely said just to wear the brace for walking. But maybe I'll use that query to go back and ask about an MRI at the same time. If I do have it out here, I'll probably ask you who the surgeon you had was. On the wiggling of the knee, I couldn't feel/see any difference to the uninjured knee against the injured one. I guess the Doctor could!!
@pam w, definitely a good reminder. Rather steep learning curve for me as had no idea that could cause an issue! At least I've learnt something even though I couldn't do my week of ski school!!
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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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@chaletgirl, I'm sure the surgeons over there will know what they are doing and see plenty of injuries of this nature. I'd use the same due diligence as in the UK and make sure you're getting a sports knee injury specialist rather than a generalist.
Having skied and instructed in Austria I can tell you that for an ACL their approach IME seems to be different to the UK (members such as Jonathan Bell may back me up or discredit my statement) where they will operate quickly on an ACL where as in the UK generally they like things to settle down allowing circa 6 weeks before surgery. Not sure if the approach in France will be the same? There are of course non surgical treatments but depends on your age and what actives and level you want to get back to, ACL is a bit of a must have for skiing but plenty seem to still ski without one using braces such as a ski mojo.
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@chaletgirl, If your seasonnaire insurance won't cover it, you could still consider doing it in France. I was still a UK tax resident at the time so didn't have my Carte Vitale. My UK insurer wanted to fly me home so I could go through the NHS. I therefore had the op in France and paid for it, then claimed back via EHIC, which covered say ~70% and then Carte Neige picked up the rest (it covered up to €3600). I'm sure there are excellent surgeons in the UK and clearly there are very happy patients of Jonathan Bell on here for a start, but if you want to start the process before you go back to the UK, then I was very, very happy with my experience here (surgeon recommended to me by local ski instructor who'd totally wrecked his knee and it's now good as new). Operation by May should see you skiing by beginning of next season unless it's complicated (i.e. meniscus and other ligaments involved) I think... JB can correct me on that obviously as he's the expert!
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