The snowHeads ACL rehab club !

A snowHead

@legalista, Plasters on & then clingfilm! I was advised to swathe my leg in the stuff prior to showering & it kept the leg beautifully dry Very Happy

@margaret, Glad you are doing so well Very Happy

A snowHead

Thanks! Will do the trick with the cling film. I'm more mobile (albeit on crutches) than I thought I'd be but am trying to get the range of movement back - is there any reason why I shouldn't sit on my static bike and gently work the pedal back and forth into the area where it gets tricky (I can't turn the pedal all the way round)? Also, I want to sleep all the time - is this normal?

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@legalista, I can't think of any reason not to sit on a static bike & gently work pedals back & forth. My physio had me on the bike within 2 weeks & my only concern was getting off it without coming a cropper! As for sleeping - well, it's a great healer & having pain/discomfort is tiring. I'm sure it takes a little while for the opiates to work their way out of your system too.

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@legalista, I found that sitting on a static bike and going backwards and forwards (could not go all the way for a good while) seemed to help. Every time I went a mm further. Again, getting on and off was the tricky bit. Get as much rest as you can, healing is tiring. At least you have started your journey and have an end goal.

Anyway, snowHeads is much more fun if you do.

@genepi, @margaret, Thanks for the advice! I agree re perils of trying to get off the bike - am doing so in super slow motion!

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Brilliant to see so much positivity on here

I haven't been able to get an MRI here (when I rang I was told the earliest was June Sad

).

However, I'm fully mobile. I haven't skied, but I have been able to do about 5 - 7 minutes cycling (indoors) most days and quite a lot of walking. I've sometimes not cycled if I've done a LOT of walking. Up until today I had some 'not quite' pain just under the bottom of my knee cap when walking (as I lifted my leg to bring it forward). Haven't been able to go back to the yoga I used to do because it puts too much pressure through my knees, but I do a little each day.

Yesterday I had to load a small motorbike into a van; hadn't asked anyone else to help as I can load it up the ramp on my own just fine, as long as it starts and I can use its power to get it in!!! Sadly, it didn't. I tried twice to bump start it, then had to push it up into the van without using its own power. (succeeded on the third go!)

I fully expected my knee to be in agony today and have trouble walking - BUT its been fine and I've had none of the pain that was there before. I've been packing and cleaning and shifting boxes around.

Once I'm home, I have an appointment with a guy that helped fix my left knee and feet (NeuroKinetic Therapy & P-DTR - a bit 'alternative' but it worked for me!) just to see if he can help with getting me more balanced, as the limping for those few weeks has left me with back and hip pain (similar to when my knees and feet were bad) and I can feel that my right leg isn't working as well as the left. If he can straighten that out for me, then I will be working with a PT and finding a physio in Bristol to help get me fit.

I still want the MRI to try and find out exactly what the issue is. But currently, the knee is very stable and not painful - here's hoping that continues as I'm coming back out next season and plan to ski a shedload more than I have this year!!!!

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@chaletgirl, good to hear you're doing well - fingers crossed for you! The physios with me were very keen to avoid getting into a pattern where you limp when you walk - apparently once you start doing this it can be difficult to stop and this can lead to pressure on other joints. They told me to use crutches rather than limp and also to make sure that I always start with the foot on the bad leg striking the ground on the heel rather than the toe. It makes sense to me and it sounds as though you are dealing with this anyhow but I just thought I'd say it sounds to me as though you're doing the right thing.

After all it is free

@legalista, Excellent advice from your physio there. It takes a little longer to get moving, but always try to get into a good standing position first - so, upright & leg straight, before setting off. And definitely no limping Toofy Grin

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@chaletgirl, ask your guy to look at your hamstrings around the knee. They could have torn a bit below the knee and be tight as a result, especially after less use. This could cause more pressure under the knee and below the kneecap, especially after a bit of exercise after not being used and not having been straightened as much immediately post accident. Nothing that a bit of massage and stretching won't help ease.

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@22 dropout, I wondered about that. Thank you. He is excellent and I'm writing down how the knee/leg feels as I get different feelings/pains, so he'll have a decent bit of info to work with. Bit gutted I couldn't get the MRI before leaving, but I guess its not the end of the world!

Thank you Smile

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one week now post surgery and feeling pretty good (touch wood). I'm putting weight through the knee when I walk with the crutches - the swelling is still there but gradually reducing. I have almost complete extension when I try hard and a bit of flexion. I can do the straight leg raises and hold them (yay!). I'm taking paracetamol when needed - perhaps 3 in a 24 hour period.

Can I ask advice on two points though? Firstly, is the feeling of having a compression bandage around the knee when I try to work on the range of movement due to swelling? It does seem to vary so I'm assuming it's that. Secondly, should the staples they used to do up the wounds come out at 14 days post op (I was told at the hospital but was out of it mentally and may have remembered wrongly - OS is away at the moment or I'd ask him). Thanks!

@legalista, 14 days sounds a bit long to me...did they not give you an aftercare sheet?

You know it makes sense.

They did, but it just said words to the effect of you'll need your staples to be taken out and make sure you keep the appointment - without saying when!

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

@legalista, I have felt limited in my movements due to a 'blockage' at the top of my knee which feels and looks like swelling. It gets better with time, physio and exercises but I still feel it at almost 6 weeks post surgery, especially when I walk down steps.

I can't help with the staples question as my stitches were allowed to be taken out after 1 week.

A snowHead

@legalista, I can't remember now when everything came out. Why not phone your surgeons secretary & check with her on Monday?

A snowHead

@legalista, yes to the swelling as it is putting pressure back onto your nerves. Aren't you wearing compression stockings anyway at the moment? Agree with @genepi, call secretary, but for the record mine were taken out after 3 weeks or so. Good idea to stay with paracetemol, as it helps with the flexion exercises (less painful) and don't forget to do lots of calf pumps/a few raises - they really help with swelling.

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Ah - I hadn't realised I was meant still to be wearing them and I will go and put them on right away! Thanks for this. I will try to contact the secretary next week.

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It's interesting how medical advice varies! I saw the physio today (11 days post op) and he was deeply relaxed about wearing compression stockings, saying that he wouldn't bother and that they would just cause any blood and swelling to gather on the knee. This seems counter to a lot of the advice I've read on the web but having forgotten/not been told to wear them anyhow it does make me feel better! Luckily, there is almost no visible swelling now, although I can feel the band around my knee so it's clearly there somewhere. Anyhow, all is good so far - almost there on extension, 78 degrees on flexion but improving each day so I'm just carrying on what I was doing - i.e. lots of leg raises, lots of extension thingies, lots of heel slides etc etc. Am also going to start touching my toes. I feel the need for a music routine to do all this to. I note Miranda's Eye of the Tiger concept which sounds fun, but perhaps I'm in a more yogic mood - George Harrison maybe - All things must pass?

Anyway, snowHeads is much more fun if you do.

Newish topic I hope Has anyone any idea if cross country skiing is likely to be less risky for repeat injury after ACL tear?

My wife did hers 2 years ago and the surgeon is not keen on reconstruction for some reason. She does tons of exercise and seems OK generally but is very reluctant to go downhill again

Thoughts/advice welcomed

Geoff

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Hi all time for an update from me.

6 weeks for surgery and was back to see the consultant today.

As mentioned previously I've not been impressed with the the NHS physio. The surgeon and I spoke about it today and he said I was the second person to complain today about the physio department. He's going to send them a note but explained as with everything with the NHS it's somewhat of a postcode lottery and for the surgeons it's hard to hear as one it's jepordising their work and 2 it's costing the trust 8-9k for an operation which a grands worth of physio is meant to complement.

Anyhow I'm seeing a private physio and he's been great. I'm invested in a compex 2.0 Basically as I've had two operations my muscles are now non existent! They just aren't switching on so using the compex for a bit of a kick start. Got a good rate brand new from an Italian seller £200 they retail for £300+ in the UK.

My leg isn't straight yet, I spoke about these concerns with the surgeon and he said it's partly physiological but mostly muscular at the moment as there's nothing physically stopping it from straightening. I'll persevere, he's going to see me monthly from here on in.

I can start doing a static bike etc. I think I need to give myself a kick up the backside too! I have stick to walk with due to the bent leg.

Slightly off topic, I've taken to coaching while I've been injured and saw an horrific injury on Saturday. Basically a team mate suffered an injury where he broke his leg, and ruptured his ACL, PCL, and MCL Sad

People rightly get upset over an ACL injury but this is next level. The surgeon said it was a 9.5/10 severity wise and sporting injuries don't really get any worse.

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After all it is free

@Grizwald, - that accident sounds horrendous. As you say, it's a whole different level. I hope that for your injury, the private physio will be able to help you more.
@geoffo, a canadian friend who suffered an ACL injury which wasn't repaired has moved on to cross country skiing which she enjoys and is able to do perfectly well. She mentioned that she uses the skis with metal edges that grip better.

@geoffo, It sounds like your wife understandably has a confidence issue following her injury. If her knee is stable then no surgery should be fine, but any doubt get a 2nd opinion from a knee surgeon who skis! As for cross country - it is a totally different form of exercise & gets you out into wonderful countryside in the snow. I would say it puts a lot of pressure on your knees & definitely needs them to be stable. Do it as a change from downhill and it is great. It is also nice and quiet in my experience, so if crowds are an issue for her, it may well be a solution. If she is worried about downhill though, I'd suggest she has a few private lessons to regain her confidence.

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Thanks for the helpful comments guys. I will have a word and see what we can do - it's a bit tedious skiing my own!

Geoff

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@geoffo, coming back from my ACL reconstruction I had lost my confidence. I got an instructor I know and we went onto some gentle blues and went back to basics and, in the process, my confidence came back in parallel with my enjoyment of skiing (which had also taken a beating with the accident). It would have taken a lot longer if I had tried to return straight to what I used to ski.

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So 7 weeks after surgery I am now able to cycle on a stationary bike without any flexion pain for 15 minutes. Pushed up to 120 rpm on level 8 out of 20 and felt strong and only stopped as it was my warm up before my exercises.
I can do seated single leg press and calf raise at decent weight as well as single leg BOSU balance. Extension must be pretty much nigh on 0 degrees and flexion probably around 130-140 degrees, but I haven't had it tested this week to check the exact numbers.
I always have compression shorts on, that go over my knees, when doing any exercises.

I still have pain in places around the knee especially just behind the knee on the outside, where I have always have pain, but it is much less then before. Quads have definite sore points in them and some knots that the foam roller reminds me of constantly.
Physio tells me I am at the top of recovery of the 4 people they currently are treating who had ACL surgery around about the same time as mine (just to keep me competitive...!) Smile

You know it makes sense.

@Touchguru, fantastic progress to be doing those things at 7 weeks without any increase in swelling.

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

@Grizwald, the last part of your post somewhat overshadowed the rest. How terrible.

RE straightening I am sure you have been given exercises to work on this, propping your leg up on a stool etc and to get off the stick to full weight bearing and muscle usage. How is the swelling?

A snowHead

Amazingly it turns out its the 4th anniversary of my operation and this thread. I think it's fair to say I don't give it much thought these days but it can be sore from time to time.

I'd say I'm skiing harder now than before, when I'm minded so it all worked out ok in the end.

Good luck to everyone who's joined the club!

A snowHead

@AndAnotherThing.., good news Happy

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

@AndAnotherThing.., yes, good news!

This must mean I'm very nearly at my 4-year anniversary. I think it's fair to say I don't give it much conscious thought at all these days, and luckily for me it's never sore...

BUT I still have some subconscious stuff going on, namely, still much more nervous than I was before with regard to skiing on the unknown and still subconsciously not trusting my left leg so much - it's noticeable when, say, sideslipping that I will always want to have my right leg as the downhill leg and when clipping in, I instinctively want to clip into the right first even when it's the uphill leg. I just came back from doing a hut to hut tour and there were all sorts of reasons that I was nervous (my first tour of that kind) but part of it was knowing that a guest of ours had snapped his ACL on the first stage when he'd done the same tour and had to be helicoptered off and that really didn't help! So whilst I'm signing up for bolder things than I did before the injury and op, subconsciously I am less bold and I need to consciously push myself a bit more to use and trust my left leg and commit more. Or, as my ski instructor pointed out, you could just lose both ACLs as she has done... that way you can't favour one leg over the other Skullie

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3 weeks tomorrow since the op and saw the consultant for review today. All going well! Don't need the crutches any more and I have good extension. Flexion could be better but he said that was more to do with the oedema and not to get too fussed about it. I can now drive again and am going to get back to work next week - earlier than planned. So far, so good - but I know it's a marathon and not a sprint so am trying not to get too excited! Interested to hear what Miranda says about still feeling the psychological effects four years later - I can so understand how this would be so.

Anyway, snowHeads is much more fun if you do.

@miranda, Must be 4 years for you too ! Good work getting into the touring. I'd like to do more too.

I must admit that when I got back to skiing, deep down it took a while to get over the fear. I *think* I'm over that now but sometimes get a bit of a reminder if I get 'back' or if the snow if especially heavy. Crap or thin snow cover is ok for me ( http://snowheads.com/ski-forum/viewtopic.php?t=92360&start=160#2888481 ) and in some ways offers good training as you have to focus on doing the right thing. Still, not for everyone !

Interestingly, last time out doing that stuff I did wear a helmet Laughing

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Thing is, I would have said I was no longer "psychologically affected" after the first season or two because I'd stopped consciously thinking about it but by ignoring the subconscious signs rather than facing them, I've strung it out longer than necessary. Fact is I used to be quite foolhardy, and so did something foolhardy and signed up to the Haute Route as my first real touring trip without training and and a more gentle intro experience. So there were a number of things making me nervous (not used to the soft boots, light skis and bindings, heavy backpack and not at all used to skiing above the treeline, living in the mountains so used to skipping poor viz or crappy conditions altogether + being conscious of our guest's unfortunate experience). And when nervous, it became very clear to me that I was favouring the non-operated-on leg when there was no need to do so and, indeed, when it was inadvisable to do so, plus generally skiing way below par). BUT, the good news to take from it is that I've now done the Walkers' Haute Route and the Skier's Haute Route with zero problems in terms of fitness or injury... and now I've spent a week forced to be out of my comfort zone and noticing these subconscious signs, I know what to work on and so am confident that things will get better snowHead

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@miranda,

After all it is free

If I have a ruptured ACL is it advisable to cycle on a static bike, am i likely to cause any further damage?

Just trying keep the weight off the waist!

@1969jma, the static bike is definitely fine to ride... Tbh it is advisable. The stronger you can keep your muscles the better.

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@1969jma, the good news is that once your ACL has ruptured it basically stays ruptured so you can't really do any more damage. But, the knee itself is then weakened and you need strong muscles around it to provide the support and avoid damaging anything else. Avoid twisting sports until you are properly diagnosed, including breaststroke, and otherwise do anything unless it causes swelling. Do not ignore your hamstring as it is an important stability muscle.

Lots of kicking in water is great for any knee injury, surprisingly hard, and you build strength quickly without other injury risk. Static bike needs resistance to have an effect.

Why are you keeping weight off the waist?

Help!!

The snowHeads ACL rehab club !

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