The snowHeads ACL rehab club !

A snowHead

@AndAnotherThing.., it was indeed.

A snowHead

Don't want to be spammy but for those SuperSH's with adverts turned off we have launched a return to skiing programme at Hemel. Details on our website.

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

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@Jonathan Bell, it's on the website http://www.insideoutskiing.com/uk/return.html and http://www.insideoutskiing.com/sales/index.php?route=product/category&path=88

Return to Skiing Programme
Our Return to Skiing Programme is aimed at skiers who are coming back from injury or surgery, those who struggle to enjoy skiing due to old ailments, or who may suffer from general aches & pains and are unsure of their fitness. We offer a full range of services from clinic based post injury physiotherapy, return to skiing coaching clinics, sports massage, individual functional fitness evaluations and rehabilitation exercise/pilates programmes.

Uniquely to Inside Out Skiing Lisa Cordwell who heads the programme is a fully qualified physiotherapist with extensive experience treating ski injuries as well as being a great ski coach!

Our Return to Ski Clinics at Hemel have a maximum group size of 4, ensuring lots of individual feedback and everyone skiing at their own pace. The sessions have no set programme and are run as an extended group private lesson giving you full confidence to return to skiing at your own pace.

Two 90 minute sessions on the slope with video during a break in between and also includes a Post Ski Review session with Lisa after skiing to check joint mobility, perhaps prescribe exercises or stretches for you and to track progress of your rehabilitation. We also offer one on one Private Return to Skiing Sessions.

Plus a range of off slope activities to help your return to skiing

Stability Testing for Ski Injury Prevention
Personalised Exercise Programmes
Pre-Skiing Physiotherapy
Sports Massage
Post-Skiing Physiotherapy

Anyway, snowHeads is much more fun if you do.

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@Jonathan Bell, I was looking at doing the same a couple of years ago after returning from my ACL. However trying to sort suitable midlands \ North West locations was harder than I imagined so I let it drop.

After all it is free

@Jonathan Bell, Many thanks for your messages. We are striving to be a bit different in that our ski instructor heading the programme is also a physio with 7 years of treating ski injuries in Meribel and a few years managing a ski school... A rare combination.. Also we have collaborated with a bio mechanics expert to develop a simple evidence based field stability test that I am hopeful will last the test of time and really help identify and then improve individual issues.... Have also added some testing for range of movement and strength/endurance in the ankle joint to help identify those who may need boot fitting/ orthotics after discussion with CEM and look forward to chatting about all of this with you. Happy skiing in in Cham !

@skimottaret, I had to be assessed by Jonathans physio for rom, strength and endurance before I was cleared to attend the event.very good idea and got a lot of ski related exercises to do which complemented my rehab. physio. Interesting twist re orthotics etc

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@Jonathan Bell, yes indeed, 2 trips down and the next in Canada in 2 weeks. A little hiccup in keeping fit due to unconnected injury but back into the groove now. .in fact off to physio shortly snowHead

First, hello, and thanks for all the useful info here.

@holidayloverxx, I've just looked at the webpage for Stability Testing For Ski Injury Prevention class after reading this thread. Can you tailor your programme to test against the needs for snowboarding? Well, to be specific, splitboarding, so the uphill components of ski touring in addition to the downhill boarding.

The added complication this is post combined Osteotomy and ACL reconstruction (operation approx 9 months ago). If anyone has any wider advice or experience on the return to snow after a procedure like this it would be most welcome.

You know it makes sense.

@NearlyFlying, welcome to snowheads. That's not my programme, it's an Inside Out programme which certainly looks as though it can be tailored. ..but not sure about snowboarding. I suggest you drop them an email and ask.

Good luck

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

Oops, sorry, will do! Thanks,

A snowHead

A snowHead

@NearlyFlying, hmm tough one, The testing we are doing is specific to skiing I will err on the side of caution and say no we can't tailor the tests but could certainly do the tests and then develop a personalised recovery exercise programme for you that is more specific to snow boarding . The general joint stability tests will be good for you especially if you have had knee issues.

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

Unfortunately I think I may have to join the club!
Had a fairly standard wipe out on red run I had been on lots of times - not going that fast - But as I was crashing I knew something was wrong. Bit of dull pain but nothing exciting!
Got my skis back on but when I put weight on - - my knee hinged sideways - Not good - tried again after 15 mins - same new hinge had arrived on my leg from nowhere?. Half an hour later blood tub and ambulance to medical centre. Xray and examination suggested Cruciate Ligament injury- This was 30 th January.
Drove back to Uk in our Motorhome over 2 days with lots of stops on the way to move knee about - doctors 2 days later - Knee specialist 2 week later and suspected ACL injury - MRI 2 wks after that - Now 9 weeks on still awaiting results MRI Scan - hospital have sent them to consultant - just waiting for an appointment. Tum te tum
I have read all 23 pages on here and thanks to everyone for posting - helps to hear other peoples experiences - I was given conflicting advice - Consultant pretty much said don't do anything whatsoever - keep knee brace on all day - Physio probably won't touch you. Even if you need an operation you will have to convince me - very negative and treat me a bit like an idiot - Guess they are just overworked?
I chose to ignore this as it didn't seem right? My muscles and fexibility would be non existent now after 9 weeks - have been in the pool - some mobility ex. some walking on flat - Pool was the best ever - getting the weight off the knee and being able to walk/move more normally.
Physio also thinks ACL injury - given me some exercises and has really increased my confidence and talked about options when MRI results are back - Now off crutches and walking outside with brace.
The length of recovery from these knee injuries is the most daunting I think - Never had an injury in 30 years skiing - now 55.
I will post how it goes

Puzzled

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@barney2, Welcome to snowHead

, but sorry you have had to join the club! I wonder if your age (55) was the reason for the consultant's negativity - I was 51 when I did mine & was told that I was too old for surgery. I rehabed it & did lots of exercises & it was great for 6 years when another accident completely unstabilised it. GP referred me back to the original orthopaedic surgeon with unstable knee, but I was now even older! He offered me a cadaver replacement ligament, but I didn't like the sound of that, so I struggled with it for a couple of years with it becoming increasingly unstable in everyday situations. Then I met Jonathan Bell, who was happy to operate, given how it was interfering with my life. I haven't looked back. Had op last april & have done about 4weeks skiing this year. I think first of all you need to concentrate on getting the knee straight & with no swelling & then work on strengthening it. Good luck & please keep us posted with how you get on Smile

Anyway, snowHeads is much more fun if you do.

@genepi, Thanks for that - Yeah I think age was possibly part of the negativity- and that it was skiing related. However I intend to ski as long as I possibly can and would hope into early 70's? But I will just keep trying to get as much info as possible and then try and make a balanced decision - and push for the best option for me - I can get the knee straight now - and have only ever had a small amount of swelling - It was extremely cold at the time - and apparently this helps stop swelling - and anti inflamtory drugs straight off - and the knee neoprene/brace thingy - I think all helped. Lets see how it goes?

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Sorry to hear about your accident. It's good you've got extension and the swelling down. Regarding exercise, as someone who is now 3 weeks post replacement I did loads before the op. There were times when I thought what's the point, I'm only going to lose it but I am so grateful that I did. Do more strength rather than cardio if it suits you, as that is what you are going to need to get control of the leg afterwards. Especially the Vastos Medialus. See a physio right now, choose wisely and they might recommend a consultant that you feel more comfortable with.

Then you can post your own questions or snow reports...

After all it is free

@22 dropout, Good advice re strengthening - that is what Physio keeps telling me - still bloody painful though after some exercises and I have knocked a couple of them on the head till I get confirmation of injury. I am with NHS Physio and consultant so don't think I can choose where I would go? Phoned hospital yesterday and the results are still on the consultants desk from 3 weeks ago - Frustrating but I realise NHS is busy and it is just a knee afterall -
Been reading info on knee guru and other sites trying to get as informed as possible -
Funny - but we always a hell of a lot wiser after these events -

@Jonathan Bell, Thanks very much for that - I think I must have been typing in as you had posted - Yep - steady progress and patience.

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Results today - Isolated ACL injury - so - looks like reconstruction surgery within next 3 months. Although not best of news - I am more confident with the surgeon now- talked through and showed me MRI results - so lets see how it goes and how soon they will let me back skiing after rehab post op?

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This was not my preferred Club in snow heads to join... but here I am.
3 months post op ACL reconstruction,
( Have tried to post few times before, but to be honest was pretty traumatised by whole thing)
Had a stupid little fall down to Flain on 29 Dec, very cold and bumpy. Binding did not release. I could get down to Flain and diagnosed as acl fine, meniscus and medial ligament seemed problem.
This was day 2 of 2 week Family holiday so braced and just sat out and spent next week at physio St Anton, who also thought medial meniscus and tested acl intact.

Checked into orthopaedic surgeon soon as back in South Africa, who also thought acl intact, but unfortunately MRI showed ACL rupture complete, medial meniscus and also cavitation/holes in bone.
(probably when tried to ski on it straight after injury) Got op in same week - acl reconstruction hamstring autograft, with medial meniscus repair. Unfortunately graft was too thin so they took tendons of other legs hamstring too! ( try imagining waking up to huge bandage on wrong Knee!)

Timing terrible as always and no rest even for the injured mom- did not do too badly but had to travel a lot, and had a fall down stairs at 6 weeks which did not help, but getting there. Starting biokinetics tomorrow. Knee still painful full extension and clicking a lot, flexion almost full. Gym and rehab 3 times a week.

sorry for long saga-- but if I may ask: what is usual time for getting back on skis after reconstruction?
Not a lot of experience here in SA with ski-injuries make them all say one year (Although rugby players here are back in 9 months)

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@lizski, glad you are making progress. Its going to depend but around 7 months for easy skiing for me.

Glad to hear that, as we are taking a big group of kids to Afriski in August, and don't know if I will be able to abstain Embarassed

Will of course see how progress is - getting a MRI at 6 months to see if bone cavities have heeled, otherwise apparently no running again. Should give me a good indication.

You know it makes sense.

@lizski, Some rehab diary's here - http://snowheads.com/ski-forum/viewtopic.php?t=91354

If anyone can add their own experience to the page let me know.

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

@lizski, - Yeah - pretty crap club to be in -
- Bizzarely I think I was even trying to deny that I was injured - (well i just fell over didn't I ?) Until finally saw MRI scan with surgeon. The length of rehabilitation time is pretty intimidating- I have had 3 months already from wipe out getting movement back - did away with the knee brace fully this week - now a wait of 3 months for op. - Then surgeon is suggesting several months before given the green light to go skiing again-
At 3 months you are just fully straightening knee joint? Physio is saying that after operation this is one of the most important aspects to get the knee straight - - as they can work on the bending later. There seems to be lots of differing ideas -
I see you are going to have another MRI - This is probably a stupid question - but - don't they use screws to fasten hamstring to the bone - So how can they use MRI if screws are in the knee?
Best of luck skiing in August

A snowHead

@barney2, sorry for you too - you never stop wishing it was all just a bad dream. Even though I heard an awful tearing sound with the fall I still hoped and believed it was minor!
I was very lucky to receive my op quickly, mainly because he needed to suture the meniscus tear within a certain time before blood supply lost.but then again would have been good to do a good pre op program too.
I straightened knee from beginning and got good extension, it is just that it is unfortunately still a bit painfull with full extension ( which is actually hyperextension - or basically lifting your heel off floor while pushing back of knee into the floor)
Metal in your body is not a problem with MRI
Good luck with the process, and hopefully next year we will be skiing again.

A snowHead

@lizski, the clicking could be the muscles not firing well yet, especially the vastos medialus (vmo). This is a common cause of clicking. You will know if this is the case from your rehab - is the muscle on the inside of your leg/knee twitching when engaged or slow? Speak with your physio but one option might be something like the kneehab (http://www.neurotechgroup.com/uk/products/kneehab-xp`) which will get it firing without extension or during swelling. You might be in South Africa though so would need to look for a local alternative. It helps with building knee stabilisation whilst you are waiting to be able to commence a more normal gym programme.

Interesting comments about denial. Could this be really common? I felt the same, persuading myself it was nothing, except that I also knew that the distinct pop was not normal. 6 weeks post op it has been a hard physical journey but an even harder mental one. Focussing on the next trip certainly makes it easier to do the daily rehab.

I think I remember Jonathon Bell saying on a thread that he would reckon on a March operation being able to get back on skis for a test in November and for real in December.

I winced when you said you fell down the stairs. Good luck with your progress.

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

Just booking in as I feel that I qualify to join the Snowheads ACL club and don't want to be left out.

I spanged my left knee six years ago heroically setting off on the shallowist part of a blue run whilst not looking where I was going. Landed in a heap with unpleasant hurty left knee. Didn't want to make a fuss so stood up and managed to snowplough down far enough to get a button lift up to the gondola to take me home. Whilst on the gondola I felt my knee cap slip round back to its normal position which was nice.

Limited range of knee movement so no more skiing although I did a bit of walking to fill the time until driving home. Once home I went to a physiotherapist who did massage stuff and suggested exercises but no improvement so I self-referred to a private specialist who ordered an MRI scan and a follow up immediately afterwards where I found - snapped ACL, ruptured MCL and bucket handle tear of the meniscus. Well, you have to laugh!

Surgery to repair meniscus the following morning and, on specialists advice, left ACL alone. Rehab was interesting with some bloody useless physio at hospital and brilliant advice (sought separately) at my gym.

I ski three or four times a year and every year the knee swells up but isn't too painful. Plenty of effort to build up quads and hamstrings and I generally ski without the (brilliant) monster Donjoy scaffold brace that I used for the first couple of years. Off piste, ski touring and fast on piste. I did return to the surgeon last year to enquire if it was worth sticking it all back together but he advised against quoting a very long rehab time given my size and weight and the fact that it only hurts a little bit. Reading between the lines -grow up and grow a pair!

In summary, I'm in the no repair camp - worked for me so far.

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@Snow Monkey, Well - i think for sure you qualify = If you are gonna mash your knee up - do it properly eh?
I think as you say - if it works for you then thats the main thing - and you would have to start whole process of rehab again. Very interesting to hear how you cope with so mmuch skiing without ACL -
I was looking at neurotech link that 22 dropout put on post above and also at Compex Fit 1 device - My muscles are just wasting away and really struggling with the weight/load bearing exercises - these may help get my muscles built up before and post op - bit pricey though. They may be of help to you during ski season?

Anyway, snowHeads is much more fun if you do.

@barney2, you can rent for around £60 month http://www.neurotechgroup.com/uk/products/kneehab-xp. They ship for next day. Could get away with just 1 month as you will be aiming to get back to a gym presumably when swelling goes down. Judging by 1) the market in cryocuffs on ebay and 2. the steady stream of newcomers to the forum there's looks like there could be a good second hand market for these units as well.

I am post op, still have to much swelling and I have rented for 1 or 2 months to get the muscles firing and hopefully pump a bit of the swelling out. It is satisfying to see the quad and vmo finally working even if it does take a pulse to do it. I've had it for 4 days now and am still getting used to the strength settings - word of warning - first thing in the morning your muscles aren't quite up to the setting you might have had it on the evening before!

Braces, Games Ready, Kneehab. Who knew there were so many gadgets for knee surgery? It could really rack up.

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@barney2, @Snow Monkey, this just goes to show the wide range of stability people can have with no ACL. Before I had my repair my knee felt unstable just walking and collapsed on me just going downstairs. I subsequently damaged my repair leaving just half of that intact which is fine for normal everyday use but collapsed doing straight line sprinting during a hockey training session pre doing any stick work. Sadly it means I have had to give up playing hockey but I can (once the damaged caused by that collapse was dealt with) jog, ski (with a knee brace), walk and cycle now.

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@22 dropout, Thanks again for that Link - I saw they rented and tried phoning for cost - no need now - 399 euros to buy - against the cost of the Compex Fit 1 -£149, so i think renting could be a good option for a start.
The whole b...dy process is baffling - I don't do gyms or keep fit stuff -Never knew what an ACL was - and like you say - never knew there were so many gadgets, clinics, web sites, opinions etc all devoted to knees. I have never really had to think before - body has always looked after me - skiing, walking,swimming and building work - has always kept me fit enough - Now having to learn to walk properly! how daft is that?
Using exercise bike everyday - and going to have a go next at biking on the flat - more interesting than several kilometres looking at a wall.
Some other poor sods will find out next season what ACL stands for - and as you say - maybe we can flog all our paraphonalia? wink

After all it is free

@barney2, @22 dropout, i rented the neurotech device and persuaded myself after a month that I felt a flicker in my lost VMO...fooled myself. 2 years on, with gym and physio 3 times a week I've got quads like a footballers but still no VMO. Mine wasn't ACL but I was non weight bearing for 2 months and partial for another month so had huge muscle loss.

@barney2, I know, wish I'd known what I know now and that I'd done more in the past but that's no guarantee that the ACL wouldn't have gone anyway. Knee knowledge is as significant as avalanche awareness in my book now. I've stopped beating myself up, now just feel sorry for myself occasionally! Can't wait to get enough flexion to get on a bike - who knew you bend your leg so much in everyday use?

@holidayloverxx, I am a bit intrigued. Have you actually lost the function of the VMO?

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@22 dropout, I have no idea....how can you tell? My knee drops in which might be a sign.I suspect that as the vmo is flat as a pancake what function there is must be minimal

Help!!

The snowHeads ACL rehab club !

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