The snowHeads ACL rehab club !

A snowHead

@holidayloverxx, if I read your posts right you are skiing all over the place and you wouldn't be able to do that comfortably without one. Whenever I've had issues in the past I've experienced pains in my knee cap where the vmo is not working to align it properly. This normally happens if my running has involved a reduction in pace or increase in distance - carrying a rucsac can bring this on too as you don't get the leg extension you need to engage the vmo as much as the quads. If you're not getting these sorts of pains then you must have enough going on down there to be ok. If you are, then its good old straight leg clenches and lifts for a week or two to put it right.

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@22 dropout, I think it's more complicated than that. ..but we are all different. I ski with a giant knee brace and, now, with a ski mojo as well otherwise I can barely walk at the end of the week. I can't run as that puts too much stress through the joint....I tried skipping in moment of euphoria and couldn't walk more than a few steps at a time without a massive reaction for 2 weeks...and I'm not a wuss. I have to focus on mobilty and strength...While a top notch VMO would seem to be desirable I don't suppose it would improve my overall functionality. I do leg curls and extensions at about 30kg as well as closed chain work

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That is definitely more complicated. Did you do that in one incident? That day must be etched in your memory. You must really love skiing. I have found with the kneehab that it can build strength in the vmo but that is not the same as being able to engage it yourself. Trying to engage it at the same time as using the kneehab is quite effective it seems for helping the process along.

Incidentally, by closed chain do you mean lunges and squats? Do hamstring curls not irritate the knee if the hamstring is upset in the first place?

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@22 dropout, the incident was that I tipped a 100kg night storage heater over and it Fell on my leg. All subsequent issues relate to that. There is a blog on Apres about it if you are interested. . April 2013.

Yes I mean lunges and squats with weights. hamstring us generally OK...bit stiff sometimes but loosens up with exercise.

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@holidayloverxx, A physio told me yesterday that it takes just 10ml of fluid swelling to impair the function of the vmo. That's nothing. No wonder it's hard to get these guys firing.

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@22 dropout, that is interesting and explains why I had such trouble with it after my meniscus surgery on my good knee.

After all it is free

Random question - does anybody suffer from cramp in their foot when doing Standing Quadriceps Stretch (Leg Stretches) on their bad leg? Although I have full range of movement I get cramp in my foot every time after holding for about 8-10 seconds?

@NickyJ, no but sometimes in good leg

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@NickyJ, too early to tell post knee op whether its worse but I experienced foot cramps quite frequently before. My starting point is to check two areas - firstly that you are stretching deeply into the calves regularly to keep the ankle flexible and also to make sure your IT band is not tight and throwing everything out. The thing is, your foot could be working very hard to compensate for your knee and, therefore, not recovering well in between being used. Do you get the same if doing the stretch lying down?

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@22 dropout, I don't know I'll try that.

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Well I have definitely joined this very exclusive club! I have been to see my consultant after my last injury (details in another post) and I have broken my leg again, I heard the crack. Not pleasant. I broke my leg going down ( on foot and sober) a very small incline because I had no ACL, which my NHS consultant had not informed me about. I now have an MRI print out stating the absence of it but he told me that I had a stable A cL. He could not have even read it. I have been skiing thinking that I was ok, I am lucky not to have more damage I think. Have had more xrays and another MRI. No extra damage. Back in a month, rehab going on in the meantime, to discuss about reconstruction. Knee feels very wobbly, bring it on even if I don't ski next year. Life feels on hold at the moment.

@margaret, Shocked

you must be hard as nails! Seriously though if you've broken it again are you getting your bone density checked out? ...and seeing a different consultant?

You know it makes sense.

Duplicate

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

@margaret, So - I am thinking this must be fairly complicated? You have a broken leg - so is this in a pot? and you have MCL & ACL damage to manage?
You did really well to get back skiing -
I have not been doing well with strengthening - with only what is an isolated ACL ? must be challenging with a break also to contend with.
Exercise bike has helped me for sure - Just got a Compex Fit 1 machine to try and help build muscles up without puttting extra work through the knee - I am not keen on it but have to say I think it has helped already -
I am now 3 months in - and still not walking with a proper gait yet - now starting to put a bit of muscle back on - but seems to be such a very slow process - I am amazed that people could get back skiing so quickly without an ACL - maybe skiing would be easier for me than walking?
Best of luck with your continued rehab.

A snowHead

@barney2, you could see visible difference in muscle bulk on my reconstructed knee vs good knee even though when doing leg press etc I was able to do the same. Didn't equalise it until I tore meniscus in my other knee (don't advocate THAT approach BTW)

A snowHead

Holidaylover: different consultant, last one was rubbish. I have confidence in this one. Break was caused by the ACL failure and stress on already broken bone.
Barney 2 yes it was complicated from the start, but I was not informed. Had had two bones broken in my leg, but I Was not told. Also ACL gone, mcl almost torn from the bone. Original doctor did not read MRI report. Feel that I am getting support now through a recommended knee surgeon privately. Original break healed well, no problem with bones, the second break was due to the force of the knee collapsing. Prior to skiing I was ramping up the exercise, exercise bike, step and jogging. Plus hill walking with dogs. It could have collapsed at any time, scary thought. Was scary when it did go to be fair. I went into shock. As the knee has swollen again I have to get the swelling back down and the range of movement back before seeing my consultant again. I am using a kneehabXp to energise my muscles. I can walk upstairs properly, but will not risk coming down as the knee could give way. Given my age (61) my doctor feels that as I have already skied I am a good risk as far as rehab is concerned.fingers crossed (plus legs and anything else)

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

@barney2, are you having regular physio? Which part of your gait is troubling i.e. foot on ground, foot through the air, leg to rear, leg to front etc.? Did you have any complications during your first 8 weeks or was it just that the swelling did not go down easily?

I am going to try the bike today. I tried to go on it twice a little optimistically at the gym a couple of weeks ago, walked up to it, turned the pedals about half way round until it wouldn't go any further and walked away again, tail between the legs. Today I am more optimistic. It seems like bike is a big physical and emotional hurdle.

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@22 dropout, make sure you set the seat higher than normal. it will come.

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@22 dropout, Physio has been through NHS - Very good in the early stages at helping me get some initial movement back into my knee joint - and then also to weight bear and steadily come off crutches, also at pointing how lopsided I am walking - and getting some confidence back into what knee can do. But I think they are so busy and time restrained - not seen for a few weeks now and next appointment is in July - which should be just before operation. I have exercises that I have to do up to then.
Walking with a limp and leaning over towards bad knee interstingly - Just gingerly placing bad leg on the ground? downhill slopes defintly worst -Can walk fine in shallow swimming pool when some weight is off- I think I am still thinking constantly about protecting me knee - Every single step I take i am thinking of where the foot is placed -not twisting the knee blah blha blah - and i think that maybe this thought process works against walking properly?maybe?
Never had any real complications or serious swelling since I did it really -Never needed to use ice or levitiate the joint - No real pain either unless i induced it through putting too much weight on - or walking too far. Funny enough sleeping was painful- when the weight of the leg was in the same place all the time - pillow between the legs sorted that though -
Exercise bike - I couldn't get the pedals to turn at first - tried again week later and got going - now it is by far the easiest exercise and increasing resistance seems to be going fine- Bloodymind numbingly boring though!
When I read other peoples experiences I think I have got off lightly so far!

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@barney2, When I first injured my knee, the biggest problem was the lack of proprioception - ie I had no idea of where I was putting my foot & I found I literally had to watch where it landed. I wonder if that is what you are describing? But standing tall , pre-checking the coast was clear & concentrating on walking with heel lead helped to 'retrain' the leg. The proprioception did take about 3months to settle though. The physio had me walking backwards on the treadmill too, which was interesting

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@genepi, Don't think so - I couldn't even spell that word, and certainly couldn't pronounce it - Just looking at the word makes me smile
P.........n what the f.... is that? Sounds like some nasty disease to me - or something Peter Kay would say in one of his comedy sketches! Can't possibly be anything to do with my knee! ACL injury ain't that funny - but little gems like PROPRIOCEPTION - nearly make it worth while? I couldn't even use it in scrabble as I wouldn't be able to spell it.
But yeah maybe there is something like that going on?

After all it is free

@barney2, you're pre-op? I thought you were about 12 weeks post op. I think you said you have injured just your ACL, no other major damage, which is the same as me. The idea of walking backwards that @genepi, mentions is to try to break compensatory habits. The backwards running movement grew out of this - people that had post-injury gait issues and that were encouraged to run backwards to break habits and strengthen different muscles. Some enjoyed it so much that they continued to do it. I cannot vouch for it but the knee is a joint that our brains work very hard to protect by easing the load. Of course, we ACL'ers need to do the opposite, and it does not help if like me, you keep stubbing your toe into raised pieces of pavement! A treadmill, or anywhere entirely even is a good place to practise trying to keep the hips and shoulders level throughout each step.

When I read your earlier post the first question that came to my mind was the strength in your glutes. If they are not strong, no other muscles can compensate to give you a normal gait. Have you done much work on them?

I got into the gym about 3 weeks after my accident and started to do static work on glutes, quads, VMO and core. Took about 6 weeks to get on bike as had swelling from TPF and to walk downhill comfortably, and moved up to lots of lunges by the time of the op. Well worth trying to get to lunges as they are by far the best all round exercise for hamstrings and glutes, and to get as strong as possible before op as it is then easier to regain strength later. Made me realise that my hamstrings and glutes were probably not as strong as other muscles as I run more than I cycle, and that maybe this was a contributory factor to the injury in the first place.

Hi guys, I myself have dealt with a variety of hip pain over the years while skiing, and I'm looking for best hip strengthening exercises. Do you guys have any idea, or suggestion?

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@sugar, yes, but do you know what is causing the pain in the first place i.e. referred symptoms, arthritis, old injury etc?

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Amazing that Billy did this without an ACL, and now he is going through rehab. Mind you, he wrecked his cartilage in the process. He said his ACL reattached itself giving him some support. I didn't know this could happen.

http://www.bbc.co.uk/sport/0/boxing/32331630

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Had pre op assesment today - ready for op next week - so they are using hamstring to reconstruct ACL.
Now 5 months since injury - Can walk much better now - gait has improved - gained some muscle back - plenty of flexibility and really no swelling or pain. No way could I ski though- I have no idea how others could ski so quickly after an ACL injury?
So - guess frozen peas and back on crutches after next Friday - start all over again. Can't wait to get it over with though.

@barney2, good luck Smile

You know it makes sense.

@barney2, Best of luck, lots of Physio ahead but it will be worth it in the end.

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

I am being operated on the 10 th July, maybe we can be buddies in rehab! Pre op assessment next week, fingers crossed

A snowHead

@margaret, Hope assesment goes OK - and Op -
Yeah - lets see how we both get on afterwards - Funny but I have just now started to walk easy paths in the woods near to us - But I am expecting I will get back up to speed more quickly than after the injury?

A snowHead

@margaret, good luck

@barney2, I was allowed back to hockey training with strictly no tackling at 6 months post op.

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

@margaret, @barney2, good luck with the op and rehab. I was back skiing (with a brace on) after 5.5 months of intensive rehab. Mine was a revision of a badly placed reconstructed ACL and a lot of other work as well. Working with a good physio and doing the exercises at home diligently is the key. But don't focus on the end target - always set yourself smaller, more attainable milestones along the way. I found it less depressingly slow that way. Very Happy

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@barney2, @margaret, good luck both. I am at 13 weeks post op now. Having a buddy is a really good idea as every sensation is new afterwards and, let's face it, you've got a lot of time on your hands. Immediately afterwards no time on your feet is best to get the swelling down and then into a pool. It's a marathon not a sprint. good luck for the ops.

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@AndAnotherThing.., normal advice while the stitches are still in and the water can get into the wounds. I was in the pool the day my stitches were taken out, but that was at a rehab centre and in the hydrotherapy pools there. Even then they put a waterproof plaster over the ound sites. As soon as the wounds were definitely closed I was allowed into any pool or even the lakes around my place!

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@Samerberg Sue, I reckon we have dirty water over here Wink

After all it is free

Swelling takes 2-3 weeks at which point stitches come out and get in the pool. The NHS tend not to recommend pools but they are very liability orientated and their hydro pools have been closed. My consultant and my physio swore by it, wanted me in straight away. It was me that didn't see how it would help and I avoided it but how wrong I was, especially float work. You just have to be able to take the funny looks as you walk side to side in the shallow end.

@22 dropout, my stitches were out at 10 days, I've never had them in longer than that! They started Lymph Drainage massage within 24 hours here and I was pro-active as well with a routine of ice, elevation and ankle pumps. I did not have any fancy icing/compression aid so beloved of the US et al. The LDM was gentle and very welcome to be honest, done by properly trained physiotherapists/masseurs. Over here all the physios start their training with massage techniques and it is a very hands on training, not a theoretical university-based one. There is a clear difference between the knee treated 100% over here and the knee treated in the UK in terms of residual swelling - none on the knee treated over here with LDM, quite a lot of residual swelling above and around the UK treated one. Admittedly it went through more operations, but it is a lumpy old thing!

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@Samerberg Sue, that's really interesting. I really struggled with swelling (UK op) and especially in the lower leg and planta. Admittedly, I was having to fly a lot which could never help but it was painful. There is no doubt that if you can get the swelling down everything else would go so much better. I am still not completely without swelling - it's not visible but I know it's there. I cannot really say if that is just a hectic lifestyle and pushing it too hard but I would so like to feel as though I am past the swelling at some point! Isn't it interesting how the approached differ so much?

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The snowHeads ACL rehab club !

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