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ACL Thread - what to do if you "do one" - Pre & Post operation advice - Rehab to get b

 Poster: A snowHead
Poster: A snowHead
AndAnotherThing.., by flexibility yes range of movement in the leg, as well as being able to stretch, for instance I always (even before I did my ACL) found it difficult to sit on my buttocks or to bring my leg up to my back bottom holding the ankle from the inside. Whether I have tight glutes / hamstrings / large thighs I don't know, but quite a few "athletic" types in Bikram Yoga found some of the so called easy postures really difficult, like some people can't touch their toes Puzzled
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Weathercam wrote:
for instance I always (even before I did my ACL) found it difficult to sit on my buttocks

Em, what else do you sit on?
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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?
maggi, presumed the "or to bring my leg up to the back of my bottom holding the ankle from the inside" (simple quad stretch for some) would have given you some idea Smile

But for you "Sitting down in a Yoga type pose on bended knees with back of heels against my buttocks - (I wish)
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Weathercam, ah, you mean Vajrasana! That's not sitting on your buttocks. It's sitting on your heels!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Weathercam, ok - I need to work on that. Quite painful at the moment when squatting to light the fire Very Happy
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maggi, that's what I mean, you haven't seen the way I have to do it - in fact at the end of Bikram to do the breathing exercises I sit cross legged - as if I try to sit on my heels feels like my knee caps will explode Sad
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
AndAnotherThing.., and at your age you shouldn't be trying to light your own farts Toofy Grin
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Just been reading variouys acl threads so will add my experiences for what they are worth.

First injured left knee in Jan 97 and was told I had torn acl which would need repair in resort. On returning home was told it was torn pcl (much rarer) and given physio which improved it and I continued skiing that winter.
In 2000 left knee had another bash and this time daignosis was mcl tear, I was fitted with a CTi brace and did lots of physio. I was warned any more tears would need an op.
(In 2001 I was hit by an out of control snowbaorder who broke right through the top of my humerus - but that's another thread! Was told not to ski for a year to make sure it healed but I was back in about 8 weeks)
In Feb 2004 finally tore right through left acl which with the other dodgy ligaments meant I had to wear the CTi brace all the time or I couldn't walk. Luckily I had the brace on when I fell - it didn't stop the injury but possibly did lessen it - and took arnica and inbuprofen imeediately. They did not believe I had a torn acl as there was so little swelling. I always ski with arnica and inbuprofen in my pocket.
Back home and went straight to A&E, don't bother with GP it just slows things down. Saw consultant who said it would be 9 months wait for NHS surgery. When I asked about privately he said he would normally do it the next week but he was just about to go away skiing so I was operated on just after Easter that year. Cost £4k but worth every penny. No pain as I had a nerve block and fantastic private physio afterwards for 9 months meant I was skiing the following November on plastic and Christmas on snow. I still wear the brace to ski as I want to ski all runs and do moguls. Just done over 70km in a day on recent trip. I could possibly ski blues without the brace but thats not what I want.
That's not the end. In April 2008 I fell in the back bowls of Vail and cracked the tibial plateau. It seems to be where the pin for the repaired acl is. It was only a hairline crack so just non-weight bearing for a few weeks and all OK now.
I have a large case file at the local hospital and they have said 'have you considered stopping skiing?' No I am keeping you in work is my reply.
You will also see that I tend to injure my self every 3 or 4 years. I was rather worried this season as I'm due another one but have just survived so perhaps that is it. Also on comments about acl repairs not being good for people over 40, I was 55 when I had mine done so I have had my bus pass several years now!
My advice is to get private physio as both sons have also had acl repairs and the one who had NHS physio did not get as much as with private care.
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You'll get to see more forums and be part of the best ski club on the net.
mogulski, do you have more info on "arnica" ?
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 Ski the Net with snowHeads
Ski the Net with snowHeads
AndAnotherThing.., http://www.arnica.com/
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kitenski, Cheers !

Does anyone else take it ?
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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.
AndAnotherThing.., I use an extra strength Arnica cream alternatively with ibuprofen or Volterol cream. The NSAID whether taken internally or smeared on in dollops are not very good for you in large quantities. We get given a slow-release stomach protection pill for any Diclofenac type prescription here in Germany and also Austria.

There is a preparation that is being talked about for being brilliant at reducing swelling and helping with stubborn bruising that is made from an extract from the pineapple family - bromeliad something or other it is called here. Perhaps Hells Bells knows the name it is marketed under in the UK. I know it is being recommended to a number of orthopaedic patients in the UK these days as it does not require a prescription. but as to names and doses, no idea. Cool
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
Samerberg Sue, Cheers, I'll grab a tube in anticipation.
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 You know it makes sense.
You know it makes sense.
There is very little systemic absorption of NSAID creams and gels ( about 6% of the absorption of a tablet of the same drug). so it shouldn't cause any problems to stomach. You usually get prescribed drugs (omeprazole, lansoprazole) here when you take NSAIDS, but not always. Some can take them without problems for years, others not.
If you get tablets prescribed, ask for naproxen not diclofenac as it is safer.
Bromelain is the ingredient from pineapple , but I haven't come across the cream here yet, and didn't find it in a Google search. Hirudoid Gel reduces bruising too (heparinoid).
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Samerberg Sue wrote:
There is a preparation that is being talked about for being brilliant at reducing swelling and helping with stubborn bruising that is made from an extract from the pineapple family - bromeliad something or other it is called here. Perhaps Hells Bells knows the name it is marketed under in the UK. I know it is being recommended to a number of orthopaedic patients in the UK these days as it does not require a prescription. but as to names and doses, no idea. Cool


Have never heard this mentioned with the orthopods I work with. I will ask tomorrow out of interest.

Hells Bells does Omeprazole give any protection further down the bowel? For someone who doesn't suffer any upper GI side effects as such Blush (diclofenac/diarrhoea )
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 Poster: A snowHead
Poster: A snowHead
Hells Bells, I was warned about using it in addition to the NSAIDS. It is only available (in meaningful strengths) from the pharmacies here and they warn you to take care if also taking the tablets.

As for the bromeliad extract product, I believe it is being used in tablet form but I'm not sure. It has been advised particularly for patients who have problems with high doses of diclofenac-type preparations. I've only read some articles suggesting that the results are very promising, more than that I do not know. I was interested as over the years I have consumed a huge amount of diclofenac in one form or another and still have to take it at times. My stomach does not like it any more, so a reliable alternative with no side effects and that does not require a prescription over here would be nice. Madeye-Smiley
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
mogulski, quite a history there Shocked

Back out on the water here now, and knee's quite sore after a session on the water. I'm not sailing using my brace though, and am trying to keep the board on the water as opposed to letting it go off the waves, that said have avoided some of the more manic conditions we've had lately, easing myself back into it gradually, as I live on the beach it's not a big arduous trip to get out on the water, so I can pick and choose.

Sunday April 22nd 2012 - Kite and Windsurfing from Worthing to Ferring - Happy Days from Weathercam
http://vimeo.com/40823954

Have also been doing Bikram two to three times a week as it's been so wet cycling is not that appealing. Though in Bikram as I was always inflexible there are a few postures where I'm allowed to do my own thing rather than put pressure on the knee, basically any position that involves me sitting on my heels (that's about 40% Puzzled )

Scar tissue, I presume (well two friends who are both Osteopaths have said it's nothing more sinister) is producing a click when I walk down the stairs is a bit off putting, but am coming to the conclusion that due to age etc that I will always feel the trauma of what went on in my knee.

I'm also getting paranoid that my leg / quad etc is still wasting which means I'm favouring my other leg, but that can't be

Re the drugs etc I try to avoid taking too many pills etc taking them only after knee is complaining after being on the water / cycle ride etc, are you guys continually taking them all day and every day like some people I know do, or like me just when it flares up?
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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?
gosh - this is getting to be a long thread now - i dipped into it 6 months ago when i did a complete rupture of the ACL....i am back now after seeing my surgeon yesterday for my 6 month follow up. He has discharged me and said my new ACL is fantastic and very stable. i asked what sports i can / cant do and he said "i will put GFI" in your notes....."go for it" !!! he basically said i can do anything and that skiing will be fine !!! yipeee !! i feel OK - not 100% as i haven't got full flexion but my physio is working on that (still some inflammation inside preventing me getting the last 10 deg of movement. full extension though and I can leg press about 80% of the weight that my other leg can. My quads as visibly smaller but he said it can take up to another year to get those back to the same as my other leg. he said statistically I am more likely to rupture my other ACL than my re-constructed one !
The dilema I am having is over knee braces - surgeon says I don't need one and its pointless. My leg is stable and what would it achieve - the wrong sort of brace could make it worse. My physio recommends some sort of brace to prevent wear of the cartilage long term. My argument would be that I only ski for 10-12 days a year...is it really going to wear in that short time. so who do i believe ? obviously each ACL injury is unique but I would be interested to hear other people's views and experience. bear in mind this was a total rupture an reconstruct with the hamstring and there is no instability there now. My quads are weak and I will notice than when i ski but I am working on that at the gym.
cheers
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backhojo, I'm 4 months post op and I'm hoping to do without a brace. As I understand it, it's going to depend on getting the strength\muscle back, as it's that which protects the ligament.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
AndAnotherThing.., i am thinking of a light neoprene brace (which i wear on my other knee following small cartlidge damage 20yrs ago). it helps keep the heat in and blood circulating in the cold which helps over the course of the day
will also back off the DIN settings on my skis a bit I think as that was the problem - ski stayed on. I have them set at the high end of my range as i am heavy for my height and ski hard. I think i will be better if ski comes off occasionally by them being a bit lose !
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backhojo, wow, GFI at 6 months is what the rest of us want to hear! I think this seems to be a common surgeon v physio thing with the brace. I am hoping not to use a brace too as I think some people say they become like a psychological crutch and are difficult to let go of once you get used to having one, despite the fact they're not really necessary.
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
backhojo wrote:
AndAnotherThing.., i am thinking of a light neoprene brace (which i wear on my other knee following small cartlidge damage 20yrs ago). it helps keep the heat in and blood circulating in the cold which helps over the course of the day
will also back off the DIN settings on my skis a bit I think as that was the problem - ski stayed on. I have them set at the high end of my range as i am heavy for my height and ski hard. I think i will be better if ski comes off occasionally by them being a bit lose !


Yep, it's generally better that they pop off although I guess it depends what you are doing at the time Happy

A neoprene brace will keep you warm for sure but it's not going to offer any meaningful support. I guess it depends on what the physio has in mind and what they want from it. A friend who had her knee done with the same surgeon has a fancy carbon fibre job.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
My understanding is that those fancy carbon fibre things are for when there is a tear or some instability. In some ways a full rupture is better because you then, like me, get a totally new acl which is stronger than the original. Most of the problems i still have are in the other muscles in the leg as they have not worked properly for 6 months. I am hoping that with still 5 months to go i can get those back to somewhere neqr normal. Seeing physio in a couple of weeks so will discuss further with him about braces. I tried a hinged one on and thought that it was more dangerous than not having one !!! Imagine falling and landing on the hinge !
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