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ACL Injury, looking for advice

 Poster: A snowHead
Poster: A snowHead
I messed up my ACL in Avoriaz 6 days ago, classic backwards twisting fall Sad

French doctors said it was a torn ACL with nothing else wrong they could see (they did x-rays). Currently not putting any weight on it and have a brace fixed at 20 degrees.

I have insurance and can go to pretty-much who I want to in order to get recovery etc. started, I was hoping for @Jonathan Bell as he's obviously well thought of and quite nearby (I live in Brixton) but it seems he's busy for at least a couple of weeks...

Anyone got any advice for who to go for and how to proceed in the mean-time? I'm doing isometric exercises but obviously that leg is still getting weaker every day.


Last edited by Poster: A snowHead on Tue 10-03-20 15:43; edited 1 time in total
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Adrian Fairbanks who also works out of Wimbledon Clinics?
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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?
I used Wimbledon Clinics (where Bell is based) 3 seasons ago - while he wasn't my Dr there, the one I did see was great and I seem to recall I got a more or less next day appointment, with an MRI on the same day. Was it just Bell who is busy or all of them? Might be worth another call there?
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Bad luck, @skeksis, I don't think much will change in 2 weeks - better to wait to see the person you want to see. I believe you won't get any action, surgery wise, until any swell has reduced (I maybe wrong on that) but you get my point. In 2 weeks it will still be swollen, get an MRI - keep work on swelling and then go under the knife. You will be out for most of a year so a week or 2 on this end won't change much (IMHO anyway)
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
@skeksis,
Message me if you like.

We have a system whereby you can be seen by a sport med doctor to get scans, start physio etc.
That way when you see the surgeon all the tests are done.

Jonathan Bell
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Don’t worry about waiting for a couple of weeks either.

When I did mine in, I was told that I couldn’t have the recon surgery until after the swelling had gone down and I got full ROM (range of movement) back. Message Jonathan above - As initially will, almost certainly, be physio if my experience is anything to go by.
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Then you can post your own questions or snow reports...
@skeksis, sympathies Sad
Obviously JB et all will advise, but keep an open mind about whether surgery is necessary or not for you, and do your research. Many people these days, myself seemingly included, are managing to rehab from ACL injury with just strengthening, not surgery. No right answer for everyone, but for some it's worth a go (see other threads on this forum).
Best of,

PS - get the physio and exercises going as a matter of reasonable urgency.
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Jonathan Bell wrote:
@skeksis,
Message me if you like.

We have a system whereby you can be seen by a sport med doctor to get scans, start physio etc.
That way when you see the surgeon all the tests are done.

Jonathan Bell


Thanks for the offer, if I'd known that was the system I'd have gone for it (I'm not so experienced at the choose-your-own-adventure style of healthcare, never been private before!), but I ended up going to see Martin Goddard at Parkside to avoid any extra wait. Had an MRI done now and waiting for results, still no weight bearing until then as a precaution though, which is annoying.


I do have a question that maybe you'd be able to answer:

In light of the current situation in the country, what do you think to the idea of physio by video link? Obviously it's not going to be as good as in-person, but if it's that or nothing for a few weeks...
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You'll get to see more forums and be part of the best ski club on the net.
Having had 3 knee ops and 2 shoulder ops. One of those was an ACL recon. Physio by video would not have been as effective in my personal opinion.

As to @Grizzler, point. Different people find different levels of stability without an ACL. With mine even walking it felt like I was doing a figure of 8 inside my knee with every step. I have half the ACL recon left and that was unstable sprinting collapsed and caused more damage. The half is enough for every day life and skiing with a knee support but I have had to give up hockey.
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skeksis wrote:
Jonathan Bell wrote:
@skeksis,
Message me if you like.

We have a system whereby you can be seen by a sport med doctor to get scans, start physio etc.
That way when you see the surgeon all the tests are done.

Jonathan Bell


Thanks for the offer, if I'd known that was the system I'd have gone for it (I'm not so experienced at the choose-your-own-adventure style of healthcare, never been private before!), but I ended up going to see Martin Goddard at Parkside to avoid any extra wait. Had an MRI done now and waiting for results, still no weight bearing until then as a precaution though, which is annoying.


I do have a question that maybe you'd be able to answer:

In light of the current situation in the country, what do you think to the idea of physio by video link? Obviously it's not going to be as good as in-person, but if it's that or nothing for a few weeks...


A week after and you are not weight bearing at all? Is it still swollen?
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remember to do things in the right order if you're using insurance as they might not pay up (I injured my knee, went to a physio at Harlequins Rugby Club that I know - who, of course, knows a lot about knees - and he put me in touch with an MRI clinic in Waterloo. The insurance company initially refused to pay as I had made the MRI appointment on a physio referral not a GP. Fortunately, as this was over Christmas and I managed to persuade them this was just a question of timing, not process). Check everything with them before going too far down any road. Incidentally, the whole ream at Parkside are excellent.
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And love to help out and answer questions and of course, read each other's snow reports.
@NickyJ, Sure, and no offence to you. Everyone is different. Just saying that decisions shouldn't be rushed into, and that the OP should familiarise themselves with all options and factors relevant to their circumstances and clinical case.
I had resigned myself to 2 lots of surgeries and long rehabs, but turns out so far (not that I'm 100% symptomless, but not overt instability) that none wants me to go that route (except 1 surgeon who I've seen more recently who seems to think that he can correct a laxity which no-one else can actually find).
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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
Stay at home for 3 months...
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 You know it makes sense.
You know it makes sense.
skeksis wrote:
Jonathan Bell wrote:
@skeksis,
Message me if you like.

We have a system whereby you can be seen by a sport med doctor to get scans, start physio etc.
That way when you see the surgeon all the tests are done.

Jonathan Bell


Thanks for the offer, if I'd known that was the system I'd have gone for it (I'm not so experienced at the choose-your-own-adventure style of healthcare, never been private before!), but I ended up going to see Martin Goddard at Parkside to avoid any extra wait. Had an MRI done now and waiting for results, still no weight bearing until then as a precaution though, which is annoying.


I do have a question that maybe you'd be able to answer:

In light of the current situation in the country, what do you think to the idea of physio by video link? Obviously it's not going to be as good as in-person, but if it's that or nothing for a few weeks...


I would try to attend in person.
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Update:

The MRI showed the ACL torn and meniscus damage at the back on both sides, don't know how bad though, won't know until surgery.

Luckily all the other ligaments are fine except for the ACL, so I'm back walking on it Smile Range of movement is far from perfect (2 to 100 degrees maybe) and it hurts a lot if I accidentally bend too far, but it works fine for walking with a limp, although maybe the residual swelling is holding it all in place right now and it'll feel more unstable once it's all gone down?.

Time for physio to start! And then stop, because lock-down! Terrible timing to have injured myself...
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 Poster: A snowHead
Poster: A snowHead
@skeksis, if you do end up needing physio by video link I can recommend the excellent Chelmsford Physio who have today put up that they are doing Skype consultations. Jon got me back skiing after a major TPF and MCL injury after only 7 months

https://chelmsfordphysio.co.uk
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
I'm sure most surgeons are amazing, but I lucked out and got referred to Mr. Deepu Sethi who is absolutely wonderful. I would happily pay to go and see him,. just to see how he is. https://www.deepusethi.com/about-mr-sethi
I had mine at the London Clinic and started physio day after surgery (had overnight stay). Feedback from his patients says it all - https://www.iwantgreatcare.org/doctors/mr-tapan-sethi
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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?
skeksis wrote:
Update:

The MRI showed the ACL torn and meniscus damage at the back on both sides, don't know how bad though, won't know until surgery.

Luckily all the other ligaments are fine except for the ACL, so I'm back walking on it Smile Range of movement is far from perfect (2 to 100 degrees maybe) and it hurts a lot if I accidentally bend too far, but it works fine for walking with a limp, although maybe the residual swelling is holding it all in place right now and it'll feel more unstable once it's all gone down?.

Time for physio to start! And then stop, because lock-down! Terrible timing to have injured myself...


Make sure you use crutches to ensure you don’t limp. This was drilled into me by all the doctors and physios. Otherwise you will form a habit which is really hard for to break. It is better to go slower if needed to ensure you don’t limp as well.

By the time I got to surgery with my knee it was feeling nearly normal but I could still feel the instability while walking however people vary massively on this.
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skeksis wrote:
Time for physio to start! And then stop, because lock-down! Terrible timing to have injured myself...


Not ideal, but not the end of the world. Certainly not time to stop.
The basic idea is to strengthen (though with the meniscal injuries more care might be needed?)
Physio doesn't stop, nor is rehab something which is done to you. Assessment and update advice is helpful, but that probably can be done by phone or video. You know your body, so just find out what exercises and stretches you can do, and get on with it. More lock down = more time to exercise wink
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Anyway, snowHeads is much more fun if you do.
Thanks for all the advice everyone.

After reading the consultants letter to my GP I learned that other than the ACL tear I have 2 vertical tears to the posterior horns of the meniscus with no flaps. I'm guessing that's not the worst thing possible?

I have been following physio's orders, dropped the crutches and am now walking almost like a normal human with good extension and little to no limp, getting better every day. A few 30+ minute walks have gone fine with only minor discomfort, even on slightly uneven ground.

The strangest thing just happened: I was doing a straight leg raise and when I tensed everything up hard to start I felt a weird quiver in my lower quads on the inside, maybe 5/10cm above the top of my kneecap and suddenly my knee is much less stiff and range of movement has increased loads.... Hope I didn't snap anything new ... Puzzled I guess I'll ask the physio tomorrow!
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@skeksis, I ruptured my PCL and medial ligaments last winter (plus some meniscus and ACL damage). The quivering sensation in my quad is something I noticed a few times! I don't remember it particularly being associated with any improvement in range of movement though.

Doing really well without surgery BTW. Took a long time though and it's still far from perfect, but I've just completed a 100-plus day season of snowboard instructing on it with no more than some minor niggles. Riding without a brace.
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Then you can post your own questions or snow reports...
Oh yes! Quivering leg, twitchy leg, restless leg, jelly leg... With and without changes in strength or ROM.
Seems something weird just happens within the muscles (or nerves) as a result of the injury or healing and recovery.
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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!
About 3 years ago I tore a meniscus, I've got over it.

But I could really do with a new ankle, I came off my BSA Bantam in 1966, Addenbrookes did a pretty good job on the "pots fracture" (twisty broken ankle with foot facing wrong way).

But I'm suffering a lot with pain in it now.
I guess its arthritis. Its almost certainly Arthritis.

I don't know if its worth bothering my GP about it ... they are all too busy.
I've heard you can have a replacement ankle .. a bit like all my mates with new hips and knees.

Does anyone know how you go about getting one, perhaps on the NHS?

It would be great if I could just get one from Amazon Prime Smile
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Back in 2011 I ruptured my ACL and I was in a bad way, especially when compared to numerous people I've been with who have done theirs, so does go to show how there can be different grades of injury.

There was no way I could walk down the stairs with confidence even three months after the initial injury.

I had the hamstring graft op and a couple of months after that whilst still in rehab for the ACL knee I went for keyhole on the other knee and the surgeon hit me with a bombshell in that on my right knee I did not have much of an ACL and I must have torn it at some stage.

In the vid below at 5min 10


http://youtube.com/v/Km3iF8wOCQk

Back in February whilst in Japan I had a bizarre fall and felt three clicks.

I was able to carry on skiing but in a fair amount of discomfort but no emergency evac and after a day or two of rest I was skiing again with a small brace with some support I'd brought with me just in case of a knee twinge.

Since then I have been skiing wearing my Donjoy brace but alas as we know been unable to ski now the last two weeks.

I went to my neighbour three weeks ago who is the local Dr and he referred me for an MRI which is sill happening given the situation in France April 2nd, so pretty quick compared to UK.

As for the knee, there are various pains and aches but nothing too bad and I've been doing some gnarly mountain hiking without a brace and cycling on the trainer most days along with a fair amount of stretching and using this excellent massage stick .

I know something still is not right* though so will be interesting to see what the MRI throws up, just wondering if one of those clicks was the rest on my ACL tearing but I reckon it's my lateral collateral and medial ligaments / meniscus and my Dr thinks could also be my popliteus knee muscle at the back of my knee.

*in bed if I'm on my back I contract my quads and all my muscles can feel some pain for 20secs or so
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Quote:
I went to my neighbour three weeks ago who is the local Dr and he referred me for an MRI which is sill happening given the situation in France April 2nd, so pretty quick compared to UK.
I don't know about that.
Sorry
if I'm spoiling your francophilic-gloatfest
but last time I needed an MRI, I was given an appointment 10 days away then got a call asking if I'd like to fill a cancellation slot within the week - so 5 or 6 days till the scan and another 2 or 3 waiting for the CD to come via my GP.
Sorry to see you're having to wait so long.
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@admin, it's not a Francophile Gloat fest !

In hindsight I think I could have had it sooner but I thought I was going back to the UK?

I've had three MRI's* back in the UK and the OH 2

First time I went through the NHS route start to finish, initial appt with GP, then GP referring to hospital muscular-skeletal unit, who then referred me to Orthopaedic knee specialist who then requested MRI, and then the operation, this was all within the constraints of the 13-week timescales that the NHS was then working to.

Next time around aware of the failings of that, after I did my ACL I leapfrogged the system as it were
https://www.anotherharddayattheoffice.co.uk/aclknee.html

Then I went private for the last time as I was aware I'd be looking at 8 weeks or so and I need an op whilst still in rehab from ACL op

Same story for the OH and other friends I know.

For sure people might get cancellations and the like and lucky you, but you should have a chat with KenX and how well his OH has benefitted from the French health service, and others here that we know, getting hip replacements in two months when in the UK you're told you're too old or it's not an emergency!

In much the same way that some people in the UK are now being told that they can't have ACL op as they're too old!

*should add that after my first NHS outing and prior to my ACL I was designing websites for the knee surgeon and numerous Osteo's, so I sort of had an "in" to what was happening
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