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The snowHeads ACL rehab club !

 Poster: A snowHead
Poster: A snowHead
Miranda, your not talking about Petra in Champery are you?
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
hazamadcow, no, I'm talking about the lovely Sandrine, but I'm assuming Petra is also a superfit, puts-you-to-shame instructor?

I had a serious thought about doing the Snow Trail run they do up from the village on the blue piste here in April - I thought having a goal to work towards would be good (I'd come last without a shadow of a doubt, but it's the taking part, right?). But I then looked at a video and had a bit of a wobble about the idea of my knee running down hill on snow! I'm seeing my surgeon on Thursday and he said that the next time I saw him he expected to be able to tell me I could start "running". However, as he French but likes to speak to me in English, I think he probably means "jogging"!

Got a new bike in the Cultur Velo sale today and am looking forward to getting my new rehab protocol this week Very Happy

AndAnotherThing.. well, speedos seem to be fine if you are Tom Daley Laughing
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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?
Saw the surgeon today at nearly the 4 month mark (op was the 15th of May). It was all very quick. I pretty much have full flex now so he pointed out how this showed he was right to say no physio (I think he could tell last time I was a bit unnerved by this Laughing). When I got home I did try kneeling properly for the first time and I can sit back on my heels but I did it very slowly and could definitely feel it in the operated knee but not to the point that I was unable to do it. So I am officially allowed to cycle hills, all forms of swimming and start "running"/jogging, have physio once a week for muscle building exercises, go to the gym (yeah right) BUT no hill walking at all Sad He reiterated that I won't be able to do this until the 6 month mark, when he fully expects to give me the go ahead for absolutely anything and everything. He said again that I would have no pain doing the hiking but that he would be able to feel the laxity in a new ligament that has been stretched too soon.

Still, we went for our usual post appointment drink by Lake Annecy in Veyrier and it was an absolutely gorgeous afternoon and I felt happy because the new bike will get its first outing on the lake circuit on Monday Very Happy

For those contemplating surgery or in the early stages of rehab, the time really does go much faster than you think. The final appointment and X ray is booked for 2 months' time, but having already been through 4 months and now having very few restrictions (just the hiking that's the bummer), 2 months is certainly bearable. I guess I might be feeling differently if the rehab period stretched over a ski season... but then this was a factor when planning the timing of the operation.
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miranda, sounds brilliant, well done. Very Happy
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Anyway, snowHeads is much more fun if you do.
Pedantica, thank you! Have you been to Hemel yet?
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miranda, indeedy, two full days' coaching so far, and another on Monday. Very Happy
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Pedantica, fantastic! snowHead
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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!
miranda, Good news Happy You are ahead of me now, I can't quite sit on my heels Laughing The next 2 months will fly for sure now you can be more active.


Pedantica, Good to hear you are back to it Happy
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AndAnotherThing.., would rather be hill walking than sitting on my heels! It'll all even out when we're both tearing up the mountains in a couple of months... ok, so you'll be tearing up the mountains and I'll be cruising around a bit in between hot chocolate breaks.. but, still (fingers crossed, touch wood etc. etc.) we will be on skis!
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I can't sit on my heels at the moment! Hurt my knee, really stupidly, at MK before Christmas and am only now getting some decent physio for it, other things having intervened. Actually, that was stupid too, I might just as well have had some physio while I was lolling about waiting for surgery. Anyway, the physio seems to be sorting it out - an 'alignment problem' she says, fairly certain it's nothing sinister. Pilates classes start in a couple of weeks, and I'm going to get laughed at for not being able to sit on my heels, let alone between them as required. Luckily it doesn't hurt when I ski, only when I stop. wink Walking uphill is OK, downhill not so good, and I jarred it horribly jumping down from a stile last weekend. Mad
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miranda, It's very interesting the difference between the protocols. It would be nice to question both surgeons to understand where they are coming from. I see mine next week along with the physio the week after so I'll have a few questions. The stretching of the ligament seems to be the main concern although I suspect your surgeon may be an ex watch maker from Switzerland, where as mine probably restores tractors in his spare time wink Laughing
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And love to help out and answer questions and of course, read each other's snow reports.
Had my ACL reconstruction and meniscus repair on Thursday, been really useful following this thread.

Walking around the house without or with one crutch slowly and unconfidently, but definite improvements over the last few days.

I cannot straightem my leg totally and despite doing lots of pre-op work, I can hardly notice when I tense my qauds, it puts a tremendous amount of pain on my knee as when I try to fully straighten my leg.

Not really noticing any swelling reduction around my knee, I ice 3 or 4 times a day. I read in the thread that when having my leg raised, i shoul not have the knee supported?? It is excrutiating without support under the knee but perhaps that is why I still cannot straighten my leg. Like everyone else on here, i'm just not sure how far to push myself - I want to recover 100% quickly but without the risk of doing any more damage.

I am seeing my physio on Thursday, exactly on day 7, hopefully that will put me on a good recovery path. No skiing this season for me whatever.
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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
Libertine, Glad the op seems to have gone OK.

All the rehab info I've seen suggests not to support the leg under the knee. In the early days I tended to use cushions to support the lower leg\foot while keeping the back of the knee clear. I tried resting my foot on a coffee table from time to time for a few minutes at a time and the rehab drill where you tense the quad to flatten the back of the leg against the floor. Certainly regaining full extension is a big focus for the physio's.

Keep posting updates on here Happy

I hope to tidy up my updates and bring them into the first post - that way folks can look through and see specific time related progress reports in one place. The reason I've tried to keep posting regular updates is that I really struggled to get an idea of what I could be expecting to be doing as I progressed through the rehab. If miranda, hazamadcow, and others could do the same it might form a useful reference for those trying to decide whether to go under the knife. Or not. snowHead
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 You know it makes sense.
You know it makes sense.
Libertine, good to hear you can see definite improvements. I was pretty much icing my knee permanently for weeks using the Ice Band (always had replacement ice packs in the freezer) though I had a bandage on initially so I couldn't really see what the swelling was doing. I think you're not supposed to have anything under the knee so as not to let it get used to being bent in that position. I noticed I was comfortable sleeping in the hospital bed which was raised slightly at the end, so when I got home I stuck big sofa cushions under the end of my mattress so that the lower half of my leg was still higher than the rest of my body without feeling the need to prop up the knee. I found this much more comfortable than propping my foot up with pillows or cushions.
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Libertine, Good to hear that the op was a success, you sound like your doing well early on!

Its coming up to 5 weeks for me now and I'm only just getting straightness back (still not totally straight) but in physio today I was allowed on a cycling machine which was incredible for me I was so happy (being a downhill racer it was nice to be on a form of bike), but I was only on it for 5 minutes but it means that I can get in the gym when i go back to uni and start recovery via actual exercise and get my fitness back!

Bending is still coming along but im over 90 degrees now. I went to a music festival last weekend and must have walked miles over the weekend in a very drunken state and the knee held up fine to it all thankfully.
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hazamadcow, Cool
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Well, things have taken a wrong turn over the last few days!! Having had a really good day (day 3) with minimal pain releif needed i was very pleased indeed.

Day 4 however, my calf pain and swelling caused pain beyond belief. Took myself to A&E yesterday evening, currently carrying out loads of tests and i may need to go back under the knife or i may have DVT.

Hopefully the later of the two if it has to be one of them, but either way, it will set the recovery back and any return to work!

Sitting in hospital now, waiting for another scan!!

Hazamadcow - the physio sounds good, but i was thinking i'd be on an exercise bike after a few weeks and proper riding after 5 weeks.... Guess thats not the case so ill lookforward to beer and festivals
Very Happy
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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?
Libertine, Sorry to hear Sad hope they get to the bottom of the problem - Let us know how it goes.
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DVT has been ruled out.

Now looking at an infection or MRSA.

Another night of hospital radio!! Lol
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Anyway, snowHeads is much more fun if you do.
Libertine, Jeez - the last time I was there it was the local BBC Station. If ever there was a reason to get out that was it !
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Libertine, gosh, good luck, and good for you for keeping a sense of humour. Hope it gets sorted soon!
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miranda, how is your recovery going?
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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!
Libertine, oh dear, so sorry to hear of your woes. Do hope everything's sorted out soon. Which hospital are you in? Sorry if you've mentioned it before, I've forgotten.
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Update. Week 20.

This seem a good time to post an update. Since the the last one a few I've seen the surgeon, received yet another set of physio drills and did I mention that I went skiing wink

The good:

I went Skiing at Manchester, I'm climbing a bit harder, I have a pleased surgeon who said 'do stuff, but not too much all at once' and last night I posted a fast time up my local training hill. I'm only getting minor, 'puffy' swelling if any Happy

The not quite so good:

It's still sore at times & hanging around in a fridge for 6 hours doesn't help. I'm still a weakling when it comes to quad strength. Sad


The important points are probably the skiing and strength. Skiing at 20 weeks post op will not be for everyone. I ski to a high standard (Coach & Instructor) but was very careful. As it happens my first session was shadowing an Instructor refresher course which meant that I was able to recap from straight running, through ploughing to easy parallel. That very easy progression worked very well and seems a good, safe way to get back to it. Skiing later in the day the knee felt strong with no twinges or issues. My main focus was to avoid being wiped out by some errant slope user.

With successful skiing under my belt I was looking forward to seeing my physio to hear his view on how things are going. He put me on the strength testing machine and the results were 'interesting' ! While my hamstrings are now stronger than my 'good' leg, but my Quads have only reduced their deficiency from 35% to 30% Sad

However the physio seems to think that if I put the work in we can get that down to 10% and skiing in the Alps is still a reasonable goal for early December. However it goes to show that despite it all feeling 'OK' in a dome and at home there is still a big deficiency to be corrected.

In the mean time it's going to be a case of more strength work on the quads with a progression towards more dynamic stuff (running \ jumping etc.) I've a pass to ski on our plastic slope but physio's main concern is the risk of collision. I'm allowed to climb harder which should also help with all round strength.

Next stop the Alps, fingers crossed snowHead
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AndAnotherThing.., sounds like its going ok to me.

I have been in hospital for 5 days now on a heavy dose of IV anti-biotics which were burning my veins so badly they burnt through my veins!

The infection was picked up in the operating theatre but is all settled down enough for me to go home today with a few more days tablet anti-b's.

Now, time to get on with the rehab ....
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 snowHeads are a friendly bunch.
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Libertine, Glad you are home and they have the infection sorted - that must be a relief Smile


Keep us posted with updates on your rehab progress ? snowHead
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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..,

That sounds really exciting congratulations! It sounds like you're skiing before your running, have I read that correctly? If so that is impressive and I didn't think was possible!

Ive just moved to worcester university to start an outdoor leadership course. I had my first physio session on tuesday up here and the physio was highly UNimpressed by my progress and my previous physiotherapists treatment. She has told me that im lagging way behind in both straightening and bending my knee, and she did some hyper-extending with me, which is something my previous physio hadn't done (which seemed to worry this physio). So I have a goal of getting it fully straight for next tuesdays session and 120 degree bend by then too. I have been OK'ed to get on a cycling machine and I've also been told to get hold of a 'wobble-board' which I will be purchasing tomorrow from good old Argos.

It's been very frustrating going to join all of the sports teams and societies such as football, cycling and of course skiing but having to explain that while I want to join in, I wont be able to do any of the activities until March time, which means missing out on the snowsports teams trip to Tignes which sounds fun. Im hoping to make 2 seperate trips to the alps in easter however, which my current physio thinks is possible.

So all in all I have been lazy with my exercises (and slightly ill-advised, but im still to blame) and as a result I am paying for it now! Hoping to really focus now though and crack on.

Cheers
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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
hazamadcow, Glad you found a good physio - it does seem to the key to a good final outcome.

I guess have skied before running, but them I never ran much before the accident. As it happens this months evil rehab drill set includes a series of funny walking and running plus lots of single leg 'dipping' strength work.

I'm not rushing to ski again just yet, but expect that I'll be drawn to our local dry slope for a few runs in the next few weeks.


On a related subject, I've started a 'consolidated' thread where readers can read extracts of how the rehab has gone for others here:

http://snowheads.com/ski-forum/viewtopic.php?t=91354&highlight=

If you guys would like to keep posting updates it would be cool to add a few more examples.
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 You know it makes sense.
You know it makes sense.
Week 2 update,


After the infection, have been home three days, Still on an assortment of anti-biotics (for the infection), paracetemol, Ibuprofen, tramadol and codeine. i can bend the leg to 90degrees after my leg has warmed up throughout the day. I can now lift my leg from a sitting or lying down position and concentrating on these leg raises and getting the leg tight and flat seem to be the physio's main aims.

The operated leg is clearly showing muscle waste but less than when i did the injury in March. Walking around the house without cruches with a bent over posture. Outside, one cruch for shorter distances to the local shop 500m away and the longest i have walked is just over a mile bith both sticks and minimal pain.

Stairs - i can walk up alternate steps when concentrating and holding on to the bannister with minimal pain. walking down is considerably harder and much more painful using alternate steps.

I am going back to work on monday so not looking forward to that. My hospital gym physio should start in two weeks but i may join a local gym before that to get on a fixed bike. When i first did the injury, the bike really helped get the movement back in my leg by starting off with the seat really high and lowering it over the next few visits.

The surgeons have all said that the reconstruction is really strong immediately, but i cant stop worrying that i will over stretch it or snap it etc, I need to get over that sharpish!!

Cant imagine being safe to drive yet wich is a pain for the supermarket runs etc as my partnet does not drive.

I keep thinking that I could maybe ski in march/ april......


Last edited by You know it makes sense. on Wed 3-10-12 14:54; edited 1 time in total
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
keep the faith and keep up the physio. I am at 6 months post op and have been given the all clear. the muscles wastage is now my main challenge. its not bad but obvious that my operated leg is weaker than the other one. I ran 5km on the treadmill this week and have been cycling since 10weeks after the op. i have over 4 months until I ski so got to focus and put the work in to build the muscle back.
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backhojo, sounds like you are well on your way. I was hoping to rida a bike well before 10 weeks. Possibly in another 2 (5weeks total), is that totally unrealistic an expectation? i probabably did nit research enough before the op as i also thought running after 6 weeks was likely Puzzled

I guss the weeks will fly by and as long as there is improvement every day then that is the main thing.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Libertine, My rehab protocol has 'light jogging' in Weeks 4 - 8. I'm just starting jogging type stuff 'properly' now at the behest of the physio and it's week 20. That said I was never rushing to be running. I think weeks 6-12 are the 'danger' weeks when the graft is at it's weakest. I think I was on an outside bike at 10 weeks do bits and bobs, and much earlier on the indoor bike.

backhojo, Glad it's going OK - I think I'm in the same position as you Toofy Grin
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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?
Libertine, rotten luck with the infection but sounds like you're back on track. I think the running hope is too optimistic personally, but people seem to be doing different things at different times. I thought it was a nice idea of AndAnotherThing.., to do a separate thread http://snowheads.com/ski-forum/viewtopic.php?t=91354&highlight= so you could easily see what people were doing and when.

backhojo, if you could be bothered to do a brief breakdown of your rehab timeline too, I'm sure it would be interesting and helpful for others. I contributed but I have had the weirdest rehab instructions from my French surgeon, so not sure how helpful my contribution is to those who'll get treated in the UK.
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AndAnotherThing.., why are weeks 6-12 the danger weeks?? why is the graft weaker then?
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Libertine, ah well, I'm no surgeon but my understanding is that's something to do with the way the graft consolidates. At the start it's strong as it's the original hamstring. As time passes it gets weaker but at the same time forms the basis from which the body regenerates as blow flow re-establishes, and then it gets stronger. I asked the physio about stretching the graft and he reckons it's unlikely for me at the 4 month mark and it should be 'bomber' at the 6 month mark.

The issue is really rebuilding muscle back to pre injury levels so that you are not relying solely on the graft from knee stability - which would be bad.

I'm sure someone else will be along in a moment to explain much better !!
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Well, this whole process just got a whole lot less painful as a letter arrived from l'Assurance Maladie detailing the reimbursement for the treatment. It took one month from applying for it. Only 6 weeks to go til the all clear. Very Happy
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miranda, How's the rehab going ? Are you now working with a physio ?
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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!
AndAnotherThing.., I've been on holiday, so done absolutely nothing.... Will make a physio appointment this week and it's nice weather here so going for a bike ride.... must not slack off before the final hurdle... Embarassed
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I know I'm prob teaching my grandmother to masticate an ovoid here but you lot are doing the IPT band exercises with a foam roller, are you not? Not touching the knee at all but on the exterior of each leg above the knee? You should only start doing it when you get the OK for light exercise but it's one of the best things you can do to loosen things up and flex that area. Hurts like hell intially but very good for you generally.
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RattytheSnowRat, No, that's a new one to me. Have used rubber bands at the ankle.
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