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Ruptured ACL 18.1.23 - Rehab

 Poster: A snowHead
Poster: A snowHead
@karin, A chum of mine, only a few years ago, (in the uk) was told by the surgeon that she need answer three, questions, either one of which would help her cedide,

"Do you ever run for a bus?"
"Do you ever run for a train?"
"Do you ever run for a plane?"

And if the answer to any was "Yes" she should go for the recon ... (as it happens she ski tours a lot, hikes pretty severe trails and has been known to heliski quite frequently...)
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@under a new name, Good luck today mate!
Hope they get to the crux of the matter wink
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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?
@shep, I see what you did there wink

Notably, a dodgy knee does not preclude fine sushi and nice Pouilly Fumé at the Cap Horn Laughing
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Well that's that confirmed, totally gone ACL and maybe a few other little bits of damage.
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Anyway, snowHeads is much more fun if you do.
At least you know what you're up against now. I know I felt like I was in limbo until I'd got the diagnosis.
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Quote:

And if the answer to any was "Yes" she should go for the recon ... (as it happens she ski tours a lot, hikes pretty severe trails and has been known to heliski quite frequently...)

Well obviously the answer is yes to the first question. I climb, walk, ski, dinghy sail, dance, and run a bit, but I guess none of it is to a particularly extreme level. I'm managing everything ok except the running, and haven't yet been on snow to ski. The test will be the skiing in just over a month's time.
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Then you can post your own questions or snow reports...
@karin, yep, in some ways it simplifies things.
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After all it is free Go on u know u want to!
@under a new name, Sad
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@Hurtle, well I now know what I’m doing and it seems like a not very exclusive club! My GP was funny, “have you a preferred surgeon, if not I can recommend mine” …
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@under a new name, that's good. You've got a terrific mindset, maybe that's the most important key to sorting it all out. Good luck!
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 snowHeads are a friendly bunch.
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So, if anyone's interested, I thought I'd just keeep this running with progress (or not).

Anyway, saw the sawbones on Thursday, op scheduled for March 29. Objective between now and then to bulk up etc.

Had a bike assessment with the physio yesterday so good to go with that plus very gentle squats on bar. Can walk +/- normally and don't need brace at home. Seems better/less sensitive every day.


Last edited by snowHeads are a friendly bunch. on Sat 28-01-23 11:09; edited 1 time in total
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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.
under a new name wrote:
So, if anyone's interested, I thought I'd just keeep this running with progress (or not).

Anyway, saw teh sawbones on Thursday, op scheduled for March 29. Objective between now and then to bulk up etc.

Had a bike assessment with the physio yesterday so good to go with that plus very gentle squats on bar. Can walk +/- normally and don't need brace at home. Seems better/less sensitive every day.


Is that for the recon? Are you having Hamstring or patellar graft?
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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
@under a new name, good to see you've got your time machine working again wink If only you could get it to go backwards as well as forwards.
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 You know it makes sense.
You know it makes sense.
@NickyJ, yep. I have no idea. In French it's a DIDT, http://www.genou.com/didt/didt.htm - which I think is the "standard" procedure. Physio asked to make sure it wasn't a DT4 which apparently has rather a longer initial rehab.

@Scarlet, well, quite NehNeh
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Otherwise you'll just go on seeing the one name:
@under a new name, certainly in UK, typically females are given Hamstring and Males patella..... my understanding is the hamstring one is harder and slower to rehab, as you are having to rehab both that and the knee itself and they take strips from your hamstring to rebuild the ACL. It was, frankly, really hard work and even now I still can't get my hamstrings as strong in my left leg compared to my right. Sad
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 Poster: A snowHead
Poster: A snowHead
@under a new name, *ahem* 18.3.23? Laughing
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Obviously A snowHead isn't a real person
@Scarlet, Embarassed

@NickyJ, interesting. So, if my brief research is correct... your "hamstring" is my DIDT and your "patellar" is referred to as a "Kenneth Jones" over here. It doesn't seem as commonly done.

I'm going to have to take a 2nd opinion I think as the other local, well regarded, team, seem to do what's called a "DT4" which is the evolution of the DIDT and only involves one hamstring muscle, not 2, and aims to make a more anatomically correct repair.

My physio was very against (for me) so I'll need to ask her.
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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?
@under a new name, historically I know artificial grafts were also tried - I was rehabbing in the gym at the same time who had one was rehabbing after havig his cleanup after it failed to get to the point where he could have a new recon done! Obviously that was 2005 more and more research and techniques have almost certainly been done since.

They only took hamstring strip(s?) from the same hamstring as the leg which was having the reconstruction. Sorry if I confused you there.
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@under a new name, also sacr pattern afterwards is neater from a hamstring vs patellar
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Anyway, snowHeads is much more fun if you do.
Mine (in Thonon 1997) was patella tendon, which I understood to be the "standard" procedure at the time. Seems odd to me that you'd sacrifice one or two hamstring muscles, when taking a chunk of patella tendon has no negative consequences. But finer minds than mine etc... Maybe @Jonathan Bell could clarify?
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@NickyJ, no, wasn’t confused! The DIDT takes 2 of the hamstring muscles (I think there’s commonly considered 3).

I care not at all about scarring. At the rate I’m going, all I need are some russian prison tats to look proper gangsta on the beach Twisted Evil

I recall, I think, a brief period where some of the French ski team experimented with prophylactic gore-tex wraps round their tendons Shocked I don’t think that idea lasted very long.
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Then you can post your own questions or snow reports...
under a new name wrote:
@NickyJ, no, wasn’t confused! The DIDT takes 2 of the hamstring muscles (I think there’s commonly considered 3).

I care not at all about scarring. At the rate I’m going, all I need are some russian prison tats to look proper gangsta on the beach Twisted Evil

I recall, I think, a brief period where some of the French ski team experimented with prophylactic gore-tex wraps round their tendons Shocked I don’t think that idea lasted very long.


I agree tbh, but do wonder (and seriously hope it isnt the case!) whether this is why there is a tendency for it to be preferred with females. However also scaring can cause difficulties with movement etc, part of my challenge after op was to breakdown the scar tissue within the knee as it causes problems with movements
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After all it is free Go on u know u want to!
Met up with my friend on Thursday who did hers Tuesday week ago, so 9 days, and she's still in quite a bad way, which to me suggests that she's done it badly, compared to others I know who have been able to walk nigh on without a limp a few days afterwards, and then it's only when they have an MRI that it's confirmed.

For her, and like me, it's almost paranoia that it will go again, and Jojo is one hell of a gungho woman who normally would not let things get in her way.

To hear her describing getting off the mountain was amazing, she was skiing with her son and his friend, and the son just placed 8th in the Junior Free Ride tour and is like a brother to Max Palm who got a 1st in the senior Red Bull Free Ride Tour last season, so somewhat extreme skiers as was Jojo in her day!

They were skiing above P1 in La Grave in some very gnarly terrain when it just went, the weather was too bad for a heli. Luca her son skied down and then returned with the security guys (luckily he knows the mountain really well) and blood wagon and they got her off the mountain down through steep lines in the forest that Jojo said was nigh on insane as she was vertical in the blood wagon with four people skiing down with the wagon.
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Maybe the hamstring versions are now favoured as they can be done arthroscopically? I imagine the patella tendon has to be fully exposed to remove the slice required?
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under a new name wrote:
@karin, A chum of mine, only a few years ago, (in the uk) was told by the surgeon that she need answer three, questions, either one of which would help her cedide,

"Do you ever run for a bus?"
"Do you ever run for a train?"
"Do you ever run for a plane?"

And if the answer to any was "Yes" she should go for the recon ... (as it happens she ski tours a lot, hikes pretty severe trails and has been known to heliski quite frequently...)


Hmmmm. The problem with that analysis is that the ACL deficient knee is usually just fine in a straight line. I’ve happily treated marathon runners non operatively. The knee really only becomes a problem after ACL rupture on

1) rapid change of direction. The less able are you to be able to predict the need to change the worse it is. A sport like football, rugby etc is more likely to provoke giving way than tennis or squash. Running in a straight line could be a problem if a dog suddenly ran out in front of you but not generally.

2) the other situation that is a problem is landing from even a modest height. So walkers may give way jumping off a style and of course netball and basket ball are notoriously troublesome for an ACL deficient knee. Once again being able to predict the landing can help such that the knee is at highest risk when the landing cant be seen or you are bumped off line in the air by an opponent.

Jonathan Bell
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@Jonathan Bell, My suspicion is it was a bit of lightweight heuristic to help decision making Shocked

My "goals" are (off piste) alpine & touring skiing (say, 80 days a season?), nordic skate skiing (15-20 outings), golf, tennis, trail running (3-4 days a week?) ... I'm led to understand that a non-surgical path won't be adequate.


Last edited by snowHeads are a friendly bunch. on Sat 28-01-23 13:54; edited 1 time in total
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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.
@under a new name, I had a hamstring graft. Not sure whether the patella thing was done as widely back in 2005 but my surgeon was a pretty top guy so I trusted him. The most painful bit however was the hamstring healing process. You get scar tissue building up which can then tear at any time. This isn’t necessarily bad (I think it’s sort of necessary in order to keep a full range of movement). However it feels like a proper tear in your hamstring. I remember yelping very loudly on the escalator out of a tube station to the bemusement of my fellow commuters. Thankfully that process only lasts a couple of weeks
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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
@Arno, Ta, I have the impression that as with many things, the skill of the surgeon > the actual technique selected.
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 You know it makes sense.
You know it makes sense.
Quote:

the other situation that is a problem is landing from even a modest height

I climb, mostly indoors, so bouldering is the issue, and is how I did the damage in the first place. Only just been given the go ahead by the physio to go back to it, been 3 times so far, carefully down climbing till the controlled drop from feet to floor wasn't much more than a metre. On Wednesday I lost my balance and came off right from the top - beautiful 2 footed, evenly balanced landing, phew! However, it still gave me the heeby jeebies.
Ironically I would now rather land on the leg with the damaged knee, rather than the other leg which has a long term ankle issue
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
@under a new name, I have no personal knowledge or experience to share on this. However, I did remember reading on the line the experience of a very motivated 'merican skimo chap with the same injury.

http://www.skimolife.com/journal/2019/9/24/blown-life-after-my-acl-rupture-6.html

The link is to the final one of 6 posts from accident and diagnosis, to ultimate state of recovery and back in action.

He is employed in some sort of medical capacity. Seems to know what he is talking about. It explores the myriad of options available. In the end I think he may have had some tissue from a dead person grafted into his knee. After all that I don't think it was an unequivocal success.

Made me feel a bit queezy.

You might have enough time on your hands to have a read.
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 Poster: A snowHead
Poster: A snowHead
@HammondR, thx. Cadaver grafts are not the most popular solution!! Tend not to work so very well, apparently.
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 Obviously A snowHead isn't a real person
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@HammondR, but I'm loving one quote from a surgeon,

"who coined the phrase…”there are two types of skiers in the world. Those that have blown their ACL and those that will.”" Shocked
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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?
@under a new name, well, if anything positive has come from this thread, it's that coupled with the current knee pain I'm suffering (old minor injury, apparently no higher risk than the other knee, it just hurts more), it's got me back to doing my knee strength exercises, which properly had me creaking the other day Shocked There's apparently nothing really wrong with my knee, but doing the exercises should stop it hurting – it did before, and it's been fine all summer after lots of cycling and hill walking, but I got ill and lazy and now I'm paying for that Sad The other upside should be that the exercises lower the risk generally.

I've also been staying out of the bouldering room after spraining an ankle at the start of last season and not wanting to do that again and not be able to get my ski boots on. I had never really considered it to also be an ACL risk, but there you go, a true casualty generating sport Confused I shall consider my return carefully.
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@under a new name, I tore one ACL skiing when 57 and after some rehab I did ski the next season but the knee was painful and felt unstable. I had a reconstruction with a hamstring graft. I tore the other ACL at 65 and had that reconstructed straightaway. The second one did take longer to recover but I was skiing the next season. I am skiing at 70 and both knees feel great!
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@Scarlet, nice!

@Hamlet, Hi, well, that is encouraging!! Well done you. I am feeling much happier reading that this morning, when I was feeling a little down about the whole thing.

Onwards and upwards!
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@under a new name, bin the tennis and the running and do more biking.
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@Frosty the Snowman, I have warned Mrs U that I may be investing in a road bike …
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After all it is free Go on u know u want to!
@under a new name,

Really! Don’t buy one without talking to me!
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@zzz, oh, don't worry, I wouldn't!!
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under a new name wrote:
@HammondR, but I'm loving one quote from a surgeon,

"who coined the phrase…”there are two types of skiers in the world. Those that have blown their ACL and those that will.”" Shocked

To any surgeon, everyone “will” break the bits they specialize in. Just some people died before that happens. Toofy Grin
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