skiing after acl injury

A snowHead

firstly i'm not asking for medical advice.

my daughter has recently shown an interest in skiing (actually i think she is trying to get some money out of me to buy something else, but we shall gloss over that Smile

)
she is now 21 but when she was 10 her cruciate ligament pop when she was on a bouncy castle of all things. she doesn't really have any difficulty apart from knowing when the weather is going to change.
however i've told her to go see a quack first.

so the question is is anyone skiing after such an injury and if so what was the experience

A snowHead

My husband did his ACL and had the reconstruction quite soon afterwards. He was skiing within a year, but now wears a knee brace.

As it's quite a few years after, I would suggest a medical examination. However, be warned that they will tell her never to ski again! They don't like to give people the green light as it could result in litigation! Smile

Knee brace - a proper one - is not cheap, but could be worth its weight in gold.

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

*watches thread with interest*

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i'd suggest she goes to see a good sports physio and get some exercises to make sure she's good and strong before she goes
i had an acl repair and my physio was very encouraging (as was the doctor which seems in contrast to Clare_M's experience) - their whole point was that the reason you get the repair done is that you want to go back to doing what you had been doing before

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Arno, might be different in this case, but consultant didn't want husband to do motocross again as that is how he did it originally. The consultant was probably right as Dave injured his other knee the first time he raced again after the reconstruction!!!

Hopefully the time between injury and pursuit is so long that if things were to go wrong, they would have done now, but my physio (shoulder and wrist) skis and she said even though she's never injured her knees, she straps them up as a precaution...

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mugen, There are some very famous skiers who don't have an ACL .. Bode, for example. What he does have is very (!) strong musculature around the knee.. and a little skill.

As you daughter has been functioning without at ACL for 10 years, she should be able to ski. Issue would be that the knee is not as stable as it should be - which increases risks in fall - so see a physio and get some braces.

Then you can post your own questions or snow reports...

i know some hardened skiers would tremble with fury at the thought but what about boarding? much less hassle on the knees.

I'm a boarder who has recently learnt to ski and find i'm much more aware of the knees on the skis.

After all it is free

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mugen,

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I'd be reluctant to recommended braces for a new. My understanding is there is little conclusive medical evidence as to their effectiveness; this is not to say they're completely ineffective, but some of their effectiveness may be psychological.

My background is I knackered one ACL skiing ten years ago, and it was misdagnosed for 4 months. I eventually got a correct diagnosis from the 2nd sports physio I saw; he initially favoured reconstruction, but gave me a month of intense exercise to see what I could do to control it by (re)strengthening the muscles. After this month he changed his mind and decided I'd be OK without surgery, but recommended a Titanium brace, and a program of exercise before each season.

I used the brace religiously for 2 seasons. I initially depended on it, but it was fiddly to setup right, and I could stop skiing for 5 to 10 minutes to readjust the brace. This seemed obsessive and was interfering with my enjoyment of skiing. I then consciously went without the brace when ski touring, and essentially decided my dependency on the brace was psychological and I've never used it since, with no problems (apart from damaging the other ACL). I do keep up the pre-season exercise though, and I think this is much more valuable than the brace.

The point I'm making is that I was willing to put up with the cost and discomfort of a brace, because it was worth it to keep skiing and to regain confidence. Even so, I found ways to keep skiing without the brace, but it took some effort to discard it. I think a beginner would be a) more reluctant to incur the expense and cost of a brace and b) would find it even more difficult to subsequently discard the brace if she'd never skied without it. I think sje should either be sufficiently confident in her knee to ski without a brace, or to snowboard instead.

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I posted on this thread about my husband's ACL injury only to do mine (not properly diagnosed yet, but likely) on Thursday in Meribel. Gutted Sad

Any advice would be greatly received! I am using husband's cryo cuff at the moment and he is getting me to do basic physio as this is what his consultant told him to do. I am not in much pain and have full range of movement really, so hoping I've not done much meniscus damage as well. Didn't try to walk on it when I did it as I knew what it was really.... Sad

BTW, how can they justify 535 euros to take you down the piste on a sledge stretcher!? Shocked

You know it makes sense.

Excellent source of info is the knee-geeks forum at http://www.kneeguru.co.uk/KNEEtalk/ - lots of people discussing different injuries; various stages of pre- pos-op rehab etc etc...

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

Clare_M, bad luck and best wishes for good recovery. Go easy on it for the moment, get an MRI asap and take it from there with expert advice (orthapadeic consultants and good, experienced physios). Forget everything else you hear, until you know the specifics it means nothing...Then after that, remember nothing comes close (braces etc) to a proper strengthening programme (which should start before any surgery (if needed) as you husband appears to have been told).

A snowHead

Clare_M, what have you done to your ACL? I'm assuming you've just torn or stretched it as opposed to ruptured it??

A snowHead

geoffers, will take a look, thanks.

spiceman, thanks, I am lucky Puzzled

I suppose because Dave did his and we know a bit about it already. Smile

garethjomo, the French doc seemed to think it was ruptured as he did the wiggling and pulling test and things moved in the way to suggest rupture.

I am already doing physio exercises to help not lose strength in the leg and also to ensure I can straighten it. I need an MRI, so have an appointment with my GP at 4:40pm today, so hopefully I should get a referral to a knee specialist plus a bit of NHS physio ASAP. If not, we will go private and pay. I need to get back on my feet ASAP as my job is very important during school holidays which is next week and the week after! I know I'm being optimistic, but until I get an MRI or a doc tells me what I've done, I've got to stay positive. I can partial weight bear, but also have crutches, so can walk with those with some weight on my knee.

I have very little pain! Only a dull ache really on the inside bottom corner of the knee which goes against the "internet diagnosis," but Dave also did not have a great deal of pain. I have no swelling either, though I have been using the cryo cuff to deliver targetted ice cold compression which might be helping, but even when I was still away and didn't have the cuff with me, I didn't have much swelling. I can bend my knee back all the way and can extend the same as non-injured one, so hopefully it's not as bad as I think snowHead

I can only think that I have ruptured because of what happened actually at the accident. I twisted my knee quite severely and felt and possibly heard a popping sound. I did not try to get up from it as Dave did extra damage to his meniscus by doing this, so wanted to avoid that. The guys who stopped to help me tried to get me up and I politely refused. I knew I hadn't broken anything, but something told me not to walk on it. I have a very strange fear of my knee bending in ways it shouldn't! Razz

Anyway, will keep SH posted on my progress. Smile

Clare

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

Clare_M, bad luck, I did mine in January. I'm not a doctor, so the following is simply what I've learned over the last 3 months. There are three grades of ligament tear, 1 is a strain, 2 is partial tear and 3 is a complete tear/rupture. The lack of swelling could be due to you identifying a problem early and being carful and sensible, or it could be an indication that your ACL isn't torn, because the initial swelling is due to the ligament bleeding from the tear. If it's ACL I'm very surprised that you have full flex and extension, but that could be a by-product of the lack of swelling. I didn't get full extension back until 2 weeks after my surgery (5 weeks after the injury, and I was told that I was well ahead of the recovery curve) but this could have been because I also had a grade 1 strain of my MCL as well. As you say, you won't know exactly what's going on until you have the MRI.

I was lucky in that my work health care plan allowed me to see specialist in London immediately in return (Jonathan Lavelle at the Lister, fyi) and have covered virtually all costs so far, currently running at somewhere close the 10k. I'm now back in the gym doing x-trainer and cycling, and fully expect to be back in skis this coming December (albeit with a custom knee brace fitted).

Keep up the exercise and the very best of luck with the diagnosis.

DJ

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Dr John, I'm glad you have replied, I was trying to find your posts, but couldn't find them.

I know I am surprised it's not very bad pain and I can move it well, just hoping that's a good sign, though obviously realistic too.

We have private health cover, but it's run out until the 1st May as I had some wrist trouble this year. I might pay for private consultation if I cannot get a quick NHS appt, but MRIs are expensive, so might not be able to run to that at the moment and will have to wait.....

I am quite an impatient person, so this is going to be hell! Very Happy

Anyway, snowHeads is much more fun if you do.

Clare_M, the pain, for me, came only when I got the thing twisted or tried to bend it beyond the angle it wanted to go, or spent too much time standing up. Sitting around or walking gently with a locking brace didn't cause pain because, I'm told, there are very few nerve ending in the knee joint itself. Regarding diagnosis, see if you can get an MRI. I have 4 separate docs do the "wiggling an pulling" thing, 2 of them were convinced it was full rupture, two thought it was just a strain. The 2 who thought it just a strain were juniors, the 2 who were right were senior consultants. MRI revealed full rupture, MCL slight tear and bruising to bones. Go figure.

Keep us posted with progress, I'll do the same.

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I will be asking for an MRI at GP appt this evening. Likelihood of getting one, probably low on the NHS! Wink

Perhaps I'll get some physio through the NHS, but not sure where it'll be or how convenient. How long before you could drive?

Then you can post your own questions or snow reports...

Clare_M, I was driving within 3 or 4 days of my injury. The doctors/physios all took the view that the knee was nackered anyway so i wasn't going to do much more harm by walking on it etc. they were also pretty keen to get me off crutches. in fact, i really had to plead to get crutches in the first place

After all it is free

I drove about 3 weeks after I came back, before my opp. After op I couldn't drive for about a week, OK after that. This is my right knee, so it didn't have to do much except gentle accelerating and breaking. Not so sure it would have been so easy if it was my left knee with a manual gearbox.

I have done my left knee, so clutch leg. I like my crutches, they had special spiky bits on the bottom so you can walk in snow, but they took them off at the airport Very Happy

I can probably do 90% of walking with one only. Went to the supermarket and walked round with just the one and them realised how people don't look where they're going in there! I nearly got my crutched knocked out of my hand 3 times!

The fact the doc gave me crutches straight away means what to do reckon????

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Clare_M, wouldn't read too much into being given crutches, opinions change from doc to doc and each case is different. I was given them straight away but was encouraged to lose them as soon as I was comfortable, same with knee brace. My work paid for me to get a cab to and from work for a couple of weeks so I didn't have to face the tube with crutches, but it's best to get up and about as soon as you can to keep the muscles working. The crutch is quite useful as an early warning system for others, but this only goes so far, you soon learn how little people notice what's around them.

As I say, I'm only sharing with you what I've learned with my particular case, but each case is different and you should listen to and trust what the doc says.

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[achilles mode] Why isn't this thread in the gimp forum? [/achilles mode]

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Dr John, Lavelle did my knee too. I went to see him 2 weeks after the op and dutifully took both crutches and brace. Pretty much the first thing he said to me was, "what have you brought all that kit for?" Laughing

Arno, haha, I did exactly the same. I'm seeing on Friday for my 4 week post-op check. Still got a band of swelling across the front of the knee where the endoscopes went in and a little at the back where the hamstring was harvested from, but the physio isn't worried about it so don't expect Lavelle to be either. Looking on the bright side, I'm using this incident as the push I need to get back to regular gym use. The grand plan is to return next season in better general condition than I've been in recent years.

Physio has been saying I should get a good knee brace for skiing, Donjoy or similar. Sniffing around the internet the jury seems to be out on whether it's worth getting a super dooper custom job, or just a good quality off the shelf one. Any thoughts?

You know it makes sense.

Sounds like Dave's consultant! He took the brace off him, but then let him keep the crutches to walk with because he had the meniscus tear I think.

I just tried to weight bear with a naked leg. (Without the brace for the pervs NehNeh

) Didn't feel very nice! But not painful, just odd. Probably shouldn't be doing anything right now, but like I said, I'm impatient!

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

Dave didn't get a Donjoy one, he got one after the op, and that's the one he uses for skiing. He wears some for motocross which is what did his injury in the first place.

A snowHead

I did my ACL 8 years ago, had a full reconstruction and ski without any problems now.

My wife strained hers last season and was skiing again this season.

Do the physio religiously.

My specialist had no problems with me skiing, he even sponsored me to do a charity ski challenge the following March snowHead

. I had the surgery in April and was skiing again in September, definitely needed that 5/6 months to properly recover though.

Clare_M, for my wife I paid for an MRI last year from a clinic called Vista Diagnostics in London near Waterloo- it just does MRI/diagnostics. You can book early morning slots for about £200 or £250 from memory which is A LOT less than a private hospital will quote. My wife then took the MRI scans to her first appointment with NHS consultant who was able to confirm the strain diagnosis straight away rather than referring for an MRI and another wait rolling eyes

A snowHead

Dr John, i had a bit of niggling swelling but a course of good old ibuprofen got rid of it

i used an off-the shelf brace for my first season back skiing. one with metal bits for stability but nothing very sophisticated. it really just helps confidence.

reckon my leg strength is easily better than it was before my op. my cardio fitness probably isn't as good but that is partly because i am 8 years older Sad

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

Chris Angus, that's good info about Vista. I paid £1200 for a private MRI

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Aaaaahhh a thread close to my heart or should I say my knee....for those that don't know I was helicoptered off the mountain a couple of weeks ago - and when well away from the resort (we were ski touring) you don't pay for the heli, though I'm well insured for all types of "stuff" through BMC.

When I fell it was just after skiing some great powder and steep too, as I came out on to flatter terrain I hit soft snow and did not react quick enough to change my style etc, tip went in and ski twisted back, I distinctly remember two popping click noises - most of my mates skied on past or were already down (see video link below), I also lost a ski so another mate who was behind me stopped off and we started trying to find it, though was difficult to concentrate as I was worried about the knee......anyway ski brakes had locked and ski was below me, I was able to hobble down and was "surprised" at how I could move.

Once reunited with the ski I put it on and skied down to the others and told them what I'd done, I then skied on and fell again and had another click / pop go in my knee, that's when I knew I was not going to get off the mountain though we tried a few futile methods (shovel / snowboard etc) before calling the heli in.

Once at the hospital, I was actually optimistic that maybe all was not that bad. I have had a few problems with knees (only cartilage and subsequent keyhole surgery) and actually texted the other half that it might not be too bad.

After the x-ray I was seen by the Doctor who like in some of the above posts, felt my knee and pulled it and said very matter of factly that due to the rapid swelling which was blood due to the rupture I had done my ACL.

So that was two weeks ago, and I'm still out here as we had friends and family coming out. After the first three or four days I took off the super stiff brace and then came off the crutches and have been quite mobile, I was using a ice pack three times a day and loads of ibuprofen to reduce the swelling, I was walking ok on the flat with a velcro knee brace I had for my other knee after a week!

Last Friday I drove back from Turin to Serre as I thought it safer than the other half tacking the AutoStrada, and yesterday went for a 2 1/2 hr walk up the mountain. Going up I was fine (using poles) and was able to go up quite a gnarly path but I always knew coming back down would be super slow and awkward, luckily I sussed that the footpath would link up to a mountain track that went back down at a more sensible gradient!

So being out here for two weeks I've been doing a fair amount of research on and off. I did try to get an MRI out here but Insurance Co rang up and spoke to the Dr who treated me and they decided it could wait till I get back to the UK. I then emailed my GP and sent him all the hospital documentation in the hope he could refer me without having to see me, but he emailed back saying I have to make an appt to see him so that's now for April 14th !!!

If I had to guess what I've done, I'd say it's MCL as well as ACL or PCL - when I get back to the Dr I'm not going to tell him how mobile I am, as he will only say "well lets wait three months and see how you are" think I'll walk into the surgery and make out my knee's collapsed - though without the velcro brace it feels as if it could go at any time.

If I get nowhere, then I too will contemplate going private - living in Costa Geriatrica (Worthing) we're quite fortunate in having a couple of top knee specialists (this is worth looking at http://www.mrjameslewis.co.uk/index.html and how he builds an ACL ) so the more I think about it the more I'm veering to going straight down that route!

As I do a lot of running and cycling I do have very strong quads and calf's etc and that's what enabling me to mobile and that's seems to be what a lot of people recommend in advance of surgery.

Meeting up with someone tomorrow (family friend) who is an instructress in Puy St Vincent to give my daughter & boyfriend a snowboarding lesson and she told me she's had two ACL op's!!

http://youtube.com/v/0S794ulZzew

Anyway, snowHeads is much more fun if you do.

Weathercam, mine was caused by change in snow condition, though I was on piste at the time. Stupid slushy spring snow! Hope you feel better soon, but it looks like it hasn't stopped you doing too much!

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Clare_M, mine was catching an edge on a blue towards lunch after hooning around on blacks and off-piste all morning. I was skiing normally and not doing anything stupid*, just sheer back luck.

*I may or may not have been practicing one legged skiing

Then you can post your own questions or snow reports...

To answer the original question about someones daughter, I ruptured my ACL 18 years ago while in the military. Not diagnosed as such at the time, and was told it was only a sprain/tear (memory a little vague). Any way had an MRI last Easter as I was getting some pain from skiing, results as follows:

A complete ACL rupture in the right knee, with little in the way of medial meniscal remnant and moderate to severe arthritic change throughout the knee maximum in the medial compartment. A tear in the anterior horn of the lateral meniscus and loose body fragments in the knee. There is also a large osteophyte on the front of the knee.

I have skied with the knee with little or no issue for the last 15 years, have tried knee braces but don't like them. I had an operation last October to clean up some of the damage in the knee, but was advised not to bother with reconstruction as the knee is stable.

In my favour leg strength is good from cycling, swimming, circut training and weights, and I was skiing moguls, off piste steeps and powder within 9 weeks of the operation with no issue. I appreciate I'm very lucky that the knee, despite being knackered gives me little or no pain and never feels unstable.

So to answer your question its impossible to say how someones knee will react, as everyone is very differant, however if she is fit, and never has an issue with it then it will probably be okay, however as others have said worth getting it checked out by decent sports physio.

After all it is free

Arno, ouch. I got quotes like that from the usual suspects. Had forgotten to put my wife on my work private policy Embarassed

so was in the dog house anyway- thought I'd got off pretty lightly!

Been to GP, he is quite positive about things. He pulled me about a bit and there was very little movement in the joint, but obviously he cannot be 100%. Said I could weight bear straight away, but I am a little nervous of that. Pain is minimal, but there and there is no swelling at all. He has referred me for MRI and physio on the NHS, but not sure how long that takes. Keep my fingers crossed he's right! Smile

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Dr John, those bloody blue runs! Evil or Very Mad

I'd done some really tricky, mogul-filled reds earlier in the morning, the blue should have been easy-peasy! rolling eyes

Help!!

skiing after acl injury

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