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Ruptured ACL 18.1.23 - Rehab

 Poster: A snowHead
Poster: A snowHead
Glad it's going well, UANN. snowHead
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so far so good @pam w Happy
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quick update Happy

so far so good. past week 12 so graft should be solid. running on treadmill. cycling on real bike.

very little pain. some stiffness. need to do more knee-sits. but overall, pretty happy Happy
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under a new name wrote:
quick update Happy

so far so good. past week 12 so graft should be solid. running on treadmill. cycling on real bike.

very little pain. some stiffness. need to do more knee-sits. but overall, pretty happy Happy


You are definitely further on than I was at 12weeks. Very well done!
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When they tell you that recovery is 6-9 months, they may not tell you that peak reinjury period is actually 9-12 months and that you should wait the full 12 to go back.

Not long done my 12 months of purgatory and can't wait for first Xmas away since 2019...
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@NickyJ, thanks. It's all down to the surgeon and my physio!

@imull, well, that's not what my surgeon, GP, physios say, nor the literature - got a reference handy?

Sure, as a chum who is a senior and long experienced pisteur (was sponsored freerider for a few years too) says, "one year to recover, two years to forget" my expectations are pretty sensible, but your comment is not in line with what I'm being told be actual orthopaedic professionals ...
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I'm still in limbo with mine after he crash on 4/3/23.

It does feel better and I can get upwards of 50km out of the bike with the odd day giving me enough grief to turn back after a few hundred metres.

Swimming is OK with the ability to push off in the pool and my current pace would see me completing the IM swim leg in the required time, but as Bolton IM 24 isn't running I've got/getting a refund.

Running is still out of the question, walking is fine.

Will I enter a 70.3 tri next summer? I don't know as I'm only 4.5 months into the 6-7 month waiting time for the reconstruction.
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@homers double, yeah, I wads feeling pretty good just before my op but felt a lot more stable straight afterwards.
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Quote:

@imull, well, that's not what my surgeon, GP, physios say, nor the literature - got a reference handy?

I've not got a reference handy but I was told by more than one professional that recent understanding is that the graft gets strong by 3 months, then it gets weaker again (don't ask, can't remember the explanation for that), and that full strength isn't till 9 months. So the advice for return to full exercise has changed, and is now at least 9 months.
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under a new name wrote:
@homers double, yeah, I wads feeling pretty good just before my op but felt a lot more stable straight afterwards.


Good news, a guy I know has just had his reconstructed. He's a few years older than me but feels fine now.
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@karin, that’s not quite what I am being told, but not very far off. So for instance at 12 months I could ride a normal bike, etc. But tennis is out this year.
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under a new name wrote:
@NickyJ, thanks. It's all down to the surgeon and my physio!

@imull, well, that's not what my surgeon, GP, physios say, nor the literature - got a reference handy?

Sure, as a chum who is a senior and long experienced pisteur (was sponsored freerider for a few years too) says, "one year to recover, two years to forget" my expectations are pretty sensible, but your comment is not in line with what I'm being told be actual orthopaedic professionals ...


Not sure what you're meaning. "one year to recover" is exactly what I said I was told - wait 12 months.

https://bjsm.bmj.com/content/50/13/804 - as posted on another thread - top google result and no more checking than that...
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@imull, that's a nice looking paper, thanks.

But I note, "The reinjury rate was significantly reduced by 51% for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed."

9 months, not 12, 9 ...

Critical point being that’s a December start or an April start and another lost season.
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 You know it makes sense.
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Very late to this thread I know, but check out this guy:
http://youtube.com/v/Jwu8f42rLuI . His stuff was way more helpful at rehabbing my knee that the stuff my physio gave me. Sadly he's deleted a lot of his free videos (presumably to sell programs instead) but there's still enough on there to put yourself a routine together. Walking/running backwards up a very steep hill was the thing that worked for me.
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@greengriff, my physio had me walking backwards … that all looks interesting.
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Yes, his ideas and exercises made a real difference to me. Hopefully it can for you too!
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under a new name wrote:
@greengriff, my physio had me walking backwards … that all looks interesting.


Mine did too, and on treadmill in gym. I definitely got some looks!

Once I was stronger, I used cross trainer both forward and backwards, alternating every minute to achieve the workung of the hamstring
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@NickyJ, my physio only has static machine but I’m doing quite a few things for the hamstring
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4 days shy of 6 months and I had my pre opp assessment this morning and now waiting for a date. I've advised I can do short notice just to get it over and done with.

In terms of what I can currently do, 70km bike rides whilst in Italy a few weeks ago, 1000m swims are no problem and over the bank holiday we climbed (and descended) Kinder Scout via Jacobs ladder. I did feel a slight popping sensation in the back of my knee towards the end of the walk but didn't need any form of pain relief or felt the need to complain about it.
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@homers double, yeah, I was questioning my need for recon ... tricky. Anyhoo, it's done, it's solid, starting pliometrics on Friday ...
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@under a new name,

Following on from...

homers double wrote:

Good news, a guy I know has just had his reconstructed. He's a few years older than me but feels fine now.


Said chap just completed a sprint tri
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Well, I'm still happy with my decision not to have the op. 16 months on from the injury, and I barely think about it anymore. My limiting factor is definitely the ankle on the other leg, which has been dodgy for years. If I'm jumping off/over something, I choose to land on the leg without the ACL rather than the one with the bad ankle. A couple of weeks ago I did a 14km traverse of the Glyders in North Wales, with 1000m of up (and then obviously down again...) without any problems.
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@karin, nice! I’m quite happy now that I had the recon. Isokinetic tests tomorrow - we’ll see how I’m progressing Shocked
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@under a new name, good luck with the tests
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@karin, thanks, well we only managed one, the app's not very intuitive but at least squatting I'm 48% Left, 52% right (the reconned one) so that's good. We'll hopefully do quads and hammy strength tests on Wednesday.
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When you say 48% and 52%, what does that % relate to, pre op strength?
When my physio was doing tests to determine whether to sign me off, they weren't very helpful - I was significantly better on them all with the 'bad' leg, because the ankle on the other leg doesn't flex enough to let me squat properly or push off and land properly when I jump/hop!
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@karin, the only test we managed were squats and the 48%/52% relates to relative weight on each leg. My right would have been dominant pre damage so from that point of view so far so good.

What they're going to be looking for AFAIK is good strength, symmetry in application thereof and ROM. And really the question is "can I ski come December?". Asymmetry laterally and between quads/hamstrings (and obviously basic weakness in quads) are all apparently leading indicators for either re-tear or tearing the other knee.
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I've now been told that my reconstruction isn't going to be this side of Christmas so that will put me at about 10 months before I'm to be seen.
According to the official NHS guidance that should be 18 weeks...
I'm booked in to see a rehab chap we know this afternoon to see what sensible route back to training is now possible as sitting around getting fat(er) isn't ideal.
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So just picking up on the above as we've just had a week away, I've got a program of physio on it's way and have been advised to man up and exercise.

I managed a sort run yesterday, 3.5km run/walk to see how my knee held up to impact exercise and it went surprisingly well. No pain to speak of so I'm confident I can get out regularly.
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@homers double, well done, that's encouraging.

I have been pretty diligent at the gym on strength and cardio and rather delighted to have to tighten my belt a hole.

Less amusingly I was due to have isokinetic testing done last Monday but a sudden onset of food poisoning in the car park of the DIY shop near the clinic meant I had to cancel Embarassed Embarassed rescheduled for Dec 4th
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under a new name wrote:


What they're going to be looking for AFAIK is good strength, symmetry in application thereof and ROM. And really the question is "can I ski come December?". Asymmetry laterally and between quads/hamstrings (and obviously basic weakness in quads) are all apparently leading indicators for either re-tear or tearing the other knee.


Back in 2018 I had meniscus repair / ACL reconstruction on May 1st and was back on skis for opening day 3rd November. Used a brace and took it a bit easy for first few weeks but was back in the pow by December. If your rehab has gone well hopefully you can also get back on skis this year. Skiing muscle memory and good technique will help you.

I had some discomfort on full extension and the surgeon agreed to go back in via arthroscopy and clear out some scar tissue that was the cause. I was able to ski again a few days later.
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@BobinCH, I'm pretty optimistic! My Physio is as well. I'm defo far, far stronger (sled leg pressing 135kgs, weighing 62 kgs) (and fitter) than last year and probably the last few years.
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I got the call from the hospital today, op date set for the 27th of November!
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homers double wrote:
I got the call from the hospital today, op date set for the 27th of November!


Good news! Glad it is now this side of Christmas
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@homers double, good stuff, keep up the pre-hab!!
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Indeed, skiing probably isn't happening this season anyway as we've booked a big holiday in Thailand at the end of March.
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@homers double, you don't have a lot of time now but you've been doing stuff already haven't you? Given that I've been "exposed" to quite a lot of people with injuries and ops this year (just by sitting in the waiting room Sad ) it's been really clear that pre-habbing makes a lot of difference.
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@under a new name, Yes I have but not massively so. Plenty of walking (more than usual) some cycling, some gym work and some swimming.

I was in the gym this morning and swam yesterday.
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Thats it, I'm done. Without taking the full dressing off I can summise that I've got holes in the side of my knee from the keyhole and a slice a bit lower down where they've taken a section of my hamstring to graft into the (assumed)dead ACL.
Spent a total of 7 hours in hospital as I ended up first on the list.
I'm not in any pain so to speak and am able to walk around and weight bear.
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@homers double, Sweet! Crutches? Did they do anything else while in there?
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