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My ACL rehab - not for the squeamish.

 Poster: A snowHead
Poster: A snowHead
i injured my ACL on the EOSB in 2008. i got told they wouldnt operate and that i had to live with it. i had some NHS physio which was crap. they seems too worried about giving you any exercises that might actually do you any good. in november 2008 i was so fed up that i found a private physio, he worked with an NHS surgeon and spoke to him for me. the surgeon agreed to operate and i had the operation 1 year to the day after my accident. i was told the usual, wear a brace for 6 weeks, use crutches and do nothing for 6 weeks. I ignored the advice, i did use the brace for about 4 weeks, but was walking around, and going down the shops and even walking the dog. when i next saw the physio and surgeon they were amazed at the progress of my knee. i put it down to keeping the knee active. i never pushed it more than it felt capable of. i have been seeing the physio since then, every week. its cost a fortune but i think he's worth it. i hate some of the exercises he has given me, especially the one where you lay down and put your feet on the ball and lift your bum, particularly when he makes me do it with 1 leg and hold for 20 seconds, 15 times. it hurts like hell.
I still have to strengthen the hamstrings. i admit this weather and xmas have made me stop exercising for the last 5 weeks. he has only just left me start running again.
he said i can go skiing around march. fingers crossed. i seem to have lost my motivation though.
I need to invest in a brace, i need to find a good one. i'm also worried about ski insurance. i am guessing they will rip me off.

I'm glad to hear everyone is recovered or recovering nicely.
Any hamstring exercises would be most welcome
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
taratibu2, good to see you here again snowHead Perhaps a chat with Al Phorn ((aka The Bloke in a Frock Laughing ) would help with the motivational side of things?
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Well, the person's real but it's just a made up name, see?
Any hamstring exercises would be most welcome

I had a partial ACL tear and got told to work the hams hard, 2 great exercises i found were:
1) lying on back, with 1 leg on swiss ball, then pull/curl the ball to your bum, keeping your hips high
2) standing on 1 leg, knees slightly bent and holding dumbells: lower the d/b's down in front of your legs, until you feel a good stretch in the hams; then slowly return to the standing position (called a 1 leg romanian dead lift if you want the full title...!) Important to keep a strong core, a neutral spine and use your glutes /hams to lift up & lower down
Both of above can be done with 2 legs first, then progress to 1 legged when you've got the hang
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taratibu2, I did mine at Easter (2009), the doctor in France suspected that I'd damaged my ACL and told me to have an MRI scan when I returned to the UK to confirm, the first consultant I saw seemed to think everything was fine and that an MRI was unnecessary, but I told him that I was entitled to one (not sure if this is true!!) and he said ok then!! I'm pleased I was firm with him!! Sounds like you had to do a bit more persuading!!
I'm just back from my first visit to the Physiotherapist and it all seems really positive Very Happy He's happy for me to walk without crutches and do 'normal' things, although he has given me a list of things that I shouldn't do! I have another appointment in 2 weeks where I'll get my 'plan'!
Good luck with the skiing in March, let us know how it goes Cool
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I've a cryo cuff cooler and knee pack if anyone wants to buy it?

It means you can keep your knee cooler for longer to help reduce swelling.

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taratibu2, gra, There has been a suggestion that I might run an 'injured/recovery person' week - look at the LDA snow report thread. I'm mooting June, (good snow, nice weather) with suitable off snow activities for those working on damaged parts! If I can get around 4-5 peeps interested I'll take it further. Very Happy

dave_m, that looks excellent - what a good idea - even better than frozen peas I bet! Laughing Laughing
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dave_m, I dont think I need the cooler, but, assuming those are NOT your legs then are they available instead?
(heres hoping they come attached to a female blonde)

I have been a bit naughty and not concentrated on my hamstrings, but I do do lots of walking. I am off to further test out the knees next week in Zinal, hope everyone else gets back on the slopes safely.
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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!
easiski, 'injured/recovery person' week - what have you got in mind? Are you thinking first steps on snow after an op, or something else? My rehab's well past the first steps now (have done 8 days on snow in Dec, with some swelling on my knee at the end of each of the last few days, then a bit more physio when I got back); and I've got all of Feb to look forward to, at which point I should be clear on how its doing, hopefully back to full strength.
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gra, out of interest were you skiing at same level as before the op? What I mean is were you able to push it or was it just a case of getting the feel for it again before stepping it up on your next trip?
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Gsyfreerider, i'm at a similar stage. First couple of runs I was scared witless! I started to settle down after that and didn't even feel my knee all week but didn't push it. Just skied on piste and didn't skii too hard. Most of your rehab will be about proprioception. One thing I did notice was that my turns one way were noticeably weaker, a bit of confidence but also the balance feeling in the knee was still affected. Hoping its better when I'm skiing in two weeks!
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I went to MK last night and did 3 hours skiing for the first time since my ACL reconstruction.

It had been 10 months after I ruptured it, and 9 months after my reconstruction.

It actually went pretty well, I was aphrehensive to begin with but after the first run I started skiing as I normally would and forgot about my knee and the brace around it.

I felt a little soreness in my knee, but nothing compared to the pain the stupid rental ski boots were giving me!

I plan to go again next month, but in my own ski boots this time!
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And love to help out and answer questions and of course, read each other's snow reports.
dave_m, Nice one, glad it went well, did you go for a Robocop style brace or something a bit smaller?
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I think we can see a bit Robocop!

I have one of these. It was supplied as part of my operation.

http://www.medi.de/patient/produkte/gelenkstabilisierung/kniegelenk/m4suprsup.html
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 You know it makes sense.
You know it makes sense.
Gsyfreerider, I've been through this 5 times in total over the years - 3 times on the right knee and twice for the left.

Each time I returned to skiing slowly but surely. I use a Bauerfiend MOS-GENU brace on my right knee (purely for psychological reasons these days though I think rather than any functional protection.) The last ACL repair on that knee was in 1992 and was open knee surgery (for a variety of reasons my surgeon preferred to go in this way instead of arthroscopically). I've since had numerous "service" ops, tidying up meniscus tears mostly, the last one being in 2004.

My left knee was operated on in August 2008 to revise the recon that was incorrectly placed in 2006. Along with a badly positioned ACL graft, my surgeon found a number of other things that had been missed. He agreed to me returning to skiing as being my goal, but insisted on me wearing a brace for at least 2 seasons. I researched it thoroughly and have a really good, lightweight one from the USA - Townsend Rebel Combined Instabilities.

I wear both over tubigrip as the slightest misplacement of the velcro straps can cause skin irritation. I then wear my normal ski clothing over the braces, and apart from the hinges stopping me from skiing with my knees glued together Toofy Grin, no one actually knows I'm wearing them. With the Townsend brace I was able to return to skiing less than 6 months after my operation.

Initially I was very nervous, but skiing is like riding a bike - you cannot forget it, but you can freak yourself out worrying! I found that it was my stamina that was lacking, despite rehabbing like a fanatic. I guess 3 years of not being able to really train took its toll. Talk about jelly legs - and that was only after a few short runs! Now I ski for as long as I want to and take rests when I need to - that is getting less and less as time goes on. Playing on the Wii balance board has helped no end with proprioception exercises wink

Sue Very Happy
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Otherwise you'll just go on seeing the one name:
gra, I spoke to the brilliant physio we have here and he thought it was a good idea. I was thinking along the lines of strategy as much as anything else, and adjusting technical elements in peoples' skiing to make re-injury less likely. Gian Luca (physio & osteo) thought that using an exam by him and then working on the movements that were good for, and eliminating the movements that were bad for that particular injury (on his advice) would work. I was thinking accommodation in Cortina which has jacuzzi and is in the same building as his office and a massage. Very Happy

Very, very up in the air at the mo, but it would seem to be a practical thing to do on the gentle slopes of the glacier ..... If anyone has any further thoughts then please do let me know.
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easiski, I think that it's a really interesting idea that could be a real "goer" if there were adequate publicity (I don't need it myself at present and hope I never do, but I could see that some people would really value the support on return from injury, and the help to still ski with any residual "defects" might be invaluable IMHO).
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easiski, Sounds good Very Happy
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Well, the person's real but it's just a made up name, see?
easiski, hmm, knee recovery sessions - I like the idea of learning how to avoid re-injuring. It seels from some statistica I saw somewhere that re-injury is common to the individual, which implies the first and subsequent damage is from an incorrect technique or lack of protective response. (rather than random due to the hazards of the sport)

On my last day last week I fell in the middle of a powder field - right ski popped, left ski (reconstructed ACL) remained on. As I rolled to a stop I felt my left knee loaded up and thought I heared a pop...eek

Well, I skied the rest of the run (about a mile drop of open untracked powder fields, trees, path) then walked out, took lifts to the top of the next mountain, dropped through another vertical mile of powder fields, trees and short turns down a walking path....

Knee feels gungey inside, but no swelling and it dosnt feel like it is flapping about like it did when my ACL wasnt connected. But I think I will go to a physio and get it checked out for my own peace of mind.

BTW, I was riding Volkl Gotmas - 106mm underfoot and grinning from ear to ear Madeye-Smiley
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lampbus, Hope it's okay Sad
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Just wondering how my fellow post ACL op and other knee injury peeps are doing?. I am 10 weeks post op now. Saw the physio yesterday and he had me doing mini shuttle runs backwards and forwards and then in and out of cones. Now he wants me to focus on loads on even more one legged balancing exercises.. Yesterday he had me standing on the Balance ball which was upside down whilst he chucked a ball at me, it was almost fun!. At least there is a bit more variety in the work now...still early days but almost enjoying it..........
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Gsyfreerider, ah yes, I remember being on the wobble board with nice trainee physio lasses throwing bean bags at me NehNeh

My knee is - I am still noticing it but there is now swelling at all now (reading above I said there was none before but in hindsight, it was a bit puffy)
Mind u - Tango last night and barn dancing manically tonight and it is all good.
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Gsyfreerider wrote:
Just wondering how my fellow post ACL op and other knee injury peeps are doing?. I am 10 weeks post op now.


54 weeks post MCL PCL op (missing most of meniscus), swollen like crazy, no wai am I skiing tomorrow, may as well go into work.

OK, so I got 64+ miles of XC in last week. Cool
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After all it is free Go on u know u want to!
lampbus, Shocked You little dancing fiend you! Toofy Grin

Freddie Paellahead, That's the problem - adequate publicity - like the older skiers thing, there are lots out there, but how to tell them???

spoke to Gian-Luca again and going to look into pricing after the 'stupid week' is over! He's still keen, so he might be able to hold some brochures or something.
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taratibu2,
i've just (finally) finshed reading hermann maier's autobiography - give that a read and you will get your motivation back i am sure

Coincidetnatlly i just ths week had my first physio on an achilles problem ive been having for a year. The pHysio spent ages with me the first session, and promptly told me i had practically no movement in my ankles (how i ski reaonably well i dont know) and more interestingly that i have practically no strength or stability in my Posterior (?) CL in my left leg. Which was quite interesting given that i have a quite nasty motorbike accident 23 years ago on that knee. Any way he gavce me some (absolutely B*****d) exercises and stretches for the achilles, and for the first time in years i can feel the PCL (or where he prodded and said there was a prob) starting to gain strength and i can feel increased stability there already.

Anyway - anyone had PCL experience ? Does it improve with time/exercises?
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I did 2.5 hours at MK on Saturday night with my new boots.

My knee is a little sore for the following 24 hours so I'm not sure I'll manage 6 days skiing in a months time.

Going back next week with new skis, guess I'll see how I get on.

Motocross season starts in 2 weeks, and foolishly I'm booked in for 2 races before I go skiing.
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Hi all,

Thought I'd through this question out here: my niece recently (2 weeks ago) tore her ACL in France. She is due to have surgery in the UK in April and I'm trying to find recommendations for a very good physio for her - someone with experience and a proven track record.

If anyone has any suggestions I'd really appreciate it!

Thanks
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And love to help out and answer questions and of course, read each other's snow reports.
Slipper - depends where you are in London. I had ACL replacement and meniscus strung back together in May and I've had great physio from Waterside physio at Canary Wharf (recommended by my surgeon). I think the guys do work in other london locations though.

BTW just back from my first post-op ski week. After initially feeling a tad nervous on the first day we had a light dusting of snow and bright sunshine for day 2 and I forgot I'd had a problem! My knee held up all week despite the preponderance of drag lifts.
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Crashed heavily whilst doing first MX race of seasons and since reconstruction.

Landed on head, so neck is very sore...helmet needs chucking. Went to hospital under duress from family. Neck and back was OK.

My other knee was hurting by this time....so the doc had a look at that. It had swollen massively, so went to have an xray. No bone damage was found so the doctor suggested I'd done medial ligament damage. NO WAY!

Pretty sure this is not the case, the bruising on my knee was caused by my knee brace, you can tell from the shape. I can fully weight bare....it's just very swollen, in fact a knee full of blood!

I think I am getting to old for this.
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 You know it makes sense.
You know it makes sense.
Well I did it.

Less than 1 year after rupturing my ACL, and less than 11 months after surgery I managed to do 6 days skiing, pretty much from 9am to 5pm!

Cool
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Is off piste skiing more likely to damage the knee /acl, reason I ask is, I occasionally ski off piste and and while I enjoy it and not good at it.

My right knee has always been a little dodgy, ski with a knee support - am i better off sticking to piste skiing.
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kendub wrote:
Is off piste skiing more likely to damage the knee /acl, reason I ask is, I occasionally ski off piste and and while I enjoy it and not good at it.

My right knee has always been a little dodgy, ski with a knee support - am i better off sticking to piste skiing.


No specific reason why it should although if it does lead you to more falls/bad recoveries then I'd guess it increases risk. risk mitigated by lower speeds off piste etc. For the record most pro freeskiers/ park pros, mogul pros and racers seem to have had at least 1 ACL surgery & seem to do ok on it.
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Off piste is no more likely to damage your knee, thats assuming you can ski off piste. As most people cant they as mentioned above tend to fall more often, this obviously increases the chances of an injury.

If worried about your knee and you want to ski off piste I would recommend some lessons as if just taking your on piste technique off piste......you are going to fall on a regular basis.
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adie,
Quote:

Off piste is no more likely to damage your knee, thats assuming you can ski off piste.

Is this correct? My understanding is that the kind of fall that is likely to damage your knees is a slow twisting fall where the binding does not release, personally I would have thought this is more likely off piste particularly in deeper and heavier snow where the snow creates drag on the ski thus preventing release.
I have witnessed two broken legs in people skiing with me both occurred off piste although only one could be attributed to the above mechanism.
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gra, Freddie Paellahead, The 'REcovery' week will be a reality. As soon as Tall Tone has sorted out his Trader's corner or whatever it will be called Ill be putting up a thread. In the meantime, it will be from June 19 - 26, and something will be up on the website in the near future. Very Happy
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dave_m, great stuff mate well done, any reaction at all? Did u find it easy to get your confidence up?
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T Bar,Which is exactly what I did lost concentration in deep heavy snow in the afternoon and like a lot of these things it was a low speed accident but with a high din setting I never stood a chance of releasing, it obviously does happen on piste but odds have got to way higher off piste purely especially with variable snow.
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No reaction.

I'd already skied at Mount Keynes a few times, so confidence was gained there.

My knee was sore most mornings but as soon as I got skiing the pain went. Maybe day 5 and 6 I was sore and my skiing technique suffered a little, but I was having fun and did not want to stop!
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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!
I am at just over four and a half months post op. Went to physio today and had to do a test. 3 single leg jumps on each leg he then takes your longest jump on each leg and then works out your percentage of your good leg jump against your operated leg jump. Anyone else done this in their rehab?
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My wife did her knee in two weeks last Tuesday in Hintertux. We were staying in Mayrhofen and traveled up for the day. The only upside is that she got a free helicopter ride. I have to praise the Austrain medical services, the insurance company and her treatment in this country. Its been stressful but they have done everything to alleviate it. To anyone who doesn't get insurance I'd ask you to think again. I haven't worked out the full cost but the helicopter bill arrived last week - almost 3000 Euros. As to her injuries she has a full rupture of her ACL, partial rupture of a medial ligament and two fractures.
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Corky, good to hear of an insurance company stepping up when req'd. Which insurance company?
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