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Advice on my potential return to the pistes...

 Poster: A snowHead
Poster: A snowHead
Hi guys,

So its been nearly two years since I was on here.

A lot has happened since then. I last skiied in Villars in Switzerland and was carted off the mountain with a torn ACL and meniscus in my right knee and flown back to the UK. Fell over in some soft snow and the ski didn't come off. It was my first season with my own new boots too.

I have now had reconstructive keyhole surgery and after substantial physio have gone back to playing field Hockey (which was my main sport) a few months ago.

Now, I have been invited by the same group of friends to go back to the same resort (one of the guys has an apartment there) for a week over new year.

I had the op in February this year and the physio and surgeon have both said the knee should be ok.

So, my questions are:
1) Should I go? – I run my own business and really don’t want to go through it all again.
2) What can I do to prevent further (or recurrent) injury to my knees?
3) Should I ask for looser bindings this time?
4) Any other advice?

Any comments will be much appreciated.

Pilg.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Your story is almost identical to mine (upto to the point where 6monthss post op I just started back to hockey training with strictly no tackling instructions when I found out I was Pregnant) I was all on schedule for going skiing again in the march (which would have been 9 months post op). I didn't end up back skiing until my daughter was 17 months old but when I did get out there it felt great! My knee was rock solid, hockey is great for building up your quads and hamstring - did you have a hamstring ACL-R? Provided you get them strong you will be fine. On the binding restrictions if you claim to be a beginner they will make them quite loose (which I now do) however my best guess as to why my ski didn't come off is it might have frozen up while we stopped for a hot chocolate before our last run back to the hotel (the sun had gone behind the mountain). Personally go for it!
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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?
1) This is me, 9 months after an ACL replacement:





So, yeah, go! (based on the fact that you're playing hockey...I was playing a lot of tennis before doing this kind of skiing)

2) train both quads AND the hamstrings. Then cross your fingers (NOT your legs)

3) yes, maybe, I was on lower DIN (but not THAT much lower)

4) poo-poo happens. I tore my ACL learning how to surf, a friend has torn his meniscus when fly fishing (!), it's not like the only place where you can kill an ACL is a ski resort. If you like skiing, go and try not to worry too much...
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 You need to Login to know who's really who.
You need to Login to know who's really who.
Every case is completely individual, but I'd imagine if you can cope with the cahnge of direction in Hockey, then skiing should be okay.

As for your binding setting. Not all ski rental shops are as conciencious as they could be. My own personal stance on it would be that everyone should know what their own DIN setting is. You should be able to find charts with the aid of Google, at least then when you get the rental skis you can check they are in the ball park area of where you want them. If you then know your own settings you can then adjust to suit yourself as your skiing level develops, ie, if with lots of your fall your skis stay on, and theres twisting sensations felt, this would probably require your setting taken down a bit. If you get into playing in mogul fields, or skiing fast, then you might find the extra strain causes your ski to pop off prematurely, and as we all know premature ejection is bad, so you would look to be tightening up your setting a touch. I wouldn't reccomend anymore than adjusting by more than half a din at a time if out with the binding manufactures reccomendation.

Its all worth learning about as its handy to know when you start owning your own kit.

As far as your own setting being looser, thats your own call. My brother has torn ACL and he has his down a bit, not sure exactly how much by, but he does pop out occasionally in moguls, but he knows the limitations, and can also ski on one ski no problem so tends to not bother him to much.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Pilgrimage,
1. Your call, but I would.
2. Every time you go skiing you are at risk from injury.
3. You should choose a binding setting appropriate to your age, weight, skiing style, and experience.
4.No.

All IMHO.
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 You'll need to Register first of course.
You'll need to Register first of course.
1) only you can answer that one, there is always some risk, only you can weigh up the overalll risk/benefit balance...

2) now your medics have given you the all clear, and you are back playing hockey, bear in mind skiing has some unique requirements. The best thing you can do is get in great shape for skiing: first & foremost good ranges of functional movement in extension, rotation and lateral planes, then a good level of strength over the whole body including core and legs, allied to cardio fitness, power and agility. You can make great progress in these areas over a period of several months. Anyone with ACL damage should consider extra work for the hamstrings (romanian deadlifts and swiss ball leg curls being 2 classic exercises) to ensure the hams can take some of the load off the reconstructed ACL.
Secondly, you may need to allow each day for a proper pre ski warmup, both off snow and then on snow with skis on to switch on you ski skills- I always do this and manage to fit it in without my ski partners noticing, doesn't have to be a big deal. Then a good stretch after to ensure your muscles will be in good shape the next morning.
Thirdly, look at your technique, skiing in the backseat leads to extra torque on the knees and early fatiguing of the quads, as well as preventing the skis working properly and increasing the chances of a fall - so try and develop good ankle flex and good fore/aft balance. Plenty of people here can help on this.
Fourth, think of your tactics on the slopes, and match how you ski to what you can do, common sense really
Finally, manage your fatigue levels, day 3 afternoon is a blackspot for 1 week skiers, dont push the skiing when you are fatigued. When the muscles around the knee are tired is when the ACL may be asked to take more strain

3) good question - you certainly don't want to be too tight, but it does depend on your skier type - if you're skiing hard and fast you won't want too low a setting. best to look at how you ski then be on the low side for that level - and check with an expert before your trip to ensure the shop doesn't stitch you up if you hire

4) braces are a contentious issue, some swear by them, most orthopods reckon they don't provide real support but may help proprioception
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
I should imagine the ACL reconstruction is OK. Mine was after 6 months, but then I was hit by arthritis in both kness. If you are worried wear a knee brace; a proper one not a piece of neoprene with a metal strip in in it. Expect to pay £300 plus, but you will necer damage the ACL again. I wear two!


John
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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!
Pilgrimage, I think that it depends how important skiing is to you. I bust my tibia; created 32 bone splinters out of my tibial plateau; and completely lost my ACL - along with much other damage to the miniscus etc. Luckily (!) I did this in Vail - and got an amazing operation - so that my knee is all tied together with kevlar twine. The Vail consultant (Tom Hackett !!) said that he thought I should be skiing in a year.

The consultant in the UK said that I would never ski again - and that I would be lucky if I could walk properly. I threw myself into rehab - for example, walking up and down the swimming pool for an hour every morning before I went to work. I went to Xscape 4 months after the accident - hobbled along with my crutches and still in my knee brace. I managed half a dozen runs - which were crucial to me in exorcising some of the demons. So skiing became a part of my physio - and I was off to race training camp in Schladming 9 months after the accident.

As you can see, it was really important to me. At no time did I worry about whether a further accident would cause problems for the business I run. And I determined that I would be a better and more confident skier after the accident than before - which I know that I am.

So - in the words of Henry Ford - 'Whether you think you can, or you think you can't - you are absolutely right'

All the best - whatever you decide to do.

Andy
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 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
Good advice so far...I went about 180 days skiing in between my first ACL recon in Nov 2008 and my 2nd blow out in May of this year.

No binding is designed to release in all situations that could tear an ACL (but a slightly lower DIN may help in some possible senarios). Some would say that the Knee Binding might help reduce the chances of an ACL injury by adding an extra release point, but this has not been used long enough to have solid data to support this.

Same thing with a knee brace- might help in some scenarios, but it not a complete guarantee.

My knee feels as good or better after my 2nd surgery than the 1st (and in some ways the rehab was easier knowing more about it). I plan to ski in the spring, but know there is always a risk.
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 Ski the Net with snowHeads
Ski the Net with snowHeads
Thank you all for the advice. I had forgotten how good this forum is! Smile
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 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
Pilgrimage, I did the same thing a few year back as well. My knee was really bad and had the same surgery as you it sounds like. I was back skiing the next winter, but I now have my bindings set on '7' which I know is low, but I cannot afford another none release and time off work. They were less than pleased last time. As far as low release settings, one instructor/guide did tell me that if you have good technique you should not find your skis coming off even in deep powder or broken terrain off piste. I skied some bad stuff last winter and he seemed to be right so worth giving it a try.
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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.
Thank you guys for all the advice.
Went over new year and all was ok.
A bit of achey pain but was not too bad.
Just wore a neopreme strap on each knee.
My biggest problem was lack of confidence.
I was so stressed i really didn't enjoy the skiing.
Going to try again before end of season if i can get a week away.
Loads of snow, but bad vis didn't help.
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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
Pilgrimage, How about an appropriate-level ski course to make sure that your technique is not going to add to the stress on your knee? My knees always tell me when I'm not skiing well, and I think that's often the case with skiers at a range of levels below god-like.

As for bindings, mine are set well below the "right" level for me. I don't do the kind of skiing where a pre-release would be a life and death situation, mind you. I figure that the chance of damaging my knees (which have been damaged in the past) from a failure to release is higher than the danger from a pre-release, but that would be different for a more adventurous skier, no doubt.
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 You know it makes sense.
You know it makes sense.
Pam.
That is really good advice - thank you.
I am hoping to go again in March and will look to have some more lessons I think.
I still thought my bindings were too tight, despite being lighter than normal.
They never came off - although I wasn't pushing it, but still had to put quite some force on to release them when at bars! Smile
Pilg.
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Why not adjust your binding down half a point and if you don't pre-release put it down again. If you pre-release when you feel you shouldn't, put it up again. I find a couple of pre-releases in a holiday is normal. If facing a very steep situation where losing skis could be serious I'd ramp it up a bit. (Worth carrying a small screwdriver or swiss-army knife with screwdriver attachment.)

horizon you look very stylish there! Look forward to skiing with you in 3 weeks.
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