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The snowHeads ACL rehab club !

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@AndAnotherThing.., link to that test. Interesting, thanks.
https://www.physio-pedia.com/Star_Excursion_Balance_Test
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@AndAnotherThing.., still, having the confidence to put skis on and launch yourself down at 7 months is impressive. Granted I'm two months behind that, but even the thought of running soon terrifies me. There's that doubt, when I run and land on that leg for the first time, will the knee hold? It's never been unstable post op, touch wood (or even pre op!) but the fear is there... Oh well, onwards and upwards, big girl pants on and so on Very Happy Very Happy The physio might well have to physically push me forward the first time, but I'll do it!
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@Grizzler, thank you very much! Have you tried it? And how are the knees doing?
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I have skied with @AndAnotherThing.., a few times on gnarly very mixed condition Welsh mountains, I wish I could look as relaxed as he does when skiing. He has also been a good friend to chat to when frustration or a dark cloud has set in, cheers mate Smile

Knees are a real pain in the back bottom when they go wrong, that is what I have learned. They take their own sweet time to recover too.
Im in a bit of a loop at the moment as knee pain, somewhere inside my knee - maybe where the ACL has re-attached to something (that seems to be the conclusion drawn from the Lachman tests ie only slight difference between both knees), it feels like something is going to tear, and the pain is acute, so much so that my VMO threw its toys out of the pram and decided to switch off about 5 weeks ago, so I went back to close chain exercises at the behest of the physio. The result is yes I have got much stronger in single leg squats, from 68kg to 74kg for multiple reps, and single leg squats at 83kg at present (just over my bodyweight). However my VMO has shrunk somewhat as other parts of the muscle groups have taken on its job, this hasn't reduced the pain in my knee or the slight non tracking of my patella.

So now Im back to including leg extensions in my routine, and back to a very light 5kg weight, however the prissy VMO is now switched back on, and fingers crossed I can rapidly start laddering up the weight with it over the next few months - My good leg can easily extend 45kg with no training, so I have a fair way to go. I would expect a 20kg increase over 12 weeks I think.

I must add that I have not had ACL surgery, I have been told I will rehab just fine by 2 private consultants, The hardest thing for me was healing/strengthening both lateral and medial ligaments and the ruptured quadricep muscle (I have forgotten about the tibial plateau fractures as they have started the long process of healing) the later is just starting to grow in size - apparently with ruptured muscle,neorological pathways repair first, then strength gain, followed later by some gain in muscle size.

My hamstrings are pretty strong these days, getting a good share of workouts.

So its gym, cycle a little, hill hiking a bit and the odd bit of slow jogging.
The one thing that nags me is I really dint want to spend the rest of my life rehabbing in the gym, and hopefully as training and healing progresses I can replace the gym with my normal mountain leading work and throwing myself off cliffs in to the sea etc Smile
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Blimey @Markhandford, that’s an impressive catalogue of injuries! How/when did you do them?
Sounds like you’re putting everything and then some into the rehab though. That’s a fearsome one legged squat weight!!
I hear you on the VMO, they’re such high maintenance divas! When the going gets tough they just shut down and flounceo off. Mine is conspiring with the medial hamstring (the one minus two tendons moonlighting as an ACL) to also cause my patella to maltrack - inwards in my case, which I already tended to - and to irritate my fat pad. I didn’t even know what that was 5 months ago, but oh, I know it now! It doesn’t hurt, it’s just a touch more swollen and redder than its healthy sister. And after standing about for too long or at the end of a heavy exercise day it gives me an “I’m not very happy with you” irritated sensation. But I’ll plug on with the exercises, like that McConnell squat hold I was talking about, and I’m sure it’ll get there. In the grand scheme of things I guess none of this is too terrible. It’s just taking its sweet time, as you say!
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@BorntoRun, Jan 24th 2018, skiing in Serre Chevalier, slow speed fall with hyperextensions is what was thought from my injury.
Im fed up of my non tracking patella, mine tracks inwards/medial aswell, If I give it a gentle push to the outside while straightening the leg it is fine, physio has tried all manner of styles of taping with stretchy tape, non of which eased the pain or improved the tracking.
And my knee still swells up moderately sometimes too- Im sat with the aircast cryocuff on now, so still RICE 7 months later.
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Yikes @Markhandford, very sorry to hear! I’m getting very fed up with it is well, I really wish it would settle down already. Taping down my medial hamstring, medial side of the knee and round to under the patella did help me, but that’s treating the effect rather than the cause (the weak muscles). Not to mention the hellish rash I had last time from the tape, because I stupidly left it on a whole week (and ignored the horrible itching I was getting from it for two days).
The physio gave me a little circuit to do for the VMO/hammie/tracking and I do four rounds of that at the start of my exercises. That has been helping. It’s a McConell wall squat hold (basically a single leg squat sideways against a wall), single leg calf raises, step downs and a single leg hamstring bridge with the op leg up on a chair - all to be done pushing the kneecap outwards by rotating the shin inwards and hip outwards. Sounds complicated but once you get the hang of it it makes sense. Lots more of those to do apparently, but the tracking is much improved from where it was. The knee was so slumped inwards you could see it a mile off.
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@Markhandford, no comfort, but my patellas (patellae?) were mis-tracking and catching for a good while, knees clinking and clunking, etc etc, then one day they must have stopped, as they don't now. It's all part of the patience rolling eyes as is the still swells occasionally issue. I couldn't properly kneel for at least 9 months - a lot of forced kneeling over several months cured that! - and my first skiing definitely caused swelling and needed icing and hot wheat bags (never sure which they really appreciate more). I'm looking at still taking it very easy next season, worried about booking a full week.
Frustrating, but it'll take as long as it takes. In your case, your knee and other bits took a right bashing, not just ACL but TP fracture, both lateral ligaments, a torn quad and doubtless other stuff. You've got to give the poor things time; and get out on those hills and mountains! Best exercise IMHO Very Happy (as long as you plan your escape route/return, just in case. Take neoprene braces, tubigrip and 2 poles/axes, you'll be fine.)
I'd offer to meet up for a Pennine/Lakes ski or walk - but your strength scares me Laughing
On a serious note, one thing I've noticed that I've lost is fast control (e.g. fast edge changes, fast short turns etc): so take the opportunity to get that back asap. I presume it went with the muscle switch-off, and not otherwise doing fast stuff I never noticed it until trying moguls recently. My preferred slalom is quickly becoming GS...
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BorntoRun wrote:
@Grizzler, thank you very much! Have you tried it? And how are the knees doing?


Tried that test, pretty much same on both legs. Not quite sure what it shows except that I struggle to get my foot as far forward on a pistol squat (before falling over Laughing ), which isn't news. The woman on the vid on that link was the same too.

The knees have I hope settled into a tired, deeply-aching quads and calves (and restless at night); left has fairly constant stiff, mildly sore hams and the right has an outer irritable lateral something, which can cause mild swelling and some transient restriction and pain. If that's as bad as it gets, I'll cope. Not doing enough exercise as I should, though. Bad! wink
Worse thing is, they'll take exercise but they hate not moving. So my desk-bound work has taken a significant back seat to anything where I'm on my feet and bending. Good in some ways, and the garden gets weeded and walls dismantled, but not getting the photos or writing done Confused
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@Grizzler, I think I’ll hold off on that test until I’m more “recovered”. Not least for fear of falling over and tearing my ACL graft in an ACL recovery test Smile Smile Though if I wait until I can do a pistol squat - on either leg! - I’ll be waiting a long time!
Sounds like your legs are getting a good work out, physio exercises or no, and like they’re pretty well settled. Where are you thinking of skiing next year, even if not a week?
I know what you mean about the static thing. My knee doesn’t seem to like huge quantities of anything, be it walking, exercise, sitting, standing etc., though the length of time it can do all of those things without moaning is increasing progressively. But it hates static standing most of all. I asked the physio and he said it uses different muscle fibres - type 2, fast twitch- which are hard to rebuild without heavy weights, so it’ll take a while.
Two things you said really resonated as well. One is the speed of reaction in the muscle. I haven’t tried agility etc yet, that will come in a couple of months. But I can see how the healthy leg quad “twitches” into action in a split second, whereas there’s a lag in the op muscles switching on. I think that’s as you say from the switch-off post injury. Second, the heat - like hot wheat bags, though in my case warm wraps or some time in a sauna/warm water if I can - really helps me too, with the fat pad inflammation of all things. In fact my physio is of the school of “no ice at this stage”. His view is that it helps early post injury/post op in stopping the bleeding in the joint, numbing the nerves, pain relief etc. But he thinks later on it slows down blood circulation so the “gunk” and swelling can’t be moved away. I know others will say they find ice helpful, but I have rubbish blood circulation anyway and his approach works for me. And the hammie loves a session in the heat and compression machine in the physio office. It almost forgets to punish me for robbing it of two tendons Smile
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@Markhandford, snowHead snowHead

Quote:
The one thing that nags me is I really dint want to spend the rest of my life rehabbing


I'm starting to wonder the same. Maybe it's just a symptom of old age !
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@AndAnotherThing.., Yep, I'm of that opinion too (much as I'm not a gym attendee - more for lack of money or a gym close by - but the odd gentle exercise work-out at home might be able to be managed if I'm not doing other physical things instead). And, yes, those aches of age creep in more and more, and recovery takes longer and longer (and being female it seems to come in more and earlier than for you blokes too Sad ). I think that esepcially without ACLs at all, keeping up the muscle strength is gong to be essential, one way or the other, to holding the knees together.
Still, good excuse to keep moving, walking, generally keeping fit.

@BorntoRun, With a graft, maybe you're right to hold off. I keep forgetting that there's those of us who are going it without ACL and others who are going through reconstructive surgery: different rehabs and precautions.
I don't have a physio now, and haven't had for the last year, so I'm researching and trying things on my own. Different twitch fibres resonates somewhere in my memory when I use to know about such things. Certainly never used heavy weights on the rehab: simply not had access to them. Just me, a few light home weights (which I rarely use), a swiss ball and sofa, a tough old static cycle bike and some hilly and rough ground. I do need to work on some fast agility stuff when I can think some up: it seems not just quads but ankles, calves, the whole of the hip to foot assembly. Just got lazy and out of practice I think, and all feels too tired and heavy to want to bother any more. Right at the moment I'm feeling pretty exhausted, wiped and generally not great in myself (not news, unfortunately), so dedicated exercise as such has been put on hold. Hopefully I'll get back to it now life is moving more indoors and the days are cooler.
My early-on knee physio was also very anti ice after the first few days (and I didn't actually get to ice at all in the first 4-5 days of injury because I couldn't get my hands on any where I was!). Pretty much the same justification as yours, which makes sense to me too. I reckon that it still has its place for me if there is acute swelling and obvious inflammation after a specific activity or a new pain (or after, say, a known aggravation after skiing/boarding): but I rarely use it now. The pains seem more muscle and tendon related, so heat is probably better; that and finding some good soft tissue and neural stretches. I did buy some of those portable chemical reaction bag things which are meant to provide icing, on the grounds that if I was staying away from home it's often difficult to get access to ice or bags of frozen peas. Tried them in the car returning from Scotland this spring, but they don't seem to last long or get very cold, so not sure of their efficacy or value.
Where am I skiing this year? Pennines and Scotland if and when and as often it's do-able, and hope to book 2 or 3 weeks in Europe, most likely Austria or Italy, whilst they'll still let us go. The latter will depend on when I see good prices and what conditions are like in the UK as much as anything. I have the advantage of being able to board (a bit) as well as ski (a bit), so I'll take both and swap around as knees and conditions dictate. Not sure that I really find much difference between skis and board overall these days, in terms of pains, strains or objective risk factors, but I work on the principle that there ought to be - or at least they're different - so it gives something a rest, maybe.
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Curious to see how I'd fare on that SEBT. Just for reference really, try it again later on and see how it's going sort of thing.

I'm not enjoying reading about the idea of spending the rest of ones life rehabbing... Is that fairly common for ligament injuries? I was sort of under the assumption I'd be able to forget about it someday soon-ish!


@BorntoRun, Yeah I got about half a week in before exploding myself:D
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@jjams82, as long as I exercise regularly I can pretty much forget about my knee injuries (my left I have destroyed half my reconstructed ACL and had to have two thirds the cartilage removed), however really notice when I take a break from going to the gym... erm like I did over the summer due to long days dictated childcare arrangements we had Sad. I am now working at getting back to a base level. I have also had to give up hockey, though there are times I feel I could probably do it again I can’t risk it. My knee isn’t stable.
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@NickyJ, Hmm, seems like rather a long term thing for you eh... When did you do yours? I mean, it seems you've "done" it a more than once, but you know, a general idea.

Good to hear your long term experiences, ta.
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@jjams82, I ruptured it skiing in December 2004.

Had reconstructive surgery in April(ish) 2005 (thanks to have some private healthcare cover at the time which covered you for thugs which require an overnight stay and my consultant recommended it be, which meant I could switch to private at that point and get it done sooner.

I went back to hockey training in the December with a strictly no tackling and no sprinting instructions. But shortly after I found out I was pregnant so didn’t carry on with hockey training and didn’t ski in the April as I was aiming for. By that point when I ran my knee felt flat if that makes any sense (it lacked the normal bounce). It was a while before I went back to hockey (September 2007) by then I was feeling quite normal, and skied for the first time Jan 2008 and it felt completely normal.

All was good until his happened http://snowheads.com/ski-forum/viewtopic.php?t=98989

Turned out that was when I damaged the ACL but didn’t find that out until later when having gone back to hockey training in the August is collapsed on me and jammed the cartilage into my knee joint.
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@Grizzler, I also found the instant bags pretty useless. In fact I still have a stock of them under my desk at work. I ended up buying frozen peas from the supermarket next door when I was in the office!!!
Re the weights, I've not been put onto heavy weights either. It was all body weight only until week 17, and then 3kgs and 5kgs. At the body pump classes I'm going to at the gym I'm on two fives on the bar, and only moving on to 6 next week. I understand heavy weights are discouraged anyway early on after ACLr because of the graft, and with my meniscus repair as well he may have waited a bit longer to be extra safe. Or I was slow building up muscle, or both. Hence the difficulty building up the fast twitch muscles... He did get me doing vascular occlusion training, which is essentially exercising whilst restricting the blood flow to the injured limb in a controlled way. That's supposed to use the fast twitch rather than the slow twitch, so is useful if you can't use weights.
I doubt he'll get me onto huge weights even from now on, but we'll see, I might be wrong.


Last edited by Obviously A snowHead isn't a real person on Tue 18-09-18 15:23; edited 2 times in total
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I'm also getting the impression this ACL/leg exercises thing is here to stay. I asked the physio and he said I will be long term prone to get out of shape more quickly in that leg if I turn couch potato.
He also said the hamstring doesn't ever quite reach the same strength as the other side for most people with a hamstring graft. But if it sounds too doom and gloom, he also said functionally it won't make a difference if I keep generally strong and fit.
ACLs, hey? Not sure who said mother nature was a bit silly holding two big bones together with a flimsy piece of tissue - but they're right!
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@NickyJ, That bit about it collapsing and jamming the cartilage in the joint made me wince. Also a bit uncomfortable seeing from that thread that it went pop again on you 8 years later. That can't have been fun.

Ta for typing it out though, good to hear others experiences with it... Guess I'd better start getting used to the idea that this ACL thing may b for longer than I'd hoped. At least that way, if it isn't, it'll be a nice surprise rather than a horrible one... I hope!

@BorntoRun:
"functionally it won't make a difference if I keep generally strong and fit." - I've heard similar about the whole acl/op/etc thing in general... Fine for now while I've got an active job etc, but goddammit that doesn't fit well with my plans to retire one day and get extremely old, fat, and lazy.

"holding two big bones together with a flimsy piece of tissue" - YES!!!! Have you seen the size of the thing? It looks like a piece of spaghetti?!!?!!?!?!?! WTF.
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@jjams82, it went due to my weight coming down wrong when I stopped and changed direction suddenly. I didn’t used to wear a support for traaiming only for matches partly because I wanted to make sure I was properly building up all my muscles in training but that evening we ended up doing more of a match. Up until that point it had been great.

The subsequent collapse was due to missing the fact I had damaged the ACL repair.... which then require furthrher surgery. The damage was missed due to it still be partially intact, even the later MRI said they thought it was sill intact.
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@NickyJ, Ah, I see.

It's not quite the same, but I had a similarly intact looking ACL from an MRI point of view too - turned out on further inspection out it was just hanging there in sort-of-the-right-place-ish not attached to anything. I always thought MRI's were magic all-seeing eyes... Not quite eh.
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I was just wondering - @Markhandford and anyone else who might have experience with this... I've read a lot about the VMO shutting down. Might be a stupid question, but how does one know it's happened? Is it obvious?

As it's a recurring theme with these knee and ligament problem things I'm thinking maybe it's something I should be looking out for, unless it's super obvious and I'd know it like a brick in the face?
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jjams82 wrote:
goddammit that doesn't fit well with my plans to retire one day and get extremely old, fat, and lazy.

"holding two big bones together with a flimsy piece of tissue" - YES!!!! Have you seen the size of the thing? It looks like a piece of spaghetti?!!?!!?!?!?! WTF.


I know, there go all my hopes for a life of sloth and eating pizza!

I was very pleased when it turned out the surgeon overestimated my weight by about 10kgs for the purposes of the graft. So I can have at least a few months of the pizza before it gets serious Smile

At least we now all have double or quadruple spaghetti in there- octuple in my case as one tendon was too weedy and they took two. I did not begrudge that second one, much as my hammie is now punishing me for it!
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jjams82 wrote:
@NickyJ, Ah, I see.

It's not quite the same, but I had a similarly intact looking ACL from an MRI point of view too - turned out on further inspection out it was just hanging there in sort-of-the-right-place-ish not attached to anything. I always thought MRI's were magic all-seeing eyes... Not quite eh.


That is Very true, and doubly so after having had surgery, apparently that makes it even harder to see.

I paid for my last MRI privately and so got to see that and I wonder how they can make anything out from the imagery!
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When I had my MRIs done immediately post injury they showed me the blood filling the joint and the ragged torn-in-the-middle ACLs. I think I could make out what I was meant to see.
Fast forward 7 weeks later and the Ortho Consultant told me he'd been studying the MRIs for a long time prior to my OP appointment, as after our initial meeting 6 days post injury he had a good inkling as to how I was going to present (walking, no instability etc), and couldn't reconcile that with what he was seeing on the MRIs. Make of that what you will... Puzzled
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@Grizzler, I know what you mean, the knee never collapsed on me either and I didn’t feel any instability. Pre MRI, the first surgeon I saw was 50/50 whether the ACL was affected. The physio I saw pre op told me that was because my hamstrings are overreactive, and were holding it all together for dear life. She said once she released the hammies, the knee was wobbling all over the place. A few days later her boss greeted me with “gosh, you’re the girl with the really loose knee! You really should have the surgery.” Toofy Grin
I think the damage was pretty visible on the MRI though. The first surgeon muttered obscure medicalese about “disruptions to the ACL” but the second surgeon was pretty clear: “Sometimes there are gray areas. Not your case. It’s gone.” I went with him. Very Happy
What didn’t show up was the full thickness lateral meniscus tear. But I was warned that MRI isn’t great at spotting that kind of thing.
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Week 24 update: the knee held up valiantly to two long haul flights, though admittedly work paid for posh seats so it wasn’t exactly an ordeal. The physio did spot a touch of puffiness above the knee today, which he thought was because of the cabin pressure, but my only other symptom was a pretty stiff hamstring the day after the flight out. I blame the horrible individual, whoever they are, who stole the foam roller from the hotel gym for that one. As soon as it was returned and I could use it instead of making do with my fist, normal service was resumed.
The other update, other than having to learn to use the leg press machine for the first time in my life, is green light from the physio for the return to run programme from Tuesday next week. I’m going on holiday from Saturday and I’m told to use the two weeks to work my way through as many of the first 8 levels of it as I can. Before I make it sound too exciting, it literally starts with 1 minute walking and one minute running x5 times. I should do it 24-48 hours appart, and level 8 gets to 5 minutes running and one minute walking x4. Any unpleasant symptoms, and I’m to stop for a few days until they go away, and then go back down a level. So- let’s see what the Kneedy Knee makes of that. Terrified, moi?? Toofy Grin
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@BorntoRun, Digits crossed Smile
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@Grizzler, thank you! How are the knees doing on your side?
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... I should add that this morning also proved how weedy my hamstrings/calves still are. 15 one legged hamstring bridges on a chair in a circuit and repeat the circuit 4 times? No problem. 15x4 in a row without resting? Not so much. Add 60 more with the feet in TRX straps, and 80 single leg calf raises, also without resting, and it's serious ouchies. The only consolation is that the "good leg" was just as sub-par.

Oh, and I can't use a leg press for toffee. I emailed the physio to check if to go for seated or recumbent, but really I needn't have bothered. I was physically unable to change the weights on the recumbent- too heavy for my weedy arms. So seated it was - where helpfully you just need to shift a pin. I just know he'll email back and say go for recumbent. Very Happy

@jjams82, not a chance for me and those heavy bags you're lugging around. Just as well Mr BtR didn't go into the family farming business Toofy Grin Toofy Grin How's it all coming along for you by the way?
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@BorntoRun, Wheeeey, good to hear the flights were fine:D

I've not had the best week with the knee. The week before this I was pushing too hard with it, not resting enough, up and down ladders, and working in funny positions etc... Then last saturday I was walking to my car with three bags jammed full of the weeks shopping - 10 minutes later a nasty mystery pain appeared and freaked me right out. This week it's been a bit of a step back in terms of confidence on it and the base pain level. It's improving though (or rather returning to how it was) and the physio checked it all over and reassured me it's nothing super serious, just a setback. My fake ACL is still there and I just need to chill out a bit on it. We had another look through my MRI and OP notes and apparently I did a particularly good job fecking it up in all manner of ways, so this sort of thing is to be expected if I go working it too hard this soon!
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@jjams82, sorry to hear it was a cranky knee week- what a joy they are, both for body and mind! Honestly though, don't beat yourself up. This is the story of most ACL rehabs I've heard in a nutshell. You push the knee, and sometimes it reacts well, sometimes it doesn't. When it doesn't, you back off a bit. I think Lindsey Vonn says something to this effect in the documentary about her ACL recovery. And she had the best pros in the world keeping a beady eye on her rehab. The main thing is that you didn't do anything that endangered the graft, as your physio confirmed. Allow it to rest a bit and for the symptoms to subside, which it sounds like they are, and no harm done. You're so far ahead in your recovery that you don't need to worry about slowing down a little bit. Chin up, and keeping everything crossed for a happy knee again. Well, as happy as droves of physio exercises allow our knees to be at the moment!!
Great by the way that you now have a physio who seems to know what he's talking about rather than reading back to you from the exercise rota for the week. Very reassuring!
ski holidays     
 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?
May I join in please and ask for comments/suggestions. 58 year old sporty type.

Last April, I had some of the meniscus removed, fixed the ruptured ACL with hamstring graft, and had some issue with the PCL too, but it was not ruptured. This was all done at the well-known clinic at Hoch Rum, Innsbruck (Dr Fink). No complications with the procedure.

The ACL had ruptured in the Feb. (In hindsight, the meniscus had been waiting to fail, I had not been skiing much for a year or two, and sure enough it collapsed suddenly one day and I heard the pop). After the MRI, Dr Fink said in substance it would definitively be better if I had it done, and I appreciated the firm advice rather than "here are the pros and cons, it is up to you". He said he was not bothered about my age.

I had an infection in the wound/bone which we discovered when the stitches were taken out, and blood ran down my shin. Antibiotics sorted that out but it put my rehab back by a month. I then spent about 10 months doing the usual rehab stuff with the help of an excellent physio friend. I did this more modestly than I expected as I was feeling a bit dizzy, and this culminated in an epileptic seizure in May. This, also in hindsight, I now realise has been brewing for a few years.

That has calmed down with medication, in fact I feel better than for ages, thanks to the drugs I assume, and for the last 4 months I have been ebiking most days in the mountains. This is terrific. I am doing more, but the weather is turning. Now I have some muscles back (legs are pretty even) I have been doing some rotational exercises too.

Walking downhill is still stiff and not brilliant (by which I mean I can happily go for a hilly walk but up it better than down). Stairs are fine. With ski boots on the bad leg feels a bit dodgy, because the ankle is fixed and all is concentrated on the knee.

I will do some modest skiing in the pre-season and see how it goes. But I would like to be skiing properly by Christmas, say.

Do you think this is realistic? Any recommended exercises or training? jogging? I feel the up and down, fore and aft, is OK, but outside of that plane, and all the unexpected movements and compensations skiing involves, I need to do some work. I am stealing myself for things to be not as good as I hope, but would like to give myself a good chance, and try not to be too ambitious.

thank you for reading.
snow conditions     
 You need to Login to know who's really who.
You need to Login to know who's really who.
Hi @brandegg, and belated commiserations on joining the (not so exclusive) ACL club.
Two quick thoughts, both of which you’ve probably considered.
First, budget permitting, might it be worth booking an evaluation with a knee specialist physio so he can take a look at what’s what with your stiffness/difficulties descending etc? Might be the pesky hamstrings needing a bit of work, as they are according to my surgeon and physio the most long-term deficient muscle group after ACLr. It can take up to two years to get to full recovery after a hamstring graft according to my surgeon, and my physio says most ACLr-ers have a degree of permanent weakness there - though with good conditioning it shouldn’t make a difference functionally. Also, did you do jogging/plyometrics/agility as part of the original rehab? Might it be worth doing/revisiting in preparation for skiing, maybe in a handful of targeted physio sessions if budget permits?
The second thought is one of the dedicated return to ski days that run at a number of UK indoor ski facilities. Would you have access to one or be open to doing one? A number of the folks here seem to have done them and I’m sure can recommend one.
Sorry if I’m stating the incredibly obvious! Sounds like you recovered very well after the infection etc, thumbs up to you!
snow report     
 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
6 month (+2 days) update: Just back from a two week holiday and overall the knee held up pretty well to much more walking and standing than usual, an introduction to the joys of the leg press (a number of Italian gyms were visited as per the physio's recommendation) and the first few levels of the return to run programme... Until a few days ago, when the back of the leg rebelled, threw its toys out of the pram, and went all stiff and sore on me. I went to my physio appointment today pretty freaked out about what he might find... Turns out the adductor magnus (inner thigh) and gastrocnemius (calf) muscles have both got fed up with compensating for the weedy medial hamstring and decided to let me know it. Some thorough massage and some dry needling later, I left with new hamstring exercises (Nordics) - but very relieved that it's just muscles giving me some pay-back.

So @jjams82, I literally feel your pain. How's the knee doing this week?
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 You'll need to Register first of course.
You'll need to Register first of course.
@brandegg, More belated welcome to the club type greetings... I'm afraid I'm not going to be any use answering you questions, but best wishes anyways.

@BorntoRun, Good to hear you're on the road to running again!!

Mine's been pretty uneventful lately. A very good thing! Since the blip I've been a little more careful not to over do it, and the pain levels have been steadily decreasing, now past where they were before the blip. Same with the function... Steadily increasing, now past pre-blip levels!

Did a whole lot of log chopping with a heavy chainsaw today... I was being very careful, particularly when moving weighty logs about, but it was all fine and didn't complain at all. Hardest physical work since the OP i reckon. Working isn't quite as exhausting as it was, so I've got more energy left at the end of the day for physio stuff. I make sure to do a good bunch of leg bursts 'till it's nackered, spread throughout the evening. Current benchmark - the newfound ability to wobble board one legged:D

I've booked a place on the Birthday Bash in February... With the backup plan of selling it on if it's a bad idea (it's pretty much already booked out so that should be easy). That'll be 7 months (nearly to the day) after the op. Though it's a little frightening, it's given me a target and lot more motivation to get this damned knee board-safe! I'm not expecting too much, if I can get down a few mellow blues each day and enjoy a multitude of cakes/espressos/lunches/bombardinos, I'll be a happy happy man.

And even if I can't do it, I'll be further on by then than I would have been without the goal. Win/semiWin situation really.
snow conditions     
 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Wahey! That sounds brilliant all round! I'm not even onto wobble boards yet. Guessing the physio thinks I need way more leg presses before he trusts me on that. And he's right. I'm such a klutz I'd probably break my leg - whichever one I was balancing on, injured or healthy, and the other one too for good measure. With that in mind, I think good for you booking that Birthday Bash. I bet you'll be ready the way you're going, OR you can sell it, OR you an decide to just turn up and join just for the treats, apres, and those hot chocolates (yumm). OR you can fit in some snow shoeing between those apres sessions/easy blues if you feel the need for the extra exercise (!!)... If you look at the thread about coping without an ACL, a couple of the guys there seem to be discussing doing a joint indoor ski session at some point to get their ski legs back- but it might be coming up quite soon, so might be a bit too early in the rehab. Then again, you are the Adrian Peterson magic rehab man of this board, so maybe not too early at all!

I guess I'm mid my own "blip" at the moment. Like you I'm really relieved that it's muscular, and hoping it doesn't last too long. I'm encouraged that you've come through yours not just unscathed, but feeling better. The knee was v sore last night after all the pummelling and the first Nordic curls, but a bit better this morning. I'm due a gym session today (physio approved) and two more Thursday and Friday. I'll go lighter on the weights for those. Then trying the running again Saturday and Sunday (also physio approved). Starting back down a level in the programme from where I was when I left it off though, which I think is sensible. Let's see how THAT one goes!! Toofy Grin Toofy Grin Toofy Grin Toofy Grin
ski holidays     
 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Sod the physio, get yourself a wobble board*, they're the least boring of all the exercises:D




*disclaimer - this is terrible advice!
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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.
@jjams82, I could do with keeping my physio a bit more boring! Episode 1: BtR narrowly avoids being squashed by a recumbent leg press when releasing the safety lever a little bit unexpectedly. Episode 2: bottom and ground meet heavily when feet slip out of TRX straps during hamstring bridges. Episode 3: BtR practically face plants doing Nordic curls with the physio. That’s not to mention the lengths I had to go to to sign into Italian gyms. Who knew that some - but not all, confusingly - require a passport to do so? And to get my hands on foam rollers once I finally got in. They treat them like gold dust. One guy at the front desk told me flatly that I couldn’t have it, only the personal trainer can! Has there been a spate of foam roller thefts in Italian gyms?? The mind boggles!
snow report     
 Ski the Net with snowHeads
Ski the Net with snowHeads
Ahh haha, in Italy maybe you just need to grease the right palms to get hold of such luxuries:D
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