Anterior Cruciate Ligament gone - any advice?

Hi,
I was unlucky enough to rip off my ACL last season (don't even ask, I was
doing 2mph if that), but having had an arthroscopy I am still mad keen for
it this season.

I have got most of the strength back, but get the occasional twinge as you'd
expect.
Just looking for advice really from other people who've come back after
arthroscopy.
Do you wear a knee brace? If so, what kind do you recommend (I am
intermediate to advanced, don't do off piste much). Any special exercises
( I am doing all the stuff the physio told me for general recovery, nothing
specific for skiing).

Thanks for any advice....R

On Tue, 7 Oct 2003 07:34:43 +0000 (UTC), "Richard"
wrote:

Hi,
I was unlucky enough to rip off my ACL last season (don't even ask, I was
doing 2mph if that), but having had an arthroscopy I am still mad keen for
it this season.

I have got most of the strength back, but get the occasional twinge as you'd
expect.
Just looking for advice really from other people who've come back after
arthroscopy.
Do you wear a knee brace? If so, what kind do you recommend (I am
intermediate to advanced, don't do off piste much). Any special exercises
( I am doing all the stuff the physio told me for general recovery, nothing
specific for skiing).

My wife has snapped both her ACLs (two incidents, 3 years apart). She
was advised that in order to ski without an ACL requires very
dedicated regular exercise to keep the muscles strong enough to
compensate. (So it sounds like the exercises you're doing at the
moment won't be enough for skiing. Talk to your physio and emphasise
that you want to ski). She elected instead to have surgical
reconstruction (patella tendon graft). She was skiing again (gently) 5
months after the first rebuild, and since then was pretty much OK. The
second one happened this year, and the post-op recovery has been a
little more difficult (she was very unlucky to develop a condition
called "cyclops", but that's now been sorted with a further
arthroscopy). It remains to be seen how well it holds up next time she
skis.

FWIW, I've heard some people suggest that, even if it feels ok, skiing
without an ACL is asking to cause further damage to other parts of the
knee, leading to serious problems in the future. I have no idea if
that's actually true.

"Richard" schrieb im Newsbeitrag
...
Hi,
I was unlucky enough to rip off my ACL last season (don't even ask, I was
doing 2mph if that), but having had an arthroscopy I am still mad keen for
it this season.

I have got most of the strength back, but get the occasional twinge as
you'd
expect.
Just looking for advice really from other people who've come back after
arthroscopy.
Do you wear a knee brace? If so, what kind do you recommend (I am
intermediate to advanced, don't do off piste much). Any special exercises
( I am doing all the stuff the physio told me for general recovery,
nothing
specific for skiing).


Hi Richard

Best wishes for your recovery - having also had problems with ACLs I can
sympathise with how you feel...

After I finally had reparative arthroscopy I did wear a kneebrace (with
metal hinged supports) for a number of seasons after that. I think, however,
it had more of a psychological benefit than anything else (which is not to
be discounted).

My recommendations:

1) Do the exercises religiously. Build up the muscles around the knee to
take some of the strain away from the ligament. Don't just do exercises - go
for hillwalks and put it in "unexpected" situations so you build up the
ability of the muscles to "react".
2) (and I'll possibly get some disagreement here) Do some intensive
(private) ski school lessons. You will be feeling tentative and your natural
reaction will be to fall back (literally) into bad habits - not being
positive with body position, etc. Those bad techniques will tend to put even
more strain on your repaired ligament - plus, going back to basics will help
you to become a better skier and maybe to increase your chances of avoiding
injury in future. My experience had been that going back and spending hours
on the basics has really paid off in helping with technique. Try to find an
instructor that is sympathetic to the idea of "reconstructing" your style,
rather than bombing off fast with an "advanced skier" and teaching you
powder techniques. One idea might be to ask them to replicate some of the
exercises they had to work on to qualify as an instructor...

HTH
--
Steve

http://www.skiseefeld.com/

"Richard" wrote in message
...
Hi,
I was unlucky enough to rip off my ACL last season (don't even ask, I was
doing 2mph if that), but having had an arthroscopy I am still mad keen for
it this season.

I have got most of the strength back, but get the occasional twinge as
you'd
expect.
Just looking for advice really from other people who've come back after
arthroscopy.
Do you wear a knee brace? If so, what kind do you recommend (I am
intermediate to advanced, don't do off piste much). Any special exercises
( I am doing all the stuff the physio told me for general recovery,
nothing
specific for skiing).

Thanks for any advice....R



Richard,

I blew my right ACL playing football, had it reconstructed, rehabbed
religiously and was back playing after 9 months. THEN 3 months into the
season I jumped and fell awkwardly and guess what? snapped the new ligament
again. Having discussed it with my OS and Physio, who both agreed that it
was just plain bad luck, I had it reconstructed again, this time with a
hamstring graft. That was 3 years ago. My first year back on the slopes I
was sensible, wore a soft knee brace with side metal hinges and skied
without taking risks, I.e. no jumps, off -piste. I didn't even manage to
break a sweat, because for the 1st time in my life I was fitter and stronger
than I had ever been, due to all the gym work.
I've kept up the gym work, working religiously on the quads and ham strings,
which as you know provide the support and stability for the knee. As I
approached each ski season I would step up my visits to the gym to 3 times
a week, I only go 1 day a week now to keep things ticking over.

I got rid of the brace for the 2nd year and spent a whole week last year off
piste, with no problems. Fitness is critical. I'm not one for cutting
back, which is why I opted for a recon both times, to go back to how i
performed before. If anything my performance has improved due to my new
fitness levels.

On bracing, it does provide some protection but will not stop you from
snapping that ACL under certain circumstances. It will protect the knee
from side knocks and also hyper extending, but it cannot stop the knee from
twisting, which is where the real damage occurs, as the brace is not
anchored to bone to stop this happening.

On the rare occasions that I fall, I do try and keep my knees bent. There
is some info on the net for ACL friendly skiing. Have a hunt round. You
could also post on one of the Knee boards (BOBs is about the best that I
have come across http://66.54.168.84/cgi-bin/kneebbs.pl).

I would also echo the comments about some supplementary exercises outside of
the gym. Cycling is a good low impact training for the knees, and jogging
on grass. This is also good for CV type activities.

Good luck

Regards
Neil

Bad luck on the injury, if it's any consolation I have skied with
several post-ACL-injury people and they don't seem to have slowed down any.

Richard wrote:
Hi,
I was unlucky enough to rip off my ACL last season (don't even ask, I was
doing 2mph if that), but having had an arthroscopy I am still mad keen for
it this season.

A lot (most?) of ski related ACL injuries happen at low speeds, some
even from a standing still position. Something to do with the fact you
have time to try and stop yourself falling and end up twisting. If you
catch an edge at high speed the first thing you know about it when
you're looking back up the slope and picking snow out of your hair,
hence no time to react during the fall. I've heard this from physios,
ski resort doctors and I think even read it on the internet, so it must
be true.


I have got most of the strength back, but get the occasional twinge as you'd
expect.
Just looking for advice really from other people who've come back after
arthroscopy.
Do you wear a knee brace? If so, what kind do you recommend (I am
intermediate to advanced, don't do off piste much). Any special exercises
( I am doing all the stuff the physio told me for general recovery, nothing
specific for skiing).

Thanks for any advice....R



Can't speak from the ACL-specific point of view, I've managed to avoid
that so far in my skiing career, but I did suffer a faily bad shoulder
problem and eventualy saw a sports physiotherapist. The effect was
almost like magic, OK it was quite painful magic, but the results after
only about 8 weeks (3 or 4 visits I think) were remarkable. I would
recommend you find a good one who knows about skiing injuries and
ski-specific fitness and visit now, you will be in excellent shape for
the season. It sounds like the physio you have seen may have been a
hospital physio who's job it is to get people back on their feet, but
specialist sports physios can work wonders. They can also advise on
braces, but the general opinion from medics and physios I have skied
with is that you should avoid them if possible as they can inhibit full
recovery. Perhaps if you were skiing early season a brace would help if
you were still not fully fit, but I'd take expert advice on this.

If you can get to central London I'd highly recommend the Chancery Lane
physiotherapists (do a search on the web, there is only one physio on
Chancery Lane).

Richard wrote:
Hi,
I was unlucky enough to rip off my ACL last season (don't even ask, I was
doing 2mph if that), but having had an arthroscopy I am still mad keen for
it this season.

I managed to snap mine while absolutely stationary. In a motocycle trial
I stopped at the top of a steep bank, lost balance, put my foot down
(acepting a dab) only to have the lower leg go sideways, whilst the
upper leg stayed upright. Now someone wil have to rupture theirs while
going backwards!


I have got most of the strength back, but get the occasional twinge as you'd
expect.
Just looking for advice really from other people who've come back after
arthroscopy.

It took a long time before I could get mine repaired so I skied on it as
it was with and without a brace. During that period I only had a couple
'instances' with it that resulted in sever pain and swelling. None of
these were caused by skiing (wet grass, running down stairs and the high
bar were the main ones). While skiing, I did modify my technique to
something like the follow rules to reduce the risk of injury:
1/ have no side to side bending forces in the leg;
2/ always plan what you are doing, eg plan at least a couple of bumps
ahead in a mogul field;
3/ observe the terrain and absorb every bump;
4/ never ever leave the ground;
5/ if you do leave the ground make sure you land dead straight ahead,
6/ probable heresy to the old school of skiing, but keep your weight on
both skis during turns;
7/ in a panic, lift the ski of the bad leg off the ground and ski on the
good one;
8/ don't fall.

These simple rules allowed me about 10 weeks skiing until the knee was
repaired (hamstring tendon) and I enjoyed every minute of it. It has
been no bother since.

Do you wear a knee brace? If so, what kind do you recommend

Since I had little problems skiing without a brace I found no benifit in
having one.



(I am
intermediate to advanced, don't do off piste much). Any special exercises
( I am doing all the stuff the physio told me for general recovery, nothing
specific for skiing).

Follow the phsio advice on excercise



Thanks for any advice....R




John

John Elgy wrote in
:

... Now someone wil have to rupture theirs
while going backwards!

Don't joke about it. This is my biggest worry about skiing backwards - none
of the normal rules for binding release apply.

Jeremy

Hi, Richard

I did my ACL playing cricket - bowling - and had some physio and used a knee
brace. I went to Body Factor at Snow & Rock in Covent Garden where a sports
physio gave me a set of exercises to do. One consultation was enough, and I
was very impressed with their attention to detail and care and would really
recommend them. I worked out in the gym extensively, rather than opting for
a reconstruction. Since the injury I have been skiing 4 weeks, and used a
Townsend sports brace, which is light and comfortable.

Off-piste, some jumping and some recklessness - all with no problems. You do
have to keep it up, though! There is quite a bit of stuff on the net - do a
search for ACL, knee brace and sports injury, and you will find quite a few
research papers, as well as good sites with personal accounts in the
reconstruction vs rehabilitation debate.

Haven't had the confidence to ditch the brace and get back to bowling,
though! Or is that just an excuse to not have to go out in the rain on
Sundays ;-)

good luck

Greg


"Richard" wrote in message
...
Hi,
I was unlucky enough to rip off my ACL last season (don't even ask, I was
doing 2mph if that), but having had an arthroscopy I am still mad keen for
it this season.

I have got most of the strength back, but get the occasional twinge as
you'd
expect.
Just looking for advice really from other people who've come back after
arthroscopy.
Do you wear a knee brace? If so, what kind do you recommend (I am
intermediate to advanced, don't do off piste much). Any special exercises
( I am doing all the stuff the physio told me for general recovery,
nothing
specific for skiing).

Thanks for any advice....R