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Sierra Cement
08-22-2010, 09:02 AM
Any experiences or opinions on wearing (or not wearing) knee braces during recovery activities after ACL / microfracture surgery?

I am 6 1/2 months post op on an ACL replacement (hamstring), microfracture, repaired miniscus, etc. For the last two months I have not worn the brace at all. My activities have been limited to biking, hiking, light running, PT stuff. Last time I had an arthoscopic knee surgery I religiously wore the brace and then found myself in an adjustment phase when I decided to stop wearing it a year later. I've heard from a few PT's that the brace has never been proven to prevent an injury. So I'm inclined to keep going on without one. Thoughts?

Steeze Clown
08-22-2010, 11:02 AM
I am 3 1/2 months out for the exact same surgery, and i am wondering the same thing about this comming ski season. I don't have a brace yet, but I am going to get one soon. Both my PT and surgeon said that i will be good to go to ski, but I have to wear a brace.

My opinion on the brace is its for activities that your knee is not yet strong enough for. So right off the bat doing activities that require a brace should be looked at with caution. My PT said to only wear the brace when skiing or anything real risky. Studies have shown that the brace actually engages before the muscle does so even though the quad is strong the stablizing muscles are out of practice, and I assume thats the getting used to period your talking about.

My plan is to not wear the brace when I am doing slow speed ski lessons with beginers (power plow!) And when I am on my own Ill use it. Friends of mine who have been through this say they used the brace for the first year and then never again.

What happened to your last knee? did u re-tear or is this your other one now? how was skiing the first season back with a brace?

splat
08-22-2010, 01:38 PM
After ripping my repaired meniscus four months after surgery, all I have to say is be wary of high impact hucks, etc. that might re-rip yours.
Second time around is waaaay more uglier.

Dexter Rutecki
08-22-2010, 01:47 PM
3x ACLR for me, never a brace, never had an orthopedist who advised one (one may have said I could use one if it made me feel better). Brace can't help you with your ACL anyway.

No idea how microfracture would play into this, except that the surgery itself I think is somewhat controversial.

gatorboy
08-22-2010, 02:53 PM
I can only speak for brace use for meniscus repair. If it was a displaced meniscus, then the brace would need to have clamps to stop the knee from bending approx more than 90 degrees. I was told that the brace was to be used to stop a backward twisting fall. I think that the majority of meniscus damage is from a bent and twisting, load-bearing knee movement.

If it wasn't a displaced meniscus and the damaged meniscus was trimmed, then there probably isn't meniscus that needs to heal this long after surgery and brace wouldn't be of benefit.

Sierra Cement
08-22-2010, 05:20 PM
What happened to your last knee? did u re-tear or is this your other one now? how was skiing the first season back with a brace?

About 7 years ago I had a cyst removed that was intertwined with my ACL in my same left knee. Dr Orr told me had to remove about 30% of my ACL to take care of the cyst. He also mentioned that I would probably need to have the ACL reconstructed someday down the road if I continued to ski aggressively.....down the road turned out to be 7 years later when it popped this year skiing over some pillows. So the ACL replacement was partially a wear and tear issue, where as the microfracture, meniscus repair and femur elevation were due to the impact of the knee dislocation from landing on the flat pillow.

I skied with a brace for the first full year. It was a burden in the backcountry because I prefered not to skin with it on, and then would have to expose my whole damn leg at the top of the mountain to strap it on. Didn't pack worth a damn either. Got sweaty and hot in the spring. Even interfered with the top of my boot a bit. But it probably did a lot for my confidence in that it convinced me my precious knee was protected and I could ski hard. But I clearly remember transitioning to no brace and the vulnerable feeling I had to get over. If it is more or less a mental crutch, I'd like to do without. I think it will come down to how well my agility is back by the time snow flies. I will be 9 to 10 months post op by the time I'm skiing for the first time.

A PT buddy of mine told me the last thing to come back is muscle speed. So even though from a strenght standpoint you are there, the speed may still be lacking at that leg won't get where you want when you need it there. I never felt like I had a lot of speed or agility with that big old C3PO brace on.

I'm back to iceing my knee more often now too since I still have a bit of swelling. Going to take another spin class this year this fall as well as work on plyometrics and balance drills as much as I can.

Dexter - I have heard both sides of the microfracture argument. Ultimately I trusted my doctor (Dr Orr - US mens alpine ski team doctor) on this one. I'll let you know what I think after this ski season.

GimpToo
08-22-2010, 07:23 PM
My doc, who was also the doc for a professional football team, states a brace is all for the "head trip" . . . exercise like you are supposed to and you'll be fine - a brace is a crutch!!!

Steeze Clown
08-22-2010, 08:24 PM
[QUOTE=Dexter Rutecki;2953723]3x ACLR for me, never a brace, never had an orthopedist who advised one (one may have said I could use one if it made me feel better). Brace can't help you with your ACL anyway.

How did u re-tear it twice? was it preventable or random?? I am soo parinoid about a re-tear, any advice?

Dexter Rutecki
08-22-2010, 09:26 PM
Tearing the reconstructed ACL occurred while playing hockey when I got a large bucket-handle tear in the meniscus. They actually didn't know the ACL was gone (although my surgeon told me he suspected it might be gone--I didn't believe him) until they scoped me to take care of the meniscus since it didn't show up on the MRI (screw was blocking the tear which was at the very tip of the femur).

I wish I could tell you how to avoid re-tearing. I was very fearful of it as well, but when it happened it seemed a fairly benign injury (as opposed to the original tears which involved big impacts and trauma--knew right away with both of them) and I never thought the ACL was gone (again). Now I'm even more fearful. But if you get a good graft and do as much PT/exercise as you can (to what you're allowed to do) I think you'll have the best shot to avoid being like me...

Sierra Cement
08-22-2010, 09:34 PM
May not make you feel better steezey, but my PT told me that roughly 80% of the knee injuries that occur after a knee surgery are to the other (non operated on) knee. He says people tend to be so cautious about reinjuring the repaired knee that they sacrafice the good one by putting it in awkward positions in order to not stress the repaired one. This is from the main ortho clinic in South Lake Tahoe where they see a lot of blown knees from skiing.

Obviously you want to get back to the point to where you trust both knees equally. I think the key to that, for me, will be patience and slow progression on the skis. Doc told me this entire next ski season should still be considered recovering.

the Chez
08-23-2010, 02:27 PM
Most people use the brace immediately post-op to protect the healing graft. If it were me, I would wear it as soon as it fit to get out of the post-op brace. the Donjoy brace is the only brace on the market that actually protects the ACL. All other braces become active after the ACL has been "exceeded" or injured. It has a "Fourcepoiint" hinge that helps to avoid full extension but does not prevent it. I think I would only wear it for sports that involve running cutting and contact or uneven surfaces for the first year. Don't know that I would ever want to go through the process a second time? ANything to protect the knee and especially the area you had microfractured. No way to fix that permanently yet!!!!


Any experiences or opinions on wearing (or not wearing) knee braces during recovery activities after ACL / microfracture surgery?

I am 6 1/2 months post op on an ACL replacement (hamstring), microfracture, repaired miniscus, etc. For the last two months I have not worn the brace at all. My activities have been limited to biking, hiking, light running, PT stuff. Last time I had an arthoscopic knee surgery I religiously wore the brace and then found myself in an adjustment phase when I decided to stop wearing it a year later. I've heard from a few PT's that the brace has never been proven to prevent an injury. So I'm inclined to keep going on without one. Thoughts?

the Chez
08-23-2010, 02:32 PM
Well........ maybe that is why you are a 3 X loser with your ACL???? Unless all 3 injuries were violent contact injuries, either your surgeon sucked or your rehab did. I know of only 3 people in 20 years in sports medicine that have torn their ACL in a brace. I have worked in the NFL, NHL, Intercollegiate athletics and with professional soccer. You may want to consider a brace in your future or you can continue to finance your surgeons spending.



3x ACLR for me, never a brace, never had an orthopedist who advised one (one may have said I could use one if it made me feel better). Brace can't help you with your ACL anyway.

No idea how microfracture would play into this, except that the surgery itself I think is somewhat controversial.

montanaskier
08-23-2010, 04:33 PM
I wore only a soft brace last year, my first back from a double bundle ACL repair. Did nothing physically but made me feel better. This summer I don't use it while mountain biking anymore and probably won't for skiing this year. I'm in a better place mentally about my knee now.

Dexter Rutecki
08-23-2010, 07:21 PM
Well........ maybe that is why you are a 3 X loser with your ACL???? Unless all 3 injuries were violent contact injuries, either your surgeon sucked or your rehab did.

Steeze clown misunderstood--two different knees, 3 total ACLR. So one re-tore, which is not that uncommon. And the two initial tears were caused by dropping onto icey flats (overshooting jumps). I don't think HSS hires schlub orthos, and I'll assume some of the local NFL and NBA franchises wouldn't hire him as the team ortho if he sucked. Rehab's pretty standard, so unless you know some secret about rehab that no one else does nothing was going on there, either.

I suspect if you knew competitive skiers you'd know people who have undergone more knee surgeries than I have--there are at least several people on this board I know of in that unfortunate boat. It's pretty much part of the game, and I feel lucky that I made it through 24 years of skiing without surgery or injury (it's the last 10 that have made up for it).


I know of only 3 people in 20 years in sports medicine that have torn their ACL in a brace. I have worked in the NFL, NHL, Intercollegiate athletics and with professional soccer.

Plenty of people retear reconstructed ACL's while wearing braces, as the movement that the ACL restricts can't be protected by a brace--unless it were bolted into your femur and tibia.


You may want to consider a brace in your future or you can continue to finance your surgeons spending.

Thanks, but I'll take advice from Orthos who actually know what they're talking about when it comes to braces and ACL rehab. There is no evidence a brace helps, and no orthopedist I've spoken with (including other HSS surgeons, ISK surgeons, or the editor of The Bone and Joint Journal) has ever told me otherwise:

[from orthopedickneesurgery.net]


Do post-operative knee braces need to be worn after ACL surgery?

In majority of cases, the answer is no! There is no study that has shown that post-operative knee braces has dramatically help protect the healing graft after an ACL reconstruction. In many studies, patients who have had orthopedic knee surgery surgery were given a knee brace and compared to patients who did not use a knee brace. None of these studies demonstrated significant difference between these groups of patients.

acl knee brace

It is possible that we simply donít have a good enough test to distinguish a difference among these type of patients. Nevertheless even if there is a tiny difference between patients who have a knee brace and those that do not, it is probable a very small difference. Whether or not you were given a knee brace post ACL reconstruction surgery depends on the surgeons preference or choice than on rational information.

What about the use of knee braces once Iím ready to return to sports? This is a controversial subject matter with no evident clear answer to the issue. Some patients who go back to high-level sports inside a year of surgery will use a knee brace. No scientific information has revealed that wearing a knee brace will stop re-injury to the ACL. Nevertheless several patients may make a decision to wear a knee brace anyhow.

Regardless this science, many athletes feel more relaxed using the knee brace going back or returning to sports after an ACL reconstruction. The good news is there is really no harm in wearing a brace; therefore, if wearing a knee brace makes the athlete more comfortable, then it is appropriate. The athlete should just realize that using the knee brace does not affect their chances of re-injuring the ACL.

Workman
08-24-2010, 09:54 AM
Am seven months off my second ACL surgery, same knee, and my doc here in Jackson preformed microfracture as well. Lots of meniscal damage in there i guess. He prescribed me a brace (CTI) and told me to wear it everyday at my job on a fire handcrew for the USFS. I went back to packing the saw and our line gear in May, four months out of surgery, wearing the brace everyday we hiked.....so everyday. The brace gave me the confidence to pack the 70+ pounds through the nastiest, thickest, bushwacking that only comes with fire. I just would not have felt right stumbling over deadfall and rocks and holes without it, specially with all the added weight. Hell, I even ran with it on during our first few weeks of PT. Now its almost September and I am back to my spot as one of the fastest hikers and am in the top 5/20 runners.
That brace may be uncomfortable, and believe me, after many 16 hour days of hiking my dick in the dirt I know first hand uncomfortable, and it might smell like a dead cat after a 14 day stint on a fire, it is totally worth it in my eyes.
Do you think that I will wear it riding this season? No fuckin doubt. I dont care how uncomfortable it is, or how bad it smells, if it decreases my chance of retear by 2% then its worth it to me. To each their own though. If its to "uncomfortable" maybe you need to "suck it up" as I tell myself and think back to when you were laying on your back for 6 weeks this past season with no weight bearing and crutching to PT through the ice and zero temps for three months. Yes, think VERY hard about how much fun you had this winter:rolleyes2.
Eventually, I will say goodbye to my "crutch", but this season I will not think twice before wearing that damn brace. Next fire season once I am sure that my quads are strong enough again, hopefully I can say fuck that thing and not wear it.....That will feel sooooo goooood!!!!!!

DeeAre
08-24-2010, 11:43 AM
One point that hasn't been made is the need to tailor skiing style and aggression level. Bums me out to even think that way, but on the other hand, I'll gladly sacrifice some glory for added durability and longevity. Can't be rad forever.

Sierra Cement
08-24-2010, 09:12 PM
Workman - I'm impressed you can run as well as you do at 7 months out. I can't even dream of running that well right now. Doc says it ain't happening for me for at least 2 more months ( when I'm 9 months out).

I think I'll take a hike with the brace on. See how it feels.

Workman
08-24-2010, 11:17 PM
Hey Sierra Cement, if you want the brace to be more comfortable, ask your PT for a sleeve (like a piece of tubular ace bandage, they come in all sizes and come in a huge roll), that fits your leg where the brace contacts your skin. Feels way better but can get pretty sweaty and stanky after a few uses, so get a few of them. Really helps with the velcro rub. Seems to keep it from sliding down as well. I am SOOO glad that I have been wearing the brace religiously this fire season even though it sucks ass. There has been many situations where I think something would have popped had I not had it on. Once my interior quad muscle gets stronger I will ditch it though.
As for running, I only run on dirt roads/trails and had to focus very hard at first on what I was doing each step I took on that knee. I ran with my brace for the first month of the season, then on my 28th birthday took it off and outran 17/20 people, the "old boys" out front. Damn that felt good to smoke the younger bunch just five months out:p
I am still cautious as hell on my knee cause I cant friggen wait to get out on some fuggin snow this winter, but I definately have gained my confidence back about its stability. Start out slow and kinda "test" what you can take, you will be surprised after the six month mark.

FreakofSnow
08-28-2010, 02:20 PM
I was pretty much in your same boat as far as timing of.my aclr- had it in March, tore my mcl too. I wore my donjoy for the season , like many have said I think it was mostly a confidence booster but a much needed one. I rehabbed like a mother going into the season with my strength very high. I had a pose in here with my progress if u want to check it or http://kneetopia.blogspot.com

Mofro261
08-28-2010, 05:28 PM
One point that hasn't been made is the need to tailor skiing style and aggression level. Bums me out to even think that way, but on the other hand, I'll gladly sacrifice some glory for added durability and longevity. Can't be rad forever.


There's the truth here.... problem is, taking it down a notch is actually hard to do, and with a few more days in it's easy to push things back to where they were as the familarity on snow builds the confidence to do a little more each time out.

4x ACL repairs over 22 years, the first on the right and the next 3 on the left 7 and then another 12yrs later, with the last one coming while wearing the brace 8 mos. post op- the ultimate suck which lead to removal of 60% of the medial meniscus. God I miss that meniscus.
I can't remember the exact % but tearing one ACL does increase the chances of tearing the other one. In my case with the second and third repairs, enough time had passed that the knee wasn't even a consideration when the tears occurred. Only the last one i blame as graft failure because I rehabbed that one harder than anything and was really in the best physical shape in my life when I dropped a simple 10fter to hard landing, 20 days into the season.

No brace will prevent injury of the ACL, but they are great psychological aids and will help increase the knee's feeling of stability. I don't wear the Rx brace anymore but occasionally still wear neoprene ones (one has the metal rods in it, one is just a sleeve) while hiking or skiing and also depending on snow conditions or if i'm racing. Placebo effect? Maybe but I'll take it if helps.

Sierra Cement
08-29-2010, 11:59 AM
Wow Mofro, that's a rough stretch.
I concur with the neoprene brace with metal rods and a hinge (mine is made by bodyglove). That feels way less cumbersome then the monster 4 buckle braces, and still gives you some reliable support. In months 4 and 5 I wore it religiously when I rode the bike (since then I have tapered off it altogether). Lately my knee has been a bit swollen, and achey when I pedal hard on the uphills. So I am going back to it again for a while to see how that goes. Lots of iceing after active use lately as well.

flowing alpy
09-04-2010, 10:00 PM
dont feel sorry for mofro, his knee pain tolerance is different than most riders, i really dont know if he even understands 'notch it down'.

Caucasian Asian
09-05-2010, 07:35 AM
I had my ACL replaced 13 months ago. I've been wearing my brace to play sports, mostly as a reminder to myself. I've been toying with the idea of skiing without it this year, but it doesn't bother me very much.

I have one of those neoprene socks with the hinges as well. I asked my surgeon and PT about wearing that instead, but they both agreed that it's not going to give me enough support to bother wearing it.

Mastadon
10-03-2010, 10:12 PM
Well I have had 2 ACl surgeries on the same knee. The first was meniscus and complete acl tear. The second was a acl and bucket tear on the already opperated knee while wearing a brace. So yes it is possible to tear your acl while wearing a brace. I will say though I have taken my recovery very seriously this time and have not worn my brace for months. Considering not wearing it this ski season either. What I have learned is there is no brace that can replace leg strength.

splat
10-06-2010, 01:09 PM
SC - I thought Doc Orr did an bangup job on me, but I retore the meniscus, prolly cause I'm too old and smoke. He gave it a good shot to keep me skiing without the menisectomy. In retrospect, I often think I should have been getting some ozone injected into the mensicus tear to help it heal, as the delivery of the enriched oxygen to the tear would likely have helped it heal better. Blood flow to the area is minimal, so meniscus tears take way more time to heal, from what I understand.

Sierra Cement
10-18-2010, 09:27 PM
Thanks for all the good feedback guys.

After 9 months I can finally say the knee is really starting to come around. Six months just wasn't in the cards for me - maybe it's my age, maybe it's the desk job, and I've got some blood flow issues in that leg too - so who knows. But I finally rode some fast downhill on a rocky singletrack and was pretty damn happy with the result.

Regarding the brace - I hiked Tallac and tested the knee coming down the rocky trail for 4.5 miles and 3300'. I tried my neoprene brace for half of the descent and no brace for the other half. I noticed ZERO difference in how I took steps, how it felt, my confidence, etc. I still don't trust my knee entirely and figure it will be months before I feel it is equal to my right knee. But I am pretty set on continuing on without the brace. Skiing will be the real test.

Again, the thinking behind going brace-less is so I don't have to go through a second adjustment period when I decide to lose the brace many months later. According to some in the know they say the majority of 2nd knee injuries occur on the other knee because people are over compensating to protect what they believe is their bad knee. So the good knee ends up being put in bad positions and then - pop! So a brace won't help in that situation at all.

Splat - interesting on the ozone (oxygen) injection. That makes a ton of sense to me from a healing perspective. Hope you are doing OK. Doc Orr is the man if you find yourself all blown up in Tahoe.

Summitgirl
10-19-2010, 01:37 AM
ACL Allograft- and I have a custom DonJoy brace and I love it. Maybe its a false sense of security or just a reminder to be a little more careful. Either way, I never want to have that surgery again so.... I rock that brace!

sidewall
10-19-2010, 09:44 AM
My knee is really sensitive to hyperextension after ACL avulsion this past winter. The knee works fine but if it hyperextends, I get some pain. So for that reason I'm thinking about a brace.

Abbott
11-16-2010, 11:16 AM
I have had a few knee surgies, pretty that that and that, unhappy triad on one and meniscus and acl on the other. I have resprained my mcl after wearing some prescribed don joys. On top of that, they sucked to wear and moved around while skiing. 5 years ago I got a proform for some asterisk braces and they work fucking perfect(best way to describe). They lace up in the back so they don't move around, you can barely feel them on when you are skiing or skinning, I don't know if I'd ski without them. Plus they are super beefy and have a nice patella cover that has saved me a couple times as well. If you are going to get a brace for skiing, hands down get an asterisk.

Sierra Cement
11-22-2010, 10:33 PM
Thanks Abbott, I will look into the Asterisk if I go that way. I just skied my first two days since surgery last year. No brace, feeling good, keeping it mellow so far. It was a little eerie to lean back on the boot and feel that upper leg pull back while the lower leg is kept forward - there was a haunting reminiscent moment where all I could think of was "kaboom". But the knee felt solid fortunately.

Hardest motion for me is single leg squats on the reconstructed knee - quite a bit of pressure on the patella. I figure that's a huge load on the knee and will take the longest to come back. It's coming around and I'm content. I think skiing will build back all those tiny muscles that biking can never touch.

Have not gotten out into powder or mixed snow conditions yet, just groomers. But so far so good.

T-Boz
12-15-2010, 06:45 PM
TOday was the first day on my new donjoy brace, 6 months out. I skied pow and chop at squaw for several hours it felt really great. The brace really helps your confidence in that repaired knee, and seems like it could prevent you from a twist or hyperextension. Can't even think of hitting airs yet. My therapist also said the brace is not proven to stop you from a re-tear but the doc seemed to think it would help. What sells me on it is that Donjoy will pay you 1,000$ if you re-tear while wearing the brace, so might as well use it, it's extra insurance. I will only use mine for a year or two.

Restoked
12-16-2010, 11:48 AM
I have a different issue in my knee (had a meniscus transplant after removal of the entire medial meniscus), and I have a custom Breg Fusion brace to provide stability. Before the new meniscus my knee was really loose, and even with the new meniscus, it pops really bad if my knee goes inward (don't know the term for that). Since I need it more for lateral support than twisting, it really meets my goals. I won't even consider skiing without it. Last weekend at Squaw I locked out the brace hyper-extended. Who knows had bad that would have been without it? I really don't want to be carved up again (4 on one knee is enough), so I'll be bracing it for the near future and probably forever.

I don't even notice my brace when its on. My only problem is my knee still swells a bit when I ski (not sure why other than I have a wrecked knee cap too), and the brace makes it worse since the straps are on really tight. My leg looks nasty at the car, but I wrap it with an ACE to push the fluid out and I'm good. I love destroyed knees.

Sierra Cement
02-12-2011, 01:07 PM
I'm just over 12 months post op from my ACL / microfracture and have skied about 30 days this year. With each passing day the knee is doing better, feeling stronger and creeping closer to 100% recovered. I have not had the brace on even one time - and am happy with the decision. And as the knee recovery increases the need for the brace decreases. Barring a freak injury, I will be skiing 100% brace free. It was questionable when I first came back, but as I progressed it just became unnecessary. The season has been great so far - started out with nothing but soft powder in November and December. Then the last 6 weeks have been springlike with plenty of firm snow too - which was good to get back on to really test the knee out on. I am pretty much skiing anything again. Jumping is still on hold, but pretty much anything else is good to go. Skinning has actually taken a while to get back to good form on. I think the main issue there is that the left leg is still weaker than the right. And in most activities you can actually compensate by favoring the good leg (biking, skiing) but with skinning each leg has to do an equal amount of work. It has made me really face the truth about the leg. Which is good, and the remedy is more skinning and hiking! I have had a few sore days on the knee - especially after long days on skis. But that tells me things are still improving.

So my 12 month synopsis on to brace or not to brace - if you can get through the first 20 to 30 days back on skis without one, then you'll never need one.

Good luck all and may the powder return to Tahoe.

splat
02-13-2011, 12:57 PM
Hey, SC, I agree. Though it took over a year and a half for my knee to come back, and even though it tweaks (feels a little weird) when carving on the Junuary powder with 115 waist skis, it feels stronger after every session. The other night before skiing, I did some stretches I haven't done in a long time and I felt stuff pop in both my ankle and my knee and I was just a bit freaked out. I had some fibula alignment issues after surgery that I think was the cause. But skiing went great and it appears things are just moving back into their proper alignment.

Piggity
02-17-2011, 05:21 PM
I've busted my ACL/MCL several times Over the years. Opted for no surgery back in '99 and I was fine up until last year.

This morning post pow session, I hit some crud with speed. No biggie, I got it. Until I look down to see my left ski ejected for no good reason. It was cruising right beside me charging the crud, just without my boot clamped in.

It didn't end so well. My left leg post holed into the next pile of snow and hyper-extended and jacked backwards. I had to cut it back the rest of the day and ski through the pain. Try to do the same tomorrow. Might go buy a neoprene brace tonight.

Pretty bummed to ride less than 100% tomorrow, more like 50% on a pow day sucks!
:(

Piggity
02-17-2011, 06:59 PM
FKNA, I wonder if I partially dislocated something earlier. I rolled over and my knee popped. Instantly the pressure on my MCL was reduced. Seemed to pop back into place or something. FN weird but hopefully less pain riding tomorrow

freelheeler
02-19-2011, 05:17 PM
10 months post op and 7 months post op, yesterday was day 10 skiing with the braces, all backcountry, i find that i don't think about the braces when climbing/skinning or skiing. that is till yesterday, not sure what happened as i posted but the result was my first fall of the season and the knee didn't seem to take it real well. it's tweak'd and hurts but at this point it doesn't feel unstable! the only saving grace 'mentally' for me at this point is that i was wearing braces and they're suppose to protect. today i ice the knee while the snow falls, bottom line is i don't want to go through another surgery, this is the first real 'ski' test for the braces, if it saved me i'll be singing it's graces if not hopefully the don joy warrantee picks up some of the bill. i just sit here today think'n how quickly things start to feel natural again, but they're not, i'm still recoverying!

good-luck to all recovery's...

GimpToo
02-19-2011, 05:33 PM
FKNA, I wonder if I partially dislocated something earlier. I rolled over and my knee popped. Instantly the pressure on my MCL was reduced. Seemed to pop back into place or something. FN weird but hopefully less pain riding tomorrow

Hey Piggity, how'd that go . . . hope alls well:)

Piggity
02-23-2011, 11:27 AM
Hey Piggity, how'd that go . . . hope alls well:)

Thanks man, went better than expected. The pop definitely relieved a lot of the pressure and pain. Of all the times I've busted an ACL or MCL this was the first time it's popped and felt slightly better.

Bought a knee brace that night, bought a huge bottle of advil, went to the bar for more medicine in the form of Jack and Cokes, then did my best to get through the next day with a hurt knee and a hangover. :)

freelheeler
02-26-2011, 08:11 AM
Thanks man, went better than expected. The pop definitely relieved a lot of the pressure and pain. Of all the times I've busted an ACL or MCL this was the first time it's popped and felt slightly better.

Bought a knee brace that night, bought a huge bottle of advil, went to the bar for more medicine in the form of Jack and Cokes, then did my best to get through the next day with a hurt knee and a hangover. :)

good to hear... keep us up to date on the injury or near miss...

Piggity
02-27-2011, 12:45 AM
Same man, hope your knee heals up. Any progress?

freelheeler
02-27-2011, 09:05 AM
knee is feeling better day by day, friday marked the one week mark of my fall. most all of the tenderness is gone but i'm using ice and vitamin I. Not sure if i mentioned in another post but i met with my PT on Friday, i think he thinks i'm a head case! he didn't want to screen the knee claiming my symptons and pain don't trigger a 'major' inury in his mind? not sure if he's trying to talk me down but i trust him, we've spent a lot of time together over the last 10 months, and it's not the first time i've tweaked something, but it's definitely the biggest tweak yet. I have a standing appointment on monday for a screen if i think it's necessary.

I still haven't had what i'd call signs of instability but i can still trigger a tweak of pain with certain deliberate movements. Rode the stationary bike for about 45 minutes yesterday with no real consequences this morning, held off on weights and one legged exercises figure the damn thing just needs time.

My buddy's are on a snowcoach trip today! i bailed mid week, i'd been hoping to go but knew that even without this latest tweak i'd be pushing it. and so goes my winter...

creaky fossil
02-28-2011, 07:41 PM
Most people use the brace immediately post-op to protect the healing graft. If it were me, I would wear it as soon as it fit to get out of the post-op brace. the Donjoy brace is the only brace on the market that actually protects the ACL. All other braces become active after the ACL has been "exceeded" or injured.

Not entirely true. One of the modes of ACL rupture/tear is hyperextension, with or without twisting force. I've had 3 surgeries on the right knee, 1 on the left, and have used 2 braces on the right knee (first an old school Lenox-Hill from '83-85, then a Townsend from '85-2000) and one brace on the left (Breg, 1999-2000). All 3 braces had a limiter/stop which prevented hyperextension.

What knee braces can't prevent is the internal (inside the knee joint) torque of the "false foot" when you go backseat on skis.

The braces can help with preventing hyperextension and they can provide external stability in many situations, but they can't really prevent another twisting ACL rupture, they can only reduce the likelihood by small %.

As most have said, the biggest protector against an ACL re-injury is excellent PT, as well as sensible skiing (avoiding the backseat, etc). It also helps to have an orthopod who knows what the fuck he's doing. There's a shit-ton of "sports medicine" orthopods out there doing ACL reconstructions, but the number who do them successfully for aggressive athletes is pretty small. Part of the failure rate is due to surgeon skill, but most of it comes from athlete/patient behavior... like trying to get back into activity before the graft takes hold, and/or before the surrounding musculature has been strengthened.

Also, great point on hurting the non-injured knee. That comes not only from favoring the surgery-repaired knee while active, but also from the weird gait-disturbance that happens after surgery. A good PT will watch your gait closely and will make sure you don't develop a bad habit of favoring the repaired knee to the other knee's detriment.

I don't use any braces of any kind now. I haven't used one since my first season back on the fixed left knee (2000-01).