ACL Class of 2013

In keeping with the ongoing theme of the Class of 2011, Class of 2012 threads...

As perhaps the first ACL victim of 2013 I am starting a new thread for this years folks.

I have been reading through everyone's posts and am astounded by the wealth of information and depth of experiences in this thread. I wanted to first off thank everybody for sharing all of these details.

Having never really been badly injured before, I have so many questions, many of which will never get answered, but through this community I hope I can gain some perspective, and learn to maintain a positive attitude throughout this process.

Me: 32 Yrs old
When: February 1st, Last Run o' the day
Where: Vail
What: Torn Right ACL, Torn Mid & Lat Meniscus, Bone contusions on Tibia and Femur.
Surgery: March 6th, Patella Tendon (w/bone anchors) AutoGraft Boulder Center for Sports Medicine.

Not currently in any pain, riding the bike every other day (still a bit of swelling) but can get to about 130 degrees ROM. Still Icing, doing quad lifts, walking without crutches or a brace and am able to drive.

The hardest thing for me right now is being inactive. I live to ski to and am a huge trail runner (run every day with my dog)...so going from an extremely active lifestyle to relative inactivity has been challenging to say to least. I know this is gonna be a long road to recovery, and it will be a long time before I get back on the slopes, especially with my first child on the way (August). I just want to get back to normal activity ASAP to help out the wife, and I know in time the skiing will come...

Right now, and maybe throughout this whole process I think the biggest challenge will be mental. I still can't believe my knee is shot. I have sessioned this particular cliff band 100's of times on powder days with no issues. So, I am left wondering what was different about this day?

The only conclusion I can come to is gear. After skiing alpine for nearly 26 years, for the last 4 years I have been predominantly a Tele (feels like a more natural motion, keeps my knees warmer, gives another hinge/pivot point)...

When the accident occurred I was on a new setup (Maestrales, Bibby Pros, Barons) and all I can think was that the boot was not burly enough (to soft) to drive those boards. I had just upped my DIN setting to 9 from 7 in preparation for a my a trip to Silverton (the accident happened on the way down with a crew of 8 guys). Obviously I keep replaying the incident in my head over and over again, and am at loss for words because even though I stuck the landing (slightly backseat), I couldn't ski away (right ski released on impact, knee buckled, and ski came off).

I realize too that there are no answers, but for those of you who have had similar experiences, how did you get over the mental hurdle? I mean for me, (I have a relatively low risk tolerance) this was "not risky" behavior...

Sorry to hear about your injury...

I'm a 2012 inductee - and all of your concerns are well warranted. As for me, I have been hurt alot - but I still had tons of questions/concerns.

As far as being inactive - that is one of the hardest parts and definitely is a really big bummer... I have had to adjust a bit to accommodate inactivity - i.e. diet, reduced beer consumption (lol) - but also my expectations of what normal activity is.

That said - the boredom is not avoidable, other than doing your rehab. Work as hard on the rehab as you did at some of the other activities... even though its not the same enjoyment level, and in time you will accept the fact that it is, what it is (for a few months at least).

Good luck with everything - keep us updated.

Thanks goin...reducing beer intake is a serious bummer :)

P - If I was older, doc would have recommended Allograft (Cadaver). I have multiple friends that have had the Patellar Autograft, so naturally this was my first question.

1. Apparently the Patella tendon is the perfect size for the ACL (it doesn't need to be doubled up, folded over or stretcheed.

2. Be anchoring the tendon with your own bone fragments, it promotes tissue regeneration.

3. there is a longer recovery time than hamstring or cadaver, but the patella tendon is one of the strongest and most durable replacements (this was extremely important for me because I am extremley active.

There is no "right" thing, you just need to do what feels right. It doesn't hurt that this particular dr has done 100's of Patellar Autografts..

Another 2012 inductee. Welcome to the club, which no one wants to join.

I had a hamstring graft, because that's what my surgeon (Dr Mark Heard, Banff) prefers.

From my research, and speaking to him I think it's best to go with what your surgeon is familiar with. If you have a particular preference, then look for a surgeon who uses that technique. The fact that there are three main techniques (hamstring, patellar and cadaver), and as far as I can find, no research info to say one is genuinely better than another makes me think having a surgeon who deals with knees for a living, and is very familiar with the technique they use is more important that the actual graft used.

Best of luck with your recovery.

Quote:

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Originally Posted by bilkovet

Another 2012 inductee. Welcome to the club, which no one wants to join.

I had a hamstring graft, because that's what my surgeon (Dr Mark Heard, Banff) prefers.

From my research, and speaking to him I think it's best to go with what your surgeon is familiar with. If you have a particular preference, then look for a surgeon who uses that technique. The fact that there are three main techniques (hamstring, patellar and cadaver), and as far as I can find, no research info to say one is genuinely better than another makes me think having a surgeon who deals with knees for a living, and is very familiar with the technique they use is more important that the actual graft used.

Best of luck with your recovery.

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^this x2.

The torch has officially been passed to the class of 2013!

Wildman, I did something similar on a not very big air to back-seat landing to right knee buckling, torn ACL, meniscus tear, etc. I did same knee hamstring auto because that's what my surgeon recommended. As bilkovet suggested, I think it's best to go with whatever your surgeon prefers, if you don't have a strong preference yourself. If you want something other than what your surgeon recommends, I would suggest seeking a surgeon who's preferred method matches your preference.

Also second on putting the same energy into your rehab that you do your normal activities. Actually, I might have put more into my rehab than I would have skiing with the lousy season we had last year, and did more cycling last Summer than I have in probably the last decade.

As far as confidence coming back; your mileage may vary. The first run of the season was a head-trip for sure, but everything went fine. I am definitely skiing more protectively this year, bordering on paranoia at times; other times it's business as usual. I still have some tenderness 13 months post surgery, and believe I will feel less vulnerable, and less tenderness over time, but who knows? Even if I don't experience any more improvement physically, I think my confidence will gradually increase as my brain forgets about the initial trauma.

FWIW, I've known a bunch of skiers over the years who have torn ACLs and had them replaced, and going through it yourself can be a humbling experience, but maybe also an opportunity for growth. There are far worse things that people have to go through than sports injuries. A friend of mine; a cancer patient who is younger than me, was just released from the hospital to hospice care. Not to be a downer, but it kind of put things in perspective for me. If this is as good as it's going to get, so be it. I think I knew early on that I would have to take a slightly different approach from now on, and who knows? A year from now I could be taking just as many chances as ever, or more!

Good luck with your recovery, and welcome!

BilK & Bend -

Thanks for the warm welcome fellas. That was pretty much why I decided to go Patellar Autograft...my doc sat me down and basically said "this is what i do"..."and i do it well"... So yeah, no real apprehensions at this point about going with this type of surgery.

Of course I realize that in the grand scheme of things this injury is pretty small potatoes. I feel blessed to live in a society where health care can for the most part cover the surgery and recovery...Obviously in many parts of the world an injury to you leg can result in lifelong pain and perhaps even death. I came to this "acceptance" and understanding pretty early on, but it always helps to be reminded that my injury is more like a temporary inconvenience...

I plan on rehabbing as hard as possible, and given that I am pretty driven and motivated person, Im sure i'll oneday be toeing the line between risk and reward once again.

Thanks for the support All

W

It's a huge mental game as you mentioned. Be prepared for the rehab monotony that will certainly strike. Be prepared for bouts of depression and serious adjustment to a dialed down lifestyle for the next 9 months. Stay positive and keep you eyes on the prize of having the strongest possible legs at the end of rehab. I too had a child (actually twins) during my first ACLR, it was great. Good luck and enjoy.

Hey guys,

I've been a bit of a lurker around tgr for awhile but as of Feb 9th I'm officially part of the ACL class of 2013 so now is as good a time as any to start posting.

Here are the stats:

Me: 24 Yrs old
When: February 9th
Where: Alpental
What: Torn Right ACL, High grade sprains of both MCL's, Longitudinal tear of left PCL, torn UCL (thumb ligament)
Surgery: Next Monday, Feb 25th. Right ACL reconstruction. Hamstring Graft.

As many of you know, Washington had been lacking snow for most January and early February. I didn't care however - for me skiing is skiing and by Feb 9th I had 30ish days on snow due to a very flexible work schedule. As a result I had become increasingly comfortable and was actually enjoying drops to hardpack. Sounds retarded to type that... I had the king of the hill freeride comp at Crystal Mt in March in the back of my mind all winter and figured I was "training" for it.

On that fateful night I spun off a little drop to hardpack, as had been standard practice for years (not anymore haha), over rotated ever so sightly, caught it and thought I was skiing out when my tails caught and hooked and then I felt both knees blow up. Binders never came out, but that's pretty much expected at 14DIN (note - they actually do and have released in the past, I've been skiing that for at least the last 3 years and have been happy with their release characteristics. It facilitates going straight...) Got my first ride ever down in a toboggan. I'm currently 12 days out and can walk fine without crutches. Wearing a brace on the right (ACL). The left (torn PCL) feels pretty much normal but I tweaked it pretty good getting into the car yesterday which was a big reminder it's still far from 100%. The right still won't go fully straight but the pain has subsided and I can get around fine. I've seen the same ortho surgeon as my sports med doc for the past 10 years or so and he's been fantastic at fitting me in to move the process along. I trust him wholeheartedly and we decided to go with the hamstring graft because he prefers it and said that especially in distance runners you can have ongoing anterior knee pain.

To top it all off, at some point in January I had hit my right thumb landing something and had continued to hit it. I figured taping it up before skiing was close to adequate. Before the whole blown ACL I had gone into the hand doc to check it out and was in the process of getting it MRI'd. I got the results soon after I blew my knee and was told I had "skiers thumb" - a torn Ulnar Collateral Ligament on the inside of the thumb. It had probably been torn for at least 3 weeks by this point and apparently was receded so I needed surgery relatively quickly and managed to get that done last week on Valentines Day. Luckily my girlfriend is incredible, was a college ski racer who's been hurt and has been my source for positive energy through all this so she understood calling off our plans. We watched movies that night instead while my nauseousness subsided. Mentally I'm thinking of it as a "warmup" for the ACL next monday however it definitely throws an even bigger wrench in this whole orderal because now I can't even go to the gym and do upper body stuff to keep fitness.

Like you guys have mentioned I'm worried a lot about the mental aspect of this. I'm painfully active and trail run, bike or climb every day I'm not skiing. It pretty much keeps me sane. I'm doing my absolute best to stay positive about the recent turn of events and focus on putting as much energy into rehab as I did into activities. I've been around the block -when I was younger I was a pretty avid distance runner and as I'm sure you can tell by now reading this, moderation isn't exactly my strong suit so I went through several injury cycles, each accompanied by some serious doldrums. Regardless this is still my first leg surgery and definitely my first double whammy. Yesterday was one of the most down days I've had in a long time. I can't help but feel like a dog in its kennel. I can't help but hate myself a little for pushing everything too hard. Two injuries at the same time is pretty much as strong a sign as the universe is willing to give that my redline is too high. I want to be able to ski when I'm 50 let alone when I'm 30... anyway thanks for reading. It feels kind of good just to type this out.

Positive energy, personal growth, mental fortitude. Right. Workin on it. Good luck everyone.

Thanks for sharing Garret, Good luck, stay positive and keep us posted.

Me: 36 Yrs old
When: January 31st. I think that makes me the first. Yeah!:nonono2:
Where: Wolf Creek
What: Torn Left ACL, Sprained mcl, pcl, lcl, bone bruising, hamstring strain. The mri didn't show any meniscus damage. I hope that turns out to be the case.
Surgery: March 13th, Patella Tendon AutoGraft. Same doc as Wildman.

This is my second time around. I tore my right ACL 17 years ago. It was repaired using a patella tendon autograft and is rock solid other then a bit of arthritis as a result of a majority of the medial meniscus being removed. My right acl is proof that acl reconsruction doesn't have to slow you down.

I'm not sure exactly what happened but I think I snagged the tail of my ski on the tip of a tree that was just under the surface the snow. It popped and I decided it would be a good time to fall down. I was able to ski down to the alberta lift and a lift mechanic gave me a ride on his snowmobile back to my car.

No pain, No swelling. I had full range of motion back 2 days later. I've been pretty lucky with that.

While waiting for surgery I've been doing a lot of biking, stretching, iso-metric exercies. My plan is to go into surgery as strong, if not stronger, then I was at the time of the injury.

I'm ready to get this journey started.

Wildman..When I blew my knee out, i over analyzed the accident trying to figure out exactly what went wrong. I was on indemified old race bindings cranked, theyve released countless times before, for many years. I beat myself up, but in retrospect a backwards twisting fall can damage your knee in almost any binding. Accidents happen, use your energy to pre rehab, rehab, and go with a surgeon you absolutely believe in.

Craven. You are right...I've been beating myself up about this. But im good with it now. Pre-Habbing the knee as much as possible with stationary bike. Gonna take all that negative energy and confusion and channel it towards healing and recovery.

Pesto - Looks like your surgery is one week after mine. Good luck. See you in the PT room...

Sitting in the pre-op room right now. Wish me luck, I'll check in on the other side

Quote:

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Originally Posted by garretvs

Sitting in the pre-op room right now. Wish me luck, I'll check in on the other side

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Good luck garretvs! I'm a 2012 inductee. It's a rough journey but in retrospect, a good one that taught me a lot about myself, my body, and my attitude towards the mountains. Heal fast but take it slow.

Nerve block wore off this morning. That was a bit of real pain. Stay on top of the meds post opp for sure. Been able to start putting a bit of weight on it with the aid of the crutches. Looking forward to getting after rehab. 1st goal is to walk up the 2 flights of stairs to the doc's office a week from now and have 90 degree flexion.

Cheers and good luck to all

Going in for Surgery Wednesday. Just received the Game Ready Pro Ice machine and Continuous Passive Motion Machine. Game on! Is the consensus to wait until i feel pain to take meds? or to be proactive about it and medicate prior to feeling any pain...?

Class of '96 and 2013 here.

Me: 46 Yrs old
When: February 24th
Where: BC Skiing near Stevens Pass
What: Torn Left ACL

Previously tore my right ACL back in Feb '96, repaired with Hamstring graft. Everyone's experience is different but I will say that the pain for the first few days post-surgery was the worst of my life and fortunately Vicodin knocks me unconscious. Healed up quickly though. Surgery at the end of February, hiked for a week on the Alpine Lakes High Route (all off-trail/scrambling) in August and skiing again with a brace the next winter. Hoping the same thing happens this time around.

Unfortunately, the doc that patched me up last time is now retired. He was top notch. Now I have to figure out how to find the best doc.

Good luck Wildman. The doc I saw today said they don't use the PCM much any more, they prefer to get you on a stationary bike and doing stretching exercises instead. Interesting.

Willie- welcome. Thanks for the input. I plan on using the stationary bike and stretching but I guess the CPM is still used by my Dr...I'll ask him about that next time I see him.

Sorry to hear about you knee, but after reading about heather ridge incident, obviously things could have been much worse... Good luck and keep us posted with your reconstruction/ recovery...

thanks Wildman. I was rather surprised when this doc said they didn't use the PCM. I used it the first time around and it really seemed to get the job done. Kind of a no-brainer - setup on the couch with some bananas or other snacks, a big glass of water, pop a couple of vicodin, strap into the PCM, turn on some old movie and float in and out for the rest of the day high on vicodin while the machine works your leg. After a week of that I had regained significant ROM, pain levels were way down and I was ready to go back to work (albeit with a soft cast and my leg elevated all day).

As far as I can tell 50% of docs use a cpm 50% don't and based on journal articles I've read there doesn't seem to be a lot of data showing that one works better then the other.

Last time around (in '96, like you Willie) I used a CPM and also used a bike, in PT, for stretching. I'm guessing it will be a mix of the two this time as well.

Wildman, did they tell you to bring crutches with you? Trying to figure out if I should scrounge up a set. Thanks for letting the doc practice on you before he cuts me ;-)

Pesto - yea buddy. I need to bring crutches...ill be non weight bearing for the first week or so. Stairs are gonna suck so its a Good thing i work from home. When is your surgery? Which surgery do you go with?

Good luck gents.
Thoughts are with you.

Quote:

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Originally Posted by Wildman

Pesto - yea buddy. I need to bring crutches...ill be non weight bearing for the first week or so. Stairs are gonna suck so its a Good thing i work from home. When is your surgery? Which surgery do you go with?

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Next wednesday. I'll be one week behind you. I work from home as well which is defintely going to make life easier.

I'm going with the patella autograft. It's what I had done on my right knee 17 years ago so I feel pretty comfortable with it. The only real issue I had, related to the type of graft, was the inability to kneel down on my right knee. I got used to putting all my weight on my left and after several years the issue went away.

Good luck tomorrow!

First off, good luck to wildman and Willie with your surgeries.

Bad news is Mrs. Flounder is a member of the ACL 2013 club. Happened last week at Northstar when a snot nosed little brat cut her off and proceeded to fall in front of her. While I would have run the kid over, she tried to stop and popped the ACL or so the thought is. MRI next Monday night will determine the course of action.

Probably have more questions later but for now I will peruse the older threads for background. If anyone has an opinion on a surgeon in the Burlington VT area let me know.

Thanks Pesto! I'll post up again post surgery.

Flounder - that is a real bummer. Damn ski tards! Keep us posted.