ACL Class of 2012

[retirwntm]

dropping in to say hello to my fellow knee gimp and gimpettes. i'll be hearing back soon about MRI and surgery. good resource though, thanks in advance.

[bendtheski]

Damn, it's getting crowded up in here.

SC & mtnwriter, sorry to hear/read.
I've probably said this before, but I remember sitting in my car after limping off Loveland Pass and thinking, well, this is going to be the next big challenge. Not as much fun as learning to ski bumps well or nail a double air trick, but still is going to require a high level of commitment and dedication that you most likely already possess.

I just try to keep it all in perspective; things could be a lot worse.

Welcome. I know it's a long way off for many, but I'm looking forward to reading about everyone's return to action!

[StuntCok]

REading the radiology report (in Japanese) it doesn't seen like I have a full tear, but a "stretched" (sprained?) ACL with small tears to one side. Does this make sense to anyone? Does this mean I have a sprained ACL with minor tears? Will that heal? I am trying to see a specialist but doing it before friday, when I fly to valdez, is proving difficult...
1

[bendtheski]

SC,
Not sure, but I think a partial tear can actually be worse than a full tear. From what I've read attempting to repair a partial tear has a lower success rate than total replacement.

Also don't know about the possibility of it healing by itself. Maybe one of the other dentists can chime in on this one?

[retirwntm]

here is what the "specialists" told me about that: a partial tear will often heal (ACL and miniscus at least don't know about MCL / PCL / LCL) if given time. however, they can also be fully torn or damaged in a worse manner if pushed. this was the de facto *warning* i was given. my .02. i'd say choose wisely SC. if AK is worth the further injury and at this point its not so bad (you are insured, you aren't a guide or someone that makes a living on his feet (a male prostitute perhaps?)) then go for it and see how it plays out!

thanks BTS for the welcome and good to hear there is another side and light at the end of the tunnel.

[snow gypsy]

SC, I sprained my left ACL earlier in the season (minor tear as well). It healed - sort of. I definitely pushed it. My body was timid and unconsciously protecting that knee which lead to another crash in which I tore my right ACL. It's your decision. Personally, I don't know if I would have changed anything in retrospect, but if you feel strong, the knee is secure, and an injury wouldn't spell your utter demise, get a brace, do some PT, and see how the AK winter has been.

In another note: No re-surgery on my part. Despite the slipped "latch," the graft seems to be holding and already healing where it lies. Tension is good and we're going to xray every week for the next 6 and see what happens. Gloria Beam is awesome. If we need to go back in, she's covering the cost entirely. I'd rather wait and see what happens than jump into surgery. She also doesn't want to operate at this point because my body is a scar tissue making machine.There is a technical term for this. It begins with an "A." Basically, my body's response to surgery is to freak out, royally, and over produce scar tissue on a dramatic scale. Scar tissue is invading my joints making it difficult if not impossible to extend and flex my knee and causes incredible pain and swelling (bonus!). Waited nearly a month to have the surgery to prevent this from happening... Changing the PT plan, gathering patience, and exploring various alternative options including acupuncture to help.

Any similar experiences? And if so, did anything help 1. prevent new scar tissue from forming and 2. helped decrease the scar tissue already there?

[Cedrik]

did anything help 1. prevent new scar tissue from forming and 2. helped decrease the scar tissue already there?

I didn't have extreme scar tissue buildup, but daily I rigorously massaged with lotion the scar areas to break up the scar tissue, at the recommendation of my PT. It hurt more than just about any of the other aspects of surgery, but it felt good when I stopped , and has worked.

ACL Class of 2011, one year out on 4/13!!

[StuntCok]

My colleague didn't get it right. My ACL is gone and I am off to Aus next week to get surgery. I may even get the LARS technique, which hasn't been chatted about much here but it seems I am a candidate for. Wish me luck!

[bendtheski]

LARS technique looks interesting. I've still got a fair amount of tenderness and loss of strength in the hamstring. It would have been great to have another option besides cadaver.

From what I read there isn't as much history with LARS, but at least for the short term the results look promising.

Good luck StuntCok!

[Damnstraight]

Joined the class January 28 and have been wondering through everyone's posts since.

Finally had surgery this morning (patellar) found out that during my time of procrastinating surgery my miniscus damage healed itself so I was left with just a simple acl... In and out in an hour and just put weight on it a few minutes ago and felt good. Loving the meds keeping my pain at a 2-3 and loving the attention from the girlfriend.

Flexion at 40 today on the cpm machine, thinking of naming the old girl... Suggestions?

[snow gypsy]

SC,

Let us know how LARS goes. I looked into it a bit, but unfortunately, it's not available in the states. Heard that the short term results are incredible - a good option for those who need to get back out there STAT

[flyman683]

Unfortunately I'll be digging through these threads now.

I'll post my first ever TGR trip report later, and unfortunately, it somehow ends with a "complex bucket handle tear of the medial meniscus" and a "proximal ACL tear" AFTER skiing back to the car & taking off my gear in the parking lot. So it's also my last TGR trip report of the season.

[StuntCok]

What I cannot understand is why LARS doesn't have more long term stats. It seems all the English peer reviewed journals only have 5 year time lines but the euros have been doing it for much longer. Are there No bilingual knee Dr's?

Sent from my IS11CA using TGR Forums

[aaskybabe]

Hi All,

Well I got to run yesterday for the first time...treadmill only! And I only ran for about 45 seconds..it felt very weird.(Again with weirdness...) (My surgery was Feb 1st, complete ACL tear and meniscus damage, allograft.) I've been very consistent with my rehab...since I can't work...I walk every day. I'm up to 3 miles...keep in mind it's not a race, so it takes me awhile. But I finally have a small quad muscle in my left leg and my left calf looks better. Although the muscles in my left leg are definitely smaller than my right. Overall I am very excited with my progress. But I know not to overdue it

As for pain...my knee only hurts when it rains. So yes I can predict the weather (Thats no joke either... it aches like crazy.) And occasionally my knee joint "pops"...but the PT and my Doctor said thats normal.

Snow Gypsy...I am so sorry to hear about your graft slippage. That is really astonishing. I have pictures of the bolt in my femur and I just don't see how that could have happened.

[bendtheski]

I go to the ortho for another follow-up tomorrow. I'm pretty sure he's going to add some running/jumping into my routine. Frankly I hate running, but will do whatever he recommends if it will help my recovery.

Overall my knee feels about 80% give or take. Bicycling is almost completely painless and I'm already riding just about as fast and strong as I did all last year! (I was a bit of a slacker last year so doesn't really count) Haven't taken on Loveland Pass yet this year, but confident it won't be a problem with the addition of compact gearing on the road bike.

Some days the knee still feels a little tender and wobbly, but most days it's pretty good. I'm pretty confident that six months from now I will be able to return to skiing as gaper as ever! On that note, I'll be pulling the trigger on next year's Loveland Season Pass that goes on sale tomorrow!

Woot Woot! Anything's got to be an improvement over this year!!!

[snow gypsy]

As of this afternoon, I am down to one crutch! Who-hoo! It's a small victory, but the ability to put any weight on it at this point is awesome. Still not sure what the future holds as far as any future surgery is concerned. Was able to get extension to 0 and flex to 80 as well.
Another xray on Monday to see if anything is moving (fingers crossed that its staying put) - i wonder how much its going to cost to do these things once a week
Still on a lot of pain meds due to the scar tissue buildup (damn genes!) otherwise known as arthofibrosis.

I hate narcotic pain meds and know a few friends who had to go back in for surgery to remove excess scar tissue so they could get extension and flexion back. Dear god knee, bend already! A few homeopathic options were suggested to help with the pain and to stop the scar tissue build up. Some were bogus, some seemed to work unbelievably well. I'll post the best up here once I have some longer term beta.

In another issue, I'm usually all bright eyed and bubbly...but I had a hard core mental break down yesterday watching the hubby take off on his mountain bike at hartman rocks (near Gunnison). God I love my bike...singletrack... At this point, biking outside is June or July at the earliest. No singletrack until September. I've been working on upper body strength to keep my sanity, but i still have those moments. Running, skiing, biking...it awakens something in me - a kind of passion and strength that my entire body craves desperately right now.
Any tips on keeping positive and focused? What did you guys do to help keep those spirits up while waiting to get back on the saddle?

[devon]

2-days post ACL surgery. Had an allograft and have felt amazingly good. They gave me a nerve blocker on a continuous drip through a catheter in my hip--I just took it out a couple hours ago after it was empty--what an amazing piece of technology. With the nerve blocker, Oxycontin, and Oxycodone I've feeling great. Now that the nerve blocker is gone, we will see how the pain goes.....

I have been on the CPM for the last 2-1/2 days, and using the GameReady ice machine. PT on day 1 exhausted me and I am back again tomorrow for PT.

[LoMayn]

Bendtheski - so amped on your recovery speed, and it's good to hear the bike feels so good. My PT keeps telling me that my affinity for my road bike is going to be excellent for my recovery. Best way to build up the VMO and overall strength. Keep it up!

Snow Gypsy - I was definitely in a dark place post-surgery. I had to wait 3.5 weeks for surgery, and by the time I got there I had used up all of my sunny disposition. It wasn't until I could drive, and until I got back into the office, that I started feeling like myself again. But here's what I am doing now. I was supposed to start training March 1st for a half ironman, so my whole mental state was focused on slow and ongoing training. I am really focused on replacing that training mentality, including the discipline, with PT. I get up early to work on ROM, book 30 minutes on my calendar to get in a mid-day "workout", and go to the gym every day for my full "workout" - patella mobes, wall slides, hamstring bridges, calf stretch, flutter kicks (because i have lost my entire right glute), and then 10-20 minutes on the bike with no resistance and 45 RPMs. It pales in comparison to my normal life but it's honestly hard as hell, and the days that I do 3 sessions and get in a good ice I now feel really accomplished. This is my training and the more I do it right, the better I get, every day.

I was 4 weeks out yesterday and am down to one crutch (or none for small spaces). Having a hard time getting my gait right - like I said I have no right glute, which makes me thankful that I normally have biker butt. That shit is USEFUL.

[bendtheski]

snow gypsy,

Mostly I just tried to focus on my PT and the goal of as close to a complete recovery as possible.

I saw my ortho yesterday, and again he's really pleased with the progress I'm making. He says I deserve all the credit because it's a direct result of all the work I've put into my PT, and not simply that he's a great surgeon and nailed my acl replacement.

He said regardless of who does the surgery, or what type of graft, it's only an hour or so procedure and pretty hard to F-up. What makes the biggest difference is what you do after surgery.

My mindset has been pretty much I've got nothing better to do, and as much as I hate the gym and the PT exercises are generally boring and sometimes painful, I want to be the poster-boy for successful ACL replacement surgery! It won't make a bit of difference to anyone but me and possibly my ortho, but avoiding long-term complications is motivation enough for me.

As far as staying positive, I think it helps to be social. Maybe take the opportunity to appreciate some of the things not so active people do. Movies, scenic drives, power-shopping, zoo, sporting events, aquarium, eating out, cooking-in, watching chopped... Also, try not to get bitter towards your friends/hubby who are still able to be active, just do everything in your power to get yourself back to what you love and don't lose sight of that greater goal.

I made this comparison earlier, but I think it bears repeating. I don't think any of us got to be good at skiing or whatever activity lead to our injuries easily. It probably involved a great deal of perseverance, patience and discipline, was often painful and even disappointing, but we stuck to it, for me at least because it's really fun and feels good to be good at something!

I've been lucky enough not to have any complications so far, and every time I have a check-up with the ortho and he tells me how well I'm doing, I get the same sense of accomplishment I got when a skier I considered to be better than me said something like "dood, you're ripping today"! I endured a lot of bitter cold days, cramping feet, sore back, frostbite, etc. to get there, not much less unpleasant but probably less monotonous than spending an afternoon in the gym, but hopefully you'll get to hear some similar encouragement and it will help you maintain your focus and resolve to get better.

LoMayn,

I'm pretty psyched to be re-discovering my love of road-riding, but with something like this to ride, how could I not?



-end motivational rant

[snow gypsy]

Thanks for the support and advice. Went for a bit of a walk yesterday and moved my daily PT routine outside near a community park. Looks ridiculous but being out and about is good for the soul. Every day the perspective gets a bit better. Focusing on PT helps immensely, that and being proud of small successes (which feel like big successes).
I would never never grow bitter or discourage anyone from getting out there - more of a wishing that I could be right alongside. Regardless, I've decided to live vicariously through the hubby and all others getting after it. I fully plan to be twice as strong as I was going into the injury and coming out of this experience more motivated and capable than when I first went in.

Here's too those small successes...and getting back on that road bike as soon as possible

[gato_loco]

Checking back in here at 8 wks after surgery. Good ROM and reasonable strength, but still no functional brace available as I lost a lot of muscle mass in the L quad (2.5" circumference differential @ 6" above the knee). Working hard to build that back, as well as hamstring strength, since I can't seem to pull the leg with enough power to grab my leg for that classic quad stretch. Any advice on best hamstring exercises for strength? I have been doing hammy curls and bridges on the exercise ball, but minimal gains so far.

Lots of time on the stationary bike, and like BendtheSki and snow gypsy I have been trying to focus on the positive, not get down on the fact that I am not able to get out there and after it. I find that to be especially hard for me, as I missed an Aconcagua trip immediately after this injury and am going to miss a Denali trip in June too. But, I plan to get back, stronger and smarter after it's all said and done, and continue to pursue those mountains with a vengeance.

Tone, hit me up if you're still looking for a good doc in the Bozone. I know a couple of docs at Alpine Orthopedics and I also know a good PT in town that can give you a very knowledgeable second (and third) opinion, if you haven't already gone that route.

At least the ski season is winding down, and soon I'll be able to get on my bike outside! Hooray for the little victories.

[bendtheski]

gato,

Re. hamstring exercises; if you have access to a gym I've found doing hamstring curls laying on my stomach pulling heels towards butt targets the area most weakened by the graft.

Another good one is the seated knee flexion with band. Pull back and hold for two seconds then release.

I do some seated hamstring curls with a machine, but it doesn't seem to target my weak hamstring as well as the first and second exercises.

I also do some seated quad extensions, but these don't really address the hamstrings as much as the others. They're pretty much just for rebuilding quad strength (I think).


Almost forgot the squats. I started with wall-slides, but that was only for the first few weeks, now I'm using a machine. Not a lot of weight, but I think it helps for strengthening the hamstrings as well as quads.

Just FYI, I do all my workouts in full ski gear complete with climbing harness and dos GoPros.

Just had another visit to the PT. Starting on some plyometrics, more bouncing than actual jumping, and some quick step Z's and W's, no actual running yet. Fortunately I have access to a gym in the same building I work in, and there's even a mini trampoline that I can use for most of the new exercises.

PT said my surgery leg might actually be slightly stronger than my "good" leg. I guess 15 weeks of PT is paying off. Maybe I should start doing some weighted leg-lifts with my good leg just to balance things out?

Some of the new exercises are revealing some weaknesses that have nothing to do with my ACL injury; I have some weak-ass ankles, always have and probably always will. It seems like I can step on a bottle cap the wrong way and my ankle will just roll right over. I've actually done some ligament damage on a few occasions and had to have a cast up to my knee for six weeks about a million years ago. I think the flimsy ankles contribute to my terrible single leg balance which was also a problem before tearing my ACL.

I think my terrible ankles make a bunch of the PT exercises even more difficult than they should be, but I'll keep plugging away until I'm cleared by my ortho and PT which at this point won't be for another 8 weeks or so. Fortunately Lange and Dalbello Kryptons provide good support for skinny ankles so having crap ankles has never held back my skiing all that much. The poor single leg balance might explain my tendency to ski with my feet together, well, that and growing up on the east coast and being a bump-fag...

My PT keeps comparing exercises to being like skiing bumps. I think she may just have figured out how to motivate me. All this hard work is pretty much just so I can go back to crushing zipper-lines, everything else is bonus!

[Jethro]

My wife tore her MCL and completely tore the ACL about this time last year on a touring hut trip in Canada last season. She had a hammy graft at the end of April and started therapy in april 2011. She skinned up the local ski hills a lot early in the ski season, and got her season pass in February and started skiing Alpine kind of tentatively. On her birthday on April 12, she skinned up Aspen mtn, Highlands, Snowmass and Buttermilk for something like over 10,000 vert or more. Now she is biking in Junction/fruita. I am pretty impressed with her recovery, and hopefully all you gimps can do as well. Good luck in your recoveries.

[flyman683]

2-days post ACL surgery. Had an allograft and have felt amazingly good. They gave me a nerve blocker on a continuous drip through a catheter in my hip--I just took it out a couple hours ago after it was empty--what an amazing piece of technology. With the nerve blocker, Oxycontin, and Oxycodone I've feeling great. Now that the nerve blocker is gone, we will see how the pain goes.....

I have been on the CPM for the last 2-1/2 days, and using the GameReady ice machine. PT on day 1 exhausted me and I am back again tomorrow for PT.

I just hit two days post ACL repair (hamstring auto) & medial menisectomy. They just did the femoral block at the OR w/ a "24 hour dose" and loaded me up with oxycodone. Also have a gameready, but no CPM.

When the block wore off finally in the middle of the night last evening it was brutal. Enough to wake my wife from the other room. Had to upgrade to doing the 2x oxycodone every 3 hours instead of 4-4:30....Feeling a bit better today, but mostly just sleeping and taking the meds.

Really looking forward to getting to PT on Tuesday & Dr. visit on Monday... Feel somewhat useless just stuck sitting around until then. I even called and asked if I should be doing anything - I honestly couldn't remember post-op what they told me: I basically got the "You AREN'T WALKING AROUND RIGHT?" speech. I confirmed I've got my 15 degree locked brace on and am elevating, but man I feel like I should be moving.

Crutching is ok, and I'm allowed to have "toe touch" weight for balance. I keep getting these "rolling" twitches or contractions on the right and left side of my quads, which I guess is the nerves firing off & trying to figure out what the hell happened down there?

[bendtheski]

Those first few days post-surgery were a challenge for sure. At first I thought I'd only take the pain meds when absolutely necessary, turns out they were absolutely necessary most of the time for the first 5 days, then only occasionally to get comfortable enough to sleep after that.

Flyman, I had the same procedure and was supposed to be full weight bearing the day of surgery. I still used the crutches for the first couple of days because I didn't really trust my surgery leg to support my full weight.

Seems like this has been a common thread throughout my recovery; me not being able to wrap my head around the idea of completely trusting my ortho, my PT and my knee, and all three continually proving me wrong. I hope this trend continues straight through to next ski season!

I'd imagine everyone here can relate at least a little to that "broken" feeling when you first found out the extent of your injury. It's been pretty cool so far noting little milestones on the road to recovery, stuff like walking from my car into the ortho's office with pretty much no limp or pain VS my first visit trying to negotiate a snow and ice covered parking lot on crutches.

I guess the lesson here is; being broken is giving me a greater appreciation for being un-broken.