ACL Class of 2017

[bodywhomper]

Thanks all.

I’ll ping tri-u.

[montanaskier]

Skied 2 days this weekend. Crazy nervous on Friday. Knee felt ok. Certainly not as strong as I’d like but it was ok. I didn’t stand on the outside edge and I was slow and cautious but I was out and skiing! FKNA!


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[2FUNKY]

Skied 2 days this weekend. Crazy nervous on Friday. Knee felt ok. Certainly not as strong as I’d like but it was ok. I didn’t stand on the outside edge and I was slow and cautious but I was out and skiing! FKNA!


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Hell yeah man! Slow and steady wins the race.


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[montanaskier]

15 days and 200k vert. Gaining confidence and strength but still not close to where I was. Stoked to out. Bumps are hard and I don’t have the stamina. Still don’t have the mental part back yet either. Patience!


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[grskier]

15 days and 200k vert. Gaining confidence and strength but still not close to where I was. Stoked to out. Bumps are hard and I don’t have the stamina. Still don’t have the mental part back yet either. Patience!


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That will all take a while.. not scrolling back, did you do a back to sport test?

I found the workouts for final ACL recovery on youtube to be very difficult and great for actually feeling athletic again.

[grskier]

15 days and 200k vert. Gaining confidence and strength but still not close to where I was. Stoked to out. Bumps are hard and I don’t have the stamina. Still don’t have the mental part back yet either. Patience!


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If you are on snow, you can probably start with phase 4:
https://www.youtube.com/watch?v=1zv-tPGjXqY
Phase 5:
https://www.youtube.com/watch?v=zaFv0qNjSs0&t=4s
Phase 6:
https://youtu.be/ZWu9MSC6WMw?si=ptvdnK5MM9nnJq_s

[montanaskier]

That will all take a while.. not scrolling back, did you do a back to sport test?

I found the workouts for final ACL recovery on youtube to be very difficult and great for actually feeling athletic again.

I did testing before I stopped PT….I wasn’t at a spot where they would clear me to ski, but I started skiing. I realize it’s a danger to ski before it’s ready but I wasn’t far and I needed to ski. I’ve been taking it easy and still working out at home. It’s getting there.


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[neufox47]

Not sure this is the right place but, it does involve an ACL injury. About 10 years ago my knee inexplicably blew up, swelled right under the patella so bad until I couldn’t bend it for a week plus. No injury.

3-4 times over the past 10 years a very similar thing has happened. Usually for no known reason, but recently because I stupidly front squatted 225 full depth in lifting shoes after not front squatting for years (obviously dumb and yes I do other lifting).

Back in October I banged my knee on a rock wall and the next day I woke up with a sore knee. It then blew up, almost 3 weeks of not bending it, then I went for a bike ride and it blew up again, then I hit it on a post before Christmas and it was another 8 days….

I finally got a MRI and this is the result:

Normal patellar tendon. Mild distal quadriceps tendinosis with mild focal partial intrasubstance tear of its distal anteriormost fibers measuring 1 cm with underlying mild reactive bone marrow edema in the superior aspect of the patella and with mild adjacent prepatellar bursitis. Moderate chronic partial ACL tear with attenuated appearance, otherwise normal ligaments. Normal lateral meniscus. Normal medial meniscus. Normal medial compartment cartilage and underlying osseous structures. Normal lateral compartment. Normal patellofemoral joint. Normal popliteus. No knee joint effusion. Small Baker's cyst.

Haven’t seen the ortho or any doctor yet. Anyone had similar or otherwise care to share some knowledge of what that likely means?

I did ski today, with mild discomfort, no blow up yet at least.


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[bodywhomper]

Dang. I don’t have too much info to offer about those results. I can share the orthos recommended by my PT to me that are up the hill and a physiatrist that I do not recommend. And that my custom donjoy brace continues to work well and I gain confidence with the support that it provides while skiing.

I’m considering getting a donjoy custom for my other knee (aka my “good” knee) when skiing as a protective item. That knee likely has some undiagnosed acl damage. Anybody done that with good outcomes? Out of pocket, it’s WAY less than deductible cost for the combo of doctor visit, X-ray, mri, doctor follow-up.

[grskier]

I did testing before I stopped PT….I wasn’t at a spot where they would clear me to ski, but I started skiing. I realize it’s a danger to ski before it’s ready but I wasn’t far and I needed to ski. I’ve been taking it easy and still working out at home. It’s getting there.


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The test is all about balance of strength, etc.... I'd talk to your PT about it if you still have appointments on the script.

I will reiterate a good leg workout regiment as I posted above.

I need to do some of those as well. I feel balanced after last years whoopsy, but not strong yet.

[mcski]

Whomp,
You probably already said, but did Ins cover your current Donjoy?

[bodywhomper]

Whomp,
You probably already said, but did Ins cover your current Donjoy?

Yes. It was covered by insurance. Needed fairly specific detail from a recent doctor exam. The donjoy rep, who lives in SLT, coached me about content of the exam notes, and my doctor easily obliged (it wasn’t too much of a stretch). Pre-negotiation, was like $1800 to my insurance. Post-negotiation, it was a little over a grand. I paid a co-pay amount. But out of pocket w/o insurance, I was quoted for less. I started the process by contacting donjoy through their website about their custom braces. Good luck!

[Yonder_River]

Wife just got a fitted Breg fusion brace right before the end of the year. I think they're generally covered if the ortho "prescribes" it.

[evdog]

Not sure this is the right place but, it does involve an ACL injury. About 10 years ago my knee inexplicably blew up, swelled right under the patella so bad until I couldn’t bend it for a week plus. No injury.

Over the past few years I've had a similar thing happen, though much less severe. I seem to hyperextend my knee occasionally while biking. which causes some swelling under the patella leading to knee pain during rides. Pain usually doesn't flare up until 15 miles or so into a ride, but has gotten so bad a couple times I could barely pedal or walk until I can rest for a while. it usually takes a few weeks of reduced activity for the pain to stop recurring, which I assume is the time it takes for the swelling to go away. The swelling itself isn't very noticeable.

I had ACL repairs on this same knee in 2005 and 2018. Pain during rides started in 2015 or 16. I talked to my surgeon about it when I had the second repair, so he scoped around during the surgery but didn't find anything obvious that might be causing it. He said the most likely cause is that I didn't rehab thoroughly enough following my first surgery leaving the muscles in my leg slightly imbalanced, which can cause friction between moving parts during movement leading to inflammation in the tissue and pain. I rehabbed harder after the second surgery and have had fewer issues with this since, though it still happens occasionally.

I can't translate the medical jargon but it sounds suspiciously like things aren't working so smoothly in your knee and something similar to mine might be happening, but with more sudden and severe symptoms. Best of luck getting it sorted!

[neufox47]

Thanks for the input. I’m starting to wonder if this comes down to my tight quads.


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[bodywhomper]

It sounds like you have a few things going on with the patella area. The impacts that results in large swelling seems like an odd trigger for the resultant. I suggest shopping around for the PT that you will likely end up seeing. Want: skier (ideally) and overall athlete (requirement). I have a local friend/athlete that swears by their PT who practices somewhere near you. she’s willing to drive for a few hours round trip for her visits to that PT. I can get that PTs contact info if you want.

[Duffman]

How many here had surgery right away vs delayed , and of those in the delay group, could you keep skiing. Wife got tangled up between myself and my kid getting off the lift of all places , backwards twisting fall at zero speed, but felt a pop and pain. Took a few minutes to regroup and then skiiied down from the peak of Highlands to the base with some discomfort but no major issues. Sat for a bit in the lodge and then took a lap with the 6 year old without too much pain. Swelled up that night so took the next 2 days off but skied easy groomers with a brace with the little kid after.

Swelling and mobility almost all better now 1.5 weeks out , but got her an MRI (benefits of having an MD husband) before we had a chance to see an Ortho (saw a GP at the snowmass clinic but indeterminate findings)

MRI (I looked also) shows a high grade partial tear of the ACL. Ligament looks mostly gone. No other knee injuries luckily with this.

She's kinda gobsmacked by this because the symptoms are minimal, she just figured a sprain. Obv need to get into see a good sports ortho now, but for those of you who delayed surgery and didn't have instability symptoms, did you still ski while waiting ? Braced or not?

[climberevan]

How many here had surgery right away vs delayed , and of those in the delay group, could you keep skiing.

I blew mine back in the dark days before the ACA and without insurance. So I waited 3 years to have it reconstructed....

My initial recovery was pretty quick, and I was back at work like a week later (construction). In the ensuing years I did a lot of cycling and running, some alpine climbing, and a lot of hiking. I didn't really have much trouble during that period, except that the knee would occasionally lock, which I now know was bc the meniscus was also pretty wrecked, and I probably made it worse by waiting so long.

This period also corresponded to several drought years here. But, ultimately, I tried to ski and couldn't. Even the slightest backseat shift would create that sickening feeling of instability in the knee. So, thanks to the ACA and the removal of the "pre-existing" bullshit, I finally got insured and had it reconstructed. I was skiing again with no issues the next season.

I vote get it fixed if she wants to live without limits.

[XXX-er]

One of the local ski coaches/ good skier/ former racer/ former ski shop owner blew her ACL but just used a Donjoy brace for the last 3 yrs instead of getting it fixed cuz she doesnt like pain, she said the brace worked and no pain. Now she is loving the Stoko.com product, sez it works just as well and doesnt get in the way

I never did try skiing with a completly blown ACL but the mtn biking hurt

[Duffman]

I blew mine back in the dark days before the ACA and without insurance. So I waited 3 years to have it reconstructed....

My initial recovery was pretty quick, and I was back at work like a week later (construction). In the ensuing years I did a lot of cycling and running, some alpine climbing, and a lot of hiking. I didn't really have much trouble during that period, except that the knee would occasionally lock, which I now know was bc the meniscus was also pretty wrecked, and I probably made it worse by waiting so long.

This period also corresponded to several drought years here. But, ultimately, I tried to ski and couldn't. Even the slightest backseat shift would create that sickening feeling of instability in the knee. So, thanks to the ACA and the removal of the "pre-existing" bullshit, I finally got insured and had it reconstructed. I was skiing again with no issues the next season.

I vote get it fixed if she wants to live without limits.

I think the ultimate plan if deemed the best course of action is to have it repaired, its just the timing thats tricky with life , kids, plans. etc. Being her driving leg is an additional problematic wrinkle (longish commute with no transit options to work 3 days a week). I also think from a mental health standpoint bagging the season after 4 days will be devastating for her, thats the first thing she asked me after I looked at the MRI today. Even if its just throttling back and skiing with the kids braced and having the surgery in a couple months , that may be a preferable option if it is doable and wont do additional damage. Will need to see what the ortho says, but just wanted to get some real world feedback from people who have done similar.

Obviously this is all contingent on if she can still be active without instability or pain even short term. So far that's how it looks but who knows.

[mcski]

If she’s already skied w a brace without much problem, delaying would seem like the way to go given your description. Seems like a decent Ortho would support that and Rx some PT in the interim to see how it goes

[neufox47]

How many here had surgery right away vs delayed , and of those in the delay group, could you keep skiing. Wife got tangled up between myself and my kid getting off the lift of all places , backwards twisting fall at zero speed, but felt a pop and pain. Took a few minutes to regroup and then skiiied down from the peak of Highlands to the base with some discomfort but no major issues. Sat for a bit in the lodge and then took a lap with the 6 year old without too much pain. Swelled up that night so took the next 2 days off but skied easy groomers with a brace with the little kid after.

Swelling and mobility almost all better now 1.5 weeks out , but got her an MRI (benefits of having an MD husband) before we had a chance to see an Ortho (saw a GP at the snowmass clinic but indeterminate findings)

MRI (I looked also) shows a high grade partial tear of the ACL. Ligament looks mostly gone. No other knee injuries luckily with this.

She's kinda gobsmacked by this because the symptoms are minimal, she just figured a sprain. Obv need to get into see a good sports ortho now, but for those of you who delayed surgery and didn't have instability symptoms, did you still ski while waiting ? Braced or not?

I had two male friends who skied for years without an ACL, one was missing an ACL in both knees. But I’d ask a doctor personally [emoji6].

[mcski]

Is everyone getting cadaver acls these days or is harvesting back in fashion? Any other technique options to consider?

[Djongo Unchained]

^^^^

I think cadaver parts have a slightly less durable history. More active peeps get a Hamstring, Patellar or Quad graft. Downside is that now you have 2 surgeries to recover from.

Waiting to get it fixed if you have parts and pieces moving and grinding is not ideal. Otoh, if it's a ligament and no Meniscus or MCL/LCL, I bet you could work that out ok with strengthening the muscles.

I had a bucket handle tear inside that would get much worse by waiting. Quad replacement in 3 weeks after initial swelling went down.

[Bosco]

Duffman, I blew both ACL's in back to back years (SV and JH), and saw no reason to wait. I had them both reconstructed within a couple of weeks after injury.