Partially Torn ACL

[dimi]

Well, I got in an avalanche over the winter break where I was buried fully and during the experience my knee was twisted in a weird direction leading to swelling/pain and a locked knee due to a meniscus tear. Really glad I made it out alive, could have ended up much worse than a blown knee, so I'm very happy. Here is my rescue video btw. http://vimeo.com/34644625

I started doing a lot of physio but after 3-4 weeks it was apparent my knee was locked and a piece of my meniscus was stuck in there.

Had arthroscopic surgery done on Thursday. The meniscal repair was minor and it was cut away, some scar tissue was removed. However it so happens that about 1/2 of my ACL was torn as well. I had a suspicion of this as I heard the "pop" when I was being tossed around under the snow. Currently I am working on icing/elevating to dull swelling, then I am going to start with stretches to gain ROM back and then very small steps to increase leg strength. Compared to pre arthroscope I can feel that there is nothing stuck in my knee, but the swelling is there preventing full extension.

Well, I guess its better than a fully torn ACL :dunno: and it gives me some time to think about what to do. The other good thing is all my other ligaments are fine. Usually when you tear an ACL some other ligaments go with it as well.

I'm leaning towards reconstruction as I do a lot of snowboarding/MTBing and I really don't want to have a compromised knee. Also, with a weaker ACL the chances of destroying your other ligaments if the ACL were to tear, are higher.

The other option is to wear an ACL brace and strengthen the knee a lot hoping that the muscles might give some "knee support" as well.

I've read a lot about ACL reconstruction and while it does sound like a pretty involved procedure, I think I am up for it. Physio will be no problem. I already go to the gym ~4 times/weekly and I'll put in the work.

Any experiences? Thanks in advance.

[bignerd]

Sorry no info on the ACL but just wanted to say thats pretty crazy someone caught that on tape!

Do you carry one of those GPS location/becaon devices?

[Konj]

Fuck Dimi you lucky thats a crazy video
I had to watch the video three times cause first time I watched it I had no idea what was going on you just appeared out of no where with the guys digging hahaha

[dimi]

I was wearing my beacon and all my gear up to that run and for the 2 days before that...

I had done 1 run in Feuz bowl and decided to leave all my gear in the car as I figured all was good. BIG mistake.

As well, before I hit the chute that slid, I sat up there for 5 mins thinking, "Should I take my Avalung out?" "Should I take my Avalung out?". An Avalung is a device that you bite onto when a slide occurs so you can breathe under the snow up to ~50 mins. I don't know why I kept asking myself that, but at least 3 times I thought about deploying it just in case. I will never forget that.

We'll see what happens of my snowboarding career, but I can certainly tell you, from now on you won't find me without avi gear even in a resort.

[AndyL]

Define partial tear - did they give you a %?

If its under 50% just work on stabilizing, doing squats on wobble boards is terrific for that.

As wierd as it sounds - partial tears often are almost beneficial, my partial ACL tears have tightened both my knee joints - my left was borderline stable before my last blowout (40% ACL, 30% MCL, 80% PCL tears) now its fully stable and feels 10000% better.

The real important part now is recovering then building up those stabilizing muscles... wobble boards balance balls - all those core stability products become your best friend... treadmills, bikes and elliptical are good for the major muscles, but its the little ones you need to focus on most

[dimi]

Originally posted by AndyL
Define partial tear - did they give you a %?

If its under 50% just work on stabilizing, doing squats on wobble boards is terrific for that.

As wierd as it sounds - partial tears often are almost beneficial, my partial ACL tears have tightened both my knee joints - my left was borderline stable before my last blowout (40% ACL, 30% MCL, 80% PCL tears) now its fully stable and feels 10000% better.

The real important part now is recovering then building up those stabilizing muscles... wobble boards balance balls - all those core stability products become your best friend... treadmills, bikes and elliptical are good for the major muscles, but its the little ones you need to focus on most

A bit over 50% of my ACL is left.

I was doing all of those pre surgery, and was getting my strength back but my ROM was crap. Soon as the swelling goes down a bit I'll be putting in work again.

Thanks for the tips.

[ramminghard]

Originally posted by dimi
Well, I got in an avalanche over the winter break where I was buried fully and during the experience my knee was twisted in a weird direction leading to swelling/pain and a locked knee due to a meniscus tear. Really glad I made it out alive, could have ended up much worse than a blown knee, so I'm very happy. Here is my rescue video btw. http://vimeo.com/34644625

I started doing a lot of physio but after 3-4 weeks it was apparent my knee was locked and a piece of my meniscus was stuck in there.

Had arthroscopic surgery done on Thursday. The meniscal repair was minor and it was cut away, some scar tissue was removed. However it so happens that about 1/2 of my ACL was torn as well. I had a suspicion of this as I heard the "pop" when I was being tossed around under the snow. Currently I am working on icing/elevating to dull swelling, then I am going to start with stretches to gain ROM back and then very small steps to increase leg strength. Compared to pre arthroscope I can feel that there is nothing stuck in my knee, but the swelling is there preventing full extension.

Well, I guess its better than a fully torn ACL :dunno: and it gives me some time to think about what to do. The other good thing is all my other ligaments are fine. Usually when you tear an ACL some other ligaments go with it as well.

I'm leaning towards reconstruction as I do a lot of snowboarding/MTBing and I really don't want to have a compromised knee. Also, with a weaker ACL the chances of destroying your other ligaments if the ACL were to tear, are higher.

The other option is to wear an ACL brace and strengthen the knee a lot hoping that the muscles might give some "knee support" as well.

I've read a lot about ACL reconstruction and while it does sound like a pretty involved procedure, I think I am up for it. Physio will be no problem. I already go to the gym ~4 times/weekly and I'll put in the work.

Any experiences? Thanks in advance. I tore my ACL snowboarding december 2010 and have had 3 surgeries since to try and repair it. First surgery was february 2011 and it was a full ACL reconstruction using part of my hamstring. There was no other damage to the joint, all ligaments and meniscus were 100%. I wend to physio for 4 months, 3 times per week as well as the gym 5+ nights per week. It was feeling good until July when the reconstructed ACL tore while I was walking.

Had a scope done to see what was wrong because the surgeon did not believe that I could have torn it. The scope confirmed it was torn and Had another reconstruction in November which I am still recovering from. This reconstruction used a ligament from a cadaver as opposed to harvesting tissue from another area of my body. I have had much less muscle pain with this recovery and range of motion has improved much faster.

From my experience the recovery has been much better with the cadaver ACL. My hamstring felt awful after the first surgery and the physio is much more involved/painful. Healing the muscle and trying to get back to pre-op strength is a long process. Recovery from the second reconstruction has been better but I am only 4 months out at this point. I would say I am only about 60% of my pre-injury strength and still have some pain if I try to jog or overwork my knee for more than about 30 min. I also have a fair amount clicking in the joint now which my physio is hoping will improve.

At this point I have very little confidence in my knee and do not expect to be able to do many of the things I did before. That includes badminton, squash, hockey, snowboarding, etc. I have a brace that I can wear for activities but it doesn't help the pain in the joint and I find it quite limiting. The lack of confidence is partially due to one unsuccessful reconstruction. Hopefully with physio and the gym I will be back close to 100% by July or August this year.

If you choose to go with the reconstruction budget for taking about 4-6 weeks off work post-op assuming your employment is a desk type job. Plan for more if walking, lifting etc. is involved. Physio costs add up quickly at $60+ per visit and the 7 visits after the surgery don't last long. Don't plan on starting to participate in activities for minimum 6 months but more realistically 10 months to a year. You will likely want a brace for activities after the recovery which will be $2k plus for a custom one.

Feel free to PM me if I can help!

[AndyL]

Just work on your ROM exercises and stretches for now, until the swelling mostly goes away. Until you have nearly full ROM and swelling has mostly gone away - working it should be avoided...

See if you can get into the u of c sports med clinic for physio - they're now heads and tails above anyone for knees...

[s_havinga]

I had ACL reconstruction a few years ago and have no regrets. It still hurts and gets stiff if I don't keep up with going to the gym but all in all I have way more confidence in what I can do. In my case I had a bad knee for several years before I went for the surgery. It wasn't until after my knee healed up that I realized how much in had modified my life because of my bad knee. My opinion is if your young and still have many years ahead of active lifestyle ahead of you, go for the surgery. If your ok with living a modified life then wait it out. In my case it was a total tear so I am not sure what difference a partial tear makes.

[tsi_neal]

I have a partial tear on my medial meniscus, and partial tear on one of the ligiments (cant remember which anymore). I had my ski accident over 10 years ago now, ive seen a few doctors for my knee over the years and the answer has always been the same, not bad enough to warrant an operation. When I was very active in the gym and on my bike it was never a major problem, but as I get older and life has gotten in the way of things, my knee bothers me daily. I dont ski anymore, dont hike anymore, walking the dogs on uneven ground isnt good, sitting in one position for too long hurts like crazy... I still get on the bike a few times a week, but my leg strength isnt near what it was when I was doing weights.

Would things be any better if i am ever able to get surgury? I really dont know, but my point is even if you can manage your knee in the short term with strengthing and streaching life circumstances may change and as the leg muscles get weaker knee pain may become crippling. My vote is get the surgury and take the recovery process seriously and with luck your knee will be close to good as new.

[Afrodeziak]

Couldn't really tell how much you were buried in that video... but why in the eff were there so many people just standing around ? frig...

[soccernut]

I tore my ACL playing soccer back in July. Full tear in my case. I have no choice but to get surgery. Still waiting for one.

I think you should do it as well. A weaker ACL is just a ticking time bomb till your next big crash.

I am functioning well without an ACL right now. I work out HARD without a brace. I can Plyometric exercises without it. I only wear a brace for soccer (YES, I am playing soccer without an ACL on my left/planting leg)

I am using a custom($$$) CTI brace right now but i don't want to wear it forever. It works well but not 100%. I would recommend it for you if you don't want to do the surgery.

[dimi]

Well I do think I'll be better off than no ACL, and a brace will add to that stregth I hope.

I don't think it'll work out for snowboarding though. I take big tumbles all the time as I like to push hard. MTBing should be fine. No clipin pedals anymore :(

I guess we'll see. Once the swelling is down and I can walk properly and get most of my ROM back I'll have a consultation with my surgeon and figure it out.

Thanks guys.

[AndyL]

Um, this unfortunately isn't the OP's choice... He's not going to be offered ACL reconstruction they'll do it for complete tears; And over 75% tears with ancillary damage (in other words joint has to be unstable). Unless he's paying out of pocket at cambie or similar - it's just not even worth talking about...

Welcome to canadian healthcare :)

[zipdoa]

I can't comment on surgury, but I can comment on everything else:

Get a CryoCuff.

http://kneesupport.com/aircast/knee-cryocuff.jpg

I blow a knee every couple of years and the Cuff is more effective at reducing swelling than any other method I've used.

I'll be running this brace when I ride downhill this year, it's an MX brace, but when it comes to knee's I don't think you can overdo it:

http://images.motorcycle-superstore.com/ProductImages/OG/2010-Pod-MX-K700-Knee-Brace.jpg

Aside that... physio, be a fucking FREAK in the gym, and do lots of Yoga. I'm up @ 5:30AM every day to hit Bodhi Tree by 6:15AM. Aside physio, Yoga will be your best friend.

Hit up a proper diet as well... Every morning I drink an organic shake that consists of:

Apricot seeds, Chlorella, Spirulina, Udos Oil, tumeric, chia seeds, flax seeds, hemp seeds, raw honey, bee pollen, maca root powder, fulvic acid (minerals), bananas, berries, filtered water, Oxygen drops, glutamine and whey protein.

I believe that half of a proper recovery (and segway into a better life) is what you eat... nutrition is just as important as the work you put in at physio/yoga/gym.

I've had my ass kicked doing DH MTB, and it's my goal to throw down on the bike but never suffer a crash like I did last year ever again.

[soccernut]

^ thats what my brace looks like. Only different brand. What brand is that?

I totally agree with the above. I work on my balance a whole lot. I encorporate balance elements with all my workouts. Even upper body weight lifting. Check out p90x2 for all kinds of balance exercises. I do eat healthy but i dont break the bank going organic.

But this stuff is all good for later. Just focus on getting the swelling down and your ROM back to normal. Then slowly ramp up your training.

Whatever you do, you cant just leave it alone. You have to work your ass off at the gym all the time. On the plus side, you will fitter than ever.

[zipdoa]

Originally posted by soccernut
snip

It's a POD K700.