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Seeking Advice on ACL Rehab

post #1 of 7
Thread Starter 

I saw the other ACL thread and given its age and length thought I'd start a new one.


I blew out my left knee October 9, 2011, playing lacrosse on artificial turf.  I'm 43.  Torn ACL, damaged both menicus, strained MCL, bone bruises.  Bad injury.  Surgery 9 days later with hamstring graft (from left leg).  Fortunate in that I've had very little pain, but recovery has been somewhat slow in that it is was a particularly bad knee injury and it took me a couple weeks to get off crutches (knee collapsed about an hour after original injury when changing out of athletic shorts, which left me tentative in putting weight back on it). 


I've had a good PT and been diligent about my exercises (I have about 8-9 I do 2x a day).  Walking fine now with brace (unlocked) and was at 129 degree ROM yesterday.  It is obvious to me that rehab varies dramatically by person, depending on their injury and protocol.  I'm amazed at some of the fast recoveries I see on youtube or read about, but feel confident I couldn't have pushed rehab harder and haven't been lazy about my exercises (again, was slow getting off crutches, but knew that would happen given the collapse).


My main goal is total functionality for 2013 skiing.  It's my favorite lifelong hobby and passion.  I feel somewhat fortunate that my injury didn't occur skiing, so hopefully I'll worry about it less when I hit the slopes, but I do want to rehab in the best way possible for that long-term goal.  I love moguls and powder and the steeps and tree skiing.  I'm generally a pretty good skiier, but my fundamentals aren't that great, so my form can degrade when I get tired or am in tough terrain or heavy crud - which I know is exactly where my risk of injury shoots up!


Anyway, I'd love to hear some advice on rehab and people's favorite exercises as they looked to return to skiing from an ACL injury.  I want to find the silver lining in all this and stop taking the body for granted and return stronger than ever.


Thanks in advance. 

post #2 of 7

Hey, Im recovering from a knee injury myself.


If any PT expert could please list some exercises we can do... that would rock!!!


Insurance did not cover much PT, stuck with pots and pans here :(




post #3 of 7

I'm the original poster from the other 16 months out of surgery and very happy with the results. I'm really sorry to hear about your respective injuries; ACL surgery and recovery is definitely a marathon rather than a sprint. 


I would recommend checking out these resources:


The first is a fantastic guide to the exercises you can do during recovery from injury, and a lot of them also factor into the surgical rehab (though your surgeon's protocol should always be the main guide there - I'm sure that goes without saying). It's written by a senior physiotherapist at the very well-regarded Droitwich Knee Clinic in the UK. The second is a very detailed list from another ACL patient of all the exercises he did as part of his rehab program; it's impressively comprehensive. I found both of these super helpful after I was injured, although I was also lucky enough to have a very good physiotherapist.


Hope you both continue to recover well - best of luck. 



post #4 of 7

I am 61 years old, totally tore my ACL, second degree tear MCL, no meniscus damage on Thanksgiving day, 2010.  Surgery 12-29-10 (hamstring graft) after MCL healed.  Thrilled to say I returned to skiing this past Thanksgiving with no problems:  no swelling, no pain, no brace.  Skied three consecutive days.  I am sooo thrilled, especially given my age.  Get a mean PT, work hard, bike alot.  I am a fastpitch softball umpire and was back on the field in March, despite not running real well at the time.  20 miles per day on the bike all summer.  Speed and running was back to normal by August.  My surgeon was a doc in Tulsa, ok by name of Dr. Fox.

Don't get down, the first six weeks is the worst.  I can't wait to go skiing again!!

post #5 of 7

Sorry about your injury. Sounds like a nasty combination. Did you get a rehab protocol from hospital PT, or you OS? Best to work with their protocol. I did my ACL in January, and surgery in March. I have been diligent with my re-hab, haven't missed a day, but a bit slower than average, I'm 50.


My best tip is don't try to do things too early. Your body will compensate for the weakness caused by your injury and you can end up pelvis and hips being crooked which then have to be re-educated. This has happened with a client of my PT and no skiing for them till everythingis right.  Do work at your extension though. Mine was a bit slow coming back, My surgeon said rather than slump exercises just focus on pushing back when ever you are walking...It can be painful at first. Even now I have one or two degrees of extension to get back and I sometimes get medial pain. He was right , extension is the hard part , not the flex.


Eat well, loads of protein and check out anti-inflammatory diets. Also see a naturopath or nutritionalist for suitable supplements. MSM was suggested to me about 6 weeks ago. So I did my research, including some very happy skiers on this website.

I have started running upstairs to my local there's hundreds of them , literally! Wish I had got onto it much earlier. ( MSM is sulfur which apparent ligaments and tendons need to be healthy)     NOTE...if you can't eat eggs probably can't take MSM)


One other important thing my PT made me do was don't sit with your injured leg out. If you can't keep it at the same level as your good leg move your good leg out so they are both out. I walked differently once I began to do this. Apparently it tricks the mind into thinking both legs are good , which starts to affect how you use your leg. I think it's like the mirror and box illusion used with phantom pain.


kcxd glad all is going well, Have you been skiing yet this season?? I've just booked our trip to Hokkaido Japan. We are going in January.. The resort got a metre of snow on the weekendbiggrin.gif

Bobbymac , great to hear your back on the snow, must be a great feeling .


Sorry for such a long rave but hope somehting is useful





post #6 of 7

I bought a estim device so I could use it while doing my PT exercises to get the quad firing as quickly as possible.  I think it helped in my recovery, and the PT certainly supported me in it.  I was able to buy one off of Craigslist for a reasonable amount.  I still have it and may keep it as I will likely need to get my shoulders done sometime.


For me, the big thing was the bike.  Granted, I'm a cyclist, but the low impact of the bike coupled with both range of motion and getting the quad to fire was really helpful.  I was on the bike 4 days after surgery, although at a pretty limited level and duration.  I skated the line between overwork (resulting in swelling and loss of extension) and recovery. But within 3 weeks of surgery, I was more or less up to a full hour on the bike a day in zone 2.


My ACL surgery was March 10.  I've got 11 days of skiing in this season, including 3 in a row.  I've skied a maximum of 26000 vertical feet.  I am getting a bit of swelling in the knee, but nothing significant.  I'd say I'm at about 90% of normal function.  I do ski with a brace (my orthopedist said it was not required, but recommended).  I attribute my success in returning to skiing to being extremely diligent in my rehab and training.  I had a much reduced cycling season, but rode 2800 miles outdoors (goodness knows what the indoor total was).  And I've been relentless in my strength training as well.  My squats are pretty much back to where I was prior to the injury.



post #7 of 7

I am recovering from a really nasty injury, a displaced tibial plateau fracture which I suffered in March. I also blew out the MCL, displaced the meniscus and did some damage to the ACL although the surgeon decided to leave that alone. I have a plate and 7 screws in my leg and I was on crutches for 10 weeks. It's been a long hard road back to fitness.


I also did a lot of cycling, about 1500 miles. Obviously I had a very slow start and couldn't ride very far to begin with. I've also done daily strength exercises and started to run again. I found running over uneven terrain a very good way of getting my balance back and it helped smooth out my walking action. Running backwards is another good exercise. I also did a lot on a balance plate. I worked on this until I could balance on the plate on one leg for 10 minutes.


I have done 4 days on snow this season. I would say that I was skiing like a strong intermediate. I could carve turns fine on easy terrain but in steeper terrain and in bumps I could feel that my knee just wasn't strong enough and I had to back off, slide out my tails and come down slowly. I'm using a brace (Townsend Rebel Reliever)  which helps a lot with the stability of the knee, I don't think I could manage without it at the moment.


So, yeah. I would have classed myself as an expert last season and now I'm an intermediate. My kids (12 and 10) toasted me on the steeps and my status as "family champion" is probably gone forever. But that was going to happen one day anyway. At least I can ski and enjoy the fun with the family. Plus I can get around the slopes and still be a trainer in our local alpine racing club.


I'll be continuing strength and balance training through the season and I have an appointment with a specialist sports physio tomorrow to work out a plan of action. The PT I have been seeing said I had done great and that he couldn't really help me much more, I need to see someone who really understands elite sporting performance. Another problem is that I get some pain from the plate and screws, I had a discussion with my surgeon about that today and we have agreed that all of the hardware will come out at the end of the skiing season (it has to be in for a year).





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