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How to get back to skiing for a non-expert after ACL surgery? - Page 2

post #31 of 41
Long story short did everything with and L and M in my right knee 18 months ago and have not been skiing since!

Am coming to the States (fly to Dallas) in late Feb (25th Wedding anniversary) and hope to get in a weeks skiing in between antebellum home viewing and shopping!

The exchange rate for us is a killer and am thinking of returning to Whistler (skied there on honeymoon and a solo 3 years ago) but was also looking at Steamboat.

I was an intermediate and my wife is a lot happier on groomed green blues. I think my confidence will be shot, any recommendations for resorts with a good three day instruction program and the right slopes for us?
post #32 of 41
Thread Starter 
Just got back from two weeks in Utah. Mostly skied Alta while I was there.

Wanted to thank everybody who encouraged me by sharing their experience or knowledge.

Got my confidence back and also improved my skiing. Skied without a brace for the first couple of days, and then bought a simple brace. Generally the knee felt good.
post #33 of 41
Quote:
Originally Posted by lerops View Post
Just got back from two weeks in Utah. Mostly skied Alta while I was there.

Wanted to thank everybody who encouraged me by sharing their experience or knowledge.

Got my confidence back and also improved my skiing. Skied without a brace for the first couple of days, and then bought a simple brace. Generally the knee felt good.
Great news, mate. Well done! I know from experience how important those first turns are ... keep it going!
post #34 of 41
Quote:
Originally Posted by Bob Peters View Post

Hi, lerops.

There's lots of good information here. I'm really just chiming in to perhaps give you a good feeling about the end result.

It's really hard to believe, but this coming spring will mark the 20th anniversary of my acl reconstruction. I severed mine completely while skiing and had the patellar tendon graft way back in the spring of 1989. I was 40 years old at the time.

I had the surgery the first week of May and my first time back on skis was mid-December. I had rehabbed very conscientiously and everything about the knee "felt" just fine, but I know that I didn't really "trust" that knee for several months after I got back on the snow. That first winter back on skis, I took it VERY easy. I had a custom knee brace and I skied mostly on groomers for the first few months.

I will never forget something my surgeon told me about the rehab process. He said that while the graft may be solid and your strength and range of motion may approach their pre-op levels, the tissue, bone, and ligaments involved in a knee reconstruction actually take as long as 18-24 months to FULLY heal.

For me, it was an interesting sensation. I believed - and the Cybex machine confirmed - that I had recovered essentially all of the strength in the operated-on leg by 8 months after surgery. I felt like the knee was good and I was skiing well. Nevertheless, by the SECOND winter post-op, that knee felt even better than it had in the first winter. I think that healing process does go on for quite some time even though you don't feel it over the short term.

In any case, I skied quite a bit that first winter but used a brace the whole time. I used the brace purely because I didn't want to re-hyperextend the knee and it worked for me (although I really hated the brace).

The best news is that my operation was nearly 20 years ago. That knee has felt just fine ever since and doesn't interfere with ANY physical activity I do. The results can be really outstanding.

If I were you, I'd ski relatively easy this year and listen to what your knee and leg are telling you. I think your idea of taking some lessons is a very good one because that may help you become more efficient and better balanced on your skis. Approach this winter as an opportunity to learn some good foundational skills at the same time you're bringing that knee back up to full working order. Then, by NEXT winter, your skills will be improved and your knee will be as good as new.

Good luck with the process.


Sounds great. Have you had an OA since your ACL reco ? Have you had any meniscus damage ? I have a couple of meniscus tears and that actually worries me much more than the knee reco. It is great to read your experience and give me a bit of hope that I am not set to get bad OA at very early age . I am 43 and this is my first major injury. I am very active and ski 2 weeks per year. I hope this injury won't stop my life style. Did you do anything special that you think might have help you in the long run ?

post #35 of 41
Quote:
Originally Posted by fabienzan View Post
 


Sounds great. Have you had an OA since your ACL reco ? Have you had any meniscus damage ? I have a couple of meniscus tears and that actually worries me much more than the knee reco. It is great to read your experience and give me a bit of hope that I am not set to get bad OA at very early age . I am 43 and this is my first major injury. I am very active and ski 2 weeks per year. I hope this injury won't stop my life style. Did you do anything special that you think might have help you in the long run ?


Hi, fabienzan.

 

This is kind of a resurrected thread and it's entertaining for me to think back to my mindset when I wrote that post almost six years ago.  The "next chapter" of my knee(s) is being written right now, as I'm approaching my 6-month anniversary of total replacements of both of my knees.

 

While the osteoarthritis didn't have anything to do with the original tear of my left ACL, it did eventually catch up to me in that knee and the other knee.  I had the replacements at the end of this past May because essentially all of the articular cartilage on the lateral side of both knees had disappeared.

 

That's the bad news.

 

The good news is that for over 20 years after my ACL replacement, I skied hard, often, and pain-free.  I was extremely active with all kinds of outdoor sports and never felt that the ACL injury inhibited anything about my lifestyle once the graft had fully healed.  The only thing "special" that I might have done during that time was take glucosamine/chondroitin religiously for almost 20 years.  I know that study results are extremely mixed about the efficacy of that stuff, but I'll always believe that it worked - to some extent anyway - for me.

 

The more important thing that I did was not LET the injury affect my lifestyle.  I work very hard at conditioning with a great deal of bike riding (indoor and outdoor).  I don't know how to explain it other than it being a philosophical choice.  Outdoor activity is critically important in my life and I'm lucky enough to be able to devote the time and effort to rehab and conditioning.

 

Injuries, pain, and healing are different for everyone.  I'm very lucky to have been able to heal fully and go back to my previous activities.  I know that other people are often not that lucky - for no obvious or logical reason.

 

I did have significant meniscus damage at the same time as my ACL injury.  It was "repaired" in the normal way back then, which means the surgeon removed the torn and frayed edges.  That may have contributed to my arthritis in THAT knee but would certainly not have had anything to do with the arthritis that developed at roughly the same time in the OTHER knee.

 

I think the key is to have a surgeon you have utmost confidence in and then rehab like crazy until you're strong and pain-free.  Then live your life like you want to and IF the arthritis develops over time, just deal with it when you have to.  While the first two months post-knee-replacement-surgery were certainly no fun, my new knees feel great and I can't wait for ski season to start.  Matter of fact, I'm going backcountry skiing tomorrow.

 

Good luck with everything.

post #36 of 41


Good to hear that the you managed to get 20 years out of the ACL reconstruction. What was the cartilage damage at the time of reconstruction ?

I have 2 small tears on the lateral side and 1 larger tear on the periphery of the medial meniscus (1.2 cm). All 3 tear were left in situ by my surgeon who meant to be one of the best sports surgeon here in Australia.

I am very active too and I am really scared of getting OA, How did OA affect your life and how long after your ACL operation did it start affecting you ?

 

How is life after knee replacement , do your knee feel any different to your normal knee , are you limited in activities that you can do ? Also I understand they only last 10 years which would be a pain.

post #37 of 41


One more thing. Did you downhill ski all that years or only backcountry ski ? I am a downhill skier happy to cruise the blue runs.

post #38 of 41
Quote:
Originally Posted by fabienzan View Post
 


Good to hear that the you managed to get 20 years out of the ACL reconstruction. What was the cartilage damage at the time of reconstruction ?

I have 2 small tears on the lateral side and 1 larger tear on the periphery of the medial meniscus (1.2 cm). All 3 tear were left in situ by my surgeon who meant to be one of the best sports surgeon here in Australia.

I am very active too and I am really scared of getting OA, How did OA affect your life and how long after your ACL operation did it start affecting you ?

 

How is life after knee replacement , do your knee feel any different to your normal knee , are you limited in activities that you can do ? Also I understand they only last 10 years which would be a pain.

 

I don't think there was any initial articular cartilage damage.  The meniscal cartilage damage was a fairly significant fold/tear that I've heard referred to as a "bucket-handle", where a portion of the meniscus folded under itself.  That is the portion of the meniscus that was trimmed away.  Subsequently, It was not the meniscal cartilage that eventually destroyed my knees, it was the articular cartilage (the stuff covering the bone ends).  That just gradually flattened and disappeared.  I don't think OA really started to affect me until perhaps the last two or three ski seasons.  It got progressively worse until last season was very painful and I decided that I wouldn't go into another ski season without new knees.

 

Life after replacement seems to be NEARLY the same.  I still have some residual pain in and around the knees but it's diminishing with each passing week and it's nothing like I was experiencing in the last weeks of the past ski season.  I've been hiking, biking, exercising, etc with very little pain now.  My range of motion is past straight on extension and around 140 degrees on flexion, which is well beyond an acceptable and functional result.  I've skied (on old, uneven snow, and did fine.  I'll find out in a couple of weeks how I do with lift-served skiing.

 

My doc told me that the artificial knee model I have should last 15-25 years, not necessarily dependent on use or abuse.

Quote:
Originally Posted by fabienzan View Post
 


One more thing. Did you downhill ski all that years or only backcountry ski ? I am a downhill skier happy to cruise the blue runs.

 

The last several years, I've averaged about 130 days of skiing a year.  Of those, about 30 would be "pure" backcountry.  I ski a lot and in a lot of terrain and conditions.

post #39 of 41

interesting as a bucket handle tear is normally something they try to fix . Do you know how much they trimmed of it at time of the knee reco ? Was that only on the lateral side ? Any meniscus damage on the medial side of your knee ? The lateral side is normally the one that degenerate quicker it looks like you have done extremely well.  Are you someone heavy or light ?(that comes into consideration with joins ) . Did you get more knee operations over the years ? How old are you now ? I have to say this is my first big injury at 43 and I am a bit freaked out. I am imagining being disable and not active anymore. I am maybe over thinking it. I don't think you answered my questions about doing some downhill skiing. Do you do much of this type of skiing ?

post #40 of 41
Quote:
Originally Posted by fabienzan View Post
 

interesting as a bucket handle tear is normally something they try to fix . Do you know how much they trimmed of it at time of the knee reco ? Was that only on the lateral side ? Any meniscus damage on the medial side of your knee ? The lateral side is normally the one that degenerate quicker it looks like you have done extremely well.  Are you someone heavy or light ?(that comes into consideration with joins ) . Did you get more knee operations over the years ? How old are you now ? I have to say this is my first big injury at 43 and I am a bit freaked out. I am imagining being disable and not active anymore. I am maybe over thinking it. I don't think you answered my questions about doing some downhill skiing. Do you do much of this type of skiing ?


I think you are overthinking it.  Unless you're a world-class pro athlete, these things happen and they don't have to result in long-term limitations of what you do.  I personally know probably 50 or a hundred outstanding skiers here at Jackson Hole who have had one or both acl's reconstructed and come back and skied hard and very well for decades afterwards.  Some have developed further problems (like me) and have dealt with them when they arose (like me).

 

Knee ops:  

1990 left knee patellar graft ACL reconstruction and partial menisectomy

1996 right knee micro fracture to repair holes in the articular cartilage on the femoral head

1999 left knee arthroscopic clean-out of floating debris

2014 bilateral total knee replacements

 

I'm 65, 6' 1", 190#.

 

Here's what I said above about the skiing I do: "The last several years, I've averaged about 130 days of skiing a year.  Of those, about 30 would be "pure" backcountry.  I ski a lot and in a lot of terrain and conditions."

 

The days when I'm not backcountry skiing I spend skiing the tram and all the other lifts at the Jackson Hole Mountain Resort.

 

It's understandable to be anxious about how well you'll recover from an injury and surgery like you had.  The fact is, though, that the vast majority of people who get acl's replaced eventually (like by the second year) reach a point where they don't even think about the repaired knee.  


Edited by Bob Peters - 11/13/14 at 2:42pm
post #41 of 41

You are overthinking it.  I blew my right ACL 2 years ago at age 45.  I downhill and back country.  75% is downhill - resort type terrain (pow when we have it, grooms when we don't).  I hit the slopes on groomer 8 months after surgery.  Last year I had about 50 days on the slopes and 10 or so cat ski days.  No issues - aggressive as ever (maybe trying to stay a bit more on the ground vs in the air :) ) but all is good.

 

Hit your PT hard and consistently - you will be fine!!

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