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Another skiing-after-ACL-surgery timeframe question.

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special-J
Posts: 1572 - Karma: 4,477
Yes, I've searched around, but I can't find any answers for the same situation. Anyways, I completely blew my ACL and shredded part of my meniscus in april. I got reconstructive surgery May 2nd, with a new ACL grafted from my patellar and the stray pieces of meniscus scraped out.

Currently I'm at PT 3 days/week and am recovering well. I'm walking without a limp, without a brace. Range of motion is almost back- my bend still isn't 100% but maybe 80-90%.

My question is, how much will my skiing be affected this winter? Will big jumps (50+) be an issue? In case you don't feel like doing the math, my 6-month standard recovery will be over in early november. However, I don't know if aggressive skiing exactly fits into the "returning to regular activity" category. I definitely plan on getting a small brace for support.

Sorry for the long read; figured I'd be as detailed as possible. Please let me know if you have any info for me. Thanks
Jul 6 2012 10:50PM
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Ryno
Posts: 31125 - Karma: 336
The physical recovery isnt the hard part IMO (hit up your physio, do all the extra shit at home and you will be fine), the mental game is where I found the most difficultly in getting back to 100%. I never rocked a brace because i didn't want to become dependent on it and i can safely saw now, some 6-8 years later, I have 110% confidence in my knee.
Jul 6 2012 11:18PM
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3mania
Posts: 2611 - Karma: 10,328
Your graft takes 9 months to fully attach and grow into your bone plugs completely. So i'd wait til at least the end of January before i started hitting any big jumps. Rehab is crucial though. I've seen people not do enough and pretty much loose a season, and people get way to into it and work their shit too hard and wreck all that work your surgeon just did. Get your quads and hamstrings are equally strong, and don't forget the calf raises.
Ice the hell out of that thing after rehabbing and watch out for tendonitis.
Jul 7 2012 12:58AM
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Ryno
Posts: 31125 - Karma: 336
^ Building up the muscles around the bad joint is crucial in a quicker recovery. good point. They help take the strain off the ligament
Jul 7 2012 7:34AM
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TimRiley
Posts: 1873 - Karma: 1,327

I don't think that hitting jumps falls into the category of "normal activity" as described. From the double tear you have to worry about hyper-extenting your knee, heavy impacts as well as over twisting all of which could cause reinjury. At the very least I would back down the din setting on your injured leg and give it time to fully reattach as stated above. A few extra months isn't much compared to a life time of problems.  

Jul 7 2012 9:36AM
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.Max.
Posts: 2930 - Karma: 701
This thread's kind of depressing. I've been sitting in bed for the past week and a half, had my first PT appointment yesterday. I also got a patellar graft, no meniscus tears though. Hoping I'll be on skis by February next year.
Jul 7 2012 10:38AM
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mklammer
Posts: 388 - Karma: 610
i had surgery 18 days ago. everything is fine now.. 3 PT a week. cant wait to do some work for my leg.. all muscles are gone ^^
Jul 7 2012 10:51AM
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COskier
Posts: 1066 - Karma: 131
Well,, I was back jumping freeway at Breck in about 5-6 months after my acl surgery (no meniscus tear) but I also waited a few months to do surgery and did rehab on both ends. Especially the second half of the post surgery recovery when I went like pro weightlifter for 3 months to get my leg stronger than it had ever been.
Jul 7 2012 2:11PM
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COskier
Posts: 1066 - Karma: 131
Btw, I got a patellar graft from the same knee.
Jul 7 2012 2:13PM
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COskier
Posts: 1066 - Karma: 131
Triple post- Also, I was just normal skiing lightly about 4 months out but it sucked so I only did it like 3 times to film friends and even 9 months out I would still get pain sometimes from breaking scar issue and shit.
Jul 7 2012 2:16PM
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special-J
Posts: 1572 - Karma: 4,477
thanks for the solid replies, that all makes a lot of sense.

ryno, I don't want to become dependent on it, but I can't risk losing another downhill mtb season so I'm gonna do everything I can to protect it.
Jul 7 2012 11:20PM
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Big_Willy
Posts: 2865 - Karma: 6
As much as it sucks I wouldn't hit big jumps next year. I hit medium (30-40ft) jumps mid-season after my acl graft and definitely took it mellow. Do what feels comfortable though, Adrian Peterson blew his ACL and I'm sure he will be putting everything on the line this season (after his inevitable suspension). Rehab as much as you can and listen to your body.
Jul 7 2012 11:46PM
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Forcillo
Posts: 3801 - Karma: 3,580
Do your shit at home for PT and be honest when they ask you questions about pain. They have good judgment and will know when you're ready to ski.
Jul 8 2012 12:29AM
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Lemuel
Posts: 14486 - Karma: 10,608
WHAT when did you tear your ACL?!?!?! Shit Max.


But I would take it easy the first year back, I had my surgery March 4th ('10) and was back to trampolines and normal activity at the end of August, but skiing did aggravate my knee so I didn't go too hard. This past year was fine though, no issues at all.
Jul 8 2012 9:35PM
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Ryno
Posts: 31125 - Karma: 336
Losing a season by taking it easy now could save you many seasons down the road. Any chance you could roadbike for a summer :p it's excellent rehab for the knee!
Jul 9 2012 8:51AM
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J.D.
Posts: 21362 - Karma: 5,142
This is what scares the shit out of me. My prehab has me in ridiculously good shape and I'm wondering how fucked my leg will be once the surgery goes down. Hate the idea of losing all my hard work.
Jul 9 2012 10:59AM
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reBlocke
Posts: 762 - Karma: 1,502
^It's much easier to regain the leg strength you had than to build it in the first place, especially after surgery. So even if your leg muscles are seriously weak after surgery, prehab work still pays off. When I did rehab, it was crazy how fast the muscles of some of the football/hockey players rebounded.

Also, in my experience it is definitely NOT necessary to take a year off from hard skiing. It's really important to continue to do rehab exercises until you're 100% recovered (as apposed to stopping early, when your insurance will probably stopping paying for sessions if you're stateside) would be my best advice.
Jul 9 2012 12:10PM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
This, this, this.
I had surgery April 20th, started biking for at least 1.5 hours a day 6 or 7 days a week about 6 weeks after surgery, and started PT 2X a week around the same time. I've just started running again (I was doing three miles a day before surgery) and I'm about two minutes behind the pace I was holding before. I would bet money every part of my leg except my ACL is stronger than it was before. You get what you give; take this opportunity not to just rebuild muscle when you can't do fun stuff, but develop new muscle and tone what you've got. It's agonizing seeing a trampoline, longboard, mountain bike, or my skis, but I can't stay in too bad of a mood when I know for a fact I'll have greater physical limits when I'm back to 100%.
Jul 9 2012 2:04PM
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Jibberino
Posts: 2089 - Karma: 1,346
You should probably ask your doctor or physio.
Jul 9 2012 3:11PM
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-AP-
Posts: 819 - Karma: 344
Hey random question, but why did so many of you choose the patella graft? I had the Achilles graft from a cadaver in March and all is going really well. I've had like 5 physical therapists lately and they all were amazed how quickly my knee is healing after only seeing patella grafts. The achilles is supposed to heal a lot stronger in the long run too from what I've been told. I'm supposed to be fine to ski all this winter with a brace.
Jul 9 2012 3:20PM
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TheTristanator
Posts: 1015 - Karma: 820
i tore mine about 2 months ago (along with my mcl and meniscus), never got the surgery and i can ski 80%
i havn't hit jumps on it yet, but it feels that when winter comes around i'll be good to go! i do wear a brace doe.
Jul 9 2012 3:35PM
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TheTristanator
Posts: 1015 - Karma: 820
oh and my range of motion is good, it hurts when i try to touch my heel to my butt.
Jul 9 2012 3:36PM
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dan4060
Posts: 1458 - Karma: 847

I blew my ACL during my last Tahoe season.  I got my surgery in late March.  My first year outside of Tahoe was also my first year in grad school, and I was getting used to living out of the mountains.  I only skied about 10 days that year, and I was pretty cautious.  I could have skied more, but I would definitely go slow in the early part of the year.

Now I ski on weekends, and get about 40 days a year.  My second year after surgery I was fine, it just takes a bit mentally to get over the fear.  By my third year I was fine, both physically and mentally.

I still wear a brace, but I don't need it.  I figure I might as well wear one, as it could prevent a hyperextension.

I was  lucky, in a sense, in that my first year out I was in a different place in life, and able to give my knee the time off it deserved.  If I had been going back to Tahoe for another year, it would have been difficult.  As I said before, I would take things VERY slowly.  You don't want to get hurt again, or retard the healing process.  I would scale back on big cliffs or big park jumps.  Give yourself a couple of months of skiing before you get serious.

Jul 9 2012 3:58PM
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Ryno
Posts: 31125 - Karma: 336
You are going to lose leg mass and its going to look odd for a bit but it comes back exceptionally quick IF you had it there before the surgery.

My ACL post-op rehab schedule had my entire leg in an immobilizer for 30 days (aka i was crutches and wheelchair bound)...THAT fucks your legs muscles good and proper lol. It looked like I had a leg transplant from a 5 year old girl hahaha. Once you get the range of motion back in the ligaments (which can be quite a painful procedure depending on how long they are not used for), the muscles are easy to get back and the least of your worries.
Jul 9 2012 4:20PM
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reBlocke
Posts: 762 - Karma: 1,502
Allografts don't get done as often because it a.) requires a suitable donor and b.) carries a higher risk of complications from having someone else's tissue in your body. Most people do patellar because it's an easier procedure (than hamstring) for the surgeon, so older and less specialized surgeons generally prefer it. Also, it is an easier rehab process because the hamstring isn't weakened. However, it does predispose you do developing tendonitis...
Jul 9 2012 4:45PM
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dan4060
Posts: 1458 - Karma: 847

This.

The stronger your leg is going into surgery, the more muscle you will have after it has atrophied.  If your muscles are weak before surgery it will really hurt your progress.

The part about continuing rehab is absolutely crucial.  My insurance paid for about 12 weeks, as I recall, and by that time I was jogging lightly.  Ask your physical therapist for a program you can do in the gym once you stop going to rehab.  It is critical to keep training hard on your own, as that is what will get you strong for the season.  You need to get those leg muscles as strong as possible, that will give you the stability for skiing.  If you stop training when you are done with the PT you are risking another injury.

Jul 9 2012 6:30PM
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HamFaceGirl
Posts: 5242 - Karma: 2,676
All I can say is bike, a lot. Biking is one of the best easy leg exercises and is extremely low impact on the knees.
Jul 9 2012 7:11PM
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Ryno
Posts: 31125 - Karma: 336
any idea on how well the hamstring fairs in the long run? Is it not way to long to replace ACL?
Jul 9 2012 7:22PM
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dan4060
Posts: 1458 - Karma: 847
I chose the patella graft.
Jul 9 2012 7:25PM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
It's low impact but still relatively high torque, which means extremely low risk of reinjury while still building up the ACL's strength.
Jul 9 2012 9:08PM
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NWPA
Posts: 2309 - Karma: 165
Your own tissue has a better chance of healing and fusing back to the bone better, and the patellar is the easiest, local and stronger way to do a graft. Even saying this I might have just torn my ACL graft again :(
Jul 9 2012 9:15PM
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Parks.
Posts: 5612 - Karma: 1,093
I think if you do your homework and actually listen to your physical therapist...you should be fine
Jul 9 2012 9:22PM
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Ryno
Posts: 31125 - Karma: 336
you think you chose it, but your doctor likely made you pick it :P
Jul 9 2012 9:31PM
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dan4060
Posts: 1458 - Karma: 847
That's correct.  I probably should not say I chose it.
Jul 10 2012 12:28AM
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TORVINEN
Posts: 177 - Karma: 61
I severed my acl mcl lcl miniscus on both sides and my hamstring i was told i can ski in jan. You should be good to go with just an acl and little minscus my friend!
Jul 10 2012 12:36AM
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taylornicky
Posts: 2889 - Karma: 2,579
So weird. I completely blew mine and shredded part of my miniscus (I also ruined my cartilage and fractured my femoral condyle). I got surgery May 2 as well. I also used my patellar tendon and cleaned up my miniscus. My range of motion is at the same percent and I go to pt 3/7 days. Along with all of that, I almost just posted a thread asking the same exact question. Strange. Anyways, threads. Hahaha
Jul 10 2012 1:19AM
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reBlocke
Posts: 762 - Karma: 1,502
Some data (e.g. http://www.bjjprocs.boneandjoint.org.uk/content/94-B/SUPP_XXI/93.abstract ) suggests that hamstring grafts do better in the long run, although I bet that other factors (competence of the surgeon, rehab intensity, etc.) probably have a bigger effect than graft choice.

The 'hamstrings' are actually 3 muscles. When they do the hamstring graft, they only harvest part of the tendon of one of the hamstring muscles - the prominent one that you can feel on the inside of the back of the knee if you bend your leg. Since that tendon is huge, that muscle still works (and the two other hamstring muscles are not affected).

I had a hamstring graft. No regrets from me.
Jul 10 2012 12:47PM
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special-J
Posts: 1572 - Karma: 4,477
Thanks for all the good comments- something I'm not used to seeing on NS. I would love to take an easy season this year but unfortunately that isn't really an option. Does a brace only protect against lateral movement/twisting, or does it help with forward/back movement as well?
Jul 11 2012 2:05PM
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special-J
Posts: 1572 - Karma: 4,477
care to emphasize on this?
Jul 11 2012 2:09PM
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GEORGEzimmerman
Posts: 1473 - Karma: 440
had a hammy graff 18 weeks ago. this thread is depressing me just reading it, its a beautiful day and i wanna go skiing. should i go skiing 18 weeks post op? ive already gone a few times so i have a feeling my knee is weak
Dec 15 2012 11:32AM
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.Max.
Posts: 2930 - Karma: 701
I'm 21 weeks in and I'm not going to consider skiing until January. I'd rather wait a little now than a whole other year.
Dec 15 2012 11:44AM
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GEORGEzimmerman
Posts: 1473 - Karma: 440
what the fuck are you doing for fun!!!! its torture
Dec 15 2012 11:46AM
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.Max.
Posts: 2930 - Karma: 701
Hahah I know, it's rough. I'm doing a lot of video stuff. It's as close as I can get to skiing without actually doing it.
Dec 15 2012 12:03PM
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HWW
Posts: 3084 - Karma: 3,436
• you should definitely think about taking it easy
• a brace won't stop you from twisting or moving backwards & forwards, only stabilise the movements
• a brace may do the work for some muscles, leading to these muscles getting weaker by underuse
Dec 15 2012 12:14PM
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deepvoice
Posts: 268 - Karma: 700
my doctors said 6 months you can be back to sport. i tore my acl, mcl, pcl, and meniscus. is started back at about 7 months and ended up tweaking it again. now im at 9 months and im finally back on snow. big part of it is the mental game! DO NOT charge hard the first couple weeks/month or 2. not worth blowing it out again, eh? from all my buddies who have done there knees they dont feel 100% on it till the second season after.
all i can say is get a gym membership and register for mr universe.. cause your gonna need that much time in the gym. need all the commitment you have!

for everyone else, please do some squats or something! i dont want anyone else to have to go through this . knees are shit..
Dec 15 2012 8:03PM
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T-Schill
Posts: 192 - Karma: 738
9 months homie! Ease into her nice n mellow. Don't go ham till 12.
Dec 15 2012 10:19PM
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