ACL Recovery Update

[overthehilldiva]

It's been a while since I've been on the forum. We changed servers at work and I lost the link. Update on my ACL recovery. I'm doing pretty well. Knee feels "almost normal." I joined a health club around the first of October and I'm trying to get there 3 times a week. Before that I was doing the leg exercises with ankle weights almost every day. At the gym I've been riding the exercise bike and using the elliptical and then doing a circuit on the Nautilus. My only problem is that something I'm doing is making the chondromalacia kick up or at least that's what I think it is. I've lowered the weights on the leg machines. Should I cut them out altogether and go back to just using ankle weights at home?
The last time I saw the doctor (in July I think) he said I could start skiing with the huge brace in January. I need to use it this year only. I have to admit I'm a little nervous about skiing with it. Has anyone used just a patella strap when they exercise?

 

[TUSSC]

I tore my ACl a while ago, and chondromalacia is just something you have to expect. Part of what I used to (and still) do is manually move the knee cap around, pushing and pulling it to all sides while my leg was outstretched, as a 'stretching' type exercise, and to loosen the scar tissue around my kneecap. Also, my PT had me really work on strengthening my quads and hamstrings to help overcome the chondromalacia, so I did spend a lot of time weight lifting and doing isometric exercsises.

Interesting that your doc suggested you ski with a brace. My doc recommended just the opposite - not to ski with a brace. His theory was that a brace gives you a false sense of security.

Good luck with your recovery!

 

[overthehilldiva]

Just 3 months with the brace. It cost me enough ($950) and the only time I wore it after the surgery was the first few weeks after I went back to work and for a couple of weeks after I started driving (because it was before I was supposed to). I've had the chondromalacia for years and years. I'll try moving the kneecap and see if it helps. It bothers me the most going up and down the stairs especially if they are steep and getting up from a chair if I've been sitting for a long time. I worked really hard at PT on the hamstrings and the quads. I do wonder if IT band issues are involved too. At my age (mid 60s) and having skiied since my late teens, early 20s, played lots of tennis, etc. I think it's just worn out parts!

 

[MaineSkiLady]

I have chondromalacia in one knee and last season saw a physical therapist for it. Taping was recommended, pulling the kneecap to the inside of the leg (not moving it around!!). Took me quite awhile to get this right. Serious VMO strengthening is also a part of the equation.

I do resort at times to wearing a Cho-pat brace (website is same name), which is just a basic under-knee stabilizer and helps me. DH has same issues.

As to the post-ACL surgery brace, not sure why you've been rx'd such a big, heavy one - just your doc's preference, I guess? I only have experience with my son's - he was prescribed DonJoy carbon fiber braces, which basically only prevent hyperextension, and he used each one for about a year when on the snow post-surgery (started back after 6 months w/each surgery). Was told to "wean off" afterwards. He still uses them occasionally when fatigued. They are very light, very inconspicuous, barely even look like knee braces. Good examples also on the DonJoy website, but these are stock, not custom (his were made to his quad/calf/knee circumference measurements).
https://www.donjoy.com/index.asp/fuseaction/products.list/cat/1

 

[overthehilldiva]

Mine looks sort of similar. I wore it after surgery with a jersey/spandex sleeve underneath. I think the doc was just being cautious when he said Jan. That will be 9 months. That's the time he told me it would take for the cadaver graft to fully vascularize. I think that his year I'll just be overly cautious about conditions and will start out on blues - no icy blacks. Too bad, there's a double black for the first time at Loon this year. Surgery was on the right knee. My left knee was always the one that bothered me the most with the chondromalacia. For the first time since 1983 I didn't buy a season pass. Now that they are part of Boyne, a full season pass is almost $1000 and I wasn't sure I'd get my money's worth. It will be weird buying a ticket.

 

[MaineSkiLady]

Loon's your regular destination? Let's keep in touch! Bunch of divas are planning a Loon Day sometime towards the end of the season, since those of us with Boyne pass have Loon in the equation for the first time. I've never skied there and would love to get a group together. There are already at least 5 of us in. As I said, would be late in the season. Game?

As to the cautious, remember that it's as much of a head trip as it is physical. You've no doubt had all the measurements taken for muscular output, etc.? Didn't realize that cadaver grafts required apparently that much more time to vascularize than auto grafts. Plenty of season left after January, with the best of it WAY yet to come! :D (I am a big late season fan!) This is your season to just cruise and get your confidence back. The graft is much stronger than you realize -- at least that's what my son was told, but he had a head trip to fight with as well. Just the thought of having to go through it again...... and can you imagine, he did his back to back, within 10 months, right then left. What an ordeal.....

 

[MaineSkiLady]

Now that they are part of Boyne, a full season pass is almost $1000 and I wasn't sure I'd get my money's worth. It will be weird buying a ticket.

I'm confused. Mine was $549 if purchased before last April 20, 599 until Oct 13. ?? It's the New England Pass, includes Loon, Sugarloaf, Sunday River.

 

[altagirl]

There are ENDLESS debates on whether knee braces are good are bad for people with reconstructed knees. My first surgeon was very against them - the whole "false sense of security" thing. And my current one is in favor of them - he quoted some studies showing that people who wear braces skiing post op have an ever so slight reduction in re-tearing their ACL's. Other docs will say - well, it's only a slight improvement, so it's not worth the money. And the whole issue of it being a psychological crutch seems to me that it varies a lot person to person. Some people have a hard time realizing they are back to health and are overly timid, and others can't wait for their injuries to heal before they're back at it. I definitely do not get the impression that you're going to go right out and hit the terrain park on your first day because your knee brace makes you feel invincible!

There are also debates about that if you wear a brace all the time, it can inhibit muscle development in the stabilizing muscles around your knee. Of course - hopefully skiing with a knee brace is not the only exercise you get!

Anyway - the biggest step is mental. Just plan to be patient - go out and start on the bunny slope and gradually step it up as things feel good. It'll come back!

 

[overthehilldiva]

The weird thing is that I've broken both ankles before skiing (20 years apart) and that I couldn't wait to get back on the slopes. I think this time that my real fear is just what MSL said - tearing the other one. The repaired knee is really feeling pretty good although today I wore boots with fairly high heels and it felt a little sore. I probably should just schedule another appointment with the doctor.
In terms of the 9 months to revascularize, he might have just been being cautious and maybe it's my age compared with the typical 20 year old that has this injury although the doctor complimented me every time I went in on how exceptionally well I was doing. I took my PT very seriously because at my age I think I knew that if I didn't I wouldn't get a good result. The little twinges I feel in my knee I think have to do with the incision areas. I was never told that I had any damage to the MCL but when I have any little twinges of pain, it's seems to be in that area rather than through the middle of the knee where the ACL is. Range of motion is great. Still doesn't feel good if I get down on the floor and lean on it unless I'm on a really cushioned surface.
Now, re Loon. I have a big house (condo that's not attached to anything) up there. I have 5 bedrooms, 4 baths and I'd love to meet some of you even if I'm only skiing the greens and blues this season. It's across the street from the mountain and there's free bus service. Late February or March would be great. I probably won't want to ski when it get TOO soft.

 

[overthehilldiva]

About the pass, that price is for a full pass good for every day in the season. Since I work M-F, I didn't want one of the passes that wasn't good on holidays, etc. It didn't seem to make sense to buy one until I was sure I was going to be able to use it.
If you do plan a Loon Day that's midweek, I can probably just take the time off. In any case, I have plenty of room.

 

[MaineSkiLady]

Wow and WHOA! That is SOME HOUSE! What a lovely offer!!
One heads-up, though: late Feb-early March (first week) is the Diva Summit in CO, so several among this intended group will be off doing that. How does the snow generally hold up @ Loon? We'd have to give these traveling divas a little breather to recover from that sojourn! And I'd be happy to green/blue-cruise w/you!!

Let's get a "Meet on the the Hill" thread going sometime in Feb and see how this materializes!! Could be really fun!

As to the MCL twinging, I'm guessing it could well be "referred" - meaning it's not the exact area, just where it's talking back. Very common. Also the kneeling being uncomfortable - that's even more common. My son still has issues w/it and has difficulties renewing CPR annually (uses a VERY thick kneeling pad and can't kneel for long) - Red Cross instructors are understanding. Just a tender area!

Good luck, and let's try to set this up in March!!! (also have to factor in the possibility of rough travel weather for those of us coming any distance)

 

[altagirl]

As to the MCL twinging, I'm guessing it could well be "referred" - meaning it's not the exact area, just where it's talking back. Very common. Also the kneeling being uncomfortable - that's even more common. My son still has issues w/it and has difficulties renewing CPR annually (uses a VERY thick kneeling pad and can't kneel for long) - Red Cross instructors are understanding. Just a tender area!

Yeah - I'm not too sure on the MCL, but when my knees get tired or overworked, I tend to get twinges in places that don't really have anything to do with the actual injured area, which would be "referred" pain. So if you have more steady pain or instability, I'd worry about the MCL, but if it's just occasional, it could very well be nothing. Not that it isn't a good idea to talk to your doctor about it. But I wouldn't worry too much.

And kneeling is an issue for many, if not most people with reconstructed knees. Some people are never comfortable kneeling again. Personally - I can kneel, but it takes some careful placement and weight shifting to find a comfortable spot.

 

[MaineSkiLady]

Speaking from actual (if ancient) experience: MCL injury pain is dull, throbbing ache - no twinges, pretty constant. I'm sure you've been tweaked to beat the band for every ligament's stability. Easy enough to ask, but this definitely sounds referred to me. I injured both LCL's last Feb. Man. That felt like I had nothing left between femur & tibia Ow. Took physical therapist about 8 seconds (if not less) to diagnose it and the level of injury.

 

[overthehilldiva]

Interesting about the referred pain. Years ago I hyperextended the knee when someone I was skiing with thought it would be funny to ski up behind me and through my legs (idiot). It twisted my leg around and I remember swearing all the way down the hill. Never went to the doctor, just stuck a brace on it and kept going. That's what I thought I did again when I tore the ACL until I went to take the ski off and found myself sitting on the ground outside of Camp 3 (about 1/3 of the way up the mountain at Loon at the base of North Peak).
I think I'm just nervous and you're right - all I need to do is get on the hill and take a few turns and feel that exhilaration that you feel at the beginning of every season when the muscle memory just takes over and you realize how happy you are to be out skiing again.

 

[TUSSC]

It bothers me the most going up and down the stairs especially if they are steep and getting up from a chair if I've been sitting for a long time. I worked really hard at PT on the hamstrings and the quads.

Stairs were always tough, even after I finished all my PT. One day my trainer at the gym (who was also a pro beach volleyball player), suggested that I try working on the Stairmaster to strengthen my knees. The Stairmaster was always one machine I avoided. I started out really s-l-o-w, doing 2 minutes the first day (which was painful!), and slowly working my way up, minute by minute, to where I can now do 30 minutes comfortably. If you ask me, it was a great suggestion. The worst part for me was the patience that was needed to build up my endurance minute by minute!

 

[Daria]

I was skiing 6 months almost to the day after my surgery at ~ 50 years old and no brace. My "new" knee was sore off and on for the season. It has now been 4 years and doing really well.

Last year when we had the huge storm just after New Years in California, my DH and I ended up skiing with a 60 year old man who had replacement surgery the prior spring. We were in thigh deep powder and he was amazing. So don't let this hold you back. Just go out there and have fun!

 

[Mt Mama]

I haven't posted for a long time either. Glad to hear you're doing well OTH Diva. I think I am as well. My ACL surgery was in April. My doc and PT have given me the ok to ski. They suggested the brace this first year but not after that. My knee almost feels normal too. I think it was worth the work. Now we just need it to warm up a little in the Northwest and snow more. I have my pass and my skis are tuned. I did more biking this summer than before. It was the best fresh air exercise since walking didn't feel that great. My doctor said that was the best thing I could do for the knee so that worked out. I have been doing circuit workouts about 3 times a week and hope I'm close to ready.

 

[overthehilldiva]

I posted in a couple of other threads. I hadn't visited in a while. Next week's the week. I've been trying to get some time off to go during the week. I don't want to deal with weekend crowds first time out. Going Friday with a friend I've never skiied with that usually skis in Maine I'll ski for a few hours and see how it feels afterwards. Really looking forward to getting past just thinking about it. I really need new boots but not in the budget this year.

 

[Slidergirl]

It's hard to get out there the first time, post-op and post-PT. Just go slow. Take the easy green just to get your skiing legs back under you and to see just how your knee functions. Then, go find your favorite lazy day cruiser and go for it! All you want to do the first day is to just re-acquaint your knee with skiing. You'll do just fine.

 

[overthehilldiva]

Day 1 on the slopes! I did very well. I started out skiing a short blue under the lift a few times then skied some longer greens and blues all over the mountain. Conditions were perfect and I skied for about 2 1/2 to 3 hours with one short break. Did one long long blue then all the way across the mountain before a hot choc. break then finished up with the same short blues I started on then across the mountain again. Knee felt good - brace wasn't any problem and I stopped before I got too tired. Good first day. Very lucky to have had absolutely fabulous conditions and NO lift lines! I'll have to start doing these weekday trips more often.
All in all I feel great about the day - the knee feels fine. I have some frozen veggies on it now just as insurance. I wasn't too tentative, maybe just a tiny bit on some of the steeper parts of the long blues. I didn't ski too slowly and the turns felt fine. In fact, I think it made me concentrate on having good form.
Left the skis to be tuned and will be looking forward to the next ski day!
OTHD