Brace after ACL surgery

[Little Lightning]

For those of you who had acl surgery, did you use a brace the first season after surgery.

I had surgery at the end of Feb. When I saw my ortho in August he said I didn't need a brace. However, a comment by an orthopedic in the Rocky Mtn Sports magazine stated that "bracing the 1st year bridges the gap between a normal and near normal knee." So now I'm wondering if I need a brace.

Any thoughts?

 

[Lola]

I had ACL replacement surgery last March, and my surgeon has told me to wear my knee brace ever time I ski this year. He said that the likelihood of re-injuring my knee in the first year is fairly high. Maybe you would be interested in reading our previous discussions on this topic?

How did you injure your ACL?
Lola

 

[Little Lightning]

Hi Lola,

I did read the other threads but since I got different advice I thought I'd see if there were any other opinions.

Since I also tore my MCL the brace they gave me at the clinic was to help stabilize it. It puts my knee in a bent position and even now it doesn't allow me to completely straighten my leg. Plus, it was off the shelf so who knows if its a good fit. So, if I get a brace it will be a new one.

My ortho said my ACL is good and strong and didn't need a brace. I've also biked close to 3,000 miles this summer so my quad is pretty strong. I haven't gotten the VM muscle completely back yet which concerned my dr. but not my therapist.

To help confuse the matter my Dr's office closed and my ortho went to Kaiser which I am not a member of so I cannot go back to him for advice. I called the office where my records were sent and talked to a PA but didn't get advice one way or another, it's left up to me.

My strength is not 100%, I know that from trying to bike 80+ mile days, and I have skied twice and am not back to where I was when I got injured but I also think some of this is proprioception as well as strength. I'm also lacking endurance, which my Dr. said would happen.

So the question is do I work harder on ski conditioning or get a brace?I think my insurance company will pay for the brace so cost isn't an issue.

The pt's I worked with agreed with my Dr. no brace but then my pt pointed out a brace that she thought was good in case I decided to go that route.

When I skied I didn't feel too worried about getting injured again (I've been injured before) but I just wanted to be able to ski harder. I guess as usual I'm expecting to much to soon.

Kathi

 

[Lola]

Well Kathi,

You are way ahead of me. My MCL has healed, but my ACL was destroyed and had to be replaced with a cadaver ligament. So, I'm going to follow my surgeon's advice and wear my DonJoy knee brace when I ski. Also being on the east coast, I haven't had any days out yet this year.

Sorry to hear about your injury, but happy to hear that you are skiing and biking again!

Lola

 

[Little Lightning]

Lola,

Don't laugh, I tore it running into a closed rope at the lift at Copper Mtn. When I hit the rope, I was catapulated backwards, my skis were on the inside edges. When I stopped my right leg was really twisted and I couldn't get off my skis. A ski patrol came up from behind and lifted me up and off the skis. It's lucky I didn't do the left knee too!

My replacement was a cadaver also. I was riding my bike on the trainer 9 days after surgery. At 4 1/2 mos my ortho let me ride outside with platform pedals, I wasn't allowed to use clipless until the first of June. In early June I climbed to the top of Vail pass from Frisco.

I guess this is like when I first started biking, baby steps, I didn't feel really strong on the bike until late July and it took a 400 mile bike tour in Tennessee in Sept. for me to find out that my leg is not 100%.

Also, I keep telling myself that this is still very early in the season. Who knows what I'll feel like in a month or two.

BTW, I just looked out the window, it's snowing! :D

Kathi

 

[volklgirl]

Another ACL survivor speaking up.....

Admittedly my replacement was 10 years ago and they've come a long way since then, but I also skied with a brace the first year. In fact, my leg never really regained complete strength and I still use the brace for really rough conditions and when racing. I think the brace is as necessary for your mental recovery as it is for the physical. It really allowed me to feel confident about my ability to ski after the reconstruction.

 

[Margaritamarcia]

I had surgery in September of 2004 and skiied out West in Feb. of 2005. I wore a custom brace. My orth. said I should wear the brace for one year only, but cautioned me that the brace itself would not prevent an injury or retearing. It would serve mostly as a reminder. I didn't ski much that winter, so I got his permission to wear it again last year. I wore it this past weekend at ESA in Stowe because it was my first trip this year and the snow conditions were very sticky and variable. I think am ready to lose it now and use the old neoprene wrap for awhile more.

I think the most important thing for you now is to respect your fatigue in that area, if there is any, take your ibuprofen (I take 3 in the morning prophylactically), warm up and stretch out before and after. Your PT program shouldn't be packed in the back of the closet either!

 

[Little Lightning]

Thanks for the advice. I decided not to use a brace. I've skied 12 times so far which includes bumps, powder and a weekly lesson at Copper Mtn. I used to take ibuprofen before I skied but this year I'm taking nothing.

I do experience tiredness and have to listen to my body and quit when I'm tired. We skied yesterday, easy blues and blacks, but only skied for about 3 hrs today. Tomorrow we are meeting some friends at Keystone but I know that when I am tired I will quit no matter what the rest of the group will do.

As far as my pt, I'm doing a conditioning class (strengthening and endurance) conducted by one of my physical therapists and I replicate the workout at least once during the week. 3 days a week I do a plyometrics program developed by Cincinnati Sports Medicine for women in sports. The goal of the program is to help women prevent knee injuries. Warmup, stretching and strength training is included.

Last week I got checked out by a pt from the Howard Head clinic and she told me to "keep up the good work". She did tell me that it takes a year to come back and that women seem to be a little slower.

My knee and leg is feeling a lot stronger than it was 6 weeks ago and I experience no pain.

The lack of endurance really frustrated me at first but it's getting so I can ski longer now without getting tired.

Kathi

 

[Margaritamarcia]

ACL and Brace

Hi. You know I posted my reply before I read about all of your physical training and activities. I probably would have posted differently if I had known what I did after reading fully. You GO, Girl. It sounds like you are doing just great and do more conditioning all around than I do. I stand in admiration of your focus! Keep us posted.

 

[Lola]

I wore it this past weekend at ESA in Stowe because it was my first trip this year and the snow conditions were very sticky and variable. I think am ready to lose it now and use the old neoprene wrap for awhile more.

Marcia - it was great skiing with you at Stowe and together in our braces! Hopefully by Stowe time next year, I will be skiing with a wrap instead of a brace as well. ~ Lola

 

[Margaritamarcia]

GREAT to ski with you. You looked good and you made the right choice re: the bumps. They got bigger and softer (and nicer, I might add) as the day went on, but it would have been hard on your knee. Good that you followed your inner voice (and your surgeon's advice) and packed it in when you did. Hope to see you next year in our wraps. We'll be glidin'!

 

[Pequenita]

This is a delayed response because it seems like you've already figured out what works best for you. After my first ACL surgery in 1990, I skied with a bulky, custom-fitted brace. Since I had torn the ACL skiing in the first place, I was extremely tentative. I had partially torn the ligament and did not have it reconstructed.

By 2002 I was skiing aggressively sans brace and doing a good deal of strength and conditioning. Summer 2003 tore the ACL for good and in Nov. had the ACL reconstructed with a hamstring graft. I think the different types of grafts have different strengths; for some reason, I feel as though allografts (from cadavers) are weaker than autografts. I was not instructed to ski with a brace, but it was well over a year between the surgery and my first day back on the slopes, so I had a lot of time to rehab.