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No ACL, no surgery, no problem - My new normal as a Coper

marzNC

Angel Diva
Managed to get on the slopes 50 days during my fourth season as a successful coper without an ACL (right knee). Just under half the days were out west, with the rest in the Mid-Atlantic. I didn’t go exploring in the northeast as expected because of the lack of decent conditions all winter. In general, when conditions are good at a big mountain out west, I ski more off-piste than before. Perhaps over 60% at Alta--I know Alta pretty well now--after I get adjusted to high altitude. I can feel a slight difference in a few muscles just below the ACL-deficient knee but there isn’t any impact on how and where I ski. If I ski hard, the muscles below the knee on both legs appreciate the hot tub and a little self-massage afterwards. Off-season conditioning has paid off. Better technique means that even when I’m skiing steeper terrain my quads never hurt.

Continuing to take lessons at Massanutten and during trips out west. In addition to doing several Massanutten Silver Clinics (2 hours Thu or Sun afternoons, $40) with Walter, I also joined a multi-week program that he ran on Sun mornings called the Gold Clinic. The Gold Clinic was for Levels 6-9 (of 9), included about a dozen participants, mostly Level 7/8. Walter's focus was on fundamentals. Had two lessons with ski buddy Bill at Alta (late Jan, early April) with Arthur Haskell. Arthur is the PSIA Level 3 instructor from NC who I started working with in 2014 (on the injured list last year). Most of the time with Arthur was spent off-piste this season.

Skied more than expected at Massanutten because of the big storm in Jan, as well as the Gold Clinic. Ironically, the Gold Clinic and other special group lessons were cancelled the weekend of Storm Jonas because the roads in northern VA and DC were pretty bad. I was in a condo that was a 5-min walk from the ski lodge, which is relatively unusual for Massanutten. The minivan stayed parked for a couple days once the snowstorm started. Another Diva joined me and we had a good time being snowed in. Got another powder day with 3-6 inches at Massanutten on Pres. Day. Was fun watching my friend and her kids skiing in the trees at the edge of the trails. Took her 9yo son to BK for his first experience skiing somewhere other than Massanutten (third season, 6-8 days each). He had no problems with the big bumps on Extrovert, which were soft and not icy when the trail opened that Sat afternoon. Like my daughter (starting age 4 in 2004), he’s learned to ski pretty well with the help of Massanutten ski instructors.

MID-ATLANTIC JAN-MAR 2016

* Massanutten Jan. 4-10, including Demo Day and first Gold Clinic session
* Whitetail, Jan. 8 for Demo Day
* Massanutten Jan. 15-19 MLK long weekend, with friends and their kids
* Massanutten Jan. 21-24, for Storm Jonas (27” by Sat morning)
* Massanutten Feb. 12-15 Pres Day long weekend, with a friend and her kids
* Blue Knob Feb. 19-21, DCSki/EpicSki Gathering, with my friend’s son
* Massanutten Feb. 27-28, for Gold Clinic
* Massanutten March 5-6, for Gold Clinic

Four Silver Clinics (2-hr) in Jan with Walter, mostly solo. Five (of 8) Gold Clinic sessions.

Massanutten trip posts 2016
https://www.theskidiva.com/forums/index.php?threads/massanutten-2015-16.20247

1/23/16 Massanutten with 27 inches in 20 hours
Mnut 23Jan2016 - 1.jpg

Tree skiing at Massanutten
Mnut 23Jan2016 - 3.jpg

Took an hour to dig out the minivan. Not too bad since the snow was fluffy and light.
Mnut 23Jan2016 - 4.jpg

Pres. Day powder morning, turned to freezing rain after lunch but driving south was okay
Mnut Pres Day wknd 2016  - 6.jpg
 

marzNC

Angel Diva
My mid-season trip was a ski safari with friends, including a few Divas. We started in SLC and made good use of the Mountain Collective Pass. We were lucky to catch a 14” powder storm at Alta. First time I had a lesson in powder since the Diva Week NASTC clinic in north Tahoe in 2010. Finished the lesson (semi-private 2.5 hr with Bill) with a sidestep up to High Notch, which is a little longer than going up to Catherine’s. Did okay on the ski down, but was pretty tired by the time we got to the bottom. That experience was one reason I decided to pass on the Highlands Bowl. Decided to wait until I could really enjoy skiing down the long, steep bowl. Have reached the point that I really enjoy the challenge of steeps in soft snow that aren’t too long, for instance terrain off the end of the Saddle Traverse at Alta (Christmas Tree, Stone Crusher, Lone Pine). Did a couple double-black adventure runs at Snowmass (Hanging Valley, Powderhorn). Powderhorn turned out to be pretty long for a late afternoon run, but it wasn’t that steep. JC and I enjoyed the soft bumps. He’s taken a few lessons in recent years after we started doing trips together in 2010 and it definitely shows when he skis bumps. It’s nice to not have to worry too much when skiing a new advanced/expert area for the first time. Very nice to have ski buddies who like exploring too.

Managed to catch a powder storm at the beginning of my late season stay at Alta Lodge. But couldn’t really take full advantage because I didn’t have time to adjust to the altitude before temps warmed up to spring skiing conditions. When sleeping at 8000 ft, it takes me 2-3 days, mostly because it’s hard to get a good night’s sleep. Doing more cardio during the off-season helped. When it was spring skiing conditions, I went off-piste whenever it warmed up enough to make it fun. Luckily that happened some where on the mountain almost every day. Kept working on what I learned from Arthur about skiing steeper terrain.

ROCKIES 2016

Late Jan into early Feb
* 2 days at Sun Valley
* 3 days at Alta - lesson with Arthur
* 4 days at Aspen

Late March to mid-April
* 13 days at Alta - lesson with Arthur on Day 5
* 1 day at Snowbird

Sun Valley Trip Report
https://www.theskidiva.com/forums/index.php?threads/sun-valley-jan-27-28-2016.20416/

Alta 01/30/2016 with 14 inches of fresh powder, skiing Black Pearls
Alta 30Jan2016 - 5.jpg

Aspen Buttermilk, a Tiehack black a few days after a powder storm
Aspen Buttermilk Tiehack 03Feb2016  - 1.jpg

Snowmass hike to Long Shot, takes about 10 min and well worth it
Snowmass Long Shot Feb 2016 - 1.jpg

Alta 04/01/2016 on Lone Pine with rented Nordica Nemesis, storm the day before
Alta 01Apr2016  - 3.jpg

Alta 04/09/2016 near the top of Sunspot off the High T
Alta Sunspot 09Apr2016 - 1.jpg
 

marzNC

Angel Diva
It’s fair to say that when I demo skis, the fact that I’m a coper makes no difference at all. The demo day in Jan 2013 on the short slopes at Massanutten after I rehabbed the knee July-Dec 2012 was actually the first time I skied at normal speed. That was about 7 months after injury.

The Mid-Atlantic Demo Days I did were in early Jan. Given the warm Dec, that meant very limited terrain. I was checking out skis for fun since I bought the Head Absolut Joy over the summer. Always learn something unexpected at a free Demo Day.

At the Alta Demo Day in early April, the groomers were pretty firm in the morning. In general, I skied faster than usual during the late season trip in the mornings because the slopes were pretty firm and empty when temps were warm the day before. It’s a pretty good indication that I’m not worrying about knees and have more confidence at higher speed. It can be fun to make really wide GS turns on an empty groomer. Going non-stop on the blue groomers from the top of Collins fast enough to pop my ears at the base (~2000’ vertical) is a relatively new experience. The first time I remember going that fast for that long was in 2011 near the bottom of Strawberry at Snowbasin.

DEMO DAY REPORTS
https://www.theskidiva.com/forums/i...jan-2016-demo-days-in-the-mid-atlantic.20602/
https://www.theskidiva.com/forums/index.php?threads/alta-demo-day-april-9-2016.20767/
 

marzNC

Angel Diva
For assorted reasons, I didn't do as much ski conditioning during the off season compared to the last few years. However, it hasn't made that much difference given my improved technique. But I can tell that my lower leg muscles on the ACL-less side are not in top shape. Just a bit different from the other leg. A hot bath or dip in a hot tub after a ski day really feels good. Opted to use leg warmers after skiing at Taos, which I did the first couple seasons after the knee injury and rehab.

Before my mid-season trip out west, only skied for a few days. One day at Sunday River the weekend after Thanksgiving and a couple days at Massanutten (northern VA). The day at SR turned out to be soft bumps because it was too warm the day & night before to groom. It was good that I've worked on bump skiing the last couple seasons. Normally I wouldn't have pushed that hard but it was a Demo Day and I wanted to check out skis. So included a couple runs down the trail with bigger bumps with the Nordica Belle 88 @ 154cm, which were pretty fun. Also liked the Rossi Temptation 84 @ 154cm. Was not that happy with the Atomic Vantage 85 or the Blizzard Quattro 8.4 Ti, mid 150s length. Surprised me since I like the Atomic Vantage 90.

The demo skis that I really liked were Stöckli Stormrider 85 @159cm, 128-85-110, R13.5m. Did a couple short runs at Whitetail in PA, then checked them out more carefully at Taos. Decided to buy the demo pair without the demo bindings. Put new Look bindings on because I intend to keep the Stormriders for a long time.

In some ways I was taking it a little easy at Taos. But still did several "adventure runs" down fairly long black bump runs, including Main Street off Kachina. The pay off for lessons and practice is being able to explore new terrain with ski buddies without much worry.

Trip report for Taos Ski Valley, early Feb 2017
https://www.theskidiva.com/forums/i...rst-impressions-of-taos-early-feb-2017.21565/
 

marzNC

Angel Diva
With all the traveling I was doing this spring, forgot to note the other ski trips during late season. I treated my teen daughter to a week in Utah during her spring break. First time she could really enjoy her new telemark skis. She using Black Pearls. We were at Alta midweek in early March plus the weekend at Powder Mountain. Bill was around too. Unfortunately, it was right in the middle of the unusually warm spell between storm cycles. But we still had fun. The free mountain tour was just the three of us, so we got a good introduction about where to find decent snow during spring conditions.

I rented skis at PowMow. Found that I can handle narrow skis in soft, almost slushy, snow but it's certainly a lot easier with mid-80s skis. The second day I had the Solomon QST Myriad 85 @ 153cm.

The new terrain on the backside would be great fun with a bit of fresh snow
PowMow Mar2017 - 1.jpg
PowMow Mar2017 - 2.jpg

Poma was worth riding several times
PowMow Mar2017 - 3.jpg

My usual stay in April at Alta Lodge included a powder storm. I had a good time with the Stormrider 85.

https://www.theskidiva.com/forums/index.php?threads/tr-alta-in-april-2017.21799/

Looks like the views for this thread went over 40,000 recently. Hope it's helpful for other copers who intend to keep skiing at whatever level that's fun.
 

Bex

Diva in Training
I'm responsible for quite a few of those 40,000 views in recent months and have just joined SkiDiva as a result. So thank you! I ruptured my ACL and tore both MCL's back in February skiing and assumed it was going to mean surgery, although a doctor friend of mine pointed out the research comparing surgical and rehab outcomes early on. I'm in the UK and only get to ski for a week or two a year, so nothing like many of you, but I've been hoping to ski a season when both kids are off to Uni in 18 months time. The specialists I've seen here have been very encouraging about waiting to see how I do and, at 4 months post injury, I'm running and swimming and see no reason for surgery. A search of Google is hugely frustrating as it provides almost no information about choosing a non-surgical route and so I'm hugely grateful for your documented recovery. It's helped me track how I'm doing, learn about KOOS and Skiers Edge, and have confidence that maybe I can ski again with surgery.
 

bounceswoosh

Ski Diva Extraordinaire
The specialists I've seen here have been very encouraging about waiting to see how I do and, at 4 months post injury, I'm running and swimming and see no reason for surgery.

That's wonderful!

Unsolicited commentary (and I haven't gone back to read the whole thread):

You probably already know this, but skiing is a "cutting" sport that challenges your knee in very different ways than running and swimming do. I'm sure you're talking to your specialists about this, but especially when you only get small amounts of skiing in concentrated doses, you will want to work on exercises that specifically strengthen the muscles that support lateral movements. I don't know if you should be doing that yet, etc etc.

What's KOOS? I am sure Skiers Edge would help, but I wonder if there are other exercises that are more demanding. Real skiing is a lot more variable than Skiers Edge.

Good luck!
 

marzNC

Angel Diva
I'm responsible for quite a few of those 40,000 views in recent months and have just joined SkiDiva as a result. So thank you! I ruptured my ACL and tore both MCL's back in February skiing and assumed it was going to mean surgery, although a doctor friend of mine pointed out the research comparing surgical and rehab outcomes early on. I'm in the UK and only get to ski for a week or two a year, so nothing like many of you, but I've been hoping to ski a season when both kids are off to Uni in 18 months time. The specialists I've seen here have been very encouraging about waiting to see how I do and, at 4 months post injury, I'm running and swimming and see no reason for surgery. A search of Google is hugely frustrating as it provides almost no information about choosing a non-surgical route and so I'm hugely grateful for your documented recovery. It's helped me track how I'm doing, learn about KOOS and Skiers Edge, and have confidence that maybe I can ski again with surgery.
Hello! Glad my thread has been useful to you.

Must say that I avoided running for a while. But the purpose of my last PT session at about 4 months after popping off the ACL was to learn some agility exercises. Not only for exercise purposes but because then I knew my physical therapist was comfortable with that type of activity. I told him I wasn't planning on running for exercise but wanted to be able to run to get out of the rain if needed. :smile:

I found KOOS (Knee Injury and Osteoarthritis Outcome Score) very helpful during the first year after injury. It's used for medical research related to treatment of ACL injuries and long term outcomes such as OA.

The other training aid that I found very useful is the SkiA Sweetspot. It was invented by a British physician. With the Sweetspot, it's possible to gain confidence balancing in ski boots in the comfort of your home long before ski season starts. I still use the Sweetspot balance trainers during pre-season.

What lessons have you taken? Where?
 

marzNC

Angel Diva
For those who are interested, here are a couple examples of recent research studies that makes use of KOOS for studying treatment of ACL ruptures.

2015 - Dr. Marx at the Hospital for Special Surgery in New York City is a co-author
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study

May 2017 - UK study looking at three groups: early ACL reconstruction therapy plus exercise therapy, exercise therapy with delayed surgery, exercise therapy alone
Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome: an exploratory analysis of the KANON trial

Apparently Dr. Marx was an editor for a new technical book that written to help surgeons help patients make a fully informed decision about the best treatment for their specific ACL-injury situation. At $155, this is a medical text book, not a book for the general public.

Controversies in the Technical Aspects of ACL Reconstruction: An Evidence-Based Medicine Approach, 1st edition, 2017
 

jenh-m

Diva in Training
I just want to convey my gratitude for this blog! and share some of my own experience for whomever it might help. I ruptured my ACL end of Feb this year (so 5 months ago) dancing (it was a jump-turn-land-on-one-leg kind of thing), and this blog has been a HUGE source of comfort, information and support!! So far I haven't even been able to find any online forums for coper dancers - I may have to start it. call it "middle age dancer copers" or something - hahahaha!! I have a great doc who I have full confidence in. he's the knee surgeon for a pro-basketball team, and he encouraged the wait and see with PT approach which I initially resisted a bit, but was really on board with pretty quickly - especially after finding theskidiva.com! I progressed really beautifully with PT. My form has always been really good - with a history of gymnastics, dance and yoga, my legs and balance have always been really strong. I was "graduated" from physical therapy after about 4 months (we started right away as I got in to see the knee specialist within a week of the injury), and while the PT said that if I maintain my usual activity level which is pretty high, i shouldn't need a "maintenance routine" long-term. But my injured leg is still not as strong as the other leg, and I notice it. I guess I feel like I've hit a bit of a plateau, which I have heard is ok, as long as things are moving in the right direction. I go back and forth between feeling really optimistic and encouraged about living life as a coper, and then I have periods (like when I hit the plateau periods) where I'm more pessimistic and think maybe at some point I'll opt for reconstruction. I try to remind myself that it still has only been 5 months, and my trajectory has definitely been moving in the right direction all along. I even went back to dance (not full on but eased back into it) after about 7 weeks. I haven't returned to my 3 mile per week run, but basically replaced it with PT and leg strengthening exercises. I'm at a point of considering hiring a personal trainer familiar with acl deficient knees for a few sessions. Thanks again for all of this information and inspiration which as been sorely needed since my injury! If I hadn't found theskidiva.com I would have felt much more alone and much less optimistic! What did people do before the internet? (that is rhetorical - I am plenty old enough to remember! hahahaha!!)
 

marzNC

Angel Diva
I just want to convey my gratitude for this blog! and share some of my own experience for whomever it might help. I ruptured my ACL end of Feb this year (so 5 months ago) dancing (it was a jump-turn-land-on-one-leg kind of thing), and this blog has been a HUGE source of comfort, information and support!! . . .[snip] . . . I'm at a point of considering hiring a personal trainer familiar with acl deficient knees for a few sessions. Thanks again for all of this information and inspiration which as been sorely needed since my injury! If I hadn't found theskidiva.com I would have felt much more alone and much less optimistic! What did people do before the internet? (that is rhetorical - I am plenty old enough to remember! hahahaha!!)
Hello! Glad you find this thread helpful.

While it would be great to find a personal trainer with experience working with ACL-deficient clients, it's not really necessary. You should know enough after format PT to know what to avoid. The personal trainer I found didn't have direct experience with knee rehab, but was willing to learn by following my lead as well as doing some research. By the time I was 12 months post-injury, she really didn't have make any allowances for my knee.
 

bounceswoosh

Ski Diva Extraordinaire
I go back and forth between feeling really optimistic and encouraged about living life as a coper, and then I have periods (like when I hit the plateau periods) where I'm more pessimistic and think maybe at some point I'll opt for reconstruction.

For what it's worth, I had surgery over a year ago, and I still go back and forth between feeling optimistic, and feeling like it's always going to be less capable. It's also hard to gauge because everyone's injury is slightly different, often other injuries are involved (ligaments, meniscus, cartilage ...) so talking to other people isn't terribly helpful - either freaks me out because I think I should be doing better, or freaks me out because it sounds like it will never be great.

Good luck!
 

Grizzla

Certified Ski Diva
Well, it seems that there's a few of us all giving it a go this year. Good luck to all.:wave:
 

jenh-m

Diva in Training
Hello! Glad you find this thread helpful.

While it would be great to find a personal trainer with experience working with ACL-deficient clients, it's not really necessary. You should know enough after format PT to know what to avoid. The personal trainer I found didn't have direct experience with knee rehab, but was willing to learn by following my lead as well as doing some research. By the time I was 12 months post-injury, she really didn't have make any allowances for my knee.
This is helpful to hear, thanks!
 

jenh-m

Diva in Training
For what it's worth, I had surgery over a year ago, and I still go back and forth between feeling optimistic, and feeling like it's always going to be less capable. It's also hard to gauge because everyone's injury is slightly different, often other injuries are involved (ligaments, meniscus, cartilage ...) so talking to other people isn't terribly helpful - either freaks me out because I think I should be doing better, or freaks me out because it sounds like it will never be great.

Good luck!
It's good to know I'm not alone in my vacillating, and also that it's not an easy journey with or without reconstructive surgery!
 

Grizzla

Certified Ski Diva
I think, once you've damaged your knees, it's a bit of a darned if you do, darned if you don't situation, especially if you think that you may be able to cope without surgery. Wait and see is often sensible advice, but it's not very helpful or reassuring at times. The truth is, though, it's all very personalized and different in every person, and only they can weigh up the pros and cons.
Personally, I hope to get away without surgery and certainly don't want it - but sometimes I think that it's not going to be that easy, and sometimes I get very down and get convinced that I won't get away with it. Who knows..?
 

jenh-m

Diva in Training
I think, once you've damaged your knees, it's a bit of a darned if you do, darned if you don't situation, especially if you think that you may be able to cope without surgery. Wait and see is often sensible advice, but it's not very helpful or reassuring at times. The truth is, though, it's all very personalized and different in every person, and only they can weigh up the pros and cons.
Personally, I hope to get away without surgery and certainly don't want it - but sometimes I think that it's not going to be that easy, and sometimes I get very down and get convinced that I won't get away with it. Who knows..?
Thanks for your thoughts. I feel very similarly about avoiding surgery if I can still do (almost?) all of the things I want to do, but it's by no means a "final" decision. In general I do just fine, and I'm impressed with how much I do already at 5 months, but it's definitely a new normal. It's not the same knee. I remember reading that months ago in this blog thread - with or without reconstruction you're dealing with a new normal. I continue to grapple with that. At first it was "give it 3-4 months." now at 5 months, in my head I'm saying "give it a year, and see how you're doing." Maybe I'll just keep moving the post out six months at a time. I'm mostly happy with my progress, but I still feel that it's deficient. I have had many moments of feeling grief about the loss of my "perfect" knee. The style of dance I love the most involves a *lot* of jumping. So I fear I'll never really be able to do it with everything I have again, you know? But patience and training, patience and training. And in the meantime, I'm dancing at a fun enough level for being 5 months post. When I read here that there are all of these high level skiers who have been skiing without acl's for years i am so inspired.
 

Bex

Diva in Training
Hello! Glad my thread has been useful to you.

Must say that I avoided running for a while. But the purpose of my last PT session at about 4 months after popping off the ACL was to learn some agility exercises. Not only for exercise purposes but because then I knew my physical therapist was comfortable with that type of activity. I told him I wasn't planning on running for exercise but wanted to be able to run to get out of the rain if needed. :smile:

I found KOOS (Knee Injury and Osteoarthritis Outcome Score) very helpful during the first year after injury. It's used for medical research related to treatment of ACL injuries and long term outcomes such as OA.

The other training aid that I found very useful is the SkiA Sweetspot. It was invented by a British physician. With the Sweetspot, it's possible to gain confidence balancing in ski boots in the comfort of your home long before ski season starts. I still use the Sweetspot balance trainers during pre-season.

What lessons have you taken? Where?
Bit of a delayed reply, I'm afraid, but thanks for responding. I've not had lessons in years but have skied a lot in France and Canada and a bit in the US. Thanks for the tip about the Sweetspot. I was interested in what you wrote about the Skiers Edge. I'd never heard of that but managed to track down a physio here who has one and had a go last week. Definitely good for confidence that the skiing movement is no problem.
I also have been doing the KOOS online since reading about it - again very reassuring to see the score come up over the months.
 

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