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Potential ACL Injury??

lelee

Diva in Training
#1
Hi all!

I took a relatively mild fall a little over 3 weeks ago going off of a park jump in the midwest (read: icy landing). I went off of the jump a little off-balance, and ended up landing on the inside edge of my left ski, twisting my foot inwards - I slid down the landing and it wasn't even a dramatic fall! I never felt a pop, bindings didn't eject, was able to ski afterward, and took the night off to rest (I hurt the same knee a little over 3 years ago). Little to no swelling with a little stiffness that night/the next day, and I've had pretty much full mobility with pain only at very specific angles & when attempting to straighten my leg completely. I skied last weekend in Vail/Beaver Creek and had no pain at all except when jumping off of any side hits - moguls, powder, and tight trees didn't hurt at all. Went to see an orthopedic surgeon on Tuesday, who stated with extreme confidence in about 2 minutes that I had completely torn my ACL and that it had likely been torn since I hurt my knee originally!

I have an MRI scheduled for this week and am desperately hoping that he's wrong. If it is a tear, I'll likely elect for surgical reconstruction, as I'm only 20 - but the fears of not being able to ski the same in the future, the loss of my independence for ___ months, and an inability to be physically active to help with my mental health has been eating me alive for the past week. I've never heard of anyone having a situation like this and it being an ACL tear... does anyone have a similar experience with an ACL injury? And does anyone have any advice on how to overcome the impending anxieties surrounding this situation? (my main concern!) All of my friends, who are also skiers, have been very sympathetic, but have never had an injury like this, so I feel a bit alone at the moment :frown: Thanks in advance for any thoughts or advice!
 

Susan L

Ski Diva Extraordinaire
#2
So sorry to hear that! I had a partially torn ACL many years ago (heard and felt the pop) from snowboarding and I still remember feeling no pain initially but once the pain came, I was not able to put weight nor straighten that knee for months! Since it wasn’t a complete tear, I did not elect surgery. But I was immobilized for months!!!
Wishing you speedy recovery!
 

lelee

Diva in Training
#3
Thanks so much, Susan! Fingers crossed that it's not as serious as a complete tear. Months-long immobilization sounds quite less than ideal, but glad to hear yours was able to heal without surgery!!
 
#4
Wow. Sounds like you need a second opinion — even if the MRI (supposedly) shows a tear. Doesn’t sound right to me as an ex-Ski Patrolller (27 years). I’m very leery of doctors — even though my sister is one . Do not trust blindly in the medical profession!
 

Susan L

Ski Diva Extraordinaire
#5
Thanks so much, Susan! Fingers crossed that it's not as serious as a complete tear. Months-long immobilization sounds quite less than ideal, but glad to hear yours was able to heal without surgery!!
I had a partial MCL tear shortly after, followed by a tear in the meniscus too. All from snowboarding so after fracturing the tailbone too, I switched to skiing. None required surgery and although I was able to heal and get back to my normal activities, my knees were never as strong as before. For those I know who had surgeries and followed PT rigorously afterwards all recovered fully.

Funny @Tennessee said do not trust blindly. My husband also said the exact same thing and he is a doctor himself:rotf: He did say that orthopedic surgeons (or all surgeons in general) are hungry to perform surgeries, so you really need to get 2nd opinions before letting someone operate on you. My dad was an orthopedic surgeon but he was always against surgeries unless absolutely necessary.
 

marzNC

Angel Diva
#6
Went to see an orthopedic surgeon on Tuesday, who stated with extreme confidence in about 2 minutes that I had completely torn my ACL and that it had likely been torn since I hurt my knee originally!
Welcome! Sorry a knee injury is the reason you found TheSkiDiva, but the Divas are a great source of support for any injuries.

I'm a successful coper, meaning I don't have an ACL but I can do everything that I want to do. In fact, I'm a much better skier playing on more challenging terrain than when I popped off the ACL (not skiing) about eight years ago. That said, every knee injury and situation is unique. Consulting with your OS and learning more about your options is the best approach before you make any decisions.

What you should do ASAP is start physical therapy. Doing PT will help in a faster recovery after surgery. You'll also learn how to avoid any other knee injury in the near future.

I'll send more info via PM. If you want to get a sense of my experience, here's the ongoing thread about my skiing adventures as a coper that I started in 2012.

No ACL, no surgery, no problem - My new normal as a Coper
 
#7
I agree, shop around for an orthopod with a reputation for avoiding surgery. There are several women on here who have elected not to get their ACLs repaired. Hoping they will chime in.

Best of luck! We're glad to have you here, though sorry it happened this way!

:welcome:
 

lelee

Diva in Training
#8
Thanks, everyone! MRI is today, so we'll see how it goes.

I haven't really backed off on activity since injuring my knee the first time (for example, I have a habit of landing standing back tucks on ONLY that leg), so it just doesn't seem plausible to me that it would've been injured for so long, or even that the way that I fell a few weeks ago would've torn it. Who knows, though! I think a second opinion is always a good idea - will keep you all updated :-)
 
#9
Good luck!

Sadly, I have heard of very minor falls resulting in a torn ACL. I tore my MCL (~15) years ago. Not the same thing, obviously, but I don't recall anybody mentioning surgery. That knee is a tiny bit more troublesome than the other, but nothing serious.
 
#10
Hi all!

I took a relatively mild fall a little over 3 weeks ago going off of a park jump in the midwest (read: icy landing). I went off of the jump a little off-balance, and ended up landing on the inside edge of my left ski, twisting my foot inwards - I slid down the landing and it wasn't even a dramatic fall! I never felt a pop, bindings didn't eject, was able to ski afterward, and took the night off to rest (I hurt the same knee a little over 3 years ago). Little to no swelling with a little stiffness that night/the next day, and I've had pretty much full mobility with pain only at very specific angles & when attempting to straighten my leg completely. I skied last weekend in Vail/Beaver Creek and had no pain at all except when jumping off of any side hits - moguls, powder, and tight trees didn't hurt at all. Went to see an orthopedic surgeon on Tuesday, who stated with extreme confidence in about 2 minutes that I had completely torn my ACL and that it had likely been torn since I hurt my knee originally!

I have an MRI scheduled for this week and am desperately hoping that he's wrong. If it is a tear, I'll likely elect for surgical reconstruction, as I'm only 20 - but the fears of not being able to ski the same in the future, the loss of my independence for ___ months, and an inability to be physically active to help with my mental health has been eating me alive for the past week. I've never heard of anyone having a situation like this and it being an ACL tear... does anyone have a similar experience with an ACL injury? And does anyone have any advice on how to overcome the impending anxieties surrounding this situation? (my main concern!) All of my friends, who are also skiers, have been very sympathetic, but have never had an injury like this, so I feel a bit alone at the moment :frown: Thanks in advance for any thoughts or advice!
I'm so sorry to hear about your injury and your conundrum. At age 16, I tore my ACL playing soccer. I was running fast toward the ball ahead of me and heard the pop; weirdly, though, I didn't feel much of anything, but I couldn't walk off the field on my own. I was told at the hospital that I had torn my ACL completely and that surgery wouldn't be recommended unless I was an Olympic hopeful. Well, I wasn't so that was that. Apparently unfixed ligaments disappear over time in their uselessness, leaving the knee without a crucial (the crucial?) means of structure and stability. A little over three years later, my knee locked; I had torn my meniscus and it got wedged in my knee in such a way that I couldn't flex my leg. Arthroscopic surgery took care of that, and soon thereafter I spent months doing really rigorous PT at the college gym. The staff trainers pushed and pushed me and thanks to them I have never had another problem with my knees. Crazy. But you are a skier, and so am I. I was told to wear my knee brace as much as I could after the surgery, especially while doing anything athletic, and that I should stay away from any sport with quick lateral movements, including running, soccer, skiing, etc. I moved abroad and mostly stuck to bike riding for exercise. It wasn't until I was in Japan a few years later that I went skiing for the first time since the injury. I was biking a lot at the time, which had kept the muscles surrounding my knee strong. Long story short, my knee has been fine skiing, and also running. Never wore the brace.

So I would agree with those who say to get another opinion about the surgery. Absolutely. But the ACL is such a crucial part of your knee, and if you could actually get it fixed, you may be less likely to have the kind of instability that results in further knee injury down the road. In my experience, keeping leg muscles strong, your quads in particular, is key to helping support your knee in any endeavor, whether you have the surgery or not. And to echo many others, the road to doing that definitely starts with PT, as soon as you get the green light after surgery. Wishing you a speedy recovery!
 

marzNC

Angel Diva
#11
At age 16, I tore my ACL playing soccer. I was running fast toward the ball ahead of me and heard the pop; weirdly, though, I didn't feel much of anything, but I couldn't walk off the field on my own. I was told at the hospital that I had torn my ACL completely and that surgery wouldn't be recommended unless I was an Olympic hopeful. Well, I wasn't so that was that.
Long story short, my knee has been fine skiing, and also running. Never wore the brace.
Sounds like the fact that you were a girl might also have been a factor. Glad that the later knee injury could be treated. As I remember from your other posts, you are quite a bit older than the OP. How ACL injuries are treated changed quite a bit after MRIs become more available. ACL reconstruction surgery became more common, at least in the U.S., although is still no necessarily the best solution for everyone.

In my experience, keeping leg muscles strong, your quads in particular, is key to helping support your knee in any endeavor, whether you have the surgery or not. And to echo many others, the road to doing that definitely starts with PT, as soon as you get the green light after surgery.
I'm a successful coper who popped off an ACL (not a skiing injury) about eight years ago when I was over 50. I made a very deliberate decision based on the research available at the time to avoid surgery. I had the full support of my ortho surgeon. In my case, no medical intervention was required for the collateral damage (small meniscus tear, MCL sprain) to heal in a few months. For the next year, I opted to focus on knee rehab, ski conditioning, ski lessons, as opposed to getting a custom brace. Since the injury happened during the summer, I didn't miss a ski season.

PT ASAP is important, even before surgery. For people who opt for ACLr surgery, their recovery is much faster if they have already started to strengthen relevant muscles.

My takeaway from PT was that strengthening hamstrings and keeping them strong is the most important approach. Quad strength is not that important for advanced skiing in comparison to core strength, flexibility, and balance with the current design of skis. The silver lining for not having an ACL as a ski nut is that I have more incentive to exercise all year. I've learned a lot since knee rehab how much very experienced instructors can help when it comes to the more subtle aspects of applying fundamentals to challenging terrain. I'm having a great time skiing terrain that I considered impossible a decade ago. I expect to continue doing so for the next 10-20 years.
 
#12
Sounds like the fact that you were a girl might also have been a factor. Glad that the later knee injury could be treated. As I remember from your other posts, you are quite a bit older than the OP. How ACL injuries are treated changed quite a bit after MRIs become more available. ACL reconstruction surgery became more common, at least in the U.S., although is still no necessarily the best solution for everyone.



I'm a successful coper who popped off an ACL (not a skiing injury) about eight years ago when I was over 50. I made a very deliberate decision based on the research available at the time to avoid surgery. I had the full support of my ortho surgeon. In my case, no medical intervention was required for the collateral damage (small meniscus tear, MCL sprain) to heal in a few months. For the next year, I opted to focus on knee rehab, ski conditioning, ski lessons, as opposed to getting a custom brace. Since the injury happened during the summer, I didn't miss a ski season.

PT ASAP is important, even before surgery. For people who opt for ACLr surgery, their recovery is much faster if they have already started to strengthen relevant muscles.

My takeaway from PT was that strengthening hamstrings and keeping them strong is the most important approach. Quad strength is not that important for advanced skiing in comparison to core strength, flexibility, and balance with the current design of skis. The silver lining for not having an ACL as a ski nut is that I have more incentive to exercise all year. I've learned a lot since knee rehab how much very experienced instructors can help when it comes to the more subtle aspects of applying fundamentals to challenging terrain. I'm having a great time skiing terrain that I considered impossible a decade ago. I expect to continue doing so for the next 10-20 years.
Yes, I'm very much older than OP; in fact, my son is her age and my daughter a couple years younger. It definitely had to do with being a girl. In retrospect, it makes no sense to only operate on "Olympic hopefuls." Doesn't everybody need working knees? I told my story to underscore how different things are now, even in just the breadth of possibilities she has that I did not. Which is not to say surgery is always the better alternative, of course. And you're right about hamstrings as well as quads for overall recovery and stability, whether you ski or not. Skiing wasn't on my radar in PT, as I was strongly advised never to ski again. I'm so glad I never took that advice, even if I wish I had returned to skiing sooner. I'm so glad @marzNC that you have managed your injury so successfully without surgery.
 

marzNC

Angel Diva
#13
Skiing wasn't on my radar in PT, as I was strongly advised never to ski again. I'm so glad I never took that advice, even if I wish I had returned to skiing sooner. I'm so glad @marzNC that you have managed your injury so successfully without surgery.
One of the aspects of selecting an ortho surgeon to work with that was a little challenging given where I live was to find one who knew something about skiing. Meaning one who had at least skied a little, even if not at a high level. I was lucky.

My PT had no clue about skiing. But he was perfectly willing to work with me towards my goals. Although I didn't really need the last visit, I scheduled it after the collateral damage felt completely healed. What I asked him for was some agility exercises. I told him I wasn't planning on running for fun or exercise (never liked to run that way), but that I wanted to be confident enough to run from the car to get indoors quickly when it was raining. By then I was working with a personal trainer (over 50) and she took it from there.
 
#14
One of the aspects of selecting an ortho surgeon to work with that was a little challenging given where I live was to find one who knew something about skiing. Meaning one who had at least skied a little, even if not at a high level. I was lucky.

My PT had no clue about skiing. But he was perfectly willing to work with me towards my goals. Although I didn't really need the last visit, I scheduled it after the collateral damage felt completely healed. What I asked him for was some agility exercises. I told him I wasn't planning on running for fun or exercise (never liked to run that way), but that I wanted to be confident enough to run from the car to get indoors quickly when it was raining. By then I was working with a personal trainer (over 50) and she took it from there.
That is really wonderful. And I appreciate hearing about your experience with ski instructors. I know I would and will benefit from the same when I start skiing again.
 

altagirl

Moderator
Staff member
#15
Good luck!

Sadly, I have heard of very minor falls resulting in a torn ACL. I tore my MCL (~15) years ago. Not the same thing, obviously, but I don't recall anybody mentioning surgery. That knee is a tiny bit more troublesome than the other, but nothing serious.
It doesn't even require a fall at all. My first ACL tear the knee "popped" and gave out and then my butt hit the ground. So the ACL tear caused the fall, if you'd even call it a fall. Very uneventful and painless, other then the gut punch feeling that something was very wrong. Once the swelling went down I did a lot of fairly agressive skiing on the torn ACL. Probably wasn't a good idea but i was young and very strong at the time and there was a 6 month wait for an MRI and to see a specialist. My GP said it was probably just "sprained". It kept giving out more frequently and I ended up needing a meniscus repair too by the time I had it fixed.

FWIW, MCL injuries don't typically require surgery since that ligament can hear on it's own. But a fully torn ACL cannot reattach itself without surgical intervention.
 
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