Skiing first season after ACL surgery

[oneagles'wings]

I completely tore my acl last March spring skiing. Had surgery using my pateller tendon. Well, I skied Friday for the first time since surgery and... it was great I was pretty nervous at first, but I took it easy and built up my confidence and after an hour or so, I felt very comfortable. I did notice a little more muscle fatigue in my surgery leg (quadricep), so at one point I told my son that I was going to sit out a couple of runs. I figure I need to listen to my body and I definitely want to have a healthy season. On another note, I skied on my new Dynastar Exclusive Legends and I absolutley adore them! Thanks to all the divas who gave me advice on this purchase. Just wanted to give some encouragement to anyone else who is post-op this season. Get back out there, at your own pace, and enjoy!

 

[num]

Very glad to hear your return to the hill went so well!

 

[RockSki]

I'm also in the post-ACL club this year -- so far, so good. (4 times so far). I didn't elect for surgery, and am skiing with a custom-made CTI brace, And I'm on Dynastar Exclusive Active skis, which I purchased last year. Love them. So yes, all of you in the post-injury contingent, it's possible -- and worth it, but different (and not always easy...)

 

[MaineSkiLady]

Woohoo, so glad to hear this! Oneagles, you are really on the "fast track!" ACL/patella tendon probably has the longest heal time of all possible options. So glad you are happy with the Legends - and that both of you are in the groove/in the "Dynastar" Club - we are a somewhat misunderstood but intensely happy minority around here!

 

[evaino]

For anyone who's wondering if their knee is ready to return to skiing, there's a post-ACL injury return to sports test that you can administer yourself with a bit of space. It's called the Hop and Stop test.

You can get the full details on this website, including a free score sheet that will do the calculations for you but here's the "quick" description:

Hop test:
- write down your height in meters (inches*2.54/100)
- set up a measuring tape on the ground
- stand on one leg with your other knee held up at hip level and with your hands on your hips
- hop as far as you can, landing on the same leg. When you hop, don't let your up knee drop too far in the "wind up"
- write down how far you hopped. it's ok if you don't stick the landing as long as you can see where you initially landed - or get someone to read the distance for you.
- do this 3 times on the same foot.
- take an average of the 3 scores, and convert to m
- divide the average by your height. Ideally you want this to be between 79% and 82%. If it is less than you should think about strengthening.
- do the same on the other side (remember that many people tear their other ACL when they return to sport, so definitely test the "good" knee too)

Leap test:
The same as the hop test with two differences:
- land on the opposite foot (so start on right and land on left)
- you have to stick the landing within 1 second. so if you wobble for more than 1 second, the leap doesn't count and you should try again.
- To score this one, divide the average of the leap FROM the right by the right hop. This should be 109 to 116%.
This is the score that's particularly important - if you are strong (hop) but are not able to control that strength (landing) then that suggests you are at a higher risk of re-injury.

There's lots you can do to address this - and often it doesn't take long. One of the best things you can do is set up three low hurdles (or even just a line on the floor) and hop sideways (start and land on same foot) but make sure you "stick" the landing before you hop again. Do 2-3 sets of this going in both directions on both feet but give yourself at least a minute rest between sets. You will probably find it won't take long to get better at it.

You can do the same thing with hops forward onto a low box.

In fact you could probably skip the test and just try doing the hops every couple of days for a few weeks.

Elsbeth

 

[MaineSkiLady]

^^^ Very interesting.
And very painful - both to my knees and my ego.
Because I just took this test. I was intrigued.
Didn’t have a tape measure and didn’t need one to see how far below “the standard” I was.

Interesting factoid: nothing wrong with either of my ACL’s. Or MCL’s. Right knee is wonky but has been for decades.

Not sure what this means, but I did again play the intro video about their targeted test group and was somewhat encouraged when they clearly said that the test was used for high school and college athletes. Given that DH and I are old enough to be the grandparents of a high school athlete, I think we are somewhat out of the target group for this specific test - ??

I know my son went through similar performance testing at the end of both his knee surgery rehabs. Far, far different level of athlete than either of his parents!

I do agree that force absorption is extremely important. But I think there are a lot of other factors to consider as well: when I was landing on one foot, it was my foot that wobbled and “gave out.” Not my knee. I have awful feet. Does my inability to balance on one foot reflect on my knee’s ability to absorb force? I don’t think so. It would have to be measured in some other way, at least for me, in a way that would take my FOOT out of the equation.

DH has been focusing on weight transfer, at varying side-to-side speeds. What about tests that measure the ability to fully transfer weight from one foot to the other and back again? This would be measuring lateral strength, another (at least in my opinion) extremely important aspect of knee and leg strength in skiing that isn’t addressed by these tests.

While it’s an interesting test of a limited number of performance parameters, I think there have to be more comprehensive ways to assess this “sports readiness” and strength.

 

[evaino]

I actually spent about an hour on the phone with the guy from that site (Jeremy Boone), and discussed a lot of this stuff.

It is true that the numbers are for athletes, but something to consider is that skiing is strenuous on our bodies - so ideally you need a certain level of strength to do it safely. That said, i think it's the landing test that's more important than the hopping one.

You mention it's your foot that gives way - but if you think about it that is a problem. If you are not able to absorb force on account of your foot, that will mean that something else up the chain will have to absorb it. That's not good.

Most people who suffer injuries have some movement, strength or flexibility deficiencies. Tests like this help us to figure out what they are and then address them so that we can reduce our likelihood of suffering injury. That's not to say that if you don't meet these standards that you will get injured - just that you have a higher likelihood. If I was you, I would do some balance work on my feet - even as simple as starting with balancing on one leg and trying to hold the position for 30 seconds. Then move to hopping laterally and trying to hold the landing.

I spoke to Jeremy about different test options and he told me that they used to have a lateral hop test as well as a repeated one (as you mentioned) but that they (he and Dr Juris who created the test) found that it was no more effective than this test.

By the way - I tested myself a couple of weeks ago and was surprised at how weak I was - my hop was only 65% and 68% of my height. That made me realize that I should up my leg strength a bit before ski season. But my leap test was great - 118% and 128%, so I'm not super concerned. Although I'd like to have less asymmetry. I am returning from a hip injury and so for me this is a very useful test. In fact interestingly - it's my right that is weaker than my left in this test even though it was my left that was injured.

For another perspective - I tested some Olympic team athletes and some of them scored 120% of their height!

Elsbeth

 

[MaineSkiLady]

When my feet are "encased" in ski boots, which are pretty modified, with fairly rigid, corrective orthotics, the super-pronation and collapsing aren't an issue. But...put me in shoes, and even with orthotics, it's the lateral support of the shoes that determine how well (or even IF) I can land the hop. I will land it, and my foot caves inward. I really don't think it's a knee/force absorption issue. Barefoot yoga is a huge problem for me. This is nothing new, have lived with feet issues since childhood.

Otherwise, I found the test revealing and interesting, and as I said, I know similar and additional tests were done at 6 months post-op on my son at a regionally well-known performance testing center. Super-strenous - he sweated bullets both times over the course of an hour's worth of tests, they were intense.

 

[Pequenita]

Intriguing. I'll have to try this when I'm not running on fumes.

 

[marge]

I'm so glad that you are back on the slopes. I hope your recovery continues to go well. Are you working on those quad exercises?

 

[altagirl]

Intriguing. I'll have to try this when I'm not running on fumes.

Also - try it on a soft surface. ;)

I tried last night barefoot on our slate floor in the kitchen and I think I hopped about 18" and the landing did not feel good. My knees were both unimpressed. Heh.

Then I watched the video and they're doing this on grass. I tried it in the basement on the foam padding we have our gym equipment on and was right at 82%. Which is honestly better than I expected - I do a lot of squats but never do much one legged jumping - it feels really weird.

 

[evaino]

Good point altagirl. I should have mentioned that. kitchen floor - if it's linoleum - should be ok with some type of sport shoe on, but I wouldn't suggest barefoot as that would be a lot of impact.

hardwood or carpet should also be ok with sport shoes, but I wouldn't suggest doing it on ceramic tile or cement.

 

[DobeMom]

Congrats on such a quick recovery and being back on the slopes! I had a partial tear in my left ACL after a collision at the end of the last season, and I haven't been on the snow yet (can't wait!!!). BTW, I'm on Dynastar Exclusive Legends also, :o)

 

[MaineSkiLady]

I did this on asphalt, outdoors. Some "give" to it. Really needed to have more supportive shoes. Will be doing this again before fitness class tomorrow night, wood floor. DH is intrigued. And I will have on my super-lateral support (i.e., "motion control") with orthotic fitness shoes on, I should have better foot stability. I was too focused on "sticking" the landing, foot just caved.