Question: when can I expect to be fitted for a ACL/functional brace?

[RockSki]

In other words, is it 'safe' for me to buy a season's pass for 09/10 and a ski clinic at the pre-season deep discount?

Background: injured ACL, MCL plus tibia plateau fracture in February 09. Skiing... Probably meniscus damage too. On the wait list for a MRI. Partly due to fracture, I am not planning on having ACL reconstruction for at least a year, if ever. So will almost surely have a functional brace to help compensate for the damaged ligaments. Have been lurking on this fabulous site for info and encouragement. Now that the ski season is over in my area, I'm feeling a little less sorry for myself and ready to join...

Today I saw a specialist whom I intended to ask when I could expect to be fitted for a brace. But I was distracted when my knee 'bit' me after straightening and was disappointed that the verdict was 'not yet' for bracing. In short, I neglected to ask point-blank about next ski season.

As demonstrated by the knee-that-sometimes-bites issue today, I may have the meniscus 'scoped' and trimmed.

Does that mean I will likely have the meniscus shaved before I can get a brace and begin to ski?

Any Divas out there able to provide insight?

Thanks...

 

[Pequenita]

As demonstrated by the knee-that-sometimes-bites issue today, I may have the meniscus 'scoped' and trimmed.

Does that mean I will likely have the meniscus shaved before I can get a brace and begin to ski?

Any Divas out there able to provide insight?

Thanks...

That's what it sounds like to me. But I guess what you really want to know is whether skiing with a torn meniscus/"trick" knee will cause more damage, and I don't know the answer to that.

As for brace stuff, my experience is dated by 15+ years. I wasn't even fitted for a brace until after the scope. And at the time of the surgery, they didn't know completely what they were dealing with until they went in. In my case, they found that I had stretched a ligament, and they decided to stick me in a full leg cast for a number of weeks, which ultimately required a lot of PT to even walk again.

So, you may go into the OR prep thinking you're just getting the meniscus trim, but there can be unexpected things that arise from the scope that may delay your recovery. Of course, imaging technology may be way more advanced now, and maybe they do have a clearer picture of what's going on inside beforehand. Just my 2 cents.

 

[pinto]

DH tore his ACL last year, also damaged meniscus, in late Feb 2008. The doctor gave (well, sold) him an off-the-shelf DonJoy brace the first day he went in. Later in the summer he was fitted for the custom brace, during or maybe after his physical therapy. (I don't know what the differences are between US and Canadian medicine in this case.)

He is quite stable, especially with the brace, so they are not doing surgery unless things deteriorate. He had no trouble skiing this past winter, and he didn't even keep up his pt exercises. Bad boy. But one of those lucky freaks of nature, I guess.

He cannot play squash or tennis or such sports like this, though. I don't know if I think he should get the surgery or not. Hopefully he won't tweak it again and mess up the meniscus worse, but so far so good.

 

[MaineSkiLady]

So sorry to read about your injury :(
And welcome to the forum, hope we can give you some insight.

Does that mean I will likely have the meniscus shaved before I can get a brace and begin to ski?

How's this for a vague answer: it depends.
The problem is the extreme variation in medical protocol, even within the U.S., much less between U.S. and other countries. Different doctors have different ways of approaching injuries.
Bottom line: I don't think any will know exactly what's going on until you've had MRI (i.e., extent of ligament and meniscus damage). I know it's often a long wait for one in Canada. Worth it - amazing what a good surgeon can "see."

DH had a similar injury, also last Feb (whole thread about it in this section). His MRI was 3 days after the injury. Upon reading it the next day, the surgeon completely "reconstructed" how the injury happened (without being told prior). He was spot-on. His surgery was less than a month after the injury.

In order of priority, I'd think #1 is your fracture - how bad is it? Next is meniscus (extent only somewhat visible via MRI). Is your ACL completely torn? MCL, depending on severity, can heal. Before, during and after, the key words are physical therapy.

I would think that a hyperextension-prevention brace is in order. But the fact that your knee "bites" on attempts to fully extend is pretty telling. I think, at the very least, a scope is in order.

I hope you get the MRI and report back. Best of luck!
(By the way, after ACL reconstruction, it's 6-12 months for healing, FWIW.)

 

[Jilly]

RockSki, see if there is a clinic that does MRI outside of provincial coverage. We have one locally and usually you can get in within the next week. If you have company or extended health insurance it might be covered. Otherwise you could be next fall.

Welcome to the forum. Nice to add some western gals to the Canadian crew!

 

[RockSki]

Thanks and more info...

Thanks for all the great information and support. You've developed a great community here!

Due to the fracture, I wore a 'zimmer'-style brace in full extension for almost 6 weeks, and then 3 more weeks with the brace set to bendable. The fracture was pronounced 'healed' at the end of March and I began the process of learning how to walk again -- the first night, I couldn't touch the floor while sitting at the table for supper, I had so little ability to bend the knee. Rehab is going well, with hours and hours of work at the gym and on the living room floor while still in the brace and since. The 'biting' problem only showed up this week -- I was told that as the muscles strengthen, this kind of problem becomes manifest with 'beginner' rehab excercises like straight-leg raises, and that I should now do things with the leg planted (weight-bearing) to the extent possible, especially when it comes to quad exercises e.g., standing squats, leg press machine. (Can't see how to work on the hamstring with the leg planted -- any ideas there?) So a 'good news, bad news' scenario. Will consult my physio later this week for an upgraded/updated routine. As for the MRI, I have been told that I will probably have a scheduled appointment before the orthopod surgeon's appointment (i.e., longer wait for the orthopod, but worth it -- someone with lots of experience working with women skiiers) -- and to call persistently for cancellations for the MRI.

All in all, sounds like next season might not be in the cards -- will call Sunshine (Banff) now and make sure that their injury insurance policy ($40 extra) covers pre-exsiting conditions.

I so want to be back on the hill -- I'd be so grateful for blue runs!

Check those bindings, Divas -- one study that I read showed that women who regularly had adjusted their bindings were significantly less likely to have ACL injuries.

 

[RockSki]

Good news and good to know -- Sunshine's season's pass refund option @ $40 extra will cover pre-existing injuries and injury flare-ups, as well as fresh damage. Just needs to be MD-certified. Called to check that I was interpreting the website information correctly. Was initially told no, but asked the agent to check and eventually got the desired answer...
Worth it for me this time.

 

[Pequenita]

Makes sense. Hope the medical stuff works out and that you are back to 100% quickly.

 

[Spillips]

Glad to hear about the insurance - I did absolutely no due diligence before I bought my pass, opted for the insurance as I also have a torn ACL/MCL. I did mine in on the last day of the season at about 3.30 :-(

I see my specialist next Tuesday... fingers crossed that he has good news about the 09/10 season. This is my second ACL/MCL tear, I did the other knee eight years ago, never had surgery and skied on it relatively pain-free since. The first two years were tough going but it got a lot easier after that!
When is your MRI booked for?? I'm Feb 11th... gosh that seems like a long, long wait!!

 

[RockSki]

Sorry to hear about your most recent MCL/ACL problem, Spillips.
But encouraging for someone in my position to learn that you have skiied for several years now with an ACL injury.

Still no firm date in sight for my own MRI. I am to see my sports MD specialist in about two weeks, and hope to be cleared for a brace fitting then. And I will ask again about the MRI and consultation appointment with the orthopedist.

Meanwhile, rehab is going well, with the dint of much effort. I am able to cycle quite a bit, including rather steep hills (albeit relatively short ones cf. AltaGirl's thread in the trip report section). I am also at the gym a couple of days per week and taking a weekly yoga class, pus physio and active-release massage, too.

The knee 'biting' problem that I described in starting this thread has not recurred.

good luck to you, Spillips!

 

[Spillips]

Thanks, good luck to you as well...!
I'm spinning like crazy on my bike trainer, set to no resistance and doing a bunch of other physio exercises. I find that my quad/hamstring/hip are all extremely tight so I'm going to get some sports therapy massage done as well. I'm weight bearing fine now, and even, under the advice of physio, balancing on the bad leg for up to a minute at a time.

That said, I'm finding the healing process much slower this time around. For the other knee I was a sprightly eighteen while now I'm a decrepit old twenty-six year old! hah!

Well RockSki, I'll post any interesting updates or info I come across to this thread, inclusive of feedback from my sports med doc and ortho surgeon.... this healing thing really is a journey!

 

[RockSki]

Good news!

Yesterday I met with a sports medicine specialist, whose assessment indicated no need for meniscus 'scope' surgery and who has cleared me for a slow return to jogging without a brace, and for hiking and skiing as long as I wear a brace. I should have the signature that I need for insurance reimbursement by next week, and can begin thinking about models, etc. Gear is gear.

I am thrilled.

Thanks, everyone, for the wisdom and words of encouragement.

 

[RockSki]

I now own a CAD$1400 brace -- the CTI model in metallic green.

So far, so good...

I've taken it hiking (once) and skating (twice). It does feel odd, but surprisingly natural, especially while skating (including turns and stops). Thus I am feeling pumped for the coming ski season.

As I'm functional now (without brace for most things, with brace for skiing and such-like), I'm less concerned about getting a MRI right away. I have an appointment with a 'guru' orthopod next month.

Most important, I'm still doing a lot of 'rehab' and getting my head around the idea that this a lifetime plan. Walking partway to work, 'resistance' and treadmill at the gym a couple of times per week, a yoga class, plus acupuncture and active release massage a couple of times per month.

Thanks again, everyone!

 

[RockSki]

It's official: Cleared for skiing!!

Today I saw the orthopodic specialist aka knee guru.

He confirmed that I can ski but should continue using my custom CTI brace indefinitely. He also underscored the importance of remaining fit and active. To prepare for skiing, he recommended strength training but also agility and balance exercises. Skating, he agreed, would be a good way to prepare.

Re-injury is a distinct possibility, he said, so don't ski if fatigued. I think that's probably going to be the hardest for me to wrap my head around.

But unless I do re-injure, he doesn't think I'm a candidate for surgery.

So, overall, very good news!

 

[Pequenita]

It all sounds great, especially the clearance to ski and the brace feeling natural!

 

[RockSki]

It's official: Return to skiing happened today!

It all sounds great, especially the clearance to ski and the brace feeling natural!

Opening day conditions at Sunshine Village near Banff were FABULOUS. Four high-speed quads and one triple chair lift opened today.

And I was there, having a FABULOUS time. :D

Skiied on my own for the morning -- put down freshies on a little green run to start, then worked my way up.

Just before lunch met up with DH & DS.

Have booked a group lesson for Saturday -- first ski lesson ever in my life.

Not something to be proud of -- just was so broke for so long.
That lack of jingle in the jeans helps to explain why I have been skiing in boots that are too big for me. I didn't realize how much too big until I was fitted this evening -- I was wearing a Nordica size 26.5 and shelled out CAD$599 for Nordica HotRod 90W boots in size 23.5 !! I literally inherited the size 26.5's and at the time, could only ski 2-3 times per year, and they felt so much better than what I had been renting. The Nordica seemed to be the best fit for my narrow heel -- so at least I was doing something right.

Looking forward to amoritizing that purchase over many, many ski days...

 

[num]

 

[volklgirl]

What she said.

 

[Jilly]

Great.

Where did you get the boots, for the other Alberta Diva's?

 

[marzNC]

Opening day conditions at Sunshine Village near Banff were FABULOUS. Four high-speed quads and one triple chair lift opened today.

And I was there, having a FABULOUS time. :D

Thanks for the ongoing updates. This is a great group for learning and support.