General Cycling Discussion - torn ACL? see Dr today

well, i just wanted to post...

i crashed hard while ski jumping in mid-January and hurt my knee (my ski and leg were under me and my knee was pulled back and out)... it was really swollend but it kept getting better and better although then i re-injured it beginning of March (yes, ski jumping again, i know). then last weekend i was on a ski big ski tour -- on Monday i summitted a 4056meter peak (13,400ft) "Groesser Gruenhorn" in the Berner Oberland in the Swiss Alps and was hoping to climb the Jungfrau, Monch and then Mt Blanc...

but then my knee just wasn't strong and the snow was all heavy and crappy and i crashed again, this time with a loud "pop" from my knee.

i went to the orthoepedist yesterday and he thinks i tore my ACL. i went to the radiologist yesterday and my appointment with the doctor to review the pictures is in a few hours...

ah man that will just suck if i have torn my ACL. i need to read some more, but i know a few cyclists/runners/athletes who have had the ACL surgery and it turned out ok (after a LONG no-sport recovery). i have also heard that there are some athletes who elect to not have the surgery and must work on keeping the muscles extra strong and always run the risk with an unstable knee...

yesterday the doctor was pretty heartless -- he listened to my description, looked at my knee and said "yeah, torn ACL"... and i'm like "uh, wait, uh, that's bad, huh?" and (i had already explained i am an almost pro mountain biker and with my racing and MTB guiding that my life pretty much revolves around cycling and skiing and snowboarding and climbing, etc) and i ask him what that means - he's like "Surgery."... and i say "well don't you need a lot of recovery time after that?" and he says kind of casually like it's no big deal, "oh, about 6 months" - i am stunned - shocked as i imagine taking 6 months off (yesterday morning i was very excited because my training is going so well. my resting puls is UNDER 40 bpm!!! and this is middle of March!). i said "well what about my season and training and racing?" and he just says, "well, you can just take a year off and start up training again for next year"... as if it's like no big deal like i were late for a movie and can go see it the next week.

ok, well, my girlfriend keeps telling me not to get all worked up until i know for sure... but man, i mean i guess there are worse things like being paralyzed or having a major problem like cancer... but for me having to "take a break" from sports for 6 months is just not imaginable!! it's also maybe possible i could postpone the surgery until the end of the bike season (october) and ride this season, but i mentioned this possibility yesterday and the doctor seemed to be not in favor of it. again, i guess i should wait for the diagnosis before i think too much. but of course since yesterday i have basically thought about nothing other than how i can possibly make it through day after day without training - ok, i know it sounds dumb, but my life really revolves around sports and training...

well, anyone have any experience with torn ACLs?

anyway, i am kind of scared to hear the results... but then i guess i want to know.

i'll report back after i meet with the doctor.

big difference between severing it 100% and tearing it get a doc to diagnose it. I severed mine 100%, if you did too it will be a long painfull recovery, sorry. I also killed a cartilage miniscus well. Good luck!!!!!!!!

ACL surgery is nothing now a days do not worry about long term affects you'll be fine with enough time, see Corey Patterson (Chicago Cubs). I have no knowledge about cartilage repair as my injury occured before cartilage replacement was mainstream and I have none, I am however so far OK, arthritis here I come, ehh mind over matter they say.

Well 6months is a pretty long time...I have heard with a GOOD physical therapist you could be back to light work outs 5-6weeks and MAYBE back to full strength in 4 and half months. Im not doctor but i had 2 friends who tore there ACL and they were back pretty quick.

I had my ACL replaced and some miniscus removed at UNC in Aug 2001. I was back to biking in December, lightly, and rode Cycle North Carolina without any trouble in Oct. I would say 6 months is reasonable.

Im not sure what temp1 is refering to. If you're going to have it replaced who cares if its torn partially or completely.

I tried physical therapy prior to surgery and it gave me a strong leg with a torn ACL. Not much help. If you try to put it off you could end up tearing your miniscus since the mechanism to hold the knee in place is ripped and your knee will not be as tight as it should be. This is bad.

6 months sucks. Oh well, these are the only knees the good Lord is going to issue you so you might want to take good care of them.

Dave

Dude, that's tough.

Good luck with it. I am no doctor, but I do know that if you try to come back prematurely or before you've had enough physical therapy, you will do some real severe damage. My friend had a torn ACL and continued to ride. The result is that she ended up in 2 years of therapy with no riding. Don't do it. Follow the doctor's orders, have your surgery, and find a PT who is cycling inclined that will help and support you.

Dude, BTW, I'll be out in northern Italy early summer and would love to swing by Munich via the train fora day or two.... let's PM and set something up.

Koffee

m not sure what temp1 is refering to. If you're going to have it replaced who cares if its torn partially or completely.

If it is only a partially torn PT might be enough, if your ACL is gone (torn 100%) it needs to be replaced with a material removed from your patelar tendon.

well, this morning i went to the first doctor and he glanced at the pictures and said "yep, torn ACL"... he recommended surgery in the next few weeks. and was against putting it off as i would just increase the chance of injuring it. he was estimating 6 moths total recovery time.

this afternoon i looked up the leading expert in Germany for knee problems - Dr Jurgen Troft - and got an appointment there (spent over 3 hours, first seeing an assistant doctor, then getting some tests, then meeting with Dr Troft personally)... he said it is definitely completely ruptured and recommends surgery ASAP. Otherwise he said about the same stuff except:
1) he was more optimistic on the recovery time meaning that i should be able to bike relatively OK after 4 months or so...
2) he does a type of surgery that few others do - most take tissue from somewhere else (the Hamstring i think) and construct a new ligament thread and sew it on. in the first 6 months (he actually recommends waiting 4-6 weeks after the injurs) when there is still tissue from the old ruptured ligament, he offers another procedure where the transplanted fibers are fed THROUGH the old ligament tissue giving a better more natural and less invasive finish...

his plan is to attempt the "Chanelling" procedure and if there is not enough old ligament to do a standard one.

i have to think it over but i have an appointment for surgery next Thursday with Dr Troft...

anyone know anything about the "threading" procedure? Dr Troft has done over 4000 ACL repairs.


Dude, BTW, I'll be out in northern Italy early summer and would love to swing by Munich via the train fora day or two.... let's PM and set something up.
you're welcome to visit anytime. i have plenty of floor space. my parents are visiting like the first week of June but otherwise i don't have anything planned -- well, i have a bunch of races and tours planned but they will probably now be cancelled :(

I tore both of my ACL's in half ( not at the same time) and had to have surgery on both. The six months will go by fast with a positive attitude and if you find the right PT. I didn't like my first one. But on the bright side my DR. & PT are the ones that suggested cycling for me and I have been having a blast ever since. Good luck with your recovery and don't try to do to much to soon it will only come back to haunt you later.

Well, keep us appraised of your situation and let us know if you have the surgery and how things are going for you. We're all pulling for you, and I'm sure you'll make the best decision for yourself.

I'll drop you a PM when I get something solid. It'll be me and perhaps one other person, and we'll stop through in late May and stay just a couple of days if that's ok with you and yours.

Koffee

I'll drop you a PM when I get something solid. It'll be me and perhaps one other person, and we'll stop through in late May and stay just a couple of days if that's ok with you and yours.

that would be cool... especially since i won't be able to ride much between now and then it would be nice to hear about your riding... just let me know when to expect you. a small group should be no problem - hey, hopefully by then i'll be able to ride around the city with you guys (i'm hoping i'll at least be able to one-legged cycle pretty soon after as i LOVE bike commuting almost as much as mountain biking) - for european standards i've got a big apartment and the living room has tons of floor space. i live 2km from the center of the city and directly next to the river so it's great for exploring the city or riding along the paths along the river.

i talked it over with my parents and my girlfriend and i am pretty sure i am going to have the surgery next thursday. i think it is best to do the best thing for the long term even though it really sucks for now -- as an aside yesterday before i went to the doctor i was so excited because my training was going so well - i have never been SO fit this early in the season. my resting heartrate is now UNDER 40!!! but i guess the last few months are training are kind of lost... oh well, i guess on the other hand, being so fit now hopefully i'll be able to recover fast and be competitive for the 2005 season (oh man that's like 13 months away - dang!)

i just don't know what i am going to do with myself for 3-6 months without mountain biking, skiing, snowboarding, hiking, climbing, volleyball, etc... i guess i can act as trainer and supporter for my girlfriend in her MTB race training but that won't occupy enough of my time i don't think. another really crappy thing is i'm also ruining the highlight of the summer for my girlfriend: the TransAlp Challenge in July is an 8-day 2-person team race... well, maybe we can find another partner for her but then i have to admit i'd be a little hurt if she rode it with someone else... but if she wants to then i guess i can handle that. plus, i don't think this is going to help me out with any of my sponsors... i've gotten 3 solid sponsors in the last few months and am working on a few more, but being out for most of the season is not going to help my "marketability"... oh well, i guess it could be worse if cycling were actually my main source of income.

P.S. good news is i think my insurance is going to pay for almost everything - i find out tomorrow but it is possible it might include 100% of everything including rehab - plus i'll get paid sick-leave from work no problem (germany)

Well, you could always lift weights and try boxing. I developed a ripped upper body at one point when I was doing cross training from doing a whole bunch of boxing. I was boxing with a partner and using focus mitts and the big bags to hit on and not only can it be an anaerobic activity, it can really rip your muscles and bring on some real tone. You might even get addicted...

Koffee

Well, you could always lift weights and try boxing. I developed a ripped upper body at one point when I was doing cross training from doing a whole bunch of boxing. I was boxing with a partner and using focus mitts and the big bags to hit on and not only can it be an anaerobic activity, it can really rip your muscles and bring on some real tone. You might even get addicted...

Koffee
I second this. Surgery doesn't mean you'll be in bed for six months. My PT started a few weeks after the surgery with streching, mobility etc. Listen to the therapist and don't push too hard. You could also ask them what exercises you can do.

The ligament used on my surgery was the patellar tendon www.arthroscopy.com/sp05018.htm (http://www.arthroscopy.com/sp05018.htm) I have a scar on the front of my leg from the kneecap down and few inches but its not bad.

Good luck and let us know how it goes.

Dave

I second this. Surgery doesn't mean you'll be in bed for six months. My PT started a few weeks after the surgery with streching, mobility etc. Listen to the therapist and don't push too hard. You could also ask them what exercises you can do.

oh yes! i guarantee i will be doing as much as i am allowed to. i will certainly use the opportunity to lift weights a lot. about 4 years ago i was in the gym 5-6 days a week but b/c of all my cycling have only been able to manage about once a week the last few years. but yeah, i went looking for a new fitness center yesterday as my old one is far away since i moved and i will not be able to bike the 10km so easily.

i have also already been thinking of non-knee sports i can do --- i've been thinking maybe i'll start kayaking again although i sold my boat and i guess i can't do any extreme whitewater stuff as i could hurt my knee if i flip... and i will probably do some swimming although i am a horrible swimmer. (i injured my knee 4 years ago and took up swimming and did a few triathlons although i was usually one of the last out of the water)

and i'll have to talk to my doctor about it, but i am kind of hoping i will be able to one-legged bike pretty soon afterwards as my bike is my mobility in the city and that way i can at least keep my strength in my left leg and some of my cardio fitness -- my left leg is weaker than my right leg and about 2cm smaller in circumference b/c of hurt my left knee 4 years from overtraining, so this would be a god chance to equalize the 2 legs...


Well, you could always lift weights and try boxing. I developed a ripped upper body at one point when I was doing cross training from doing a whole bunch of boxing. I was boxing with a partner and using focus mitts and the big bags to hit on and not only can it be an anaerobic activity, it can really rip your muscles and bring on some real tone. You might even get addicted...

hmm... boxing i have not tried. i did a fair amount of karate in the past which i won't be able to do, but boxing... hm never thought of it.

and yes, as far as the aesthetics are concerned... i would actually expect the surgery to be an "improvement" (depending on your taste but i think i actually look better with a little more mass than when i am in top competition form and a little on the thin side - body fat currently less than 8% - i'm 33 now so no more less than 6% like a few years ago) as i will maybe be able to actually gain some mass as i won't be doin SO much cardio. the last 2 months with all my training i am almost down to my summer competition weight: i am 185cm (6'1") and 71kg (hmm... is that right? 156lbs!)

for cycling competition i like to be under 160lbs, but with no racing on the agenda until April NEXT year 2005 it shouldn't hurt to gain a little mass (and my girlfriend won't complain if i add some bulging shoulders and biceps to my washboard stomach and increase my triceps, back and gluts...) - hey Koffee maybe you'll have to snap a photo for a future BikeForums Calendar when you're here... end of May is 2 months from now. (although hopefully i can also maintain the washboard stomach without all the cycling)

Yes, by all means... consider boxing. It's also something you and your girlfriend can do together if she's keen on cross training too, which would be nice. I'm not talking about the karate boxing either- I'm talking straight up boxing using gloves and focus mitts and doing some traditional boxing. I had to spend quite a bit of time working up to doing a full hour nonstop of traditional boxing moves- ducks uppercuts, jabs, crosses, weaves, etc. Doing a lot of combination moves will really get you your anaerobic and aerobic cardiovascular training.

Have you thought about picking up yoga and pilates too? Look at this down time as an opportunity to develop your weaknesses and take advantage of other exercise genres that you wouldn't have considered before. Then when you get back to cycling, you'll be a stronger, much more well rounded athlete.

As far as the bikeforums camera- I'll bring my professional SLR for that... I can't wait! :p ;)

Koffee

well i've got 5 days till my surgery and spring has arrived here... i got in a 4 hours trail ride today... so i'm gonna try and get in a ton of riding! the swelling has gone down in my knee so as long as i don't twist it REALLY badly or fall on it (no skiing of course) mountain biking should be ok... so i'm gonna ride!!!

i am considering driving down to Lake Garda Italy as i will be missing my 2 planned 4-day tours there in April and May (well, in May for the Bike Festival i will be there but as support/coach and mechanic for my girlfriend and friends as i won't be able to ride) and i think it will be mostly snow-free there as opposed to here where spring has arrived and our local trails are snow-free (they had 1ft of snow last week) but you can't ride in the mountains as there is still snowpack.

anyhow, the weather in Italy is supposed to be pretty warm and ok through Monday and then rainy Tuesday... would kind of suck to have to drive the 3 1/2 hours by myself and then probably ride/camp alone... but then this is my only chance to ride for the next 3 to 4 months... 2 friends of mine are arriving Tuesday in Lake Garda but as i said that's when the weather turns crappy and i have to be back by noon Wednesday at the latest for the pre-surgery check.

but yeah koffee, that's about my attitude. with my last knee injury i took up swimming and i am definitely open to trying some new stuff --- anything limited to upper body i should still be able to really do, and as i know from the 6 week recovery from my spleen surgery in 1992 i go completely stir crazy if i don't do some kind of workout/sport/activity...

yoga i've done a bit of in 2001 and found it ok... although with the knee i won't be able to do a lot i think. but what is pilates? i've heard of it but have no idea what it is...

Pilates is a core strength training program. Check out this link: http://www.pilatesberlin.de/en/jp.html and go through the first two pages. A lot of people think yoga and pilates are almost the same thing, and they are not... yoga is more of a flexibility thing and pilates concentrates on building up strength by focussing on your core muscles- abdominals and back, mainly. It's pretty popular here, and I'm sure it's popular worldwide too, especially Germany since that's where Joseph Pilates is from.

Koffee

You could also swim to maintain aerobic fitness. I used to breath on every second stroke. Drives you into oxygen deprivation and keeps you there. Nice thing is that when your judgement turns to crap you hit a wall instead of a semi.

Bummer nathan, sorry to hear this. I went through it a few years ago and I got over mine just fine. Either that or all my other nagging injuries just make it less noticable heheh.

I tried pilates a couple times. All it did for me was make me crave chocolate :p

Cross training is a good thing though, find something you like. For me it's swimming, even though I'm terribly slow. It's a cool distraction though and there's plenty of different techniques to learn to help pass the time.

Good luck dude...

well, the weather was somewhat cooperative...

i spent 1 1/2 days at Lake Garda and it rained on me twice but i stil managed to do 3 awesome tours with some sweet climbs and trails (2900meters vertical or 9600ft)

got there just after noon Sunday, on the trail just before 1pm... at 1100meters encountered some snow on the trail and a thick cloud of cold fog blew in... but the downhill was awesome (very rocky hard-core downhill)

Sunday night about 3am i was awakened by rain and i scrambled to roll up the car windows... then i realized i URGENTLY had to pee... tried to wait out the storm but after 20 minutes of waiting couldn't hold it and ended up opening the rear door and peeing out into the parking lot!

Monday morning was awesome sumemr weather and i did a sweet tour but again hit snow and had to walk the bike a ways to find the right downhill trail...

then clouds blew in but i decided to ride the Altisimo "extreme" dowhill stretch - it goes up to 2000m where there is lots of snow but i was hoping to do the bottom half so start at 1000m... i was SO fit and climbing SO fast, but the weather kept getting worse and then it was raining. i decided it better to ride down rather than risk doing all the vertical on the wet and slipper rocky trail so i started down... and the first few minutes were awesome... then it got wet and the ROCKS were so slick. then i noticed a little sun and blue sky and decided to wait... found a good spot and waited almost an hour for the trail to dry a little... and had an awesome descent down the extreme 601 trail! back at the lake i went to a pizzeria and came out to RAIN so i drove home.

well, at least i got soem good climbing and some extreme downhill in before my surgery... still some unresolved points about the rehab. my girlfriend is encouraging me to try and get into a in-patient rehab so my recovery goes as quickly as possible, but i'm not yet sure what my insurance will pay for...

good luck nathank. I'm no pro athlete like you , but giving up mountain biking for my last 5 months of pregnancy sent me into withdrawels and the recovery after delivery sucked. (I did swim and road bike alot though..but it's not the same as you know) I think you may actually return stronger. My last 24 hours of adrenaline 2 years after giving birth was one of my best in terms of speed and time, almost as if the time off to recover and build back up after the delivery helped!

I think you may actually return stronger. My last 24 hours of adrenaline 2 years after giving birth was one of my best in terms of speed and time, almost as if the time off to recover and build back up after the delivery helped!

well i hope you are right. after my slpendictomy in 1992 where i was out of sports for 6 weeks i was SO worried i wouldn't be as fit/strong as before... (i was on the university volleyball team at UT Austin) and i trained hard and i was particularly worried about my vertical jump --- and as you said, the next year i was one of my best and my jump IMPROVED to 36 inches...

i think it has to do with attitude and when you are not able to train you are even more determined than if it had never happened. i'm not a pro, but Lance Armstrong says basically the same thing about his return after cancer...

and thank you all for the comments and sympathy... i'll be back VERY SOON...

2 days to surgery... (actually it's kind of weird b/c the swelling is all gone in my knee and it FEELS strong i just know if i did something like ski or jumping again it would go out)

ok well, i leave for the hospital in a few minutes... stay overnight and will be home tomorrow afternoon. have gotten some differing opinions on how soon i can train - one doctor said "no way" to my race end of July but another said i can start hard training again after 8 weeks which would be May 23rd...

anyhow, i'll post again after i'm home and have some energy to log on to the Internet...

ok, well the surgery went great! the good news is that other than my ACL there was no other damage to my knee (it was expected that there would be some damage to my cartiliage that would have to be repaired).

i was supposed to be released on Friday, but my knee was so swollen they decided to keep me an extra day. they drained fluid from my knee: 2 coke cans worth!!

anyway, then the only real mishap: i had gotten 2 shots and then went and sat down and then had some xrays done. then i was told to go back to my room... the receptionist girl was nice but i think she is new and i told her i felt a little weak and she said she would like to esccort me but was alone at her station so couldn't... anyway, i was sweating and couldn't think so well so i hobbled on my crutches to the elevator... and it got worse and i was really lightheaded. the elevator opened i got in and pushed the button... then i could hardly stand and propped myself against the wall. the elevator opened and i yelled for help and a patient went to get help. the next thing i remember they were lifting my into a wheelchair - i had passed out and had been lying in the elevator! fortunately i was wearing my brace so i probably did not injure my knee.

anyhow, Saturday (2nd day after operation) i went home and things are good!

the bike trainer i ordered arrived and i set it up and yesterday i very cautiously tested it when a friend was here. today i managed to ride 20 minutes one-legged with my injured leg propped onto phone books and my hand supported by the crutches instead of on the bars. it went well! the hardest part is getting on and off the bike as i have to mount from the rear as i can't bend my knee enough to lift the leg over the bar... but i got my pulse easily over 130 and up to the mid 150s (my LT is 165 and max 192). i didn't want to overdue it, so i only did 20 minutes, but i am stoked!!!

in 2 weeks i start my therapy and until then i am at home - and on crutches - and i do my passive knee therapie in this machine that moves my knee - 2-3 times / day...

Friday and Saturday i was REALLY weak and felt really crappy... but today is much better and although my knee is a major inhibitor (i took a shower today and it was not so easy) things are ok.

Good to hear from you! Glad things went well except for your syncopable episode. Good luck. You have the right attitude. Keep us informed!

Oh gosh, I feel just terrible reading your posts. Glad to see you've got the right attitude (hopefully optimistic). I'm glad to hear that there's no further damage, and I'll keep my fingers crossed.

Take care,

Koffee

The ligament used on my surgery was the patellar tendon www.arthroscopy.com/sp05018.htm I have a scar on the front of my leg from the kneecap down and few inches but its not bad.

exactly. that's what i had too. the tendon was folded over 2 times (so 4 times as thick) and then they drilled through both bones and then threaded the tendon through my old torn ligament (i actually have the whole ting on video and it is pretty crazy - they use what looks liek a regular DRILL!)

i still haven't gotten a great look and as i said it's all swollen, but i took off some of the bandages today and there is some yellowing and all... but the actual scars should be pretty minimal. there is no big "cut" like i see from most knee surgery scars like you describe, but rather just 4 "holes" (actuals holes or cuts max one inch long): one above the knee, one below, then one below and inside, and one above and outside.


Oh gosh, I feel just terrible reading your posts. Glad to see you've got the right attitude (hopefully optimistic). I'm glad to hear that there's no further damage, and I'll keep my fingers crossed.
well, i think the worst is over. my knee is still swollen and i have some pain, but it is MUCH better. last nicht i managed to walk on the crutches across the bridge to meet some friends at a cafe. this afternoon i will try and make it to the subway and get to the gym to do upper boody wieght training. and tonight is the Guide and tour introduction for my MTB Guide group... my tours and technique courses in April and May have been cancelled, but i hope to still give mine in (june maybe) and August September for sure.

i managed to get 30 minutes in one-legged on the trainer yetserday. pulse 125-150, but i must say it is HARD as the hamstring muscle or whatever it is that pulls the pedal through the upstroke become worn out after about 2 minutes and it is a hard mental concentration to keep pedalling... hopefully i can get 30-60 minutes almost every day so i don't loost too much heart/cardio fitness and muscle-tone in the left leg... mounting and dismounting is now not SO scary as i have a little better use of the right leg for support and am just more comfortable on the crutches. man i bet i look funny riding one-legged on a trainer with my hand supported on crutches and my right leg sitting on phone books (but nobody sees me)

good god! i don't know how ya'll can be this casual about this! :eek: i've had some pretty sever tendonitis and bursitis in my knees, hips, elbow, and shoulders before.. it hurt like hell! after an h.s. football game that i was marching and playing at... i was crying when i got home. i had to take a shower cus they made us wear like 3 layers of wool...but i didn't want to cus it hurt soooooo bad. god it hurt.. like sandpaper in the knees.... gawd it makes me queasy to read even part of that... apparently skiing is evil and you (nearly puking... seriously) should stop. do EVERYTHING your doctor tells you to. take plenty of glucosamine, chondroiton and msm. man... and seriously. stop skiing... ... i'm done.. (i'm not even gonna look at this thread again.) eeeeeeeeeerrrrrrrgggggggggh!!! it's too much.. g'day. :cry:

ok, well things are progressing well.

yesterday was day 6 post-surgery and i went to the doctor for my check --- everything good. there was a little swelling still in my leg and the doctors/nurse had wrapped the bandage starting about mid-calf and then up over my knee to mid-thigh. but the areas between my mid-calf and my sock had been REALLY swollen the last 2 days - like well over an inch!! and so i had a very large very painful blue/purple bruise... anyway, the doctors removed some fluid from my knee again and then gave me some cream and re-wrapped the knee starting lower. that night (yesterday) it was SO painful whenever i would stand up as the blood ran into my leg and hit the bruised area!!!

but the good news is that today the swelling was significantly reduced!!! i almost feel like IF i didn't have to baby the knee and wear the brace, it would be almost normal!!

and i got on the trainer one-legged today -- man is that mentally tough!! i managed to crank out 33 minutes doing three "intense" sessions where i got my pulse up to 160! (max was 164 and my LT is 165 - not bad for one leg!). as before it is very taxing on the hamstring as there is not the other leg to push the crank the other half... some of the time i used my hand to help pull the leg through the bottom-stroke.

well, i know that 30 minutes a day on the trainer isn't much, but it sure is better than nothing!!! unfortunately because it's one-legged "light spinning" is not really possible...

did you check out www.understandaclsurgery.com ? cool.

hope all is better soon.

did you check out www.understandaclsurgery.com ? cool.

hope all is better soon.
Great link. That would have been nice to have that before I had both of my ACL's done.

ok, just wanted to post an update - 3 weeks post-OP

my recovery is going REALLY well. i am almost a week ahead of the "normal" recovery.

i have no pain, have full extension/flexion and only slight swelling...

yesterday the doctor told me i can get off the crutches as soon as possible -- today i walekd for about an hour witht eh crutches in hand as a "helper" and in a few days i will be fully without them.

tomorrow i am seeing the doctor again and i will probably be starting on stationary bike training.

i will hopefully be able to start road biking next week.

i can't tell you guys how wonderful it is to be able to WALK normally again. the short hike yesterday with my girlfriend i was beaming a huge smile and just overjoyed.

i just have to watch the swelling and not do too much and see how it goes... i'm still on track to be able to do my big race end of July!

Kewl! I'm glad to see you're making a lot of progress there! Get better soon!

Koffee

what is the acl anyway?

what is the acl anyway?


anterior cruciate ligament

ohhhh. why the crap is that such a big deal? can't they just staple it back together and have it heal? arthritis is worse than that. how does one tear that thing anyway?

It is a major, major stabilizer of the knee, unlike the PCL (posterior cruciate ligament) which many times does not need to have surgery. An orthopedist with biomedical engineering and a structural engineer can explain it best. The ACL has very little blood perfusion so stapling together will not allow it to heal along with the sheer forces it must deal with unless it is 100% structurally intact. (They have already done the clinical research to see if simple suturing or stapling will help.) If you left the acl unrepaired and remain active, the knee pretty much gets destroyed in many many ways.

so how do they fix it? aren't there any steroids to speed the healing?

so how do they fix it? aren't there any steroids to speed the healing?
An orthopod can tell you the latest and greatest but I will tell you what I see commonly.

The most common type of knee surgery after an ACL tear is a "reconstruction" of the ligament.

This means that the torn ligament is removed and replaced with a new one.

Today, a part of a tendon usually from somewhere else around your knee is removed and put in the place of the torn ACL. (However, in some very special situations a torn ACL may heal on its own without being replaced. This happens very rarely, and only when the ACL is partially torn or has pulled cleanly away from the bone.)

The remnants of your torn ACL need to be removed, and a similar ligament from somewhere else around your knee needs to be inserted in the place of the original ACL.

Using a ligament from somewhere else around your knee may sound a bit like robbing Peter to pay Paul, and in fact it is, for each of the grafts that are used for ACL surgery has some drawbacks. The grafts that are currently used today are the central part of the patellar tendon, some of the hamstring tendons, or an "allograft" from a cadaver.

Several factors influence what type of graft may be the best choice for you and your surgeon. If you have a history of patellar tendinitis or patellofemoral pain, or if you happen to have a very narrow or very short patellar tendon, then a hamstring tendon graft may be necessary for you. However, if the hamstring tendons are too small or not strong enough to replace the ACL you may require either a patellar tendon graft or allograft. Most surgeons develop a preference for one type of graft versus the others. The graft that your surgeon chooses may be influenced by the practice prevailing where he trained, but he might employ any of a number of alternative techniques as well. While there is a lot of scientific debate at the moment about what type of graft is the best, there is no clear answer to that question. Each graft certainly has its place in today's surgical reconstruction techniques. Across the United States today, most surgeries are done with hamstring or patellar tendon grafts.
see below.

does the knee ever get as strong as it was originally? any tips on preventing such an injury?

this is why we need more stem cell research.

does the knee ever get as strong as it was originally? any tips on preventing such an injury?

this is why we need more stem cell research.


Will my replacement ACL be as good as the original one?
The answer to this question is a bit complicated.

From a functional point of view, we can say that many athletes who have torn their ACL and have returned to their sports, won national championships, won Olympic gold medals, and enjoyed long professional careers. From this point of view, the function of the knee is nearly completely restored by reconstructive surgery.

However, from a scientific point of view, it is clear that a replacement ACL does not function as well as the original ligament.

This is because the original ligament has special nerve fibers that provide each person with a sense of the position of his or her joint. This function is not replaced when a new ligament is used to reconstruct the original one. The native ACL also has special properties that allow it to stretch and relax, and it has a complicated arrangement of individual fibers that perfectly balance the tension in the ligament during flexion and extension of the knee. These properties are also not completely restored when the ligament is replaced. In the long run, nearly ninety percent of people who have had ACL surgery say that they are very glad that they had it done, and would choose to have it done again.

Stem cell research may not help us grow such a tissue whose development is as much directed by the mechanical forces exerted on it ( to form the unique alignment of fibers etc.) as well as the gene that gets turned on to form the ACL. Thus, this development of a specialized tissue such as the ACL cannot just be grown or harvested, but must be obtained from the environment that created its geometry and tensile strength....in other words, a functional knee. This is unlike stem cell research to grow neurological cells dedicated to producing dopamine that is deficient in Parkinson's etc.

does the knee ever get as strong as it was originally? any tips on preventing such an injury?

this is why we need more stem cell research.

I don't think there's any 100% tried and true method to prevent injury, but you can help protect the knee by strengthening the muscles around the knee. This would involve knee flexion and extension strength training (hamstring curls and quad extension), squats and lunges, including alternating isolated leg lunges. All these things will help develop the muscles around the knee and strengthen the area overall.

Koffee

ok, so here's my 4-week post-OP update:

i'm doing GREAT!

end of last week the doctor said i could slowly get off the crutches. i started waling "normally" immediatley, but used the crutches for 3 days as "helpers" and have been walking normally the last 3-4 days! i can climb stairs regularly although a little more slowly. going down i only go one step at a time with both feet...

my range-of-motion is EXCELLENT. tuesday it was: -7 to +122 which is not bad for 3 1/2 weeks! yesterday i was on the bike trainer for the first time and rode 15 minutes today (easy with very little resistance, the first 10 minutes my pulse didn't get over 85, then i went a little faster but still didn't get my pusle over 105)... but i have to start slowly

about 4 days ago the swelling REALLY reduces a lot and you could for the first time really see my kneecap. it's of course still swollen when compared to the healthy one, but that is to be expected i think.

yesterday i had the controlling MRI (or whatever it is with the pitcure) but the printer was broken, so tomorrow i get the reoprt --- hopefully all is perfect!

the only bad thing is that my muscle has really ATROPHIED!!! the diameter is about 1-2- inches less than it was 4 weeks ago, but what is really bad is the muscle on the front of the leg just over the knee - no idea what it's called, but the "cycling muscle" is almost nonexistent --- on my left leg it bulges out and on the right leg with the swelling from my knee it actually bulges IN!!!!

but everything is going well and as of a few days ago i am allowed to use the muscles and start re-training the muscle and SLOWLY increasing my training.

cbhungry, thanks for all the info.

the patellar tendon was used for my new ACL. it was folded over 4 times and then threaded through my old ligament, but unfortunately in the 2 months between my accident and the surgery the body had "unbuilt" much of the original ligament so the "threading" was less successful than hoped.

please don't ski again.

please don't ski again.
what?

of course i will ski again... maybe go a little easier on the big jumps and airs...

actually this winter BEFORE i injured my knee i had already decided that skiing is more dangerous than snowboarding despite how everyone talks about snowborading being so dangerous... the injuries in snowboarding are in general less severe and more preventable: shoulder, wrist, head and foot injuries. i wear a helmet, have wrist-guard gloves and (only for extreme stuff) body armour with shoulder/elbow/back/knee protection. in my years of snowboarding i have separated my shoulder, broken 2 fingers and gotten lots of bruises -- in skiing this is virtually no way to really protect against knee injuries.

so next winter i will probably be snowboarding more than skiing and try and do most of my jumping and extreme stuff on the snowboard...

P.S. some people think i am a "freak" or "crazy" or "dangerous" for doing extreme sports like snowboarding, freeride skiing, downhill/freeride mountain biking, rock climbing, mountaineering, ski touring, kayaking, etc... but if people were really concerned about their safety they would reduce the most dangerous activity most do: DRIVING A CAR. i personally HAVE drastically reduced my auto usage and didn't even own a car (by choice) the last 2 1/2 years - i bought a car in January and have driven it now max 7 times in 3+ months. _THAT_ is reducing risk!! i am 33 years old, 165lbs at 6'1" with 6-9% body fat with a resting pusle of 40bpm... there is history of high-blood pressure in my family and at age 30 mine was a little high... now again in the green zone! the "sport is murder" saying is such a scapegoat for people who want to justify being lazy!

so next winter i will probably be snowboarding more than skiing and try and do most of my jumping and extreme stuff on the snowboard...

P.S. some people think i am a "freak" or "crazy" or "dangerous" for doing extreme sports like snowboarding, freeride skiing, downhill/freeride mountain biking, rock climbing, mountaineering, ski touring, kayaking, etc...


Must revive old thread, must not avoid compulsion.....

ANyway, I recently injured my knee (very minor compared to ACL) and was doing some web searching
about knees and ended up my session today reading this thread, which I found interesting and informative.

What I'd like to hear from Nathank, is how things are going post ACL surgery. Full total recovery and back
to your 'mad' former glory extreme sport activitylevels or are you having to moderate yet?

:beer: :beer: