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  1. #1
    cycle-powered nathank's Avatar
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    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.
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  2. #2
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    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!!!!!!!!

  3. #3
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    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.

  4. #4
    Adios, Mofo J-McKech's Avatar
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    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.
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  5. #5
    Not Green, Celeste!!! cwodave's Avatar
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    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
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  6. #6
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    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

  7. #7
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    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.

  8. #8
    cycle-powered nathank's Avatar
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    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.

    Quote Originally Posted by Koffee
    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
    why drive when you can ride?
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  9. #9
    Senior Member bertt's Avatar
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    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.

  10. #10
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    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

  11. #11
    cycle-powered nathank's Avatar
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    Quote Originally Posted by 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)
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  12. #12
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    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

  13. #13
    Not Green, Celeste!!! cwodave's Avatar
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    Quote Originally Posted by Koffee Brown
    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 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
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  14. #14
    cycle-powered nathank's Avatar
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    Quote Originally Posted by cwodave
    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...

    Quote Originally Posted by 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...
    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)
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  15. #15
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    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!

    Koffee

  16. #16
    cycle-powered nathank's Avatar
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    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...
    why drive when you can ride?
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  17. #17
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    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

  18. #18
    Senior Member late's Avatar
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    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.

  19. #19
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    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

    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...

  20. #20
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    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...
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  21. #21
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    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!
    Last edited by cbhungry; 03-23-04 at 06:28 AM.
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  22. #22
    cycle-powered nathank's Avatar
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    Quote Originally Posted by cbhungry
    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)
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  23. #23
    cycle-powered nathank's Avatar
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    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...
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    now a fully certified German MTB Guide! (DAV)

  24. #24
    cycle-powered nathank's Avatar
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    Mar 2002
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    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.
    why drive when you can ride?
    now a fully certified German MTB Guide! (DAV)

  25. #25
    Jungle lady cbhungry's Avatar
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    Mar 2003
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    Good to hear from you! Glad things went well except for your syncopable episode. Good luck. You have the right attitude. Keep us informed!
    Ride forever, work whenever.
    XX power
    Eat more mud, mountain bike 'till you die!

    http://www.pnhp.org/

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