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The snowHeads ACL rehab club !

 Poster: A snowHead
Poster: A snowHead
@Grizzler, When I was rehabbing mine, my physio strength tested bad v good as a reference. However he was also very interested in my fine 'control' of the repaired leg as well as strength.

@Harry Flashman
There are some rehab diaries on here which give some real life experiences. I think I was getting back on ski's by 6 months but it was done carefully. With hind sight I reckon it was actually 3 years before I was fully back to where I was pre accident.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@AndAnotherThing.., Trouble is, whilst one seems better than the other, I have both legs/knees to get back into shape...

My physio also said that full recovery is likely to be in matters of year(s) - but "strong enough" is, I presume, going to be some time before that, just with appropriate caution and reduced time/mileage/aggression.
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Well, the person's real but it's just a made up name, see?
@Grizzler, Presumably 'out there somewhere' is the data that ought to give a base line reference.

Shame pulling the data together will be difficult.
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@AndAnotherThing.., Difficult, yes. And I've been looking online since pretty much week 7 post injury (so end April) and asking many healthcare professionals who claim knee expertise - and, sadly (never mind annoyingly) I can't find said data or baseline references anywhere.
It does seem that I, and I assume many others in a similar boat, are just left to take their own risks and proceed with cautious trial and hopefully not too much injurious error. Very non- impressed by being left extremely alone and unadvised in this decision and in rehabbing in a return to ski way. Unfortunately, except for Wimbledon Clinic's RTS course, which is inaccessible for me, it seems it's the only option for most, and getting a physio or doctor who skis is pot luck to rare. Any practical guidance to assist in making the potentially-
risky 'when to try it again' decision (and the attendant 'strong enough' assessment) is, if available, clearly a very closely-guarded trade secret...

Due to personal circumstances and time constraints/availability, I've decided to have a go again indoors next week. That's 5 1/2 months post injury. Part of me thinks it's a bit soon (on one knee, anyway), the rest thinks it's about time and that I should be OK if I don't over push it for too long and pile on the tubigrip and neoprene braces. So wish me luck, and hope that I've made the right decision and assessment of where I am up to. I guess that I'll find out either way...
Now, how does one do this turning and controlling skis thing again???
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Oops, sorry; duplicate post somehow...


Last edited by Anyway, snowHeads is much more fun if you do. on Mon 25-09-17 22:34; edited 1 time in total
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@Grizzler, Very much wishing you luck next week.
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@cad99uk, Thanks, and maybe it helped Very Happy
Went to Chill Factore today, clad in Tubigrip and wraparound braces. Won't say it was technically great, certainly nowhere near what I was capable of, but actually managed about hour and a half of various turn types and the usual chopped up lumps and hardpack corridors before deciding that discretion was the better part of determination.
Sore, weak, no way have any confidence and am terrified of speed or falling (did get on the race SLs but no way could handle the speed or skis).
But, hey, I stayed upright and seemingly in as much of 1 piece as how I went in. Smile


Last edited by Then you can post your own questions or snow reports... on Mon 25-09-17 22:34; edited 1 time in total
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@Grizzler, That's good news. Well done for being so positive. Hopefully that was the first of many sliding sessions in the future.
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@Grizzler, Brilliant. My first time back was also Manchester. I ended up shadowing an Instructor refresher course so started with straight running working through the plough stages until I was skiing a bit more like. As you say 'Discretion' is an important element at this stage Smile
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@Grizzler, what's the rush? It's all about the graft isn't it - graft gets weaker in first three months, starts to recover next three and actually starts to gain real strength from months 6-12? Is there any reason you need to get skiing so early, otherwise reducing physical worries, i.e. not rushing could make getting back on skis easier?
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@22 dropout, She hasn't had a graft.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
@22 dropout, Yep, no graft, just 2 sore and stiff legs and their middle bits.
Rush? I want to ski and board!!! And, seriously, I don't know if, how much, when, to what level, etc, etc. It's all about finding out in my particular circumstances, testing my abilities and strength and knees/legs with very little advice or input from healthcare or other people (most go the recon route), except to get strong and see how I do...
Also, it's getting to time when a little Grizzler's mind starts turning to wanting to book snow holidays, plan next season etc etc ( or sadly decide that it isn't happening, as the case may be).
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@Grizzler, yep sorry. As it's an ACL thread I automatically assumed graft. I am not so sure its necessary to have a physio that skis more than one that deals with vigorous sports such as rugby or football.
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 You know it makes sense.
You know it makes sense.
@22 dropout, The only thing which I found, though my physio seemed very knowledgeable about knees and muscle strengthening in general, was that he had no understanding whatsoever about the movements and stresses which skiing or boarding involves, so could not offer any advice as to how to return to snowsports or tailor any rehab or exercises to them specifically. Maybe that's not an issue: a bit (OK lots) of net research pretty much gives me the same list of exercises to strengthen the same muscles). However, I'd feel much more comfortable with someone who knew what was involved in what I want to do and could tell me when I was ready, what to avoid etc.
My physio was a basketball player. Not a lot of use, really, telling me to avoiding jumping in the air, landing and pivot on the leg I land on... Ski jumping is not on the agenda Laughing Couldn't, however, advise me if I should or shouldn't attempt moguls.
Good basic physio plus good ski/board instruction is probably the best that I'll find - but then again, I was talking to a UK ski instructor a few weeks back, and they had absolutely no clue at all about what it's like coming back from and with an injured knee and ligament deficiency, and how that might affect my technique, ability, strength, stamina etc etc. Didn't even see why I was struggling and not able to attempt my usual style, speed or confidence. Not impressed Sad
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Bah. Knee the size of a football for the last 2 days. Didn't even do anything unusual, just my standard routines of dog walking, cycling, table tennis...mild pain in the hamstring as a precursor then woke up yday unable to straighten! Many years post acl op, the trauma lives on. Also 9 months post partial menisectomy....it had been fantastic... Sad
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@coddlesangers,

Crying or Very sad
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Hi, I'm an ortho surgeon and do alot of ACL reconstructions and ACL repair with the internal brace....if anyone has any questions just ask. My website is www.wessex-knee.com if you want more info. I also have a private group on facebook to chat about anything in a more private setting? www.facebook.com/wessexknee
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
ok, nearly 1 month later and I'm a little closer to finding out whats going on. Thought it was just an issue with hamstring/ITB/connective tissue generally and had been resting and rehabbing as if i had a small hamstring tear -- along with 4 sessions of physio therapy where my guy was reasonably certain we were on the right track...so feeling confident I went for a small slide in Villar yesterday - turn 1 or turn 2 it became clear that all was really really not well with the knee, it feels like its gonna give way on the lateral side, so couldn't really use my left knee/leg in any meaningful way. Stopped more or less immediately while my daughter took advantage of the blue sky and lovely conditions, was a nice day to sit outside anyway and have a beer. Physio tested it this morning, thinks the lateral ligament is fine, but was able to identify some issues with the nerves (lateral side of knee has very little sensation, is pretty numb), so possibly a nerve impingement of some sort - Off to the doc properly thursday for tests and what not. Knees are complicated it seems. Bright side for me is that it doesn't appear to be a mechanical problem inside the knee, so ACL intact, no fresh meniscus damage or no symptoms thereof...fingers crossed for a diagnosis of some sort now, so I can look forward to a ski!
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Hi @coddlesangers as a Sports Therapist I've rehab'd many people back from ACL repairs and they're never the same twice. Surgeons like our friend above are pretty good at them these days and it's not often that anything structurally goes wrong with the knee. Though it's always best to get this checked out for your own piece of mind. In my experience what happens is two fold. The body adapts a 'non-optimal' movement pattern after all the pain from the original injury and reconstruction. Usually you will hike the hip up on the injured side. This will alter the way muscles and nerves feel down the leg and continue to give an array of symptoms. For example, a recent piece of research suggested that 90% of professional footballers coming back form ACL recon will have a soft tissue injury within 6 weeks of return. Which confirms this imbalance causes strains we simply don't want. Secondly, especially post operation, there is lots of sensitivity which take a long time to ease off. This can remain for a long time. Re-balancing the body will normally help reduce this sensitivity. I have series of exercises on my website for knee injuries which you ACL'ers might find useful: https://www.brightonsportstherapy.co.uk/uncategorized/brighton-knee-pain-exercises. Feedback greatly appreciated.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
@Jamie Webb, So how does one interpret your comments when both knees / ACLs done in at once? wink ( serious question, actually)
Agree with you re sensitivity - though I'm non-surgical. Still struggling with what I assume is an 'itis' somewhere within, though no-one can say anything specific. Have movement, ROM, etc - if all very different from before injury - but also a lot of stiffness, muscle and nonspecific pain, etc. Made worse by exercise ( delayed) but also lack of exercise...

Interesting website, at least some things not always seen on the standard list of exercises, i.e. stretching for lower back and femoral nerve issues (does the sciatic get involved too?). I'd do a bit of careful editing and checking re a few typos and other text or language bits though.


Last edited by Anyway, snowHeads is much more fun if you do. on Thu 25-01-18 20:41; edited 1 time in total
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And just as a general update, things still far from what they were, variable muscle problems, especially in one leg, and a huge loss of stamina despite exercising. Not done as much as I could have done, to be fair, because of a house move and ongoing work and sorting; not as much walking and hills either Sad . Lots more kneeling though, which the knees and legs really didn't like but which, in the end, seems to have done some good.
First day back on real snow was Pennine combat turf-hopping, followed by unpisted Nevis Range reds followed by pretty- and totally-unpisted Glencoe.
We are still in one piece. Now, what was that but about taking it easy and gentle... rolling eyes
Confidence is utterly shot, technique ditto; I am acting like a doddery old dear who's been skiing a week. Legs will take it only for a short while before muscle fatigue sets in, but no bad after-effects so far except aches and twitches. Fallen a few times, which was and is one of my big fears now, worst one being catching a tip on something in deep snow and pitching forward and sideways, feeling knee inner pulled just before binding released - and being very surprised and grateful when got up and found nothing seemed wrong. 4 hours of sitting in the car stiffened out that theory (pain oddly on the outer knee) but it now seems recovered and was fine in the Pennine snow for a few hours last weekend, with a tad of the old me on planks maybe showing momentarily.
Early days...
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Grizzler wrote:
@22 dropout, The only thing which I found, though my physio seemed very knowledgeable about knees and muscle strengthening in general, was that he had no understanding whatsoever about the movements and stresses which skiing or boarding involves, so could not offer any advice as to how to return to snowsports or tailor any rehab or exercises to them specifically. Maybe that's not an issue: a bit (OK lots) of net research pretty much gives me the same list of exercises to strengthen the same muscles). However, I'd feel much more comfortable with someone who knew what was involved in what I want to do and could tell me when I was ready, what to avoid etc.
My physio was a basketball player. Not a lot of use, really, telling me to avoiding jumping in the air, landing and pivot on the leg I land on... Ski jumping is not on the agenda Laughing Couldn't, however, advise me if I should or shouldn't attempt moguls.
Good basic physio plus good ski/board instruction is probably the best that I'll find - but then again, I was talking to a UK ski instructor a few weeks back, and they had absolutely no clue at all about what it's like coming back from and with an injured knee and ligament deficiency, and how that might affect my technique, ability, strength, stamina etc etc. Didn't even see why I was struggling and not able to attempt my usual style, speed or confidence. Not impressed Sad


Jumping in on this. I did my knee when I was 18 playing Aussie Rules football at University. At the time because of the limited availability of MRI's the only way to truly know if a knee had been done was properly was an arthroscope. My surgeon wasn't keen to do that given my age and the uncertainty. The uncertainty was that despite the injury, the muscle bulk around the knee kept it stable. I rehabbed - lots of physio, hours in the Uni gym working on Quads, Hamstrings and Glutes. 13 weeks later i skied - very, very tentatively, only greens. It was difficult. I kept re-habbing. About 6 months later a mate and I went out again. It was end of the Aussie seasons, real spring conditions and we went for it. Amazing days skiing, really pushed it. By days end the knee had blown up again, so heaps of ice and compression, but at that point I knew I could ski.

My advice is keep building muscle. Keep working on flexibility. Keep testing the knee - wobble boards are great, becasue they throw the knee off balance getting the micro muscles to react. Most owhat you are going to battle is NOT physical, but psychological. What I always kept in the back of my mind was that doing a knee skiing is surprisingly hard, bad luck really. So ski in control and at a level whcih you are comfortable with and push it slowly.
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After all it is free Go on u know u want to!
@FrediKanoute, Yes. Muscle, muscle, muscle. Not so easy (but not impossible), nor as ache-free, when female wrong side of 50. Please send strapping 18-year-old Aussie bloke to assist (scruffy blonde preferable). Room for 2 on my wobble board.
And as for your last sentence? Great advice, certainly the way to approach things. See my last post... rolling eyes
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@Grizzler That's quite a feat to do both at the same time! I'm assuming it was a pretty spectacular wipeout. So sensitivity will definitely be an issue for you. And non-surgical. Are you hoping to get back skiing? I presume so if you're on this site.

Don't get hung up on the 'itis' it rarely is. The femoral nerve has a branch which terminates just where the patella tendon is. So I'd look to release this along it's length. This will also give you more bang for your buck. If you check out the 'Leg Pit' stretch in that article you can release the muscle off with your hand as you feel where the tightest bits are. It might hurt a bit - but that's when you know when you're on the good bit!

You can do the same with the hamstring stretch for the issues you have when kneeling. This is very common for post ACLers. Post-op or no. I'd be tempted to find a decent Sports Massage local to yourself and ask them to work through your obliques, adductors, quadriceps and hamstrings. That should short cut you to some better muscle strength. I would offer myself but you can't bet much further away than Brighton up there!

Thanks for the feedback on the website. I've got a lot of work to do to tidy it up! I tend to splurge it out and post it. Trying to be a bit more patient these days.
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Has anyone suffered mentally since their ACL rehab and been unable to ski like they did before the accident?

I injured 6 years ago, and have never managed to overcome the fear and get back to the level I was pre-injury. I still try every year, and I've gone back to lessons, but I know exactly what I SHOULD be doing, but my brain just stops it, I seize up, the voice In my head tells me I can't do it, and I end up sat in a cafe all day miserable while everyone else skis because I feel bad for slowing them down.

So desperate I'm considering hypnotherapy or even starting snowboarding. I really enjoy the mountain but I'm at the point of giving it up forever. Has anyone experienced this and how did you overcome??
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@The White Stuff, lessons help. In fact one instructor told me that I needed to fall over Happy. I was so nervous of it afterwards. I obliged him a day or so later and it did help.
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And love to help out and answer questions and of course, read each other's snow reports.
@NickyJ, It's a mental thing. I have this fear that ill re-injure and I just can't ski with that mindset. I need to break it but I just feel like my brains constantly telling me I shouldn't be doing this. And thats when the enjoyment stops.
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Quote:

or even starting snowboarding

Can't help with the injury come back but nothing wrong with snowboarding. A couple of inches of fresh on a nice blue is an absoluge delight. Give it a go.
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You know it makes sense.
The White Stuff wrote:
@NickyJ, It's a mental thing. I have this fear that ill re-injure and I just can't ski with that mindset. I need to break it but I just feel like my brains constantly telling me I shouldn't be doing this. And thats when the enjoyment stops.


I realise exactly- same for me
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
@The White Stuff, Most definitely! Only just starting back on skiing and boarding, not had surgery and still nowhere near the knees and legs which I had before - but the biggest problem is my brain. Same on other activities too. Understandable, I guess: fear of slipping or falling, fear of more injury, fear of pain...
You should have seen me a few weeks ago, first few times back: utterly terrified, frozen to the spot, refusing to make a turn or go down or accross the slightest uneven bit. Felt like an utter beginner idiot, wanted a huge sign explaining why I was acting like one. Improved my side-slipping ability on skis no end...
I skied much better after I then did 2 reasonably minor and then one spectacular falls (with knee strain/pull and ski release on the latter). A load of Pennine turf-hopping and a good day's falling over on a board had helped too (not saying that the snowboarding didn't hurt, especially when 'punting' on a traverse and went over onto the free leg).
Yes there's pain and some strains resulting: but the more that I do without things instantly falling apart or collapsing at least give me some hope and make me want to do more (stuff these dangerous crowded icy pistes, this off piste and jumping business looks fun... Very Happy )
Lessons - yes, I do need lots of those, just to ensure that my technique's as good as it can be. But I don't think that they can necessarily take away whatever your fears are: and those are often very sensible and realistic existential fears.
Hypnotherapy? Yes, I happen to be a fan of that (from an appropriately-experienced person); visualisation and other confidence-building techniques can work wonders.
Snowboarding? By all means - but it's just as scary and a lot more painful in the beginning, and with just as much risk of injuries (and, I think, actually takes a lot more guts until you're getting pretty good).
At the end of the day, for me, having suffered a reasonably-annoying, and certainly painful and activity-changing injury (which could have been worse, I know - and which maybe is the real issue) it's maybe going to take a long time before I ski again with the confidence and considered risk-taking that I did before. (Same as after climbing or motorcycle accidents and every other kind of trauma and life- or limb-threatening experience.) It's also going to be questionable if I ever have the strength and stamina and ease of movement that I had before too (and I don't think that surgery is necessarily the answer for me, either). And I don't know if I'll end up doing myself more damage or managing to continue snowsports for many more years yet (do any of us? It's a risky activity; as is life.) But I'll still find a way to enjoy it.
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The White Stuff wrote:
@NickyJ, It's a mental thing. I have this fear that ill re-injure and I just can't ski with that mindset. I need to break it but I just feel like my brains constantly telling me I shouldn't be doing this. And thats when the enjoyment stops.


A you doing any other sports or activities ? It could be that doing more sport away from skiing will give you confidence and help build muscle strength to support your knee.

I probably kidded myself on return to skiing that I wasn't affected but in truth I'd say it took 3 years to get fully back, certainly physically. These days I'm weary of crappy Welsh snow and assorted breakable crust, but then it has focused me to ensure I'm applying good technique.
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@The White Stuff, first time skiing l had an instructor ( older one!) he took me through the skiing learning curve, and by the end of my lesson it was almost as if l had not had an injury. He was 10 years + my age ( l am 63) and he took an extra hour on my lesson to prove to me l could still ski. I had an ACL reconstruction and skied in 10 months, though to be fair it took a little longer to really get my ski legs back
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Well, the person's real but it's just a made up name, see?
@The White Stuff, I agree with you but i find other sports cause issues as well, like ice skating etc. anything that requires the effected leg to seem to be at risk. I find with the skiing though that I put more effort into technique that I forget the knee to some degree until I have a moment of instability or some loss of ski control. I have also found my balance has been affected as i favour the stronger leg. I found this out after trying to get back on a surf board.

I have made a balance board to help and find that i can feel the knee working to keep balanced, but the psychological barrier is very real. Hopefully you can find a way around it.
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Have you tried indoor rowing. Make sure you watch some technique videos. I have found it excellent for building my leg strength up and particularly around my knee and my cardio fitness is now better than at anytime in my life.
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Anyway, snowHeads is much more fun if you do.
@The White Stuff, do you, or have you considered, wearing a brace?
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Now here's a weird thing. I'm over two years out from my acl surgery and have skied two seasons since. The knee remains stiff, though and I can't sit on my bottom. But at the gym on the rowing machine the other day, there was a series of clicks and all of a sudden I had almost completely free movement. I could sit on my bottom and the feeling like there's a compression bandage around the knee had gone completely. It didn't last - within 30 minutes or so it was back to how it had been but every time I go on the rower now, the same thing happens. I'm imagining that I'm starting to break up some scar tissue. It's very strange!
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Bumping this thread as I've just go home from an ACL reconstruction.

No longer will I scroll past this thread full of those daft skiers with their constant ligament snapping antics, safe in the knowledge that snowboarders never bust their knees.

Hope you'll allow an ex smug-knees boarder (now humbled by reality) in the club.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
@jjams82, welcome rolling eyes
How did you do it, then? Pray educate the masses.
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@Grizzler, ta:D

Had a bit of a tumble down a cliff (well, really a mellow-ish rocky outcrop, if that's the right word?) on the gnarbug bash. Thought I'd got away with it until I tried to ride off!
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Theres video of it...


http://youtube.com/v/hc8ngiMlCto
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