ACL Tear - JP Fitness Forums

eastcoastsurfer · 10-02-2007, 07:40 AM

Doc told me today he's 90% sure that I tore my ACL a few months ago wakeboarding. Ugh...

Anyways, after the original incident I let the pain go away and have been lifting fine ever since. When I tried to do some running the other the other day the pain was still there and so I went to the doctor. After messing with me knee he let me know the bad news and sent me for an MRI to verify. If it is tore, (which I think it is after watching him move my knee around) the doc told me that my prognosis is good and my current leg strength will help out a lot in my recovery.

He did say I could keep lifting and cycling for cardio. Said to avoid running or any sports which include cutting for now. Bummed out, b/c I'm probably going to miss my goal of a 500lb DL by eoy

Does anyone else have any experience with having their ACL replaced and/or know some good places I can read up about what to expect?

Thanks!

UConnJulie · 10-02-2007, 01:54 PM

There is lots of info out there ... not only have I treated a lot of patients with ACL reconstruction, but I've also had the surgery (in 1993). What exactly did you want to know?

eastcoastsurfer · 10-02-2007, 02:32 PM

My main questions center around how long I won't be able to workout for. Over the last 4 years my workouts have been my retreat. The place I go when life wasn't all that great. I've also worked pretty hard to gain the weight I have and am already feeling pretty depressed about how much I'm going to lose over the process.

I understand that heavy leg work is something that will be worked back up to over the course of months (6-9?), but what about upper body? Will I be limited in being able to pick up and carry weights to load the bar for a great length of time also? How long is average till I could go to the gym and get an upper body workout in? Assuming I have the surgery in the next couple weeks, the doc seemed confident he could have me snowboarding by Feb. After reading on the internet that seems like a pretty aggressive timeline. Is it?

What other questions should I be asking the doc?

UConnJulie · 10-02-2007, 03:07 PM

Where on the East Coast are you? Some of the best knee guys in the country are here. If you had surgery in October then being on the slopes by February is pretty aggressive I'd say ...

Check out Skwigg's blog ... she blew out her ACL doing martial arts (I think) and gives a good progression of her rehab and what her progress was like. She's super-fit and antsy and did really well.

You'll still be able to workout, but you'll have to modify. For upper body I don't see any reason why you can't continue with what you have been doing ... he'll likely have you in a hinged long leg brace ... if you workout with a partner, I'd just get him/her to swap out the plates. After surgery, you'll be in pain and kind of woozy for a few days/a week ... the timeline to return really should be set by your doc ... but for upper body stuff it usually isn't very long - around 2 weeks.

What procedure is he looking to do? What kind of graft (patellar tendon, hamstring, allograft)?

Read Skwigg's blog ... she probably answers most of your questions ...

eastcoastsurfer · 10-02-2007, 07:35 PM

Cool, I'll check out her blog. I'm in Charleston, SC. The doc seemed confident and said the patellar tendon surgery is his specialty and preference.

I did push him for an aggressive timeframe since I am/was supposed to move to Denver for the winter so I could snowboard. Most of my reading is saying that's out now. He did say my quads and hams are really strong and that actually gave him trouble in being able to say my ACL was torn 100%, hence the MRI. Although I saw the way he was able to move my knee while testing, I think he could tell I wasn't going to take his word for it regardless lol.

eastcoastsurfer · 10-02-2007, 09:52 PM

Hey, I read through her blog. Her recovery seems to be taking quite a bit of time. It does sound like she hurt her knee pretty bad up front though. When I originally hurt mine, I limped around for a couple days and slowly stretched it out and started lifting weights with it again on my own. Hell, I even pulled a new DL high of 465 a couple of weeks ago. The only reason I went to the doc is because I started running again to prep for flag football and it hurt pretty bad from running on the uneven grass. But other than that I've been surfing, DLing, squatting...

Alcoholiday · 10-02-2007, 10:33 PM

how bad of a tear is it?

if you go to marunde's board, and look for threads on acl tears, there's some good info there. They talk about which method of reconstruction is the better of the 2, and the success rates.

UConnJulie · 10-03-2007, 06:27 AM

Patellar tendon will give you the strongest graft because of the bone plugs on each end, and thus the quicker rehab ... I believe that Skwigg had an allograft (from a cadaver) which has a longer rehab because the blood supply takes longer to reestablish. Plus I think they were very conservative with her given her personality and tendancy to push through things which wouldn't be good for the healing of an allograft.

Sure, the shape you are in before will help with outcome after surgery ... if your doc says February barring any complications, then I'd believe him ... and snowboarding doesn't carry the risk to the ACL that skiing does.

My advice for pre-surgery focus? Get those hammies and glutes as strong as possible ... RDLs, GMs, pull throughs, GHRs, etc ... and make sure you get full range of motion back (ie can stretch heel to butt). The first month will be a little rough, but after that you'll be feeling good, and if you find the right therapist, you'll be snowboarding in February!

eastcoastsurfer · 10-03-2007, 06:46 AM

I have a appointment with my doc tomorrow morning to go over the MRI results. I guess I'll find out then how bad it is. I did lift legs hard yesterday. I think I'm mentally preparing to not be able to work them for awhile hehe.

Just saw your post Julie:
That's what the doc said about the patellar. He said it'll hurt like hell, but be the strongest for my situation.

Leg workout yesterday consisted of DLs, SLDLs, squats, and lunges. I have already gotten heel to butt movement back in my knee on my own. It's still a little sore when I stretch it all the way, but not much.

Thanks for all the information/advice!

eastcoastsurfer · 10-04-2007, 02:21 PM

I saw the doc again today. MRI confirmed ACL tear, but everything else looked good. Going to set up the surgery for a couple weeks from today and start the process of getting fixed.

He laid out to me what's going to happen. First, he's going to use a patellar tendon for the replacement, and hollow out some space in my knee where the ACL goes through which will lower the chances of tearing it again. The first week is going to suck, but then he'll fit me with a brace and get me moving around. By week 3ish he said I could potentially be walking again, all based on how fast my quad re-strengthens. Hopefully straight line running 3 months out and moving to full cutting/changing directions by month 6.

UConnJulie · 10-04-2007, 04:58 PM

Sounds good ... similar to the surgery I had except I have a lateral incision too where they went in to anchor the femoral component ... now that is all done through the anterior incision.

One suggestion I have is to practice quad setting now ... it is easier to do after surgery if you have the hang of how to do it before ... if you've never used crutches, it's also good to learn proper technique and practice ahead of time.

Also ask him about a CPM machine ... the research on keeping/gaining range of motion is inconclusive, but they are great for additional pain control ...

eastcoastsurfer · 10-17-2007, 08:47 AM

Surgery is scheduled for the 29th. Would rather have it sooner, but that is his first opening.

I asked about the CPM machine. He said in his experience he found extension to be the hardest motion to regain, so post surgery for the first week he wants to lock my leg straight in a brace. After that week he'll put it in a bendable brace and start PT from there.

And, I've been doing my quad setting exercises as you suggested at the end of my leg workouts.

Thanks again!

UConnJulie · 10-17-2007, 06:17 PM

Wow ... okay ... so he doesn't want you out of the brace doing any movement for the first week?

eastcoastsurfer · 10-18-2007, 08:09 AM

That's what he said. From his experience full extension was harder to get back than bending, hence the lock it in full extension for the first week. At my follow up appointment he would take it out of the lock and then put it in a bendable brace. At that point he said he was expecting me to be able to walk on it by the end of week 2 or 3, depending on how fast my quad re-strengthens. He knows I want the fastest recovery possible and will do whatever it takes. I'll ask about the machine again and see what he says. He's done tons of these (I'm the 4th wakeboarder he's done), but I don't want to miss something that may make me recover more quickly

At this point, I'm more worried about that crazy staph infection that is going around than I am about anything else.

UConnJulie · 10-18-2007, 09:16 AM

No worries ... he's the surgeon! You'd be better off asking him about a cryocuff ... if you aren't moving it, you will want to be doing something to help alleviate the swelling ...

eastcoastsurfer · 10-22-2007, 05:30 PM

You know of any supplements I should ask about that could speed up healing? Stuff like glucosamine or something? I already take creatine and fish oil daily.

UConnJulie · 10-23-2007, 01:56 PM

You could ask him ... I find that most surgeons aren't big on supplements since the research doesn't present a clear arguement for it. I would think fish oil would be your best bet ... protein and vitamin C are helpful for healing ... but talk to the surgeon first to make sure that there are no contraindications for any of those (based upon post-op meds and anesthesia).