Questions for those that have torn ACLs before

[BumKnee]

Hi All,

Last week I took a spill on the ice and wrenched my knee in a horrid way. Was massively painful then, but after a few hours was not so bad, just couldn't walk on it...it gave way. So I went to my family dr who did that test where they pull your calf forward and she says....yeah, guessing it is a torn ACL. She gave me a brace to immobilize it, told me to use crutched for a week, then after XMAS when the trauma part settled down, go to the Ortho.

So here I sit. Over the last 3 days I have been able to put more and more pressure on it. If I walk on my heel it feels fine. If I step on my toe it is bad, although getting better day by day. It does feel progressively better.

So I have an appt with the Ortho later next week.

In the meantime, some questions.

1) Could it be anything other than a torn ACL? At what point to the operate? (I am a 30 yr old female, not an NFL player ...that being said, I lift my ass off and have finally got my squat up to 190lb after my last baby, so now I am just pissed).

2) Am I hurting anything in the meantime by using that leg some?

3) Will I end up completely out of balance if I do some unilateral leg work on my good side?

4) Motions like leg extensions feel fine on my bad knee....is there a reason not to do motions on that side that feel fine?

Thanks for any advice.

J

[laxer32]

Originally Posted by BumKnee

1) Could it be anything other than a torn ACL? At what point to the operate? (I am a 30 yr old female, not an NFL player ...that being said, I lift my ass off and have finally got my squat up to 190lb after my last baby, so now I am just pissed).

2) Am I hurting anything in the meantime by using that leg some?

3) Will I end up completely out of balance if I do some unilateral leg work on my good side?

4) Motions like leg extensions feel fine on my bad knee....is there a reason not to do motions on that side that feel fine?

Thanks for any advice.

J

Tore my ACL playing lacrosse back on '05.

1. The ortho is most likely going to schedule you for an MRI to give a definitely diagnosis. if you have an active lifestyle and workout they will most likely encourage you to get surgery.

2. If there is no pain, not really. If it is torn its torn. I completely seperated mine in two pieces. I tore mine on March 31 and didn't have surgery till May 25. My ortho told me to do as much leg exercise as I could handle because it would make therapy easier the more muscle I had.

3-4. Do both legs. I used a leg press.. ask your ortho about squats or other BB exercises. I did the leg press one leg at a time so my good leg wouldn't take over. Just be careful doing quick movements in the meantime. Over the two months my knee gave a out a few times (was doing stuff I shouldn't have done with out an ACL)and I found out why I needed an ACL.

[BumKnee]

Great reply...thanks so much. Did you brace yours, or just wing it?

[laxer32]

Nope no braces. You really only need a brace when you're cutting/lateral movement.

[domers50]

Originally Posted by BumKnee

Hi All,


1) Could it be anything other than a torn ACL? At what point to the operate? (I am a 30 yr old female, not an NFL player ...that being said, I lift my ass off and have finally got my squat up to 190lb after my last baby, so now I am just pissed).

2) Am I hurting anything in the meantime by using that leg some?

3) Will I end up completely out of balance if I do some unilateral leg work on my good side?

4) Motions like leg extensions feel fine on my bad knee....is there a reason not to do motions on that side that feel fine?


J

1. most likely a torn ACL. Have the surgery if that's the case. 6-9months of thorough rehab and you'll be fine. Since you're young and active it's better to just do the surgery, even though you can live perfectly fine without an ACL. Doing sports like basketball etc is hard without an ACL, but not everyday living. But since you're lifting hard, get the surgery so that you don't have to worry about your knee giving away.

2. I would encourage you to "rehab in advance" before the surgery. Stationary bike is great for range of motion, likewise leg presses. Focus on keeping your knee directly over your second toe. Start doing some stabilizing exercises for your knee. Increase load gradually.

3. You're good leg will not grow uncontrollably, but your bad leg will most likely shrink a lot if you don't use it. Do unilateral work on both legs, so that you prevent muscle loss in your bad leg.

4. Since leg extensions are not challenging your knee's stability they will not harm your knee. Exercises like lunges, squats, etc are challenging for the knee's stability and you have to be careful with those. Squats are less challenging than lunges (lunges are unilateral and weightbearing).

Concerning the brace: Do you know if there's damage to your MCL (ligament that's on the medial side of your knee that keeps your knee stable sideways)? It's very common to injure the MCL at the same time as you tear the ACL. The MCL need to be properly healed before surgery on your ACL. The MCL heals by itself and doesn't need surgery, but it normally takes 6weeks for it to heal. If you don't know the extent of injury to your MCL, I would recommend you to keep the brace on as a precautionary measure. I would even recommend you to sleep with the brace on the first few weeks. If there's no injury to your MCL, the brace is not needed. "The rehab before surgery" will also promote healing of the MCL.

[girl8]

[QUOTE=domers50;263461311]

2. I would encourage you to "rehab in advance" before the surgery. Stationary bike is great for range of motion, QUOTE]



yes!!


I have completely torn mine it was 4 years ago in basketball

they would not operate untill the swelling went down so I was actually walking around fine no pain but I knew my knee was unstable

doc just told me to wrap it in an ace bandage if I wanted to

even after surgery my doc said if I wanted a brace fine but he told me I could walk on it if it did not hurt
(I had a cadaver ........ didn't harvest from myself though) AND I wasn't lifting....

best of luck
especially with that range of motion after surgery!! :-)

[paul0616]

assume the ACL is torn, and just avoid any activity that might cause another twisting injury. Without an ACL, the meniscus is more vulnerable.

[Rob878]

After having my ACL rebuilt this year, and still on the road to recovery, i hope the infomation i received can help you.

My ACL tear also included a bucket tear of the meniscus, bone bruising of the tibia, and various other chondral defects.

1) Get the injured leg as fit as possible before the operation. This will aid recovery as the graft in my case needs about 6 weeks inactivity post operation. So muscle strength size etc will reduce

2) Only do closed loop exercises, leg press, squats using body weight, recumbent or normal bike i did a bit of rowing, but really controlled the speed i was operating at, the main muscles you are trying to hit are the hamstrings and Vastus Medialis.

3) i was warned off leg extensions for the following reason. Think of how they tested for ACL rupture, pulling fore and aft, and looking for movement. Now imagine doing this with your foot unsupported with a weight on the end. The knee will tend to drop rearwards as you extend thus putting your meniscus under increased chance of damage. The knee will extend obviously, but not in the correct position. Instead if you can straighten your leg, and do isometric contractions holding for 20 seconds on each with the leg fully straight and supported on a bench.

4) Don't rush after the operation. It will take up to 4 months for the graft to take properly, before this it is simply held in place with the screws. Professional sports men/women can return a lot faster simply due to the fact that once the graft has taken they are rehabing constantly.

Additionally ask your surgeon what kind of graft he is going to use, and read up on whether it is suitable for you, I ended up with a hamstring graft as the scar involved with a patella graft would have made kneeling for my job much more difficult. However a hamstring graft does have reputation of being slightly weaker, due to using only one plug of bone. But it is horses for courses.

Finally good luck!!

[neilyoSoCal]

Originally Posted by Rob878

After having my ACL rebuilt this year, and still on the road to recovery, i hope the infomation i received can help you.

My ACL tear also included a bucket tear of the meniscus, bone bruising of the tibia, and various other chondral defects.

1) Get the injured leg as fit as possible before the operation. This will aid recovery as the graft in my case needs about 6 weeks inactivity post operation. So muscle strength size etc will reduce

2) Only do closed loop exercises, leg press, squats using body weight, recumbent or normal bike i did a bit of rowing, but really controlled the speed i was operating at, the main muscles you are trying to hit are the hamstrings and Vastus Medialis.

3) i was warned off leg extensions for the following reason. Think of how they tested for ACL rupture, pulling fore and aft, and looking for movement. Now imagine doing this with your foot unsupported with a weight on the end. The knee will tend to drop rearwards as you extend thus putting your meniscus under increased chance of damage. The knee will extend obviously, but not in the correct position. Instead if you can straighten your leg, and do isometric contractions holding for 20 seconds on each with the leg fully straight and supported on a bench.

4) Don't rush after the operation. It will take up to 4 months for the graft to take properly, before this it is simply held in place with the screws. Professional sports men/women can return a lot faster simply due to the fact that once the graft has taken they are rehabing constantly.

Wow, couldn't have said it better myself. Kudos to you.

Neil Lang PTA