Here's how it happened. As a Ranger at Mt. Wachusett, I go out on the hill two times a week at night to help the Ski Patrol with injured skiers and snowboarders, and to help maintain a certain amount of sanity among the nutjobs flying around like unguided missles. January 18th, I arrived and immediately went up the lift to help out at an accident scene on a trail called Smith Walton, or trail 5 as we refer to it on the radio. Just after going over the first pitch, I washed out on an ice patch, and in trying to recover my balance (instead of just taking the fall, as I should have) I hyperextended my left knee. I felt a small 'twang' in the knee, not exactly a pop. There was no twisting, wrenching, and nothing especially violent about the fall. I was not going very fast, either.
When I got up, I knew I'd done something, but it didn't hurt a lot, and I was able to keep going. I remember saying to myself, 'jeez I hope I didn't do what I think I just did.' From the accident scene, I skied down, following the Ski Patrol sled, taking the injured skier's own skis on my shoulder and skiing more or less normally, though a little unsteadily. Turning to the right was a little exciting. Later on, during a single run, I fell twice, which I almost never do, and realized something was up.
Taking a break for coffee, I noticed walking around in my ski boots that there was some definite pain on the outside of my knee, so I decided to quit for the night and put some ice on it. I'd read about ACL injuries, and while I suspected that could have happened, I wasn't convinced. I assumed it took a lot more violence to tear an ACL. The fall I'd had was almost incidental. I'd never hurt myself skiing and was having a hard time accepting the idea that I'd done something serious.
First doctor's visit
But I was concerned enough, never having injured my knees, to get it looked at right away. I was able to get an appointment with my family practice physician the next day, who gave my leg some tugs, noted that there wasn't a lot, if any, discernable swelling, and sent me on my way with the advice to ice it, stay off skis for 4 weeks, and not to worry. We figured it was a sprain.
The specialist
I was already scheduled to see an orthopod early in February to look at my shoulder, so I figured I'd have him take a quick look at the knee while he was at it. During the appointment, we spent 20 minutes talking about the shoulder, which I'd had some trouble with over the last tennis season. In October I'd elected to quit playing until I figured out how to alleviate the pain I was having. I had assumed that the problem was a small rotator cuff tear and that we would be talking about when to schedule arthroscopic surgery. As it happened, he didn't think it was a tear -- the MRI was inconclusive -- so instead, he offered to give me a cortizone shot and put me on a physical therapy regimen. Then we had a look at the knee.
Now, the knee had not really been bothering me at all. It never swelled up much. I could walk a straight line and do stairs without any discomfort at all. I figured a little rest and I'd be back in action. The one thing that nagged at me was that it felt unstable, like I could really do some damage if I stepped off a curb wrong.
He got me on the table, did a few manipulations of my good leg, and then moved over to my left leg. After about two seconds of examination, he told me I had a definite tear in my ACL. This was quite a shock to me at the time. He said he didn't need an MRI to confirm it, but that he'd order one anyway to determine if there was any other damage to the knee, which is pretty typical of an ACL tear, apparently.
The Lachman and drawer tests he did were dramatic. On my good leg, the calf moved forward slightly and stopped with almost a 'thunk.' On the bad leg, the calf moved forward twice as far, and stopped with a certain mushiness. So in a moment, my ski season and my 2007 tennis season disappeared before my very eyes. As I've been saying to friends, "I went in with a shoulder and came out with a knee."
A knee knows
6 comments:
Hi I tore my ACL in both of my knees but for each surgery I had a different surgeon. For my first one he told me I would be able to start jumping at 6 months and the surgeon for my second tear told me at 8 months. I was wondering when you started jumping after your operation because I think 8 months is a little to long and I am already at 6 months right now.
At about 13 weeks, my PT had me start doing some light jumping exercises, but being very careful about form (butt back, keeping knee above foot). From that point, I was soon also doing an exercise where I hopped over a set of about 8 short hurdles (about 6 inches high). On the 13 week entry in my blog, I describe the ladder drills I started doing. Good luck with your knees.
I had reconstructive acl surgery Aug 7. It is nearly a week now and the pain i feel is getting worse. I am taking pain killers, and icing most of the day and night. How long into recovery did the pain start to subside. I haven't started physical therapy and i am guessing that the pain might even be worse. I am getting restless as the day goes on, but basically stay in bed, getting out of bed for 1-2 hours each day. I find that resting, and not moving my leg as much is least painful. I want to add that they removed a tendon from my hamstring and put that in my knee. Did anyone have that done? A lot of my pain is coming form the removal of the tendon, as well as the surgery.
I know this is a long recovery and chose to go through with the surgery because i am 27 years old and have been active in soccer and skiing for over 20 years. I know i want to participate in these sports one day again and the only way that was possible was if i got the surgery. Any advice????
V: Hope you're feeling more comfortable. And apologies for the response lag, I've been on vacation.
Read around in my posts, and you'll see that I also had the hamstring autograft, and still have a bit more weakness on that side by comparison. The site of the graft bothered me at first for a while too, and during the first four weeks or so, I kept tearing scar tissue inadvertently, which hurt like hell. Look ahead in the blog, and you'll see a section on how one PT I worked with helped me correct that in *one day.*
As for your future recovery, I can only say that sticking with the rehab worked for me. It's the one thing you can control and it has everything to do with your ultimate recovery and long term mobility. So stay focused, and if you're having any trouble, get help from someone: a workout buddy, a PT, anyone who can help keep you motivated.
Your knee is going to be fine. It's been over 2 years since my procedure, and when I'm playing tennis or skiing, I have zero awareness of my "involved" knee, like the injury never happened. I don't need a brace either. Just need to stay strong and flexible: strengthening, running, stretching, etc.
Interesting stories. I have a partial ACL tear with a positive pivot shift and a little front to back laxity. I'm a 24 year old female. It has been nearly a half year since the injury. I can bicycle without much pain now, however jogging still causes pain... especially at the lateral aspect of my knee and a certain spot which might be called the femoral condryle at the outside back of the knee. MRI from a few months ago showed no meniscus damage or other significant trauma besides to the ACL and some significant bone bruising.
The pain during jogging is probably caused by the pressure on the bone bruises; the OS doesn't think it is a meniscus pain.
I am still positive for pivot shifting, but my leg feels really strong and pretty good with all the rehab. The pain is subsiding everywhere but the femoral condryle area, so I'm not sure if jogging is worth it. The O-surgeons I have consulted say that surgery is a reasonable option because I have a positive pivot shift, but they say that I should give it some time to see if the instability in my everyday life is that bad...
How am I supposed to know if it is that bad? When I keep up on my exercises (come on, you know you skip them sometimes), then I think that my knee is pretty strong, but maybe that is psychological. I am just afraid that I am going to think my knee is good some day and then play soccer or something and ruin my meniscus or articular cartilage. They suggested a petellar-tendon graft if I opt for surgery, since I am young and have a pivot shift even with such little front-to back laxity... they think I should get one that will not be as likely to stretch over time.
Now I am wondering, if I keep with my partial tear, will I have to do these exercises forever to try to keep it stable? People in my family get pretty old, and I don't want to do these exercises for another 65 years. Also, will I ever be able to wear shoes that don't have arch support and not bother my knee? My knee tends to twist when I rest on that leg in such as way that more pressure goes on the inside of my foot and crushes the arch down. I'm also not fat now or planning on it, but I'm only 24 and women in my family are not stick figures by any means. There's no arthritis in my family history and I'm told that having a pivot shift at such a young age does have the potential to lead to OA, especially if I end up injuring my meniscus.
So, anybody out there with reasons to believe that I should or shouldn't have knee surgery? I want to do the best thing to have a healthy knee for years to come. I really enjoy hiking up and down mountains and bicycling... and my job requires the hiking. I have a limp that is only noticeable to me and which is worse with hiking and carrying weight...maybe that will subside with the bone bruises though? I also like swimming, but feel a noticeable instability in my knee with the breast stroke, which is all I really do.
Okay, enough of a post. Any comments?
Hi,
I had a ACL surgery for my left knee in august 2006 (damage done in soccer) and it was successful. I got back to runnning a lot a year ago. The strange thing is now my right knee is hurting a lot but i don't know why i didn't injure it anywhere. I have been told that it might be caused by the asymmetric loading on my right knee because this is how the body acts to protect the left knee, but the body does so subconsioucly. Is this possible? If yes, how to fix the problem? any type of exercises to do. Please help me it's so furstrating, I worked so hard to recover and now my right is the problem.wHat can be done to fix the problem ??????
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