ACL tear - what should I expect - Calgarypuck Forums - The Unofficial Calgary Flames Fan Community

Ruttiger · 04-12-2011, 09:55 AM

So I received confirmation yesterday that my left ACL is torn after a ball hockey breakaway gone wrong a few weeks back. I was given the options of rehab or surgery and I'm leaning strongly towards surgery but was wondering what experiences any of you can relate or advice you can pass on.

I try to stay somewhat active - golf, hiking, the odd triathlon, ball hockey - and it sounds like as long as I do the proper prep work and rehab that the surgery has a pretty high success rate.

rohara66 · 04-12-2011, 10:21 AM

Rehab, rehab, rehab.

Do no push it too hard too quickly. You need to slowly rebuild the damaged area. I sprained (slight tear) my MCL a couple years ago playing hockey and it sucked. Was easily a couple month until it felt 100%. Did lots of stationary bike during rehab.

kevman · 04-12-2011, 10:42 AM

As of today I'm at 9 weeks post op and the one thing I can say off the top of my head is the surgery was (at least for me) way more difficult than I anticipated. I figured they're making things better how can it possibly be worse then the original injury right? Boy was I wrong... No regrets though, surgery is the right thing to do if you plan to be active in the future.

I found it incredibly encouraging just how many people have actually gone through this injury and surgery. Once you're part of the club every day you meet someone new that has been down the ACL road. Some of them you've known for years and had no idea they have a "bad" knee. That to me is a testament on how well you can recover from the surgery!

You have to rehab before anyway so get on that right away! It's going to take a while to get in and see a surgeon so you've got time to make the decision. You might find that you feel comfortable without your ACL and opt to not have surgery. With a brace and lots of physio I was snowboarding comfortably (albeit like a girl) 2.5 months after my injury.

Um there's really so much to say I don't know where to start... haha.

Edit: I should add, when I said harder then I thought, I assumed I'd be ahead of the curve with rehab. Turns out I'm pretty damn average after all...

habernac · 04-12-2011, 11:03 AM

a whole raft of threads here:

http://forum.calgarypuck.com/showthr...highlight=knee

Ruttiger · 04-12-2011, 01:06 PM

Quote:

Originally Posted by habernac

a whole raft of threads here:

http://forum.calgarypuck.com/showthr...highlight=knee

Thanks for this - did a quick search but this didn't come up.

Eric Vail · 04-12-2011, 02:09 PM

I may have responded in the first thread, I am not sure. I tore my ACL 20 years ago. My doctor said he wanted me to rehab it first to see how it responded. Over the next two years I completely ruined my cartilage by walking on an unstable knee. I had the reconstruction done since and my knee is now very stable, but it is wrecked. I haven't been able to run or ski or do anything that is stressful on knees for 20 years and never will. I am now on track for a knee replacement likely sometime in the next 5-6 years.

My advice to anyone with a torn ACL is to get the surgery right away. The surgery is brutal and requires a lot of rehab. One tough year will get you back in the game, however. The rehab route ruined my athletic life.

Anyone comparing an MCL tear should be discounted as they are completely different injuries. MCLs can bounce back much easier than ACL injuries.

JiriHrdina · 04-12-2011, 02:18 PM

I've talked about my experience on here before (ha! that's my thread above). My recovery didn't go well. I hit the rehab hard and worked my arse off. But I developed a very stiff knee and never re-gained full range of motion, even after a 2nd procedure and going to physio 3-4 times a week for a couple of years.

I was on crutches for far too long - and even after I dumped the sticks I walked with a limp for a long time.

I'm a few years removed and things are better now - day to day my knee feels good. Most days I have no real stifness though if the weather changes or if I sit too long (at a movie for instance) it can still get stiff. I initially returned to playing ball hockey (like you that's how I hurt it) but I made the decision last summer to give it up after I felt something not right. My doctor advised me that I was playing with fire and I would probably re-injure it again. Since I gave up those type of sports my knee has improved a lot - but it sucks I can't do those things anymore.

My advice
- Get a chryo-cuff for your recovery. It is worth the money many times over and is superior to any other means of icing the knee down.
- Find a physio therapist you a comfortable with and talk about their overall approach.
- I found working in the pool once the wounds healed was great - the water provides both resistance for the leg but also supports the leg
- For range of motion I started going to active release therapy about a year after the operation - and it helped me make some real gains that I wasn't able to achieve through standard physio. It should be covered as part of chiropractic services in most benefit packages.
- I didn't find much value in acupuncture at all

The main thing, particularly following the operation is to do the exercises multiple times a day. Going to your physio session isn't enough - you need to do the range of motion exercises throughout the day.

It's not an exact science. My doctors and therpists were in agreement that I did everything I could to get a great result - and it didn't happen. Others who took a far lazier approach to their recovery had a way better result than I did so its frustrating.

But at minimum put yourself in position to give yourself the best chance by working your butt off.

Good luck. PM me if you have any specific questions.

JiriHrdina · 04-12-2011, 02:19 PM

One more thing - if they are saying that rehab might be an option that would allow you still play sports without surgery - I would try that first.

Don't go under the knife you don't have to - it's not a gaurantee.

Ruttiger · 04-12-2011, 04:17 PM

Jiri, you're one of the few I've heard from that didn't have success with the surgery. It does sound like everyone's situation is different, but like you say, giving yourself the best chance to succeed should tilt the odds in your favour.

If I was 60 I'd probably hold off in favour of rehab but being that I'm only turning 40 this year I think I'm still young enough to want to give myself a chance to stay active in the things I enjoy.

Ruttiger · 04-12-2011, 04:35 PM

Quote:

Originally Posted by fotze

40 is old dude. "Only". hehe, good one.

If only I knew your Mom well enough to make cougar jokes.....

IliketoPuck · 04-12-2011, 05:55 PM

I went under the knife a few years ago, full recovery. But I won't lie it was one of the most difficult things I ever had to do and I worked my fataing ass off to get back my range of motion and muscle strength.

MCL injuries can actually repair themselves given enough time if there is some of it still connected, but if your ACL is torn completely, there is zero chance of it rehabilitating itself. You can build the strength of the muscles surrounding the knee, but the ligament itself will never repair, and in order to play sports that require lateral movement you will need to wear a brace, and even then your knee is still at risk of popping out of place and causing further damage to your meniscus.

If you have some questions feel free to PM me and I will gladly help out with as much info as I can.

NBC · 04-13-2011, 02:23 AM

I'm almost 2 years post-op for an ACL reconstruction and my knee is 50% where it was before the injury. The surgery was successful as the graft is strong and the knee stable, but just like poor Eric Vail, it took 7 years to get the procedure and I have permanent knee damage as a result of the wait. I can't run and skating hurts. I lost too much muscle bulk post-op as a result of the pre-existing joint surface damage which caused excess pain in the joint while rehabbing.

My advice is to go into the surgery as strong as you can and get the operation sooner rather than later. Pre-surgery physio would have worked wonders for me as it has with other posters here.

Best of luck.

Hockeyguy15 · 04-13-2011, 07:18 AM

Had my ACL done probably about 7 years ago, best thing I ever did. Don't kid yourself though, you are going to have to work at it. Work out before and work on your hammies and quads since those are your main stabilizing muscles and they will be the ones that get a little weaker after surgery.

Surgery came and went, I had no damage to the miniscus so that was good. Did not have a cryo-cuff just did regular icing and it was fine. DO NOT put a pillow under your knee even though it might feel good it's bad for the new ACL, put a pillow under your calf to elevate your knee. Also I found that putting a couch cushion inbetween the mattress and box spring of the bed at night kept my knee elevated all night and helped bring the swelling down.

I was going to physio 3 times a week and I think that really helped...At first it was just maintenance stuff to try and get the swelling down and motion stuff to get it moving. I think I started physio a day after surgery, can't remember for sure though but it was either a day or 2 days after.

Biggest thing is get that range of motion back quick, don't be afraid to move your knee around after surgery (the doctor should tell you that I think). Once you get ROM back then everything else should come quick.

I was off crutches after 6 days and was in a wedding party on day 7. I was skating at the oval after 2 months and back playing hockey with my knee brace (under doctors orders) after about 3.5 months. The physio team at Father David Bauer was awesome, check them out if you are close to it.

Oh and if you go the surgery rout try and book it in the summer so you don't have ice and snow to contend with. First little bit with crutches and then walking with your new knee you don't want to risk slipping and hurting yourself.

If you wanna know more or want to see what my knee looked like let me know, always willing to help a fellow gimp.

Deuce Bigalow · 04-13-2011, 08:58 AM

I had similar surgery and think JiriHrdina had some good advice with the cryo-cuff, its worth it for sure. Make sure to get the one with the electric pump (instead of the manual one) so it circulates the water for you, and you dont have to pump it. I found this fantastic for when I slept as my leg would never get itchy and stayed nice and cool.... plus you can put some beer in there for when you are bored and it stays nice and coo. win/win!

Ruttiger · 04-13-2011, 01:04 PM

Thanks for all this.

Another question - I was given a prescription for a custom ACL brace, which runs up around $1500. I've received conflicting reports on whether or not these are covered by Alberta Health Care if I have a prescription. Experience anyone?

Drury18 · 04-13-2011, 01:13 PM

When I worked as a Physio Assistant the majority of the braces were not covered. I believe the only ones that had coverage were Seniors, WCB claims or if you absolutely needed it to work in which case you could state your case to Alberta Health Care but it was still discretionary.

They are usually covered by your Employer/Group/Private Benefits plan and you will be asked to take that route first before any Alberta Health Care reimbursement since it was injured during a recreational activity and an "Accident" rather then being an eventual medical issue or an on the job injury.

JiriHrdina · 04-13-2011, 01:14 PM

A brace like that typically isn't covered by Ab Health Care - but should be covered by most company packages.

Tiger · 04-13-2011, 01:26 PM

It's just four weeks after my surgery. There seems to be a lot of horror stories on this thread and others, and I heard a lot of horror stories from friends and family etc. Truth is for me (and I consider myself lucky). I had no pain, I'm rehabbing well, walking without a limp, so there is a potential of things going well.

To the people that had issues, what type of ACL replacement did you get? Patella or hamstring? Mine was Patella, I don't know if the type has any outcome on pain or recovery.

as for the brace, my work insurance will cover it not AHC. I haven't picked it up yet because my doctor didn't want me to use it during rehab at all. And depending where you go to get the brace, you only get to resize it so many times.

PIMking · 04-13-2011, 01:30 PM

Quote:

Originally Posted by rohara66

Rehab, rehab, rehab.

Do no push it too hard too quickly. You need to slowly rebuild the damaged area. I sprained (slight tear) my MCL a couple years ago playing hockey and it sucked. Was easily a couple month until it felt 100%. Did lots of stationary bike during rehab.

Surgery surgery surgery!!!!

It will never be the same either way, but your knee will be better off with surgery than just rehab.

nfotiu · 04-13-2011, 02:53 PM

I partially tore mine when I was about 20. 2 scopes, and after re-injuring it about 12 times over, I had the surgery about 4 years later. Very, very successful. I played tonnes of beer league hockey, ran a marathon, all with no knee issues.

I went to physio, and worked out hard for 2 months leading up to the surgery, and always thought that helped with the recovery.