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Virtual_Rachel


May 31, 2013, 6:26 AM
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Torn ACL
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Hi,

I've just joined, so apologies if this has been discussed before.

I tore my ACL a year ago climbing Ben Nevis. For one reason or another it's taken a year for them to diagnose, and I've been indoor climbing more or less throughout (obviously not immediately after the injury!). I had meniscus surgery on the 19th April (apparently he repaired it rather than removed) and they then confirmed my ACL is completely torn, and I'm going for surgery for that on the 17th June. I'm climbing again now with no problem.

My questions are: how long do people reckon it will take post ACL surgery (bearing in mind I've also had meniscus surgery) until I'm able to indoor climb again?

Also, I've just heard an indoor ice climbing wall has opened up near me!! I've never tried it but would like to - do you think I would be able to go now (prior to the ACL surgery), given that my meniscus was only repaired on 19th April (but I have been walking on the flat, cycling, indoor climbing since then)...?

Cheers! Smile

Rachel


skelldify


May 31, 2013, 10:54 AM
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Re: [Virtual_Rachel] Torn ACL [In reply to]
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I went through ACL reconstruction (torn MCL also) about 6 years ago. Mine was so bad I couldn't even touch the ground with my big toe without my knee spazzing out and going wherever it wanted.

I had surgery on the ACL approx. 3 weeks after the incident. The MCL healed on it's own. A graft was taken from my patellar tendon for the ACL.

I had 6+ months of physical therapy starting a few weeks after the surgery. PT was my life. Daily visits to the PT office, and 2x/day at home additional. However, part of this was to make up for the fact that my original therapist, who I saw for the first two months post-surgery, was completely useless.
I was able to climb again "for fun" 6 months after surgery. This was when I first felt like, if I fell, I miiight be okay. I was completely back to normal after a year. At this point my knee was the same as it was before the incident.

I know a lot of people who've healed more quickly. The biggest factors are how seriously you messed up your knee, and what type of graft they use to repair it. Mine was very seriously messed up, and the doctor used the most reliable type of graft, but also the slowest to heal.


jonapprill


May 31, 2013, 2:27 PM
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Re: [skelldify] Torn ACL [In reply to]
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If you're not having instability episodes with your ACL-less knee then I would seriously reconsider having the surgery. Some people for whatever reason do just fine without an ACL. There was even an NFL running back who played without an ACL although his name is escaping me at the moment.

If, on the other hand, you have had instances where you knee 'goes out' then you should have the surgery. Especially with a repaired meniscus.

But, don't take my word for it. Rather, get another opinion from an ortho and be sure to be honest about any instability. If you're not sure your knee 'goes out' then it doesn't. There is no mistaking that feeling.

An ACL reconstruction is not a surgery you want to have unless you really need it.


Virtual_Rachel


May 31, 2013, 3:30 PM
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Re: [jonapprill] Torn ACL [In reply to]
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Ah I am having the surgery - on the 17th June.

I was just wondering if:

a) I could try out ice climbing before then (just found out there's an indoor ice climbing wall near me. I've opted to give it a go tomorrow anyway. If it's a problem I'll just stop, but I'm going on the basis that I've been climbing fine since my meniscus surgery, and the fact that after the ACL surgery I won't be able to do anything fun for a long time, so I might as well try and have it now! Smile )

b) how long it might take me to get back to regular climbing which I think Skelldify has given some indication of.


Virtual_Rachel


May 31, 2013, 3:34 PM
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Re: [skelldify] Torn ACL [In reply to]
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Thanks for this feedback. Gosh, 6 months does sound like a long time :( I'm not an obsessed (or particularly good) climber, but I do enjoy it, and am really disappointed at the prospect of all of this (though I know that ultimately it will be for the best in the long run! I just don't have much patience!).

I'm having a hamstring graft. I am hopeful I might recover well as I seem to have done after the meniscus surgery. But apparently having the two surgeries close together slows rehab. And I have been running/climbing/hill walking on this leg minus the ACL/meniscus for the last year so I don't know if that will have contributed to the damage.


Partner rgold


May 31, 2013, 4:11 PM
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Re: [Virtual_Rachel] Torn ACL [In reply to]
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I blew my ACL sprained the lateral collateral ligaments, and tore some of the meniscus about a year and a half ago. My knee was totally unstable, so surgery was not optional for me. Some of the meniscus had to be removed. I got a cadaver achilles tendon, which has a shorter (or maybe just less painful) healing period.

I was able to lead mid fifth-class climbs after six months. During that first six-month period, I stayed away from the gym and concentrated on rehab. It is now a year and a half, but I can't say I'm completely better. I don't notice anything climbing or hiking, but running hurts---probably because of the removed meniscus. Also, in spite of pretty conscientious rehabbing, my quads and calf on the operated-on leg are not yet back to the very modest full size of the other leg, and so I assume the operated-on leg is weaker, although I don't notice that.

Of course, the fact that I am nearly 70 has a lot to do with this; a younger person will heal faster, maybe a lot faster. On the other hand, there have been quite a few professional athletes with ACL injuries in the past year, and they seem to require a year to come back. These are athletically superior individuals who have access to continual state-of-the-art rehab facilities and whose only job is to rehab. Of course, they are trying to return to professional sports that are much more demanding on their knees than climbing and hiking is (most of the time).

I've heard different stories from lots of people, but I'd say on average it is a year before you genuinely stop being conscious of your repaired knee.


onceahardman


May 31, 2013, 4:20 PM
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Re: [Virtual_Rachel] Torn ACL [In reply to]
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Virtual_Rachel wrote:
Hi,

I've just joined, so apologies if this has been discussed before.

I tore my ACL a year ago climbing Ben Nevis. For one reason or another it's taken a year for them to diagnose, and I've been indoor climbing more or less throughout (obviously not immediately after the injury!). I had meniscus surgery on the 19th April (apparently he repaired it rather than removed) and they then confirmed my ACL is completely torn, and I'm going for surgery for that on the 17th June. I'm climbing again now with no problem.

My questions are: how long do people reckon it will take post ACL surgery (bearing in mind I've also had meniscus surgery) until I'm able to indoor climb again?

Also, I've just heard an indoor ice climbing wall has opened up near me!! I've never tried it but would like to - do you think I would be able to go now (prior to the ACL surgery), given that my meniscus was only repaired on 19th April (but I have been walking on the flat, cycling, indoor climbing since then)...?

Cheers! Smile

Rachel

General principles:

Meniscal repair, by itself, can be a 6 month recovery. Ask your surgeon, and be specific about the positions you need to climb. They can vary greatly depending on the specific injury.

ACL repair, for professional athletes, is at the very least a 6 month proposition, and 12 months is standard. Get your extension back in the first 2 weeks post op. Then start increasing flexion as soon as cleared by the surgeon. Work hard. Tolerate the pain. Strengthen your hamstrings like crazy as soon as you can.


onceahardman


May 31, 2013, 4:29 PM
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Re: [rgold] Torn ACL [In reply to]
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Wow, Rich...when I started in PT, 35 years old was the cut off for ACL repair. You would not have been a candidate for surgery. It's not cruelty, it's actually statistical kindness-the outcomes were poorer for those over 35. Surgeons who do ACLs don't want bad stats.

Techniques have improved, and I'm glad you have improved stability. I'm not sure whether you are "satisfied" with your outcome, but in your age group, I'd say you are doing really well. Congrats.


Partner rgold


May 31, 2013, 5:10 PM
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Re: [onceahardman] Torn ACL [In reply to]
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Yeah, my surgeon wasn't enthusiastic. He said SOP would be to give me a cane. But then he said my x-rays revealed very little arthritis in the knee, and that made him more optimistic about the operation. Apparently, the more arthritis the less good the outcome.

I realized the odds against total recovery going in, but felt I had no chance at climbing any more without the operation. I didn't mean to imply that I'm not satisfied either. My knee isn't holding back my climbing at all. My biggest climbing problem seems to be recovering hand endurance after seven, maybe eight months of layoff from any kind of hard pulling. I'm working hard at it, but the progress is just excruciatingly slow.

The remaining knee problems all seem to be related to absorbing impacts (running, jumping rope), so are, I suspect, related to the removal of meniscus rather than the ACL repair. I'm able to sustain a sort of shuffle/jogging gait, using poles, for four-mile hilly trail "runs" of that drag on for an hour or so. These are really at a fast walking pace, but with my feet (barely) leaving the ground as in running. In short, I'd lose terribly at a walking race, were it not for the fact that I'd be disqualified anyway for an illegai gait.

But make no mistake: I ain't complainin'. Life is good, my brain is functional, my family is fine, and operation and all my limitations for a person my age, are miniscule. I ain't Donini, but then, who is?


Virtual_Rachel


Jun 18, 2013, 7:33 AM
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Re: [onceahardman] Torn ACL [In reply to]
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I went for it and did the ice climbing. It was fine - just ached a bit afterwards. And I walked up a mountain the following week. Again, fine, just some ache. I've been indoor rock climbing and the surgeon just warned me off putting the knee up high and stepping up on it, but my body could really sense that and I would probably have avoided it.

And I've been going to the gym a fair amount in an attempt to prepare for the ACL surgery.

I had the ACL reconstruction done yesterday so guess I'll be off the walls for a while :( Thanks for the tips on this.

If anyone else has any, they'd be much appreciated. I'm going to a hydrotherapy pool on Thurs which should be interesting, and hopefully they'll get me on a good physio programme.

Any idea how long post ACL surgery it might be until I can climb again?


Partner rgold


Jun 18, 2013, 11:16 PM
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Re: [Virtual_Rachel] Torn ACL [In reply to]
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What kind of graft did you get? The grafts taken from your own body parts (patella tendon, hamstring), called autografts, seem to be associated with more post-op pain but ultimately result in less knee laxity. An allograft (cadaver Achilles tendon) naturally involves less trauma to you and is seems to be less painful initially with quicker recovery, but clinical studies suggest more knee laxity results.

The allografts need extra time to be "incorporated" into your own body tissue and actually weaken initially, and meanwhile there is less post-operative pain, so the tendency to push too hard initially has to be resisted. I've heard people speak of returning to climbing/skiing after three months; from what I've read they are probably lucky not to have ruptured the graft at that point.

Some doctor protocols say 4--6 months, some say 9--12 months. Quite a few professional athletes get this injury; my observation is that they need 9--12 months to return to competition. The graft can continue to heal for up to three years.

Here's a pretty understandable and comprehensive article about the whole process: http://rehabeducation.com/...AllograftACL2012.pdf

There's a recent thread about ACL tears and repairs over on SuperTopo: http://www.supertopo.com/...92/Complete-ACL-Tear


Virtual_Rachel


Jun 19, 2013, 1:29 AM
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Re: [rgold] Torn ACL [In reply to]
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I had a hamstring graft.

Two days after surgery and the pain is pretty low and I can even walk a very tiny amount without the crutches (yesterday I wasn't really even putting that foot down!). I've just got to be careful not to go too fast, get ahead of myself and tear it... Certainly no point in rushing it and doing that.

Thanks so much for those links.


singletrackmike


Jun 19, 2013, 6:02 AM
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Re: [jonapprill] Torn ACL [In reply to]
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jonapprill wrote:
If you're not having instability episodes with your ACL-less knee then I would seriously reconsider having the surgery. Some people for whatever reason do just fine without an ACL. There was even an NFL running back who played without an ACL although his name is escaping me at the moment.

If, on the other hand, you have had instances where you knee 'goes out' then you should have the surgery. Especially with a repaired meniscus.

But, don't take my word for it. Rather, get another opinion from an ortho and be sure to be honest about any instability. If you're not sure your knee 'goes out' then it doesn't. There is no mistaking that feeling.

An ACL reconstruction is not a surgery you want to have unless you really need it.

I sheared my ACL when I was 22 and didn't get it properly diagnosed until I was in my 30's, but was able to stabilize the knee with a lot of biking, and even running after the initial pain & swelling had gone away. I've stayed active and still have no problems at 63 yrs of age, despite the warning from Orthopedic doctors that I'm due to get arthritis in that knee eventually. I have stopped running (don't want to push the prediction) but continue to bike aggressively.


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