Anyone hiking with a torn/repaired ACL?

[GNR]

Recent moves on the basketball court have resulted in at least a partial tear of my left knee's ACL...I'm not quite suicidal, but I'm upset, because this damages my Fall/Winter/Spring? hiking. Trainer friend says I could take pain killers, but I want this to heal and be done with it. Problem is, I see athletes getting ACL's repaired by surgury, or even not playing sports for a year or so. I've got a doctor's appointment Monday and hopefully an MRI, but in the mean time, anyone else have this and hopefully overcome it, maybe without surgury? Thanks.

 

[king tut]

I completely tore my acl and cartilage back about 9 years ago. The lucky thing is that i also tore the nerve endings, so i did not feel any pain when it happened, just huge amounts of swelling. This was the summer before my senior year in high school, and i ended up missing my last year of soccer, complete bummer. I got surgery, the doc used a graft from my patellar tendon, which is right above the knee. They also sewed up the cartilage, and i was on crutches for 6 weeks to let that heal. Normally if the cartilage is not torn, you can put weight on it immediately.

As far as the surgery, it was the most painful thing i have experienced in my life. The pain being the next 2 weeks after the surgery. The good thing is that my pain threshold is so high now, that i don't really experience pain anymore. They gave me percocet for a few weeks after the surgery, and man that stuff takes you from complete pain to lala land in about 5 minutes.

The rehab timeframe for me was about 6 months before i was completely back to doing normal stuff. I think it was about 3-4 months before the doc would let me do any kind of running activity. The hardest part of the rehab was building my muscles back up that had atrophied for 3 moths due to not using my right leg at all. Gaining flexibility back was also very difficult. It was also difficult to wait the 6 months, i was out skiing some nasty stuff about the 4 and a half month mark and almost blew my knee out again before i decided to take it a little easier. The good news is that i was able to ski that winter, as i raced x-country and downhill skiing in high school. It took awhile to be back to normal, but i ended up doing well, placing 3rd in class A skiing for skimeister, which is the overall best skiier across the four disciplines.

So, i would suggest getting the surgery. If you don't you could bust out your knee at any time. You can go on without the surgery, but there's always a chance you will re-aggravate the injury. Science has also come a long way in the last 9 years, so the surgeries are a lot better than when i had it done. My acl is rather healthy now, but i think my cartilage is a little thin.

After reading a few other posts, if it is only partially torn, you might not need surgery. I would say check w/ a doc to see what he says. My advice was based on my experience of having completely torn the whole thing to shreds.

 

[jbrown]

My brother hiked with a partially torn ACL for several years, even completing the Upper Range (ADKs.) in a 10 hour marathon day.

(Hey, it was a marathon for us, we're not all Tim Seaver or Cavedog here...)

He was in alot of pain going down the Orebed brook trail, but just tossed back a few vitamin-I and kept moving.

I can't give you hope without surgery in this story because he blew it the rest of the way out playing soccer. Some dope playing keeper sideswiped him on the indoor field and blew his knee sideways. He had surgery this last year and is almost back up to 100%.

I can give you two pieces of free advice on this, after speaking with him and my uncle who is an orthapedic surgeon.
1. If physical therapy is an option right now, jump in with both feet.
2. If you end up blowing it out the rest of the way, opt for the hamstring tendon method of replacement. It's the strongest and least painful. (Then be totally and completely committed to therapy afterwards...)

Good luck!

 

[Puck]

I tore my ACL skiing, My orthopedic surgeon did alot to talk me out of surgery. His approach was exercise and a brace. Initially I had alot of swelling and needed to have it drained, a painfull procedure. He warned I would need to have it drained a second time if needed. He thought that I was gaurding the knee more then what he considered normal. It started to swell up again and I went to an acupuncturist. worked like a charm.

Some time later I did have pain with it while I hiked. I was wearing a brace, I had done my exercises. I also took ibuprofen as directed to contain any swelling. I did use homeopathy which helped me get over that hump. I now hike without a brace and any ibuprofen. good luck with it.

 

[el-bagr]

I injured my knee skiing last March -- complete MCL tear and partial ACL tear. My physical injuries ultimately resolved without surgery. (All that's left is minor psychological harm. I'll probably need a few weeks of full-force skiing under my belt before I re-lose my tentativeness at speed.) In my case, the slopeside ER doc got the diagnosis wrong -- he said 100% complete ACL tear with no MCL damage and told me to schedule surgery and cancel the rest of the ski season and the summer surf season.

As it turned out, I was back on snow within a month, albeit painfully. I focused on boating for the spring, and by June, I had only minor pain in that knee; now, it is fully recovered.

Get the MRI and a second opinion -- these injuries can be hard to diagnose correctly, and you'll feel better when you know for sure what happened. You may well be back sooner than you think.

Out of curiosity, how'd it happen?

 

[Tim Horn]

My condolences on your injury, First I did the left knee and three years later the right. The surgery call is up to your doc. Some prefer surgery even if there is a chance of re-hab others push re-building. My body needed a full year of rehab before I felt like the knee was reliable. It took another year before it only hurt after a hard day of hiking or skiing. Now 7 years after the last injury it only hurts on bad days. I do not use a brace to run, hike or ski. I have run 2 marathons, walked the NH 4K's and ski everything on the mountain.(I stopped hucking cliffs) I am not as fast or as agile as I once was but I still get around. Don't get too down about not participating in sports for a year or so. Trust me you will be getting plenty of work-outs and probably be in better condition and stronger at the end of the re-hab. Oh yeah if you have an HMO be sure to tell them that you are an athlete and give them a goal of a race or other major event that you want to be ready for. You may have to push to get the real re-hab programs at the better facilities.

 

[lamerunner]

I tore my MCL and ACL mountaineering skiing while pregnant. MCL heals itself. I had surgery, allograft, to repair the ACL, and it seems good now. The surgery ws 6 yeaars ago approx. I was extremely active even before the surgery (after the swelling went down) with biking and swimming, and I continued biking right up to the surgery date. I also started up on exercise bikes as soon after the surgery as I had enough range of motion. I was on snowshoes carrying my son within two months, biking outdoors 3-4 months later then running after 4 months. I did have some muscle injuries as I was ramping up the running, but my knee recovered well. I hiked the following summer, missed one whole ski season but then skiied the following year. I don't know if it is as strong as the other leg, but it has not been a problem yet for hiking and moderate skiing.

 

[Homer]

Even an MRI isn't 100%. Back about 10 years ago now I was having problems with my knee. It was starting to give out going down stairs and things like that. I had an MRI that showed a torn meniscus and other loose cartilage and fluid. So I went in for a scope job to clean things up. While in there the doctor found the real problem was that my ACL was completely gone. Nothing left. The MRI didn't show them what they needed. They had asked when this might have happened, but I told them I didn't know. Probably happened sometime during football in college. Anyway, the decision was made to go in and replace the ACL. At the time I had the surgery they took the middle section of my patella tendon out and made a new ligament out of that. The recovery was quite painful as I found out that I was allergic to percocet, percodan and vicodan. They were running out of drugs to give me to kill the pain. Anyway, the rehab is painful, but worth it. That leg ended up stronger than the other. It wouldn't have been as bad I guess if I had chosen to get a part from a cadaver, but I didn't want to go that route. I believe there are much newer techniques that take a section of hamstring muscle to make a new ligament. Not as intrusive and easier recovery. After about 6 months I'd say I was back in full action. The only problem I've had since then is I had to have one of the screws taken out of my tibia because of some pressure pain I was experiencing. I still have one screw up in my femur that I can't even tell is there. I do plenty of hiking, running, skiing etc and have no problems at all. I do take 1500 mg of Glucosomine Sulfate a day and absolutely notice a difference with my knees and all my joints. Great stuff. I think with the surgeries today, I recommend doing it and you'll be just fine.

 

[Rick]

GNR, Tough Break.
I tore my ACL in November 93 (Complete Tear and damaged Meniscus) during a slight fall while scrambling in the Niagara River Gorge - Horrible pain and swelling. First Orthopede said strengthen my quads and hams and it will keep my tibia from going out of joint. Didn;t help - I stepped off a curb a month and a half later and it went out and down I crumpled.

I then got some recommendatins and saw the Buffalo Sabres Surgeon - He recommended that at 33 and keeping with an active lifesyle to go with reconstructive surgery using the middle 1/3 of my patellar tendon as a new ACL.
Surgery took place Feb-94 and the pain was incredible. I was bedbound for a week before I could start to walk I lost 25% of my meniscus. I remember going to the Memorial Aud about 45 days after surgery and being terrified by the steps to the orange (top) section. I had to retrain my muscles to walk and to take steps. Hard to beleive but you completely lose the muscle memory and I understand how a paralyzed person feels. Your brain is telling the leg to do something and it doesn't respond. It took my quite a while to get over my fear of heights, afterward.

By April of '94 I was out dayhiking again with a robocop brace and by June I was backpacking again. (I started back doing peaks on Memorial Day '95)
I haven't worn robocop brace since 1996. I don't run 5-8 miles like I used to and I don't do squats or anymore serious lower body weightlifting either, though I work my legs on machines still.
I took to wearing a red ribobn on my bad knee when sparring in Karate as I was always worried about getting side kick.

I can certainly tell when bad weather is on the way as it stiffens up now.
Otherwise, I have a couple of small spots on my leg near the knee where there is no feeling due to the nerves being cut during surgery.

I am glad I had it done. I did not want to live my life wearing a brace or fearing it could give out on any non-level step or slip. I am good now with no issues other than occasional stiffness. I did put weight on after the surgery because I stopped running and just kinda slowed down in general.

I would give myself a good 6 months after surgery to get better and you probably can't have surgery for a month or so until the swelling goes down.

Might be a good time to take up piano or guitar playing?
Seriously, I do wish you all the best
Rick

 

[Undershaft]

Painfully Slow

No advice, just a short anecdote. I gave a ride to a south bound AT thru-hiker in Franconia Notch on Sept. 15. Her trail name was "Painfully Slow". She had torn her ACL two days into the hundred mile wilderness, but refused to quit and was determined to hike through the injury. It took her 50 days of hiking just to get through Maine. Garfield Ridge to Liberty Springs (where we met) was a very high milage day for her. I believe she is somewhere in Vermont about now. The point....if you're injury isn't too bad you could still hike this fall/winter(albeit in some pain), but you won't hike far or fast. You may even do permanent damage. Best of Luck!

 

[JeffAndrews]

The procedures to replace a snapped ACL have come a long way. My brother had his replaced in the 80's and it was a horrible, painful experience that he never fully recovered from.

I had mine replaced about 10 years ago. Having seen Mark go through it I was expecting the worst, but it really wasn't that bad. I was off the pain killers they gave me the second day after surgery. And I skied for the first time 6 months afterward. But there was a lot of rehab and time on crutches.

Now I run and hike without noticing my knee. Haven't had to wear my brace in years.

Someone in my office had theirs replaced this spring and they were back in the office after a couple of days. And they were off of crutches in a couple of weeks. Their doctor used a donor ligament from a cadaver. And it seemed to go really well. They are now getting ready for a full ski season.

My advice is to find a doctor who treats a lot of these injuries. Explain to them your goals (getting back to hiking, basketball, etc.) and do everything that your physical therapist tells you to do (but don't try to be a superman and do more than they advise - they generally know what they are talking about)

There is are really good chance that it is not completely torn and that would definitely speed recovery time and get you back out there sooner. I knew immediately that the whole thing was gone - there was a telltale pop.

Good luck Monday!

 

[GNR]

Thanks everyone...

Great to hear that people can come back from this...MRI tomorrow. I have already put away my maps and stored most of my gear to try and "brace", no pun intended, for my long off-season.

El-bagr...Just went around a guy on the basketball court, bent my knee a regular amount and I heard something, although I don't think it was the telltale pop people have mentioned...hope that is good.

Anyway, thanks for the well-wishes, I don't think I have the technology to post the actural MRImage, but I will let people know what the doc says. GNR

 

[Cath]

Fix it & get over it

GNR ~ Make sure you impress upon your Orthopedic that you want to correct the problem now, so that you can heal & move on.
As Kevin noted, I've ruptured both my ACL's, had them replaced with a piece of my own hamstrings, and I'm back to what I was doing prior to the surgeries.

I let the surgeon know I'm active & I couldn't accept not being able to hike & ski in the future. He told me that I would be at least 98% back to perfect, or as perfect as I was before the surgery He got me into rehab 2 days after surgery with the first knee, and after learning what I'm all about during that first round, he put me in rehab prior to surgery for the 2nd knee to keep my legs strong. I never wore my custom knee braces for hiking, only for ski patrol, because workman's comp. dictated that I do so.

My surgeon told me to concentrate on "slow & stead" during the critical 3 - 6 month recovery period. I could road bike as much as I wanted during that period, and Rehab actually had me on a stationary bike that first week post surgery. As the time goes by during the healing process, it's tough to behave when you feel fine, and have the need & desire to be active. That is when you can be your own worst enemy & try to use your knee before it has healed enough.

I have heard from other folks that the Patella Tendon procedure is very painful. I can't say I was in pain with the Hamstring procedures, other than the discomfort related to extensive swelling within the first 24 hours after surgery. With both my ACL ruptures, they were severed completely, so there was no pain prior to surgery, and the actual incidents were more of an internalized POP sensation and not painful experiences.

If you live in NH, and need a 2nd opinion for any reason, contact Concord Orthopedics and request Dr. Douglas Moran. He took care of me 100 % !!!
My first replacement was in January 2000 and the second was in February 2001. I've hiked & skied a lot since then ~ Hiker X

 

[Sugarloafer]

I have heard from other folks that the Patella Tendon procedure is very painful.

My wife has had both of her's done and is fine now and skiing about 50 days a year, but she would echo your comments about the patella tendon. In fact, for her the worst part was during her rehab, she got tendinitis in the spot where they took the patella graft. She found this to be very painful for about a year and has learned to what not to do to aggravate it...no hot tubs after skiing (for a long time, she thought heat would help, but the surgeon told her it aggravates the hell out of the tendinitis), 2 Aleve's before skiing !

 

[truepatriot09]

I've been reading this thread with nervous anticipation of my own doctor appt. for my left knee which I had yesterday. I gave it a good wrench back in August while trail running and it's been very sore (minimal swelling however) since than. Coming down Chocorua two weeks ago was quite an effort. Anyway I have lucked out, being diagnosed with Patellar Tendinitis. Still, no running or cycling for 2-3 weeks and rehab twice a week to get it healed up.

GNR, Let us know your results...

-ct

 

[GNR]

Mri...

Thursday at 10:00pm...doctor says "something" is wrong but didn't want to name names until after seeing the MRI. I'm holding my breath until then...till Thursday eve...

 

[bintrepidhiker]

Back in the spring of 99 i had a full ACL tear that required surgery to fix. Like you i also did it while playing basketball. My suggestion would be to do the same and try not to do anything that could make it worse and that would unfortunatly include hiking. Wouldn't want to be out in the backcountry and have go completely on you. Once its fully torn, walking is next to impossible.

 

[Gris]

Once its fully torn, walking is next to impossible.

Hardy-har-har! I've been hiking on an ACL-less (complete tear) for the last 25 years, plus i have NO cartilage in that (left) knee and only a wee bit in the right. They told me i would have to wear a brace to ski and play tennis but after a year i threw the brace away then proceeded to win the city singles league year after year. Moral of the story? Everyone's different and if you are somewhat stocky and stiff like me the muscles in you legs will keep your knee in place - OTOH if you are thin and flexible you'll need that ACL. BTW, all the ACL does is keep the lower leg from shifting forward/hyper-extending relative to upper leg. So, the key to dealing with an ACL deficit knee is to avoid putting any weight on your leg when fully extended; i.e, land with knee slightly bent.

 

[F-Face]

Hi - I too wrecked my ACL on my left knee pounding huge moguls one fine spring day in Vermont. I was a crazy skier in those days, at the age of 32, i ought to have been throttling it back... (also wrecked my shoulder and chipped a tooth skiing). Now, I ski little

I had reconstructive surgery. Same as many here - middle 3rd of the petellar tendon. My time line went like this:

APril: wrecked knee
June(late): surgery. Prior to surgery, I was advised to make my knee as strong as possible.
Oct: Hiked up Mt. Watatic, with a brace.

I was on crutches for 10 days, MAX, the Dr. was very aggressive so was my PT person, who was excellent. The PT post surg is a 14 week program, i did it in 12.

I rode my bike - single plane of activity for the knee, that helped a ton. For hiking, I wore a brace religiously for 2-3 yrs post surgery, then got myself off it. Now, about 7 yrs hence of surgery, i do not use it (I used a brace mfr'ed by EDGE, cost me 500 bucks, insurance said "sorry, we don't pay for that").

I continue to hike. I do not do backpacking trips where i have to haul a HUGE pack up and down a ton of elevation. Going down really beats the crap out of the knee and taxes your ACL. Now, I backpack in, setup a base camp, and day hike from there. I plan to do a trip to the whites this weekend, perhaps in the dry river area or something like that, or maybe central NH in the pillsbury state park area (monadnock-sunapee greenway).

I crank my MT bike close to 1,000 miles per year now... in addition. At the GYM, I stay away from things that pound your knee (running, stairmaster), stick to the eliptical runner.

Make sure your hamstrings get exercised as well, they can really help in keeping your knee solid.

I am now 40 ... and my knee rarely bothers me (it does when I swim in water below 62F for a long time).

 

[GNR]

Here is the final scoop...

After hearing a torn ACL from a trainer, and then a torn medial miniscus from a GP, I finally went to an orthopedist who told me, even before looking at the MRI, that I have a severely torn ham string and/or torn calf muscle. Apparently, the tear is just below my knee, where the muscles attach, which is why it feigned like a knee problem. I have taken muscle relaxers and a series of anti-inflamatory's, and the issue has almost completely resolved. Some stiffness after moderate exercise, but the orthopedist says this is how it will be until it fully heals. Stretching is the new pre/post hike routine.

Thank you all for your comments and sharing...I feel lucky.