ACL Injury?
ACL Injury?
First day up Mt Washington end of Feb and wrecked my knee on a lame blue groomed run. Did my ACL and MCL. The ortho at Comox emerg. didn't "class" the injuries but said "they're gone".
So I have a first appointment with an orthopediac surgeon in Nanaimo at the end of this month and was thinking of dropping for an MRI ahead of the appointment to speed the whole process along. The referreal would come from my GP and while he is a great doc I wanted to do some background research just to see what type of MRI would be appropriate as there seem to be a couple of options: high contrast and arthroscopic being two.
Anyone been through this or have advice?
S.
So I have a first appointment with an orthopediac surgeon in Nanaimo at the end of this month and was thinking of dropping for an MRI ahead of the appointment to speed the whole process along. The referreal would come from my GP and while he is a great doc I wanted to do some background research just to see what type of MRI would be appropriate as there seem to be a couple of options: high contrast and arthroscopic being two.
Anyone been through this or have advice?
S.
Last edited by saulman on Thu Mar 13, 2014 9:39 pm, edited 1 time in total.
Big drag, ACL can go just like that, no triple black diamond required 
For all those that haven't done one, one avoidance tactic is to "not try to save it" and just go down, fall sideways and not backwards, secondly don't get blind sided cuz your body cannot brace for impact so don't ski through a crowd....with mine a minor hit of the ski tails mid turn caused all that damage....didn't even go down just lost the ski. Later I tripped on a step, landed back on my heel, that did the rest of it in....the neighborhood heard that one a few blocks away
As for ACL or MCL, I doubt they need a whole bunch of imaging to confirm, just by doing the basic tests they can tell the ligaments are damaged and require repair. Mine was severed for all intents and purposes, cartilage took a bit hit too Once they get in there it's pretty clear, watched it on video. With mine the wait was for the blood to be re-absorbed and tissues to mellow out, there is a lagtime between incident and surgery recommended as I recall. Hard physio, drilled holes in my femur for attachment for some reason, pretty darn good results, skied carefully 4.5 mo after. Move right after surgery as much as you can stand is important, but I bet your meniscus suffered too, that's the bigger loss. Shaggy should know all about this one, fresh in his mind
For all those that haven't done one, one avoidance tactic is to "not try to save it" and just go down, fall sideways and not backwards, secondly don't get blind sided cuz your body cannot brace for impact so don't ski through a crowd....with mine a minor hit of the ski tails mid turn caused all that damage....didn't even go down just lost the ski. Later I tripped on a step, landed back on my heel, that did the rest of it in....the neighborhood heard that one a few blocks away 
As for ACL or MCL, I doubt they need a whole bunch of imaging to confirm, just by doing the basic tests they can tell the ligaments are damaged and require repair. Mine was severed for all intents and purposes, cartilage took a bit hit too
Once they get in there it's pretty clear, watched it on video. With mine the wait was for the blood to be re-absorbed and tissues to mellow out, there is a lagtime between incident and surgery recommended as I recall. Hard physio, drilled holes in my femur for attachment for some reason, pretty darn good results, skied carefully 4.5 mo after. Move right after surgery as much as you can stand is important, but I bet your meniscus suffered too, that's the bigger loss. Shaggy should know all about this one, fresh in his mind 
Wish less, sail more!!
Vancouver Island Windsports
Chinook /Takuma /KA Australia
You're either in or in the way....
Doing things the hard way since 1963....
Vancouver Island Windsports
Chinook /Takuma /KA Australia
You're either in or in the way....
Doing things the hard way since 1963....
Sorry to read you blew your knee. I have blown out both ACLs and have repaired one. The only thing worse that tearing up my knee was fixing it.
Like Kus said, the doc will likely be able to assess the knee and schedule a surgery date well ahead of getting the MRI.
You can go to a good Physio ahead of time and they will also be able assess things for you and forward their report to the surgeon ahead of your appointment.
My suggestions:
1) pick up some salmon oil, or other Omega 3 pills to help with reducing inflammation. This worked better than multiple anti-inflammatories per day.
2) do as much strengthening as you can ASAP.
3) be super nice to your family because you will likely be a dick for a couple of weeks after surgery
4)get a stationary bike from craigslist - one that you will actually use
If I had to do it all over again, I would request that they use the cadaver parts for the ACL reconstruction instead of harvesting hamstrings. The hamstring recovery was the hardest part for me.
If you have ton of money to spend, sure get the MRI. Even consider paying for private surgery. Otherwise I would say a good physio would be best money spent.
-Todd
Like Kus said, the doc will likely be able to assess the knee and schedule a surgery date well ahead of getting the MRI.
You can go to a good Physio ahead of time and they will also be able assess things for you and forward their report to the surgeon ahead of your appointment.
My suggestions:
1) pick up some salmon oil, or other Omega 3 pills to help with reducing inflammation. This worked better than multiple anti-inflammatories per day.
2) do as much strengthening as you can ASAP.
3) be super nice to your family because you will likely be a dick for a couple of weeks after surgery
4)get a stationary bike from craigslist - one that you will actually use
If I had to do it all over again, I would request that they use the cadaver parts for the ACL reconstruction instead of harvesting hamstrings. The hamstring recovery was the hardest part for me.
If you have ton of money to spend, sure get the MRI. Even consider paying for private surgery. Otherwise I would say a good physio would be best money spent.
-Todd
Sympathies. I agree, the only thing worse than the injury is the surgery ( and recovery). i just had a regular MRI. Then the patella graft. research the best option for graft. Patella is supposed to be " stronger" than hamstring, but the patella surgery site was one of the longest to recover in the end. if there is a viable non- harvesting approach, do it. Get really fit and lean before the surgery. So much so that you wonder why you are doing it the day before you go in. Build up the quads and hamstrings. The recovery is slow - lots of isometric exercises that feel so slow. On the plus side, it works. I only wear the brace if I am doing something I have a psychological "fear" of an awkward fall or twist - like snowboarding. Best of luck.
Echo what the others say about the MRI. I didn't even have one. A good knee guy should be able to know what is wrong in about 20 seconds. That was my experience anyway.
Had the petalla option for my ACL going on 15 years ago. I also had to have the cartilage cleaned up...twice. For me that cartilage was what was causing the most pain and lack of motion.
The only thing I would do different would be more diligent on the rehab once I got back to 50-75%. It is easy to be dedicated when it is very obvious that you are screwed up, but once I was able to do things without really noticing the repair then I started to do less and less stretching. That was a big mistake, that limited my range of motion to this day.
It will be a good year before you are in the 100% range for things like skiing, windsurfing, etc. You will be able to do these sports before then, but you will not be on the podium for at least a year. : )
Good Luck!
Had the petalla option for my ACL going on 15 years ago. I also had to have the cartilage cleaned up...twice. For me that cartilage was what was causing the most pain and lack of motion.
The only thing I would do different would be more diligent on the rehab once I got back to 50-75%. It is easy to be dedicated when it is very obvious that you are screwed up, but once I was able to do things without really noticing the repair then I started to do less and less stretching. That was a big mistake, that limited my range of motion to this day.
It will be a good year before you are in the 100% range for things like skiing, windsurfing, etc. You will be able to do these sports before then, but you will not be on the podium for at least a year. : )
Good Luck!
Give'R
I feel your pain Saulman. I did my full ACL tear and MCL grade2 last April in Whistler. Considered paying $700 for a MRI to speed up the process but was talked out of it by a doc. MRI is only needed if they're not sure what's going on, but if you've fully torn your ACL the Ortho will know right away by performing the "drawer test".
You've got to recover from the injury before they will operate which takes 6-8 weeks with physio. Get a proper brace as soon as you can to get off the crutches. Mine cost $900 in Whistler and as soon as I put it on a could walk pretty normally. I had to where it 24hrs a day till surgery to protect the remaining ligaments. No brace after surgery till you start back at sports, then for the first year or so for sports. Get a stationary bike or a trainer for your existing bike. The bike will become your friend. I was on one the day after injury for 5 minutes a day. Very important to get that leg as strong as possible before surgery. Your muscles start to atrophy within hours of the injury. Get a good physiotherapist ASAP.
I had a hamstring graft. Patella graft can cause issues if you're on your knees a lot, I'm a house painter. So if you're a carpenter, carpet layer or fluffer then patella is not your option. Had my procedure done in Squamish by Dr. Sally Clark and Dr. Alexandra Brooks-Hill from Sea to Sky Orthopaedics. Went this route for speed and top notch surgeons. Had surgery 7.5 weeks after injury by docs who work on the ski team. They were awesome and did a great job. This took 2 visits to their knee clinic in Whistler presurgery as well as follow up at 3 and 6 months after.
After you've been re-injured from surgery, rehab/physio is a daily part of your life forever. Stretching is also very important to regain full range of motion. I'm a daily stretcher so this part came naturally. Was on the indoor bike day after for 5 minute sessions. Crutches, pain killers and elevated knee for 2 weeks. Swelling and discomfort lasted 4 months. Biked outside at 3 months, hiked in Peru at 5 months, surfed at 6, skied at 7 and windsurfed at 9. Leg is still visibly smaller than good leg at almost 10 months but feels strong and pain free. Scored 3 big pow days at Whistler 3 weeks ago and had no issues, even felt strong from all the squats. I've never been a gym guy but now I'm out of my 20's😉(my first emoticon ever), I think I'll be setting up a home gym. While in there they removed half my meniscus from a lifetime of fun. So all the more important to keep the quads strong as they hold the knee in alignment.
It's a slow recovery but you'll get through it. If you want to chat call me at 2-five-o8931967.
Get on that bike dude!
Pete
You've got to recover from the injury before they will operate which takes 6-8 weeks with physio. Get a proper brace as soon as you can to get off the crutches. Mine cost $900 in Whistler and as soon as I put it on a could walk pretty normally. I had to where it 24hrs a day till surgery to protect the remaining ligaments. No brace after surgery till you start back at sports, then for the first year or so for sports. Get a stationary bike or a trainer for your existing bike. The bike will become your friend. I was on one the day after injury for 5 minutes a day. Very important to get that leg as strong as possible before surgery. Your muscles start to atrophy within hours of the injury. Get a good physiotherapist ASAP.
I had a hamstring graft. Patella graft can cause issues if you're on your knees a lot, I'm a house painter. So if you're a carpenter, carpet layer or fluffer then patella is not your option. Had my procedure done in Squamish by Dr. Sally Clark and Dr. Alexandra Brooks-Hill from Sea to Sky Orthopaedics. Went this route for speed and top notch surgeons. Had surgery 7.5 weeks after injury by docs who work on the ski team. They were awesome and did a great job. This took 2 visits to their knee clinic in Whistler presurgery as well as follow up at 3 and 6 months after.
After you've been re-injured from surgery, rehab/physio is a daily part of your life forever. Stretching is also very important to regain full range of motion. I'm a daily stretcher so this part came naturally. Was on the indoor bike day after for 5 minute sessions. Crutches, pain killers and elevated knee for 2 weeks. Swelling and discomfort lasted 4 months. Biked outside at 3 months, hiked in Peru at 5 months, surfed at 6, skied at 7 and windsurfed at 9. Leg is still visibly smaller than good leg at almost 10 months but feels strong and pain free. Scored 3 big pow days at Whistler 3 weeks ago and had no issues, even felt strong from all the squats. I've never been a gym guy but now I'm out of my 20's😉(my first emoticon ever), I think I'll be setting up a home gym. While in there they removed half my meniscus from a lifetime of fun. So all the more important to keep the quads strong as they hold the knee in alignment.
It's a slow recovery but you'll get through it. If you want to chat call me at 2-five-o8931967.
Get on that bike dude!
Pete
Hey Shaggy I totally agree with your recovery process and a daily exercise program to stay fit and keep the cardio going .Last year after tearing my shoulder five years ago[full thickness tear of the superspinatus tendon in the left arm ] I managed to do 80 pushups nonstop with no surgery . I also did 1000 deep knee bends nonstop after trashing my miniscus . I agree with you 100% that a program of exercise and perhaps some glucosamine and msm will pretty much speed up therecovery . I am turning 68 this year and had two great 2 hour sessions today in La ventana
If your not paying for the MRI,,,go for it. The more info you give the surgeon the better his judgement. An MRI has no harmful affects, shows the whole architecture of the knee and will show any boney bruising, fluid build up, state of the cartilage, meniscus, both cruciates and co laterals. The surgeon will probably want to scope the joint to confirm any damage to ACL PCL and meniscus, however a MRI will show that also..... give him as much info as possible ,,,,If you have to pay for the MRI, just wait to see the surgeon, most likely he will rely on 2 things, an X-ray and a scope. After years of use and abuse I ended up having to get a total knee replacement .... its never as good as the original equipment ,,, do everything you can to keep your knees man!!saulman wrote:Thanks for the feed back guys. Consensus seems to be skip the MRI so I cancelled the appointment. We'll see what the surgeon suggests on Wednesday and go from there. The words of wisdom are motivating and I think I will be re-reading them over the next while to keep me on the fitness train.
