Hi folks! This post is about Post-ACL rupture recovery, a common ski injury. This will give you some guidance and may help you get the bigger picture of what to do next. If you have snapped your ACL ligaments in your knee, you are probably faced with the option of a surgery or/ and physiotherapy to strengthen your muscles around your knee. I will try to help you with making your decision by sharing my story.
My ACL ski injury
I snapped my ACL ligament on a ski slope in France. I was skiing off the piste and lost control resulting in big strain on my knee when the ski did not come off.
First thing that you would notice is how the knee gives a way. Your knee would be really unstable when trying to stand up and put pressure on your leg. I knew exactly what happened and what injury I was dealing with, when I had my accident.
The first doctor who seen me gave the same diagnosis. A rupture of the ACL ligament. This was even before the MRI scan.
If this happened to you the chances are you were advised that the recovery will take 3 to 12 months. Your options are physio and/ or surgery.
So you naturally get worried about the future and how it is going to affect you long term. There is a lot of different opinions about this. Some say you need the surgery some say you can live without it.
I was really confused of how to approach the recovery. First advise I had was to rest for at least 10 days, put ice on my knee, avoid moving around and take anti-inflammatory pills prescribed by the doctor.
The best thing I did, that could also help you to recover from this injury and avoid the surgery is to be pro-active. To do this you should ask different specialists for opinion, as relying just on the doctors may not always be the best. Let me explain why.
For the first 3 days I was in bed like advised by the doctor, because of this my job was at risk as I worked in a ski resort. So I was motivated to do something about it as my contract was about to be terminated due to my inability to perform the duties.
Another motivation to get up and start doing something was the fact that I didn't have a job to come back to. In addition, because of the ACL injury I could not start the job I had lined up for the summer in Italy. So my goal was to regain as much ability as I could while I was still in France and employed by the tour operator.
So I have signed up at the local ski physio centre and after the consultation I went to the doctor to give me a fit note to work. This was a surprise at the medical centre, but I needed it to work. I have then agreed with my manager to resume some of my duties.
Timing is key
First appointment with the physio was around a week after the injury and my physio advised I should've came earlier. The physio advised the longer you wait, the harder and longer your ACL rupture recovery.
What's more, the physio therapist gave me a lot of hope and self-belief which is really useful after all the sad talk you get from the doctors. So this is why you should not wait, and try to consult a private physio therapist as soon as possible.
The physio started with careful but aggressive therapy and exercises for my leg to recover. This would probably be against the advise of your doctor, which is to rest. You were probably advised to rest 10-14 days, but you should start exercises on your leg instructed by a physio therapist straight away.
The first few exercises were quite hard and painful but they were really helpful. In total I have seen the physio 5 times over the course of 5 weeks and I have been doing the exercises 3-5 times a day.
My manager resumed most of my duties at work, at reduced hours and with some lighter duties in the first week. Over the next two weeks my duties were back to normal and I was doing my normal 35 hours week. From time to time I had to put the brace on my knee, as on occasional days my knee would be giving a way and cause pain. But it was manageable.
6 - 8 weeks after the ACL injury
This was the biggest break through in my recovery from the injury. At the point of 6 - 8 weeks I was walking fine and I was getting ready to start skiing again. Many people advised against it, but my physio has prepared me for it with the exercises given.
I have consulted my physio before going back on the slopes, and been advised to give it a go. To my surprise, my knee had no issues with skiing.
I took it easy, and was very vigilant and careful. However I was really happy I could even ski. On occasion if I had a longer day skiing, my knee would be a little weaker later on or the day after, but rarely.
The end of season
At the end of the winter season I went back home to the UK and as advised by the first doctor and from MRI results, I have booked to see a specialist. This was still to consider the surgery.
In the meantime I have signed up to the gym and continued to exercise my legs to strengthen the muscles. When I have seen the specialist I had no symptoms whatsoever.
However because it was all still fresh I was advised to see another specialist for more in depth consultation. My knee was tested again, and even though the doctor could feel slight instability he advised to hold off from the surgery and review in 6 months.
A year after the ACL injury
It has been a year since the accident, I had no operation but physio, going to the gym and there is no symptoms. Currently I deadlift 100-130kg, I squat 80-100kg and leg press 140-180kg and have no issue at all.
I do sometimes feel that the knee may not be as stable as it was before the accident. Sometimes a click here and there but nothing major. However both the specialist and my friend who had this surgery said; it will never be the same, and even after the surgery there might be some instability.
So if you balance the small chance it could get slightly better, against 6-12 months post surgery recovery and the actual risks that this surgery could have (i.e. loss of sensation in parts of your leg or an infection), I think the results achieved through physio and exercises are amazing.
Summary: should you do it?
I think if you are worried about the future, take this as an example that it may not be as long or as bad as you think. Take into consideration the good and bad sides to it. Test your body, seek professional help, be pro-active and see how it goes.
Each injury and body is different so you would need to judge by your situation. However you can use this as an example that you could fully recover without the need of a surgery.
My biggest debate and worry at a time of the accident was which direction to take, and due to the circumstances and physio it never went to surgery. The biggest lesson I have learned is that you can recover, function and live without any pain or discomfort just following the physio.
I also have an uncle who snapped ACL in the army, and never had the surgery. He has lived without it for over 30 years, and works in construction so walks, moves and lifts a lot. He is just fine without it.
One of the guys who worked in the same ski resort, who had ACL rupture a few years back had shared his story with me. He did not have a surgery, and he said that it took him much longer to recover, then me.
However what is important in his story is the fact that he was only following the advise of the doctor. He did not have any physio therapy. On the other hand a girl who also ruptured her ACL at the beginning of the winter, who went to the same physio as me also recovered really fast and was able to ski after 6 - 8 weeks.
So try not to rely on one source of advise 😌
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