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ACL Tear

Posted: Jun 06 2014 12:27 pm
by Trishness
I'm just curious if any members of the HAZ community have completely blown out their ACL and how many of you opted for ACL reconstruction and how many just let it be and modified your activities.

It happened to me when I was hiking in CT on 05-17-14 and got my foot caught between some tree roots and some rocks, went to take a step and pivoted on my straightened left leg. Felt that sickening/nauseating "POP" along with a fresh burst of pain and then wondered what the heck did I just do? I was about 3 miles in on my proposed 12 mile hike, so sat in the middle of the trail and luckily I had a 1/2 frozen bottle of water with me so immediately iced it down, popped an Alleve, elevated it and then wrapped it in an Ace. I was able to weight bear on it and kind of "limp-hiked" out the 3 miles and only had problems for 2-3 days after with instability when getting in/out of the car, going up/down stairs and anything requiring pivoting. I had very little pain, virtually no swelling and no bruising at all. I work for an orthopedic surgeon so saw the PA when I got back and got an MRI which shows an acute fill thickness tear of the ACL, a partial thickness tear of the MCL and bone contusions.....no meniscus tears.

It's been 3 weeks since the injury and my knee is only a little sore (nothing an Aleve doesn't manage), I have no problems with stability, can walk on it fine, I even hiked 5 miles last weekend! I've started a PT regimen for strengthening the quads and hamstrings and plan to wear a hinged brace for hiking and other activities. I made a decision NOT to have surgery at this time but that doesn't mean I won't need it down the road if the knee becomes unstable. So I would appreciate anyone with this type of injury sharing your experience with ACLr (reconstruction) or how you manage without the ACL. I appreciate the feedback.

Trish

Re: ACL Tear

Posted: Jun 06 2014 1:11 pm
by RowdyandMe
You'll be OK. I heard only old people need surgery.

Re: ACL Tear

Posted: Jun 06 2014 1:40 pm
by SpiderLegs
I was standing next to BiFrost last year when he tore his ACL on our hike up the Four Peaks. You might want to send him a PM. Think he went the surgery route and if you look at his triplogs this year it did not slow him down. He's back actively hiking.

Re: ACL Tear

Posted: Jun 06 2014 2:22 pm
by Tough_Boots
yeah... Karl is not only actively hiking but doing some of hardest and most interesting hikes of anyone on HAZ. That'll keep you optimistic :D

Re: ACL Tear

Posted: Jun 06 2014 2:27 pm
by kingsnake
Both knees at one time or another. Put off going to a doctor until after I did the right knee (a decade after the left) in 2012. :roll: Basically, just gutted it out. Probably should have, or should still, get it fixed, but I'm not too smart that way. (Plus hate hospitals, probably due to having spent several weeks in one when I was five years old. :scared: ) Biking, and more recently hiking, have helped a lot. Problem with hiking is you need to be very careful how you place your feet, to avoid tweaking it -- which not having proper ligaments, is thus easier to do, as ligaments stabilize the joint, not bear its weight per se. (I am not a doctor, nor did I stay at a Holiday Inn Express last night ...)

Re: ACL Tear

Posted: Jun 06 2014 6:37 pm
by BiFrost
I had pretty much the same injury you did in May of last year. There was very little pain after two weeks of rest so I continued to hike. However, there were problems with stability and it would get pain/fatigue hiking more than 6 to 8 miles. So based on the MRI showing a tear decided to look closer at surgery but still went back and forth many times on the decision. My doctor specialized in sports injuries so he basically said that if I wanted to do difficult off trail, climbing, etc that surgery may be the best odds of recovery. Considering everything I even had doubts right up until surgery time but still had the procedure.

Within six months I was doing 10+ mile hikes and some off trail stuff with no problems except a little tightness. Now a year removed my ability is pretty much how it was before the injury and although it's hard to say what represents 100% recovery pretty satisfied with the hiking I can do. But even the doctor said that everyone is different and no two knee injuries are the same so there is always going to be some risk in surgery.

Also consider the risk of injuring the good knee or other injury from over compensation while trying to protect the original injury. The doctor and physical therapist also were not fond of braces because they said it masked the recovery of the injury before and after surgery. Their opinion was that a brace was only good if you had a debilitating condition that wouldn't get any better and encouraged me to rehab and walk without the brace soon as possible.

Anyway that's the experience I had...hope it helps making a decision :)

Re: ACL Tear

Posted: Jun 06 2014 7:04 pm
by RedRoxx44
As a PT for over 25 years those that rehab and no surgery strengthening and proprioceptive training is the ticket. The only concern I would have is later---pay me now or pay me later. The slight motion in the knee joint might hasten wear and tear on the meniscus and perhaps in years hasten the need for a knee replacement. That's what I've seen in a few patients that tore the ACL years earlier and had no repair. Then there are those patients that have had ACL surgery ,done very well, and those not so well. Good luck with your choice.

Re: ACL Tear

Posted: Jun 06 2014 8:53 pm
by outdoor_lover
I pretty much gave you the take on mine already Trish and the experiences of a few of my Friends who opted not to have Surgery...I think the big difference in mine was that I tore the ACL completely off the Bone and half of the Meniscus with it...Mine was a sloppy Mess with a lot of Pain right from the Moment it happened...I had what my Ortho here describes as the Gold Medal Surgery back then and the Reconstruction was still perfect with all of the Screws still in place when I had an MRI about 4 years ago...My problem now, as I've been Bone on Bone for the last 20+ Years so the Arthritis has really settled in...Not sure what difference losing the Meniscus did, as my Right Knee is intact and I have trouble with Arthritis in it as well...I've been hard on my Knees in my Lifetime and according to my Ortho, Replacement of both will most likely be needed in the next 10 Years...Good Luck with whatever you decide....

Re: ACL Tear

Posted: Jun 06 2014 10:13 pm
by kevinweitzel75
In '89, I had a slight tear in my left ACL playing baseball. Opted to not get any surgery, due to only being a small tear. My knee some what gives me trouble here and there, nothing too bad. A little ice sometimes at night after I get home from a hard day at work, but for the most part, very bearable. Have noticed that when I go on any multiple day trips with a heavy pack, there is quite a bit of soreness, but usually the pain is gone after a day. Probably getting worse the older I get, but will deal with that when it comes.

Re: ACL Tear

Posted: Jun 07 2014 7:33 am
by CannondaleKid
In 2000 I had an injury for which surgery was the only practical option. With how much was removed I still can't believe how much abuse it has taken over the years and it's still doing fine. In truth it would be more accurate to say the beating I've given it, racking up well over 12,000 miles of mountain biking and now almost 5,000 miles of hiking.

In 2010 I had a bad fall mountain biking (the seat bolt broke and I was practically gored in the thigh and stomach... I was going 25 mph at the time) which I would later find left me with one hip joint almost a full inch higher than the other. So after 6 months of hiking this altered gait had worn through the left meniscus until I couldn't live with the pain. Having such great results from the right knee surgery, I went ahead with the surgery (at the VA hospital in Phoenix, no less) and have very much the same positive result, even with the majority of the last 2,000 miles of hiking being off-trail and rough terrain.

I already had mild arthritis in both knees prior the injuries and even worse in both ankles, so the only way I can keep the pain under control (using biofeedback/mind control only, no meds) is by constant and vigorous physical activity. If I haven't hiked in 3-4 days my ankles stiffen up to the point I can barely move them in the mornings, so I keep active.

While I do agree every person and every situation is unique, for me surgery was the best route for three reasons:
1. I didn't have to wait out 6-12 months of PT hoping for a recovery (which I was told at the time)
2. Barely 12 days after the surgery I did a 5.6 mile 2,200' AEG hike off-trail in rugged terrain
3. I haven't had to baby my knees worried about re-injuring them (any more than normal anyway) and I haven't modified my activities

Yes, next time around it means knee-replacement, but I may have worn out the rest of my body by then anyway.
:M2C:

Re: ACL Tear

Posted: Jun 07 2014 2:07 pm
by imike
...I just lost a month with a torn knee... and am back hiking using a crutch to avoid misplaced steps. My hiking partner tore her knee out a few years back and opted for the surgery. We now compare recuperation times and aspects; she feels if she knew then what she knows now she might have tried to rehab sans surgery... at least for the first year. Each person, each injury is likely different... I like to believe the body will/can endure. Of course I also believe in soft landings from 100' falls....

Re: ACL Tear

Posted: Jun 08 2014 7:54 pm
by RowdyandMe
@Trishness
So when are we going hiking? I am limbing around pretty good right now.

Re: ACL Tear

Posted: Jun 10 2014 10:14 pm
by Trishness
Widowmaker wrote:@Trishness
So when are we going hiking? I am limbing around pretty good right now.
:) Me too! Actually I'm heading to Alaska in July for 2 1/2 weeks so I'm not doing anything to screw my knee up further before I go so maybe when I get back we can "tear those trails up"....ya know just limpin' along..............

Re: ACL Tear

Posted: Jun 10 2014 10:21 pm
by Trishness
Thanks to all who replied to my post about their experience with ACL injuries. I know each person and situation is different and there are many factors for me to consider. I especially liked Letty's frank remark of "pay me now or pay me later" because I know (having worked for orthopedic surgeons for years) that the decision I make today may affect what happens 10 years from now.

Re: ACL Tear

Posted: Jun 13 2014 2:27 pm
by rayhuston
@Trishness
If it's a complete rupture (sounds like it if it popped), you should see an orthopod. A tear can heal over time, but a rupture means there isn't much left to stabilize the knee. I ruptured the ACL in my right knee playing basketball 20 years ago. I opted for the ACL reconstruction and spent the next eight months rehabbing. I've been bicycling and hiking actively ever since. No problems, no regrets. The surgical procedure they use now is better with a much shorter recovery time. You should give it some consideration.