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Author Topic: Swimming without an ACL  (Read 3290 times)

Offline strive2thrive

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Swimming without an ACL
« on: August 28, 2010, 12:18:06 AM »
Hi - I'm a newbie to this forum and long-time lurker (complete ACL rupture 12/28/2009, left knee, no surgery).  I was inspired to post because two weeks ago the best thing happened: I discovered that I can swim freestyle laps without pain!  Anyone had experience with swimming after ACL injury?  I find it interesting that I can swim, but the extension machine (open chain) is still too painful.  Are there any dangers with swimming that I should keep in mind?  I've just been so excited because all of a sudden I can DO something that shows how far I've improved after 8 months of hard, hard, work.  I generally split my sessions between freestyle and kickboard.  I'm not super fast or anything and I only do about 400 meters each time.  Thoughts?  Advice? 
December 28, 2009 - ski accident - complete ACL tear left knee - no surgery

Offline Snowy

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Re: Swimming without an ACL
« Reply #1 on: August 29, 2010, 05:24:08 PM »
Isn't swimming awesome? I relied on it heavily both during the time I spent without an ACL before surgery, and since getting my new ACL.

My PT had absolutely no problem with me swimming without an ACL, as long as I stuck to flutter kick. He told me not to use the other kicks (breaststroke, butterfly) but to swim as much crawl (and kickboard with flutter kick) as I wanted.

Leg extensions are actually very, very hard on an ACL deficient knee. The motion causes forward motion of the tibia and places significant shearing force through the knee. It places direct stress on the ACL if you have one, so it's no wonder that it's painful without an ACL. How do you find the closed chain exercises (e.g. leg press) in comparison?
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline strive2thrive

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Re: Swimming without an ACL
« Reply #2 on: August 29, 2010, 07:51:08 PM »
Oh I love love love being in the pool.  It's refreshing and I can do stuff like JUMP!  Sometimes after swimming I feel an ache on the medial side of the patella, deep in the knee- still not sure if it's aggravating something or just working it.  When that started happening, I tried to concentrate more on keeping my knees together and my abs tight when kicking, which seems to help.  did you experience anything like that?  How long do you swim for usually?

I actually find that my quads are more tired after swimming than after the machine workout (leg press, glutes, ab/adduction), perhaps due to duration?  I find it very difficult to do elliptical or bike for very long.  I get bored and it hurts more than swimming.  Lately I've been going to a conditioning class, which I think is helping with balance and strength.  Also, I can't poop out early so I get a longer workout than when I do the weights on my own. 

Do you like your new ACL?  I don't have insurance but maybe in the future...  Did your swimming change after the repair?
December 28, 2009 - ski accident - complete ACL tear left knee - no surgery

Offline Snowy

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Re: Swimming without an ACL
« Reply #3 on: August 29, 2010, 09:10:53 PM »
I wouldn't have thought the swimming is aggravating anything in the knee - it's generally one of the most knee-friendly activity out there. If your knee does get sore, try focusing on kicking straight-legged from the hip rather than the knee.

I usually swim for 1-2 hours, depending on how much time I have to spare. I love being in the pool as well - I'm still in the fairly early stages of rehab (7 weeks post-surgery) so the knee gets stiff and achy on dry land, but in the pool it feels a lot better. When I first got back in the pool after surgery (11 days after the operation) I had a lot of trouble using that leg. It just dragged behind me, giving these odd little floppy twitches rather than real kicks. I used a pull buoy to keep my legs still until it felt a bit better, then after a couple more weeks started working in a few lengths of kicking. For a while I could kick okay but the effort was exhausting as the leg obviously still wasn't up to par, but as I've practiced more it's felt better and better and now it's pretty close to normal. At the moment I swim 22 lengths of our local pool each day (3km), and just use the pull buoy for two lengths in the middle.

I'm happy to have the new ACL, but have to be honest about rehab - it's a lot of work and very slow. My OS aims for release to full activity at 8 months, and currently I'm still in the stage of doing a lot of closed chain gym work while the graft revasculates. Sticking to the rehab deadlines and not trying to push ahead with more activities takes a lot of patience. For the first six weeks the knee was really sore, swollen and very limited in what it could do, but things have improved quite a bit in the last week or so - I gather this is fairly typical for the 6-8 week mark.

That's too bad about the insurance...how did you injure your knee? It sounds like you're doing all the right things...keep working away on the PT and leg strengthening. As well as helping you manage without an ACL for now, it will also stand you in good stead if you do have the surgery in the future.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline knicknack

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Re: Swimming without an ACL
« Reply #4 on: August 30, 2010, 05:00:31 PM »
Just wanted to second the swim freestyle but nothing else comment. My doc told me not to do anything but flutter kick, especially not breaststroke. I had the ACL surgery but it failed and my knee goes every which way but straight these days, but freestyle doesn't bother it at all. :)

Offline strive2thrive

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Re: Swimming without an ACL
« Reply #5 on: August 31, 2010, 04:11:34 AM »
@ knicknack - It's really good to hear that freestyle is appropriate :)  Thanks for the recommendation.  I hope you find a solution for your wacky knee.  At least you know you have swimming to look forward to.

@ Snowy - I tried kicking from the hip more today and it did help!  I'm looking into a pull buoy too.  So, I tore my ACL on my first day of skiing ever.  It was late in the day and my (younger) friends wanted to go back out for "one last run".  I said I was done for the day but gave into the idea...got going too fast, stepped on my right ski to turn but stepped too hard and whipped around.  I landed facing uphill and heard the dreaded POP as I twisted.  Thanks for your kind words.  What kind of closed chain work are you doing?  Lunges, squats, leg press, glutes and the like?  I'm trying to figure out whether the pain of rehab is worth it.

December 28, 2009 - ski accident - complete ACL tear left knee - no surgery

Offline Snowy

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Re: Swimming without an ACL
« Reply #6 on: September 01, 2010, 06:17:47 AM »
Ah, another ACL skiing victim - that's really too bad. I busted mine crashlanding a jump, for which I have no-one but myself to blame. Will you be trying to ski again in the future, or did the accident put you off?

The closed chain work that I'm doing at the moment includes squats, leg presses, step-ups and step-downs, glute bridging, heel raises, toe presses, wobble board (rim rotations, standing on the operated leg and catching a tennis ball, squats) and lots and lots of biking. I was just recently allowed back on a real bike after an eternity on the stationary bike, so I'm trying to make the most of it.

Having the surgery is definitely a tough decision to make. I was lucky in that I recovered well from the injury, after an initial couple of weeks that were very painful and unpleasant; however I had almost no instability, rode a 100k bike race at a month out and was back on the slopes in a brace two weeks after that. That made it a harder call to have the surgery, because functionally my knee was doing really well. However all the tests showed a lot of laxity in the joint, and given that I already have early stage arthritis in both knees I knew I would be at significant risk of more drastic future injury and/or more serious arthritis if I chose to live without an ACL. Given that and the fact that I really want to return to high level skiing, there was only one route to go. Rehab is very tough - more so than I expected - but I am confident that the short-term pain will be worth it for the long-term benefits. I think so much depends on what your goals are, and how important sporting activities are to you. It's a bit of a game of chance, as well - about a third of people do fine without an ACL, a third do okay but have to give up certain sports, and a third never regain stability for day-to-day activities. The problem is that there's no way to know which category you fall into until you've given PT a good go.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline strive2thrive

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Re: Swimming without an ACL
« Reply #7 on: September 02, 2010, 04:42:02 AM »
Sigh.  I have no wish to go back to skiing, except to conquer the fear.  My mother was a world class downhill skier in the late 60s...she moved to warm weather country before I was born so it was never an option for me until I went on our first "fancy" winter vacation with my husband's well-to-do family.  Mom has had so many bone breaks that she used to set off metal detectors in airports.  I shoulda known I'd have her crash and burn tendency, but for some reason it took actually doing it for me to accept it.  She was VERY fast.  I was just TOO fast and way too determined for my own good.  My husband is a good, experienced skier, which makes me want to join him on the slopes.  But.  He's got thighs of steel and I don't.  Yet.  :)  Plus, so far we still live in Florida...maybe if we move to Colorado where my family is from...then perhaps I will consider putting on ski boots again and address the shudders of flashbacks that I get just thinking about it.  uhhgh.  maybe I just belong in the water!

So what is "glute bridging"?  Is it like doing backbends or bridge pose in yoga?  I never thought to do that - fantastic idea.  Today is my day off, but tomorrow I'll add that to my workout.

I, too, am highly functional without the ligament, with significant laxity.  My physician recommended LOTS of PT.  Sounds like you are quite an athlete (kickboxing?! ski jumps?! 100km bike?!).  Sometimes I feel like I've been too aggressive with my workouts, but it's so relative.  Nice to know people for whom working out and working hard is simply part of daily life, instead of "oh my gosh, I had to take the stairs today, and I am so tired now!" (add valley girl accent for full effect).  Not terribly inspiring.  I dread surgery...I hope I'm in the first category.  But that's why I'm here on this forum.  I'm curious, and I won't be satisfied with "ok" if there is "great" waiting for me.
December 28, 2009 - ski accident - complete ACL tear left knee - no surgery

Offline kscope09

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Re: Swimming without an ACL
« Reply #8 on: September 02, 2010, 11:36:13 AM »
This is a great thread as i should really do some swimming.

My right knee ahs a partial tear, which has been debribed and my left knee has a slightly attenuated acl.  There is about 1cm movement in both of them.  I don't run because I've got other problems but I can walk in a circle and a figure of eight without problems and turn corners quite well.  I've done a hydro session 6 weeks post scope last year and it really overdid things and my knee was red and hot for a few days.  Whenever I was trying to swim with a straightleg kick I would find myelf doing it the wrong way and the knee would hurt.  This was a year ago.  Earlier this year I asked a pt about swimming and he said he thought I might be able to do regualr breat stroke again.

I'd like to know though; with a partial tear is this wise?  Can others with partial tears swim normally?  I notice that many people who live without acls do very well and are very functional and I thijnk if it wasn't for my chondral issues and my plica/scar tissue ten I'd be doing a lot better because I've worked really hard on my quads and my knee is stable and solid and there is very little movement.  Two pts say it is within normal limits and my OS said i'd eventually be able to go back to Karate.  I havn't quite managed that yet and I'm doubtful now that I'll ever get back in the Dojo but I wodner if I could swim normally.  By which I mean with rotation as well as flutter kicks.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Snowy

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Re: Swimming without an ACL
« Reply #9 on: September 02, 2010, 05:38:39 PM »
S2T - Here's a pic of a glute bridge:

http://restorepersonaltraining.com/?p=401

You can do them on one leg for extra effect. This is particularly interesting if you've had the hamstring tendons in that leg removed and turned into a new ACL - I was totally shocked by how feeble my left leg is now!

Good for you on not necessarily writing the skiing off. It's hard to go back to something when your only experience has been a traumatic injury with severe consequences. I don't kickbox anymore, as I did have to make some sacrifices to preserve my knees for skiing; I try to avoid high impact activities, which isn't too difficult as I also love to swim and cycle. My OA hasn't deteriorated significantly in the last few years, so I think this has been worth it. They'll never keep me off the slopes, though. ;)

It's worth plugging away at the PT and seeing where you end up. Surgery isn't fun at all, and the rehab is grindingly slow and frustrating. I'm still confident that it was the right choice to make, but knowing that I still have 6 months of battling my way back to normal activity ahead of me is pretty daunting. I know I'm going to be a bear with a sore head when the snow starts falling and I'm still sitting on the sidelines.

Kscope09 - you can certainly swim with a flutter kick (I was back in the water and kicking away a couple of weeks after a complete ACL rupture) and I don't see any reason why you wouldn't be able to swim breaststroke if your knee is strong and stable enough. I lived with a partial tear in my left ACL for four years and swam both breaststroke and front crawl regularly. I did find the whip kick a little tougher on the bad knee, but was able to resolve this by alternating 10 lengths of breaststroke and 10 of crawl - this seemed to work well in terms of balancing the work. I'm not sure if your other knee issues would affect your ability to kick, but from an ACL point of view it should be okay.

Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA