partially torn acl and softball

[shelbo]

I partially tore my acl last week and am the catcher for my HS softball team.  What are the possibilities of me catching for them this year.  Our season starts in February.  The Dr wants to wait until I completley tear my ACL before he does surgery.  Help

[kendra]

im sure you're doctor has a reason for wanting to wait until you completely tear your acl before doing surgery, but that sure sounds odd - does this mean he is expecting it to tear soon and encouraging you to do so?  or does this mean the tear is very minor?

if he's expecting it to tear soon and then followup with surgery, i would say your odds of playing softball as actively as before this year to be low.

if the tear is minor and you can work it out through PT than you might be good.

[jb-knee-geek]

whether you can play or not depends on the stbility on your knee. If you have no instability or pain, then you can play on. I did for 3 years, I did it  with a brace. Now I have a torn meniscus as I inch closer toward ACL surgery.

However, playing pivot sports with a torn ACL is an accident waiting to happen. Wish I could be more optimistic, but I've been down the road, I continued to play pivot sports, it was a gamble that I lost.

[shelbo]

Well we went to the Dr today and was told we had a complete tear of my ACL.  

He told me that we could wait and have surgery until after softball season.

That we would do some intensive rehab and wear a knee brace until surgery. 

Any thoughts?

[kendra]

yes, good luck!

[jb-knee-geek]

tough call, depends on how old you are, how much you are willing to play with a brace, how stable is your knee AND are you willing to gamble on tearing your meniscus because of the instability from your ACL.......

speak to your OS, your coaches, your OS and anyone who you think can help you. ultimately this is up to you.

check these sites:

http://steadman-hawkins.com/acl/overview.asp

http://www.orthoassociates.com/Sports_Topics1.htm#topics

and this book:

http://www.amazon.com/gp/product/0446678198/qid=1106693736/sr=1-2/ref=sr_1_2/103-8002501-3245457?s=books&v=glance&n=283155

good luck,

[messed^kneegurl]

Well we went to the Dr today and was told we had a complete tear of my ACL.  

He told me that we could wait and have surgery until after softball season.

That we would do some intensive rehab and wear a knee brace until surgery. 

Any thoughts?

hey hun
im 14 i play soccer, softball, volleyball and just about everything active u could think of
i tore my acl completely last spring
but my doctor said i was 2 young 2 have surgery
so i did hard core PT and that summer i played softball
i also played vball in the fall and they said the stability in my knee (scar tissue)
was strong enough 2 play soccer
i ended ^ tearing it
but still there is hope
haha
that sounds really corny
but our softball team won the league
just DO PT it helps really
with the strengthening and everthing
actually the reason im on is cus 2 months out of surgery i slipped on ice and broke my knee cap so if u do get surgery B VERY VERY CAREFUL
honestly
knees suck especially wen u screw them up wen u play a competitive sports
wishin ya lots of luck
olivia
 

[Heather M.]

ACL's are replaceable, but your meniscus isn't.  If your knee is not stable...well, playing on an unstable knee seems like an unwise choice when you consider the serious damage that can occur in other parts of the knee.  Playing with a complete tear is really not recommended for young, high-level athletes.  Because bouts of instability can involve the knee buckling, and this can lead to tearing of a lot of other structures in the knee, like the other cruciates or the collateral ligaments, soft tissue, tendons, and meniscus.  And NONE of these is easily replaced...articular cartilage restoration attempts make an ACL recon look like a piece of cake.

I guess the most important questions to ask would be:  is the knee stable?  And what does the doctor say?  What are the potential consequences of not repairing the knee now?  What are the benefits to waiting (and there may be some--every case is different!)  Perhaps the doctor thinks surgery is inevitable given your lifestyle?  So if that is the case, perhaps you should consider this:  Why wait if surgery is going to be the end result anyway?  Because if you are going to end up with ACL recon, I'd think it would be worth thinking about doing it now rather than potentially adding in a meniscal tear or articular cartilage damage as well...that's just my take.  I've never had ACL recon, but I do know what it is like to not be able to trust your knee.  It's a really bad situation to plant your leg and not be sure if it will hold you up.  And I can't imagine squatting behind the plate like that!!  Do you think in your heart that you can play with the knee as it is now? What do your instincts tell you?  These are usually pretty good, so I always try to listen to them.  What are yours telling you? 

Anyway, the decision is yours, so do your 'homework' and see how others with a complete ACL tear and a young & active lifestyle have managed for the short and medium term.  I think most sports medicine doctors would assume ACL recon is a 'no brainer' because you want to do a high impact sport with pivots, quick starts and stops, and sudden direction changes.  That's got to be next to impossible without an ACL....unless you wear a heck of a strong stabilizing brace.  So that's probably what your doctor is talking about.  However, if you do a search, you'll see posts from some folks who suffered a complete ACL tear even with the brace on!  Others complain about the bulk of the brace, but with the new stuff out there hopefully this wouldn't be a problem for you.  I wear a functional ACL brace and it's very lighweight and comfortable.  I imagine you'd have to stop periodically and pull the brace up/tighten the straps, especially if you are sweating.  And if you are allergic to rubber/neoprene, then you would have a big dilemma, because the braces are lined with this material.  I get a rash in the summer and I don't wear mine for long (to walk the dogs), though I do wear it every day.  You just have to take it apart and wash it regularly, then let it dry.  So my point is that braces can be a pain, but for some folks they are worth it.  That's a choice for you to make, but you may ask the doctor to see an example of the brace you'd have to wear.

Which leads to two other questions:  does your school/sports league allow frame knee braces on the field?  Some do not for fear of injury to other players during a collision--the metal bits of the brace can really hurt someone else if they bang into it.  Also, would your team's insurance and/or medical clearance process even allow you to play with an ACL deficient knee?  Would the coach?  I can't really imagine any of them letting you risk your knee like that, to say nothing of worrying about you being a heartbeat away from an incident of instability at literally any moment....just a thought.

Here is a link to a great web page with easy to understand information about ACL injuries--including the decision about whether to reconstruct or not.  http://www.steadman-hawkins.com/acl/overview.asp

Here's additional information about meniscal tears, which are very often found either with an ACL injury or in an ACL-deficient knee.  http://www.steadman-hawkins.com/meniscus/overview.asp

More details about articular cartilage damage, which usually occurs over the long run in an ACL deficient knee.  (It also happens as a natural part of the aging process, but happens earlier in patients with mechanical problems, missing ACL's, or trauma/fractures around the knee.)  http://www.steadman-hawkins.com/knee_chondral/overview.asp  Focal damage to a small area of articular cartilage is also a risk during bouts of knee instability, especially if the knee buckles and collapses.  Or, you can get lesser damage over a larger area if you have repeated subluxations or stability lapses.  These areas of damage are sometimes called chondromalacia, and again this would be something to look out for *in the long run* in an ACL deficient knee.  Just wanted to put the information out there for those who are considering not reconstructing the ACL at all.

Finally, if you are confused by the doctor's advice, it's perfectly okay to get another opinion from another doctor, preferrably a sports medicine physician who sees a lot of young athletes.  Then you and your parents can sit and make a decision, confident that you've got the right information and have done as much as you can.

If you do decide to hold off on the surgery, I really encourage you to see a physical therapist and also to be fitted for a very good sports brace.  That should help you get through the season.

Heather

PS there's a board out there dedicated strictly to ACL injuries, which might help you and your folks--you can search terms and look up old threads, and see how people who have delayed or decided against recon are doing.  That may help in the decision-making process, too.  http://factotem.org/cgi-bin/kneebbs.pl

[patpalloon]

I tore my ACL in August playing football and am waiting for reconstruction. I was told by my physio that if I work on my hamstrings, they can compensate for the lack of ACL and I could go skiing in March/April.