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Author Topic: Torn ACL, okay to wait?  (Read 2090 times)

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Offline NHjenson

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Torn ACL, okay to wait?
« on: September 07, 2010, 03:53:26 AM »
Hello there wasn't sure which forum to post this in so it's here.

Tore my right ACL at the end of april 2010 playing football (rugby is my main sport), after being to the doctors and getting and MRI etc. today we have decided to get ACL reconstruction surgery. I'm 18 at the moment.

I'm going to University in october, currently i can use my leg to walk and to do daily activities.

Would it be okay to wait until December/January (when i have holidays) to have the surgery? or are there some risks involved in that.

I would rather wait so the surgery won't interfere with my studies, but i want whats best for my knee.

Having my knee back by the end of next year would great and running on to the field should feel amazing.

Thanks

Offline Kaputt_Knee

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Re: Torn ACL, okay to wait?
« Reply #1 on: September 07, 2010, 05:51:48 AM »
Sorry to see you here but at least you came to the best resource on the web for help from fellow sufferers! ::) 8)


You are only 18 and male which probably means you have a growth spurt to come. This means there is the possibility of having open growth plates in your knee, so you need to be treated by a specialist in dealing not only with knee injuries but also very experienced in working with young people and the associated problems. Have you seen an orthopaedic consultant yet, let alone a specialist in knee ligament reconstructions?

It is possible to wait, often it is advised, in the interim you should use the time to build up as much muscle strength in the thigh, knee and calf muscles. Do this by using a system of high reps and low impact/weights. So swimming and cycling are good methods, heavy weight-lifting is not! You need to avoid any cutting, pivoting or twisting movements , so just because your knee feels good, don't play rugby or football (or any other ball game to he honest). These actions can lead to further complications such as as collateral ligament damage and meniscus tears.

Make sure you register with the uni health service, so that if anything gets worse you have immediate access to a referral system.

Do not "plan" on returning to contact sports in any particular time frame. The rehab from an ACL reconstruction is a long slow marathon. For rugby, write off this season, i.e. 2010/2011. Depending on when they operate and what they find when they go in, you could have a loose return to contact sports in 12 months, maybe a wee bit earlier. Professionals do it earlier but they have 24/7 guided intensive rehab facilities, and shot knees by their mid-40s!

Good luck, if you let us know whereabouts in the world you are, then others can chip in with recommendations for surgeons, physios, etc. If you have any questions, ask away as there is bound to be someone who has one way or another found and answer that may be good for you! I've assumed that you are in the UK from some of the words you used and how you described things but I may be completely wrong!

Sue ;)

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline NHjenson

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Re: Torn ACL, okay to wait?
« Reply #2 on: September 07, 2010, 04:05:21 PM »
Thanks for the quick and thorough reply!

I turned 18 in June and i thought i may have a problem still growing, I'm in Abu Dhabi at the moment and I have seen two orthopaedic doctors and one surgeon that specializes in sports injuries, I'm moving to England at the end of this month and will be studying at the University of Leicester so when i arrive in the UK I will inquire once again about my knee.

This summer i have been swimming and cycling to improve my leg muscles, but what about squats and lunges etc.? are exercises like this too much for my knee?

Yeah what you say about the time frame is true, I was just using a rough estimate really, I mean I guess my only motivation to go through with this properly is being able to play again.

Thanks once again!

Offline Kaputt_Knee

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Re: Torn ACL, okay to wait?
« Reply #3 on: September 07, 2010, 04:28:25 PM »
Just a tip for the UK Health Service:

Don't tell them that you have already had an evaluation! I know it sounds odd but they may tell you to take your treatment in Abu Dhabi or to go privately. I no longer live in the UK although I am a UK citizen. If I have problems that need treating, they always check to see whether they were pre-existing. I was told all pre-existing problems have to be treated in the country that is my main residence.

Register with the uni health service, then have an "event" in which your knee gives way or whatever. This way they will not automatically send you off to a private service.

However if you do have private cover, select a consultant near to your university and see them. There should be plenty as Leicester is a teaching centre for medicine and someone is bound to have a recommendation for you, either at Heath Services or maybe even here!

There is a list of surgeons and specialists in the Information Hub:
http://www.kneeguru.co.uk/KNEEnotes/node/396 this links you to the page for the UK.

Take care

Sue ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline roo222

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Re: Torn ACL, okay to wait?
« Reply #4 on: September 07, 2010, 10:14:09 PM »
Hey there, im in a very similar situation to you. Am 19, tore my ACL end of march playing football, and start uni in 2 weeks. Like you i have no issues walking and doing normal day to day activities, and in terms of further damage to the keee, i would be quite comfortable leaving the op until december.

However, i am electing to go ahead with the surgery asap (doc says early october most likely) as i am really eager to get back to sports and im starting to get quite down and frustrated at not being able to do all the things i want to do. I realise it will set me back a week or two in terms of uni work, (I will be going home for a week or so post surgery - until i feel able to cope on my own!) but im more than willing to put in some extra work if it means returning to sports 2 months earlier!! I hope i can get my course tutor to email me the lectures i will miss, or set me some reading to do while im recovering!

In terms of excercises - specifically squats and lunges like you asked about - my physio has had me doing them for as long as i can remember, especially one legged squats. I go to a physio class where i have been instructed to do one legged squats on trampolines, wobble boards, foam pads etc etc. They're great for building up quad muscles and balance. They do get a bit tiring after a while, (physically and mentally) but they dont put too much strain on your leg. I was advised to simply slow down with them, or stop them if it gets tiring or in any way painfull.

Hope this helps
March 2010: Torn ACL and meniscus damage to right knee (football)
April 2010: Arthroscopy to partially remove meniscus
October 14th: ACLr (hamstring graft) :)

Offline NHjenson

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Re: Torn ACL, okay to wait?
« Reply #5 on: September 07, 2010, 11:36:28 PM »
Ah very interesting Sue i will take that into account when I go there, thanks for the link too a lot of good information on this site.

Hi roo222, nice to see there is someone in a very similar situation!

I guess i will wait and see when i am able to have the surgery.

I have been doing squats and lunges and was worried that i could be doing more damage to my knee in the process! good to know that they help.

Thanks for the help and good luck to you sir.

Offline Kaputt_Knee

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Re: Torn ACL, okay to wait?
« Reply #6 on: September 08, 2010, 06:15:46 AM »
Squats, especially deep ones where your knee goes beyond 90, are a big no-no until a qualified practitioner OKs them. Lunges are OK as long as you do not go too deep. Far better to work on high reps low resistance work to build not only the main muscles but also the core, deep structures that really work at protecting the knee.

The reason for this is that go do not have one of the key mechanisms nature developed to prevent the end of your femur sliding across your tibial platform. How much "play" there is in this movement is critical to how much the ends of the two large bones slide. Only hands on testing my specialist can determine this. If there is a lot of movement, you could be risking meniscus tears and damage to the articular cartilage on the ends of the bones.

Just because you can do these currently without pain or swelling does not mean that you are not causing further damage. Get a detailed evaluation from a sports physio and a programme of exercises that fit your particular circumstances.

Good sports for building up the strength are swimming, cycling, walking (as long as it is on even ground and you take care about the correct gait) as well as gym work. Balancing and static holds of shallow squats and lunges are also good.

If you have surgery in December, depending on your surgeon's protocol, you will be rehabbing intensively until Easter at least. As I said earlier, the surgery is the easy part; the rehab is long and slow and you will meet lots of highs and lows in that time. You may be released for running in straight lines by June/July and then plyiometrics specific to football/rugby type sports could be introduced somewhere around the 8 month mark. That is a very generalised time line by the way, some people may be quicker but often things do go a wee bit slower.

One thing you will learn if you read through the rehab reports here, there is no such thing as a standardised recovery. Every single one of us is unique, so comparisons are useless to be honest. I've been through this 5 times, twice with the same surgeon and not one rehab protocol was identical to any of the previous ones.

Knowledge is power, before and after the surgery, so read as much as you can here and ask questions when you can't find the answers you need. If you prepare well and go into your surgery with  clear and realistic aims, there is no reason why in a year's time you will not be taking part in your sports again.


Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline roo222

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Re: Torn ACL, okay to wait?
« Reply #7 on: September 08, 2010, 01:32:41 PM »
Your right of course Sue, i should have clarified myself when talking about the excercises!! I only do very shallow squats so i can feel my quad muscle working a little, so as not to put too much pressure on the knee joint. As you say, low resistance and high reps is key.

Also, to back up what Sue says again, each individual situation is unique, so make sure to double check with a physio or other specialist before you do anything you feel uncomfortable with or unsure of - better safe than sorry. Im most definately not an expert, I only wanted to give my story as we're in a very similar situation!!

Good luck, let us know how you get on!

 8)
March 2010: Torn ACL and meniscus damage to right knee (football)
April 2010: Arthroscopy to partially remove meniscus
October 14th: ACLr (hamstring graft) :)

Offline kscope09

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Re: Torn ACL, okay to wait?
« Reply #8 on: September 09, 2010, 11:12:51 AM »
Just out of interest when a person tears their acl completely, how much movement is there usually on a lachman test?

My left knee has a partial tear and my right knee has a slightly attenuated acl and both ahve about 1cm movement.
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 arthriticknee

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Re: Torn ACL, okay to wait?
« Reply #9 on: September 09, 2010, 12:07:53 PM »
Hi kscope09,
This is extremely variable which is why we first assess the uninjured knee to get a feel for what is "normal" in that individual. Some people are naturally lax and it is amazing how much anterior movement of the the tibia they have without any injury. I am at the other end of the scale and don't move at all.
When both sides have been injured most clinicians will do a quick test for general ligament laxity on other joints throughout the body to get a feel for that person, then add a bit of experience to come up with an idea on ligament integrity. For tricky cases like these imaging will often be called in. Now that MRIs are readily available things are much easier.
Remember that any advice on an online forum is of a general nature.
You are always advised to be assessed by a medical professional so your individual situation is addressed.

Offline kscope09

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Re: Torn ACL, okay to wait?
« Reply #10 on: September 10, 2010, 10:17:37 AM »
I had an mri on the right knee that said the acl was fine andeverything else was fine and of course it wasn't.  It hurt like Hell so I had a scope and that showed my acl had a very small tear and the surgeon said it would be strong and just debribed it.  I had a chrondoplasty as well and at 15 weeks another mri because the surgeon suspected that might be failing and yet again the results came back with a pristine acl.  My othe rknee was hurt six years ago in a fall when it twisted ukwardly but never gave me much trouble after the first couple of weeks and I could do everything as if nothing had happened until my right knee was injured and the left had to do a lot of the work.  My left acl is slightly attenuated but I've managed to wim with it as normal, run iwth it and do four eyars of my best Karate with it and no problems until the right one go injured.  If I stand feet shoulder width apart and push my knees back my left goes noticeably further than my right but when I lay down and try to hyper extend them they look about equal.
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 NHjenson

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Re: Torn ACL, okay to wait?
« Reply #11 on: September 14, 2010, 11:06:41 PM »
Sorry for the delay in replying, thanks alot for the input guys im seeing a sports specialist tomorrow and will keep you guys up to date on the road to recovery.