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Author Topic: Should I still exercise with a fully ruptured ACL?  (Read 1832 times)

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Offline Sandy_lad

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Should I still exercise with a fully ruptured ACL?
« on: March 06, 2011, 10:32:59 PM »
            Hey there! Wow, what a wealth of experience out there! Hope some people might be able to give some advice on my knee.
Injured my right knee badly playing futsal in Nov 09. Instant pain and instability, followed by swelling by the time i got home an hour later. The next few days were spent hobbling at work but got through it and within a few weeks wasn't limping but couldn't fully straighten my leg. Didn't get any medical advice at this stage. Obviously didn't play again for a few months, but by the time outdoor soccer training started, it was feeling better so i started training slowly, and by the time the season started, it was feeling strong and stable. Decided, just in case, to see a recommended Phsio and get his opinion before i played. After hearing about the injury, doing various manual tests, and performing exercise in his office waiting room, he concluded I might have a slight medial meniscus tear, but should be right to play. Played 3 full games with no problems. Knee felt strong, could turn, stop and it felt 100%. During the 4th game, tried to break the back of the net out and fully extended my knee which cause some pain and later swelling. Went back to the physio, more tests. Sent for an MRI. Result. Full rupture of ACL but no damage to either meniscus. Sent to Surgeon. By the time i got to see the Surgeon, 2 months, and with exercise given by the Physio, knee was feeling stronger than ever. Surgeon cinfirmed the ACL rupture, but agreed the stability was good for the absence. He explained that unless it was giving way regularly, or i wanted to return to competetive soccer, there was no rush for the surgery. He also suggested that unless it was giving way and unstable, and i was able to keep my legs strong, there was no evidence to suggest an increase in osteoarthritis later on.
                At the moment my knee feels great. No pain from work, I'm a carpenter. I run 6 k's twice a week. cycle 10 k's once a week. Train for outdoor soccer Mon nights, not full contact. And do regular leg strengthening exercises daily. My question is...... should i continue to do all this exercise even though there is no pain. Anyone with any advise ??
« Last Edit: March 07, 2011, 06:26:22 AM by Sandy_lad »

Offline Snowy

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Re: Should I still exercise with a fully ruptured ACL?
« Reply #1 on: March 07, 2011, 05:28:08 PM »
Absolutely. When you don't have an ACL muscle strength is crucial for keeping the knee stable, so all the training you're doing is probably the reason the surgeon isn't pushing you to have the reconstruction sooner rather than later.

The ACL provides stability for the knee during lateral movements, so there's very low risk in straight up-and-down exercises (cycling, running, swimming) that don't put lateral pressure on the knee. The one thing you should watch out for is any kind of reaction from the knee when you're doing soccer drills that require lateral movement, e.g. cutting or pivoting. The risk here is that without an ACL, the shinbone can move too far in relation to the thighbone when the knee is under lateral pressure and cause damage to other structures in the knee (like the meniscus.) This is why your OS has advised you that you should have the surgery before returning to competitive soccer, where movement would be more extreme and you're less able to control things like the risk of impact.

If your leg is strong enough you may find that the soccer drills don't cause any problems, but you may also want to consider getting an ACL brace to protect the knee during these kinds of movements. I was in a similar position in that I had a very strong, stable leg while I was waiting for surgery, and I was even able to return to skiing with a brace. I still opted for the surgery because I wanted to go back to the kind of high level skiing that I was doing before, but with the brace and a few restrictions (no bumps, jumps, or off-piste) I was able to ski for the rest of the season. I kept up a program of cycling, running and weights work in the gym before surgery, and having the leg in such good shape also helped me regain strength quickly after the surgery.

Hope this helps. As long as you avoid things that would put the knee at high risk, exercise is definitely a good thing to be doing. If you're unsure about certain exercises or activities, I'd suggest seeing a physiotherapist for advice or giving your surgeon a quick call.
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 Sandy_lad

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Re: Should I still exercise with a fully ruptured ACL?
« Reply #2 on: March 09, 2011, 10:39:46 AM »
              Thanks for the post! Very reassuring. Feel pretty blessed that i can exercise after reading a lot of the posts here. I used to think a torn ACL was the worst thing that could happen, but I'm feeling pretty lucky really.

Offline Sandy_lad

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Re: Should I still exercise with a fully ruptured ACL?
« Reply #3 on: March 14, 2011, 03:42:48 AM »
Hi, just wanted some information about that brace you used while you were skiing. Am interested in wearing a brace for support at soccer, but the ones I have seen seem very bulky and not designed for activity, more for recovery. Any suggestions?

Offline Snowy

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Re: Should I still exercise with a fully ruptured ACL?
« Reply #4 on: March 14, 2011, 05:33:39 AM »
I use an Ossur Paradigm. It's impressively lightweight and most of the time when I'm skiing, I completely forget that I'm wearing it.

There are some good threads on brace choices in the Cruciates and Knee Braces sections, but one thing I'd emphasize is that the best way to find the right brace for you is to go out and try a variety on. Ossur were great when I was being fitted with my brace - I must have spent a good hour trying on different ACL braces and wandering around their corridors. I went in thinking I would most likely pick the CTi brace, but as soon as I tried on the Paradigm I knew that was the one I wanted. It was so much lighter and less obtrusive than any of the others. I went with the custom fit even though my copay was quite a bit more; I knew that with injury and surgery my quad muscles would be going through some size changes, so I wanted the reassurance of the lifetime warranty and refitting options. I've never had any issues with slippage and I've worn the brace both over base layers and against the skin.

As far as other braces go, I've heard great things about Townsend but wasn't able to find a local supplier when I was looking. Breg and Donjoy are popular, but I've seen a lot of comments about them being bulky and/or prone to slipping. As I said, though, there's nothing that can compare to actually trying a brace on and walking/running in it for ten to fifteen minutes - you know immediately whether it's comfortable or not.

Here's a pic of the Paradigm:
« Last Edit: March 14, 2011, 05:35:24 AM by Snowy »
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