Physical Therapist putting me to work this week! Getting an MRI this Friday. Realizing why rest of staff has been complaining about lousy medical coverage at job (now that something has actually gone wrong with me.......deduct. is such that it prevents me from experiencing economic ruin (should I be run over by a bus) but that's about it.)

?'s what do I do to prevent/minimize atrophy? what's the best way to get back to how I was? what questions should I ask the doctor?

if anything I'd just like a few, "been there, done that, but you'll be okay" kinda things. My life is filled with people whose joints hurt because they're overweight and do nothing. I'm afraid I did some really sudden and serious damage to this knee.

Gory details:


.........I was about half way down a double black diamond and sunk up to my thighs in powder. Caught my right ski on something (perhaps just too much snow). Only rolled 3-4 times, but left ski popped off (thankfully) and right ski did not (I really wish it had!), so my right knee was twisted and turned in ways not intended by God, nature, nor me. Felt okay, so I put left ski back on, put weight on right leg to put on right ski, and in addition to feeling my right knee give way, I sunk into the snow smacking my cheek bone with the pole..........

Thankfully I've learned to quit while I'm behind, so I swallowed my pride, stayed put and asked the next soul to come past to go get ski patrol.

Okay you sadistic lurkers...........

Won't know until I get an MRI, but the doc is pretty sure I tore the ACL. I'm starting PT and waiting for the swelling to go down and range of motion to return.

At least now I can get around the house. I think in a day or two I'll be comfortable driving with the brace on.

I've had a similar injury in '94. My left knee was broken (the patella was what broke into two pieces). The end of my femur was also cleaved off and my leg below the knee twisted out to the left.

Don't fear. I maintain mine today by doing squats and other leg work. I need more muscle to keep the joint in its range since the ligaments are forever stretched and in the last 14 years they have not shrunk! Don't despair, while it may never be the same you should be fine.

The PT is going to be the one to really get you back to "normal". My best advice is to tell him/her that you really want to get back to being able to be active doing (list all your activities here) and are willing to put in the time and effort. Then prove it. Most people the PT sees are who really don't do all the stuff they are suppose to and would rather have a pill fix the problem then put in the sweat equity and put up with the pain that successful therapy requires. I've always found they almost get excited and are willing to give you a little extra attention when you actually show improvements at every appointment because you do the exercises required.

Christmas of '02 I was skiing and twisted/sprained my knee. I was in college at the time and "too tough" to go see a doctor, and it got better on it's own after about a month. Then I started lacrosse practice in the spring - second practice of the season I jumped, came down, and felt something go pop.

ACL gone.

I didn't want to have surgery during the school semester, so I waited almost 4 months until college was over and had surgery in the early summer.

I never wore a brace in the meantime - it only hurt me once, when I slipped on some ice and felt the bones in my knee ride over each other. I still jogged, walked all over campus, and was relatively active. I still lifted some weights as well - just nothing massively heavy. My doc suggested I be as active as possible as it would help recovery after surgery.

A couple things to consider if it is an ACL replacement. There were three options I was presented with - cadaver, hamstring, and patellar replacement.

Cadaver was the weakest option - I was told they really only use that for older inactive patients who still want replacement surgery but want as little rehab as possible.

Hamstring is the easier rehab but patellar grafts will give the best ultimate result. I went with the patellar option - they took the middle third of the patella tendon along with bone plugs from either end out and threaded it up through my knee where the ACL was.

Surgery went great. Get a continuous motion machine and get your knee moving as much as possible as soon as possible. I hurt. A lot. I tried not to take the pain pills, but sometimes it was easier just to go to sleep for a while pain free...

I started rehab 4 days after surgery. I was walking without crutches a week later. Early rehab was reactivating the quad muscle with electric stimulus and range of motion. Then they got me on a stationary bike pedaling back and forth, never all the way around. Finally I went all the way around (and almost passed out the first time). Then came balance training, pulling myself around on a chair with wheels, doing wall sits, stair machine, elliptical, treadmill, jogging outside, etc. I also incorporated light weights getting progressively heavier as well. At this point, my injured leg quad was about 2 inches smaller than my healthy leg and the calf was 1.5" smaller. It was visually noticeable.

Just before Christmas of '03 I was fitted with an active brace. In February, I was starting on the lacrosse team again. In April, almost a year after surgery, I forgot to put my brace on before one of the practices and went two hours of full speed without it. It wasn't until after when I went to take it off I realized it wasn't there, so I was close enough to 100% for my liking.

I could still tell I favored one leg. I was still sore after every practice. Kneeling on the knee that had the patella tendon chunk removed hurt for over 2.5 years - I couldn't kneel on that leg. PT sucked - no way around it. It hurt, and it was hard thinking of what I could do before I was hurt vs. where I was at. I pushed hard during the first 6 months of rehab. I took the suggested work from the therapist and asked how much more I could do that would help and wouldn't risk reinjury. I never skipped a session and didn't have any setbacks - I became the therapy center's example of what happens when you do everything you're supposed to. So often, they get people in who don't take it seriously and never do fully recover.

So, 5 years later... I feel when a weather front rolls in at the age of 26. After a long day of hiking or trail biking, I am sore in that knee more than the "healthy" one. My legs are the same strength, but one quad is still between .25" and .5" smaller. I don't know if this will ever get better - I don't know what it was before I was hurt, so maybe it's natural.

I actually had a checkup last year and my repaired knee is more stable than the other one. Anyway - been there, done that, but you'll be okay...

Been doing my exercises as prescribed. My calf always feels like it's about to spasm. My PT said a lot of inactive folks who aquire this injury over many years work to get their legs into the shape mine are in now......I still want to improve it, though.

Unfortunately, this does not exist in a vacuum. Still have work. Still moving 90 miles down the road in a few months. Still have a stupid cat who walks a half step in front of me and periodically stops for no apparent reason. Still have a 5 year old with some behavioral health issues. Still have a husband not too thrilled with his career.

I've been getting around pretty well, but now my lower back is sore. This is going to be a long process, but I'm going to do whatever I can to make this better.

Looks like it's a partial ACL tear. Knee is unstable enough and I am(well, I want to be) active enough that I'm pretty sure I'm going to have surgery on this thing.

The doctor said there's good news and bad news and overall good news.

The good news: everything else is fine.

The bad news: my ACL is completely torn.

The overall good news: he can fix it, and I'm in good enough shape already that we went ahead and scheduled the surgery for mid-April.

I'm now over 99% just me and some small percent donor ACL. This thing hurts. Per my student's requests, I'm going to blog about my surgery and recovery and take photos daily ala John Stone.....