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Knee Ligament injuries

SteveC

27-Oct-2006
11:51:07 AM

Howdy All, I recently injured my knee in a triad of snowboarding, bouldering and trailbike incidents. The snowboard gave me a lateral strain, about 2 weeks later while landing off a boulder i heard something like a fresh carrot snapping, this I believe gave me a medial meniscus damage and possibly anterior cruciate ligament damage. Being a glutton for punishment, I followed this up 4 weeks later with a motor bike incident, there was a sharp snap in the knee and I couldnt walk for 2 weeks. This was the ACL and no doubt further damage to meniscus and cartilege.

Firstly I would like to say: impatience is not a virtue! If i had let the original sprain heal properly I would not be facing this mess, anyone could have told me that but it is up to the individual to listen of course.

So what I would like to know is if anyone has actually torn their Anterior Cruciate Ligament and whether they had the surgery to reconstruct it or is it possible to keep climbing without it.
I have had a series of quacks look at it, fisrtly an Orthopaedic Surgeon who wanted to cut me up, remove all the meniscus and replace the ACL.

I have seen a Sports Medicine Physician who has organised through one of his preferred surgeons an MRI next week. Interestingly he believes the ACL may not be completely torn while the first surgeon demonstrated with the Luchmann test that the tibia can come forward with a definitive clunk. He also thinks that the amount of swelling is consistent with articular cartilege damage on the femural condyle.

My Ostepath is quite adament that I dont have surgery I understand that removing meniscus means that there is basically bone on bone action, but is this better or worse than having, say, a bucket handle tear of the meniscus which is jamming up the joint. At the moment i cannot straighten the leg past around 170 degrees and can bring my heel no closer than 4 inches to my glutes without feeling pain.

Hopefully the MRI will give me a definitive diagnosis. But Id like to hear any advice others may have in regard to their own experience with knee injuries. especially tips on strengthening and rehabilitation, and further complications after surgery or without surgery. And any thoughts on glucosomine supplement for ligament repair.

In the meantime I will be dangling off the campus board!

IdratherbeclimbingM9

27-Oct-2006
12:00:28 PM

Sorry, can't answer your questions; but in relation to
>I followed this up 4 weeks later with a motor bike incident
... you are better off than a bloke in Wodonga who had a motorcycle accident with a fire hydrant earlier this week, in which he severed his leg below the knee. It was the early hours of the morning and he was found lying in the street by some of his mates some time afterwards ...
:(

AlanD

27-Oct-2006
12:53:03 PM

I did my ACL a few years ago, also damaging the meniscus. The MRI is going to give to give a reasonable indication of the amount of damage that has been done, but not a definitive answer. That will only be found out during the operation. In my case the actual damage was more severe than the MRI indicated.

The main complication if you don't have surgery is that the joint will have arthritis within a few years. From what I've read from people who put off the operation, most eventually go in for the operation, just to deal with the arthritis. Another issue is that if you haven’t completely torn the ACL, any subsequent damage you do will cause inflammation and a lot of pain, basically you’re just tearing it again and again. Stability of the joint will always be an issue, I found before I went under the knife that if I stepped onto uneven ground un-expectantly, the knee could just buckle and I’d fall over.

With the operation, if you do all the phsysio work, you won't notice much difference in the knee's performance from before you did the damage, in my case there is no loss in flexibility. The only post op problem I have is terrible cramps in the quads from near where they took the graft from and this is from dehydration after exercising, so it can easily be dealt with. The thing that takes the longest to recover from are the mental issues, i.e. loss of confidence in the knee, again that takes time.

With either option, you have a life time of exercise ahead of you, with no operation requiring continuous work to keep the muscles surrounding the knee as strong as possible. You can be a little slacker if you have the operation, but it's important to make sure the supporting muscles are as strong as possible when you are doing activities that will be putting the knee at risk, i.e. skiing.

As for specific exercises, go see a physio that deals with sports injuries. Once you have the flexibility and strength back, they'll give you the exercises you need to keep doing like weight sessions, riding the bike, running, skipping, etc. Once the flexibility and strength is there, with or without the operation, climbing is possible. I think I was back indoor climbing within 10 weeks of the operation I just had to be careful for a few months not the twist on that leg, when there was any weight on it.

dougal

27-Oct-2006
3:18:35 PM

Did my ACL and medial CL ligament in 1981 at the age of 19 now 43 yrs old and deal professionally with these problems. If you have seriously torn or ruptured the ACL (which the last poster pointed out can only be verified when they look inside (no scan is 20/20) then the instability is now and will continually cause the joint to deteriorate (the damage ie 'arthritis' does not suddenly happen down the track). Be wary of any professional who says they know 100% whats going on b4 they stick a scope inside the joint. The definitive diagnosis happens when they see it. The guy who wants to see an MRI sounds cautious which is good but don't expect him to say "Ah, there it is." Ask lots of questions and expect good answers. Don't rush into things but don't be afraid of the idea of surgery. This type of thing has come a long way in recent years.

...ah and yes be a bit more cautious.

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