Climbing with a torn ACL?

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Dave B
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Climbing with a torn ACL?

Postby Dave B » Wed May 25, 2011 4:32 pm

My girlfriend/climbing partner tore her ACL two weeks ago on a ski descent of Quandary.

Obviously, as couloir season is about to ramp-up and summer backpacking trips are just around the corner we're extremely bummed at what might be a summer of sitting on our rears in agonizing post-op recovery. Despite the MRI showing a complete tear, she still has great mobility and little pain in the knee, just the common complaint of lacking stability.

I know of some pretty stout knee braces for situations like this but I was curious if anyone had experience climbing (steep snow, 4th class-low 5th) with these braces? Was the lack of stability an issue? It seems that descents could be miserable, but could the brace compensate for that. I saw a couple of threads at mountain project and super topo about people continuing rock climbing with a torn ACL while wearing a brace, but figure the rigors of mountaineering are probably a bit more traumatic on the knees than cragging.

BTW, I'm not hoping for a diagnosis or other medical advice here, just some nice anecdotal experiences.

Cheers!
Last edited by Dave B on Wed May 25, 2011 5:59 pm, edited 1 time in total.
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tmathews
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Re: Climbing with a torn ACL?

Postby tmathews » Wed May 25, 2011 4:53 pm

Yikes. That's a tough call. I've never had the injury, but I'm not sure I'd want to take a chance of aggravating it or possibly making it worse (and therefore completely immobilizing her) before it's completely healed.
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Theodore
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Re: Climbing with a torn ACL?

Postby Theodore » Wed May 25, 2011 4:59 pm

I would get it fixed. I've always heard that the only candidates for non surgeries are people that aren't active at all or older folks.

I've torn the ACL's in both my knees. Right was ACL, a tweak of the LCL and a severe bone bruise on my tibial plateau. Left was ACL, LCL, PCL and 1/3rd of my hammy.

Left leg was essentially debilitating, right, I walked around on for almost 4 months before surgery. I did not trust it to do anything very athletic. Toss in the added risk of getting hurt in the mountains and I would suggest she play it safe.

On both my knees, the test to check for ACL stability (if there is anything left) was the Lachman Stress test and the Anterior Drawer. I'm sure her doc gave her the same. W/o my ACL's I was shocked at the amount of movement in the joint. I would imagine, kicking steps, stubbing your toe, kicking steps etc would stress the joint considerably. In addition, I've found that walking in mountaineering boots tends to put a bit more stress on the knees, especially when you can't "roll" your foot as you would in tennis shoes.

Just my $0.02. I'm no doc by any means, just a fan of learning what the docs were doing to me.

I would sum it up as: Get the surgery, kiss the season good bye and be strong and ready for the ski season/winter climbing.
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Jay521
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Re: Climbing with a torn ACL?

Postby Jay521 » Wed May 25, 2011 5:33 pm

Theodore wrote:I would get it fixed. I've always heard that the only candidates for non surgeries are people that aren't active at all or older folks.

I've torn the ACL's in both my knees. Right was ACL, a tweak of the LCL and a severe bone bruise on my tibial plateau. Left was ACL, LCL, PCL and 1/3rd of my hammy.

Left leg was essentially debilitating, right, I walked around on for almost 4 months before surgery. I did not trust it to do anything very athletic. Toss in the added risk of getting hurt in the mountains and I would suggest she play it safe.

On both my knees, the test to check for ACL stability (if there is anything left) was the Lachman Stress test and the Anterior Drawer. I'm sure her doc gave her the same. W/o my ACL's I was shocked at the amount of movement in the joint. I would imagine, kicking steps, stubbing your toe, kicking steps etc would stress the joint considerably. In addition, I've found that walking in mountaineering boots tends to put a bit more stress on the knees, especially when you can't "roll" your foot as you would in tennis shoes.

Just my $0.02. I'm no doc by any means, just a fan of learning what the docs were doing to me.

I would sum it up as: Get the surgery, kiss the season good bye and be strong and ready for the ski season/winter climbing.


+1 on what Theodore writes. I, too, had to have a replacement ACL. While once the ACL is gone, it's gone (I think...), having a loose joint could lead to meniscus damage... And like Theodore - I'm no doc, but I did pay attention to them. A lot...
I take the mountain climber's approach to housekeeping - don't look down
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TriAnything
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Re: Climbing with a torn ACL?

Postby TriAnything » Wed May 25, 2011 5:46 pm

Sorry to hear about your girlfriend. I too tore my ACL about a month ago and just recently had surgery. It does suck to have something like this happen right before summer. I also had complete mobility in the knee and hardly any swelling at all when I tore it. I was hopeful it was something less until the MRI came back with a complete tear. I did mention, with tears in my eyes, to my doctor all the summer hiking and backpacking plans I had made. He stated that I could try and just rehab by building the muscles in my legs, but I would ultimately be doing more damage to the knee. Especially the meniscus due to the instability of the knee and the grating of bone on bone with no ACL to hold the knee joint properly in place. My physical therapist also mentioned if I didn't get the surgery, I would most likely have to deal with arthritis and pain later in life.

It's not getting up a mountain that's hard, it's the getting back down that's tougher on the knee. I agree, it would be a worse situation to injure the knee even more and to not be able to get back down the mountain without additional outside assistance. Because of all of those factors, I decided on the surgery and am planning for some great hikes towards the end of the year.

I wish your girlfriend speedy recovery! The mountains are calling, but they will still be there when we're healthy and strong!
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Re: Climbing with a torn ACL?

Postby MtHurd » Wed May 25, 2011 5:52 pm

+4 on getting it fixed. No brace can compensate for a torn in two ACL. You could get yourself into trouble in the hills if it pops out on you and it probably will at some point. You'll be back hiking in 3 months if you have it fixed, although it will take a full year for a total recovery.
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Re: Climbing with a torn ACL?

Postby Nelson » Wed May 25, 2011 6:10 pm

The thing that is a problem with a torn ACL is walking downhill. She will definitely not like that. Choose your descents well.
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Dave B
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Re: Climbing with a torn ACL?

Postby Dave B » Wed May 25, 2011 6:13 pm

Theodore wrote:
I would sum it up as: Get the surgery, kiss the season good bye...


Where is a crying, sad-faced mime emoticon when you need one?

Thanks for the stories and advice everyone.
The mountains - whose summits reach or exceed arbitrary thresholds for elevation and prominence - are calling and I must go.

-John Muir
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rebek5
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Re: Climbing with a torn ACL?

Postby rebek5 » Wed May 25, 2011 6:23 pm

TriAnything wrote:Sorry to hear about your girlfriend. I too tore my ACL about a month ago and just recently had surgery. It does suck to have something like this happen right before summer. I also had complete mobility in the knee and hardly any swelling at all when I tore it. I was hopeful it was something less until the MRI came back with a complete tear. I did mention, with tears in my eyes, to my doctor all the summer hiking and backpacking plans I had made. He stated that I could try and just rehab by building the muscles in my legs, but I would ultimately be doing more damage to the knee. Especially the meniscus due to the instability of the knee and the grating of bone on bone with no ACL to hold the knee joint properly in place. My physical therapist also mentioned if I didn't get the surgery, I would most likely have to deal with arthritis and pain later in life.

It's not getting up a mountain that's hard, it's the getting back down that's tougher on the knee. I agree, it would be a worse situation to injure the knee even more and to not be able to get back down the mountain without additional outside assistance. Because of all of those factors, I decided on the surgery and am planning for some great hikes towards the end of the year.


Davey_rocket's gimpy girlfriend here.
It's really amazing how similar the stories are. My Dr. told me all the same things.
Speedy recovery to you as well. You'll have to drop me a line and let me know how your recovery is going!
Thanks for all the advice guys. Now we are going to go cry in our beers and wish for this time next year. (insert sad face here)
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Re: Climbing with a torn ACL?

Postby tmathews » Wed May 25, 2011 6:25 pm

rebek5 wrote:Davey_rocket's gimpy girlfriend here.
Thanks for all the advice guys. Now we are going to go cry in our beers and wish for this time next year. (insert sad face here)


Here's to a speedy recovery! :iluvbeer:
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Theodore
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Re: Climbing with a torn ACL?

Postby Theodore » Wed May 25, 2011 6:36 pm

In addition, not to be harsh, but realistic, you are looking at at LEAST 9 or so months before regular activities return for us active types.

ACL's are curious things when replaced.... As the body takes on the new tissue, it goes through a strong, weak, strong phase. Initially, right after "installation" it's bombproof. Then as the body takes on the tissue, and it feels great (usually in the 6-ish month range) it's actually weak as it will ever be. After that stage, it starts strengthening again.

As for types of replacements, here's my next $0.02....

Left knee = patellar graft from my own knee. I'm ~10 years out on this one. It is not the most comfortable thing to have a 4" scar right where you kneel. You will feel it for a LONG time. Up until my other knee in 5/08, I was doing MMA/Ju Jitsu. Kneeling still bothered me then.

Right knee = allograft. (dead person tissue). My R ACL is an achilles from a dead 'un. It's a lot more pleasant surgery as there is no harvest site. There is always a slight risk of rejection/disease from someone elses tissues, but it's done me well.

Hammy grafts are very popular as well, but I don't have experience with those.

Biggest thing I would suggest is for her to absolutely ravage her PT. Range of motion is THE MOST IMPORTANT THING. Strength can come later, get that ROM!
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Re: Climbing with a torn ACL?

Postby sstratta » Wed May 25, 2011 7:07 pm

I'd also recommend getting the surgery. If your girlfriend doesn't, she runs the risk of her knee periodically "giving out" for the rest of her life, injuring other parts of the knee, and in general not having as much confidence with any sort of outside activity. Recovery speed depends a lot on your age, the strength of your knee and leg prior to the surgery, and how well you do physical therapy after surgery. I tore my ACL skiing and got surgery on March 17th (just the ACL, no meniscus or anything else) and just climbed two 14ers back to back this past weekend (princeton and yale). I also started running a week or so ago. While I realize my recovery is faster than most (and it helps that I'm 22), if your girlfriend makes sure her legs are in good shape prior to surgery and does lots of physical therapy afterwards she might recover fast too and be able to climb again by the end of this summer. I got the patellar tendon graft from my injured knee...I've heard negative things about the cadaver grafts from many different sources so I wouldn't recommend that route, but whether you get the patellar tendon or hamstring is dependent on your doctor's preference and sports your girlfriend is invovled in.

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