The Grind: ACL and MCL tear diary

Palinpropism · 28-08-2014 1:22pm #1

Thought I would start a an account of my road from ACL and MCL tear playing a rugby match 5 days ago and try and keep it updated regularly enough with progress, rehab programs, experiences, tears and tantrums from tear to (hopefully) a return to the field!

The main goal being maybe at the end of it all having a guide of my personal experience and to get tips on rehab programs, exercises and any other advice from other boards members with similar experiences to hopefully help people in the future. Something like that. It will hopefully also make me honestly reflect on the work im doing!

Some Background to start off i suppose:
Grade 3 ACL tear
Grade 2/3 MCL tear

Happened 5 days ago, currently on crutches, was initially unbearably painful for about two hours and then the pain went away completely and hasnt really given much bother since unless i accidentally put some valgus force (i.e. knee being pushed in) on it. My knee bends to the left - its painful and gross and sends a shiver through the body. Even so much as fully externally rotating my leg and doing a straight leg raise (with my inside knee pointing to the ceiling) is enough weight for it to bend. Ugh...

Had an MRI to confirm 3 days later and have an appointment with an ortho surgeon this evening in Santry where I will hopefully get a timeline and plan of management. More on this tomorrow...

Biggest problem for me at the moment is final year of college starting on Monday and it is an intense course with placements and plenty of exams so the next 12 weeks until im finished placement is going to be really tough to fit in a surgery (may have to wait till the end of placement), rehab and study but im determined to come back from it better than i was before. Just keen to get the poa now, put my head down and get on the grind!!

Experiences and advice through the process will be much appreciated!

MD1990 · 28-08-2014 3:51pm

Best of luck with your recovery. Take it slow coming back & make sure u have good strength built up in your legs.

Palinpropism · 29-08-2014 10:57am

So after seeing the ortho the plan is to wear a brace for 6 weeks to let the MCL heal up and then do surgery.

Some minimal prehab exercises were given too like straight leg raises and heel slides to increase ROM and fire the quads a bit. My leg is already wasting away having been on crutches for a few days!! But given that I hav to wear a brace and wait for the MCL I heal there doesn't seem to be much I can do....I'm doing good bit of research on additional exercises I can do pre surgery and hip abduction seems a positive one I can throw into the mix.

But main thing at te moment it seems is just icing it every chance I get! And maintain ROM

Ivan.Drago · 29-08-2014 1:11pm

I tore my ACL back in 2012 playing in a soccer match. I also went to SSC in Santry so I will share what I think I did well with my rehab and what I could have done better.

Things I did well:
- Was obsessive with rehab. Do your rehab religiously, do more than prescribed. Prioiritize it over any other training you may be doing (ie. if you feel there is a chance you might skip it after doing some other training, do the rehab first and ingrain that good habit)
- Identify the underlying cause of why you tore your ACL/MCL and address it. My experience with physios during rehab was that they were very enthusiastic about rehabbing the actual knee and giving specific exercises to do so, but they gave me absolutely no indication as to why I might have injured myself in the first place (even when I tried to initiate the discussion). In my case it was a distinct lack of mobility further down the chain (in the ankle) that may have been a significant contributor. Don't be that person who re-injures the knee after returning to do exactly the same thing you were doing before the injury - educate yourself.
- Rented a stationary bike to cycle in my living room while off work to keep the blood flowing through the leg and promoting healing. You can rent these very cheap online - can't remember where but this is more for post-surgery. The bike will be right there in front of you and therefore increase your chances of using it.

Things I did badly / could have done better:
- Be confident and happy with any professionals who are helping you on the road to recovery. In hindsight, I was not happy with my physio (was left on a bed with an electrical current machine strapped to my leg for 20 mins while they were dealing with other patients, was not receptive to intelligent discussion from a person who had done their own research on the topic, questionable testing protocols etc). I should have changed to someone I had confidence in given the amount of follow up sessions required for this type of injury.

If I think of anything else I will post it up, but shoot me any questions if you feel like it.

MD1990 · 29-08-2014 1:20pm

Ivan.Drago wrote: »

I tore my ACL back in 2012 playing in a soccer match. I also went to SSC in Santry so I will share what I think I did well with my rehab and what I could have done better.

Things I did well:
- Was obsessive with rehab. Do your rehab religiously, do more than prescribed. Prioiritize it over any other training you may be doing (ie. if you feel there is a chance you might skip it after doing some other training, do the rehab first and ingrain that good habit)
- Identify the underlying cause of why you tore your ACL/MCL and address it. My experience with physios during rehab was that they were very enthusiastic about rehabbing the actual knee and giving specific exercises to do so, but they gave me absolutely no indication as to why I might have injured myself in the first place (even when I tried to initiate the discussion). In my case it was a distinct lack of mobility further down the chain (in the ankle) that may have been a significant contributor. Don't be that person who re-injures the knee after returning to do exactly the same thing you were doing before the injury - educate yourself.
- Rented a stationary bike to cycle in my living room while off work to keep the blood flowing through the leg and promoting healing. You can rent these very cheap online - can't remember where but this is more for post-surgery. The bike will be right there in front of you and therefore increase your chances of using it.

Things I did badly / could have done better:
- Be confident and happy with any professionals who are helping you on the road to recovery. In hindsight, I was not happy with my physio (was left on a bed with an electrical current machine strapped to my leg for 20 mins while they were dealing with other patients, was not receptive to intelligent discussion from a person who had done their own research on the topic, questionable testing protocols etc). I should have changed to someone I had confidence in given the amount of follow up sessions required for this type of injury.

If I think of anything else I will post it up, but shoot me any questions if you feel like it.

Brillant advice. I have suffered a few knee injuries myself (2 MCL's from tackle's & tendonitis). Mobility is crucial. Whenever i slack off from mobility work i tend to get slight IT band problems. Ankle flexibility is crucial too in preventing tendonitis. Also imo there is too emphasis put on quad strength. Hamstring & Glute strength is more important.

Ivan.Drago · 29-08-2014 2:26pm

Just to note, when I say do more rehab than recommended, use some common sense in terms of intensity. Some rehab will be painful at the beginning (for me, the site where they took the patellar tendon graft) but, overall, rehab should never be very intense. Get in some extra volume at a low/moderate intensity.

Brego888 · 02-09-2014 11:45am

I'm 3 weeks post a complete rupture of my left ACL. Currently waiting on orthopedic/surgical review from SVUH. I could be waiting a long time for this on the public system. Has anyone recommendations for getting the surgery done privately? I contacted the sports surgery clinic in santry who cost €5,400. I don't have private health insurance so clearly cost is an issue but id equally want a good service.

MartyMcFly84 · 02-09-2014 3:08pm

I have complete tears of my ACLs in both knees they happened in about 6-8 months of each other.

I am a very active person, and was devastated. The first (left knee) happened while living abroad and did not have medical insurance, the second (right knee) about 9 months ago now with VHI cover. I have had MRIs and have seen an consultant. My insurance only covers me if the surgery is in a public hospital, and I have been waiting for about 7 months now. Currently I don't think I even want the surgeries any more.

I spoke to many people with the same injury, a former very high level GAA player also a former county manager told me he played much of his career with no ACLs.

I followed a strength program and after about 5 months I could train again with little issue. Now its been over a year since my left ACL tear and I have no problems what so ever, and my right knee is at about 90% without any surgery. I currently compete and train with professional athletes and its has been a good few months since I have had issues. For a while I adapted my game, but feel this has made me better player in the long run.

Generally the knee is so unstable and weak after it first happens people rush into surgery, and surgeons obviously say you need it as they get paid. However in my experience the body adapts fine without surgery. But of course everyone is different.

Alf Veedersane · 02-09-2014 3:15pm

MartyMcFly84 wrote: »

I have complete tears of my ACLs in both knees they happened in about 6-8 months of each other.

I am a very active person, and was devastated. The first (left knee) happened while living abroad and did not have medical insurance, the second (right knee) about 9 months ago now with VHI cover. I have had MRIs and have seen an consultant. My insurance only covers me if the surgery is in a public hospital, and I have been waiting for about 7 months now. Currently I don't think I even want the surgeries any more.

I spoke to many people with the same injury, a former very high level GAA player also a former county manager told me he played much of his career with no ACLs.

I followed a strength program and after about 5 months I could train again with little issue. Now its been over a year since my left ACL tear and I have no problems what so ever, and my right knee is at about 90% without any surgery. I currently compete and train with professional athletes and its has been a good few months since I have had issues. For a while I adapted my game, but feel this has made me better player in the long run.

Generally the knee is so unstable and weak after it first happens people rush into surgery, and surgeons obviously say you need it as they get paid. However in my experience the body adapts fine without surgery. But of course everyone is different.

There are factors that determine whether or not surgery is required though. Not every ACL tear can be overcome with a return to previous performance levels without surgery.

MartyMcFly84 · 02-09-2014 3:30pm

There are factors that determine whether or not surgery is required though. Not every ACL tear can be overcome with a return to previous performance levels without surgery.

True, this is why I said everyone is different. However I think we are strongly lead to believe that surgery is the only option for active people.

Most people have surgery within a couple months of the injury, without giving a chance to rehab the knee themselves.

The surgery option will always be there. But this is a personal choice and will depends on many factors. But I feel it is often a rushed decision fuelled by the wanting to get back ASAP, and people being lead to believe surgery will get them back on form the quickest.

Alf Veedersane · 02-09-2014 4:03pm

MartyMcFly84 wrote: »

True, this is why I said everyone is different. However I think we are strongly lead to believe that surgery is the only option for active people.

Most people have surgery within a couple months of the injury, without giving a chance to rehab the knee themselves.

The surgery option will always be there. But this is a personal choice and will depends on many factors. But I feel it is often a rushed decision fuelled by the wanting to get back ASAP, and people being lead to believe surgery will get them back on form the quickest.

It's understandable though. Aside from the fact that the extent of the injury will dictate whether or not surgery will berequired to get them back to teh same level, most people won't want to wait 3/4 months andt hen realise they'll need surgery anyway.

Thud · 02-09-2014 4:07pm

I think there's a difference between partial tears and full tears and for sports and non sports people.

if it a partial tear there's a chance of recovery, many will suggest giving it a chance without surgery.

With a full tear if not playing sports you may be grand if you build up muscle to stabilise the knee but if you want to play sports where turning is involved you'll need to get it reconstructed.
Running in a straight line will be ok but if you turn sharply you're knee will likely pop out. Mine did 3 times between initial injury and surgery.

http://www.philly.com/philly/blogs/sportsdoc/Do-I-need-an-ACL-to-play.html?c=r

Bit from Kilkenny hurler on his recovery:
http://www.independent.ie/sport/they-got-parts-for-my-finger-from-england-like-a-bad-car-30551222.html

cc87 · 02-09-2014 4:47pm

AFAIK there is research that suggests people have similar successes with and without surgery. So if the success rate is the same, people and athletes will go with the option that will allow them to return to previous activity levels the fastest which is with surgery at the moment.

Thud · 02-09-2014 5:08pm

cc87 wrote: »

AFAIK there is research that suggests people have similar successes with and without surgery. So if the success rate is the same, people and athletes will go with the option that will allow them to return to previous activity levels the fastest which is with surgery at the moment.

Do you have a link?

cc87 · 02-09-2014 5:23pm

Thud wrote: »

Do you have a link?

I'll see if I can find, it was a while ago I read it now.

MartyMcFly84 · 02-09-2014 5:25pm

AFAIK there is research that suggests people have similar successes with and without surgery. So if the success rate is the same, people and athletes will go with the option that will allow them to return to previous activity levels the fastest which is with surgery at the moment.

This provided you get the surgery quickly. In my case due to my VHI cover I am still on the waiting list. In the 7 months I have been waiting (9 months since last ACL tear) I have rehabilitated my knees and now compete at a higher level than I ever did before.

Kieran McGeeney continued to play intercounty football with No ACLs and trains Brazilian Jiu Jitsu at the same gym as me to a very high level without ever getting ACL surgery. So it is not true you will defiantly be unable to turn or pivot. I do it every day. Granted I am not side stepping an All Black you get my point.

I really think its depends on the person and the activity. But if you have to pay 5K + that you don't really have, you could try seeing how you get on without surgery, and follow a rehabilitation program. It will give you time to save if you do need surgery, and if you don't happy days take yourself on a nice holiday.

Brego888 · 03-09-2014 11:13am

For any of you who had the surgery, how long were you off your feet post surgery?

Ivan.Drago · 03-09-2014 11:26am

I was weight bearing straight away (on crutches). I remained on crutches for 5-6 weeks if I remember correctly (may have been 1-2 weeks longer, can't quite recall), transitioning from 2 crutches to 1 crutch, all the while putting more and more weight on the injured leg.
I was told to remain on crutches until I could walk without a limp so that was the key thing for me as opposed to sticking to a strict timeline of when to come off them.

ingodwetrust · 21-10-2014 12:56pm

Brego888, I am now exactly 9 months post ACL patella tendon graft recon surgery and 10 months meniscus repair.

I was off work for a week following surgery and was on crutches for no longer than 3 weeks.

I had surgery done privately in SSC.

Rehab, as stated, is huge. Do it religiously!!

I was able to walk around without any crutch fast but would not have been the most confident.

The muscle loss in the quad is scary!! so fast and dwindles down to match sticks!!

Just focus on rehab and 6-9 months begin to think about return to sports!!

Best of luck, any further info just ask.

Stay classy

The Grind: ACL and MCL tear diary

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