ACL tears

[tcamom]

Follow the physical therapists instruction carefully right from the beginning, and there is no reason to develop pain on the front of your knee. The first few weeks are crucial, (and painful), but set the tone for the rest of your life, literally. I am working with a 16 year old now. She had her ACL repair (patella tendon graft) in July. She is running, jumping (not landing on the injured leg by itself, so no layups), participating in all the basketball drills with her team, except scrimmaging and rebounding situations. I am just afraid she will have a giving way episode if she lands on another player's foot.

 

She is still coming to PT 3 days a week, where we are working on first step quickness, and quad/ham strength. She has no knee pain at all, and no swelling, even after a hard workout. Tuck jumps on the tramp, fitter with random ball passes, five point drills, carioca. She is doing it all, just waiting on the ortho MD to okay her to return to full sport. Her brace is to come in next week.

 

Advice: don't get fitted too early on for your functional brace. Get your quads built back first. The brace is expensive, and tends to not fit as you rebuild your quads and hamstrings if it is fitted too soon.

[up2late]

How painful are ACL tears? Can a kid run, jump, cut, etc. through the pain?

[rick7425]

My daughter tore her ACL in 2007 in her team's next-to-last basketball game of the year. She was a junior. She had a patellar tendon graft performed by Dr. Kurt Spindler of the Vanderbilt Sports Medicine center. The surgery was done on 3/29/07. She worked really hard at her rehab. Her senior year, she played soccer and basketball, ran track, and ran the half-marathon. She did experience some occasional soreness in the front of her knee, but all in all, I think the patellar tendon graft she had was quite successful.

 

I'll add a little more based on our experience.

 

It took roughly 5 months following surgery before my daughter was able to get on the soccer field in competition. She didn't wear a brace for soccer or basketball after surgery. I asked the doctor if she needed a brace, and he responded by asking, "for which knee?" He then explained that after this surgery, her reconstructed ACL would be every bit as strong as the other one and she would be at no greater risk of injury to it than to the other one. That information seems to be borne out by the literature.

[ksgovols]

How painful are ACL tears? Can a kid run, jump, cut, etc. through the pain?

 

 

I recently found out that an ACL that I tore 25 years ago was........torn. I could do everything I always could do moving forward and built the muscles around my knee up such that I didn't have lateral stability problems all the time but when it gave, there was a sharp pain at the time and I'd usually end up in a heap. It could be moving on a ground ball or taking Christmas decorations out of the attic. In 25 years I probably had 3 or 4 collapses where I hit the ground and any number of 'catches' where I'd feel the knee give. When I found out that I had a torn ACL at age 45 the advice from Vanderbilt Sports Medicine was to leave it alone. That would be different for a high school athlete for sure, but I played 7 or 8 years of slow pitch softball on it without even wearing a brace and haven't really shied away from anything but skiing whether on water or snow.

 

Keith Davis was a running back at UT in the 80's while I was there that opted not to have his ACL repaired and he continued to play at a pretty high level.

 

Whatever pain that I experienced with mine was not an ongoing thing. A sharp pain when it went out and limping around for an hour or two and no noticeable pain the next day. Jumping, running and walking didn't seem to bother it. Sudden cuts or twisting a certain way with weight on it would bring out an instability issue.

[lilc3]

Follow the physical therapists instruction carefully right from the beginning, and there is no reason to develop pain on the front of your knee. The first few weeks are crucial, (and painful), but set the tone for the rest of your life, literally. I am working with a 16 year old now. She had her ACL repair (patella tendon graft) in July. She is running, jumping (not landing on the injured leg by itself, so no layups), participating in all the basketball drills with her team, except scrimmaging and rebounding situations. I am just afraid she will have a giving way episode if she lands on another player's foot.

 

She is still coming to PT 3 days a week, where we are working on first step quickness, and quad/ham strength. She has no knee pain at all, and no swelling, even after a hard workout. Tuck jumps on the tramp, fitter with random ball passes, five point drills, carioca. She is doing it all, just waiting on the ortho MD to okay her to return to full sport. Her brace is to come in next week.

 

Advice: don't get fitted too early on for your functional brace. Get your quads built back first. The brace is expensive, and tends to not fit as you rebuild your quads and hamstrings if it is fitted too soon.

 

thank you so much tcamom. this is an encouragement to me.

i have a question for anyone who has an answer.

Will all 6 months of my recovery envolve therapy? my othopaedic doc starts me with a therapist in 2 wks, (a month after surgery) will it last until the full 6 months are done?

Also, will i need a brace after i have made a full recovery?

[lilc3]

lilc3, thanks for starting this thread. I am a physical therapist, my daughter had an ACL reconstruction 1 year ago, and i have rehabbed lots of ACL patients. The comments from you and others about the emotional struggle is helping me with a high school girl (bball player) right now. Keep up the great work, and your transparency is appreciated!!!

 

no problem tca mom, you guys are helping me, and i get to help you. it goes both ways=)

[lilc3]

How painful are ACL tears? Can a kid run, jump, cut, etc. through the pain?

 

ACL tears are very excrucating to say the least, at the point of the injury, the player often hears a pop or two.

After it happens, much instability is felt in the knee depending on the grade of the tear. if it is only partially torn, the injured person may be able to wrap it tight for the remainder of the season, but most often an ACL tear requires surgey.

There have been a handfull of very committed athletes who have torn it all the way thru and played a whole season thru much pain and risking it being injured worse, and had surgery after the season.

every athlete is different.

[worden55]

ACL tears are very excrucating to say the least, at the point of the injury, the player often hears a pop or two.

After it happens, much instability is felt in the knee depending on the grade of the tear. if it is only partially torn, the injured person may be able to wrap it tight for the remainder of the season, but most often an ACL tear requires surgey.

There have been a handfull of very committed athletes who have torn it all the way thru and played a whole season thru much pain and risking it being injured worse, and had surgery after the season.

every athlete is different.

 

 

 

If you play on a torn ACL then you risk tearing up the meniscus, and that causes a whole new set of problems. A repaired meniscus takes 4 months to heal, and you are on crutches for 4-5 weeks. The success rate drops to 80% because of blood supply or lack of. Some surgeons believe in braces and others do not. My daughter's surgeon does not reccomend it, he says there is no evidence that it prevents re-ruptures. My daughter wore a brace, it was a mental thing with her, but she tore her meniscus up, while wearing a brace, while going for a rebound. She also tore her other ACL, wearing a brace on the other knee, while making a jump stop. I would say, if your surgeon recomends wearing brace, to listen to their instruction. I hope you are progressing well. I might say, you opened a very interesting thread, a lot of good information has been posted. Keep us up to date with your progress. /thumb[1].gif" style="vertical-align:middle" emoid=":thumb:" border="0" alt="thumb[1].gif" />

[tcamom]

thank you so much tcamom. this is an encouragement to me.

i have a question for anyone who has an answer.

Will all 6 months of my recovery envolve therapy? my othopaedic doc starts me with a therapist in 2 wks, (a month after surgery) will it last until the full 6 months are done?

Also, will i need a brace after i have made a full recovery?

 

lilc, the duration of PT is very individual, and depends on lots of factors: some of it is hard work on your part, some of it depends on your "support system". By that, I mean, if you have an ATC at your high school practices, you will be discharged sooner from PT. The ATC can progress you through the final goals for return to play. Here in Bolivar, we do not have an ATC at the high school (I would love to hire one for my clinic and send them over during practice periods, but rural west TN is a challenge for medical staffing).

 

The basketball coach communicates with me at least weekly, and I send a written program for my patient to do during bball practice. As she progresses, I will alter her practice plan at school. But, since we do not have an ATC, I continue to see her in PT. Basketball requires very high level responses from the knee, especially in females. I don't like to completely discharge from PT until I am confident the patient can return to sport safely. I also address the other leg (hip strength, etc.) for prevention purposes.

 

Sorry this is so long, your duration of PT will be based on your goals, and when those goals are met, you will be discharged. The brace sometimes helps with confidence, sometimes is needed if the ACL is not as firm as the MD would like. Remember, with a patellar tendon graft, you are transferring elastic (tendon) tissue to replace non-elastic (ligament). It takes time for that graft to scar down and build tensile strength.

 

Keep up the good work!!!

[lilc3]

lilc, the duration of PT is very individual, and depends on lots of factors: some of it is hard work on your part, some of it depends on your "support system". By that, I mean, if you have an ATC at your high school practices, you will be discharged sooner from PT. The ATC can progress you through the final goals for return to play. Here in Bolivar, we do not have an ATC at the high school (I would love to hire one for my clinic and send them over during practice periods, but rural west TN is a challenge for medical staffing).

 

The basketball coach communicates with me at least weekly, and I send a written program for my patient to do during bball practice. As she progresses, I will alter her practice plan at school. But, since we do not have an ATC, I continue to see her in PT. Basketball requires very high level responses from the knee, especially in females. I don't like to completely discharge from PT until I am confident the patient can return to sport safely. I also address the other leg (hip strength, etc.) for prevention purposes.

 

Sorry this is so long, your duration of PT will be based on your goals, and when those goals are met, you will be discharged. The brace sometimes helps with confidence, sometimes is needed if the ACL is not as firm as the MD would like. Remember, with a patellar tendon graft, you are transferring elastic (tendon) tissue to replace non-elastic (ligament). It takes time for that graft to scar down and build tensile strength.

 

Keep up the good work!!!

 

thank you. my school does not have a ATC, so i gues im in the same boat she is.

i'm not sure if having torn my lateral meniscus, cracked my kneecap and bruised my femur added on that will have any effect on my healing time.

i may wear a brace just for the mental part, but i guess ill cross that bridge when i come to it. that is interesting info about the elastics and non elastics of the graft.

i hope my therapist will stay up to date with my coach as you have with hers, that would be great.

ok i have another question. my first week of therapy, generally what will i be doing? (seeing that it starts 1 month after surgery)

[worden55]

thank you. my school does not have a ATC, so i gues im in the same boat she is.

i'm not sure if having torn my lateral meniscus, cracked my kneecap and bruised my femur added on that will have any effect on my healing time.

i may wear a brace just for the mental part, but i guess ill cross that bridge when i come to it. that is interesting info about the elastics and non elastics of the graft.

i hope my therapist will stay up to date with my coach as you have with hers, that would be great.

ok i have another question. my first week of therapy, generally what will i be doing? (seeing that it starts 1 month after surgery)

 

 

 

They will try to restore full motion asap, so it will be simple at first and they will give you work to do at home. Then the next goal will be to build the quad muscles and they will probably get a little agressive with that.

[fuzby]

UConn guard (freshman starter) Caroline Doty just tore her ACL this past Saturday at Syracuse. She also tore it as a junior in high school (on the soccer field though) & did not evenplay hoops as a high school senior. Here's to a full recovery to her. Go UCONN!!!