Crack climbing after ACL reconstruction
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Hi all! |
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What graft did you get? I've had both knees reconstructed, and with my first I was asking the same questions as you. In hindsight it was a waste of time and I wish I had focused my energies elsewhere. |
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I tore my ACL/MCL in May of 2014 and had reconstruction with a hamstring graft in July 2014. From there I had lots of scar tissue complications which slowed my recovery. I had to have a manipulation to get it mobile again. I worked hard in rehab but it was still a slow process. I made my first real mountain trip with a heavy pack in August 2015. We climbed Gannett in 4 days from Elkhart Park. Hiking on loose talus and scree was a terrifying experience at first especially tired legs. The loss of eccentric strength, i.e. stepping down, makes me a lot slower, but that is starting to come back now. I think the Bugaboos at 6 months would be pushing it, unless you have a complication free recovery and a very aggressive rehab schedule. |
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I had a hamstring graft ACL done in January 2006 and was in Yosemite by late summer. |
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Echo the above comments. ACL reconstruction (hamstring) Nov 11, trip to the winds July '12. That said, my knee still felt kinda weak on the hike in, and didn't feel 100% normal until the 1.5-2 yr mark. I never notice a difference now save some soreness at the incision site and partial numbness in a few spots.Take your time, you'll be back before you know it. |
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ekh6929 wrote: I had a Bugaboos trip planned for 6.5 months post-op before I tore my ACL in the first place, and I'm pretty excited about it. But is that simply too early?The average pro football player needs 54 weeks to return to pro football after ACL surgery---according to foundrysportsmedicine.com/p…. You already know from my post to your other inquiry that six months could be pushing it in terms of the physiology of tendon incorporation. See, for example, youtu.be/GoC00OslhJE As for the doctor's opinions, some reading might be of interest: Some relevant reading at drdavidgeier.com/when-athle…. A few quotes: A 2010 survey asked NFL team doctors what percentage of NFL players return to play. 90% of the physicians answered “90% – 100%. A study of NFL players who underwent ACL reconstruction showed that only 63% returned to play in a regular-season game within two seasons after surgery. A study of high school and college football players showed similar results. 63% of high school football players and 69% of college players made it back two years after surgery. Only 43% of them had returned to preinjury levels. Finally, a 2011 study of competitive athletes in a variety of sports showed that only 33% of athletes had returned to their sports at their preinjury levels 12 months after surgery. Strength, motion, and neuromuscular control of the hip and knee in multiple planes, and for both legs, can all predict the risk of reinjury. All of them can be improved with training, however. This process can take as little as four months, but it can require 12 to 24 months. It is vital not just for preventing injury of the ACL graft or the opposite knee’s ACL. The work is crucial to getting that athlete back to playing at his former level. These are the criteria we are starting to use. I think that mountaineering (as opposed to cragging) poses extra risks, because you might just have to push through something that doesn't feel good (for instance, as a giant lightning storm is approaching). You are young and have many years of Bugaboo trips ahead of you if you don't totally eff up your knee. I'd wait until next year if I were you. |
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Moreover, listen to your doctor and physical therapist, and not the internet :-) |
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Being a physical therapy student, I'll echo that you need to be careful. Honestly, though go to a local gym or some type of tight knit climbing community and ask if they know of any physical therapists that climb or if there are any they would recommend. I'm not saying that who you are seeing is a bad PT, it just helps if you have someone who knows exactly what you will be needing. Healing time can be extremely variable. The most important thing in the beginning is range of motion. Once you have good range is is a lot easier to layer on strength. Research shows that there will most likely be strength deficits still at a year, so work hard on that. But I would also contend that you could probably get away with strength deficits while climbing. The biggest limiting factors will be pain and range of motion. |
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Thanks everyone. I know that I should listen to my surgeon and PT, but two surgeons (my own and another from an earlier consult) both suggested that I could be climbing or at least following at 4-5 months, which is a slight difference of opinion compared with my PT's advice. |
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Medical student climber here. The usual mechanisms of injury for an ACL tear are either a direct blow to the knee (think Tom Brady) or a "cutting" motion where the foot stays planted and the femur continues to move laterally and forward on the tibia. You're unlikely to receive a direct blow to the knee climbing, but the lateral/anterior pressure on your knee joint is pretty much exactly what happens during a foot jam. It's a relatively static force, but would still stress the knee, especially the LCL. |
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That was pretty much my experience (leading face climbs at 7 months). I got rid of the expensive custom brace pretty quickly; it is awful for climbing and hard to wear hiking for long periods of time. But if I was going to be hiking on possibly unstable boulders with a pack---at 6 months no less---I'd definitely have been wearing that brace. |
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Glad to hear you are in the recovery phase now! Things will only get better from there. I would have to agree with james sledd's comments about climbing around the 6.5 month mark. Also the comments about the hiking in the bugaboos. If it was me I would cancel my trip because I feel like I would be slowing my partner down attempting to do long and involved hiking and climbing. I pushed it a couple of times around the 6/7 month mark and began wondering if I was going to make it back to the car/camp without stopping and taking a long rest. |
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Oh yeah!!! I love me some poles!!! |
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I tore my ACL twice from bouldering. The first time was a fluke in the gym, my feet 5 ft off the ground, and the second time was because I went back to bouldering at 9 mo post-surgery and took a normal fall--my graft just wasn't ready yet. Needless to say, I've been doing intensive PT (more like serious personal training in terms of weight lifting, kettlebells, plyometrics, etc.). I'm 15mo out of my 2nd surgery with my own hamstring, am sport climbing, and butt-dragging-back-slapping bouldering. I've been a huge advocate about ACL surgery information for climbers since there's so little info out there, and I personally felt that if I had had more info, I wouldn't have torn mine twice. I've got a comprehensive ACL surgery guide at http://www.patchworkandpebbles.com/acl/. It covers everything from pre-surgery graft choice, to logistics post-surgery like showering, to the graft healing process (necrosis, ligamentization, etc.), and rehab for back-to-sport climbing. Please take a look--I hope it helps! I've also got a survey at goo.gl/o23rf9, capturing data about which graft people chose and after what time periods they went back to TR, sport, lead, bouldering. It would be great if those of you who went through surgery share your data (it's like 10 multi-choice questions)! I'll publish results on the ACL guide. |
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That's a great idea about the survey, Melodie. I hope you get lots of data. When your survey asked about running and jogging, I assumed this covered even very short distances (e.g., 100 feet, which is about all I do). But you might want to quantify the distance range in the question. Getting back to the original question - My surgeon and assistant were both climbers, and they warned me against bouldering and doing foot jams for a year. |
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Melodie!!your site was one of the first I read when I realized I was facing a new acl..super informative! I'm getting the slice in a week! I do 50-80 mile hiking days in 24 hours and am big into hard long trad days so yah none of that for a year is my personal choice..no falls and no toes jams . Their really is no hike or climb worth going through this shit...I'd say 6 months post op to do the bugaboos is risky..you grafts to new and your body has lost its ability and proproception. Also it's not just you at risk you have a partner and if you get screwed he is also in danger |