Torn ACL?'s

[jennywho]

Ive read a lot on hear about torn ACLs and returning to riding, but I’m wondering how long for farm chores.

I see the orthopedist tues and will know more, but I want to go in with some kind of idea what I want to do.

Brief history. I tore my ACL in a fall 12 days ago. Between my own farm and my job I manage 18 horses right now many of them under the age of 3. There aren’t any other employees at either farm.

My SO, who has had to pick up a lot of the work, is gone from mid Jan to June. If I can convince the ortho to do surgery immediately am I going to be able to manage on my own by mid Jan? Otherwise I have to wait unti sept due to my schedule with the horses. My biggest fear with waiting to do surgery is that I’m not going to have enough knee stability to deal with the youngsters safely. For sales prepping they are usually hand walked 30min each 5 days a week and they are young and hot.

Anyone been in a similar situation? Did you feel safe handling the unpredictable horses without an ACL?

The closer I get to my appointment and the longer I spend not able to do everything the more freaked out I am getting.

TIA

[AKB]

My daughter tore her ACL about 6 years ago. She was in school at the time and worried that she would have to take a year off school if she had surgery and was on crutches. The student handbook for her program at Virginia Tech said no student could continue the program while on crutches. She elected to wait on having the ACL surgery. The ACL does not bother her now, so she has not had surgery. Admittedly her ACL tear was not the most common kind of tear. The bone where the ACL attaches to the tibia was torn off, so it is possible that it reattached.

See what the recovery times are for your surgeon. Different techniques have different recovery times. Also think about what you need the knee to do. If you ski or do other activities that require a good ACL, you may want a minimally invasive surgery ASAP. Get a second opinion from a surgeon at a teaching hospital if you are not sure of what to do.

[enyo44]

I ruptured my ACL ten years ago and opted not to do the surgery. Instead I did physical therapy to strengthen my thigh muscles above the injured knee to help stabilize the joint. I have never regretted my decision. I have more flexibility in my knee than a friend I know who did the surgery. I can walk, run, and ride normally.

[SonnysMom]

Having gone through ACL surgery I would say even if you got it done today NO WAY could you be doing 18 horses and handling youngsters on your own.
Generally speaking to be able to tear your ACL you have done other damage such as torn the meniscus, partial tears of the MCL etc… To be able to put enough force on the ACL to tear it it normally means something else in there partially let go.

My surgeon gave me two options:

1. He could go in clean up the tear in the meniscus, clean up the frayed part of the MCL and remove the ACL that was flopping around. (For me the piece of the ACL had landed in a spot that impinged on the motion of the knee as it was getting pinched)

2. All of the above but he would also replace the ACL with a cadaver ligament/tendon

The recovery time for option 1 was pretty short as in about a week.
The recovery time for option 2 was in terms of 6-8 weeks before I was done with physical therapy and could get back to riding. I was on crutches and in a brace that ran groin to ankle for a good portion of that. Not really safe for being around any horse except really quiet lesson types.

My surgeon did say that there are people that have ACL dependent knees and those that don’t. John Elway played his entire profession football career with a torn ACL. Therefore there are people that can function at a high athletic level and never need the ACL reconstructed.

Therefore something like Option 1 may be your best bet for now and get the ACL reconstruction in the future if necessary.

Disclaimer: I am not a medical professional. The above is based on my personal experience and reading.

[jennywho]

Thank you all so much. Sonnysmom, I am in the same situation, where my ACL is balled up underneath my knee keeping me from bending it fully. I will see what the surgeon says, but I am leaning towards waiting until I have some downtime. I am planning to get a recumbent bike and I already have an elliptical, anything else I need? My knee is still unstable, but seems to be getting better.

I am so greatful for COTHers who have been there and done that.

[Shannon.Ryan18]

My senior year in high school I tore my left ACL mid-February. Saw a doctor the next day who took x-rays and told me I sprained my knee. A month later, my knee was still hurting so I went back and they got me into PT immediately and had an appointment with orthopedics scheduled in April. Finally see the orthopedist in April and she was all, “why has no one ordered an MRI yet!?” So I had to wait another week or so, have an MRI, and then wait another 2 weeks for results. Tore my ACL in February, actually found out it was torn mid-May! Needless to say by this point it wasn’t so bad and I decided not to have surgery my last summer before going to college. I opted to finally have my ACL surgery in December of that year (at anther hospital, since the one I was originally at obviously wasn’t rushing things along…). For the roughly 10 and a half months I had a completely torn ACL, I was riding and doing normal barn chores (at that point I was still competitively figure skating as well). Had my surgery right before Christmas and did my 10 days of not leaving the house (with the knee brace locked in full extension). I obviously babied my knee and strictly followed doctors orders, which ended with my poor leg being quite atrophied and a lot of electrostim work at PT. Probably took a good month and a half to get back to riding.

Now, fast forward to the beginning of my sophomore year (September). I was playing ultimate frisbee in college wearing a knee brace on my left leg and BAM, tore the right ACL. Things went a little differently this time, knew exactly what I did the moment I did it. Saw the same orthopedist within the week and was scheduled to have knee surgery around Christmas time again. Had the surgery, did my 10 days again, although I walked around and was more active. This time I came out of surgery doing quad sets (contracting the muscle right above my knee). My recovery was much much faster and my leg never really atrophied. I was back to riding in about a month, although I kind of went back before I was truly cleared

Both knees are fine now and I ride and do barn work without an issue. If I had to, I would definitely opt for surgery again. Both of my ACL’s were repaired via allograft, which also makes a big difference.

I suggest doing lots of balance exercises, core training, and quad sets. That was definitely most beneficial to my recovery.

Sorry for my rambling account, thought it might help

[arlosmine]

I obliterated the ACL s (both) in my right knee almost thirty years ago. I did not have surgery, and the knee slowly improved. There were three months on crutches and a knee brace, which I finally decided was causing so much atrophy that it was counterproductive. I was riding within a few weeks, and riding was fine as long as I was riding dressage and kept a very aligned leg (no rolling ankle out, weight slightly on inside of foot). WALKING was worse than riding, especially on anything but flat pavement…for years.
I never did have the surgery, and the last surgeon I saw told me that I should wait until I have profound pain (I don’t), and that every year I wait gives me better technology for any surgery. He also said that the biggest thing I. Could do to keep this knee happy was to stay skinny. Every pound counts.

One word of warning: I DO NOT recommend handling ANY fractious horses for any reason with a newly tweaked or repaired ACL. You are extremely vulnerable to any bumps or shoves from the side. While you may feel ok just walking around, you cannot predict what sudden moves you have to do while controlling a horse. Any twisting or torquing motions are THE WORST thing you can do to that knee. Also “giveaway” experiences, where your knee unexpectdly collapses out from under you, are normal for quite a while. If a youngster bumps your already injured or recovering knee, you could need a knee replacement. I am sorry to not be more positive about this part, but I really just don’t think that handling young horses is a fit for this knee injury.

[nextyear]

[QUOTE=enyo44;6707923]
I ruptured my ACL ten years ago and opted not to do the surgery. Instead I did physical therapy to strengthen my thigh muscles above the injured knee to help stabilize the joint. I have never regretted my decision. I have more flexibility in my knee than a friend I know who did the surgery. I can walk, run, and ride normally.[/QUOTE]

This! I tore the ACL totally and was told that only thing was surgery, after schedule was set I chickened out and went to work getting it strong.
I also had several young colts getting sale prepped at the time of the injury and was not comfortable doing alot of ground work with them, was better in the tack and it took the first horse about 1/2 the ride to suck up through the pain for about 2 mos.
Now it has been 8 yrs and I am only reminded of it if I kick something sideways def a no!

[jennywho]

Shannon.ryan18, they told me the SAME thing, that it was just sprained. I convinced them to write me a script for pt and am lucky that we have an excellent pt here that is also a horse person. She knew right away that it wasn’t just a sprain and got me in for a MRI. Otherwise Dr told me to come back in a month if it wasn’t bettet

[jennywho]

Yes definitely the kick in the ass I needed to lose the weight.thanks for the warning. This is totally why I am hesitant to do surgery now. I would hate to muck up a newly repaired ACL. In sept the racehorses are still in training, yearlings are gone and babies aren’t ring messed with much.

I really appreciate all the input, I am much calmer now that I have an idea of what to expect and a tentative plan. Hopefully my surgeon and ins co won’t throw it all out the window.

[QUOTE=arlosmine;6708646]
He also said that the biggest thing I. Could do to keep this knee happy was to stay skinny. Every pound counts.

One word of warning: I DO NOT recommend handling ANY fractious horses for any reason with a newly tweaked or repaired ACL. You are extremely vulnerable to any bumps or shoves from the side. While you may feel ok just walking around, you cannot predict what sudden moves you have to do while controlling a horse. Any twisting or torquing motions are THE WORST thing you can do to that knee. Also “giveaway” experiences, where your knee unexpectdly collapses out from under you, are normal for quite a while. If a youngster bumps your already injured or recovering knee, you could need a knee replacement. I am sorry to not be more positive about this part, but I really just don’t think that handling young horses is a fit for this knee injury.[/QUOTE]

[jennywho]

Next year, I think the salesbabies will be doing a lot of ponying this year

[ako]

I had an allograft to repair an ACL rupture. I was out of the saddle for about 5 weeks after surgery, though it should have been longer. I didn’t have any complications and nothing to clean up in surgery aside from the ACL.
While people can function without an ACL, I really didn’t want to worry about an unstable knee, and knew I wanted the surgery.
If you do decide to wait for surgery, absolutely get into PT quickly to strengthen the knee, quads, etc. You’ll really need PT before surgery, anyway. The bike and elliptical are great. Exercises with weights, too. And I would get a good, strong brace to use at the barn.

[SonnysMom]

For my home therapy portion of my PT I used a regular exercise bike (not recumbent). With the regular bike I could get a good idea how close to 90 degrees I was able to get.

I was doing leg lifts on my side and on my back. I started with no weights and then used one of those ankle weight wraps and slowly added weight. They have multiple pockets with sand bags. I was eventually up to having both full ankle weights wrapped around my ankle during the leg lifts. During those exercises my cat Smudge used to “help” me by sitting on my chest or hip. I called him my thera-pet. I lost him shortly before I was done fully rehabbing. I miss Smudgey.

I seem to remember eventually doing wall squats, with and without a beachball.

At the PT place I used a treadmill and a weight machine.

Two oddities for me were that I found it easier to bike backwards first and then forwards and I got better range if I did. Second oddity was that I was more comfortable walking down stairs backwards and holding onto the handrail. I think I felt more stable with the whole ball of my foot on the stair tread.

[The_Crone_of_Cottonmouth_Count]

No cases are identical, but here’s my tale: I blew out my ACL – full rupture – a year ago when an emergency dismount went horribly wrong. Couldn’t stomach the idea of yet another surgery (don’t ask!) so decided to try PT for a few months and see what would happen.

My therapist pronounced that I am a “coper,” meaning I have regained full use of the knee simply by strengthening adjoining muscles, without surgery. Took about 8 months for me to be able to bend it all the way back in a kneeling position, but I finally got there, and today I’m pain-free. I walk, run, ride more or less normally for a crone of my advanced years, but I gotta keep up the PT exercises or it could all go south in a heartbeat. I am told that I will eventually develop hideous arthritis in this knee and will require surgery anyway. Well, we’ll see about that!

[saabski]

[QUOTE=The Crone of Cottonmouth County;6720938]
No cases are identical, but here’s my tale: I blew out my ACL – full rupture – a year ago when an emergency dismount went horribly wrong. Couldn’t stomach the idea of yet another surgery (don’t ask!) so decided to try PT for a few months and see what would happen.

My therapist pronounced that I am a “coper,” meaning I have regained full use of the knee simply by strengthening adjoining muscles, without surgery. Took about 8 months for me to be able to bend it all the way back in a kneeling position, but I finally got there, and today I’m pain-free. I walk, run, ride more or less normally for a crone of my advanced years, but I gotta keep up the PT exercises or it could all go south in a heartbeat. I am told that I will eventually develop hideous arthritis in this knee and will require surgery anyway. Well, we’ll see about that![/QUOTE]

I usually post on the ‘trashed knee/ankle’ thread but will throw in my 2 cents - had an ACL / LCL reconstruction at 32 yo (27 yrs ago). Protocol for PT was vastly different then (no WB for 3 months!!) R leg never did recover full strength or ROM. Docs did say that every knee surgery, no matter how invasive, increases likelihood of arthritic changes. And … they were right! I had both knees replaced in late August this year. Best decision I ever made.

My sister tore her ACL 2 years after my injury, opted not to repair and has full strength and only a very occasional instability.

I think, even with the much more aggressive recovery and PT protocols associated w. these types of surgeries these days, trying the PT only route is WELL worth it.

on a complete side note, Crone’s blog “Dreadful Acres” is positively HILARIOUS. that is some funny sh*t … thanks!

[saabski]

acl

[QUOTE=The Crone of Cottonmouth County;6720938]
No cases are identical, but here’s my tale: I blew out my ACL – full rupture – a year ago when an emergency dismount went horribly wrong. Couldn’t stomach the idea of yet another surgery (don’t ask!) so decided to try PT for a few months and see what would happen.

My therapist pronounced that I am a “coper,” meaning I have regained full use of the knee simply by strengthening adjoining muscles, without surgery. Took about 8 months for me to be able to bend it all the way back in a kneeling position, but I finally got there, and today I’m pain-free. I walk, run, ride more or less normally for a crone of my advanced years, but I gotta keep up the PT exercises or it could all go south in a heartbeat. I am told that I will eventually develop hideous arthritis in this knee and will require surgery anyway. Well, we’ll see about that![/QUOTE]

I usually post on the ‘trashed knee/ankle’ thread but will throw in my 2 cents - had an ACL / LCL reconstruction at 32 yo (27 yrs ago). Protocol for PT was vastly different then (no WB for 3 months!!) R leg never did recover full strength or ROM. Docs did say that every knee surgery, no matter how invasive, increases likelihood of arthritic changes. And … they were right! I had both knees replaced in late August this year. Best decision I ever made.

My sister tore her ACL 2 years after my injury, opted not to repair and has full strength and only a very occasional instability.

I think, even with the much more aggressive recovery and PT protocols associated w. these types of surgeries these days, trying the PT only route is WELL worth it.

on a complete side note, Crone’s blog “Dreadful Acres” is positively HILARIOUS. that is some funny sh*t … thanks!

[amastrike]

I tore my ACL in May 2010. I also broke the opposite leg, so I had to wait until that was mostly healed to get the ACL fixed. Had the ACL repaired late July and was getting along pretty well within a few weeks. It was probably 3-4 months before I was totally better.

I would not even think of not getting it fixed. Not being able to stand up straight or walk normally because straightening your knee means it’s going to give out? shudder Maybe it’s different for others–some people get along with an ACL just fine. For me… no.

OP, on the off chance you’re in the WNY area, I’d recommend my ortho. He is amazing. If not, talk to friends or contact your PCP (if you haven’t already) for a recommendation. Find a good sports medicine ortho and talk about it. You might be okay getting surgery now. You be better off waiting and using a knee brace in the meantime.

[jennywho]

Well I took a gigantic crash picking out a tree yesterday and realized that there’s no way with my job I can risk my knee giving out on me. That would. Be a horrible phone call - umm your six figure yearling got hurt because my knee gave out and it got away fom me. No thanks. Now I’m on a push for surgery asap

[jennywho]

I’m 2 days post op and pretty much useless. I have a love hate relationship with my Percocet. I did manage to drag my sorry self to pt this morning and am going o attempt to help with stalls here in a bit, we’ll see. Never thought I would see the day that getting up to o to the bathroom would be a huge accomplishment

[SonnysMom]

The percocet helped me sleep. I did have one day it caused a pretty upset stomach. I found if I ate half a small container of vanilla pudding and then took the meds it helped. Kozy Shack was my favorite. I also found that if I took the meds on a schedule that helped. If I waited until I hurt then I was in trouble.

I remember the whole getting up to go to the bathroom. It was complicated for me since I had a large lab at the time, that loved to jump. Normally I didn’t mind the jumping but it was a problem then.
Good luck. Don’t overdo it.

I was on the Percocet for about two weeks before it really was too much but I still wanted something stronger than Advil. Called the PA and he prescribed something else-Ultium I think.