ACL Repair Recovery – Working through Knee Pain

Those of you who read my review of the Donjoy Ski Armor will know that I returned to skiing 9 months or so after ACL surgery.

At first I took it easy so as not to disrupt my ACL repair recovery but on my second time skiing I decided to return to the black runs. To that point my recovery had progressed well from simple range of motion exercises shortly after surgery, through a return to cycling and eventually running. In fact I was running again 5 months after surgery and didn’t suffer any adverse effects from this weight bearing activity.

Admittedly I did very little to risk disrupting my recovery during ACL rehab which, in hindsight, meant that I mistakenly avoided pivot exercises. Also, I was particularly precious about unnecessary twisting when I started running again. However, when skiing a black run turns need to be made when and where they need to be made and the pressure a hard turn can introduce to the knee joint is significantly more than when jogging by the creek.

Those first few black runs made me realize how much stress skiing introduces to your knees. I actually only made three or four runs that day but the discomfort afterwards was palpable. It wasn’t quite outright pain but I knew I had shaken things up quite significantly. Injury or merely a reawakening?

Most of the discomfort was down the sides of my knee (the MCL and LCL). I had seriously injured both at the time I tore my ACL so it was not totally unnatural to feel some discomfort following such a hard workout. After all, we’ve all experienced muscle ache after a return to exercise so why shouldn’t my ligaments hurt too?

Two weeks after those first black runs I drove with my wife, Esther, to Jackson Hole in Wyoming for a weekend’s skiing. For those who know ski resorts, Jackson Hole is probably one of the most extreme mountains in North America if not the world. Ten months after ACL surgery, I was to spend two full days pointing my skis downhill and hoping my knee (with the support of my DonJoy Armor) would make the turns I would undoubtedly need to make.

As I write this it is one week since we left Jackson. It was a fantastic weekend and I managed to ski what I wanted to ski, almost in the manner I wanted to ski. But, boy, did it hurt. Slamming my knee into turn after turn was extremely painful. There is no doubt that I couldn’t have skied at all without the brace but, even with the brace, every turn on my right leg was painful.

I have drawn one conclusion from the experience and have two questions to resolve. My conclusion is that my knee, despite all the PT I did, is nowhere near as strong as it was prior to the injury and nowhere near where it needs to be to allow me return to skiing without pain. I have much PT still to do.

My two questions are: 1) have I harmed my ACL repair recovery by skiing hard before I was ready to, and 2) will I ever be able to return to pain-free skiing or do I need to learn to snowboard which is altogether more forgiving on the knees?

I will have the answer to 1) on February 27th this year when I return to see Larry Meyer at Boulder Community Sports Center. Depending on what comes out of that session I may be spending most of March learning to snowboard. Until then…