BC skiing without an ACL

I'm interested in hearing from people who back-country ski without an ACL. Has anybody had long-term success with choosing not to have surgery ?Does it affect you physically or mentally? Anybody had long-term success (i.e. continuing to ski fairly aggressively in the bc) with a second ACL surgery on the same knee?

Any recommendations for strengthening programs? How about for physical therapists who understand the particular strain that bc skiers put on their knees. I've torn one ACL once and the other one twice, all three tears occurred while skiing.  Just pondering options and I would love to hear from anyone who has had experience with this.

Thanks

I have a friend who has ski guided and BC'd well over 20 years without an ACL in either knee. He uses expensive burly braces for stability and is one of the best extreme skiers I've ever seen. They call him Uncle Huck because he loves to catch air. You'll figure out what you need to do to make it work. Good luck!

Hey snow_crystal,

I have fit this description a few times over the years- I have been unfortunate enough to sample 3 different types of graft choices for ACL replacement on the left knee and had 2 seasons in a row continuing to ski without an ACL, another ~50-60 days after consecutive December tears and May fixes.

I rehabbed like uh... MoFro- to increase the quad and hammy strength, a lot of spinning on the bike (30-60+ min/day) with eventually full resistance along with some general p.t. exercises (quad sets, straight leg lifts etc). My insurance covered a brace so I had a "custom fit" cti II brace that I used as well. Without an ACL I was probably able to return to ~90-95% physically for skiing- though touring with a bulky brace is a bit of a drag since there is a whole lot more chance for rubbing/chafing/slipping of the brace on the up than the down.

Mentally though, it was something that was always in the front of my mind to not be stupid and end up hurting the knee worse than it was by jumping/falling awkward/skin track slip ups. The brace did a great job to stabilize the knee and displace some of the weight on the joint and does prevent hyper-extention but none of the braces can really guard against rotational injuries- I was wearing the brace 8mos post op when the last one occurred. From my experience through 4 ACL surgeries (88, 95, 2007, 2008-all skiing) that recovery is 100% until you damage the meniscus or articular cartilage and lose some of the padding on the joint.

Enough seasons have passed such that I don't bother with braces now while touring, but will occasionally wear a neoprene sleeve if I'm thrashing around in bounds. I'd say I still ski fairly aggressively despite all the knee setbacks, i really love to ski.

Go train hard in the gym and mountain bike in off season!

Gigantic quads and hamstrings will help protect your reconstructed ACL OR insufficient/absent ACL.

Any recommendations for strengthening programs? How about for physical therapists who understand the particular strain that bc skiers put on their knees.

I recommend Olympic Physical Therapy, they have many offices in the Puget Sound.  My wife and I take a class at the Totem Lake location called "Athletic Engineering" and all the exercises are tailored for skiers.  Olympic PT also works with some people on the US Olympic ski team - they really know their stuff.

My wife had cadavear reconstruction in February and her therapist at Olympic PT is a true gem.  You can send me a PM if you want the name of the therapist my wife worked with.

The previous advice on this thread is great - strengthen your quads and hamstrings as much as you can to prevent future injury and cycle as much as you can (especially pre and post op before you are cleared for more activity).  I would add that strengthening your core is also very important too.  This is something we learned only from Olympic PT.  Redmond PT never emphasized strengthening the core at all (this is where we went first and the experience was terrible). Our therapist at Redmond PT was rude, demorilizing, and extremely negative.

I rode 09/10 w/o my ACL and it was not fun. The instability of the knee wasn't felt on average conditions, but was painful on jarring hits. Had my surgery last March and was running 5k's by Aug and had full recovery on the slopes last winter w/o a brace. It really depends on your current knee condition (cartridge and meniscus), muscle strength and so on I guess. The doc's also say that w/o an acl the knee will have more movement then with an acl that can wear out the joint faster then otherwise, but that's just an opinion I guess.
If I were to blow out another ACL I wouldn't hesitate to do surgery again.