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Return to sailing after ACL reconstruction |
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richardhook01 
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Joined: 30 Nov 11 Online Status: Offline Posts: 1 |
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 Topic: Return to sailing after ACL reconstructionPosted: 30 Nov 11 at 2:33pm |
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Hi, Arthroscopic ACL (anterior cruciate ligament) reconstruction surgery procedures have come a long way over the years. Orthopedic surgeons get a lot of practice with this particular knee injuries.
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ex laser
Really should get out more 
Joined: 25 Mar 09 Online Status: Offline Posts: 725 |
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Posted: 22 Nov 11 at 3:42am |
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thats because there are so many middle aged sailors on this forum!
 and a lot of us have bad knees!!!!!!  |
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Posted: 22 Nov 11 at 1:15am |
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Crumbs, who'd have thought there was so much knee knowledge on Y&Y?
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andymck
Far too distracted from work 
Joined: 15 Dec 06 Location: Stamford Online Status: Offline Posts: 397 |
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Posted: 22 Nov 11 at 12:49am |
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Hiking itself is not likely to cause a major effect on your graft. The other stabilisers become more important as the knee gets straighter. Once the posterior capsule is tight, it is impossible to tell if a knee is ACL deficient. We always therefore test the ACL in 30-90 degrees of knee flexion. Here the ACL prevents forward movement of the tibia (shin bone) on the femur (thigh bone). Even then in most ACL deficient knees there is little issue with static type loads we get from hiking, as long as the quads and hamstrings are strong. This is why ACL deficient sailors get little problem.
The issue comes with pivoting, and deep flexion. Everyone will remember the video of Michael Owen popping his ACL at the world cup. This loaded, twisting motion is the point that most ACL's go. This is why the rehab regime is protected against pivoting till you are ready to resume active sport. This is usually 6 to 9 months, although varies on regime to regime, and time spent in rehab. Once you are able to do this in rehab, sailing should be fine. Reconstruction is designed to allow "normal" pivoting to occur. Major knee issues in sailing normally come from deep knee flexion. This can have a significant effect on the menisci, and can cause meniscal injury. Meniscal injuries can be associated with ACL rupture, and are more likely to cause you a long term issue. Most sailors who complain of knee issues have had arthroscopy and meniscectomy. They don't like shallow boats with a double bottom that require crouching or kneeling. They like trapezing, except in light conditions. A meniscal tear would worry me much more than an ACL for my sailing career, trouble is they often come together. Bottom line is when you have rehabed your quads and hamstrings, and have stability on pivoting, get back to it, otherwise there was little point having the op in the first place. The damage done at the time of injury, and before stability was restored is much more important for your long term outcome. N.B ACL reconstruction is not a pre requisite to returning to sport at elite level, there have been two Premier League players I know of who have made it back in recent history. Having said that, I would have mine done if needed, mainly to protect my meniscus. This is a personal view, there are many unanswered questions regarding knee kinematics, and the effects of ACL reconstruction. Andy FRCS (tr and orth) |
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Andy Mck
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Sheetpuller
Posting king 
Joined: 22 Feb 11 Online Status: Offline Posts: 114 |
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Posted: 20 Nov 11 at 11:18pm |
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Thank God we have someone on this thread who knows what they're talking about; nice one, Norman.
Common sense dictates caution, and any return to sailing taken gradually and with a 'gentle' boat as already suggested. Chances are that a gradual approach will get you get back to where you want to be rather quicker than jumping straight back in as the troll suggested. One thing that occurs to me is that a static demonstration of hiking as earlier suggested won't properly convey to a non-sailing medical specialist just how a boat moves in waves, and how it's occupants constantly react. This also exerts a continuous low-level pressure on knees whilst hiking. There are many vids on youtube which should convey the sensation adequately. Edited by Sheetpuller - 20 Nov 11 at 11:20pm |
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I'm not arguing. I'm explaining why I'm right.
Merlin Rocket 3545 - 'Smooth Operator' Sprint 15 1342 - 'Still Crazy' |
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MrBrightside
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Joined: 20 Nov 11 Location: Cambs Online Status: Offline Posts: 2 |
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Posted: 20 Nov 11 at 9:08pm |
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I have a little ACL reconstruction knowledge, having had both knee's reconstructed.
I snapped my rhs / ACL in a skirmish at the age of 18, 11 years ago whilst working as a sailing instructor. A full recovery period without specialist help has helped and this knee seems to be stonger then previous. Last year i snapped my lhs ACL riding motocross. I quickly had the LHS privately operated on in March of this year. I add, i've not sailed in ten years (just looking at buying a Laser again and a 1/4 tonner and stumbled across this thread) but my experience would lead me to conclude the following; Dont exert undue stress on the knee before 9mnths post op. The knee op is a graft joining ligament to bone and needs time to fuse... The knee will become stronger then previous due to focused training. Dont run on the road ACL grafts STRETCH! after 10 to 15 yrs the ligament graft will become lapse relying on muscles around it to compensate, surely hiking will only exasperate. Edited by MrBrightside - 21 Nov 11 at 7:19pm |
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Pierre
Really should get out more
Joined: 15 Mar 04 Location: United Kingdom Online Status: Offline Posts: 1532 |
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Posted: 16 Sep 11 at 11:27am |
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Thank god.... someone who knows what they are talking about.
Well commented Norman and good luck with the dissertation.
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Norman
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Joined: 16 Mar 04 Online Status: Offline Posts: 2 |
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Posted: 16 Sep 11 at 11:01am |
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Hi
My name is Norman Byrd, I'm a GP with an interest, and a qualification, in sports medicine. I'm not orthopaedically qualified though (I know of lots of orthopaedic surgeons who sail but don't know whether they read this forum). I'm about to submit my M.Sc. dissertation, the topic is femoral blood flow in the hiking dinghy sailor and its relation to hikers. There we are, that's who I am.
Your ability to return to your previous level of activity is not guaranteed by surgery. Surgery without good quality rehabilitation is unlikely to be enormously successful. It also depends on any other damage that was caused by the initial injury and what may have occurred between injury and rehab. I agree with the advice that you should take some pictures of sailors hiking out etc to see your physiotherapist. This isn't the space to discuss rehab' and ACL injuries as it is a vast topic of which I know only a relatively small amount. Not everyone needs a functioning ACL, it depends on lots of factors such as stabilty of the knee, age and lifestyle.
I disagree strongly that sailing does not have an impact on knees. Damage may occur from twisting etc within the boat as any injury to the knee, but additionally from the high load transmitted through the patello-femoral joint whilst hiking.
I would urge you not to accept general advice without discussing this with your physio' and surgeon or GP. You may be able to return to "normal" sailing, you may not.
Best wishes, good luck and keep up with the rehab'.
Norman Edited by Norman - 16 Sep 11 at 5:22pm |
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gordon1277
Really should get out more
Joined: 24 Mar 10 Location: United Kingdom Online Status: Offline Posts: 665 |
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Posted: 15 Sep 11 at 8:57am |
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Hi White wizard
I would avoid boats that you have double bottoms like 400 crewing, phantoms and FD ETC as a deeper boat like the Osprey and Solo will give you more room and avoid kneeling. I would also be careful of to strong a non slip as i used to find tacking the 505 involved twisting on the balls of my feet and could be bad if my knees were playing up. Both my knees were caused by Squash not sailing but common sense dictates looking after them especially in rehab. Good luck and do your exercises and you should be able to sail what you want in a year or so. Gordon |
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Gordon
Lossc |
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Stuart O
Really should get out more
Joined: 22 Jul 07 Online Status: Offline Posts: 514 |
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Posted: 15 Sep 11 at 8:22am |
what we are not sailing is that sailing is dangerous...HOWEVER THE GUY IS ON REHAB having had the surgery, the advice been given so far is very good advice
and see you in court coz Im going to say that sailing has a link to the factors that cause bursitis of the knee...often mistaken for tendonitis. Also please read into Osgood Schlatters syndrome...a major health worry for young sailors espcially females.
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