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Return to sailing after ACL reconstruction

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Chris Turner View Drop Down
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Post Options Post Options   Quote Chris Turner Quote  Post ReplyReply Direct Link To This Post Posted: 13 Sep 11 at 7:50pm
I did actually break the ACL sailing...pitchpoling the 14 and the strap not breaking. 
Six months later and three operations I was able to compete at the 14 Worlds, as I said, in the previous post we finished 4th.
So, you can sail anything you want to post op, it is up to you how much you want it. If you put maximum effort in to your recovery you should have no problems at all.
I know we are not talking proffesionals here, but look how quick footballers recover from ligament damage.
This year, some fourteen years on, still doing the exercises and still competing in hiking boats. Did OK at the 15' Worlds...you get out what you put in.
If you want my advice, PM me.... 
 


Edited by Chris Turner - 13 Sep 11 at 7:50pm
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Stuart O View Drop Down
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Post Options Post Options   Quote Stuart O Quote  Post ReplyReply Direct Link To This Post Posted: 15 Sep 11 at 8:13am
The ACL does respond well to surgery and a near normal life can be resumed after proper rehab. Infact you dont need the CLs ask one of the Sale RFC front row players, you just have to make sure the hamstrings , especially Biceps Femoris, are strenghtened.
Having said that I would suggest good bracing initially and plenty of Ice/cool packs after sailing for the 1st year...lightning the support as strenghtening continues. Also go to a decent sports thereapist and get those muscles 'ironed' out on a regular basis.
Sailing is a relatively safe sport apart from manouvering the boats around the dinghy park...thats were 95% of injuries occur excluding sudden trauma (eg Chris pitchpoling and breaking ACL).
The MCL, Medial Collateral Ligament, and LCL, Lateral Collateral Ligament, however will affect sailors longevity as they are really the ligaments that control the knee joint, and ruptures partial or full will mean that a very supportive knee brace should be worn at all times during sporting activities.
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Stuart O View Drop Down
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Post Options Post Options   Quote Stuart O Quote  Post ReplyReply Direct Link To This Post Posted: 15 Sep 11 at 8:22am
Originally posted by pondmonkey

there is no correlation between dinghy sailing and dodgy knees.  

FACT- if you want to dispute this, you risk disputing it in a court of law under accusations of libel.

Sail whatever you want, your knees will be absolutely fine.  Trust Pondmonkey- life long fan of Laser Dinghies.   (Although we're not quite sure who pondmonkey is as there 10 users who are currently sharing this IP address at the time of posting)  

These sailors coming out here giving 'sensible advice' to take it steady for a while- well they're all like you, must have screwed up their knees playing football or doing something that wasn't related to dinghy sailing at all.

Dinghy sailing and knee issues... p'ah what a load of b**locks.
Pondmonkey
 
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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Post Options Post Options   Quote gordon1277 Quote  Post ReplyReply Direct Link To This Post Posted: 15 Sep 11 at 8:57am
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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Norman View Drop Down
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Post Options Post Options   Quote Norman Quote  Post ReplyReply Direct Link To This Post Posted: 16 Sep 11 at 11:01am
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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Pierre View Drop Down
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Post Options Post Options   Quote Pierre Quote  Post ReplyReply Direct Link To This Post Posted: 16 Sep 11 at 11:27am
Thank god.... someone who knows what they are talking about.

Well commented Norman and good luck with the dissertation.
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Post Options Post Options   Quote MrBrightside Quote  Post ReplyReply Direct Link To This Post Posted: 20 Nov 11 at 9:08pm
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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Post Options Post Options   Quote Sheetpuller Quote  Post ReplyReply Direct Link To This Post Posted: 20 Nov 11 at 11:18pm
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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Post Options Post Options   Quote andymck Quote  Post ReplyReply Direct Link To This Post Posted: 22 Nov 11 at 12:49am
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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Post Options Post Options   Quote Peaky Quote  Post ReplyReply Direct Link To This Post Posted: 22 Nov 11 at 1:15am
Crumbs, who'd have thought there was so much knee knowledge on Y&Y?
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