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Torn LCL...Anyone Ski With One?

AmyPJ

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Well, I just had a major revelation regarding my struggles since I fractured my tibial plateau 3 years ago: I also tore my LCL, which is a major knee stabilizer. I just found that out today. I cannot even begin to explain how much it explains. So, the surgeon has opted to not do surgery based on my age ETA among other factors, the biggest being I've done pretty damn well with that knee for almost 3 years now. I will try a brace first.

I'm looking for advice from anyone out there who is skiing with a torn LCL, or knows someone who does and how they cope.

I'm smiling and crying. Smiling because it's nice to have answers. Crying because I've really struggled for 2 full seasons now, and it's really set me back.
 
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mdf

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So, the surgeon has opted to not do surgery based on my age.

That may be based on an image of old people not needing good knees, or not being dedicated about rehab, rather than real data on outcomes.
Certainly worth trying to be a "coper", but if it doesn't work you aren't too old. You will lose almost a full ski season, though.

I have no idea how LCL compares to ACL, but I had an ACL reconstructed at 55 and the other knee (separate injury) at 60 years old.
After the first surgery, one of the other surgeons in practice with my ortho (Eric) commented to my wife,
"I asked Eric why the heck he was doing an ACL recon on a 55 year old",
"Well, he wants to ski."
"Yeah, that's what Eric said."
 

bbinder

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Weird. I will let others with better human experience chime in, but my understanding is that the LCL was pretty difficult to injure, especially without injury to the ACL at the same time. I can tell you that I have seen a LCL rupture in a dog exactly once, and that dog had an ACL and a meniscal tear as well. And unless I have my anatomy screwed up, the long digital extensor runs pretty close to the LCL and helps protect and support this function of the knee. Was this confirmed by MR, or just by exam?
 
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AmyPJ

AmyPJ

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No MRI, haven't had one since the one I had when I fractured the tibial plateau. No MRI now because the exam made it VERY obvious (my jaw dropped when he showed me the difference between the two knees on the test.) Plus, my symptoms are consistent with an LCL injury, as is my original injury. The swelling in the joint most likely hid this injury at that time. The concern was with the fracture. I wish the surgeon at THAT time had insisted I come back 6 months later to check the other soft tissues. I feel a bit let down by him. No surgery now because I've lived with it fairly well for 3 years, minus skiing like shit. I am getting a brace fitted for it to see if that helps with skiing stability enough to hold off on surgery. If it doesn't, I'll opt for surgery in the spring so I don't miss another ski season due to this stupid injury.

It wasn't that age was a consideration in a bad way, it was more the thought that at this point, I could very well be looking at knee replacement in 5-10 years anyway. Plus, I've done pretty well with it for 3 years now. I'm all for a conservative approach. I'll reassess in the spring. I'd rather miss biking season and be able to rehab by walking the neighborhood and eventually hopping on my bike on easy trails, than miss another ski season. In some ways, I've missed 3 seasons already, because I just have NOT been able to progress.

It's all making sense to me. I have maintained (jokingly, at least half) that I am an advanced skier on my right turns (balance on the left ski) and a beginner on my left turns. My biggest gripe is that I can never find a balance point over the right ski. Now I know why. That poor knee is so unstable, it can't hold me up properly while I'm moving across often choppy snow on a 65" plank. Imagine that! No wonder my poor IT band is always on fire on that side. I'll be treating it with extra kindness from here on out.

I'm also really hopeful that the brace will stabilize that knee by at least 50%. Anyone have feedback on that? I mean hell, I've skied 200 days since the original injury, and while I've been frustrated as hell with my lack of progress, I DID ski and had fun in particular on fresh powder (duh!) and smooth groomers. It's the cut up stuff that I still REALLY struggle with. Makes sense.
 

Pat AKA mustski

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Bob wears a brace whenever he skis. He had an LCL injury - not a tear, but bad enough that it goes “out” on him if he doesn’t wear the brace. He uses a donjoy brace that supports ACL, LCL, and MCL. He’s had no problem for the last 7 years. In fact, he’s a worn a brace as long as you’ve known us.
 
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AmyPJ

AmyPJ

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Bob wears a brace whenever he skis. He had an LCL injury - not a tear, but bad enough that it goes “out” on him if he doesn’t wear the brace. He uses a donjoy brace that supports ACL, LCL, and MCL. He’s had no problem for the last 7 years. In fact, he’s a worn a brace as long as you’ve known us.
Yes!! Sounds exactly like my injury. Surgeon said the brace would support them all. If I can just get some stability in that knee, I think I'll be fine.
 

cantunamunch

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I'm also really hopeful that the brace will stabilize that knee by at least 50%. Anyone have feedback on that? I mean hell, I've skied 200 days since the original injury, and while I've been frustrated as hell with my lack of progress, I DID ski and had fun in particular on fresh powder (duh!) and smooth groomers. It's the cut up stuff that I still REALLY struggle with. Makes sense.

Sorry. Skied with a Breg for years but it was a MCL/meniscus combo not an LCL.
 

Lorenzzo

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Well damn. Hopefully a brace can keep you out there this year.
 

neonorchid

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@AmyPJ, I admire your optimisim and resolve ogsmile
While I don't have a crystal ball or silver bullet, I feel very confident in thinking that you will get thru this latest speed bump just fine ogsmile

Good luck to you AmyPJ :crossfingers:
 

Brian Finch

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@Brian Finch PT courtesy desk, please.

LCL surgery is pretty rare- most people I’ve seen having LCL reconstruction have been kicked by a horse.

Knowing that this is an issue is the first part: force is the language of the tissues. If you want to improve the quality of a ligament, you need to apply graded stress loading. Otherwise the body lays down new stuff here, there & over there..... aka useless scar tissue.

Find a good PT or S&C and work it for a solid 16 weeks!
 
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AmyPJ

AmyPJ

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LCL surgery is pretty rare- most people I’ve seen having LCL reconstruction have been kicked by a horse.

Knowing that this is an issue is the first part: force is the language of the tissues. If you want to improve the quality of a ligament, you need to apply graded stress loading. Otherwise the body lays down new stuff here, there & over there..... aka useless scar tissue.

Find a good PT or S&C and work it for a solid 16 weeks!
So, if the scar tissue is already there (after 3 years, it definitely is) then how effective would this be? I'm all for PT if it will help quite a lot.
 

Pat AKA mustski

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This is similar to the one Bob uses. Don joy (and I am sure other companies as well) make ski specific braces. The advantage is that the fit above the top of the ski boot and bend the way skiers need them. Bob skis everything - even Huevos Grandes at Mammoth (last season). He has full movement and is not inhibited by the brace in any way. Without the brace, he has no stability in the knee at all. This is a Don Joy model. He chose Don Joy because they have a shop in Carlsbad so he could go in and have them fit him.
Armor-Product-Features.jpg
 
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AmyPJ

AmyPJ

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This is similar to the one Bob uses. Don joy (and I am sure other companies as well) make ski specific braces. The advantage is that the fit above the top of the ski boot and bend the way skiers need them. Bob skis everything - even Huevos Grandes at Mammoth (last season). He has full movement and is not inhibited by the brace in any way. Without the brace, he has no stability in the knee at all. This is a Don Joy model. He chose Don Joy because they have a shop in Carlsbad so he could go in and have them fit him.
View attachment 34674
I've been prescribed a Don Joy that will be fitted to me. I'm guessing it's similar to that one. Thanks for sharing that! It's encouraging that even though he has no stability without it, it helps him immensely while skiing. I still have quite a lot of stability in the knee, hence my ability to hike and mountain bike and ski since the initial injury. Now, I have to wait several weeks for the brace! Gah! I guess I should be glad ski season is taking its time getting here?
 

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