The effects of knee surgery on hiking.

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Boozeman
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The effects of knee surgery on hiking.

Post by Boozeman » September 26th, 2014, 6:38 pm

Howdy folks,
I have had a few knee problems over the years which have caused me pain while hiking. Recently I suffered a miniscal tear and an MRI uncovered a partially torn ACL from an older injury which was contributing to my knee instability and discomfort. My doctor is suggesting surgery to repair, at least, the torn miniscus (I'm of the mind that as long as my knee is being cut into they might as well fix the ACL as well).

My question is, has anybody been through this or something similar ? How long did it take to recover and were there any long term effects ( i.e. how did it affect your hiking & choice of trails)? I have had to reevaluate doing several hikes even before this recent injury because I suffered a lot of pain from heavy elevation gain and steep up and down areas. I don't know if this surgery will help or hinder my hiking even further.

Most research that I've been able to find is for sports injuries and is about how quickly you can return to football, basketball, etc. I don't need to have "quick cut" and jumping abilities restored, as I never really had that in the first place (Even before the original injury) :lol: . I just need to be able to continue my hikes and possibly , if the surgery DOES alleviate my knee pain, do more elevation intensive hikes in the future if I can.

One good thing is that my injury occurred AFTER prime hiking season and I got in a few great hikes this year. I'm going to have to rely on other people's hiking TRs to experience fall colors this year though, so make sure to post as many as you can. ;)

Thanks in advance for your replies. Any feedback will be helpful and greatly appreciated.

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jessbee
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Re: The effects of knee surgery on hiking.

Post by jessbee » September 26th, 2014, 7:33 pm

Hi there, I had a complete ACL tear in 2008 and a heel fracture in 2010 (on the same leg) and needed surgery for both. There was a period of a few months of recovery after each injury/surgery but I was able to get back to exactly what I'd been doing before, after physical therapy plus lots of work on my own and of course pure stubbornness.

The only thing that changed for me is that now I almost always hike with poles. Walking downhill is going to be your biggest challenge at first, I'd imagine, so the poles are essential for that.

I'd advise you to seek out a good physical therapist, as they range widely in quality. Let them know your intention is to get back to hiking, describe exactly what types of hikes you like to do, and if they look at you funny go find someone else.

My surgeon and pt both told me essentially there was no way I'd get back to my previous level of normal activity but they were totally wrong.

If anything an injury provides an opportunity to really reflect on what's important and focuses your attention on how to move efficiently and with intention. Sure it will set you back a few months but you'll come out stronger and more in touch with your body than you were before.

Best of luck.
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Lumpy
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Re: The effects of knee surgery on hiking.

Post by Lumpy » September 27th, 2014, 12:23 am

I'm only recovering from two broken toes from two weeks ago. I hope the folks with bad knees can get back into hiking shape. You have my empathy. I don't know what I would do if I couldn't get out in the woods and take my nice walks as (relatively) easily as I can now, but I hope to learn about what may be in store for my future when I read discussions like this.

I already use poles, and try to use them to help reduce the shock of walking downhills. I know that they can help reduce pain, and I hope they can prevent the onset of needing medical repair for knee problems until much later in my life. Thank you for starting this discussion.
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Crusak
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Re: The effects of knee surgery on hiking.

Post by Crusak » September 27th, 2014, 7:27 am

I suffered a complete blowout of my left ACL back in 1995. The doctor removed my ACL and I hobbled around on that knee for 15 years, trying to hike and backpack. Fast forward to 2010 and I further injured the same knee, which led to my decision to get ACL reconstruction done.

After ACL reconstruction surgery in June 2010 it took me about four months before I felt comfortable getting out on an easy trail to hike. I did a few short hikes and slowly built my strength (and confidence). It was nearly two years before I felt good enough to trust my knee on really steep downhill hikes. I still have pain in that knee, and even though I have worked that knee very hard over the past four years it's still not as strong as my 'good' knee.

I know two young guys at work that both had ACL reconstruction surgery, and both of them ended up getting the surgery re-done (because it didn't "take" the first time, for whatever reason). It seems that success and recovery time vary depending on luck, the skill of the surgeon and the healing power of the patient.

I hope you find the right solution to your knee problems, and if you have surgery I hope you make a rapid recovery.
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Grannyhiker
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Re: The effects of knee surgery on hiking.

Post by Grannyhiker » September 27th, 2014, 9:23 am

Back in March 1988, I completely ripped out both ACLs and the medio-collateral tendon (the one on the inside surface of the knee--I may not have that spelled right) tendon. Reconstruction involved using pieces of the patellar (kneecap) tendon screwed at each end (one end to the bone, the other to the kneecap). It took about a year for me to get back to full activity, and my knee never quite returned to 100%--I can't bend it completely and can't run for more than a few steps without discomfort. I also had to give up trying to carry 40-50 pound packs, which eventually led me to lighten my load. Now that my total pack is half that weight or less (15 lbs for an overnighter), that problem is solved. Considering the extent of my injury, I feel quite lucky.

It took me about 8 weeks before I could get out and hobble around and even depress the clutch pedal on my car (if I had it to do over again, Lord forbid, I would have rented a car with automatic shift!). By July 4 I was back up to 3-4 miles per day; by Labor Day I was easily doing 5 mile hikes. In a year I was doing all sorts of hikes up to 10-12 miles with big elevation gain/loss, and had permanently dumped the knee brace. Any slowdown since has been due to aging, not the knee.

Your injury is not nearly as severe as mine was, so you should be fine and back to full activity much sooner than I was. Surgical and rehabilitation techniques have improved in the last 26 years, too. Do get a referral to a good PT, one who understands what kind of activity you do. Work really hard at it!

With weaker ligaments, strong muscle support for the knee is even more crucial. Expect to keep on with those exercises your PT gives you--daily for the rest of your life!

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BurnsideBob
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Re: The effects of knee surgery on hiking.

Post by BurnsideBob » September 27th, 2014, 11:38 am

I had an ACL repair on my right knee in 1996 following a ski accident. I have had no long term loss or impairment and hike and ski today as if nothing happened. That said, it took about 10 years before I could deep squat without pain--the repaired knee was just not happy about deep bending.

I religiously followed my PT regimen and followed it up with lots of extracurricular activity like climbing Mt Hood and Adams within a year of surgery. I completed the John Muir Trail 6 years later, but I did not return to downhill skiing for about 10 years.

If you can choose the surgeon, choose one with lots of experience. Those associated with sports teams would be best because they need to have their patients back to full speed as quickly as possible. Rebound Orthopedics, which is the orthopedics outfit for the Winterhawks, Portland State, and, at one time, the Trailblazers, would be a good local choice. And use their recommended PT person for the same reason.

Discuss at length what will be used to replace your ACL. Your choices boil down to self-donated--usually a hamstring or part of achilles tendon from same leg, cadaver tendon, pig tendon, or ?? My surgeon wasn't big on cadaver or pig, and, because of my age (late 40's at time), achilles, so he harvested one of my hamstring tendons from the same leg.

Since I have had some minor hamstring muscle group pain and irritation to this day, I've wondered if the Achilles Tendon choice would have been better. A couple years after my surgery, US skier Picabo Street had a complete ACL rupture--she had the achilles tendon repair. I remain unclear as to why age makes a difference on which tendon is sourced for an ACL repair, although she was in her early 20's at the time of injury vs my 40's.

Having an intact ACL will reduce your chance of future serious knee injury and allow you to do whatever you want. You won't regret having your ACL repaired.
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Boozeman
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Re: The effects of knee surgery on hiking.

Post by Boozeman » September 27th, 2014, 12:27 pm

Thank you all for your replies and information concerning your injuries/surgeries. It has really given me a lot to consider. The fact that all of you are still out doing what you love afterwords gives me a lot of hope. I'm going to have the ACL reconstruction done as long as the surgeon feels that I'm a good candidate for it . I'm 41 and in reasonably good physical condition, so I feel like I can make a full recovery within a year or so and still have a lot of years for hiking. I will definitely take all of your advice and look at finding a PT who can help me to get back on the trails with confidence. Thanks again, and feel free to keep the advice coming. Every bit is appreciated. :)

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