UKC

Had a fairly bad knee injury in January, after 4 months of inactivity I'm climbing the walls a bit and keen to, um, actually climb some walls. Thinking an easy indoor session will be do-able. Been looking at getting a knee brace, but there seem to be endless options to suit any budget. 

For background, the injury was a tibial plateau fracture, which has been plated, plus partially ruptured ACL. Started trying to mobilise the joint about 4 weeks after the injury, but struggled to get much range back. Had an arthroscopy plus manipulation about 6 weeks ago, the surgeon cleared out some bone fragments, cut away lots of 'dense fibrous tissue' and 'unstuck' various bits as 'everything was glued together' in his words. Getting about 15 to 110 degrees of movement at the moment. Will most likely have another arthroscopy soon, should find out in a couple of weeks. The consultant said he may end up cutting out my ACL then doing a reconstruction. Currently just about walking with a stick or can hobble a bit without. Had comments from various medical staff that it's a particularly bad injury, one guy said it was the worst he's seen

So anyhow, anyone have any experience or knowledge of getting back to doing sports after similar injuries? What should I look for in a knee brace? Is there a risk of doing significant damage (above the normal risk inherent in climbing)? I know the sensible answer is don't, but I can only take so much sitting on the couch watching TV. Will ask advice from the consultant and physio when I get chance, but thinking on here I might get some answers from people slightly more understanding if how frustrating it is.

Knees are difficult - certainly for a knee replacement rapidly going into physio and getting range of motion back by 6 months is critical. Knee replacements are nice controlled things, however. Your knee sounds a lot more complex with fracture plus ACL damage. Nevertheless, I would have thought that some of the same guidelines would apply and early gentle physio would be important to avoid exactly what happened with things getting stuck together. 

I've had knee issues over the years, but not as bad as you.  After the most recent arthroscopy I've been given an offloader brace, which is brilliant.  However, it restricts motion enough that I don't climb with it, but I know what moves are bad for me.  If I get to a move which could cause the injury to repeat I just stop, or drop off.  

My best advice would be to speak to your consultant/physio and see what they recommend.  It may be that you wont be able to push into the 6's, but could be quite happy staying active in the 5's with a support.

Just less that 20 years ago I ruptured my ACL, damaged the meniscus and one of the other ligaments. I could get around OK and even run a bit after the initial trauma had passed.  About 6 months to a year later I had ACL reconstruction. The surgeon said the ACL was not there. After the operation it took 3-6 months of serious rehab to get back to a reasonable state.

So I would say that best not to rush things and take rehab seriously and rebuild and strengthen around the knee. 

I have managed quite a lot of skiing, hillwalking, running and climbing without much in the way of issues. Maybe I would have been OK without ACL reconstruction. either way it is possible to be quite active with a knee with bits missing, damaged and patched up.

Best of luck be optimistic but patient? 

If you can get to Wilmslow, near Manchester, I would recommend a visit to Harris and Ross physio/rehab. They work with a sports knee specialist surgeon and treat all the red bull team, national rugby team etc. Obv it will depend on the grade of tear, and what level you want to return to, but if you gonna get the acl reconstructed, get onto it as soon as you can cos you looking at 9mnths to full recovery. In the meantime anything you can do to prehab range of movement, strengthen quads and hamstring will improve surgical recovery time (and make your knee more stable while you wait). 

If you happy to live with the partial tear (no highballs, or running downhill etc) then again its quads that stabilise the knee in the absence of a good acl. Again, go see a sports rehab specialist like Harris and Ross to get a program of exercises, and do them religiously for the rest of your life. 

My partner just had the acl reconstruction 2 wks ago, is why im familiar with the choices. Other physios are available (although some dont give the best advice )

In the meantime, the fracture should be fully healed by now, so strap up your knee, take one climbing shoe and one wooly sock, and one-leg top rope the hell out of the climbing wall. Stick to overhanging routes where you can't bash your bad leg if you fall, and enjoy the weird technique you have to employ with your good foot!

Good luck! 

I suspect that your knee will still improve a lot, 4 months isn't too long for the injuries you describe.  You might want to check out Blatchford's of Sheffield and the STEPS physio clinic that they work with.

Here my strategy.

My experience with knees = Twice a meniscus rupture. 

First time it was ill diagnosed. Waited two years before operation. Meanwhile trained hard and climbed at lower grade, did Denali and did some easy winter stuff in Scotland. Decided I needed a brace. Brace men said no brace, get surgery. Got surgery.

Rehab 3 times a week, nine (9) month. Now back to a normal steady knee, with good climbing. A good sport physiotherapist can make a big difference if you want more then average (walking the dog, etc). 

Then two years ago again pushing hard doing a hard move while climbing the other knee was damaged. Went to see an orthopaedic surgeon. MRI etc. She said hopeless, no treatment was needed. Waited 9 month to get it better, what it didn’t. Bum seated down the stairs, etc. Went back to the first knee surgeon. He concluded the knee needed definitely treatment (same scan!). Now 6 month later I am climbing again 6a. Train 5 days a week. I can still feel my knee sometimes at night if cycled 40 miles and climbed 90 feet. There is still a lot of progress to be made.

In those 9 months before the operation I had good days and lesser days. To get a view I started to note in a book the daily pain. Just a pain number and a short analytic description. What movement I could (not) make and if it was painful. 

I also learned that there are good craftsmen and lesser (doctors/physiotherapist). It is just like with plumbers some are really good. Do research read their thesis, etc.  Go with two to the specialist. Four ears hear more then two. Have your questions ready and get answers. 

Train before the operation, the stronger you get in the better you get out.

Be safe out there and happy climbing

Similar to ivanwindrush I did my ACL with some cartilage damage almost 20 years ago playing rugby. In the end I had two ops, one to clear out the knee and the other to repair the ACL. I did all the rehab and physio diligently and was unable to play for about a year although  managed some less strenuous activity. I'm still playing rugby now and have managed to ski, climb and do all sorts on my knee....it does get sore after a long day out especially on downhill stretches but generally its been good. With regards the brace I was recommended not to use one long term as the knee becomes dependent on it and overall weaker in the long term....I did use one a bit during the rehab stage but quickly tried to go au natural....cant say I've used one since. Good luck with it all.