Bummer. Torn PCL.

[Mike T]

Those of you who were at OES may recall me mentioning my gimpy knee. Well, turns out that I had partially torn my PCL 3 weeks before. I decided after 6 weeks to have it looked at again, "should have healed my now if just muscle damage". Doc agreed and sent me for an MRI and there it was. Thing is my good knee is somewhat loose too, so when he originally checked he compared and it didn't seem much looser than the good one.

I've seen 3 folks tear ACLs playing sports, and they were in agony. Not so with PCLs... if you've got good quad strength you can tear one (and don't tear anything else) and it'll be a bit sore but you might not think anything is seriously wrong. It sure fooled me and it fooled my doc the first time around too. If you sustain a blow to the tibial plateau while you knee is bent, keep this in the back of your mind. Especially if you've got good leg strength... it's obviously not that hard for the symptoms to be masked.

Thankfully I don't need surgery - I will do a few prolotherapy treatments to encourage it to finish healing properly. I am sure I didn't do myself any favors by riding and running on it, so fingers are crossed that it does indeed heal properly.

[KingCrimson]

That NSR will dry out and warp if it's not flexed on a regular basis, and it needs to be crashed and cartwheeled a few times to keep the titanal from oxidizing. Mail it down here, I've got it covered till May.

Heal up!

Theo

[inkaholic]

Best of luck with the healing.

Ink

[Dan]

Hey Mike, sorry to hear that! Best wishes for a quick recovery.

[Galen]

Crap-ola, that blows! Done for the season? Only a month left. Not related to the tree you had a fling with? Get better, bub!

[nekdut]

Sorry to hear that Mike! Heal up quick!

[David Glynn]

Mike sorry to hear of your injury. Glade to hear that you know about prolotherapy. I've posted about it a few times here. I think every athlete

should know about it. I've had it on both knees for partially torn acls and mcls.

Had very good results on both knees.

Hope you heal fast.

[nigelc]

Sore knee on return from whistler recently which also did not improve - yup the MRI confirms a ruptured PCL and damaged medial collateral. Worse is that like you the other knee is almost as loose - because as it turns out according to the doc I have also destroyed that one, probably a couple of years ago. What fun. As a friend of mine said growing old is not for sissys

[Mike T]

Crap-ola, that blows! Done for the season? Only a month left. Not related to the tree you had a fling with? Get better, bub!

Yep, this is the aftermath of the tree incident on Feb 14.

Probably not done for the season, since TLine is a short 2 hours from my house

[Mike T]

If you don't mind me asking, what were/are your symptoms? I'm doing PT for a bum knee right now, and neither the doc or the therapist seems eager to send me for an MRI.

Excellent question!

The original injury was me clipping a tree. I had tried to get the board out in front but the edge caught the tree and flipped me toward it, my shin grazed the tree. I had a pretty nasty bone bruise and road rash on the shin, which hurt a hell of a lot more than any ligament damage did. I had it looked at, but the swelling from the shin spread sufficiently far up to the knee that it masked anything that had gone wrong with the knee ligaments.

Three weeks after the bone bruise was well on its way to healing and the knee felt a little weak but not unstable, and a little soreness but nothing bad. The thinking at this point was "the ligaments probably got stretched but not torn". Walking and running was no problem and I was snowboarding on it just fine, albeit a little carefully by that time. One more week and it felt fine. A little swelling but nothing too bad.

I twisted the knee a bit getting out of my car last week (6 weeks after injury) and felt some pain, almost like the knee had slipped and then gone back. That's when I knew something was still wrong and it was time to have it looked at again. Since there was no longer any swelling from the bone bruise (which was keeping the knee from being too loose the first time on the examination table) the ligament damage was obvious... both drawer tests raised red flags.

Thing is other than the bone bruise and when I tweaked it last week the level of pain was never anything that made me think "torn ligament". It was sore but just not that bad. It fell under the radar since I'm used to getting bumped and bruised snowboarding. The drawer tests - which demonstrate how much the tibia moves fore and aft - should be enough to either raise a red flag or not in your case.

[Mike T]

Mike sorry to hear of your injury. Glade to hear that you know about prolotherapy. I've posted about it a few times here. I think every athlete

should know about it. I've had it on both knees for partially torn acls and mcls.

Had very good results on both knees.

Hope you heal fast.

Yep, this will be my 2nd adventure with prolo. I had it on both SI joints around the beginning of this season... they were weak, most likely from spending too much time sitting in front of the computer, and various muscles were compensating my spasming. The results on the SI joints were fast and positive, I hope it's as effective on the PCL. My doc claims that "as long as there's a few fibers left prolo will stimulate the body to heal the ligament in its entirety, given enough treatments". I'm optimistic. I'm hoping the rehab part won't be too bad either since I have ~90% ROM right now. They are telling me to ride my road bike, work out on the elliptical etc throughout treatment, get back on my snowboard when I feel ready, and not to ski, play basketball, skateboard or anything else that involves knee twisting till it's back to 100%.

Ignorance was bliss - when I thought it was just another bump/bruise I had no metal issues riding through the discomfort. Now that I know what's wrong with it, the thought of the ligament completely tearing is first and foremost in my mind.

[Dave ESPI]

My buddy Angelo goes in for MCL/ACL surgery tomorrow from a "Tree" incident.

Hope EVERYONE heals up before next season :)

[David Glynn]

Yep, this will be my 2nd adventure with prolo. I had it on both SI joints around the beginning of this season... they were weak, most likely from spending too much time sitting in front of the computer, and various muscles were compensating my spasming. The results on the SI joints were fast and positive, I hope it's as effective on the PCL. My doc claims that "as long as there's a few fibers left prolo will stimulate the body to heal the ligament in its entirety, given enough treatments". I'm optimistic. I'm hoping the rehab part won't be too bad either since I have ~90% ROM right now. They are telling me to ride my road bike, work out on the elliptical etc throughout treatment, get back on my snowboard when I feel ready, and not to ski, play basketball, skateboard or anything else that involves knee twisting till it's back to 100%.

Ignorance was bliss - when I thought it was just another bump/bruise I had no metal issues riding through the discomfort. Now that I know what's wrong with it, the thought of the ligament completely tearing is first and foremost in my mind.

My acl tears were 40 and 60%. They healed up fine. My son had an 80% acl tear and he healed up 100% in a few of months. Prolo works.

Hope you are 100% soon.

[Jack M]

Damn! At least you didn't do it back in January like my wife did. She severed her ACL. Yeah, I had never seen anyone do it before, but she was hurt but not in agony, and she actually skied down. Her limp disappeared a few weeks later and she is walking around like normal. Her surgery is next week. I had always thought that when you did your ACL, you couldn't walk until you got it fixed.

[Steph]

Mike - I hope your PCL heals to 100%. I'm interested in hearing more about what prolotherapy is? I tore the meniscus in my left knee a month ago, and am done riding until next season. I'm going for my MRI tomorrow to see how bad the tear is and whether surgery is necessary. The pain is off and on, and my knee locks up sometimes. I can get around on my own, but w/pain.

[skatha]

Damn! At least you didn't do it back in January like my wife did. She severed her ACL. Yeah, I had never seen anyone do it before, but she was hurt but not in agony, and she actually skied down. Her limp disappeared a few weeks later and she is walking around like normal. Her surgery is next week. I had always thought that when you did your ACL, you couldn't walk until you got it fixed.

Up to 25% of knees are ACL deficient-she may have had a "buckling" incident-her knee subluxed-and she may have not had an ACL to start with!

[skatha]

Those of you who were at OES may recall me mentioning my gimpy knee. Well, turns out that I had partially torn my PCL 3 weeks before. I decided after 6 weeks to have it looked at again, "should have healed my now if just muscle damage". Doc agreed and sent me for an MRI and there it was. Thing is my good knee is somewhat loose too, so when he originally checked he compared and it didn't seem much looser than the good one.

I've seen 3 folks tear ACLs playing sports, and they were in agony. Not so with PCLs... if you've got good quad strength you can tear one (and don't tear anything else) and it'll be a bit sore but you might not think anything is seriously wrong. It sure fooled me and it fooled my doc the first time around too. If you sustain a blow to the tibial plateau while you knee is bent, keep this in the back of your mind. Especially if you've got good leg strength... it's obviously not that hard for the symptoms to be masked.

Thankfully I don't need surgery - I will do a few prolotherapy treatments to encourage it to finish healing properly. I am sure I didn't do myself any favors by riding and running on it, so fingers are crossed that it does indeed heal properly.

I usually do not recommend braces for knees, but braces are important for protecting previously injured PCLs. I'd recommend a brace for use with riding in the future. Ask your orthopod about a good company that can make you one. As for athletes coming back from a PCL tear, look to Randall Cunningham, former QB for the Eagles.

Sorry about your injury!

[Mike T]

I usually do not recommend braces for knees, but braces are important for protecting previously injured PCLs. I'd recommend a brace for use with riding in the future. Ask your orthopod about a good company that can make you one. As for athletes coming back from a PCL tear, look to Randall Cunningham, former QB for the Eagles.

Sorry about your injury!

Is there something special about PCLs that gives them a tendency toward reinjury?

[Mike T]

Mike - I hope your PCL heals to 100%. I'm interested in hearing more about what prolotherapy is? I tore the meniscus in my left knee a month ago, and am done riding until next season. I'm going for my MRI tomorrow to see how bad the tear is and whether surgery is necessary. The pain is off and on, and my knee locks up sometimes. I can get around on my own, but w/pain.

Thanks Steph! This article is from my doc's website. It's probably as good a launching point as any to research prolotherapy. This site may be helpful for locating a practitioner.

[Mike T]

First prolo treatment was this morning. My knee feels like a balloon. Hoping for a smooth recovery. Two more sessions and then we re-evaluate, if it doesn't respond then I go see a surgeon :(

I am still befuddled by the fact that I was riding on it, pretty hard, while it was torn, and it just didn't seem all that bad. At least my wife has stopped calling me a hypochondriac!

[nigelc]

Funny i rode on mine every day for a week after the injury. It was good while riding but other more mundane stuff like going down stairs was very painfull.

A good friend of mine is a good orthopedic surgeon catering mostly for knee injuries here in NZ. Due to the rugby culture there is a limitless supply of customers for a knee surgeon. His advice to me is that the outcomes for PCL reconstruction are no better than I have now - a grade 2 (100%) rupture and that there is a 90% chance of undergoing a painful oeration for no gain. He has told me to get on my road bike and start pedaling to build up the muscles holding my knee together. Luckily my quads are reasonably good from carving!

The captain of the NZ rugby team - the All Blacks - sustained exactly the same injury before the world cup in australia in 2003. he was declared fit to play international rugby again four weeks later and he is still playing, though in semi retirement.

[Mike T]

Funny i rode on mine every day for a week after the injury. It was good while riding but other more mundane stuff like going down stairs was very painfull.

A good friend of mine is a good orthopedic surgeon catering mostly for knee injuries here in NZ. Due to the rugby culture there is a limitless supply of customers for a knee surgeon. His advice to me is that the outcomes for PCL reconstruction are no better than I have now - a grade 2 (100%) rupture and that there is a 90% chance of undergoing a painful oeration for no gain. He has told me to get on my road bike and start pedaling to build up the muscles holding my knee together. Luckily my quads are reasonably good from carving!

The captain of the NZ rugby team - the All Blacks - sustained exactly the same injury before the world cup in australia in 2003. he was declared fit to play international rugby again four weeks later and he is still playing, though in semi retirement.

Thanks! My instinct is to avoid surgery at all costs since I was, after all, able to ride decently on it. I road bike quite a bit and in fact and supposed to go do that as soon as the swelling from Prolo Round 1 is down. I am still going to at least talk to the surgeon IF there is no progress after 3 prolo treatments. I suspect there will be much progress, as my SI joints repsonded to prolo really well.

[boarderboy]

I usually do not recommend braces for knees, but braces are important for protecting previously injured PCLs.

for sticking around, Skatha, even though you (can) no longer board.

Your advice on incidents like this is mucho valuable and much appreciated.

And those DarkSide cookies are the shiz ... !

BB

[Mike T]

Now *this* feels like a sprained knee. If it had felt like this after I did it, I might not have missed the fact that I had sprained it.

I think I used too much arnica, it just didn't swell up enough to hurt, and this may also explain why it hasn't healed better.

[wallstrum]

mike - it sucks to have to do this, but welcome to the exclusive "torn pcl club". when i asked my ortho about it, he said he sees ~10 acl injuries per week, and only ~1 per year on average. i completely severed mine playing soccer 2.5 years ago when i had a freak "off-balance, landed on my shins and hit my tibial crest on the ground" exercise. i knew *immediately* that something was wrong, but wanted to make sure the swelling had gone down enough before i went to the doc to see what had happened. i was, with the help of hiking sticks that i would not normally need, able to go backpacking a week later, and spent several weekends hiking into remote creeks to go fall-flyfishing ; ) by the time i saw my doc, he did the drawer tests and said that my knee *measured* fine, but considering the story of how it happened and the symptoms of needing hikign sticks to traverse any sort of incline, he still wanted me to get an mri. results came back that i had *no* pcl left. i've heard 2 schools of thought on this: 1 - surgery is absolutely necessary to continue playing sports like i do, or 2 - you don't really need a pcl, just rehab it and you'll be fine. well, my doc has a huge reputation in the reno area as being the top knee surgeon, and surgery was what he recommended. i opted for the cadaver tendon as the basis for my pcl to grow back, and i have to say that it was a good decision - at about 1.5 years post-op, i was back up at 100% of where i was when i tore it originally. now 2.5 years later, i have *no* issues related to it, and i am playing soccer 5 days a week and boarding when i can on the weekends... good luck with it, i hope everything turns out as well as it did for me. if you have any questions about it, feel free to let me know.

wally

p.s. i found the info here *extremely* informative and helpful: http://www.stoneclinic.com/posteriorcruciateligamentinfo