Skiers, Take Note: ACL Injuries Are Serious, But Not Career Ending
By Heather Maloney
Beth Israel Deaconess Medical Center staff
If you're like a lot of people, you may be savoring the last few weekends of the winter ski season. Hopefully, you'll come out with only a few bumps and bruises, but if a
knee injury ended your season early, you're not alone.
Knee injuries are the most common type of injury suffered by skiers and snowboarders, accounting for 25 percent to 40 percent of all injuries, according to the
U.S. Department of Health and Human Services. And one of the most common knee injuries is an
anterior cruciate ligament (ACL) sprain or tear.
"ACL tears happen in a variety of sports: football, basketball, soccer," says
Dr. Arun Ramappa, Chief of
Sports Medicine and Shoulder Surgery at Beth Israel Deaconess Medical Center in Boston. "But skiing has an especially high risk of injury to the ACL."
The cruciate ligaments-the anterior cruciate ligament (ACL) and the
posterior cruciate ligament (PCL)-form an "X" inside your knee. Together, these ligaments control your knee's back and forth movement.
Too much stress on these ligaments can cause them to stretch too far-or even snap. Most of the time, injury occurs by changing direction rapidly, stopping suddenly, slowing down while running, or landing incorrectly from a jump. Injury can also occur as a result of direct contact or collision (which is what happened to Tom Brady).
The bad news: the ACL and the PCL cannot be repaired; once they are torn or stretched beyond their limits, the
only treatment is surgical reconstruction.
Luckily, according to Dr Ramappa, the surgery is very successful. "Our surgical techniques have evolved, even over the last few years," he says. The procedure only takes about an hour to do, and
it's all done
arthroscopically
. Most patients will eventually be able to return to their previous level of activity.
"Typically, if you have an ACL injury, you will be able to resume skiing," Dr. Ramappa says. "Bode Miller tore his ACL in 2001 and he's back skiing. For most patients, it's not a problem."
And while surgery may seem drastic for some, Dr. Ramappa recommends having ACL tears reconstructed--wearing a brace won't give you the necessary level of support if you plan to return to the slopes.
"Skiing with a tear is risky," he says. "Even if you're wearing a brace, your knee remains at a high risk for injury if you don't have an ACL."
Recovery time from the surgery is typically about six to nine months. Dr. Ramappa points out, however, that participating in a rehabilitation program is crucial.
"
Rehab is critical," he says. "If you don't do it, you won't have a good outcome. It's as simple as that."
Now, how can you protect yourself from getting injured in the first place? Dr. Ramappa recommends plain old common sense.
"It's not complicated," he says. "Ski in good conditions, ski on trails that are match your skill level, and probably most importantly, if you're tired or fatigued, stop skiing.
Injuries are most likely to happen near the end of the day, so if you're tired, it's better to back off."
Oh, and if you're not Bode Miller, listen up:
"Remember, you need to prepare for ski season, you can't just jump off the couch and go," Dr. Ramappa says. "You need to get in shape and do some strength training so that you're physically ready."
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted March 2010