Wednesday, September 21, 2011

Jordon Has A Question-Let's Help

My name is Jordan and I guess the best reason I can give for sending this email is I'm looking for advice. Last September to June (2011), I was captain of the UCLA ultimate frisbee team and known as one of the best ultimate frisbee players in the Los Angeles area. I'm not sure if you know much about the sport at all, its somewhat obscure, but it basically requires the same type of athleticism and movements as soccer, football, and basketball. In May 2011, the last and biggest tournament of our season, I suffered a knee injury. Running at full speed I fell and landed flat on the front of my knee/shin. An MRI revealed I had managed to tear my PCL and only my PCL. It is a complete tear. My orthopedic recommended physical therapy and discouraged surgery because he thinks that intense physical therapy will be able to hold my knee in place. The test for a PCL tear, pushing/pulling on the shin forward and back, reveals about a half inch of movement..... I'm now 5 weeks into my physical therapy and that movement has not gone away at all. I'm beginning to wonder if my orthopedic and physical therapist know anything at all about PCL tears, because they're so rare. Right now my exercises are a lot of holding my leg out straight with ankle weights, and light lunges/squats with just my own body weight. I'm just wondering if I'll be able to return to sports after just physical therapy or if my doctor just doesn't know whats going on.


Molly said...

Get a good brace and work it until you really strengthen your quads. I get what your surgeon is saying - you can stablize your PCL with quad strength and a brace. IT WILL NEVER BE THE SAME - even with PCL reconstruction. Soory, but that's the truth in my experience.

Jai said...

I have exactly the same injury picked up 5 weeks ago, snapped straight through my PCL. No other significant damage, same amount of movement in the lateral drawer test, about 1cm. I fell and hit my left knee on the top of a wall and had a mini 'dashboard injury'. My OS (I'm based in the UK) has told me that a large percentage of isolated PCL tears heal themselves, even when completely torn, and has also put me on a PT course to strengthen quads. Like you I'm finding that difficult when no weights are allowed but I'm sticking to the PT course. I'm very sceptical about the long term outlook, it's difficult to find information- nobody seems to know and there are lots of conflicting opinions out there.
Best of luck.

Lillipod said...

Hi Jordon

I'm so sorry about your injury.

I had to make the decision about surgery too over the last few months. I had a lot of conflicting opinions and read a lot of stuff on the internet but, basically, if I wanted to keep up my active sporty lifestyle then surgery was the only option.

After the accident and after a lot of physio, I was managing ok-ish until one day my knee gave way. After that, I couldn't even walk well. I was bumped up the surgery waiting list and had the operation two weeks ago. It's too soon to tell how it's going to work out but, for me, there really was no other option.

I know some people can manage without a pcl, rugby players for example have such strong quads that this compensates. Everyone is different and you have to do what suits you and your lifestyle best.

Good luck with whatever you decide.


susanv85 said...

Hi Jordon,
I also managed to tear my PCL and only my PCL in a skating accident a few years ago. It's a stupid story, and a bit embarassing for me because I had been skating since I was 5, but oh well... these things happen. Anyway, I would say you already have a leg up (heh) on me because my initial injury went undiagnosed. The first OS I saw didn't test my PCL, and things kind of healed up on their own, and I got back to my daily life.

I still ice skated, I went skiing, running, etc. Granted, I didn't do any of these things at an ultra serious level, except for ice skating. I did go back to jumping and spinning and things like that for a while after the injury. About 5 years after the injury though, it started catching up to me, and my knee started giving out on me while I wasn't doing anything, just standing around or taking a walk, it would just collapse on me. So I ended up getting it repaired, I'm about 10 months out now, and my knee feels amazing. I have no more pain, my knee is stable, I'm able to do whatever I want without worrying about my knee.

My advice? A second opinion never hurts, but try to find an OS experienced with PCL tears. They're so uncommon that I almost feel like people say you can do fine without surgery because the surgeries are so uncommon that a lot of docs aren't comfortable doing them, so they don't push it like they do the ACL repairs. And if you think rehab now is bad, it's nothing like the slow and agonizing and painful and boring rehab after surgery.

KJ said...

Oh Jordan, so sorry to hear about your injury!

I tore my PCL when I took an awkward straight-on tackle during rugby. It was a partial tear and I went for 6 years with it, tearing it completely at some point along the way. I had an 11m drop which is about the same as yours.

I had very strong legs from a lifetime of sports, gynastics & dance so I agree that you can go without the PCL with strong quads. I played high-level rugby 3 years after the original injury and didn't have issues initially. But like Susan, my injury caught up with me.

The lack of a PCL caused chondromalicia so now I'm dealing with patellofemoral syndrome. It's not fun and I wish I'd had surgery MUCH sooner.

My surgery itself went very well. My surgical knee is "tighter" than my non-surgical knee. I don't need a brace and my knee is completely stable. I now coach rugby but I've joined a rowing club and just got into CrossFit recently so I'm still very active. Molly is right though, it will NEVER be the same but I think I'd have much less damage in my knee had I had surgery sooner.

Follow Susan's advice, get a 2nd opinion...and maybe a 3rd! I got 3 opinions and I'm so glad I did because I ended up with a top ortho in the country after my 2nd ortho referred me to him.

If there's no one in your area don't be afraid to find a surgeon elsewhere. Insurance does cover it if certain criteria are fulfilled. I only had to travel an hour to Cincinnati but there was a gal who came from Seattle for her PCL surgery!

You are right that there's very little information out there about PCLs. That's why this blog is so wonderful!

KJ said...

A side note for regular readers: The synvisc injection I had ended up lasting for 2 months. I was really hoping I'd get more out of it.

My cost was $800. It honestly made my knee feel so good that even with the cost I'm considering getting another one at the beginning of next year! It was so awesome to have relief for even just a couple months. Too bad I'm not rich ;)

Eli Weber said...

My roommate and I are both ultimate players as well (Colorado), and we both had isolated pcl tears from laying out. He tore his a year and a half ago and after a few months of pt, the pain was intolerable and he had surgery. Now, he is hiking again and is not limited in what he wants to do, but has quit ultimate, swearing it is a masochistic, self destructive sport. He is trying to keep himself healthy to preserve what he has left.

I tore my pcl in november and am going through pt right now. I haven't started playing ultimate yet, and I'm not sure I will. I'm tempted to get surgery to keep my knee tight and keep it from getting arthritis. I've already had acl reconstruction, which went by very quickly and with good results. The pcl knee doesn't feel normal at all, even though I can run on it and bike. Still waiting on a custom brace, so maybe that'll help. Thought I'd share from two ultimate players to another.

ALYM said...

Jordan ~
So sorry to hear about your frustration surrounding your injury! I experienced a very similar situation with my docs and my PCL Tear. My PCL tore while I was training in Taekwondo. I was sparring my Master Instructor, our knees clashed right under my knee cap, and I found that after the pain and swelling had gone down...that my PCL was torn clean through.
The laxity in my knee is also quite a bit. My General Doc initially misdagnosed my injury and told me hot/cold compacts for a few weeks will get me as good as new.
Then I went to my husband's Ortho doc, who prescribed aggressive PT to strengten my quad muscles, but DID say that my PCL would not heal on its own. He confirmed my injury with MRI images, it was very obvious that my PCL was damaged.
After several months of PT, I have pursued a 2nd and 3rd oipinion because my knee is NOT stable and the laxity has gotten worse. I have not been able to train for months which has been frustrating in itself. I reccommend getting as many opinions as you can until you meet with a doc that can give you the level of treatment that will allow you to return to the lifestyle that you want to maintain.
I found a doc after 3 docs who says that he will be able to fix my PCL. It is ProActive move since a torn PCL makes the knee in general more suceptible to early stages of types of arthritis that might be avoidable with surgery and proper post-op therapy.
The deal breaker usually is the rehab - 8 weeks in an immobilizer brace and 8 months of intense PT. If you can take the time and if your life allows you to complete this kind of post-op regimine, then perhaps PCL repair surgery is for you.
There ARE docs out there who can help you - good luck in finding one that will work with you and give you back your life!! :)

Ryan C said...

these are all great comments to read, everyone. Sorry about your injury Jordan...and everyone, for that matter . I'm about 3 weeks into an injury, just had my MRI yesterday, and am going back to the doc next week to see how bad the PCL tear is. I'm already thinking that I should find another doc for a second opinion regardless of what this one says, and I'm already leaning towards surgery if I expect to be able to do the things I want to do. since I'm just starting out, maybe I'll start my own blog on this whole journey?

arnuschky said...

Hey y'all,

any new on Jordon or the other Ultimate players on this site with a PCL tear? I tore mine and I would really really really like to get back to playing. Did anyone continue playing with a fully torn PCL for a while? I tried but it's really a no-go, so I was wondering if this is it or if things get better.