This is Part 1 of a series outlining my recovery. There’s an impressive set of information online about how best to recover from an ACL tear, but I wanted to share my own story for a few reasons. There are a few critical resources online that made an outsized difference to me that I’d like to share. I also wanted to actualize the story I wanted to tell when I got to the other side. Finally, for me it was comforting to read the journeys of others going through the same process. I hope you find this helpful and do reach out with any questions you have.
Part 1 - The Injury [this page]
Part 4 - The Early Rehab (weeks 2-7)
On Feb 24, my wife and I headed to Stevens Pass ahead of a powder weekend. I was feeling strong and grateful for the season so far, and convinced myself I was ready to ride the expert level chutes with more experienced friends. My wife wasn’t too excited on the idea but she knew she wouldn’t have been able to stop me. The next day the crew and I started the day out by bootpacking to the top of a ridgeline before dropping in. I was feeling sloppy, quietly wishing I had warmed up but not willing to say that out loud. I couldn’t bootpack my way down now though. I didn’t see the exact line taken by my buddies dropping in one at a time. I nervously peered over the edge and took a deep breath. Someone said “alright, whenever you’re ready…” and I decided to go in aggressively, tips down, with a plan to turn just where the mouth of the chute opened up to a wider gully on the right.
This wasn’t the right move, at least for me. In a short distance I picked up too much speed, catching what felt like a few small inches of air before landing in the backseat. I screamed, feeling a compression in my right knee. I was doubly surprised. How did I hurt myself this badly on what looked like such straightforward terrain? How am I in such pain to have screamed? Through the burning sensation in my knee, I instantly felt ashamed I had let Leah down. She didn’t want me to be here and made that clear. I stood up and felt weak, and decided to sit back down again. My friends, now split above and below me, all waited quietly. Waves of disappointment crashed over me. I was breathing hard. I was still in shock that I could’ve gotten hurt here.
MISTAKE #1: Not warming up for a ski run, not speaking up, not watching carefully for the right line to ski down
I got up and side slipped my way down. At least ski patrol wouldn’t be needed. I then skied a few turns, one side feeling a lot more responsive and stable than the other. I was cursing myself now because this snow was amazing. I could see why they had invited me up here. Everyone was relieved to see me moving my way down despite the pain. I decided to call it a day and skied all the way back down with a friend. I was entirely fine on the groomers. In hindsight, it was the adrenaline that made me strong and dumb. This is where I could have further injured myself.
MISTAKE #2: Skiing aggressively down groomers after a knee injury
Icing the knee
When I got to the cabin at the base, my knee had swollen up and we used an ace wrap for some stability, assuming it was a sprain. I rested on the couch with some ice to cool me down. I took some Aleve and Tylenol, and the thought in my head now was whether I’d be okay to go trekking in Nepal in 6 weeks. Leah and I had been planning this honeymoon for months and I didn’t want to be the reason we missed out.
Leah drove us home. I was quiet for most of the car ride. I was embarrassed, emotionally devastated, and regretful. I had let her down but she wasn’t calling me out on it at least. When we got home, I took the stairs one step at a time, leading with my good foot. I made the critical mistake that night of wearing my ace wrap to bed. My bedtime HR spiked from a normal average of 46 to 57 because I had essentially put a tourniquet on.
MISTAKE #3: Not elevating the knee, sleeping with an ace wrap
That Sunday I was icing whenever I remembered to and decided to cut off the NSAIDs and Tylenol. I did have a mostly normal gait with a bit of a limp, still walking the stairs in our townhouse one step at a time. There were moments when I’d be walking and feel a sudden “slip” of my upper leg over my knee. It was scary, and I didn’t have an excuse for what it could be.
I realized my mistake from the previous night and slept with just my leg elevated on a wedge pillow; no ace wrap. Like magic, the visible swelling and pain was gone the next morning. On Feb 27 during a virtual appointment with my primary care doctor, he suspected a sprain and maybe minor meniscal damage. His recommendation was to use an OTC knee brace and NSAIDs and to come in for a physical exam if it still hurt in two weeks. This would later turn out to be terrible advice because I didn’t have any pain in two weeks even though I had torn my ACL.
MISTAKE #4: My inexperienced doctor not realizing I showed signs of an ACL disruption, which should’ve prompted him to ask me to come in for a physical exam asap.
I began to treat the injury like a sprain, wearing my OTC knee brace around the house, elevating my knee at rest, icing periodically, and using my massage gun. I even had friends come over on Feb 28 and cooked a three course meal which had me on my feet for several hours. Both legs were fairly sore after that.
On Mar 1, five days after the injury, I decided to get on my spin bike with zero resistance. I felt great and was able to get a few brief minutes of movement. I still had random moments of instability when I’d be walking and happen to fully straighten my leg. I still wasn’t sure what to make of this.
I began to notice the quadriceps on my right side were significantly smaller than the left. The muscle felt more like soft cheese when I pinched it. This concerned me, but I still figured there was a possibility I’d be back in shape to skin up and ski down Mt St Helens later in the month with some exercise. My IT band was tender to the touch, and I’d later find out it was my body compensating for the instability post-injury.
MISTAKE #5: I stopped icing my leg as often, given that I didn’t think it was too serious of an injury. I’d later learn the IT band pain I felt would instantly go away as soon as I iced it.
I also noticed I couldn’t sleep on my side without pain in the MCL area. I went down a YouTube rabbit hole and tried every physical test I could to clue into what might be wrong. I wasn’t able to do a Lachman test on myself though. I was confused more than anything. My symptoms didn’t feel very serious, and my resting HR was back to a normal average of 46. On Mar 5, eight days after the injury, I went out for a walk for 2 miles around a museum. My knee felt aggravated even with the brace but it was progress. By March 8, eleven days after, I was able to walk up and down stairs entirely normally.
In the week since my injury, I’d had read a book on shopping for stem cell therapies and PRP, figuring this was the best shot I’d have at accelerating my recovery for Nepal. Again, I figured I had a strain and maybe some light ligament tearing. I still couldn’t explain the dramatic muscle loss though. I scheduled a consultation with an Ortho for March 9th, a full twelve days after injury. This meeting would end up being the turning point for me, and it would dawn on me that I had an ACL tear which would change everything about how I behaved.
I called out the mistakes I made in these two weeks. Here are some of the great things I did. The Amazon links below are affiliate links, which means I get some change if you purchase. Running this site is an expensive hobby.
Skiing down with a friend - I should’ve skied down slowly after the injury, but I didn’t. Still, the one thing I did right was allowing a friend to ski with me. I insisted on going back alone because I didn’t want to separate him from the group. He’s a good guy though and saw right through it. It helped a lot emotionally.
Accident insurance - Beyond having health insurance, my wife also convinced me to get Aetna’s supplemental accident insurance. I’m still not entirely sure how it works, but I get paid cash for any medical ‘treatment’ related to an injury or accident. There isn’t any paperwork to file, beyond telling them to look through my billing statements. I got $200 for the video call with my primary care doctor (and many hundreds more for the eventual MRI, Ortho visit, etc).
Elevated wedge pillow - We coincidentally ended up with this 12 inch wedge pillow just before my injury. It’s quite large and single-purpose, but it is heaps better than stacking random pillows.
Getting ROM - I kept testing for my range of motion every day out of curiousity. Within just a few days I was able to get on a spin bike.
Really good OTC brace - I bought a knee brace within hours of the injury, knowing it would come in handy. I ended up buying one of the more premium ones and I’m so glad I did. Don’t settle for less. You only have two knees.
In Part 2, I’ll share my prehab story: diagnosing the ACL tear, exercising with an injury, and traveling for several weeks internationally. Part 2 - The Prehab