Climbing without an ACL

May

Climbing without an ACL

May 2, 2016

In Articles, Beginner Climber, Climbing Geekery, Indoor Climber, Sport Climber, Trad Climber, Womenclimb Favourites

For my entire climbing life, I have climbed with an ACL injury. The Anterior Cruciate Ligament is one of a pair of cruciate ligaments in the knee, forming a cross shape with the Posterior Cruciate Ligament. It provides crucial stability to the knee, preventing the knee from twisting and rotating. You can find out more in this Youtube video about what the ACL is and what it does.

Background – how I tore my ACL

20 years ago I saved up over many months by waitressing for the princely sum of £1.80 an hour, so I could go on a ski trip. Off I set to France and I hadn’t been there a day when I had an accident; my ski didn’t come off, my knee twisted and I was carted off the mountain in one of these:

Being rescued from the slopes in one of these might seem glamorous, but it’a not! Image courtesy of: http://www.patrolquip.com.au/model-100-rescue-sled/

I had attenuated my ACL. Over the next 20 years, despite having a torn ACL I decided not to have surgery, as the surgeons at the time didn’t feel it would add anything to my life. I carried on doing some sports, like skiing and snowboarding, by using a knee brace.

Hinged Knee Brace similar to one that I used for sports over the last 20 years http://www.physioroom.com

Around 8 years ago (2008 ish) I had another setback. Running across a road to avoid getting run over I tore some cartilage and also completed the rupture of my ACL. If you want to find out more about ACL injury symptoms the NHS has a good page. At this time, I had a day surgery to tidy up the cartilage, but decided to leave the ACL without repairing it, as I had adapted my life by avoiding sports like squash. Then, around 6 years ago I fell in love with the outdoors and started doing sport fairly seriously – hill walking, fell running, road running, a little bit of snowboarding when I had the chance, and, of course, climbing.

Can you climb with a torn ACL?

I have climbed indoors and outdoors since 2011, with a fully ruptured ACL. I have managed to do a lot of activities without my ACL including the following:

Ran a marathon distance
Ran a few 10k races
Summited Ben Nevis, Snowdon, Kilimanjaro, various munros
Lead climbed up to VS
Seconded up to E2
Climbed indoors up to 6c
Skied & snowboarded
Roller skated across the Netherlands

How to do sport or climb without an ACL

The way I have managed to continue doing sports is by keeping my quads and hamstrings strong. The hamstrings and quads help to stabilise the knee and mobilise the knee and hip joints. Precision Nutrition have some interesting information. Obviously you should always seek professional advice related to your specific condition. It was hard for me to maintain good strength permanently, particularly after my knee gave way, as the pain and inflammation made me depend on my other leg for a time, causing a certain level of muscle atrophy. This, in turn, caused further instability. What I would say is that ongoing work for my quads and hamstrings would have helped me continue to have stability.

Adidas Performance Waterproof Jacket Green6 Sports Injury Clinic states: One of the most important aspects of ACL injury rehabilitation is proprioception. Proprioception exercises teach the knee ‘where it is in space’ and facilitate the surrounding muscles to react quickly enough to prevent further injury should be performed progressively throughout the rehabilitation process.

With ACL rupture my knee was very unstable and would occasionally give way. In situations where my knee gave way I tried to pay attention to the PRICE method:

Protect
Rest
Ice
Compression
Elevation

Women are up to six times more likely than men to suffer a knee injury compared to men, so looking in retrospect, the ‘protect’ element is probably the most important (2001 “Journal of Athletic Training” article). In my case I caused further damage to my knee by not protecting it well enough and not keeping up my strength exercises.

One of the things I pay good attention to when climbing is safety – I only climb roped, rarely boulder, as I haven’t felt able to protect my knee well enough bouldering. It’s meant that I have developed as a trad climber rather than a boulderer, which I’m more than happy with!!

I hope this has been useful. I would love to hear other people’s experiences and questions. Please comment below.

I’ll be talking about my recent ACL reconstruction over the next few weeks, so sign up for the newsletter and we’ll let you know when it’s out.

Post Tags:

Climbing Injury

6 Comments

Crissie Constantinou
May 2, 2016 at 6:41 pm

Loved this article… considering life without an ACL seems daunting to say the least.

I completely ruptured my ACL in one go, totally failed an indoor Boulder problem and fell from 15ft onto all fours something popped and that was that.

I think a lot of people (initial consultant included) took a real flippant attitude towards the injury as it was done doing something adventurous (silly).

Totally scared to Boulder again (with or without reconstruction) but this has just made me super keen to get back on the walls!

- Emily Pitts
  May 2, 2016 at 7:34 pm
  
  Hello and thanks for the comment – glad it has helped! I wonder if the consultant would have treated you differently if you were a man playing football? Going forward, take a look back here later in the week – there’s a blog post including the sort of things you could ask your consultant, if you decide to opt for surgery.
  If I were to have my time again I would very clearly explain my lifestyle – that I enjoy lots of sports, and want to know the implications of having or not having surgery. My knee has severe osteoarthritis because of my ACL and cartilage problems. ACL surgery is a big thing to have – 12 months off climbing and a massive commitment in terms of physio (at least 1hr per day, pref 2hrs). It’s an individual choice that only you can make. Try not to allow medical professionals belittle your experience. Being armed with information and the right questions worked well when speaking to my consultant – he knew that I meant business.
  
  Where in the UK are you based?
  
  Emily
  
- Jennifer
  October 21, 2016 at 1:17 am
  
  Thank you so so much Emily!! I stumbled upon this article on an Internet search hoping to read exactly about this. I’ve torn my ACL twice (first time was in 1999 playing soccer and second in 2012 in a big fall skateboarding with a fracture and b/l meniscus tear and cadaveric repair). I’m embarrassed to say it, but I’m nearly 100% sure I re-tore it running through an airport due to new instability issues. I know I don’t want a 3rd repair until I replace the whole thing and I have plans to hike Kilimanjaro in March. I do go to a trainer twice a week so I’m in fairly good shape. I’m glad to hear you did this as well and makes me have more confidence! Any other advice for the climb?
  
  - Emily Pitts
    October 23, 2016 at 1:37 pm
    
    Hello! So pleased that this has provided you some reassurance. It sounds like you’re working hard on your recovery, which is so important, from my experience. I’ve just been reading through my Kili Diary. One thing I would ask is whether you’ve ever had migraine. I suffer from Migraine and I had a really bad one on summit day, but didn’t recognise it as that until weeks after. It made it quite tough. Other things: Drink as much water as you can and don’t be embarrassed about the regularity of your peeing! Eat as much as you can on the days preceding summit day. After the summit I was off my food for about a week and not back to normal for a good few weeks. My overall advice for ACL recovery is get strong and stay strong. I think the staying strong and balanced is the most difficult part of it – keeping on rehab and strengthening when you feel you probably don’t need it.
    
    Any more questions?
    
    Emily x
    
vivek
September 16, 2017 at 4:52 pm

hello, i tore my ACL in 2013 playing football. Apprehensive about going under the knife as it would lay me off from my duties(i am a pilot) for a couple of months which i cannot afford. My knee is stable and i only get pains on the side of the knee sometimes and/or while climbing stairs which according to a doc was patellarfemoral issue. i am a runner and have competed in several marathons after the tear. After the tear i had a cooling off period for about 6months after which i resumed running and have been off other sports completely. Sometimes during the rare days when i feel the pain my friends tell me that i should get my acl reconstructed and that puts a doubt in my mind as to whether i should go for it or not. Is the surgery is necessary? will it hamper me in old age? I am 35yrs now.

- Emily Pitts
  January 23, 2018 at 11:32 am
  
  Hello,
  
  I think this is a very individual thing that you could probably do with discussing with a consultant. I have recently had the ACL repair, because I had significant instability, causing further complications – torn cartilage, which required repair and then advanced osteo-arthritis, which is now painful and limiting to some degree. For example, I find full mountaineering days quite difficult due to a slight limit in mobility and power, but more because of pain.
  
  When I saw my surgeon, he asked whether the instability in my knee was causing problems. For me, it was. My glutes and other leg muscles weren’t strong, because I was favouring my good leg, which led to all sorts of other problems.
  
  I’m not a professional, so you should always seek professional advice. I wonder whether you could ask for a referral to your local consultant and speak to her/him, about it before making a decision.
  
  If you’d like to chat about any of this, drop me a line hello@womenclimb.co.uk.
  
  Emily

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