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Climbing without an ACL

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.

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.

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