Skiing is one of the top sports at risk for this injury.
In this Q&A, Nadia talks about her ACLR experience:
- How long it takes to get back to sports
- Knee confidence and returning to sports
- How you can feel more confident in returning to sport after an ACLR
As a musculoskeletal physiotherapist, I’ve treated many athletes who have suffered from an anterior cruciate ligament injury (ACL), and had a surgical reconstruction (ACLR). I asked a previous patient of mine, Nadia, to share her experience on recovering from her ACLR and returning to the ski hill.
Nadia returned to downhill skiing and ski touring this season after going through a year of ACLR rehab. At the end phases of rehab, we focused a lot on building confidence and translating the confidence and results from her return to sport testing to how she would feel on the ski hill.
How did you injure your ACL?
Nadia: I was going off a jump while skiing, under rotated and landed in a way that caused my knee to badly twist.
What surgery did you have and when?
Nadia: I had surgery in October 2022 (8 months after initial injury)
What are your main sports?
Nadia: Skiing, biking, running
How long after your ACLR surgery did you return to your sport?
Nadia: Biking long distances outdoors and running 5k was about 6 months, Skiing was 13 months.
In terms of confidence, how did you feel about your knee and your abilty heading back to your sport?
Nadia: I felt confident with biking and running, skiing was mentally more of a struggle due to the injury being caused by skiing. I knew I needed to trust the strength in my knee from all the physio that I was doing, however this is difficult since no amount of jumping can directly simulate skiing.
Did you have certain strategies or thought processes you used during your first times back?
Nadia: I knew I needed to take it really slow skiing the first few times back on the hill. I took lots of breaks and stuck to groomers.
What would you say to someone about to head back to their sport after their ACLR surgery?
Nadia: I would tell them that the reason you got surgery was to be able to do your sport again! It takes a bit of time to get back to where you were pre-injury, but with time the strength will return and so will the confidence.
Listen to your body and recognize fatigue to ensure you do not over do it and rest when necessary. Trust that all the work you did before returning to sport will pay off!
Were there aspects of your training or rehab that helped you feel more able and ready for your sport?
Nadia: I love to have something tangible to recognize strength and ability. All the jumping and strength drills Hannah would test before each appointment was a great way to keep me accountable and help me see areas where I needed improvement. I loved that I received a custom program tailored to exactly what I needed to ensure my knee was the strongest it could be going into ski season.
Add any other comments, advice, or strategies you’d like to share:
Nadia: Hannah is a great physio and coach! She really understands the process of returning to sport from ACL injuries as she has been there herself. This makes it easy for her to relate to all the concerns I had during my recovery. Her programs are backed by research and make you feel like you are really taken care of and getting the highest quality of rehab!
Favorite ski hill:
Nadia: Definitely Lake Louise. There is just so much terrain to choose from!
Favourite run:
Nadia: On a good snow day, I love some laps in the Paradise bowl.
Key takeaways:
Nadia took her rehab into her own hands after completing the initial stages, looking for more advanced training knowing that her goal was to ski around the 12 month mark after her surgery. Flying through her return to sport testing, we had a few dicussions around going back to the sport that where the injury occurred.
When I was returning to soccer for the first time post-op, I felt the same. You read the ACL-RSI questionnaire (assessing psychological readiness) and you think to yourself, “Well, I can do xyz in the gym and on the field, so I am confident in my ability, but I haven’t done THE thing yet, so how can I be 100% ready?”
To tackle this, on the first day back, we made a game plan for Nadia. This was based loosely off this paper, as well as Nadia’s goals.
The keys for returning to sport after ACLR here were to:
- listen to your body, if there was general knee soreness of a 1-2 we were going to be ok with that, but if there was anything that was described more as pain, or sharper, or not residing, then to call it
- have planned breaks and short runs only (groomers) – this will take expectation management and a deliberate choice to not overdo it on the first day (and season) back
- have some warm up movements and stretches to stay warm after getting off the chair lift, dress properly and head inside if you are feeling overly cold
- accept you will not be back to your pre-injury level right away – again, expectation management!!
- acknowledge you may have some knee and full body soreness after the day – don’t plan back to back days for the first few weeks of being back and work with your physio to plan maintenance exercises and workouts around your ski days
Get the ACL Injuries ebook to feel prepared as you navigate your ACL injury.
Have more questions about your own rehab? Book a 1:1 virtual session with me.