Can Lindsey Vonn Win on a Torn ACL?
Can you really ski race on a torn ACL? What damage are you doing?
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I believe you’re asking because of Lindsey Vonn’s return to the slopes last weekend to compete in a World Cup event in Alberta, Canada. In February, Vonn tore her right anterior cruciate and medial collateral ligaments when she crashed during a super-G competition in Austria. She promptly underwent reconstruction surgery and intense rehab, but crashed again in November during training, partially tearing her reconstructed ACL. She placed fifth in the super-G on Dec. 8, just two-and-a-half weeks later.
So clearly, the answer is you can ski on a torn ACL. But for how long? We asked orthopedic surgeon and sports medicine specialist Dr. David Geier, who has not treated Vonn, for the lowdown on ACL injuries.
“The ACL provides front-to-back and rotational stability to the knee,” Geier says. “It’s not that you can’t do activities without an ACL. A road runner or someone who lifts weights could probably do fine without an ACL. But with an unstable knee, anything that involves landing from a jump, or cutting, or pivoting, or changing direction like in skiing, you risk doing further damage.”
That damage includes tearing your meniscus, rubbery discs that cushion your knee, and the articular cartilage, tissue that covers the ends of bones where they come together to help them glide over each other with little friction. Without enough of an ACL, the tibia (your shin bone) can shift out from under the femur (your thigh bone), causing these issues.
If Vonn’s ACL is seriously torn, she’ll need surgery again to fix it. ACL surgery, Geier says, is an outpatient procedure that takes about an hour to an hour and a half. The surgeon harvests part of the patellar tendon, or hamstring tendons, and uses them to make a new ACL.
Recovery from surgery takes between six and 12 months. “It takes time for the tissue to become a new ligament and become strong again,” Geier says. And the outcome can vary greatly. “The numbers are anything between 50 and 90 percent that you’ll be able to return to the same level of sport.”
So if Vonn needs a second surgery, the next few months before the Sochi Olympics begin on Feb. 7 would be a gamble for her. She can’t go through an ACL surgery now and compete in Sochi—“there’s not enough time,” Geier says. She would have to decide if her knee is stable enough to get through a competition, potentially risking the further damage discussed above, or if she’d undergo a second surgery that would prevent her from competing in Sochi.
“If you tear your ACL, there’s very little chance of getting back to elite sports without the surgery,” Geier says. “Just a brace and trying to treat it without surgery doesn’t typically work for very long. That knee is unstable and very often gives out again.”