Anterior Cruciate Ligament does provide stabilization to the relatively loose knee joint (compared to a ball and socket such as hip joint.) They happen to be in a good location to get snipped in a loose knee that is twisting. Worse is stretching the Lateral and Medial Ligaments as well, so if you already have a less stable knee, the last thing you want to do is make it worse by harassing the remaining ligaments. The bad news is yes, they do not heal as a laceration or muscle tear. It will never be brand new again. And be good to it because it will really bite you in another 10 years or so. The good news is people can get by pretty well without one. Accept the limitations and find solutions to work around them.
Disclaimer: Im not a licensed physician, do nothing I mention here, because I can not practice medicine. And, very important, no foul if you bag the day and reschedule.
However, I have several observations I can mention in passing relating to my personal experience. Im one of the least experienced divers out there but I have managed to do other things and these may help.
History: National ranked amateur and professional athlete with 4 ACL reconstructions and 15 years working in Ortho: Sports, Trauma and Total Joint Reconstruction. Or, how I continued to do what I wanted given the situation. In water related situations:
One knee is relatively unstable and I managed to lock it (excruciating pain with the slightest movement) the first time I was getting into an outrigger canoe while changing boat in fairly heavy seas no less. I was pleasantly surprised to unlock it in the water (let alone get that knee unhooked from the side) without drowning (no fins, mask or snorkel and Im no water baby) since previously a solid surface was necessary and did 2 more change boats as well, knowing what not to do.
3 days later in a Masters class long distance race, I managed to spasm my back carrying the 6th Koa canoe into the water. I debated bailing out but there wasnt an extra in that class on our team and I had only seconds to decide. I went for it (pain is for wimps) and was seriously wondering if I would never walk again before we got to the turn around about 8 miles out. In a sprint from the final turn into the finish line we beat the elite young pup crew of our club by a nose and won our class. I doubt I was responsible and only hoped I didnt hinder too much.
Each time I avoided further insult to injury by for one thing, not carrying the boats back out LOL. I also followed my own advice of aggressive treatment. And continued the remainder of the racing season even though I was moved into steersman position that allowed absolutely no opportunity to take it easy.
Short term aggressive actions:
Elevate that sucker above your heart every opportunity, I mean EVERY opportunity. For less than a minute before you have to stand up again? YES and keep doing it until it doesnt swell any more. Swelling causes pain and reduction of motion, be very aggressive about getting and keeping the swelling down.
If your stomach can handle it, you can take up to 2400mg of Ibuprofen in a 24 hour period. Do not, under any circumstances, push that limit. Take it with complex carbohydrates, avoid dairy and flush with a lot of H20. If stomach complains, Ranitidine may make it tolerable. (Generic names, many OTC products, look for the ingredients.) Topical and oral Arnica may help with pain (not the cause). Dont use narcotic or similar pain meds. They mask the pain (symptom) and most likely will result in much further insult vs anti-inflammatories that are directed to the source of the problem. Plus I suspect narcotics are a big no no regarding diving.
After inactivity like sleeping or lying on the couch with it up above your heart, warm it up. Loosen the joint gently by flexing within low pain range working up to a reasonable range of motion. A low heat pack would be good if youre going to be on it a while.
Avoid locking the knee straight, especially when sleeping, make a pillow platform, and get it above your heart. Let someone else drive while you sit in the back with it up. Avoid leaving it in one place like sitting in a theater, keep it warm if not lying down (Rest).
After being up and active, slap Ice on it. Always have some in a cooler or freezer, gel packs are great flexible - ace wrap it on. Remember to re-warm the joint again before you are going to be using it.
Get somebody else to do as much of the grunt work as you can. Yes you are being a woosie. Try bribes or just take the taunts like water off a ducks back.
Understand the situation; you have an aggravated injury and want to play, right? If you play, you are further aggravating the injury; so stop what further aggravation you can and save it for the play part.
Think before moving. Any uncertain surface like slippery, uneven or moving; secure the joint as best as you can with the surrounding muscles. Think of them squeezing the joint to hold it in place. Keep your weight centered over the leg, no jumping down onto a boat deck or nimbly maneuvering thru rocks. Move carefully, slowly and deliberately.
Ive really wondered at times if I can safely dive considering how much my knee, among other assorted injuries (if you play hard, youre going to get hurt) is complaining. So far, so good, I move very deliberately on slippery wet Lava, and havent resorted to anyone else lugging my gear yet. A major concession was forking over the $s for fins that in theory provided the most propulsion for the least required force. The much derided Twin Jets have been a huge improvement or reduction in pain and swelling after diving in current and long swims, but then Im already a girl.
Long term:
Ask around and find a good Sports Injury Ortohopod and ask about the options and recommendations. Reconstruction in not necessarily recommended if infrequent incidents.
There are RX meds that work really well, but I lived on Motrin for years. Research Astazanthin, Boswellia serrata, Coleus forskohlii, MSM and DMSO, Ive significantly reduced my potential liver damage Rxs with them.
Ask for surrounding muscle strengthening exercises. I got by (as a professional athlete) an entire year by just attaining ironclad gluts and quads.
If running caused the flare up w/o any twisting, there may be cartridge (Meniscus or cushion) damage (also does not heal). Get an opinion; there are ways to work around that too may need to access what activities are more important. (I never did like to run really anyway, but I do miss biking now that Im 50 and my knee is almost 80.)
