ACL reconstruction and technical diving

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broncobowsher

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Any issues with a freshly rebuilt ACL and planned decompression diving? I know the typical answers, talk with your doctor, talk with DAN. I plan to. Until then I'm open to the armchair keyboard crowd.

The background (a little long)...
This past summer I tore out an ACL. Out in the forest, jumped off a rock, too much rotation on landing and folded the knee sideways. Spent a few months trying to live with it. The knee was not stable. Could not take a side load, just getting into a car could cause issues. Jello moments. Gave out when taking a step backwards. Any rotational loads were cause for concern. But walking on flat even groud was no issue. Did no diving as I could not trust the knee to walk on uneven ground (shore dives) nor a rocking dive boat. I was having rough ground issues without any gear on my back. So ACL was done.

Couple weeks ago I got the ACL redone. Starting physical therapy. I'm off the pain meds other than a random Advil from time to time. Crutches are done. Hope to be freed from the knee brace later this week. The last time I did the ACL (I did the same knee 9 years ago, but that time did a patella graft and this time a cadaver graft) it was a month off work and still wasn't fully cured for several more months. This ACL recovery is going a lot smoother than the first one. Got off the pain meds much faster, mobility feels like it is coming back quicker. The motorcycle forums (hint of how I hurt it) telling me that the cadaver graft heals faster as well.

The first time I did the ACL I was barely doing any recreational diving. Really not even on the radar. But in recent years one of those bugs in the water bit and I went down the tech path. Normoxic Trimix with a rEvo. Bikini planned for next summer. Random cold water California diving until then. Add some local lake dives as well.

So with that background, is there anything I need to be worried about outside the normal stuff? I know I am still months away from getting back in the water again. But working on physical therapy in that time. My muscle memory is likely to be garbage, working on a refresher class to make sure I don't miss anything when I get back at it. Equipment wise, that will be a different discussion, to be mixed in with the refresher.

Which leaves me with the question, Any issues with a freshly rebuilt ACL and planned decompression diving?
 
From a mobility standpoint, frog kicking will probably be the last thing to come back for you. It puts weird torque on your knee that you probably won't be able to replicate doing anything else. So breast stroke for rehab?

After I had my ACL done in high school, it took a few months to get back to doing things as normal, and 9 months to go back to skiing, aside from the last few degrees of flexibility in a squat (think sitting on your heels in a squat). That took YEARS, mostly because it wasn't really a normal range of movement. It was still annoying.

The decompression standpoint is probably a bit more complicated. I'm not sure how scar tissue and grafted ligaments affect blood and gas perfusion. I'm sure there is research out there about it, I'm just not aware of it.

Have fun with the rehab!
 
And I wasn't that good with the frog kick before I tore up the knee.
 
I tore my ACL and had an allograft repair in May 2015.

Recovery wasn’t too bad, but I BUSTED ASS at the rehab. However, don’t get tricked by the apparent speed of allograft recovery. You might feel like you are healed but you are not. It takes closer to a year for your body to replace the cadaver structure and regain full proprioception.

I was back in the water doing tech stuff relatively quickly, with a brace initially on boat dives, but quickly got rid of it. I did a long swim cave dive just a few months after surgery and that probably wasn’t the smartest. My knee was very fatigued after that.

I’ve never had any DCS symptoms in my knee since the repair. It’s really been 100%, no range of motion of strength deficits.
 
https://www.shearwater.com/products/swift/

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