How I Skipped ACL Surgery
(pretty easy to do with no health insurance)
by Jeffrey Vyain
Back in Summer 2009, I took a super weird fall on my skateboard while skating in “switch.” Basically I was skating with my opposite foot and trying to ride the board the opposite direction I would normally. At the time, I was riding these super tall top mounts with really loose trucks, and I guess I was just getting ahead of myself and skating way too fast. As a lot of boarders of all types will know, when you’re going your opposite direction and you fall, it’s very awkward. Especially before you have learned how to fall that way. So I fell really awkwardly and hyper extended my knee and ended up with a 50% tear in my ACL tendon. Doctors pretty much guaranteed that I would need surgery eventually if I didn’t go ahead and get it right away. They followed up that with a pretty awesome $25,000 quote for surgery, which was completely unattainable, given the fact that I didn’t have health insurance at the time. But the fact that they said that I didn’t HAVE to get surgery right away was actually quite a blessing. It didn’t feel like one at the time, given the outlook by the doctors. But this way, I could at least take the time to heal the immediate injury to my knee and see how things progressed.
From that initial moment with the doctors and the way-too-expensive-but-necessary MRI and having to face my predicament, my reality left me with only one option, and that was to heal. For the first 2 months, I was basically out of commission. About four weeks of nothing, two weeks of hobbling, and 2 more weeks of starting to just barely move around and feel like I could start considering the strength and flexibility of my knee.
Strength And Flexibility
Those two elements are clearly the keys to physical health over time, whether you’re healing from an injury, counteracting the aging process, or just working out of a more sedentary lifestyle. And all these terms are relative. Injury feels like a weekly thing sometimes (hello kid’s playground, let’s play), age is happening every day (I’m a 35 year old teenager), and sedentary-ness feels different for everyone (standing all day and working on Pantheon at night has had me feeling extra sedentary, but recently I’ve been running my dog around the neighborhood at night and making serious weekend efforts toward being more active, including skating). For whatever reason that you aren’t feeling super mobile but are working toward becoming more mobile, strength and flexibility will be the key to your ability to continue to push without being forced to stop.
My neighbor, Mike, is probably nearing halfway through his 70s. I never feel inclined to ask him, actually, because the number undoubtedly speaks nearly nothing to his ability. He hikes and/or bikes every day with his wife. I see him walking around the neighborhood almost daily. I’ve seen him chop wood, helped him load a Christmas tree into his car, and even saw him riding his bike in the park last weekend right after he climbed a massive hill and before I went the opposite way on my board. He told me at the top of the hill that he was on his way to Denver University (was surely another 15 miles away, if not more). He routinely tells me the reason he can do what he does is because he never stops. He never gets weak because strength never leaves him. And he’s not alone. His wife, Caroline, keeps right up with him!
The Path to Recovery
My personal path to recovery started with walking around a little bit and then really just spending time trying to bend my knee. It was so tight, I couldn’t even bend it 45 degrees at first, and after a week or so of dedicated stretching, which felt as mental as it did physical, I was able to get it to 90 degrees. The key after a good stretch was to wait and see how it felt the next day, and then, assuming I didn’t injure it further, continuing to stretch it so it never had the ability to tighten up. I would create a pillow pile at night to sling my knee over so that it wouldn’t straighten out, because given 15 minutes in a straight position, it would be harder to get it bent again. Keep it moving. Keep the blood flowing.
So after really only a couple weeks of dedicated stretching and moving it and feeling actual muscular improvement to the point where I could walk without my knee crumbling under me, it became clear that I could push it a little bit and as long as I didn’t push it too hard at once, I could continue the path to recovery without significant setbacks. Sure, maybe after a hard day, it might improve less than it did the day before or even start off the day feeling like I had moved backward, but that was just the body telling me where the limits were. Most of the time, I was pushing that limit threshold forward and seeing daily progress. It was at this time that I really wanted to skate.
I took my board out the first day. It was my only board at the time. My big, tall, top mount pumper. I remember it feeling like I was learning how to skate all over again. The distance from the board to the ground was so far that I had to sort of fall from my left balance foot to my right foot on the ground and sort of bound off the tip of my right toes to propel forward to keep my left knee from bending too far and putting too much pressure on it. It was clear my limits were not ready to be pushed on the skateboard, but it was also clear that that particular movement–the one legged squat that happens with your balance leg when you push–was a good one for my knee. I couldn’t quite do it yet like a real push, but that micro motion felt great, raised my spirits, and I could feel my knee getting stronger. Looking back on it now, a lower board would have made a world of difference for me.
Up until this point of pushing a skateboard, I really felt like I was only working my flexibility, but just the slightest hint of strengthening started to propel my recovery forward at an increasing rate. In two weeks I was pushing flat footed and could actually push pretty hard, and I had learned that as my knee started to feel a little bit of pain, I could actually switch feet and push with my right foot as my balance foot and it was working flexibility in my left knee instead of strength. As long as I pushed super easy, I was just shaking my leg out. And I could switch back once it felt good and start working the strength again. Two more weeks of this and I actually was able to travel to a skate event, the Broadway Bomb in New York City, that I had been dreaming about all year. I had wanted to be competitive originally, but after having that dream taken away from me, the concept of skating it even at a super leisurely pace was something I hadn’t even considered to be possible until several days before I actually left to do it.
A Long Road – Don’t Kid Yourself
The recovery happened so slowly at first, and once the flexibility started to come back, skateboarding allowed for a perfect outlet to strengthen my knee and bring it back to life. I’m not going to pretend like it was a quick path to truly being better. I gained so much traction at first, but it actually took me two whole years before I could bend my knee to the point where I could touch my heel to my butt again. It took me over a year before my knee stopped buckling consistently when I would land in a step with my knee straight, and it took me probably three or four years before that never happened again. Skateboarding was there with me the entire time, though, fueling my desire to do more and push it harder and providing an outlet to actually do it.
Two years after my 50% tear in my left ACL, I went on to win $10,000 at the Adrenalina Skateboard Marathon, winning the race. And I would go on to win it again two more times and set a World Record at the distance alongside my friend Paul Kent the next year. Maybe marathon skateboarding is a bit niche, but I don’t want to downplay the effort. I was a 4:10 miler on the track once, and I pushed myself marathon skateboarding one year to the point where my stomach turned so hard I couldn’t eat for two days without puking the food back up. I had never pushed myself that hard running, and I had a good set of accomplishments under my belt in that sport. Long distance skateboarding saved my knee to the point where I could be a world class athlete. And I know for a fact that it’s stronger today than it was the day before I tore my ACL. And no less than 95% as flexible. All without surgery.
The Physiology of Pushing a Skateboard
I could get into this a bit, but I’d sort of be talking out my ass. I’m not a doctor. I understand that my body needs strength and flexibility, and I know that pushing a skateboard, especially with both legs, is a huge part of my regiment for keeping my body properly updated. It keeps my knee strong, of course, but also keeps my core strong, my balance well practiced, and for some reason seems to shake out back problems that I’ve been plagued with since I was a kid. I’m a pretty awesomely imperfect human being.
One thing I definitely do feel through my experience is that the balancing act that you are performing when pushing a skateboard and controlling the deck with one leg–this action does a lot of work for all of the minor muscle groups in your legs that are responsible for your balance and contribute greatly to the stability of your knees and ankles. You feel all of these activated from your ankle to your hips. I believe this to be the major contributor to my recovery, as I was able to work both the major muscle groups in my legs as well as all of the balance muscles all in one activity, and I had the ability to regulate how much I was working them on the fly because I could switch legs at any point and choose to recover, while still going forward! Physical therapists may put you on a mildly inflated half-dome and tell you to hold your balance, but two sessions of PT would likely cost you about as much as a decent low skateboard. I’m not trying to talk anyone out of PT; only emphasizing the value of the skateboard. I push this thing on a good distance skate just about every weekend!
I owe this simple act of pushing a skateboard a great deal of gratitude. So I’m just going to leave you with a picture of me taken last year in 2017, 8 years after I tore half of my left ACL, going full steam down a bike path in Summit County, Colorado. I’m pretty sure I’m going to do this for the rest of my life.