Lindsey Vonn wiped out in a downhill race on January 30. She bought up limping, then was airlifted from the course. The prognosis: a ruptured ACL — a season-ending injury for many.
But the three-time Olympic medalist introduced on Tuesday she would go on to compete in her fifth Games.
For anybody who’s hobbled off the sector, it’s onerous to not ask: How?
“It is a big deal to tear your ACL,” stated Lindsey Lepley, an affiliate professor of athletic coaching on the University of Michigan. “And doing anything while being ACL-deficient is a big deal.”
Vonn, 41, who is ready to be the oldest Alpine skier to race at a Winter Olympics, has an in depth historical past of knee accidents and surgical procedures, together with two prior ACL accidents. Dr. Martin Roche, a surgeon on the Hospital for Special Surgery, says Vonn’s first injuries date again to the start of her skilled profession within the 2000s.
She’s had issues with each knees, however her left was the “stronger” one, in response to Roche, who performed a partial knee substitute on the Olympian’s proper knee in 2024. After Friday’s crash, her left knee is now injured — a new flip in Vonn’s lengthy damage saga.
What is the ACL and why is it necessary?
The ACL — also referred to as the anterior cruciate ligament — is a ligament that connects the bones of the knee, stabilizing the joint and stopping one bone from sliding in entrance of the opposite.
“The knee is not a joint that is completely stable,” Dr. Anthony Petrosini, an orthopedic surgeon at Hackensack Meridian Health, stated. “The ligaments play a great role in keeping the knee in position.”
Petrosini, who has torn his personal ACL, says the construction is definitely injured as a result of it has a hefty duty in controlling the knee’s rotational stability. It’s probably the most common knee damage, affecting greater than 200,000 folks per yr within the United States.
Weight-bearing and high-speed actions, notably these involving sudden twists and stops, place the best burden on the ACL.
And snowboarding suits that invoice. It’s among the many highest-risk sports activities for ACL accidents. Vonn’s sex and prior accidents additional improve that threat.
When injured, the ACL can be partially torn, also referred to as a tear, or totally separated, known as a rupture. The phrases are often used interchangeably, as Vonn did on Tuesday.
A jolt of ache is felt when the ACL is first injured. Some folks additionally really feel a pop or instability within the knee. Fluid then accumulates within the joint, inflicting swelling and stiffness. The inflammatory response can additionally trigger a locking sensation and decreased vary of movement.
For many, which means hassle standing on the injured knee and continued ache.
The buildings above the knee additionally really feel the ache. Lepley studies how muscular tissues of the higher leg shut down after a knee damage — a course of referred to as muscle inhibition.
“It’s sort of this unique forgetfulness that happens between the brain and the muscle,” Lepley stated.
The damage additionally travels as much as the mind, triggering a concern response. “People are going to have fear of re‑injury,” Lepley defined, noting the psychological element can trigger somebody to vary motion patterns.
That’s why, Lepley says, Vonn was doubtless performing field jumps after the damage. “They’re sort of testing that fear,” Lepley stated, noting the workout routines can additionally assist struggle off muscle inhibition. “If you can’t jump and stabilize yourself on solid ground, that’s a good indication that somebody has too much hesitation.”
In a video posted on Instagram on Thursday, Vonn squats with weights, lunges backward and forward and does quick kicks towards a ball.
Once the ACL is torn, it doesn’t regenerate in the identical method that bone does. “Unfortunately, we’re not like lizards,” Lepley stated.
Most folks endure surgical procedure to reconstruct the ligament, and almost all athletes get the process after the damage, in response to Roche.
While a surgical method doesn’t pace up restoration time, it can stabilize the knee, scale back the chance of additional damage and permit for return to high-demanding actions like snowboarding. Some information suggests surgical procedure can additionally scale back the chance of osteoarthritis — a widespread long-term concern after ACL damage — although the proof is conflicting.
Regardless of whether or not somebody has surgical procedure, months of rehab are commonplace. Those who don’t go for surgical procedure stick with ache management and rehab, studying to dwell with out a functioning ACL.
Vonn said on Tuesday that surgical procedure “hasn’t been discussed.”
“It’s not really on my radar screen right now. The Olympics are the only thing that I’m thinking about,” she stated. “We’re doing everything to make sure I am making smart and safe decisions.”
Yes, a few of Vonn’s teammates stated they’ve done it. Other skiers, like Slovakian Veronika Velez-Zuzulová have achieved it, too. And Vonn says she’s achieved it earlier than.
“It’s possible,” Roche stated. But different components of the leg must compensate.
“When that ligament is gone, your muscles have to step up to help stabilize the joint,” Lepley stated.
All the consultants NCS spoke with emphasised that a right away return to competitors is much from the norm — and never really useful. Far more often, athletes do the alternative. Hitting the slopes would expose Vonn to substantial threat of additional damage.
Plus, there was extra to her damage. She additionally reported bone bruising and meniscal harm, each widespread companions to ACL accidents. These extra accidents increase the chance additional, making her return to racing much more harmful. The excellent news, although, is that Vonn didn’t report any vital bone fractures, Roche stated.
Roche, who is aware of Vonn’s medical historical past nicely, says it comes all the way down to the athlete.
“She knows her body better than anyone,” Roche stated. “She’ll be able to determine if she can overcome any injury to her knee quickly or if it’s going to set her back.”
Training runs are scheduled for Friday and Saturday, and Vonn is ready to begin racing on Sunday.
“I don’t think she’s going to be able to perform at 100%,” Lepley stated. “But I think she’s going to be able to make the best of a bad situation.”
Parts of the course that put extra stress on one knee might be particularly dangerous. Lepley says the Olympian would possibly lack symmetry as she compensates.
The largest concern is Vonn’s meniscus, which acts as a shock absorber and helps the knee transfer easily. Without a functioning ACL, the construction is extra susceptible and, if injured, it’s notoriously difficult to heal.
At the end line, three issues will matter most, Lepley says: a medical examination to verify for any extra harm, shut monitoring of ache and swelling and a renewed give attention to restoring regular movement and strolling. And if her knees are on her aspect, a medal.
“She’s in good hands,” Petrosini stated. “To be able to pull off what she’s attempting is really remarkable.”