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Coming back from torn ACL?

2486 Views 17 Replies 13 Participants Last post by  MarkEasthill
Have any of you come back from a ACL reconstruction? How did you do it? How long till you were racing again? Any advice.

Tore my ACL this week and having surgery next week. Looking for thoughts and perspective from those who may have had the same. Plus not much to do right now.
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Wow. Right up my alley. I tore my ACL (and shredded the meniscus and damaged the MCL) in 2006, actually playing soccer. I had ACL reconstruction in early June, was off my feet for the first 2 weeks, on crutches for a total of 8 weeks, and maybe 2 months of physical therapy (only because my insurance was up-I probably could have gone for longer). I ended up going back to the gym in early October (?) and started light cycling again in late October/early November.

Be aware that I had done significant damage to my knee and because of the meniscus tear (it actually flipped in on itself and I didn't have full range of motion before the surgery, so I didn't do any pre-surgery therapy), I had a much longer recovery. When I went to the gym, I was still doing range-of-motion exercises. Hopefully, yours isn't as bad as mine was.

After recovery, I didn't enter my first race until August of '07. I was a novice racer and could have entered races earlier, but wanted to take time to make a full recovery. (I'm racing sport now with no knee/leg problems whatsoever).

For me it was a full year, but I could see maybe by August (VERY non-professional opinion). Definitely ask the Orthopedic Surgeon.

And a word of advice for you: Do all of your take-home range-of-motion exercises! And prepare for the fun of range-of-motion therapy. AND BE PATIENT!! It will take time, but it will heal and you'll be ripping again before long.:thumbsup:

Good luck!
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Are you having ACL replacement or repair? A tear doesn't necessarily require replacement, but if it's a replacement, are you getting - patella, hamstring, or cadaver replacement?

The replacement recovery is a slow process. I had the hamstring replacement. (In my case, but I think in most cases -->) many of the nerves, around the knee, were severed in the surgery. You won't be able to flex your quads for awhile, and will have to endure electroshock treatment (it's not that bad, weird, but not that bad) to retrain the muscle nerves. Then you have to fight to get back the range of motion, because of fluid / scar tissue build up. Then you will have to regain balance, and coordination. It takes awhile to get back to 100%. I ?think? I was back on the mountain bike in 6 months, but taking it easy. If I'd had a road bike back then, I probably could have done that sooner.

The good news is - your muscles around the knee are probably in great shape going into surgery, so you'll most likely recover faster. Plus, the biggest part of my PT was spent on a trainer, so you can (sort of) still train. I would go into PT and treat it like a workout, sweat my ass off. The therapist would come over and say, "you know, you don't have to go all-out the whole time.", but I recovered much faster than others, and it's because of the effort I put into getting back.

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Goodl luck with your surgery. The patellar tendon autografts are more popular in my neck of the woods and the results are fantastic as long as a good, progressive protocol is followed to ensure gradual ROM, graft protection and quadriceps facilitation through supervised PT. The biggest thing to keep in mind is to ensure you are able to fully straighten (extend) your knee post operatively as the biggest complication is loss of extension due to adhesions in the groove (intercondylar notch) that the acl graft travels thru. Usually on the bike 2-3 weeks post-op only for range of motion (semi-circular motions) with no real aerobic intensity. Zimmer splint for 1-2 weeks with progression to one crutch or cane by the end of the 2nd week. Of course all of these timelines are dependent on the severity of repair (i.e.|: meniscal repair) and the surgeons specific protocol as they are all a little different. Hope all goes well.
tore my meniscus back in February of last year had surgery and got back on the bike in April. then I had a tibial plateau fracture in early November surgery a week later and i'm still on crutches as of today. :(

leg is totally atrophied i gained twelve pounds and have zero fitness so when i do get back on the bike i'm gonna be starting with a clean slate 2009 was a really messed up year so i'm thinking positive for 2010.
First off - my condolences.

I had an ACL replacement and MCL repair in high school and it sucked. I am sure the procedure has come a long way since then though. I wasn't biking then so I can't speak to that but every case is going to be different anyway.

The most important thing to focus on for recovery is leg strength around the knee and you need all the muscles to be strong so that means lifting weights or some other kind of cross training to engage everything - not just the ones for riding.

Your recovery will depend on your age and fitness, could be as little a few weeks / month.

Biking is a great choice long term compared to say running, but you could have other problems down the road. For example, I am 34 and have arthritis in the bad knee already. basically no cartilage left. Some studies have shown this may stem from earlier traumatic injury, which would fit in my case. But I still bike, road and mtb, as much as I want, it just hurts some times.

Good luck

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Wow. Thanks for the replies. I have been talking to many people and all the stories are so varied. We will see how it goes. According to the MRI meniscus damage is not evident., but can't tell until they are in there.
I have surgery this wednesday, i will be having the patellar tendon autograft. Thanks a lot for the replies. I'll keep you up to date.
Sounds like you will make a fair recovery & being you were so fit prior to the injury, your rehab will go well. If the MRI Doctor's report is as accurate as stated, you'll do great.
About 9 yrs ago, I completely tore my ACL plus had torn flipped meniscus cartelage. Ortho doc removed 75% of the meniscus. Problem is now I got almost zero amount of cushion below the knee cap. Since I decided not to have the reconst surgery on the ACL, i always wear a custom-fit steel-hinged knee brace, except when road riding. But now after quitting freeride, I'm not limping around anymore (from lost meniscus/no cushion) & not hardly ever using cold/heat gel pack! XC Only for me nowdays...
Whatever, Good Luck on your surgery & rehab. RIDE ON!
I'm just finishing the recovery on my 3rd Acl replacement, not fun, but you will probably be set to mtb about 16 weeks post op, depending on your surgeon. Racing this year might be tough, maybe by the late summer/fall. But you should get a good riding summer in.
First off, my condolences on the ACL injury. It's definitely not the end of the world, but it sure can seem like it when you are sitting on the sidelines.

Secondly, as someone else said above, everyone's recovery is different. So all these stories you have to take with a grain of salt. Just listen to your ortho and PT and follow their advice as best you can. Convey to them (as I'm sure you are) your MTB racing goals and they will help you get there.

I tore my ACL in 2004 playing soccer. I had surgery in November 2004 (hamstring graft) and was only on crutches for a week. When I went back to visit my doctor 1 week post-op he yelled at me for still using my crutches. He wanted weight bearing on it pretty quick, which IMO, was great!

My rehab always seemed like 2 steps forward, and 1 step back, but overall it went great and I was actually skiing again (carefully) around 5 months post-op.

About a year and half after post-surgery I hucked a 120 footer on skis (click on my profile and see pic) and my knee held up fine so that when I figured I was 100% healed :D

Road biking was actually my main recovery tool.

I actually look at my ACL reconstruction as a good thing. It got me way more into cycling and changed my lifestyle a bit to a healthier more active one. Weird how these things can change you.

Best of luck.
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Recovery varies by doctor.

At my 1 week check up my doctor yelled at me for only using 1 crutch instead of both of them.
From the reading I did, he was a really conservative Sob.

I had mine in April, at 6 weeks I put myself back on the road bike and easy bike paths.
Nothing hard though.
I think I ended up using the lame brace on the bike for the next 6 months. Not sure if I really needed it but it gave me some confidence.

If you get bored, and I know you will be while recovering.
I blogged my whole experience, I knew there was a reason I did that.

It happened to me in 04 or 05 so you'll have to look back through the archives.

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I haven't had an ACL in my left knee for the last 20+yrs.
Duckman said:
I haven't had an ACL in my left knee for the last 20+yrs.
And you don't have any hyperextension problems or stability issues? My knee was mush when I tore mine.
the bionic knee said:
And you don't have any hyperextension problems or stability issues? My knee was mush when I tore mine.
Sure do. If I tweak it(step in hole, lateral hit, crash on it, etc)'ll soon need draining and a cortisone injection. Been done countless times(its an old MX injury from the 70s. actually destroyed it twice back then. then a 3rd time roadracing superbikes in the mid 80s). My doc says the joint is too deteriorated for any additional repair. I'm 51, and was told to just get it replaced when forced too. The other knee is having issues now since its had to be the strong joint for all these years. As long as I keep my legs strong, it minimizes these issues.
Peter, I had my ACL rebuilt about 18 years ago. It was a very painful recovery since I got the patella graft. Every time I needed to use the quads on that leg the pain was immense, at least for few weeks. I was riding after 3 or 4 weeks and was basically fully active after 3 months. The issue with the ACL repair is weakness for a year or so. If you don't let it heal fully you'll tear it again, and even fully healed you'll have 80 to 90% strength in the 'new' ACL compared to the original. I took it very easy even after the knee felt OK for almost a year after surgery. It took about that time anyways to get full range of motion back. I had shredded most of one of my menisci when I tore th ACL.

There's no question you could race within months of surgery but I'd strongly recommend a brace to protect the healing process, at least for a year or so. Also expect some atrophy on the injured side; my right leg is about an inch smaller that the left measured around the thigh.

more ACL injury info

btw, for MTB riding, I always wear one of my custom fit knee braces which has metal side hinges that provide extra lateral stability. hinges lock at about 170 degrees to prevent hyper-extending. Contact or get your PT to order a high quality one from Benik Braces

after 4+ yrs of freeride, finally had to quit the harsh impact stuff. No more drops & jumps, nor long rough DH rides -- too much pain & limping caused from loss of meniscus cartelage... Luckily I can still do epic XC rides & climbing is not problem - only technical DH & hike-a-bike sections are tough.

Good Luck & RIDE On
Don't know if you've had the surgery yet, but I wanted to give you my experience. Tore my ACL in July 07. Playing indoor soccer. By the way, that devil sport should be banned. Had a 2 week old baby at home and received a job offer the day after the tear. Emotionally it was a very difficult experience.

What no one prepared me for was the pain. I had never broken a bone or had any major surgery. I'm not trying to scare you or anyone, but two weeks after surgery I talked to someone else who said ACL surgery was the most painful surgery they experienced. This actually made me feel better, becuase I was so worried something was wrong.

Use this as an excuse to buy a trainer. I'd say I was on the trainer soon after my surgery. I would leave my shoe clipped into the trainer because I was so worried about unclipping. As many have stated, a stationary bike was part of my PT. Get as much PT as you can. I worked out on my own, but I never did as good of a job as when I was with my therapist (Thanks insurance for deciding I was healed!!!).

I wish I could remember how long it took until I mountain biked again. I was very afraid of crashing and trying to unclip and tearing my knee. I suppose I started when I felt like I was ready. I'm sure my knee was ready before my confidence was. Best of luck with the surgery and to a speedy recovery.

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ACL surgery & trainer

Good post TTU; I totally agree on using the trainer 1st. Altho, I passed on ACL reconst (only had torn/flipped meniscus cartelage removed & trimmed out). After the initial 5 wks of intense PT, I was able to get on my stationary bike & almost turn a complete revolution, tho, took me almost a week to bend the knee enough to do that. Then after a day or so, got outside to begin riding on the sidewalks, USING FLAT PEDALS, non-SPDs. In fact, I still use flat pedals mostly (for MTB).

Go Aggies!
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