# ACL surgery or not



## czechgurl (Jul 28, 2008)

I tore my ACL and MCL at the end of summer. I have not been on the bike since. I am on the trainer every day though. MCL is almost healed.

I am MTBer and I race mainly ultra endurance NUE series. My question is do I really need ACL? I was told by doctor that I am a bit old fir the surgery. I am 39 and since I do not play hockey, soccer, basketball I should consider not having surgery. 

I want to know if anyone is riding hard single track without ACL? And what are your experiences with ACL surgery and recovery.

Thank you for your help


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## edubfromktown (Sep 7, 2010)

I shredded my ACL and strained my MCL 10 years ago (in my late 30's- doc never said nuttin about approaching "too old" for the surgery!). 

A lot depends on what level of activity you are involved in other than cycling and the configuration of your supporting leg muscles (which is not all the same for everyone). I've seen people with a blown ACL go back and play soccer and other sports with cutting / pivoting like tennis and have no issues. There was enough looseness in my knee after a couple of months strengthening post injury that I opted for the surgery. I had the 1/3rd of my patellar tendon installed as a new ACL and glad I did it.

Rehab was not fun- I regained full flexibility though... no pain no gain


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## ferros (Nov 8, 2010)

I tore the remainder of my acl mountain biking July 2013. First injury was snowboarding 15 years ago. I decided to go ahead with the surgery in October. The doc had me wait until the knee was not swollen to access the extent of my damage. I had completely torn my acl and also ripped my meniscus which I think is the more painful part of my injury . He said that I could go without the surgery but that I would most likely need a brace for certain sports. My main concern was having my knee give out while playing with my kids or something like that. By the time October came I was already doing some light trail ridding on the injured knee. 
I opted for a cadaver graft instead of harvesting from some other tendon. It's been a year now and am still not where I was when I injured myself. I am able to ride everything I was before but I am not as strong and am still missing a little bit a flexibility. I think a lot of that is dependent on how much time you can put into rehab and exercise. Having young kids has made recovery a bit slower as I do not have the extra time to train. 
Good luck either way!


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## czechgurl (Jul 28, 2008)

Thanks for your help. I decided go for the surgery. Wait time is 3-6 months. I hope to get it done soon. My MCL is almost healed now but I do not have back my flexibility. I think the problem is the meniscus at this point. And you are right, it hurts more than ACL and costs more grieve. My legs are strong so I do not feel instability bit I am active and I do not want wear brace for other sports. And i want to trust my knee.


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## nauc (Sep 9, 2009)

i would. i tore mine and didnt use a cadaver. he used part of the ligament going from my knee cap

it turned out fine but i make sure i lift weights to keep it all solid. i was given a $1000 Bledsoe knee brace but i dont even have it anymore, dont need it


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## zgroove (Feb 10, 2009)

I have posted this opinion on other forums regarding ACL surgery and i speak from experience. Get the surgery, technology is good and since you are a rider and have strong legs, you will be riding in 3-5 months easy. Definitely throw in some aquatic resistance swimming pool running to your physical therapy, as well as focusing on doing what the doctor says religiously and putting your recovery in front of everything you do until you see your performance come back. Keep your weight down and get through the first month which is the toughest mentally. I had a great support group of riders that pushed me along the way and I can't say enough on how that helps. Feel free to PM me if you need someone to slap you in the face after the surgery to get you motivated! 

Ride on rider!!


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## ferros (Nov 8, 2010)

Some other things I forgot to mention that helped me. If you can start PT before you have surgery. Keep up with exercise before the surgery. Strong legs will help. I was able to walk without crutches or a knee brace immediately after surgery thanks to my leg strength. 
I had several milestones that helped me through the process the first was when my PT let me use the spin bike. The second was when I was able to ride paved roads and then fire roads. 
The Difficulty for me was not overdoing it. I ramped my pace jogging because lungs felt good and legs felt ok. Went from 11 min miles down to 9. I was very sore for weeks after that so much so that I had to take the elevator at work instead of stairs. I think this has more to do with the meniscus injury though.


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## thatguyat99 (May 20, 2014)

I too suggest the surgery. A buddy of mine tore his ACL playing soccer over 10 years ago. He opted to not have surgery because he could not afford to take the time off of work. (He works as a guide so he has to be able to hike and climb to make money). 
He regrets it though. He no longer plays soccer or basketball because of the fact his knee will randomly buckle when he makes a cut. He is not able to climb as hard as he used to. He even has issues from time to time when just hiking. 
He rides and as far as I know he doesn't have any issues with riding. I know he misses team sports big time though. He loved playing soccer and was very good at it too. So maybe not so much of an issue with cycling but like someone posted earlier, the other activities you partake in might suffer. 
Get the surgery. You're still youngish...


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## mtb_brew (Oct 7, 2014)

i suggest the surgery. You can run and ride your bike perfectly fine but once you plant sideways, forget it... it takes you down. I tore my ACL and both meniscus playing indoor soccer when i was 24. Opt'ed out of the surgery, lived with it for 1.5 yrs with occasional pain. Rainy days sucked because if your foot slipped you are quickly reminded how bad your knee truly is. It feels like you are dislocating your knee with sharp pain and swelling.
I had the knee surgery where they took a piece from my hamstring. Little longer recovery but stronger and almost guarantee that your body won't reject it as a foreign object as it came from my own body.
Now i can play any sport and do whatever i please with no pain whatsoever. Recovery sucks but as long as you work hard at physical therapy its the way to go.


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## someoldfart (Mar 14, 2013)

I had my left ACL repaired in 99. I was 42. Had the right ACL repaired in 2000. Tore them alpine skiing and the knee surgeon told me I needed them repaired because he knows how I ski. I think with no ACL the knee can be unstable and lead to problems. My left is now a bit loose so I need a brace to alpine ski. It has just started to clunk a lot this summer and it feels a little stiff at times but no significant pain. Riding is good rehab though.

My sister in law had her meniscus removed when she was young because that's what was done then. Plus a torn ACL in each knee neither repaired and she has significant issues now at 52. She wears unstable silky shoes too which are generally stupid but more so in her case with wonky knees. 

Good ode to see you are getting the surgery. There are risks of course with any surgery and rehab hurts but I think it's a good idea.


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## mastakilla (Sep 3, 2005)

czechgurl said:


> I tore my ACL and MCL at the end of summer. I have not been on the bike since. I am on the trainer every day though. MCL is almost healed.
> 
> I am MTBer and I race mainly ultra endurance NUE series. My question is do I really need ACL? I was told by doctor that I am a bit old fir the surgery. I am 39 and since I do not play hockey, soccer, basketball I should consider not having surgery.
> 
> ...


I would probably not do it. If you do, go to a high end sports med doc and get a "double bundle" (google it) done. Otherwise the risk of getting arthritis from acl reconstruction is too high.


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## czechgurl (Jul 28, 2008)

Thanks guys for all your suggestions,

I decided to go for surgery. Problem is wait time is around 6 months here. My MCL is almost heal I still can not fully flex my leg. And I want to ride outside. 

MY issue is how much i can push my knee. Now is fall so I am on my trainer any way every day now. I just do not know how much I can push it with watts. 

I know that i have long way to go, I work on my strength and flexibility a lot. That way the post surgery recovery will be easier.


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## aerius (Nov 20, 2010)

Riding without an ACL isn't bad at all, one of my friends has been doing it for around 10 years. The problem is what happens when you take an unexpected fall on your bad leg, it's very hard to train out the instinct of trying to stop a fall by putting a foot down, and putting your bad leg down to stop a fall is bad news if you're missing the ACL. It's quite easy for your leg to get bent the wrong way since it's lacking stability, if you're lucky you get away with a sprain that puts you off the bike for a few days to a week, if you're not so lucky the rest of your knee gets wrecked.

Other issues are hike-a-bike sections on slippery or uneven terrain, especially with XC style shoes which kinda suck for walking. You won't have the same balance with a missing ACL and once again, if you slip the wrong way it's bad news. And pedal strikes on rocks or other obstacles. I had a meniscus and partial ACL tear about 5 years ago, if you're unlucky enough to whack a rock when the pedal is near the bottom it'll hurt like you wouldn't believe. It felt like someone had taken a hammer to my entire leg.

So yeah, definitely get the surgery if you can. As for training in the meantime, you can go as hard as you want until you feel pain or discomfort, just try to pay attention to your form and make sure you're not doing anything unusual to try and compensate for your bad knee. This shouldn't be a problem since you're using a trainer.


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