# ACL (Knee Injury) Tear anyone.



## liltommy (Aug 9, 2004)

Hi all,
I tore the ACL in my knee back in February and will probly have surgery sometime in April. Has anyone else done this and had the repair done. I'm wondering how long before you got back on the bike. I'm looking for experiences. I found "Bobs" Acl board but am curious as to how this type of thing effects mtb'rs. 

Tommy


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## connie (Mar 16, 2004)

I've had the ACL's in both of my knees reconstructed - one 5 years ago and one just last October. You should be back on a stationary bike within a week or two (mind you this initial phase is more for regaining range of motion and such than any sort of exercise, and you'll feel elated just to be able to get your feet around a rotation pain-free). Before long I was spinning/using the elliptical trainer for hours at a time, then gradually adding resistance back in. Doctors recommendations seem to vary pretty wildly on when you can get back to riding a regular bike - I waited about 5 months, but mine was during winter, so I could have back earlier but it wasn't the right season. My doc said I'm well ahead of schedule; I went XC skiing at about 4 months with knee braces and that felt fine, and at 5.5 months I'm back doing regular skiing. Just be cautious - even if you're taking it easy, if you put a foot down wrong early on, you can damage the graft and in a split second be back to square one, so while you can be back on the bike earlier, you really need to be cautious for a while. At 6 months you're generally allowed to go back to farily full sporting activities. I'll be wearing a custom brace for downhilling this summer, but my doc said I should be fine to race in June. 

Rehab hard and you'll be back as strong as ever!


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## crashtoomuch (Nov 7, 2004)

*Tore Both*

Sorry to hear about your knee. The good news is that this is becoming a pretty common repair. It does make a big difference if you tear meniscus along with the ACL - unfortunately for me, I did on both of mine. Left was 14 years ago, right was 3 years ago.

You'll be on a real bike within 4 months, but you may want to keep it on the road and in the saddle. The one thing that I did wrong with mine was to try to keep my fitness during rehab. You will lose some fitness. I got hung up on returning to triathlon and running. Running is much harder on the knees than biking. Your focus needs to be getting the range of motion back, then strength, then a return to fitness.

Bob's acl board is the best acl site on the web.

Good luck.


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## arturo7 (Feb 2, 2005)

It will depend on your doctor and the type of reconstruction. My doc was pretty conservative for this last one. I could ride a roadie after about 4-5 months but he didn't want me on a trail for almost one year.

Good luck with the surgery and the rehab. Regaining range of motion is key.


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## iammlb (Oct 4, 2004)

*Acl*



liltommy said:


> Hi all,
> I tore the ACL in my knee back in February and will probly have surgery sometime in April. Has anyone else done this and had the repair done. I'm wondering how long before you got back on the bike. I'm looking for experiences. I found "Bobs" Acl board but am curious as to how this type of thing effects mtb'rs.
> 
> Tommy


Tommy a few variables you didn't mention . . have you decided what type of repair hamstring & patella tendon are the most common . . . generally speak hamstring is a easier recovery, but patella gives you a more solid knee, at least that the information I git after tearing mine.

I had the patella reconstruction late November and was riding by May

After your surgery start the passive range of motion machine as soon as possible, 24hrs or so after the surgery and start PT as soon as possible, the less scar tissue you let develop the easier and faster your recovery

good luck


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## Mudman (Jan 13, 2004)

I have had 4 knee surgeries. For me, 4-6 months I was back on the road, closer to a year before I could thrash the trails. 

The real kicker is I slipped on a ladder (one rung) and screwed my left knee again. It has been the size of a softball for a month now. they are talking about reconstruction/replacement . That will be awhile out of the saddle. I am only 33


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## imjps (Dec 22, 2003)

*Welcome to the club*

All good advise, plus the web page is great. I had a serious talk w/ my doc. I mean serious. I really stressed to him that I was active and planned to be active for many years to come and that I didn't want anything to come out. That was in '88. My knee lasted until '04, then I went in for some clean up and it still works great.

I was able to ride the trainer, as others have said, after about a week or two.

Oh yeah, I almost forgot. Get him to video tape the surgery for you. It's awesome to watch.

Good luck,

jps


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## simian23 (Aug 13, 2004)

*One thing that hasn't been mentioned...*



liltommy said:


> Hi all,
> I tore the ACL in my knee back in February and will probly have surgery sometime in April. Has anyone else done this and had the repair done. I'm wondering how long before you got back on the bike. I'm looking for experiences. I found "Bobs" Acl board but am curious as to how this type of thing effects mtb'rs.
> 
> Tommy


Shop for a surgeon. Get tons of recommendations from friends, associates, websites. See 5 or 6 surgeons, if not more. Find out how many they have performed, their preferred techniques, recovery methods. Sniff out any personal biases for techniques (they ALL have plusses/minuses, so any surgeon that says one is DEFINITELY better than another is full of crap).

Also get a surgeon that will spend time with you - not just slash and then pass you on to their staff. Choice of surgeon is probably the most important step in reconstruction, followed very closely by a long, slow, patient recovery process.


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## connie (Mar 16, 2004)

simian23 said:


> Shop for a surgeon. Get tons of recommendations from friends, associates, websites. See 5 or 6 surgeons, if not more. Find out how many they have performed, their preferred techniques, recovery methods. Sniff out any personal biases for techniques (they ALL have plusses/minuses, so any surgeon that says one is DEFINITELY better than another is full of crap).
> 
> Also get a surgeon that will spend time with you - not just slash and then pass you on to their staff. Choice of surgeon is probably the most important step in reconstruction, followed very closely by a long, slow, patient recovery process.


Defintely! And don't get suckered into "He's the surgeon for XXXX super athlete" or the local pro something or other team. Good for him. That's nice, but make sure they have the time to focus on YOU as well.

And shop for a good physical therapist too (hopefully your good surgeon who you found will have a few that they recommend). I have friends whose PT visits were 15-30 min visits with minimal attention. Mine were often HOURS of personal attention and if I had a question or problem I could stop in without an appointment and get whatever I needed. There are other PT offices in town that are bigger, have fancier gym equipment and a larger staff... and you're rushed in and out. To me, the unlimited personal attention from qualified, experienced people was really helpful.


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## gcaz (Mar 28, 2005)

connie said:


> Defintely! And don't get suckered into "He's the surgeon for XXXX super athlete" or the local pro something or other team. Good for him. That's nice, but make sure they have the time to focus on YOU as well.
> 
> And shop for a good physical therapist too (hopefully your good surgeon who you found will have a few that they recommend). I have friends whose PT visits were 15-30 min visits with minimal attention. Mine were often HOURS of personal attention and if I had a question or problem I could stop in without an appointment and get whatever I needed. There are other PT offices in town that are bigger, have fancier gym equipment and a larger staff... and you're rushed in and out. To me, the unlimited personal attention from qualified, experienced people was really helpful.


I had my ACL done on the 20th of April (hamstring autograft), almost a month ago exactly. I've been on the trainer since week 2. Supposedly can road bike after 6 weeks.

Because my insurarance sucks I'm paying for my of physical therapy with the best sports-oriented group in town. They are good, but frankly the indoor biking has been the best thing for me so far.

You can pedal a bike as soon as you have about 115-degrees of flexion. Man, the first time I tried to get the pedals around it was tough! freewheeling backwards is better at first. Then go forward with no resistance (my trainer can lock the resistance freewheel away from the bike tire). If yoiu have the hamstring graft, unclip your pedals by bringing your heel in towards the frame, not outwards. Also, my knee had a lot of crepitus at first as the swelling was causing the patella to mis-track. This is way better now, but my ITB is tight and I'm working on getting all back to top form.

Post or PM me if I can give you any more info.

Oh, and pre-hab like crazy! I got in pretty good shape by biking before the operation, and I'm convinced this helped my quick recovery.


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## liltommy (Aug 9, 2004)

*I'm back.*

Don't ya hate people that start a thread and leave it for dead. Thanks everybody.
In a nutshell.
I had surgery on 4-8-05. Had the hamstring graft.
Therapist had me on stationary bike the first week for range of motion only.
I was doing trainer at home at about 4 weeks.
At 5 weeks 5 days I took my first road ride. This was without asking the doc. I took it upon myself.
Currently six weeks 1 day. I'm going to play it by ear and see how quickly the muscle strength and control comes back before I evan think about any dirt. 
Definately nothing technical.

See yall
Tommy


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## Morfious (May 11, 2005)

You should be fine. The worst thing you could do is fall and potentially harm you knee again, but that is unlikely on a road bike. Range of motion and the ability to fully extend (straighten) your leg/knee are the most important things. Strength will come after that. Don't worry about hammering out a 40 mile ride on the road bike, just take it easy and enjoy the ride. I have had both my ACL's repaired (autograft Patella tendon) within 8 months of each other. I'm also an orthopedic Physician Assistant so I know a bit about ACL tears and their subsequent surgery. Usu 6 months is a good time to start going back to regular activity / intensity levels. It all depends on how quickly you regain your strength.


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## imjps (Dec 22, 2003)

*Thanks for the update*



liltommy said:


> Don't ya hate people that start a thread and leave it for dead. Thanks everybody.


It's always nice to see a thread get completed. Good luck on the rehab. I found that "listening" to what my body told me what to do and its limits were a vital part of my rehab. Yeah, I too was on the trainer soon after and then riding the roadie very soon after that.

jps


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## gcaz (Mar 28, 2005)

Morfious said:


> You should be fine. The worst thing you could do is fall and potentially harm you knee again, but that is unlikely on a road bike. Range of motion and the ability to fully extend (straighten) your leg/knee are the most important things. Strength will come after that. Don't worry about hammering out a 40 mile ride on the road bike, just take it easy and enjoy the ride. I have had both my ACL's repaired (autograft Patella tendon) within 8 months of each other. I'm also an orthopedic Physician Assistant so I know a bit about ACL tears and their subsequent surgery. Usu 6 months is a good time to start going back to regular activity / intensity levels. It all depends on how quickly you regain your strength.


At 4 weeks out I'm still working on extension. I think I'm somewhere between 3 - 0, and my other knee gets to like -3.

Any advice on getting that last bit of extension? I'm trying the coffee table prop, hanging the leg off the bed while laying on my stomach, and pushing gently down on the knee to get it to 0.

Can't wait to get outside again!


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## Morfious (May 11, 2005)

gcaz said:


> At 4 weeks out I'm still working on extension. I think I'm somewhere between 3 - 0, and my other knee gets to like -3.
> 
> Any advice on getting that last bit of extension? I'm trying the coffee table prop, hanging the leg off the bed while laying on my stomach, and pushing gently down on the knee to get it to 0.
> 
> Can't wait to get outside again!


The best exercise for me was the painful wall climb thing. Lay with your back on the floor, your butt 6-8" away from the wall, and your feet resting on the wall. Put your foot on the wall and slowly slide your foot down the wall till it hurst too damn much or until you can't lower it anymore. Hold for 5 seconds and straighten as much as possible (trying to lock out your knee). Repeat 20x. Do this 2-3x a day. It hurts like hell in the beginning, but range of motion will come from it. Do NOT walk arround on a bent knee, make a conscious effort to straighten your knee out as much as possible when you walk. Also don't worry about trying to force your knee into hyperextension (-3) Depending on how tight your surgeon made the graft you may never be able to get your knee that straight (hyperextended).

My other suggestion is to take a towel and roll it up. While you are watching TV lying on the couch, put the towel under your heel. This raises your leg slightly and allows gravity to pull your knee straight. That plus teh wall thing whould help you get on your way. But follow the advise of your physicla therapist, they should not lead you wrong. My suggestions come from my persnal expierence and what we tell patients. YMMV and your doctors know your case better than I. Good luck and quick recovery.


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## sundevil98 (Jun 11, 2004)

I tore my ACL last April. I thought it was just a sprain (it didn't hurt at all), and gave it four weeks for the sweeling to go down. I was playing softball after that, and ended up tearing my meniscus (both sides) as well. At least, that's what the doctor thinks happened from the way I described things... I didn't realize my ACL was even torn until I had the second injury and went in to see the doctor.

Anyway, because of scheduling, I didn't get my surgery until September of last year (the doc was very popular and booked up). 

Since I had the meniscus damage, I was on crutches for 4 weeks after the surgery. I started PT right away, but couldn't put any weight on it for the 4 weeks. Had to do some hydrotherapy to build up the strength that I lost while I was on crutches. I was in therapy until the end of the year last year.

I had a real hard time getting things to go straight. My doctor really made the graft (patellar) tight - which isn't really a bad thing from what my therapist told me. It wasn't until a week or two before I quit going to PT that I was able to straighten fully on my own. It's still stiff some days, but it's slowly getting better and better.

I started being a bit more physical around April. I'm playing softball now, but I can't do any sprinting - only moderate running. I'm having problems getting my strength back in my quad because of all the atrophy I had while on crutches. I'm a big guy (6'3", 260) and my fixed leg is still quite a bit smaller than my "good" leg (I used to have tree trunks for both legs, now it's more like a trunk and a thick stick!).

Six months is about the time you'll be able to get back to full activities. But, from what my doc and my therapist said, it'll be a year or so before you're back to 100% (if ever). Two other guys on my softball team had ACL repairs too, and it was two seasons until they were both back to "normal".

Good luck with the rest of your recovery!


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## ProEdgeBiker (Jun 24, 2004)

liltommy said:


> Hi all,
> I tore the ACL in my knee back in February and will probly have surgery sometime in April. Has anyone else done this and had the repair done. I'm wondering how long before you got back on the bike. I'm looking for experiences. I found "Bobs" Acl board but am curious as to how this type of thing effects mtb'rs.
> 
> Tommy


Check it our new product for the knees while you're injured:

http://search.ebay.com/_W0QQsassZproedge_distributionsQQhtZ-1


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