ACL Reconstruction of the Knee

charliemil

My wife is about to have an ACL reconstruction of her right knee after a skiing accident this year, which has messed up her plans for a bunch of sportives this summer. Any body had a similar op and if so how has their return to cycling been?
With thanks,C

Kudders

I had an ACL reconstruction op in January 2008 after dislocating my knee falling off some north shore.

By June 2008 I was running and cycling pretty comfortably. In September 2008 I did my first 'long' road ride of a 36 mile charity ride. In October I got my first road bike and trained through winter. I did my first sportive yesterday (Essex Roads' Spring Lambs) which was 150km in 5hrs 33mins (including stops of 12 mins).

I still see my physios around at the gym and they are both surprised and impressed with my progress.

Turning to your wife, based on my personal experience I would say she it will be about 6 months before she is ready for sportive distance. Even now I get slight swelling on my operated knee, slightly more than my good knee but still noticeable.

Hope it goes well, was very pleased with progress. If your wife has a while until her op (say couple of weeks) I would suggest train like mad to build muscle bulk as muscle wastage post op is HUGE, seriously, I had one Mr Muscle leg and one normal leg!!! Even now I visibly have a difference in muscle bulk although this is balancing up with time- and I exercise a lot!

Good luck to your wife with the op!

Doom

I didn't have an ACL reconstruction however my rehab protocal has been as though I did. My advice would to not listen to other people's prognosis as the knee is complicated joint and invariably every injury is very personal.

If she was fit before it happened her recovery will be quicker than if she wasn't however her recovery time will be very personal and will depend on lots of factors. Get as good a physio as you can with the perfect scenario being that they are cyclists as well. She should take her time as there will be good days and frustrating days but it gets better.

With a bit of work and consistency she will get back to where she wants to be. Most of all don't focus on the missed rides but focus on getting the knee strong again.

Kudders

I would agree with some of what Doom says but also disagree with some of it.

My surgeon and physios had certain targets/expectations as to level of my recovery over time- these targets appeared to be the same for those I was on group physio with.

The ACL reconstruction is a well trodden path (excuse the pun) and I understand that a certain level of recovery is expected industry wide provided you are strict in terms of complying with the physio's directions and exercise regime. Of course to an extent everyone is individual but I understand that recovery is more predictable than where you choose not to have the reconstruction, as where you don't have the reconstruction you are reliant on your body's ability to adapt to functioning without the ACL.

One thing has occurred to me. I scheduled my surgery for a time which was convenient to me. My surgeon advised that I need not have the ACL reconstruction at all to continue with cycling but because I do other sports we made the decision it would be better for me in the long run. It might be worth your wife speaking to her surgeon about deferring the operation say until the autumn/winter, which would mean she could do the sportives this summer. She may have to restrict her exercise to things that won't put stress on the knee structure (i.e. no skiiing). This certainly would have been an option for me, so it might be worth exploring as an option

Feltup

The first active sport I undertook after my reconstruction (hamstring graft) was cycling. I was told to take it easy and use flat pedals to make sure I didn't torque the knee. That was after about 4 months.

The thing that really helped my recovery was making sure I worked as hard as I could on flexion and extension. It was uncomfortable but has really helped since. I find now that long distance i.e. over 15 miles running can agravate it but so far 85miles with 8000ft of ascent on the bike has been fine apart from tired legs ofcourse!

My skiing is as good as before and tbh I don't even think about the reconstruction when skiing, boarding or kitesurfing.

I hope your wife recovers well and she gets back on the bike quickly.

Road Red

Agree with Kudders on the work beforehand.

I'm sure you will be told to start physio as soon as possible afterwards. The stronger the muscles beforehand the quicker the recovery time.

hobbescp

Depending on age, fitness levels etc you can estimate for a 9 month recovery period post op. It took me a bit longer as I wanted to play rugby again.

The process of recovery is also effected by whether she has the hamstring graft (which is more common this side of the pond) or the patella tendon graft. I understand the latter may cause a considerable amount of pain at the front of the knee (unsuprisingly) and it means that you don't have a shorter hamstring which can effect your athletic performance if you are a sprinter etc.

Apparantly Jerry Rice, the NFL legend, had an ACL recon (patella graft) and returned to play within 4 weeks....! That is a hardcore dude.

Best of luck to your mrs - it's a painful road but the more she gets stuck into the stretching exercises and physio the better she'll do.

Tom Butcher

Both the guys I used to play football with that had ACLs done had them fail when they returned to playing football - one at least was fanatical in his rehab and gave it plenty of time. Anecdotal I know but if I it done I'd be very wary about returning to sports that were high risk for ACL injury unless I was really passionate about them. Both my mates were more or less finished playing football seriously anyway.