Doh! Torn Anterior Cruciate

IvanDobsky

Hi all, thought this might be a good time to de-lurk on here.

Until my piece of less than textbook skiing 2 weeks ago I was a regular commuter (5 and a bit miles).

I've been told my anterior cruciate ligament is completely torn and I should have it rebuilt. Although with a few weeks of physio my knee should apparently be strong enough to run and cycle.

I'm already back on the exercise bike and walking with a slight limp (no pain just stiffness).

Does anyone have any experience of cycling after this injury? Did you use a knee brace?

flicksta

Our kid tore his ACL whilst playing rugby 10+ years ago, he has no issues cycling or skiing without a brace. I know multiple others who have torn ACL's skiing and returned after recuperation.

lost_in_thought

Listen to the experts! They're called 'experts' for a reason!

UndercoverElephant

I have nothing to add. Except, "Ouch, heal well".

thecrofter

Tore my cruciate ligament in a motorbike crash twenty years ago. They spoke about braces and so on at the time, but I've never felt the need for one, even although my knee is a bit loose. Cycling is no bother at all, as all the force through your knee is in one plane, the only things I am a bit wary of are sports that may involve contact or twisting, like football which I used to enjoy but have only ever had kick-abouts since then. I ski-ed a couple of times when I was younger but have never given it a try since my accident as I'm sure any falling over could be potentially disasterous.

thecrofter

lost_in_thought wrote:

Listen to the experts! They're called 'experts' for a reason!

I'm not going to argue with a lady, however, the experts can only generalise. If I had listened to the experts I wouldn't have played any football again, wouldn't be running 10K's and doing 100 mile sportives. Certainly listen to the experts, but also listen to what your own body tells you you are or aren't capable of. And don't rush it, it took me two years to sprint properly again!

Rushie

I had my ACL repaired about 15 years ago. I've lost some flexion but it's much more stable than it was so haven't regretted having it done. I would suggest having it done - short-term pain but long-term gain.

IvanDobsky

thecrofter wrote:

lost_in_thought wrote:

Listen to the experts! They're called 'experts' for a reason!

I'm not going to argue with a lady, however, the experts can only generalise. If I had listened to the experts I wouldn't have played any football again, wouldn't be running 10K's and doing 100 mile sportives. Certainly listen to the experts, but also listen to what your own body tells you you are or aren't capable of. And don't rush it, it took me two years to sprint properly again!

Thanks for the replys. In my case the expert was saying I should have it reconstructed because of being in my early 30s and fairly active. However he also said because my regular activities (cycling/running/swimming) were fairly one-directional, I would probably get on ok without an ACL if I built the muscles up around the knee. A percentage of people go on to have stability issues however.

I haven't ruled out the op but I just wandered what people's experiences were.

jugglingphil

I can't give you any specific advice but my story may be of interest.

I tore my ACL July 2009, although I didn't know as doctors / etc a bit useless at the time.
After letting the swelling go down, I just got on with life. Stopped playing Ultimate frisbee and started cycling a lot more. Only problem was playing football with my kids, where knee would hurt. This is due to exerting pressure while twisting.

So decided this can't go on, eventually pestered GP to check it properly, and was booked in for an MRI. This showed ACL tear and miniscus tear. Had an arthroscopy in January where the surgeon removed what was left of ACL, miniscus had healed naturally.

So I'm building back up to see if I'm happy to carry on without an ACL. Due to meet with surgeon in the next month or two to decide on whether to go for reconstructing ACL or not. I should be able to carry on without ACL without much/any adjustments in life. But it all depends on what sport / activities you want to do.

I've known a couple of people who have had the reconstruction done and it requires a serious amount of physio afterwards (6 months). But after that your knee will probably be stronger than before.

bearfraser

"DOH" & good luck

walkingbootweather

Sorry to hear about your injury Ivan. Everyone is different but I had the same injury and am happy to share my experiences. Think I may have had a slight tear in my ACL for a while which was not too debilitating, but managed to snap it completely playing beach volleyball. Tried to struggle along for a while as apparently strong muscles can compensate to a degree, but mine clearly weren't up to the job, so if I tried to change direction when walking, or if I swung a golf club I was inclined to fall over :oops: .This happened more and more regularly then my knee locked up completely to the point where I had to be physically carried down the stairs. Took about a month to have scans and full diagnoses and nearly three more before I could be booked in for surgery. General anaesthetic put me out for about an hour in which time the surgeon took another ligament to rebuild the ACL, tidy up torn cartilage and removed the debris. Was allowed out after 24 hours and told I wouldn’t be able to walk unaided for at least a couple of weeks or drive for about 6 weeks. In fact I began physio within 3 days and was back at work just over a week later. I did take about 18 months of pretty intensive physio before I felt fully recovered and cycling played a significant part of this. Initially I was unable to generate much power with my bad leg but I gradually built this up to the point where I sometimes forget which is the bad leg. Now I cycle even more than I did before the op.

I did use a knee brace to protect my knee when I had a slight tear (before it was snapped). Any ‘in-line’ movement such as cycling was fine, but as soon as lateral forces were involved I had a problem. A brace may offer some support, but since my op I haven’t needed one.

Would I go thorough it all again? Absolutely, but if your injury is not so severe that it impacts upon your ability to do stuff, you may decide to put it off for the time being.

Hope you make a speedy recovery.

secretdancer

Sorry to hear about your injury Ivan. Everyone is different but I had the same injury and am happy to share my experiences. Think I may have had a slight tear in my ACL for a while which was not too debilitating, but managed to snap it completely playing beach volleyball. Tried to struggle along for a while as apparently strong muscles can compensate to a degree, but mine clearly weren't up to the job, so if I tried to change direction when walking, or if I swung a golf club I was inclined to fall over Embarassed .This happened more and more regularly then my knee locked up completely to the point where I had to be physically carried down the stairs. Took about a month to have scans and full diagnoses and nearly three more before I could be booked in for surgery. General anaesthetic put me out for about an hour in which time the surgeon took another ligament to rebuild the ACL, tidy up torn cartilage and removed the debris. Was allowed out after 24 hours and told I wouldn’t be able to walk unaided for at least a couple of weeks or drive for about 6 weeks. In fact I began physio within 3 days and was back at work just over a week later. I did take about 18 months of pretty intensive physio before I felt fully recovered and cycling played a significant part of this. Initially I was unable to generate much power with my bad leg but I gradually built this up to the point where I sometimes forget which is the bad leg. Now I cycle even more than I did before the op.

I did use a knee brace to protect my knee when I had a slight tear (before it was snapped). Any ‘in-line’ movement such as cycling was fine, but as soon as lateral forces were involved I had a problem. A brace may offer some support, but since my op I haven’t needed one.

Would I go thorough it all again? Absolutely, but if your injury is not so severe that it impacts upon your ability to do stuff, you may decide to put it off for the time being.

Sorry to resurrect an old thread, but I'm due to have the same surgery tomorrow :shock: I've tried to do as much research as possible, which mostly involves scaring myself half to death with youtube vids, then I came across this old thread.
How long was it until you were back on the bike?

Wrath Rob

Can't offer any help but good luck with the surgery. My wife had it done and was on crutches for a few weeks. However, make sure you have good physio afterwards and do all of the exercises they give you. She didn't and is still not confident due to the lack of strength in her knee. And trust me, I've tried to get her to sort it but you can only lead the camel to water...

Underscore

My wife also had a knee ACL reconstruction about 6 years back. From recollection, you have to be very careful at around 4-6 weeks post op as this is when the graft (assuming your are having an auto-graft) is at its weakest as it is only just starting to revascillate at that point. I think my wife was told not to ride a bike due to the potential sideways forces on the knee when starting and stopping. However, she was told that a stationary bike (or a road bike on a turbo, I assume) was very good exercise to aid recovery so we bought a stationary bike for that purpose.

Ultimately, ask the experts (which is probably your physio, in this case) what they recommend and go with that but don't push it to much - the last thing you want is a revision due to a graft rupture! There'll be plenty of time on the bike once the graft has strengthened up...

Good luck,

_

Feltup

I was cycling about 3 months after reconstruction but no clips only flat pedals. The actual graft is at its weakest at 3 months so you have to be very careful about twisting and damaging it. Went clipless again after 6 months. I was kitesurfing and skiing etc again without a brace after 9 months.

walkingbootweather

Sorry to hear about you injury secretdancer and hope your op goes well.

Since you quoted me, perhaps I can give an update. I had an excellent physio who I cannot praise enough - I hadn't been convinced by the value of good physiothearpy until this operation but certainly am now. I was on a static bike as part of the treatment within a week of the op, gradually building up time and intensity over months. Took me about 6 weeks before I started riding a bike outside again. Because parking at the hospital was so difficult I actually started by taking a folder in the back of the car, parking about a mile away from the hospital, then riding the folder to and from the physio session. Was clipped in and riding on the road within about 10 weeks, but gave it another couple of months before venturing off-road.

Having had so much intensive physio, I got to meet lots of other patients and they split pretty much into 2 equal groups. One half had pretty much decided that this was a life changing event for them, and they would never again be properly mobile. These were the ones you would hear making all the groaning noises while exercising and would rarely complete the presecribed number of repetitions. The other half were determined to get back to normal, would grit their teeth and get on with it (sometimes over-doing things). I'd put myself very much in the latter group. Since my op I ride further, faster and more frequently than I ever did before. There are however some things that I can't do so well, and these I attribute largely to the injury. I used to be a pretty decent runner and volleyball player but I no longer have the 'bounce' that I used to have. I am inhibited (mentally at least) in any stop / start / direction-changing activity like football or squash, and I ache for days afterwards - but I still hold my own with younger people that haven't had the op and don't ride a bike . Used to be a regular skiier, but haven't dared to risk it since the op.

As has been said before, everyone is different and you need to put your trust in the professional medical experts rather than listen to random people on the interweb, but I'd argue the outcome is more dependant upon your attitude than anything else.

Best wishes for a speedy recovery.

LeDomestiqueTours

That is really bad luck but glad that you seem to have made a pretty quick return to a decent level of activity.

Definitely exhaust/research your other options before going down the route of surgery and try if possible to get a second opinion from a doctor with some experience of your interests - ie cycling as they will have a better understanding of how your injury will cope.

jodypress

secretdancer wrote:

Sorry to resurrect an old thread, but I'm due to have the same surgery tomorrow :shock: I've tried to do as much research as possible, which mostly involves scaring myself half to death with youtube vids, then I came across this old thread.
How long was it until you were back on the bike?

Good luck with the op, should be fine. I've had ACL repairs on both knees now.

Left knee 15 years ago by NHS, right knee April 2011 done privately by Professor Haddad.
Both were skiing accidents ironically. This years op was gutting as I was booked in to do an Alps bike trip in July.

I can echo most of what has been said and that is, physio, physio and physio, plus patience. Don't try and overdo it early on.

I was off two crutches after 2 weeks, but physio recommended walking with one for another few weeks. I was on a turbo trainer at home doing light, no resistance riding for 10 mins or so after about 6 weeks or so.
8-10 weeks I was riding flat pedals on the road (commute to work)
12-14 weeks I was in clipless but no hills.
approx 16-18 weeks I was riding hills on weekend.

I'm now approx 6 months down the line, cycling daily and weekends. I won't be skiing until Feb next year (with a small brace - nothing like the custom one I had for left knee).
The knee still aches from walking longer distances but no problems riding, just take a bit more time when warming up.

I'm more than happy to share experiences if you PM me.

flimflam_machine

Ooch! Best wishes for a speedy recovery.

If you're after some inspiration for getting on with your physio to get you back on your bike, you may want to reflect on the fact that a damaged knee didn't seem to hold this guy back, even without surgery.

secretdancer

Thanks for the messages of encouragement folks. Op went well as far as I know [haven't actually seen the doc yet] and I was packed of home last night. Day surgery is a strange thing but there's no place like home for recovering. Currently bandaged up fr 48 hrs, then I can have a look at the damage. Am expecting four 'ports' - holes basically where they harvested the hamstring graft and fixed it in place. The hammy is the sore bit at the moment, thes rest is ust a dull ache.

I'm not daunted by the physio in the slightest as I went into this knowing the rehab was the hard bit. My ligament injury is old and I've been thrugh copiuous amounts of physio and strength training in the past. Decided to pursue the op as I was finding physio was just not enough to allow me to do what I wanted to do.

Am trying to do the basic exercises as often as I can without doing too much - little and often I've been told. I have a fair bit of movement for day one post op., so hoping things progress well. I guess the most alarming part so far is receiving a 6 week sicknote :shock: there was me telling work I'll be off for a week, maybe two! I don't plan to use the whole six weeks, but I'm also not planning on ruining my recovery. Just see how it goes I expect

Anyhows, got the turbo in place for when the time comes and keen to start moving less gingerly again. I'll try to remember to post some pics of the gory bits for those that like that sort of thing! Am also keen on seeing the shaving job - the question is do I keep it to see if it improves my times

walkingbootweather

Glad the op went well sd. I was kept in overnight so you did well to get home on the same day. Can't even see my scars now but a mate who had a similar op 10 years earlier looks like he was the victim of a shark attack - just shows how much procedures have improved.

I was given a 6 week sick note too, but took just 8 days sick, worked from home for a week and was back in the office I think 16 or 17 days after the op.

Sounds like you have the right attitude. Don't overdo things though. You may find you have period of rapid improvement then stabilise or even feel like you are getting worse before the next significant improvement. I was getting around pretty well and doing most things inside 4 months, but I reckon it took 2 years before full strength returned.

You might get a chance to watch a few more dvds than usual, but you won't get through the entire run of 'Sopranos' before you are back on the bike.

secretdancer

For those that like these sort of things, here's a pic of my post op and still hairy knee:



Have had it redressed and movement is slowly improving.

Kieran_Burns

So you weren't sent to Azkaban for uttering one of the unforgivable curses then?

(no? too vague?)

Oh, and I thought you couldn't go back to work if you were signed off with a sick note? Something to do with insurance or the like.

secretdancer

Sorry, lost me there K_B?

I think as long as your employer agrees to you going back to work then you can, even if the 'fit note' says otherwise...http://www.nhs.uk/chq/Pages/2559.aspx?CategoryID=87&SubCategoryID=87

walkingbootweather

My employer just said "if you snap the ligament in your other knee as well, don't come running to me"

Kieran_Burns

secretdancer wrote:

Sorry, lost me there K_B?

I think as long as your employer agrees to you going back to work then you can, even if the 'fit note' says otherwise...http://www.nhs.uk/chq/Pages/2559.aspx?CategoryID=87&SubCategoryID=87

http://harrypotter.wikia.com/wiki/Cruciatus_Curse


In my defence - I am very rarely funny... :oops:

secretdancer

tenuous yes, but It brought a smile to my face
best to leave it there though.