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I did a complete tear of my knee ACL 12 months ago and have been riding a fair bit since. The knee does fee a little bit less stable when riding but I can make do.

Has anyone else torn an ACL and not bothered to get surgery and continued to ride?

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I did it about 4 years ago. Bugged me for 2 years, especially when it was cold.

Bought knee braces straight after incident. I felt it supported the knee and hopefully will prevent it from happening again. Touch wood it hasn't yet.

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I tore my ACL playing soccer about 8-10 years ago. The advice I got off an AFL doctor was to get it fixed up as soon as you can becasue it'll only bother you more and more as you get older followed by arthritis.

A mate of mine got a knee reco done after about 6-7 years after doing his knee and after his surgery, he got excessive bleeding in the knee and they operated on him again. They said it happen because he took so long to get it fixed.
Not cheap getting it done private

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Yep, torn meniscus and diagnosed with partially torn ACL, apparently not completely torn on MRI scan. This was late Sept last year, was back riding by Xmas.

Pretty much because I'm over 50 was told that they won't operate but still too young for a knee replacement. Done a heap of rehab and physio which has given back a good amount of strength but occasionally if I give it even a little over stretch it will be sore for a day or 2.

As Crusty says, I can look forward to some arthritis later in life but for now just getting on with it, hanging out to get back on the bike.

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Hey Doug,

Sorry to hear about your knee injury.  It's good to hear that you've been able to return to normal activity. Given that you're talking about choosing not to go with surgery, I assumed that you have been diagnosed with a full rupture of the ACL. I'm not sure if you've sustained damage to any other structures of your knee (such as cartilage), but that will also affect your long term function.

  • The ACL and PCL help to stabilise the knee when the upper leg is rotating while the foot is planted on the ground, such as changing direction; and when forces cause the femur (thigh bone) from sliding forwards or backwards across the tibia (shin bone), such as stopping quickly or trying to slow down when going down a steep hill. 
  • When the ACL or PCL are ruptured the knee loses support, which is fine if the patient leads a sedentary lifestyle, but it can become problematic when they are involved in vigorous activity.
  • Most athletes will have surgery if they are continuing to compete in their sport because they require their joints to function at 100%. Otherwise they are unable to perform at their usual high level; they have an increased risk of injury; they have an increased risk of more severe injury; risk of needing more surgery; greater chance of post-op complications, which leads to longer recovery periods; more time on the bench
  • Usually the surgeon will reconstruct the ACL with a graft from the middle third of the patella tendon, or from part of the hamstring. Recovery is usually straight forward, unless there are post operative complications.

At the end of the day, you will be fine with most activities. You do have an increased risk of dislocating your knee due to the instability, but you can reduce the likelihood of that occurring.  The aspects which you need to be cautious with during riding will be:

  • Planting you foot on the ground while moving - avoid this at all costs!
  • Remaining completely upright with hard acceleration or hard braking - ensure that you're shifting your pelvis forward during acceleration, and to the back of the bike during braking to ensure that your muscles are loaded to support your knees

Another measure that will help far more than taping your knee is to strengthen your calves and hamstrings as much as possible. Your calves and hamstrings will stabilise your knee and prevent it from shearing anteriorly and posteriorly. You can strengthen your quads too, but they are secondary to your hamstrings and calves - don't go overboard and allow the quads to dominate your training or movement patterns - you should feel your calves & hammies holding you strong.

Hope this helps.  Let me know if you have any other Qs, and I'll answer whatever you need to know.  All the best, Doug!

Cheers,

Rus

Please excuse any spelling or grammatical errors - I'm typing this as fast as I can with a screaming 8 month old demanding my attention :divertenti-03: 

 

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Hey Doug,
Sorry to hear about your knee injury.  It's good to hear that you've been able to return to normal activity. Given that you're talking about choosing not to go with surgery, I assumed that you have been diagnosed with a full rupture of the ACL. I'm not sure if you've sustained damage to any other structures of your knee (such as cartilage), but that will also affect your long term function.
  • The ACL and PCL help to stabilise the knee when the upper leg is rotating while the foot is planted on the ground, such as changing direction; and when forces cause the femur (thigh bone) from sliding forwards or backwards across the tibia (shin bone), such as stopping quickly or trying to slow down when going down a steep hill. 
  • When the ACL or PCL are ruptured the knee loses support, which is fine if the patient leads a sedentary lifestyle, but it can become problematic when they are involved in vigorous activity.
  • Most athletes will have surgery if they are continuing to compete in their sport because they require their joints to function at 100%. Otherwise they are unable to perform at their usual high level; they have an increased risk of injury; they have an increased risk of more severe injury; risk of needing more surgery; greater chance of post-op complications, which leads to longer recovery periods; more time on the bench
  • Usually the surgeon will reconstruct the ACL with a graft from the middle third of the patella tendon, or from part of the hamstring. Recovery is usually straight forward, unless there are post operative complications.
At the end of the day, you will be fine with most activities. You do have an increased risk of dislocating your knee due to the instability, but you can reduce the likelihood of that occurring.  The aspects which you need to be cautious with during riding will be:
  • Planting you foot on the ground while moving - avoid this at all costs!
  • Remaining completely upright with hard acceleration or hard braking - ensure that you're shifting your pelvis forward during acceleration, and to the back of the bike during braking to ensure that your muscles are loaded to support your knees
Another measure that will help far more than taping your knee is to strengthen your calves and hamstrings as much as possible. Your calves and hamstrings will stabilise your knee and prevent it from shearing anteriorly and posteriorly. You can strengthen your quads too, but they are secondary to your hamstrings and calves - don't go overboard and allow the quads to dominate your training or movement patterns - you should feel your calves & hammies holding you strong.
Hope this helps.  Let me know if you have any other Qs, and I'll answer whatever you need to know.  All the best, Doug!
Cheers,
Rus
Please excuse any spelling or grammatical errors - I'm typing this as fast as I can with a screaming 8 month old demanding my attention :divertenti-03: 
 

Thanks a lot Urustu for taking the time to write such a detailed response. It has definitely given me much to think about. Very much appreciated!
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13 hours ago, Doug TREZ said:


Thanks a lot Urustu for taking the time to write such a detailed response. It has definitely given me much to think about. Very much appreciated!

You're very welcome, Doug.  Feel free to pop any questions through at any time. All the best with your recovery, mate.

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  • 4 weeks later...

Decided to bite the bullet on Tuesday and get the surgery done. I figured now was the ideal time to get it done whilst I’m stood down from work. I also plan on riding for another 25+ years so 6-9 months off the bike is worth the sacrifice in attempt to get back to where I was prior to the injury. So far so good.

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14 hours ago, Doug TREZ said:

Decided to bite the bullet on Tuesday and get the surgery done. I figured now was the ideal time to get it done whilst I’m stood down from work. I also plan on riding for another 25+ years so 6-9 months off the bike is worth the sacrifice in attempt to get back to where I was prior to the injury. So far so good.

Sounds like a good plan, Doug. One thing to keep in mind is that surgeons are like mechanics - they aren't all good at what they do, so it's best if you have a medical professional who can advise you about who is the best in the industry. If you have a great GP, then ask them who they recommend.  Otherwise, let me know if you need a hand with finding a good surgeon, and I'll ping you the names of the people who we use with our patients. 

All the best, Doug.  I look forward to hearing how things go.  

Cheers,

Rus

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  • 3 months later...
On 5/5/2020 at 5:18 PM, Doug TREZ said:

 

I did a complete tear of my knee ACL 12 months ago and have been riding a fair bit since. The knee does fee a little bit less stable when riding but I can make do.

Has anyone else torn an ACL and not bothered to get surgery and continued to ride?

 

I did mine and had surgery.  Did three months physio prior to surgery - wanted to try physio first as I know a few people that were happy with the outcome from physio and did not get surgery.  I did not realise how weak my muscles were until I started physio.  Had the op and had a real good recovery period.  I believe the physio prior to surgery helped in my recovery.  My wife has been living a very active lifestyle for past 10years with a complete ACL rupture.   

I am going to presume you did your ACL not riding?

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  • 1 month later...

If you have been fighting it for a year then you need to do something different then what you've been doing.It ain't going away if you continue as you are. I've had 3 knee related operations (not an acl) and 2 of them both required 5mths off work and solid psysio and commitment by myself. I could of gone back earlier but due to the nature of my job and the long hours required, time was the best thing to give me the best outcome so thats the way i went. Research and seek some professional advice and then make an educated decision on which way you want to go. Your knee will need to be managed for the rest of your life, as it will never be as strong as it was, even if it feels 100%,remember this. Don't run, jump from heights or carry over 20kgs if you can help it.

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Hi Cluffie, it’s been 6 months since I took the plunge and got the ACL surgery done. I’ve read reports of people going back to riding or racing then but I think 9-12 months is the normal.
I’ll probably just start doing a few easy rides between now and 9 months and see how it feels.
I’ve got some custom CTI braces on order to give myself the best chance.

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Hi Cluffie, it’s been 6 months since I took the plunge and got the ACL surgery done. I’ve read reports of people going back to riding or racing then but I think 9-12 months is the normal.
I’ll probably just start doing a few easy rides between now and 9 months and see how it feels.
I’ve got some custom CTI braces on order to give myself the best chance.
Awesome mate. Just take it easy and start on easier flowing trails. No mega hillclimbs or creek riding at your uncles property for a while till it strengthens. Those braces are great for some extra support and are the same as i use.
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  • 1 month later...
On 11/6/2020 at 5:42 PM, Doug TREZ said:

Hi husky. Yeah I did my ACL riding around a friends back yard.
How long after surgery did you ride?

I was off the bike for around 6 months.  Got on the road bike first then took it easy returning to dirt.  Did not get on the dirt bike until after getting knee braces.  I took the post surgery physio pretty seriously and worked hard at it - so had a good recovery.  If the professional footy players can get back playing footy after around 8months post surgery why shouldn't I be able to get back on the bikes around the same time.  Your body will tell you when you are ready to get back on the bike.

Believe it or not - depending on your life style and what you want out of the surgery you can have an active lifestyle without an ACL - just ask my wife.

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