[Wa-Aw]

This is one of the rare times the doc gave me an option when it comes to handling injury and it turns out ACL tear's are a lot more common than I thought.

Doctor says I can leave it be since I only compete in "cycling" but I don't think he understands what I mean when I tell him how I ride.
Or I can get an operation which will put me out for the better part of a year.

I'd like to get as much feedback as possible from anyone who's been ACL'd and has either got it fixed up or has carried on with a brace.


I ask because the recovery time doesn't sound fun, including 2 months for a bone edema to heal before they could cut, not to mention being bloody expensive.

 

[chillindrdude]

how old are you? if you're a young'un, get it fixed while your healing powers are at their peak. overall, despite the long recovery and PT, getting it fixed BY A GOOD/EXPERIENCED surgeon is the way to go and will be a far better "fix" than a brace.

in my opinion, a brace is just kicking the can down the road. look at Brendan, he used a brace to finish out the year, but ultimately, he is getting it repaired/reconstructed. And note how many times during videos he said that it was still painful and felt unstable during him riding.

 

[samnation]

Your body becomes reliant on braces as well if you use one just for riding now soon you will need it for running then for jogging then ultimately for walking.

Telling your doctor stuff can go a long way too. I dislocated a shoulder and tore a whole bunch of ligaments last April and had a big job starting in July, so surgery was not an option i told them that i was probably going to be riding trails digging and using chainsaws by the first week in July. Because of that we were able to set up a recovery process where by I was able to get lots of motion and stability back in a short period of time.

Don't know if any of that helps or applies to a knee. But I would say get some opinions then go have another chat with the Doc.

 

[Da Peach]

Get it fixed. It will hurt like a b!tch, but it's worth it.

Wearing a brace sucks.

 

[Brian HCM#1]

Had mine done 10 years ago, and well worth it. I planned my surgery during the off season, and was back riding within 6 months.

 

[alpine slug]

I've blown out both ACLs and both were rebuilt.

I played 3 years of collegiate sports on my right knee with no ACL and a Lenox-Hill brace. It sucked. I got it rebuilt right after graduation.

I blew out the left knee 14 years later and got it rebuilt within a month.

I have known people who have played all sorts of sports with no ACL and no external bracing. But most who try to play sports without an ACL end up doing further damage to their knee, little damages here and there which rip up the cartilage and lead to sore knees -- if not nearly impossible movement -- when older.

My right knee is very problematic now, thanks to avoiding the ACL reconstruction for 3 years. I can no longer hike or run because the knee will not tolerate it.

Maybe you'll be a lucky person who can make do without an ACL.

And if your doc doesn't want to work with you toward your goals, get a different MD. Lots of "sports medicine" docs don't know jack schitt about real athletics... for them it's just a marketing phrase, not a true perspective. If you encounter one of those MDs, run away. They're frauds.

I suggest avoiding all off-road riding for a full year after the surgery. It would be stupid to fall and ruin the rebuilt ACL. The human body needs about a year to incorporate such surgery and heal properly.

I was able to ride stationary bikes at PT, and my road bike on a trainer at home, within a week of the ACL reconstruction. I was released to ride my road bike on road rides within 3 months of the surgery. But trail riding is a totally different game. Don't rush it.

And do your Physical Therapy -- the surgery really is only a portion of the picture... your PT efforts and making the leg strong in every way are the real anchor to long term utility.

For quickest recovery, find an orthopaedist who puts you in a cryo-pack and a motion cradle right after surgery. This means finding an orthopaedist who believes the new graft can be stressed lightly immediately after surgery.

And for the 2d time -- don't rush getting back onto the bike. It will "feel strong" long before your body has integrated it at 100%.

 

[dirtyjungle]

I did my ACL and MCL at the same time I tryed not to get it fix after about a year of wobling around on my left leg I got them fix and I feel better. If it is competely towrn it will be longer recovery time. The most important things are do all of your PT I mean all of it and make sure your doctor puts you in a CPM right after you have surgey if your doctor won't find you a doctor that will. The CPM is very important for recovery if you don't use a CPM you have a lot more scare tissue and your PT will be longer and way more painful. I have had the surgey twice once with the CPM and once without it. Please beleive me about the CPM. PM me if you have any questions about the CPM.

 

[sunringlerider]

Not having torn my ACL, but having torn my MCL, PCL, and shattering my tibial plateau. More pain now=less pain later. Get it fixed.

 

[davet]

get it fixed

the more time you spend without an acl the more damage you will do to your mensicus and condial surfaces. I waited 3 years and there is damage that can't be repaired. I just had to return (5 years post acl surgery) to have my meniscus trimmed as the repairs they tried didn't hold. My surgeon said my knee shows signs of wear and tear.

I was back riding my xc bike within 4 weeks and back riding dh in 3-4 months. There wasn't much pain and I didn't wear the brace at all post surgery.

 

[zdubyadubya]

Not having torn my ACL, but having torn my MCL, PCL, and shattering my tibial plateau. More pain now=less pain later. Get it fixed.

Me too!
--like everyone else said, do the surgery and do it right.
Pics.

NSFW

 

[squiby]

I had no ACL for the last 15+ years and did not realize it. My knee would pop a few times a year with huge swelling and lack of movement. I could get it back working typically within 2 weeks using compression bandages, anti inflammatories and massage. Over time it would pop more & more easily and on the last occassion would not heal up for over a month. Finally got it checked out only to discover I had no ACL. I thought it was just a loose bit of cartiilage floating around causing the issues.
Got it fixed last year and was back into DH within 6 months (but I'm a bonehead as evidenced by the previous 15 years of neglect, so don't use my example as a template). It is so much better now! Still do not have complete range of motion with the knee bent so can not kneel or crouch properly. I am extremly lucky that I did not cause more seroius damage to the joint as a whole by continueing with activities that popped the joint.

Get it fixed and look after yourself or you'll regret it!!!!!!

 

[Wa-Aw]

Thanks a lot guys. This has reassured me. I'm definitely going to go for having it fixed right.

CPM

cryo-pack and a motion cradle

Are these the same thing?


How many of you have gotten your ACL's torn while riding?

I was surprised how easy it was. I dabbed because the front wheel slipped. I was going pretty fast but I have kicked myself out of similar situations before. I never thought of this as a consequence of having an aggressive riding style and just putting your foot out there whenever you lost it. Makes me strongly think about going to less balls out riding stlyle or going clipless.

Was also wondering if anyone has torn a fixed ACL during recovery or after it's healed.


Thanks again. Definitely reassured me!

 

[no skid marks]

I had my ACL replaced with a piece of my hamstring tendon(they can also use a dead dudes one, but your body might reject it). I was walking next day gently(a friend spent a month in bed)on crutches for a week, gentle bike in a couple of weeks. Good surgeon is the key.
I've since learned there's another fix. The attach a gauze tube to each bone, stick each end of the ACL in the middle(not attached I think), and let it heal itself, and the gauze is good to go pretty much straight away(again I think). Search for this method. Find out what surgeons the football team pros use, and use them. Do your own research though, each surgeon will sell his own style to you.
Geterdone
Oh yeah, I wore a brace for a year, and a couple of years skiing, just as a precaution so as not to waste any more of my precious youth healing again.
I'm a bit suss that the braces might actually pull on the ACL if not worn properly.

 

[Da Peach]

I had the hamstring tendon procedure as well. I waited a year before getting the repair done, just because I was told it was not a necessity. I got a fancy CTi brace and was careful. It sucked. Finally got it fixed and wore the brace for another year just to be safe as NSM mentioned above.

I hurt it casing a landing on my snowboard. Hurt like a bastard. The repair hurt even more, but it was worth it.

Been 8 years and still working well.

 

[dirtyjungle]

continuous passive motion is what CPM stands for. And it work great.

 

[demo 9]

Been there done that, before i had it fixed i would fall down the stairs continuously when i turned on the landing, you dont realize how important it is. A brace is more of a band-aid fix, do you really want your knees stability based on a bandaid fix?

 

[bizutch]

You didn't say for certain that it was a complete break of the ACL, but I assume that it is. Doctos for the most part are about as active as a belly button. When they say you don't "need" it...they're usually refering to walking from car to job and back.

In the 2 months I had to wait to have my surgery done, I found at least a dozen daily activities in which an active person needs an ACL. Walking and stopping. Chasing the dog. Racquetball. Any kind of "ball" game. Heck, I think even sexing the ex sucked b/c of it.

Get the surgery and it will keep you from destroying the part I messed up in the 2 months down time...the meniscus! It's the part that makes every step a joy...or misery.

Mine was done in '96 with the patellar graft. Hurt like a b! Woke up with my leg in the motion sling thingie and had a stationery trainer. Doc was a roadie and told me to clip in and pedal with my good leg.

It worked wonders with removing swelling, elevating my heart rate and recovery.

 

[alpine slug]

Are these [CPM and motion cradle] the same thing?

Yeah I just couldn't remember the acronym "CPM".

As bizutch said, there's a ton of things where you need an ACL and in each place where you'd notice them (when going about life without an ACL), you find ways you can tear a perfectly good ACL. I tore my right one 3x before the final pop. Usually it's a strange twist, or a hyperextension... or both at the same time. But if you have a partially torn one, you can hyperflex it into rupture... I did that while skiing.

The key is finding a good MD who does ACL rebuilds all the time, and who has a good PT person or group who works with him on all ACL rebuilds. Hopefully you have access to that kind of orthopaedist.

Both my ACL rebuilds were patellar tendon graft. The right one in 1985 was a totally different procedure than what's used today... a huge opening on the outside of my right leg, about 12-14" long. The left one in 1999 was much more like what you get today... 2 or 3 arthroscope holes with a small (2"-4") incision. You recover much faster in the modern method. But for long term durability, it's good to be cautious and let the graft fully incorporate and make itself solid. You'll feel strong enough to ride trails maybe 2 months post-op... but I wouldn't risk it.

 

[no skid marks]

I got a video of my surgery("the new method/key hole"), fricken brutal to watch. I waited to I'd healed before watching it. They stick like a coat hanger wire right up half way to your nuts, and pull a muscle/tendon down and out the hole, then cut some off to use for the ACL.
Then there's footage from inside the knee, all calm and interesting, then blood n bone n sh!t goes everywhere, and this drill tip comes through the bone at you.
The muscle at the back of my leg is now deformed a bit, has a lump at the start, not smooth, more like a bicep muscle now. Anyone else cop that?

 

[Wa-Aw]

Mine isn't completely torn, or so I understand from an "Acute ACL Tear" and disruption of the fibers, but some other ligament has buckled and my patella has moved to somewhere it's not really supposed to be. This leads me to think the ACL is there but is too messed up to function. The doctor didn't go much into explaining what's wrong but was pretty quick to decide that it needed to get fixed. Definitely getting a 2nd opinion some time this week.

Which makes me want to ask around about this.

I've since learned there's another fix. The attach a gauze tube to each bone, stick each end of the ACL in the middle(not attached I think), and let it heal itself, and the gauze is good to go pretty much straight away(again I think). Search for this method. Find out what surgeons the football team pros use, and use them. Do your own research though, each surgeon will sell his own style to you.
Geterdone

Thanks for the responses guys, makes me feel better that a lot of you guys are still out shredding hard after getting the fix. The recovery time on this absolutely sucks though, almost wish I broke a bone instead.

 

[Da Peach]

, almost wish I broke a bone instead.

seems I just tear ligaments all the time... johnny slack-joint. sucks.

 

[karpi]

Get it fixed by a knee specialist. I tore mine about 2 years ago. I tore it, did specific physical exercise and got operated all in under a month from tearing it. 8 months later as was back to Downhilling, skiing and windsurfing all togeather. Knee felt kinda weird at first, but now it feels stronger than my other knee. If you do sports, surgery is a no brainer.

 

[EVIL JN]

Kind of opposite to the saying, dont fix what is not broken. In your case fix what is broken, it will be better in the long run.

 

[no skid marks]

Hold up.
If it's not torn in two, it will heal itself I think. I'd get a second opinion.
You'll know if it's torn in two.
Sit on a chair, so your legs are bent at right angles. Relax, and get someone to gently pull and push on your lower leg. Do it to the good knee first to see what movement is there(remember to relax, so no muscles will hold it, and other person to be gentle). If ACL is in two, lower leg will be able to move over an inch, unlike the good one that will move less than half inch.
GENTLY do this.
and DEFIANTLY get a second doctors opinion, and a brace while it heals itself if surgery isn't needed.

 

[slyfink]

Hold up.
If it's not torn in two, it will heal itself I think. I'd get a second opinion.
You'll know if it's torn in two.
Sit on a chair, so your legs are bent at right angles. Relax, and get someone to gently pull and push on your lower leg. Do it to the good knee first to see what movement is there(remember to relax, so no muscles will hold it, and other person to be gentle). If ACL is in two, lower leg will be able to move over an inch, unlike the good one that will move less than half inch.
GENTLY do this.
and DEFIANTLY get a second doctors opinion, and a brace while it heals itself if surgery isn't needed.

this is not a reliable test, and does not replace an MRI or a scope. When I tore my ACL they could not detect any movement this way. yet when they went in with the scope to clean up the meniscus damage they determined my ACL was completely torn. also, ligaments get so little blood flow that they can't heal. a partially torn ligament is as useless as a fully torn ligament in situations where you stress it, ie sports.

i have nothing to add to what others have said, ie, get it done, and get it done right, other than if you have the time, train as hard as you can before surgery. I hit the gym hard for the 4 months leading up to surgery, and I'm convinced it helped speed up my recovery. My PT said she'd never seen anyone recover so fast, and she's treated national rugby team members and pro hockey players.... I was biking to work 3 weeks post op, and I did the Chilcotins float-plane trip just a little over three months post op (yes I wore my brace, but I think it's mostly mental at that point in time - I had a Townsend).

 

[Wa-Aw]

Thanks for the encouragement.

I'm still training with the swimming team and finding out I can lay down more power than I thought. But the ACL is definitely not working, after a long day i can feel the clicking and the looseness. According to the one doc I have gotten the MRI readings to so far, I have to wait another month for a bone edema to subside before I can get cut open.

Would you guys suggest gym training over (or in addition to) normal non-impact activities? Mostly swimming and roading.

 

[no skid marks]

this is not a reliable test, and does not replace an MRI or a scope. When I tore my ACL they could not detect any movement this way. yet when they went in with the scope to clean up the meniscus damage they determined my ACL was completely torn. also, ligaments get so little blood flow that they can't heal. a partially torn ligament is as useless as a fully torn ligament in situations where you stress it, ie sports.

Cool, listen to SlyFink, as I'm wrong. I was going from what a ski doctor had said about that style OP with the Gauze, and just putting each end in the gauze pipe and it'd connect itself. He obviously left out some details.
Get a second professional opinion.

 

[alpine slug]

I would suggest stationary bike or road bike riding. Something that doesn't load/stress the knee, but instead cycles it.

Worst gym exercise for a bad ACL: quad extensions, the kind where you sit on a sort of bench or seat with your leg bent and your ankle behind a padded arm... and extend the leg. They'll ramp up the shearing force (shearing the tibia from the femur) and possibly damage the ACL worse. Same thing for hamstring curls. Avoid those two for sure!

I was going from what a ski doctor had said about that style OP with the Gauze, and just putting each end in the gauze pipe and it'd connect itself. He obviously left out some details.

As I understand things the ACL is not just linear tissue, but is also under some functional tension when it's normal (uninjured) and the "regrowth" model doesn't address that tension issue so it improves the ACL-less knee but doesn't make it as functional as a full reconstruction where the graft is tensioned and anchored.

This is what I recall from my 1999 discussions with my orthopaedist before he fixed my left knee, anyway. Things could have improved in 12 years though?