Anyone riding with a knee brace or ACL deficient?

kidwoo · Apr 21, 2004

I had ACL reconstruction done at the end of a February and was riding DH (dumb, really really dumb) by that summer. If you ride cross-country at all, this will be much better for you. Clipped in and climbing will strengthen your hamstring muscles which take up some of the slack when you have a weakened or no ACL.

If you really tore your MCL, it's not going to heal by itself anytime soon. You'd need surgery and graft just like an ACL. If you're dead set on riding this summer, pay the money and get a custom brace from Donjoy. They're expensive but this is your knee we're talking about. I never rode with mine but a friend I ride XC with a lot is and has been riding with his for about 4 months now. He had his surgery last fall. You can put limiting shims for setting max extension/compression and it will keep your knee from moving laterally. It's a good thing. Beating the crap out of your knee this summer with no ACL jumping off ladder bridges and doing a million jumps on A-line is not smart. Doing it with an ACL/MCL specific brace is slightly more smartererer

Repack · Apr 21, 2004

I was pretty much in the same exact situation last summer. My ACL had bee torn for 4.5 years without me knowing it. At Snowshoe, I crashed in practice putting a 2nd tear in my meniscuc. I had no ACL damage. I stupidly raced at Mt Snow the next weekend and did 1 local race after that, but no more. Racing Snow was just plain stupid.

I have a CTi2 and the thing is great. If you ride with Dainese lowers it will fit on over them. They fit snug enough together that combined they offer additional support. The CTi2 is a great thing to get no matter what. After surgery they want you moving ASAP. My doc told me to take off the surgical brace 48hrs after surgery and just use the CTi2. Having that kind of support and the mobility that a hinged brace offered made things heel up MUCH quicker.

PM me your email address if you want a page of notes I put together after being involved w/ several other ACL conversations.

Craw · Apr 21, 2004

I tore my ACL in 2001. It's still torn, I have not had the surgery yet. I ride with a custom brace made by Townsend Designs. It's been really nice.

I wish I had the surgery done a while ago, but with the brace and everything, I figured I might as well not take time off school.

I don't experience that much knee instability. There have been a few times where my knee gives...it makes me sick. But for the most part, any catastrophic knee blow outs have been avoided. I don't play any sport like tennis or bball without the brace. I played baseball this past sunday withouth the brace with no ill effects, although I really really play it safe. Which meant I was tagged out, all the time because I wouldn't do any fancy base running.

XC I usually don't wear the brace. DH all the time. Snowboarding, all the time.

What I don't have and will never have is piece of mind. I'm always aware of my knee. I'll never feel confident on it, and I will always second guess any movement that requires anything other than just walking.

That sucks.

BRacing · Apr 21, 2004

Wow, that's tough. I had a very similar experience...

About 4 years ago I tore my ACL, but the doctors only diagnosed it as a strain/sprain. After a few weeks, the pain went away and i seemed to be "healed". However, any squatting or any weight on my knee when it was at an angle would cause sudden and severe pain, and back to the doctor I went. They continued to give it the same diagnosis of a strain/sprain.

The more this would happen, the more likely it would occur. As it happened more and more frequently, I finally went to different doctors. Finally I went to a doctor that told me I had actually TORN my ACL completely, and that each reoccuring pain was my cartelage tearing because of the lack of support my ACL should be providing.

Surgury was to graft a ligament from the top part of my knee into the ACL position. It was to take about 1 1/2 hours and I was supposed to be able to walk out of the hospital.

3 hours later I awoke from surgury in massive pain and in a cast. The surgons had found severly damaged cartelage within my knee when they did the ACL surgury. They attempted to salvage any cartelage that they could while they were in there, and removed the most damaged cartelage.

Because of the cartelage damage, I was in a cast for 3 months. After I had the cast removed, it took another 4 months of physical therapy to get my range of motion and strength back in my leg.

It has been a year since I completed my physical therapy, and I'm doing good. I feel I have about 80% of my support/strength of my knee - and that's all I will ever have. Since my recovery I have been able to race successfully and enjoy life.

From my experience, I would strongly suggest that you complete both surguries as quickly as possible. While it is possible to function without your ACL, you risk severe damage to your cartelage and long term damage after surgury.

It's only a season of riding. But it's the rest of your life you'll have to live with your knee. Take it from me...

-B

UiUiUiUi · Apr 21, 2004

i had multiple knee surgeries over the last years.
my ACl got replaced and damaged a little in another surgery.
anyways so my knee is a little "loose".
i ride with a custom knee bracewhich was designed for Icehockey, and they guys modified it together withme to make it work for biking.

it works pretty damn excellent.
and i believe it can help you riding without the acl.
but please try to do lots of training (gym) without the brace.
talk to a trainer or doctor for the right excercises.
this will keep vegetative nerve system (I don't know whether thats the right word in english) active. because if you do sports only with the brace this will weaken some muscles which keep your knee together.

let the MCl heal and then start from there
maybe visit a 2nd doctor which is specialized in sports injuries.

chillindrdude · Apr 21, 2004

i hope that all of you realize that by riding around with torn ACLs or any other knee ligament damage, you are hindering the healing process. your knees are building up scar tissue, and adhesions, and other goodies. the knee brace is just a crutch...when you are older, like 10 or 15 years down the road, your knees are gonna be creakin and hurtin' and basically arthritic up your arse. so...enjoy.

i hope chronic pain and arthritis is worth those few months of riding. listen to your doctor...he/she didn't goto medical school and go thru all that training for nothing.

Tenacious Doug · Apr 21, 2004

I tore my ACL about 7-8 years ago now while playing rugby. At the time I was still growing so surgery was not an option as it would have halted growth in my left leg leaving me a bit lopsided!

I undertook a period of intensive physiotherapy both at home and at the hospital, after a while (I cant remember time periods, its a long way back now) I was back on the bike, at first on the turbo trainer in my room, then on the road and finally on the MTB, not long down the line I bought a roadbike, it helped me even further. For a long period I had regular checkups at the hospital, I think it was over a period of 18 months. My (well respected) surgeon was pleased with my progress all along the recupuration path, he was keen to stress that I needed to get the muscles built up to compensate for the fact that I couldnt yet have surgery.

At the end of this 18 months I had another X Ray that confirmed I had stopped growing and surgery was now an option, however my surgeon was of the opinion that strength of the knee was so good that the benefit to be had from the surgery was small, he thought that anything was big enough to damage my new strong knee would also be major enough to damage a re-constructed knee. I was at a critical stage at school and it didnt seem the right thing to do, plus the benefits to be had were small.

One thing the surgeon did point out at this point was that I was going to get arthritis. He also made the point that whether I had the ACL re-constructed or not, I was going to get it. to be honest I am not sure of whether this was to do with the ACL damage or the cartilage damage that was done at the same time but all I know is that he was of the opinion that reconstruction would make no differnce to the onset of arthritis. (GiantDHRider take note)

Since then I can count on one hand the instances of instability I have had, in the last few years I have had one nasty crash of some North Shore that I actually think would have done in anyones good knee, that put me out of action a week. I dont ride with a brace, I have never felt the need, the knee is not instable, I dont see I would get any benefit from riding with a brace.

When I came off the North Shore last summer I ended up in the ER just to have it checked. The doctor checking it refused to believe that any surgeon would have advised me that surgery was not necessarily the best route to take and basically called me a liar. He did confirm that the acl was ruptured (not that I needed to know that) and that there was instability. I dont however doubt the opinion of my surgeon I got way back at the start, he is known and respected in the field and I never had reason to doubt him.

One thing that does cross my mind now is that in the time since I did this, I would imagine the surgery has advanced in some shape or form and I would guess this will give a greater chance of success and give me a stronger knee. What I dont see is how this is going to benefit me, the knee does not stop me doing anything I want to do, I ride DH, XC, play squash with my buddies, kick a football around. The only thing I miss is the rugby at which I was a pretty good player as a youth......but I am over that now, I started riding my bike more after I did my knee and that is my first love now (it was only joint first before!).

largerthan9 · Apr 21, 2004

Originally posted by crashing_sux
I have a grade 2 MCL tear (about halfway torn through). Unlike the ACL the MCL has a good blood supply so grade 2 tears will heal by themselves and even complete (grade 3) tears will heal by being sutured back together or stapled to the bone, they don't need to be replaced completely like an ACL.

I had the ACL in my other knee done a couple of years ago and I was back at it in about 4 months feeling great but considering 1-2 months for the MCL to heal, then getting the reconstruction and waiting another 4 months for it to heal that would ruin my summer in Whistler

Skiing?

heikkihall · Apr 21, 2004

Originally posted by kidwoo
If you really tore your MCL, it's not going to heal by itself anytime soon. You'd need surgery and graft just like an ACL.

Thats where youre wrong. Either you havent seen a doctor in about 5 years for a knee injury or the Doctor you go to is out of the loop. I have worked with some of the top sports medicine doctors from around the world trying to get my MCL back to normal and everyone has said that the MCL heals itself better than any doctor can repair it, as long as everything is taken care of properly. They all said they would do more harm than good if they did surgery on it. The reason I am a bike rider now if because of injuries to my knees.

1000-Oaks · Apr 21, 2004

Originally posted by Craw

XC I usually don't wear the brace. DH all the time. Snowboarding, all the time.

What I don't have and will never have is piece of mind. I'm always aware of my knee. I'll never feel confident on it, and I will always second guess any movement that requires anything other than just walking.

Ditto that, I tore my ACL just over six months ago. It's strong enough now that I can do XC without a brace and go up stairs without limping (much). I also use the custom Townsend brace for DH, which from what I've seen is BY FAR the best one out there.

Anyhow, the doctor says the knee has finally healed enough for me to have reconstruction next Thursday. It sucks to have to go though the healing process all over again (and miss riding this summer), but it's dumb to put stuff like this off for anything.

Repack · Apr 21, 2004

Originally posted by GiantDHRider
i hope that all of you realize that by riding around with torn ACLs or any other knee ligament damage, you are hindering the healing process. your knees are building up scar tissue, and adhesions, and other goodies. the knee brace is just a crutch...when you are older, like 10 or 15 years down the road, your knees are gonna be creakin and hurtin' and basically arthritic up your arse. so...enjoy.

i hope chronic pain and arthritis is worth those few months of riding. listen to your doctor...he/she didn't goto medical school and go thru all that training for nothing.

I think that the people here all fall into the "lost cause" group when it comes to trying to talk them down.

Maybe the info you have is dated. Knee surgery has come a long way in the last 5-10 years. Its all about keeping it moving. Keeping it still is what lets the scar tissue build up. They used to imobilizes knees for 6 weeks post-op, now they don't ever want you to stop moving it.
My knee brace has been far more than a crutch. It keeps my knee moving it in the way it was intended to move, making it more stable and stronger. But that was mostly before the surgery. Now thta I am recovering the process is similar, but less pronounced b/c my knee is stronger overall. And cycling is one, if not the best of the best things you can do for a knee injury.Obviously not DH or FR, but I started PT 9 days after surgery, and right from day 1 they had me riding a stationary bike. And once an ACL is torn, there is nothing left to heal. At that point, the issue becomes keeping the knee stable so as not to injur the meniscus. Its the meniscus that allows the knee to move smoothly. All the ligaments do is keep things lined up.

About arthritis: When I broke my tib/fib right above the ankle, the ortho said that I would likely develop arthrits b/c one of the breaks went into my ankle joint. He said that if they had had to operate, it would only be a matter of time, but since they didn't, my ankle will always be "pre-arthritic"-whatever the hell that means. Basicly you are ripe for arthrits in any joint any time you damge the layer of cartilidge that covers it.

freeridekid · Apr 21, 2004

I tore my acl early last april and was riding dh in june with a Donjoy brace, which worked pretty well. you can even get knee/shin pads that strap onto the brace so you can really use it even after the surgery as a permanent knee pad. i got my surgery in late july and just started riding full on in february. its better to play it safe and wait the whole 6 months after the surgery than to tear it again doing something stupid. speaking of stupid though, I still have the brace but i only use normal knee/shin pads now :rolleyes:

TWISTED · Apr 22, 2004

I recomend Cti2 knee braces. I've got two torn acl's and these braces let me ride the way I want to.

ito · Apr 22, 2004

I tore my ACL last August in Durango, at the NORBA. I had surgery 4 weeks later....way too early IMO, but I needed to before school started. I spent 4 weeks with a brace on whenever I had to walk more than down the hall. I am now walking with almost no limp and no brace. I'm starting to ride my jump and dh bike again, but am taking it easy. I've been riding a road bike and some xc since mid November. Stairs are fine for me, but running is a problem as I still don't have all the fluid drained from my knee...it is still slightly swollen(the result of not having any long term profesional physical therapy).

This December I talked to my doctor about a brace for riding. His opinion, and mine too before I talked to him, was that I should wait until my knee is strong enough before trying to ride downhill and putting alot of stress on it. The brace is artificial and while it will help, ultimately your muscles are your best brace. It can be different for everyone, but I'd rather go slowly and not become overconfident because I have a brace. So far I haven't had any problems, I know my limits and stay away from putting too much stress on it....that or I pay the price the next day when it hurts like hell.

As for the MCL, I don't know, didn't tear that.

The Ito

Repack · Apr 22, 2004

WIth all the talk, thought I'd post a pic. I had this for 5+ months pre-op. Kept my knee tracking propper making it stronger. Its one of those things that did about 10x for me than what I thought it would. Had surgery Dec 22 '03 and now only wear it when my knee feels "tired" or I'm going out partying.
I mentioned before that it fits over Dainese. All you need to do is pull out the shin pad as ssen in this pictire. I added the tan colored mole skin as that it wouldn't stick to my thight and ratchet down.

1000-Oaks · Apr 22, 2004

Did you guys use a CPM machine after the surgery? My doc signed me up for three weeks on the machine, but my insurance isn't going to cover much of it and it could cost me $8,000. I can't see spending that kind of cash to rent the gizmo, I'll probably just tell them to keep it and do what I can without it.

Any experience with these?

Renegade · Apr 22, 2004

My two cents: I won't give you a long story, I've blown a knee out recently and had it repaired. I lost a summer because of it. But I wouldn't change that. Putting off the surgery cause you don't want to miss a season is a short-sighted selfish act that you will regret as you age. You're apt to further injure the area, build up scar tissue, prolong your eventual recovery, and most likely suffer from pain and restrictions later in life.
Do the right thing NOW and enjoy yourself next year and the years to come. Unless you plan on dying within a years time.

DO THE RIGHT THING!

Repack · Apr 22, 2004

Asked, they said I wouldn't need one. Didn't ask any more questions. 48hrs later it was "weight bearing as tollerated.' Which for me meant using crutches but going through the motions of walking. Stairs were the best excercise. Actually, 'walking' with the critches was much easier than holding my leg up. It took about two weeks before I took my first steps. ~4 weeks into it I would keep 1 crutch in my truck just in case.

Putting off surgery:
Don't. The sooner, the better. I had it dones as soon as I could get it scheduled after I was correctly diagnosed. If I had had it done when I first blew it, I would have not torn my meniscus. Instead, I have a meniscus w/ 2 tears instead of 1, and I had 4 mediocer (sp?) ski seasons, missed 1 ski season completely and had a VERY weak '03 bike season. If I had had the surgery right away, I would probobly have had it just before Christmas (I was at college) and missed the rest of the ski season and had a fun (but probobly not competitive) bike season.

But I can't change anything so I aint bitchin'!

TWISTED · Apr 23, 2004

Originally posted by crashing_sux
From the research I've done it seems the CTI2's are the best,.

How does it affect pedaling and movement such as jumping/drops. Have you crashed in them? How much worse is the heat, compared to say a pair of full coverage knee pads like the old 661 wraparounds?

Do you get a discount for putting that sticker on your bike or are you just that happy with them?

When properly adjusted I can pedal better with them on.
I have never done drops or jumps without them (tore both acl's motocrossing before getting into mtbs)
I'll bet they are more comfortable than any regular knee/shin pad on the market. They don't have to be as tight and they don't slide down.
Yes and yes.
If these braces didn't exist I wouldn't be able to participate in this sport.

Tenacious Doug · Apr 23, 2004

This thread has kinda got me thinking again about the possibility of reconstructive surgery on my knee again. Like I said in my earlier post, my torn ACL does not limit me, it gives me very little hassle and I ride care free. Has anyone else had experience of a torn ACL that they have just compensated for with the surrounding muscles?

While I am a fit young guy it doesnt bother me but there is the thought of what would happen later in life when I am not so active and the surrounding muscles come weaker.

Repack · Apr 23, 2004

Originally posted by Tenacious Doug
Has anyone else had experience of a torn ACL that they have just compensated for with the surrounding muscles?

Not exactly, but the CTi2 did keep everything where ti belonged to the extent thnat my knee did get stronger, but I still needed the brace. Muscle cannot completely make up for what the ACL does- keep the lower part of you leg from sliding forward.

Lexx D · Apr 23, 2004

My best friend ripped MCL, ACL, PCL(yeah that's three out of four) in a skiing accident. Damaged his LCL? and other damage. He had surgery and did his physical therapy like he was supposed to. He's 6'3" 275 and rides hard with no barce(bunny hopping onto picnic tables in 3 months). It's more the doctor and therapist that will decide if you need a brace or not. I'm not saying people shouldn't have a brace, just exercise and keep the leg strong and you'll probably be OK.
He now calls it his good knee

DH Dad · Apr 23, 2004

There's a ton of information over on the Forums at www.dirtrider.net

There's actually one under the Vendor Connection for Asterisk. Lot's of MX guys actually prefer the "cheaper" non-prescription Cell over the CTi2 for comfort. I'm in the process of getting a set of the Asterisk Cell braces for preventative measures while riding my KTM. Not sure I want it on while MTB riding but maybe for DH it'll be a good idea, I'll have to see how comfortable they are to pedal with.

My wife has had ACL reconstruction and has a custom DonJoy that she wears for FR style XC rides but not less tech. XC trails. Only side effect I've noticed is the top tube of her Bullit and her C'Dale are pretty hacked on one side from the brace rubbing. I've put the 3M clear protective film on her new V10.

1000-Oaks · Apr 26, 2004

Yeah, my buddy has been hitting big stuff without his ACL but wearing a brace, doesn't mean it's smart. Any day he could turn a bad injury into a catastrophic injury.

Not to be negative, but I doubt your doctor has your kind of riding in mind when you tell him you "like to ride mountain bikes". I'd caution against it, but it's your knee.

Repack · Apr 26, 2004

Originally posted by crashing_sux
........................

My doctor said that I happen to have a very stable knee, and that without the MRI showing that the ACL is gone the manual tests he did make it feel like I still have one.

My doc could tell more from the physical exam than the MRI. He did one test and said that I "did not have a functioning ACL" (as in skinning a cat, there is more than one way to ruin an ACL). When he saw the MRI, he said, "I can't see anything, but I know its not working." He sould not see it b/c it was not there. the MRI did confirm that I had 2 meniscal tears as he had expected.

Motionboy2 · Apr 26, 2004

I am laying on my couch right now, and I had surgery on Monday to have my ACL replaced. I have to read through this thread still to see what everyone has to say, but I would start researching what surgery you are going to get.
This is what I think. I say sacrifice your summer, mainly because it seems like the people that push back the surgery just seem to skip it over and "deal" with whatever pain they get.
The problem is down the line it will get worse. you will hurt yourself more eventually. It is pretty tempting too, I got my surgery about a month and a half after I tore it and I was so ready to ride and skip the surgery.

After the surgery, you shouldn't clip in for about 4-6months, I am 1 week out of surgery and I am just starting to use that leg to walk. I think I will probably loose the crutches in about a week or 2.

You need to look into Hamstring or Patteller tendon grafts. I recommend talking to a doctor that does both. Research info on your own also.

I went with the Hamstring tendon graft. I spoke to 3 doctors, one did patteller only, one did hamstring only. The third is the one I went with. He does both surgeries and has had both done to him. So I was very interested in what he said.

Good luck choosing what your next step is.

Repack · Apr 26, 2004

Originally posted by crashing_sux
Physical tests and MRI's show different information......

I forgot to say that he couldn't see it b/c it had eroded down to nothing. Doc said post-op that that 2 little nubs were all that was left of my ACL.

On choosing a doctor- mine was refered to me by my long term/trusted family doctor. Turns out my neighbor also knows him. I have gotten very good at judging doctors. One of the things that really stood out to me was that he is a marathin runner. In other words, more of an athlete than I'll ever be, so I know he takes his work seriously b/c he knows what it is to lead an active life.

Jm_ · Apr 27, 2004

I tore my PCL (posterior cruciate ligament). Not all the way, but pretty good (as well as like 1/3rd of the meniscus or so im told). I let it heal without surgery, especially when I was given the awesome odds of 1/3rd are successfull (it's not like ACL reconstruction). I opted for physical therapy and it worked out good. For many months after though if I tried to do something like ski, and put on a ski boot, it felt like the lower part of my leg was not connected to the upper. A wierd feeling at all, and not one that I wanted to try and push, so I haven't skied since I did that. I think it's to the point where I am about 100% now, this is a fwe years down the road though. I don't have any intrest in how much $$$ it takes to ski as well, but I don't really notice any affects anymore in the sporting stuff that i do. When it happened it took a few weeks before I could walk at all, and months before I could run again at all. Now I don't really feel any "effects" of this, but I do have a lot of "lag" in that knee know. It's a medical term for what happens when you lay on a table, bend your leg so that your thigh is about 45° to the table, and then the doctor pushes on your lower leg and detects the fore-and-aft "slop" in the knee. I still have this, but as far as I can tell it hasn't had any drastic consequences.

spincrazy · Apr 27, 2004

I rode 4 separate days a month and a half after blowing my acl. I had surgery a few weeks later. I was very wary when riding those four days - very wary. I'm glad I had mine done in July. It's been awhile and

I'm pretty fully recovered by all standards, but I wish my quads were the rocks they were before the injury. You see, the quads will never be the same. They shut down to a certain extent due to the injury, and they never fully recover. Will your quads ever be what they once werre/could have been even after surgery? Most likely not, but at least you have an ACL to take some of the slack off. Your knee is stable because you've got strong ass legs. I did too, and do now again. However, I'm not going to be in top shape for the rest of my life no matter how much I'd like to be, people age. I enjoy being as back to 100 % as I can be. There is confidence in that like there is confidence in a bike that you've inspected and adjusted, that you trust won't be your failure downt the road - a failure that's not going to possibly cause you more failure because it's deficient. I don't hit that drop on the trail after blowing out 4 spokes in my rear wheel on a sketchy section of the trail earlier that day. Weigh your risk vs pleasure decisions carefully.

Anyone riding with a knee brace or ACL deficient?

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