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  1. #1
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    ACL Reconstruction

    Hello. I had ACL reconstruction back in June, the type using a double hamstring harvest. Recovery has been a long, grueling process, but I was finally cleared to mtb again this past Thursday, and went for my first mtb ride since June yesterday (Saturday). I had already been riding cross on gravel roads and double track for several months, and it has been going well. The one area that seems to remain uncomfortable is pedaling while standing, at the top of the pedal stroke. Basically the little push forward. I've been doing barbell squats and deadlifts and that seems to have helped a bit on the cross bike, but I noticed that it felt quite a bit different on the mountain bike yesterday, and was still somewhat uncomfortable.

    Any of you fellow ACL reconstruction veterans out there go through the same thing and have any pointers?

    Thanks in advance. It's great to just be able to ride again.

  2. #2
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    I had my ACL reconstructed about 6 weeks ago at the beginning of April. I had the Patellar graft procedure.

    So far progress has seemed really slow, though I have been positively religious with my PT. I've been on a stationary bike for the past 2 weeks and doing a lot of exercises to strengthen my quad and other supporting leg muscles. My knee is still pretty achy, and I really can't walk very far at this point. My Doc expects full sports recovery in 6 months, MTB as early as July. I sure hope he is right, but it seems a bit optimistic to me right now.

    How is your recovery progressing?

  3. #3
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    I had my ACL reconstruction about 13 months ago. I'm not the best example - I had a lot of complications and another surgery as a result at about the 6 month mark to remove scar tissue and correct a few issues.

    PT is intense (I'm still going). Twice a week for about two hours at a time on top of daily rides and exercise routines. The most important aspect of the physical recovery was plyo. Basically, being able to be strong in motion (jumping, landing, leaping, fast feet, tele lunges, etc.). Full recovery for an athlete with nothing to do but recover is about 6 -8 months. Recovery for a "real" person is usually closer to 12 and for someone like me with complications, it's about 18 months. I was cleared to ride hard at about the 12 month mark and had been riding "easy" at the 4 month mark. Hard = techy, steep single track with consequence for failure and rides over 20 miles. Easy = I'm not going to fall or need to stress the joint or muscles.

    I've been riding hard for about two months now and am finally seeing good results - good enough to plan my first endurance mountain bike race in June.
    I'm always going to deal with some lasting issues however, in large part due to those complications.

    Standing up on my bike and pedaling is difficult - I can do it but not sustain it for more than a few strokes before the joint begins to ache. This will go away with time, but by time we mean years.
    Clipless pedals are out of the question. Again, this is due to my complication. I've had to move on to flats (which after getting the right ones, actually, I love).
    There are also the lingering mental questions and concerns. At times I give up on a difficult move simply because I don't believe that my knee will handle it or I fear that it will give out (though it won't).

    Another side effect? I like biking. I love biking. A lot. It gave me my strength, freedom, and confidence back. Day by day, ride by ride, the knee is improving and I'm looking forward to the season. Take it slow, listen to your body, and keep your goals realistic. This is the time to take care of yourself and to celebrate just how amazing it is to have two legs that work (most of the time).

  4. #4
    psycho cyclo addict
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    I had an autograft ACL replacement (using the central one-third of my patellar tendon) 9 years ago (only major injury in 30 years of playing soccer). I had a long and drawn out rehab that took more than 1 year before I got 90+% flexibility back and it was more like 2 years before odd pains went away. I noticed it most when sitting and extending my leg straight in front of me, walking down stairs and something similar to what you describe when pedaling.

    For me, it was less a pain than an odd pressure sensation. I had a meniscus tear/repair and strained MCL too! I felt really comfortable ~2 years out and returned to most activities (other than I don't play soccer or run anymore since my cartilage is ~50% worn down from what the doc said).

    The best thing to do is go sloowwww and build up strength and stability over time. I frequently do knee/quad, calf and hamstring stretches before riding and haven't had any issues pedaling 60-80 milers on smoother terrain or 15-20 milers on extremely rocky and technical terrain.

    One thing my orthopedist was adamant about is no more squatting. That puts the most stress on the knee and should be avoided whenever possible.

  5. #5
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    I just had the same surgery(Patellar tendon replacement of acl) last Tuesday, the 21'st. Pretty much still in bed- can almost put weight on it. Can not wait till Physical therapy so I can be doing something active towards recovery-( there was a delay and confusion concerning who was supposed to do my referral) but terrified at what its gonna feel like. Still agonizing to bend slightly and when I put weight on it feels like its not there, like my leg will fold up. Cant wait till I can bike- I plan on buying a trainer so I can at least use my own bike this season.

  6. #6
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    Good luck with your recovery. I am closing in on 7 weeks since my surgery (I also had the patellar tendon procedure). So far both my doctor and physical therapist say I am a model patient - both healing and rehab are going great. I saw my doctor about 2 weeks ago. He said it will probably be August before I can get back on my MTB and start pushing myself. That will be about 4 months after my surgery .

    Get the trainer. It's really helped me to be able to replicate all the exercises from PT at home. They put me on a stationary bike after about 2 weeks of PT (4 weeks out of surgery). That is the only exercise I am cleared to do right now that gets my heart rate going and feels like conditioning.

    As others have said, be patient with your recovery. I've come to understand this was major surgery and recovery is a long process that I can't really hurry along. My pain is way down over past couple weeks, but my whole body - not just the injured leg - is so out of shape from basically 2.5 months of very limited activity (I had to wait a month after the injury to have surgery. Building back my basic stamina is a big part of my recovery right now.

  7. #7
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    Yikes! That injury sounds awful. I personally had shoulder surgery and I know that I wasn't the same afterwards. I would suggest not rushing your recovery and doing all of the rehab exercises within the time frame.
    I'm Dante. I'm a passionate programmer who occasionally does some research paper writing on the side.

  8. #8
    dru
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    Ah, you young pups! My surgery is more than 20 years old now. Got the patellar graft version. 10% left of one of the menisci (outside one I believe)....It has held up amazingly well and I was told that I'd have arthritis by now, which somehow hasn't happened.

    As for pain, it's a biatch. My leg doesn't completely straighten compared to the other one. Fully bending it is very tough too.

    After surgery I went on to get a black belt in karate and then boxed off an on for a few years. Running and the impact from these sports did my knee no good at all. The knee was swollen up pretty good for more than a year before settling down. I dodged a huge bullet jsyn. That was 10 years ago. I do no impact sports at all, the knee can't take it.

    Lifting weights is just fine (I'm skinny so I'm not lifting much) as well as using my elliptical machine.

    Cycling gives it no issues at all, although I can feel the odd jolt of pain once in a blue moon, which goes away by the next pedal stroke. These jolts seem to be caused by having my knee in an abnormal position when pedaling or from hitting bumps.

    As for you guys, who knows what to say? We all heal differently that's for sure. I consider myself very lucky.

    Drew
    occasional cyclist

  9. #9
    OMG!
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    i had the pattelar graft 3 weeks ago along with meniscus repair and femur microfracture. It's no weight bearing for the first 6 weeks. Glad to be half way through my stint on crutches. The pain is still there, but has dulled down a lot. I'm off the percs for the most part now.

    Can't wait until I get the range of motion to ride a stationary bike, and eventually work back into riding trails and dh.

    This is my 3rd ACL and 5th major surgery. As I get older (30 now), this injury makes me think a lot about slowing down and taking less risks. I don't know if that's even possible for me. If I see a gnarly trail or jump line, it's almost like i have to do it...

    Have any of you taken a step back from risk taking behavior after serious injury?

  10. #10
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    Wow, 3 ACL surgeries - I can't imagine. I tore mine skiing and though my Dr promises I'll be able to ski again this coming season, I definitely plan to dial it back quite a bit next year. 30 is young. I'm 51. This is my first major injury, and the recovery has been tough for me mentally and physically. I don't want to go through this again. Get well soon!

  11. #11
    OMG!
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    ya repo, it is tough both mentally and physically. i'd say the hardest part is not being able to be active. my solace is that the doc cleared me to do upper body work at the gym a week ago. i've been going every other day, and doing a short 3 exercise circuit- lat pulldown, bench press, row.

    Good luck with yours! Sounds like you're on the right track!

  12. #12
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    Today was a big milestone. 11 and a half weeks since surgery I had my first ride on a real bike outdoors! It was only for 25 minutes, on a near level gravel and paved neighborhood bike path, but it felt great to be back on the bike again.

    My physical therapist wants me to work my way back slowly, listen to my body as I add time and mileage to my rides. The biggest fear is a fall or collision, so I'm sportin' some nice new POC VPD knee pads for added protection.

    My knee felt good during the ride - actually better the longer I rode. Hopefully I'll be cleared to ride singletrack again within the next 6 weeks. For now, I'm pretty happy just to be outside turning the cranks and watching the ground pass by beneath my wheels.

  13. #13
    OMG!
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    congrats man that's awesome!

  14. #14
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    Quote Originally Posted by adjunkie View Post
    This is my 3rd ACL and 5th major surgery. As I get older (30 now), this injury makes me think a lot about slowing down and taking less risks. I don't know if that's even possible for me. If I see a gnarly trail or jump line, it's almost like i have to do it...

    Have any of you taken a step back from risk taking behavior after serious injury?
    Lol. Love this post.

    I had surgery to fix a pretty gnarly Tibial Plateau Fracture exactly one year ago yesterday. My recovery has been tough and still ongoing. I'm back to riding but not nearly yet to the point that I feel comfortable doing some of the drops and rocky stuff I used. Although I was more of an XC guy anyway. Anyway, I'm just hoping that I can physically get back to the point where I can actually choose whether I should be doing some of the riskier things.

  15. #15
    OMG!
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    Last week was somewhat of a turning point for me. week 6. the doctor finally allowed me to bare 25% weight on it, and increase the rom past 90 degrees.

    This allowed me to pretend I can walk (with crutches) and more importantly, RIDE THE TRAINER BIKE!

    Next on the agenda- increase rom to 150+, and increase weight baring by 25% per week. Next tuesday is 50% week!

    Walking and riding a real bike are almost in sight.

  16. #16
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    Great news for you! Keep with your PT, sounds like you are making progress. I've gotten used to incremental progress myself. 13+ weeks since surgery and I'm back on my bike and riding level trails using low gears now - up to 45 minutes. Working up to 1 hour by the end of this week.

  17. #17
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    At just shy of 15 weeks since surgery, I finally added some mild singletrack into my riding this week. I threw in a loop at one of our local parks. I've been doing 10-14 mile rides every day now and my leg is starting to feel noticeably stronger and better. My knee is not normal yet, but it has tolerated the increased riding very well.

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