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  1. #1
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    Post ACL surgery - did you change anything?

    Just had an ACL reconstruction a few days ago. Will start PT within a week. Still far from riding but want to know from those that have had knee surgery:

    Did you change to platform pedals?
    This seems logical to me, but hate to go back from riding clip less.

    Do you ride with a knee brace?
    It seems like the repetitive motion would be horrible with a brace on. Any tips? Do you wear a sleeve under the brace?

    Do you now ride with knee pads?
    This seems logical, any preferred pads for an XC single track style? Can you wear them with a brace?

  2. #2
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    I had ACL reconstruction last April. I'd ridden platforms before, so no changes there. I waited a month or so after I got back to riding to try my clipless road bike pedals. I backed off the release tension on them first. No problems.

    I never rode with a knee brace, but I guess it should depend on the type of riding you do. I would use my knee brace for DH.

    I rode with knee pads for a few weeks once I was riding outside again. I had a patella graft, so the front of my knee was recovering as well. My PT's biggest concern before clearing me to ride outside was that I would crash, hit my knee and suffer some sort of setback on my therapy. A year out from surgery now, I don't feel the injured knee is any more vulnerable than the good one.

    Good luck with your recovery. I progressed pretty quickly. I was riding the indoor trainer within 3-4 weeks post-surgery. I was riding the bike path in just under 3 months. Finally, mountain biking on technical trails 4 months post surgery. It was a long 4 months though.

    Repo

  3. #3
    dru
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    I had the patellar version more than 20 years ago.

    The issue going forward isn't the ACL, it's other damage.

    For the OP, if you've also had any meniscus damage and subsequent removal of torn meniscus you'll want to consider avoiding impact activities such as running and skipping. Arthritis will likely set in after 20 years or so on average. I'm probably right on the edge for this right now. If you are overweight in any way lose that weight and keep it off.

    The ACl repair should heal up perfectly, just watch it for the 1st year. No need to change anything you do on the bike.

    After my surgery I ran a fair bit off and on over the years, got a black belt in karate, and boxed off and on for a few years. The last time I was boxing I was also running which was a huge mistake. My knee stayed swollen for nearly 2 years after I hung up the gloves. I was limping every day for a long time.

    Miraculously the knee settled back down and I put all my fitness efforts into biking; it is the best thing for the knee, and 4+ hour rides are no issue at all, nor is hammering as hard as I want!

    Drew
    occasional cyclist

  4. #4
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    Did you change to platform pedals?
    Have always ridden flats.

    Do you ride with a knee brace?
    No brace after surgery for any activity. I had a custom one made with the thought I could avoid surgery. Bad thought. I've heard this from the medical community and I agree: The benefit of a brace, largely, is that it makes you conscious of your injury and favor it. I don't believe any articulating brace can truly immobilize the lateral movement of the knee enough to depend on for structural integrity. There's just too much muscle everywhere and too much leverage on those long bones.

    Do you now ride with knee pads?
    Usually yes, but only for impact injuries. Not related to my ACL replacement.


    Be patient; your knee will eventually be bomb squad for most anything you're likely to do on your bike. The worst case scenario biking IMO is bailing off the bike and jumping onto unstable ground.

    I've pounded my replacement for almost two decades (no jogging, tons of fast hiking, backpacking and biking) and only recently had to go back in for a bucket handle tear fix, so have to concur with dru there about "other" damage. The knee and ACL itself is tight as a drum and trouble free. Patellar tedon graft.

    Be well...

  5. #5
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    I will actually be taking my first ride this weekend post-op following my 2nd ACL repair (the other one was 14 years ago).

    I switched to platforms because of my knee injuries, and ended up liking them better for the style of riding I prefer. But interestingly, the surgeon who did my most recent surgery disagreed with this decision. Her logic was two-fold, one, that platforms with a good shoe give you NO float, whereas clipless does, and two, quad dominant people are more susceptible to ACL tears and she felt clipless would be better for helping improve my hamstring strength relative to my quads.

    I tried wearing my brace the first time around and found it rubbed my frame and was very noticeable. So now I never do.

    My parting words of wisdom: by a mile, biking is the best thing for my knees. It is pretty much therapeutic. When I'm at the height of biking season I barely notice any knee pain and my legs are strong and I feel good. In the middle of winter, despite frequent exercise/skiing, I start to notice creaks and pains in my knees.

  6. #6
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    thanks for all of the replies.

    I'm now 9 weeks post surgery. My recovery is going really well. PT is helping a ton. Going 3 times a week.

    Been riding around the neighborhood with my boys. Itching REAL bad to get back on the trails, but I know I shouldn't. Been hearing from everyone that right around the 8 week mark is the most dangerous .... you start to feel good, but under 3 months and the graft is still at it's weakest.

    I will be looking for some sort of a soft knee pad. I rode with some neoprene pads last year that i used to were underneath skateboard knee pads to keep them from slipping. They were tight and had a gel pad over the knee. I liked the support it gave but want a little more protection. I see 661 makes something I may be interested in. I'm more of a single-track rider than a downhill, so I don't want anything too armor-like.

    My Dr. also said that clip less was better. Strengthens the hamstring more - which i guess is better for the ACL. I'm not sure I want to do clip less as it's my left leg and that's my go-to leg to take out all of the time. Seems like a lot of twisting to do. Plus it seems like I always tend to fall over to the left when hill climbing when I get stuck. No idea why on that one!

    So - now give me some good ammo to use so I can use this knee surgery to buy a full suspension bike!

  7. #7
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    Flats, kneepads, no brace.

  8. #8
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    Re: Post ACL surgery - did you change anything?

    My only knee issue post acl due to riding came from using simano pedals and not having my cleats alignes properly. I switched to egg beaters which have a ton of float and take almkst no twisting force to get out of and the problem went away instantly.

    Egg beaters are very knee friendly


    Sent from my GT-I9192 using Tapatalk 2

  9. #9
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    Last year I switched from the shimano to the Crank Bros pedals and noticed the increased float.

    I wonder though - is there a "best" position for cleats for knee issues?

    I currently run with the cleat all the way toward the arch, with my toes angled out. I wish that the cleats were much more fine-tunable. I'm very specific on my snowboard binding angles and they are in 3 degree increments.

    I also wonder about pedal shaft length. Seems there's not much offered to change that.

    Probably a good thing to get a fitting once I'm back riding.

  10. #10
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    Re: Post ACL surgery - did you change anything?

    Get a fitting and they will explain the intricacies of vleat position, float etc beyer than i ever will... my taje away from my fitting was i am naturally to out which is why iwas getting knee pain from my xts set up neutral. The egg beaters just let my feet ait natural without locking them in.

    Spindle length isnt a variable but with most cleats u can adjust this on the shoe by moving tje cleat left right, same thing as changing spindle length and fitters use this feature to get optomal alignment

    Sent from my GT-I9192 using Tapatalk 2

  11. #11
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    I'm now 3 months post surgery. Rode 9 miles on a paved bike path and felt awesome after.

    Just took my 7 and 5-1/2 year old on a moderate single track of 6.5 miles. Did a lot of walking up hills with my youngest, but felt good after.

  12. #12
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    4 months post. Finished with physical therapy. 10 minutes of jogging and lots of jumping. Knee still hurts a bit, and will stiffen up if I sit in one position too long.

    Went on my first single track ride at my normal pace. Pretty difficult terrain. Wore a neoprene knee wrap. Ended up posting my 2nd fastest time on that trail without really trying. Knee was fine. No pain. Hated climbing with platforms though. Will probably change back to clipless soon.

  13. #13
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    5 months post. Can ride as hard as I want. But stamina isn't there yet. Just picked up a Trek Fuel EX8! Doing single track. A little timid about what COULD happen with the knee if I catch myself from a slip out. Have had a couple of close calls, but so far ok. Can do some small jumps with no problems. I feel best wearing a tight neoprene sleeve over the knee for stability. But not really sure if I need it - more of a confidence thing I think.

    Knee is still stiff if I sit too long (desk job). Still have a numb spot just below the knee that hasn't recovered yet. Pain is probably a 2 out of 10 consistently. Not taking any meds. No swelling - well except the back of my shin when my leg slipped off and got a pedal hit! Using clip less now.

  14. #14
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    My son was on the US Ski jumping Team 13 years ago, blew out his ACL. They had him riding bikes as a part of his recovery and he tore out the new ACL. This caused his retirement from skiing. He has no ACL. They had him on the bike too early. He still bikes with no brace. He did a 100 mile road race last summer on a fixie, don't ask, but he says he will never do that again. He recently rode his bicycle from NYC to Vermont and back for a wedding. I blew out my knee 40 years ago and have had no ACL since then. Ny knee has no cartilage, bone on bone and the joint is made out of bone graphs. The ligaments on the inside of my knee were detached surgically and reattached on the outside to help stabilize it. I have a real big scar on the outside of my knee and lower leg. I was on crutches with no weight bearing for 6 months and then had several months of rehab, but was skiing that winter. They gave me a brace and I have had the newest versions. I never use them as they are a pain in the butt and piston down when running or XC skiing and cause chafing. I occasionally wear it skating, if I remember. For about 10 years after my knee injury I did orienteering and wore the brace for running XC through the woods (even won the National Championship in my age, which is pretty good for a one legged runner). A knee replacement is in my future, but with my type of injury they have a 20% failure rate. Anyway, with a knee replacement I couldn't abuse it like I do MB and I want to do that as long as possible. I MB bike about 30+ miles a week. Both of us have pain, but we ignore it. I am almost 69 and if you are young you should do fine, probably have some issues when you get older so enjoy your self. I ran, skied, biked but began to slow down about 20 years ago from the knee pain, but so far it hasn't stopped me entirely. Avoid clips. My sons Dr. who did his ACL repair told me that skiing is not his main source for ACL repairs anymore, it is mountain biking. He said that you come out of the clips, put your foot down toe first and the foot twists to the inside and ruptures the ACL. My son never wears knee pads when MB. I only wear them or elbow pads after a crash where I badly bruised or exploded my skin. Always wear a helmut. I split one a month ago after dropping off a the trail into a drop off and slamming face first into a rock wall. Got a concussion, and road rash and exploded fingers. The bike had a bent wheel and bars. Last Wednesday I was riding in a group and we were going over 21 miles an hour (GPS) when the person in front of me tapped the bar end on a tree and slammed back wards headfirst into a tree. The helmet was split and compressed, but no head injury, just pretty massive road rash.

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