I snapped my ACL 6 weeks ago on an off mtbing through Wales (and got impact fractures in tibial plateau but they’re healed now).

I’m getting conflicting advice whether to have surgery (long recovery, poss complications as I’m in my 40s) or see if my knee will get strong enough just with physio (so I can be riding much sooner than with op).

I do big remote epics plus trail centres and BikePark Wales (reds not blacks at BPW).

Any experiences and advice welcome!

Of the people I know who have had them fixing works, about 6 month of recovery.

I’d go physio route to begin with, my recovery to full on football was 14 months after the op, biking after about 10 months, and I was 22. I did physio religiously. Your physio could help you make a decision after a few months of exercises.

Get a balance board, do things like cleaning teeth while standing on it ( just to integrate in to my daily routine), and squats, may be one legged ones. A few resistance bands may do the trick too.

Good luck, not a great injury to have, but you’ll get there.

Thanks guys. Mrwhyte, I got a T-130 RS in April – it’s killing me not being able to ride it!

I feel your pain! I have just broken my scaphoid so am currently in plaster. No riding for a few months 🙁

Oh no, that sucks!

I snapped mine when I was 24 and would definitely recommend an op. Regular physio meant I was back on the bike in under six months and playing football within the year. Everyone’s different though.It’s very difficult to tell the difference between the two now. I remember starting physio though and the idea of jumping off one small step was terrifying. Sure they’ll give you lots of exercises but the wobble board and balancing/squatting on one leg seemed the most effective for me.

Good luck. – if you can get an op soon at least you’ll miss the Winter!

OP, it sounds like you have a similar injury to what i had. Depressed fracture of the tibia plateau,ruputured acl and i also ruined my cartilage all at the age of 38. I had surgery mainly because it was all a bit of a mess inside my knee. i was on crutches for just over 6 months and then a year of rehab (had to have a knee abridement done half way through rehab which is why it was a long rehab). It felt like it was forever but now i can do most things but running distances and playing football i have stayed away from under advice plus i couldnt go through that again now i have kids. You could do rehab for 6 months and then find it hasnt worked and your knee is still unstable thus prolonging your recovery. Flip side to that is going through surgery and a longer process when there is no need. Listen to the medical team and ascertain how confident just doing rehab will be in terms of success or just go for the op which is likely to be successful but will be a longer process to full ability.

Appreciate your responses guys.

I ruined my knee a couple of years ago. It was locked due to cartilage damage and when that was fixed they found my acl had gone too. Physio advised me to get it done as it would help protect the cartilage. Recovery was about 6 months to get back on bike. Still have a bit of weakness in it but its ok for most things. Struggle to run. I was 40 then.

Thanks anagallis.

I snapped mine playing rugby just over 6 years ago when 37. I was able to go on a family skiing holiday and snowboard (it was my rear leg) 3 weeks after doing it and was back on the bike within about 6 weeks. I did it in Jan and was able to ride the SDW that Summer. The club I was playing for paid for rehab and specialist advice and I did eventually (Dec) have it reconstructed as it still felt pretty unstable. I did lots of “pre-hab” work before the operation to build the hamstring which helped recovery post op but it still took longer to recover from the op than the original injury – the knee was ok but the hamstring (which is where they take the graft from) took a while to stop spasming / tearing every time I ran. Again the club paid for lots of rehab and a residential course that really helped – I’ve pretty much got full functionality back now although it can still be sore if I push it. I suspect that’s more to do with other damage I did to the PCL at the same time.

My advice would be to do lots of rehab, see what functionality you get back and take it from there. The rehab won’t be wasted even if you decide to go for reconstruction as it will reduce recovery time from the op. One other consideration is ensuring you get a surgeon who specialises in knees – not sure how easy this is on NHS but if you’re going privately your Physio should be able to reccomend someone with a decent record.

Mine was just partially torn, I was right on the cusp of where surgery becomes a good idea but there was no real concensus so I resisted it and it worked out well. This is layman’s/half remembered advice but, the main thing I took away was that surgery would probably be better but could go very badly, and was basically irreversible, whereas other options might not work but didn’t rule out future surgery. And that to me made it pretty simple.

Thanks for the advice everyone

Get the surgery.

My story. Broke my left one at 1984 at 21 when I was super fit and playing a lot of reasonably high level hockey. Not sure surgery even existed then. Did rehab, not even physio and was back playing sport 9 months later but never quite at same level. Learnt how to manage it. Have skied aggressively, played tennis, took up mountain biking, alps holidays etc etc till at 49 in 2012 I bust the right one. Based on prior experience I decided to try physio / rehab route route. In hindsight this has been a mistake. With 2 bad knees it’s harder to manage, other meniscus damage has meant rehab / excersize is compromised as the less strong your leg is the worse it is. I am now looking at getting surgery done and private consultant wants to do both starting with the older injury.

Knees are complicated and often best left alone as surgery can make it worse. However techniques are now very established and rehab should be 6-9 months before you can be reasonably active and probably 2 years before as good / better than new (note have spoken to people who have had the surgery and broken the replacement).

The longer you leave it the older you’ll be and rehab / recovery will only be harder. The longer you leave it the more reluctant the NHS will be to do it – basically saying “well you’ve managed so far and anyway you’re too old to need to be playing sports, why not just take up walking …”

If you have private medical take advantage of it, you never know whether you may not have it in the future.

Good luck.

Thanks jambalaya.

I second the wobble / balance board. Everyone undsrstands the need for the “macho” quad building excersizes but the rapid little movement balance stuff is very important.

I’m 53 I imagine it will be ops at 54 and 55 and physio etc till 56/7. As its the best chance to be able to ski powder to more than a micky mouse level again and I certainly don’t feel like slowing down and raising a white flag 😉 FWIW I’ve done 2 Alps bike trips on the bike with no ACLs, I ride reds and easier blacks inc steep off-piste (eg Chamonix and Verbier). I don’t do anything except small jumps but that’s as much ability as knees. I wear a support for confidence not sure they really do much. One issue is whatever off you had to bust your knee if I (or you) did that again it would be much worse as no ACL to break / limit movement. You can get expensive fitted knee braves (£400 a pop) if I get surgery I will get those too.

Get yourself on a scheudle for an op and appointments may be a decent wait. Have you had an mri, that can be a 12 week wait. If you have the cash get a private mri / consultant meeting as it will accelerate the nhs schedule (on basismthey’ll ask you to wait months otherwise). If you are going nhs then say you have pain, better chance of not being fobbed off.

Steve Peat had his done so you (and I) will be in good company 8)

Cheers. Yep I’ve had MRI and just seen NHS consultant and had to fight to get put on op waiting list as don’t have any pain and stupidly told em so…

Snapped mine in September last year, had to wait till June for an op, back riding within 6 weeks, and 3 months on full on mtbing. Definitely go for the op, before my knee would keep giving way and couldn’t peddle out the saddle. Drop me an email if you need anymore info mate.

Thanks treklee, sounds like you’ve had a really quick recovery compared to other people – did you do loads of physio/rehab before and after?

If you intend to have an active life get it done. Tore mine at 39. Six years of physio and problems followed 🙁 Having the reconstruction was the best thing I ever did, went from not being able to race cyclo x (mini dislocations when jumping on and off the bike) to being able to racing Motocross at 56 😀

It sounds like you live a very active lifestyle. I don’t think you’ll regret having it reconstructed once you’re through the initial non weight bearing phase. My gf left hers for 2 years and was really pleased when she finally had it fixed. Get it done if your life circumstances can allow.

racing Motocross at 56

now we’re talking !

OP yes try and get the knee and muscles as strong as possible before the OP, better to loose muscle starting from 8/10 rather than 5/10 if you know what I mean

My French friends who have had the OP have had daily intensive physio for many weeks after the op and generally have had a month off work after the OP so half day physio is possible. I had a lot of physio in France with a specialist who had this specific hydraulic machine (have since seen pictures of professional rugby players using similar for rehab)

I would get it done as soon as the surgeon recommends it.

Mrs Dubs had both hers done before I met her.

The one she had first on the NHS was done about 2 years after the damage. She still doesn’t have full movement in it & recently had to have the cartilage cleaned up with more keyhole.

The second one was done immediately by a good surgeon. Almost perfect repair.

It was this dude, if you get a choice. http://www.parkside-hospital.co.uk/consultants/mr-jonathan-bell/

Yes to an op.. Had mine done around 10 years ago after years of problems.. Give 100% to Physio/rehab and you’ll be back to full strength in no time ..

I was 9 months before physio signed me off I was riding after around 8 weeks though

Thanks everyone, really appreciate all the advice. Yep I want to keep riding well into my 70s and beyond (saw the Iron Nun on fb who’s 84 and still doing ironmans!) so seems consensus is for the op…

http://www.physioroom.com/catalog/Wobble_Boards/3183.html

Cheap- but worth every penny and more!

Thanks mrwhyte!

Hey mate.

Really shit feeling when an ACL gets damaged. Good advice above from tallie above re doing lots of strength work pre surgery and reviewing it then. Surgeons love working with strong, good quality tissue, so the more you do now the better when/if you decide to go down the surgical route. There are many examples in pro sport of people who strengthened up the knee/hip to improve stability in the absence of an ACL so it is possible to perform without one if there is enough strength, proprioception and stability there.

The best bet is plenty of single leg work like Bulgarians, split squat, balance/wobble board work and then progress from there. Test it out on the bike and see how it feels after a long strengthening phase 4-8 weeks. Make a final decision on surgery depending on how it feels.

Best of luck,

Thanks Clem. That’s impressive those guys who’ve played on without ACLs…

Yes to operation. Got my torn at 18 playing rugby and nearly 30 years later it’s got worse to the point where my knee swells up if I walk more than a 100 yards. Never really affected my cycling at all but just got a referral to a knee specialist and will be pushing for an op.

Have a feeling that if I don’t get it I’ll be using a stick within a couple of years. Which would be depressing……..

Good luck with yours birdage…

@birdage, remember to tell them you are in pain. Best of luck

Have a feeling that if I don’t get it I’ll be using a stick within a couple of years. Which would be depressing……..

My consultant told if I didn’t have it done, I’d be seeing him for a complete knee replacement sooner rather than later. Some pro sportsmen have managed to function with ACL injuries, but usually only short term. I’d be interested to see how much arthritis they develop in the affected knee later in life.

Thanks. Planning on doing a comedy fall in the assessment for effect…..
It’s the impact stuff that makes it worse over the years, like running, walking down stairs etc. And damp weather!

Good luck with the knee specialist Birdage