Innocuous rock garden dab in Sierra Nevada 10 days ago has torn my left ACL as confirmed by MRI yesterday and knee specialist has said surgery is a must with 6-12 months off the bike. It’s hard to take in if I’m honest, it certainly wasn’t the answer I was expecting.

I see others on here saying they just turned the surgery down and tried to physio their way through it. Has that worked? I just want to get back on the bike ASAP. No other damage to meniscus or other ligaments.

Is there hope?

Loads of hope! I don’t have an ACL in either knee and ride without any issues. If you do other stuff like Ski-ing you may still wish the op but recovery is long as surgeon has said.

I had an ACL reconstuction when i was 19 so i could get back to rugby and skiing and it was a pretty long slog but at that age i thought it was worthwhile. I have subsequently ruptured both the graft and the other ACL playing rugby and have not had further reconstructions.

I have had 3 meniscus ops as well and the surgeon indicated that the lack of ACL allows a little more movement in the joint and therefore more chance of injury. In saying that none of my injuries have come through cycling and following my most recent op earlier this year i am pretty much cutting back my sports to cycling.

I would seriously consider the physio only route in the first instance you can always have the op later.

I first tore mine about 4 years ago racing moto-x bikes. Didn’t realise straight away what damage I’d done due to the fact I could still do most things. When I did go get it checked out and had an MRI it was confirmed and I went down the physio only route which worked for about a year and then as I was warming up to play hockey I finished the job off properly!!!
So then I opted to go down the surgery route after I’d had the cartilage removed due to me damaging that as well. Had the surgery and was off the bike for about 4 months that was 15 months ago and so far so good am back playing hockey and running and back working as a plumber again.
Did carry on riding the whole time my ACL was torn though without any side effects which the surgeon said was unusual. Am off the bike at the moment after bruising the cartilage in my other knee playing hockey 2 weeks ago. Think I may just stick to mountain biking

Friend did his ACL skiing four years ago in France. At the time he decided against the operation (which would have been done in France on the insurance), and despite intensive physio it’s never really been right for him since and has given way on quite a few occasions.

After many issues and 4 years he has finally had a reconstructive op 6 months ago through the NHS. Lots more physio after the op and he’s doing a lot better now. We walked up Scafell Pike with him the other weekend and it was all fine.

Judging by his experience, if it was me I’d get the op every time.

Done my left twice. First time totally ruptured. No walking for 6 months. This time in Feb partial tear with fibula fracture so cast for 12 weeks and knee brace. Back on the bike in June. But have ostechondritis disscans and lateral discoid meniscus tear. So surgery in December.

Snapped mine many years ago. Limped for about a week, since then it’s been mostly fine. I can run, walk and ride, but rapid direction changes, throwing shapes and kicking people in the face are all out now.

Edited to add not had any surgery.

Spotted this related article today new ligament found in knee

I’ve snapped my right and torn my left (one on the bike and one skiing) – both in the last 5 years. Had an MRI on both that I paid for, put them in front of a good physio on the basis that this might work and would be a better option than surgery. I’ve been riding since, a lot! Skied at least 4 or 5 times as well and no ongoing issues. I can’t give you a medical answer, simply based on my own personal experience – the bit that made sense more than anything else was that I had little to loose by trying and everything to gain…good luck!

Get the opp deffo! It’s ok riding with a torn acl but when you come off the bike you bloody know about it! Well I did anyhows! And it will get weaker every time it comes out. Doc told me to stay off the bike about 9 months too but like you, I couldn’t and was back riding after a month, stupid I know, but I was gentle to start with and worked my way up, keep doing the stretches and go for the patella graft over the hamstring, it’s a lot stronger although kneeling down will never feel as comfortable again, but I would rather it be more stable.

I snapped my ACL just over 3 year ago after an off on the bike, had the accident early October, think I was laid up for about 3-4 week, then started at the phsyio and gym to build my leg muscles back up before the op, had the op late December (removed part of hamstring tendon and made a new acl from it), was walking with crutches the same day, hobbling around the house without crutches within a few days, think it was about april time that I was back on the bike (just on the road), I done a fair bit of phsyio / gym work to get back into action asap, i’m sure it late summer and I was back out off road again, was abit dubious at first, but it never gave me any bother, i’d say within 12 month of the accident I was back to doing everything I was before hand without any issues at all.

Snapped mine completely four years ago, also partially tore my medial. I opted for survey and had the hamstring donor option.

I was walking the day after, albeit gingerly.

Physio commenced two weeks after surgery and I was still going to Physio eight months after surgery.

It took me twelve months from surgery to be back at as close to 100% as I’m going to be.

Things I learned-

Do not ignore your Physio and go for a bike ride before he gives it the ok

Do exercise and do your Physio religiously

There are as many folk going to tell you to get surgery as there will be telling you not to. It’s up to you, I’m firmly in the surgery camp.

I tore mine skiing in 2012 and waited until this September to have surgery. In the time between tearing and surgery I had a few of episodes of knee giving way (playing football and putting a foot down mountain biking a couple of times) which was seriously painful. However most of the time I was fine but I never really trusted the knee again it was always at the back of my mind during techy sections on the bike plus I want to play football and go skiing again. But everyone’s knee is different.

The surgery wasn’t particularly painful but I thought it was worth giving the physio a try 1st as it will help build up the muscles which you’ll need anyway if you have surgery. I’m now 9 weeks post op and the knee nearly feels normal again and already more stable. The Acl graft is weak up until at least 6 months and not full strength for 12 months, so I’m not looking to go off-road until at least next spring. Last thing I want to do is to rupture the graft by being inpatient. I am spending at least one hour a day doing physio and need to keep this up probably for the next 6 months.

If you get surgery chose a surgeon who does this op regularly, they will have a preferred graft donor site and I would go along with their choice. I think the hamstring option is usually the best although you need to build up the hamstring afterwards.

My surgeon warned me that the knee will never be the same again as you can’t fully replicate the ligament by surgery. Over time the tendon changes and becomes more like a ligament but you won’t have a nerve supply to it so you lose balance feedback. The knee could still give way and sadly you are 95% likely to get arthritis whether you have the op done or not after an Acl rupture.

In the end I decided to give the surgery a go and so far it’s gone really well.

Hope this helps

completely destroyed mine about 7 years ago but it was a long time before the effects were obvious – like at least 4 years. Then it got gradually less stable and loss of ability to stand from a squatting position.

I got the op about 16 months ago. I was walking unaided the next day, no limping at all within a couple of days, gentle biking after a week and running a few km within 3 weeks. Back up to pre op fitness within a few months.

I put the fast recovery down to the fact that there was no acute symptoms – due to being several years from the initial trauma. I would suggest trying to avoid the surgery for as long as you have no other symptoms. Once you start getting signs of wobbliness though it’s prob best to get fixed.

I’ve had ACL reconstruction in both knees, it was a hard slog but in my opinion was very much worth having the surgery. After both ruptures I found stability wasn’t great which in turn knocked my confidence which is why I opted to get fixed up. One thing that I found is key is that as long as you keep fit and stay on top with physio the surrounding muscle does all of the hard work which makes recovery that much quicker and easier. I was riding bikes fully about 6-7 months after each op but I really put the work in with physio to allow that to happen.

Good luck with whatever you decide to do but I really would think about what’s best in the long run. I was only 26 when my second op took place and 3 years later I know I made the right choice.

Tore my right ACL about 8 years ago, was fortunate to have medical insurance through work so had an MRI a week later and first of two ops the week after that, to cut out the torn ligament. 6 weeks later another op to reconstruct using part of my hamstring, and then what felt like an age in recovery.

All told I think it was about 9 months before I could really get going. I tried to start too soon at about 3 months and set myself back a few weeks.

All in all I’m glad I had the op as I carried on running, biking, climbing, skiing, snowboarding, playing footy. BUT I was lucky to have insurance, my neighbour had the same injury about 6 months after me and had to go NHS, it took him about 18 months to get the op IIRC.

Good luck whatever you decide.

Another one here who snapped the left ACL and tore other things in and around the knee. I had the surgery plus the hamstring graft.
After the surgery, I was back on the bike within 3months. Thats not to say the knee felt secure in that time, so I wouldn`t recommend clip ins or anything too adventurous.
I had physio to build legs up prior to op. Probably because my thighs are skinnier than an 11yr old girls arms, and doc thought they`d wasted away..

Thanks for all your experiences, really useful.

Turns out from the radiographer’s report that I’ve also torn my meniscus so Doc says operation now urgent for that at least (keyhole). So all told I’ve decided to get the whole thing sorted out surgically. Doc’s view is that the risk of it buckling and doing more damage will always be there otherwise and with the type of riding I do (drops/ jumps/ technical etc.)he strongly suggested getting it sorted now. Luckily I have private medical cover to get it done quickly.

Here’s to being back on the bike ASAP!