Torn ACL ahead of charity 100 mile ride

I ruptured my ACL some 30 years ago and it was undiagnosed for 20 years, I've never had it repaired and providing I keep my muscle tone up around the knee I don't have instability problems. Surgery can have complications, especially on the knee. I both cycle and run a lot without problems so your long term prognosis should be good but you'd do best to avoid knee twisting sports.

Lots of good advice above, but I'll chip in my 2 cents' worth.

I had my ACL reconstructed on 14th May last year (I tore it years ago but it healed well enough for me to go 6 to 9 months' at a time before tearing it again...). I finally had enough of spending about 4 weeks a year on crutches...

Anyway, getting back on a bike was quick: I managed my first full rotation of a pedal about 2 weeks after the operation, and was cycling about 1 week later (when I say cycling, I mean gentle commutes in low gear). It was a lot easier to cycle than to walk of crouch, since a bicycle restricts one's movement and prevents any twist on the knee. The real worry - and this is not trivial - is not cycling per se but getting on or off the bike, and taking a fall: that is likely to send you right back to hospital, since during all this time (and for about 4 - 6 months after the operation) the knee is fragile as the transplanted ligament vascularises and bonds with what remains of the torn one.

Anyway, I didn't fall, and by week 6 was out doing 100km rides, and on 14th July got up Mont Ventoux (from Bedoin) - all the time praying for no mishap, and staying within what I felt the knee would take. And that is the trouble: there *IS* no typical recovery. I was lucky (no fall or twist), and intuitively felt when I was getting to my knee's limits (and had further luck that my intuition seemed to have been correct).

In sum, stay within what you feel is possible, get the knee moving as soon as as you can, and see how it goes. Good luck.

Hi

Having done a less severe version of what you did (Only completely tore my ACL) playing football.

I had my ACL repaired as i was lucky enough to be determined as highly active.

If they aren't going to repair your ACL before the charity event then cycling won't be a problem as the ACL is there to stop twisting of the knee (which there is very little of in cycling) but it might be worth having a shoe/cleat fitting to ensure that you are only moving your knee in one plane of movement i.e you knee isn't swinging in or out on the full rotation of the pedal.

Rehab wise i was completely weight bearing after about 4/5 weeks without crutches and running again after 7-8 weeks, so i think it is reasonable to be back on the bike doing light riding after 6 weeks(ish) and to build up from there onwards. My Mother has 2 torn ACLs and completed the Ridelondon100 (86 last year) in a very respectable time.

Key to ensuring you will be in the best condition for the ride will be strengthening the muscles around the knee to support whilst the ACL is not there and trying not to do to much heavy weight bearing exercise.

My wife did her ACL skiing and was treated via NHS. They didn't replace it but gave her a tough programme of physio for about 6 weeks. She kept up the exercises for months and to cut a bit of a story short was skiing again 12 months later - in fact she is stronger on that leg than she was before. So it will be ok! But give it time, you can always do the century next year.

I hate to say this, as I'm not in any way anti-NHS, but when it comes to treatment and recovery from the perspective of an athlete (however amatuer) it's very difficult to get the best and fastest result without private treatment. I've had recent experience with private healthcare vs. NHS for broken wrists and the differences have been vast. The NHS consultant felt that physio was *unnecessary* but the private care that I received recognised that it would be *beneficial* and it's certainly helped me to get back on the bike sooner.

I can't offer any advice on your specific injury other than to consider the care and treatment that you are getting. If stability of your knee is an issue a knee brace of some sort might allow you to ride sooner but get professional advice on the subject.

Andy, when I had my achilles injury I used to use an online forum for general grumbling and support. It was really useful to read other people's rehab progress and post your own - but important not to follow other people's advice if it sounded risky It can be a real downer when something like this happens but you can use it to focus on being fitter / stronger when you recover.

I'm trying to find the site... maybe it doesnt exist any more - but will post it here if I can find it.

Sorry to hear this Andy wishing you better. I fortunately haven't done ACL but have a mate who's had his done twice (and subsequently posted a good time at last year's Pru100) so if you have the motivation you'll get back on the bike.
I did however tear my articulate cartilage (playing fecking footie, like you) quite badly which left me needing keyhole surgery to trim it. I spent a couple of weeks after the op hobbling around on crutches and got myself back on the bike earlier about a fortnight earlier than the surgeon/physio expected, partly cos walking was a pain and annoying.

Cut a long story short I was back running within a few months and played footie about 6 months later; this proved that my rehab was complete. I don't play very much at all nowadays, got a young son and some lovely bikes to ride instead!

If your physio recommends that you attend a 'lower limb clinic' as part of the rehab then you will most likely be in a group with older folks, they may not be appealing at first, but GO, these were seriously good for my rehab as they had all sorts of machines to help the knee get back to normal. I'm now cycling 110-140 miles a week on my commute, so you will recover.

All the best hope you're back to full fitness soon.

Snapping your ACL is quite common place in my cycling world; BMX. My own ACL is ruptured and has been for quite some time. The only time it really causes me issues is when I forget about the inherent instability, twist it and subsequently dislocate the joint (usually happens when I'm rock climbing). I also have friends with similar situations. One thing that really helped us all was having strong and developed quads. The quads alone help stabilise the knee to some extent.
I saw a specialist recently with the view to getting fixed and was told the following recovery times: investigative arthroscopy, two weeks recovery. Full reconstruction: up to six months for full recovery. This will be where having strong quads will help reduce recovery time as they'll provide some support. My plan is to ride, race and rock climb as much as normal and go under the knife at the start of winter when I'm less active.

It seems the main difference with your injury is the cartledge damage, it's an unknown to some degree and may heal differently. Injuries can be unique and should be assessed and treated differently. The best advice I can offer is to listen to your doctors but more importantly your own body. You and only you'll know what you can achieve comfortably. Don't go destroying yourself for the sake of it but pushing yourself just a little can really help recover.

All the best!

One more thing, I can give you the details of my specialist, I chose him on the basis of him being a specialist in sports injuries to knees and would hopefully give me a fair assessment based on me rather than just being treated like just another job on the screwed knee human conveyor.

You have my full sympathies. The description of your injury was highly reminiscent of an afternoon a long time ago when I tried to pivot to catch an American football thrown behind me, and my left foot just didn't release from the sticky ground, causing both my ACL and MCL to snap (I still made a great one-handed catch of the ball, though ). As it's only your ACL that's torn, you'll have more stability in the knee than I had, and I'm glad you seem to be getting more proactive treatment than I was. The NHS put me in a cast, gave me crutches, and told me just to rest it as much as possible and come back in six weeks, at which point they'd re-evaluate it and decide if I'd need surgery. A couple of weeks later it was the Easter holiday, and I went back home to Austria and saw a surgeon there who took completely the opposite approach. He cut off the cast, told me to walk around as much and as normally as possible, and sent me to a physio saying that he wanted me to have huge thigh muscles by the time I came back for an operation in the summer. So I was able to do a lot, but, in contrast to you, I didn't have any cartilage damage, and I don't know how that will impact you.

The rehab after my ACL repair took a long time, and it was weeks before I even got back enough range of motion to get on the bike. However, I understand that there are now better ways to perform that surgery, so I hope you would have a quicker rehab.

Best of luck for a full and speedy recovery.

Commiserations - that sounds like a nasty injury. I'm sure with the right training and rehab you'll be back on the bike but you need to do it right and not push back too early, even though you feel you are letting the charity down. I am no expert but 3 months to recover and train for a 100 mile ride sounds optimistic / risky.

More importantly though, did you ask the consultant for their opinion? They should be in the best place to give you a considered view rather than someone random on an internet forum who knows nothing of the particulars of your injury or physical state.

FWIW I ruptured an achilles tendon a few years ago, also playing football (gave it up after that) and the rehab was long and frustrating but you have to take it as it comes. It's good to have some goals to aim for though as long as you are realistic about them and prepared to adapt as you go.