Post operation rehab - torn ACL & miniscus

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Post operation rehab - torn ACL & miniscus
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flag mikeross92
Posted: Mar 1, 2019 at 23:05 Quote
Hi All,

I’m 26YO, and six days ago I had a large fall snowboarding and did some quality damage to my left knee.

Damages:
1. Complete rupture of ACL (requires reconstruction using quad graft)
2. Minor tear of Miniscus
3. Potential damage to MCL
4. Non-displaced fractures to Femur & Tibia within the joint.
I go into surgery in five days for full repair to my knee and am very nervous about being able to ride enduro again in the future.

I’m wondering if any of you:
1. Have any rehab tips, excercises or advice?
2. Have had similar injuries/ operations and know of time frames before it’s possible to ride again?
3. Ride Enduro with a knee brace, or know of any good knee braces for mtb?

I’m really nervous, as I haven’t had surgery before, nor have I had a serious injury that affects my performance in a sport before. So any info/ experiences or knowledge is much appreciated.

Yew!
flag tony76us
Posted: Mar 3, 2019 at 12:04 Quote
1. Best advise is take it easy after surgery. Don't push it too hard and let it heal. Use straps and lightly stretch it out.
2. I tore my acl, meniscus and broke my leg from jumping out of a building (POLICE DEPT) 10 years ago. Don't know about time frame for bike riding, didn't ride then. I waited almost 7 years to have surgery, screwed up big time. Should of had surgery after the incident. Now I have horrible arthritis and inflammation.
3. I tried a knee brace for a bit, but it didn't help.
flag mikeross92
Posted: Mar 4, 2019 at 14:26 Quote
Thanks for the advice!! That sucks to hear about your knee now!
flag lblizzard
Posted: Mar 7, 2019 at 10:15 Quote
had lots of broken bones but no ACL, however my girlfriend has had ACL on both knees from bike accidents and many of my bike friends have as well. Any surgeon in sports medicine will give you mild exercises to do and most important stretches. She was back on a stationary bike within 3 weeks, no resistance to start. Back on a mountain bike 12 weeks later doing simple single track.
The surgeon that did her knee wrote this book, he's retired now but worked with the US Ski team many years. Maybe it will help.

https://www.amazon.com/Knee-Surgery-Essential-Guide-Recovery/dp/0312362935
flag lblizzard
Posted: Mar 7, 2019 at 10:20 Quote
you mean hamstring graft? the hamstring graft will actually end up being stronger than the original ACL, that's what some studies says anyway and i know MANY folks that have had it done and believe that.
flag mikeross92
Posted: Mar 12, 2019 at 16:42 Quote
lblizzard wrote:
you mean hamstring graft? the hamstring graft will actually end up being stronger than the original ACL, that's what some studies says anyway and i know MANY folks that have had it done and believe that.
thanks so much for your help this gives me some confidence!!
flag lewiscraik
O+ FL
Posted: Mar 27, 2019 at 6:07 Quote
I only partially ruptured my ACL (about 10 years ago), I opted not to have an operation, but seeing a sports physio helped with rehab.
flag mderoy
O+
Posted: Mar 28, 2019 at 17:14 Quote
Had ACL surgery last year with BTB method.

Don't go to hard in the beginning. lots of stretches and physio every single day. If your doc know anything about sports medicine he will give you couple exercise to do starting the next day after surgery. follow them but don't over do them.

you will start feeling good sooner than you think BUT DON'T think you are good enough. this is where most people f**** up. It takes a full 6-9 months for a tendon to become a ligament I don't care if you are Usain Bolt or an homeless dude it will take time to the body to generate a ligament. Your tendon is gonna deteriorate the first 6-9week after surgery and then the cells are gonna start building back into a ligament. You'll be able to pedal with no resistance pretty quickly and ride a bike inside 2-3 months. it doesn't mean you should go out and ride it. Stationary bike will be your best friend.


If you're not already eating healthy you should start the second you are reading this. Lots of water, good food and nutrients will help your recovery.

If I had to do it again I would choose the hamstring Graf.
It's been 18 months and I'm still struggling with my patellar and I have a pretty decent back ground in rehab (had couple surgery including shoulders).


And just so you keep hope I was ridding enduro trails 5-6 month after my surgery. Small rides not to wear my knee down but enough to make me smile again.

Good luck
flag xzyragon
Posted: Apr 5, 2019 at 11:59 Quote
1. Have any rehab tips, excercises or advice?

Follow your PT's advice. They'll have plenty of exercises to keep you entertained. If you're itching to ride, pick up a road bike and don't crash. I started MTB as cross training / rehab from my ACL surgery.

2. Have had similar injuries/ operations and know of time frames before it’s possible to ride again?

Time until you're back on a bike? 4-6 weeks as biking is a key component to build strength and endurance back in your quad. Time until you're riding enduro? Probably 4-6 months depending on what surgery you opt for and how aggressive you are with rehab.

3. Ride Enduro with a knee brace, or know of any good knee braces for mtb?

I don't use a brace for any of my activities. Braces are a crutch for poor form and muscle imbalance. There's no reason your leg can't return to at least 99% of it's original strength if you follow your PT's advice.

TL;DR: do what your PT says. Anything from here is anecdotal from personal evidence, BUT if you treat rehab like a daily exercise, you'll get better a lot faster. Just stick with it. I was back to doing all of my hobbies within 6 months, and had full confidence after a year post op.
flag xzyragon
Posted: Apr 5, 2019 at 12:11 Quote
mderoy wrote:
Had ACL surgery last year with BTB method.

Don't go to hard in the beginning. lots of stretches and physio every single day. If your doc know anything about sports medicine he will give you couple exercise to do starting the next day after surgery. follow them but don't over do them.

you will start feeling good sooner than you think BUT DON'T think you are good enough. this is where most people f**** up. It takes a full 6-9 months for a tendon to become a ligament I don't care if you are Usain Bolt or an homeless dude it will take time to the body to generate a ligament. Your tendon is gonna deteriorate the first 6-9week after surgery and then the cells are gonna start building back into a ligament. You'll be able to pedal with no resistance pretty quickly and ride a bike inside 2-3 months. it doesn't mean you should go out and ride it. Stationary bike will be your best friend.


If you're not already eating healthy you should start the second you are reading this. Lots of water, good food and nutrients will help your recovery.

If I had to do it again I would choose the hamstring Graf.
It's been 18 months and I'm still struggling with my patellar and I have a pretty decent back ground in rehab (had couple surgery including shoulders).


And just so you keep hope I was ridding enduro trails 5-6 month after my surgery. Small rides not to wear my knee down but enough to make me smile again.

Good luck

The actual tendon replacement (whether you're doing the patellar or hamstring) is usually healed within a few weeks. And by healed, it's not the ligament regenerating (most ligaments do not regenerate at all), but really your bone grafts repairing themselves and cementing in the new structure. The problem is that your quad (after not being fully used for several weeks) is extremely weak and cannot stabilize the knee effectively. That's why PT is so important.

Professional athletes have been known to get back into their sport in 4 months with VERY aggressive PT. Most non-athletes with normal schedules can expect to be back at 100% (not confidence, just strength) within 6-9 months.

But I agree with the hamstring vs patellar graft. What I've read says that you should only do the patellar graft if you need to be back at 100% ASAP. Otherwise the hamstring graft has the least risk for post op knee pain.
flag lblizzard
Posted: Apr 5, 2019 at 17:26 Quote
ACL hamstring graft does regenerate in 80% of surgeries, the percentage goes higher the younger you are. It's at about the 12 week point that the graft is fully healed to the bone. prior to 12 weeks its vulnerable.
flag xzyragon
Posted: Apr 8, 2019 at 8:25 Quote
lblizzard wrote:
ACL hamstring graft does regenerate in 80% of surgeries, the percentage goes higher the younger you are. It's at about the 12 week point that the graft is fully healed to the bone. prior to 12 weeks its vulnerable.

"regenerate" is a misnomer. Your ligaments don't spontaneously heal. Once they're torn, they "repair" themselves by forming scar tissue on either side of the tear until (hopefully) the scar tissue reconnects.

In surgery, they anchor a piece of your hamstring (or piece of the patellar tendon) to the surrounding bones to replicate an ACL ligament. The "healing" time on these is to allow the damage to the surrounding tissue and bone grafts to heal, not to allow the ligament to regenerate. No ligaments (without being exposed to stem cells) have the capability to regenerate or re-grow ligament tissues.
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