Had mine repaired in 1991, and I rode 13000kms last year.
I'm tipping the surgery & recovery has come a long way since then!
Indoor riding will be safe & I'd start hitting the bike as soon as you get the all clear.
One thing...err on the side of caution, running wise - and be guided by the medicos...particularly with anything involving a change of direction.

My knowledge of this injury is limited to college basketball. One of our top players tore his ACL midway through the year & the timeline to play again (on a minutes restriction) is ~8 months. Full minutes 10-12 months. It's one of those where it really takes a year to rebuild & get back up to normal training load/volume.

I can’t help but I am sorry you have such a major injury.
If you go the surgery route, don’t be afraid to get multiple opinions.

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

In 1997 I had reconstructive surgery from a wrestling injury. I was given the 6-12 month timeline for full recovery. I also tore the meniscus pad which concerned the surgeon because they can sew it up but it often only partial heals leaving spot that are not attached that cause pop in the knee. There was a girl in two of my high school class who also had ACL surgery by same doctor on the same day as me. We had our first rehab session at the same time and I was not able to get a full revolution on the stationary bike and she was. She was getting the rehab done and I was whining because it hurt too much and was too hard. So I committed to do 100% of the therapy that was assigned from there on no matter how hard it was or how much it hurt. At 5 months I was released to go back to 100% activity with no limits. I was shocked. Best case senecio was 6 months and average was 8-9 months. The keys for me was that my mom has a stationary bike that I could use every day. That really hurt but got my mobility back. I also had a weight machine that I could use every day after I was released to do weights at 3 months. That also helped a ton. In the first months it was a lot of leg lifts then medicine bands. It was slow going and some days it took 75 minutes to do all those leg lifts that were prescribed. I all of wrestling practice on week days to get through my PT though so I stuck to it and got it done. I didn’t think I ever would be able to do triathlons. My knee was good for about 5 years then it became apparent that it was weak. I couldn’t sit in a car for 30 minutes without my knee acting up because I had to stretch it all the way out or it would go numb or get that asleep limb tingle. I was a runner and could run without limitations in straight lines but corners gave me that weak knee feeling and side to side pivoting was a no go. My younger brother did two full Ironman races in 2002 and since we did everything together growing up I wanted to know what a triathlon was like (just not a full Ironman). It wasn’t until 2014 that I decided to see if I could do a triathlon. The first fews in the water the knee felt weird. I could feel it wobble with any type of whip kick. Straight lines like I did in running seam bearable though. The knee also felt weak on the bike and after a 15-20 mile ride was sore. I was causing any damage though so I kept at it and after two month I was able to sit in a car for 30-minutes with out the knee acting up for the first time in over a decade. The wobble in the knee went away in the water, the knee no longer limited me on the bike (although my bike position is non conventional to take some of the pressure of the knee and alway my to straighten the leg out at the bottom of the stroke if needed). I can now run corners with no knee weakness and can ever do side to side pivots. So, for me triathlon has done wonders for my knee. Follow your PT 100%. Don’t do anything before the doctors and physical therapists release you to do it, and use you bike, weights, and swimming to strengthen that knee and get its full mobility back. Hard work goes a long way.

I'm not a doctor but I've had two ACL repairs - same knee, about 10 years apart.

Swimming with a torn ACL is fine but breaststroke or eggbeater kick may give you problems. Once you have it repaired, you'll need some time out of the pool. But you'll be focused on PT and rehab. Do what they say and make sure you get your range of motion and strength back. Part of that PT will be on a stationary bike - which is one of the safest things you can do. The docs will let you know when you can get back to running or lifting.

If they let you start lifting, be very careful with quad and over-the-knee weight. Leg press laying on your back is ok, but avoid squats and leg extensions for awhile.

I imagine triathlon would be possible without repairing your ACL but I didn't like the feeling of instability and it would have impacted other things I like to do. Obviously it's your choice, but docs are very good at this surgery nowadays.

That does align with what I've been told. Pity it takes so long!

13000 kms is a decent effort! :-) Good to hear you don't seem to be limited by it! I will keep that in mind when I get to running. I'll have to hold off on playing too many enthusiastic games of chasie with my daughter!

You are correct about multiple opinions!

I've already had to get a 3rd opinion because my Sports med Dr and Physio did not agree on how long I should be using crutches for my fracture. I went to discuss it with a surgeon and it turns out the fracture was at the back of the shin bone - not on the top - as my femur hit it when my knee dislocated. So I was going to be on crutches for 6 weeks before going to my next phase of treatment / rehab but now I know I don't have to be. I thought I had to keep all my weight off of my leg but I just have to use the crutches to NOT fall over. In just 2 weeks of using crutches I lost close to 50% of my left quad muscle and now I need to build it back up. I shudder to think about how shrivelled my leg would've been after 6 weeks!

Thanks Spudone

Luckily I do have a Wahoo Kickr so I'll put that to use! So far I think I agree with you in terms of the lack of stability without getting the ACL repaired. It is just the weirdest feeling! I'd like to feel like I can run again one day without stacking it as soon as I find myself feeling fatigued on uneven ground.

Thank you for sharing your story. There are so many depressing stories out there RE how long it takes to recover etc. Your story gives me some hope! Did you ever go back to wrestling?

How are you measuring the 50%? Just curious.

If the crutches are just to prevent falls, would a cane work too? Might be easier on your shoulders, or you could mix and match. Or even trekking poles?

Keep us updated. I'm glad you don't have to be non weight bearing for 6 weeks!

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

The 50% is my physio's estimate based on my right side compared to my left. It's just a rough eye ball estimate but I can see the difference myself.

A woman at the local swimming clubs uses trekking poles and they DO look more user friendly + easier to get in and out of car etc!

Thanks for replying. It's a bit too easy to feel negative about hings at the moment so I apprediate your support!

I've been injured an embarrassing amount of times. DM me and whine any time. I know how hard it is.

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Hey Sharla.

Good luck with the recovery. Be guided by the consultant and physio and don't compare yourself to anyone else.

Look at the recovery as a training challenge rather than rehab. And alway look on the positive aspects. You may be stiff or sore one day but that is still better than last week or month.

Pre-operatively get as active as you can as early as your consultant and physio allow you to be. To go into surgery with as much range of movement and strength as possible will facilitate a better result overall.
Without a functioning ACL (and without other damage or the stump catching in the wrong spot) you can still walk, jog, run, sprint and hop on one leg in a straight line. Just cannot rotate through it.

Stationary bike can be as early as 3 weeks as it's straight line. Pool exercises are encouraged once the wounds are fully healed but avoid breast stroke kick.
Graft is at it's weakest and most vulnerable at around 2 months so no inadvertent twisting. For every month beyond the graft will increase in tensile strength but will be 6 months before it can withstand a moderate strain, and is still only around 70% of it's eventual strength.

Some people may allow running as early as 3 months but they are really taking a chance in my opinion. I wouldn't be jogging on it until after 5 months to give it the best chance of not getting an accidental strain. Month 3-6 can be spent on general fitness, strengthening and lots of learning how to land, with bouncing hopping and skipping.

Return to full level sport involving rotation is generally accepted to be anywhere between 8-12 months. Back years ago there were so-called 'accelerated protocols' which claimed to get people back at 6 months but due to re-rupture rates and the 2-3 month graft weakest point most people have moved away from these as it's not worth the risk.

Again, best of luck and listen to your Consultant and physio.
And get your knee straight as early as possible. That's the key to the entire recovery.

I had the ACL Surgery my Junior year of High School. yes, I was able to wrestle part of my senior year.

Wrestling wasn't good to me though. I had season ending injuries my Sophomore (knee), Junior (Knee, ACL), and Senior year (separated Elbow). I went undefeated my 9th grade year at the junior high level. I thought I was a lot better wrestler than I was a runner, but if I had to do it all over again I would have been better off just focusing on running.

I promised my mom after I separated my elbow that I would never wrestle again. I walked on to the University Cross Country and Long Distance Track team, but after missing my junior year of running from knee surgery and half of my senior year from wrestling injuries too I didn't get any scholarship offers. I was the sophomore regional champion in the 1600m but ended up as the only guy on our varsity cross country team who did have a running recruitment offer. I just did the redshirt freshman walk on thing one year. I didn't earn a scholarship so I just focused on studies after my freshman year and didn't run for the university.

One year my mom saw that there was a intermural wrestling tournament at my university and she excitedly asked me if I was going to participate in it. After all the worry I put her through every time I wrestled I was sure that she would be telling my to not even dare to break my promise and wrestle. She didn't have to though. She told me it was okay if I wanted to do the intermural wrestling tournament but I didn't break my promise. I haven't wrestled.

I did get to wrestle in few duals meets and tournaments my Senior year, but the ACL injury was in all practicality the end of my wrestling career. I never finished a season after that, never got to go to the state meet, etc.

Thanks Mart!
At the moment I'm just walking as even that feels a bit weird after being on crutches for 2 weeks. I wonder if I can stationary bike before the surgery safely?

I've been swimming - just using my upper body and a pool buoy to keep my legs afloat.

It feels a little weird if I don't take the turns at the end of the pool super slowly but otherwise it seems ok.

I expect my surgery to be scheduled in a few weeks.

I see a trend in everyone's responses - Sounds like I need to make friends with the bike!

I appreciate your input 🙂

I ruptured my ACL about 20 years ago but it wasn’t correctly diagnosed at the time, and was only discovered in an MRI earlier this year. Over the past 20 years I’ve played soccer, tennis, squash, kitesurfing, snowboarding and Ironman. With sufficient rehab it is definitely possible to function entirely normally without an ACL!

Really!

I have a friend without an ACL who wrestles but she's an Olympian so her physical conditioning is likely to be better than what I can realistically achieve as a mum with a full time job. She says there are some things she can't do - she can't come up onto her toes and pivot at the same time. Her wrestling style had to be adapted to deal with not having an ACL. So no kickboxing etc.

My concern RE not getting it fixed is also the idea that my knee will be more prone to arthritis etc. However, I would have expected your knee to complain a bit more than usual doing long distance races such as the Ironman.

What was the MRI on your knee for? Is it possible that whatever injury / pain you have had the MRI for is a consequence of the ruptured ACL?

I'm also concerned about being an elderly lady one day and being more prone to accidents leading to a broken hip as my muscles weaken. I'd prefer to go quietly in my sleep very late in life than to suffer after breaking a hip. I know that's a very specific example - a friend's mother died that way last year and I gather it was a painful way to go!

This

I haven't had an ACL in my left knee and damaged menisci for the better part of 20 years as well. ARMY Dr's told me not to worry about it.

I had one occasion playing football where it gave out but since I've enjoyed moderate amounts of Basketball and as much Triathlon related sports as possible.

I do avoid serious trail running because the fear is in the back of my mind.

I think you'll be just fine. Listen to the Physio here during the acute phase and you''ll be back before you know it.

I have torn the ACL on my right knee 3X. A couple words of wisdom: 1) if you choose to have it rebuilt... go the cadaver rebuild route... faster healing time in my experience 2) cycling and swimming without a healthy ACL are very possible, but cycling can be very hard on damaged knees... especially if you are climbing and/or out of the saddle a lot 3) you can choose to avoid a rebuild (I am still contemplating #4) and still train aggressively, but you will have to a LOT of work to strengthen the supporting areas to avoid knee instability. And even then, you will get the occassional buckling that will freak you out and 4) go to the BEST orthopedic practice you can. I finally wised up and went to an elite ortho practive that supports US Olympic athletes and the interactions, discussions and (IMHO) treatment was far superior. This practice understood what my lfestyle and training regimen is like vs treating me like a couch potatoe that tripped and blew out his ACL and just wanted to return to the couch.

Good luck and dont let a little thing like a torn ACL hold you back...

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In search of the righteous life... we all fall down

Thanks for sharing your story ckoch!

I have decided to get the surgery because I hate the idea of being unable to do everything I could before. I gather I could do most things the same way again without an ACL.

However, I like a few things that require coming up onto my toes while pivoting and I don't believe rehab exercise will be enough for me to stabilise that motion. If I was 100% sure I didn't want to go back to martial arts I'd take a bit longer to make my decision.

I haven't experienced the knee buckling yet and I totally believe you when you say it will freak me out!

The surgeon told me that it takes 12 months to return to full sport but that I'd need to do rehab on both knees as his patients are more likely to hurt their other knee post ACL reconstruction. I guess it's easy to overcompensate with your good side and to develop movement patterns that are no longer optimal.

He also said it will be 18 months until my body has replaced the cells in the graft with new cells including nerve cells. So I won't have the same propriorecption until 18 months post op. I imagine I'll need to be quite careful doing anything that involves uneven surfaces or unpredictable people + having regular physio appointments to guide my rehab training until then.

I really admire your determination and that you have still taken the time to post an encouraging reply in spite of facing your own ACL stress! Thank You!

The MRI was for a meniscus tear sustained whilst rock climbing. Having looked into it afterwards, the position my knee was in when the meniscus tore is exactly the position that is known to cause meniscus tears (deep flexion with rotation) so I don't think (and neither did either of the two specialists I have so far seen) that the tear was anything to do with the missing ACL.

I can honestly say there is no movement in the last 20 years that I had found I could do on my right leg, but not my left - I'd never tried it before but I tried going up onto my toes and pivoting and I could do a 90 degree pivot no problem (the same as I could do with my 'good' knee). I wonder how much not knowing about it helped, as I just rehabbed what I thought were weak muscles from 6 weeks in a full cast to heal a suspected fractured patella (I didn't think at the time that was actually the correct diagnosis, but who was I to argue with the professionals).

Anyway, it looks like you've decided to go with the op, so good luck. One of my friends had it about 18 months ago, and has made good progress. She found the first few months very tough though, as progress was very slow, so be ready to expect that. She then got to a point around 4 months or so where everything seemed to speed up a bit. Hope it goes well. Keep us informed of how your rehab is tracking.

Thank you!

If for whatever reason my ACL reconstruction fails I think I'll take your story as hope I can make a good recovery andd continue to particpate in sports without an ACL.

I don't think I could go through more operations if my best efforts at a careful, dedicated rehab plan still didn't allow my body to accept / keep the transplant.

I definately expect to be uncomfortable for a while! Surgery is booked in on March 7th.

I'm getting my bike serviced and the fit professionally adjusted so I can use with my Wahoo Kickr a lot during rehab without placing any undue pressure through my knees.

Glad to hear your friend's journey with it is progressing well past the most painful and restrictive initial phase. :-)

Here's one research paper I found RE cycling in rehab post ACL reconstruction in case it is of any use to your friend. It looks like we need to keep it going at a moderate intensity (to avoid DOMS) for at least 12 months post surgery.

My non-professional understanding of it is that it helps to prevent us from becoming permanently assymetrical in our movement / balance without the proprioreceptive feedback of nerves in the ACL. It also supports the new nerve cells forming andd functioning correctly. There nerve cells in the new ACL are not along the full length and properly functional until the 18 month mark when the body has hnaturally replaced all of the cells as per normal rates of cell division etc.

I'm getting my bike set up without cleats as just thinking about the twisting action of clicking in and out of cleats makes me feel a little sick.....