ACL reconstruction surgery recovery ?s

Triathlon Forum
1

Hello ST nation

The bad news
On April 5th I suffered a bad accident and completely tore my ACL and MCL

The good news
Follow up MRI a week ago compared to the MRI 2 weeks after the injury show the following
-MCL is healing
-NO cartilage damage
-both MRIs show no damage to the medial meniscus

Speaking of, surgery is scheduled for the 22nd, the day before Thanksgiving

Since the injury I have not done any swimming. It is the least favorite of the 3 sports and since I knew any racing in 17 was off the books, I opted to abstain from the pool

I only ran once, with a brace, since the accident. It just did not feel right and prior to the accident I was having a number of issues running over the past 2 or 3 years regarding hip/high hamstring issues. I guess the silver lining is I was forced to stop running and that has been a blessing. A number of issues I had prior to the accident regarding my hip and hamstring have really settled down

I have cycled a lot since the accident. Nothing like the years prior when training for long course, but a high frequency with intervals thrown in all with the goal to get the knee as strong as possible going into surgery. The bike has been my friend the last seven months and I have been able to cycle basically 100% pain free.

I also did a ton of upper and lower body strength training, things I let go in past years where S/B/R ruled the day. Going into surgery in six days I feel that my knee is in the best place possible minus the ACL. No pain, zero discomfort and the knee is pretty darn stable

So, for those of you who have had this, what should I expect moving forward? How quickly will I be able to cycle? Time post surgery before I can expect to do any intervals ie: 10-20’ LT/3-5’ VO2 max, short brief anaerobic stuff? How about running? How long is long enough before I lace up the shoes? And finally, swimming? I have heard that oddly enough, swimming is sometimes the toughest of the three to get back into, although I may be misinformed? I plan on doing a lot of dry land swimming exercises to help me replace the last 10 plus years of bad swimming habits ie: lack of high elbow etc Thinking of something along the lines of a homemade Vassa trainer using bands and a bench where I can teach muscle memory to the arms and shoulders and maybe just maybe lock into some better form…perhaps wishful thinking ( :

This isn’t going to be a whole lot of fun, but when life hands you lemons you make lemonade. If nothing else, I might actually improve my stroke technique and more importantly, get back to running without all the issues that have plagued me the last few years. Before the injury I was really getting burned out. Funny how not being able to do what you once did can light a fire in you. I look forward to embracing the challenge

Thanks for your opinions and thoughts, much appreciated.
And I will be lurking a lot on this site in the 4-6 weeks post op as I will have a lot of free time on my hands LOL

Happy early Thanksgiving wishes to you and yours

Regards
Mark

2

Hey Mark,

I have torn both ACL’s and one meniscus. Have you decided what surgery you are going to do? Allograft( taking donor tissue) or Autograft (your own tissue)? For both of my ACL replacements I chose to do the allograft. Every person I had talked to said the recovery time was short roughly 6 months compared to a autograft which would be a bit more trauma on your body from removing a section of your hamstring pushing your rehab closer to 9 months. Cons of taking the allograft is your body can reject it, being it was someone else’s at one point there is no saying if it will take. Along with the chance of it failing faster could be another reason to consider going for an autograph. For my personal experience both knees took 6 months to return back to normal, it took roughly 3 months post surgery to get full ROM and the last 3 to really build strength up and have confidence in my knees. If I had to rate my knees on a scale 1-10, 10 being perfect both knees are a 9, only reason they are not a 10 is when the pressure drops when a storm is coming both hurt pretty bad until the storm passes. For life and training I have no limiters. Although I do not play any sports that require you to plant and push off I have full confidence when I race on courses that have off road sections. I will say I do pay much more attention to bike fit and running shoes not wearing out. As a reference my first acl surgery was in 2009 and second was in 2011. My biggest advice would be FOLLOW THE PT ADVICE!! haha I followed their advice to a T for 6 months and I believe that had everything to do with my knees being fine now. I hope this helps!

-Justin Mendoza

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I had allograft ACL reconstruction in 2006 after an ugly rugby tackle that left me with a shredded ACL and MCL. The MCL healed on its own in six weeks. Surgery in June 2006 and I was back playing a pretty high level of rugby by mid November. Admittedly, I would say it was nearly a full year before I felt truly comfortable planting and cutting without fear.

To answer your questions- you’ll be in a fair amount of discomfort for a few weeks and you will lose a significant amount of flexion after the surgery. That’s why PT will usually tell you to get any range of motion you can before the surgery. Doctors and PT can only push you so fast due to insurance scares and whatnot, but off the record, I was encouraged to really push my rehab which included a significant amount of time on the rowing machine and bike. I know one of the biggest fears the doctors have about riding the bike is sustaining a fall. If you’re on the trainer, I’d imagine you would alleviate that concern.

I wasn’t a cyclist or triathlete at the time of the surgery, so I don’t have data or numbers to back up my story, but I felt like I had regained 80-90% of my strength in that leg within 6 months and actually found myself to be stronger within a year due to my taking an intense rehab route probably more seriously than my typical training(I’m gauging this from olympic lifts i.e. squats, deadlifts, cleans, etc.).

This is obviously just one story for you, so I’m sure many others have different experiences, but while the rehab can seem daunting, I see no reason why you couldn’t be back to a competitive place by mid summer next year after a November surgery.

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I have torn my left ACL twice, 14 years apart. The first time I had it repaired with a patella tendon graft (painful, I don’t recommend it). 2nd time was an allograft. I was also lucky like you and never tore cartilage.

The patella tendon graft makes it hurt to do any deceleration, walking down stairs / downhill, that sort of thing. I was able to do light jogging after several months but it was nearly a year before I was back to full activity. And to this day I still don’t have full flexion - can’t sit on my knees unless I stretch out a lot first.

The allograft was much easier and didn’t hurt much at all. You will feel like you want to push your recovery PT, but as mentioned above, listen to your physical therapist. There is a stage in the recovery where the graft is somewhat vulnerable, so you want to be careful not to re-tear it.

The good news is you will recover faster because your cartilage is not damaged. What to expect? Well, for me, they wanted to get me weight-bearing ASAP after the surgery. From there, I did some exercises to work on extension - basically laying face down with my leg off the end of a bench or couch. And exercises to work on flexion, which included stationary bike. You raise the saddle until you can make a full rotation, then work on that a bit, then lower the saddle, repeat.

Once you get that flexibility back you can get to more normal (indoor) cycling and the PT will tell you when you can start jogging. They’ll have other exercises for you to do, just make sure you stay on target with them

Edit: I would say swimming is good anytime leading up to the surgery. After the surgery, whenever the stitches are removed and the PT gives you the green light. Just stay away from breaststroke kick.

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Hey I hope I can help answer your questions. I am in the field of sports medicine as an athletic trainer.

First thing since you are an athlete I would recommend the Hamstring for the ACL replacement. I know some doctors might do cadaver tendons on non athletes because the stress on the tendon is less. Hamstring is or about to be the gold standard for ACL tears. I know every Ortho has there own preference though.

You are looking fully cleared in around 6-9 months. As I tell my athletes do not be an idiot and not listen to anyone and start doing your own rehab plans. I have heard of terrible story’s ofACL retear. You dont want to waste 6-9 months of your life again.

You will start biking on a trainer fairly early and should get cleared for biking before the 6 month part. The cycling will be just be long slow distance for awhile but always check with your doctor and PT’s. Running should take around 6-7 months depending on how fast you progress. Swimming I do not have much experience with getting people back into swimming from ACL tears. I do not want to give you the wrong info.

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Sadly, mgorris, welcome to the club …

I had my reco in 2005 and it’s held up really well since.

It’s worth noting …

  • You’re right, it isn’t pleasant. But you’ll be fine.
  • Make sure you have a good surgeon and a good physiotherapist. Once you have a good physio, make friends with him/her, because you are going to become well-acquainted over the coming weeks and months.
  • In my humble experience, there are five keys to recovering well from a reco: patience, rehab, patience, consistency, and patience. Get the picture?
  • Physios are sadists. But in a good way.

By all means, message me if you want to talk about this more.

And the very best of luck.

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I had PCL reconstruction in 2014.

The doctor used cadaver parts. I had full ROM in a few days after surgery enough that the pT didnt want to push past what the protocols said on ROM tests.

I was biking on the trainer I think in 1-2 weeks or so they generally want you doing stuff ASAP, it’s no longer wait for a month to recover then start to do rehab.

I pretty much was given persmission to do any straight line stuff after a month but any cutting/twisting movements had to wait 6 months.

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Thanks everyone for your comments and insight
A lot of good information on the replies
Very much appreciated and will take a lot of the info to heart
.