Whos done it? How was the recovery? Did you have surgery? How long until you got back on a bike?
Looking for some real world cases that might give me some hope.....
I did mine.
They were more than happy to operate but being a coward I said no.2 of my customers are radiographers and said that if you can avoid knee surgery you should.
Took over a year before I really trusted it. It gave way a few times and there was no way I'd run on it.
10 years later it's fine. I wear a brace if I'm going to be doing big lifting jobs and a patella strap for long walks or running.
Reading various physio blogs it does appear that people fall into two camps, those who need surgery to resume activity and those who basically don't and carry on without the ACL with little or no problems. Unclear what the differentiator is, probably type of sport and relative strength of surrounding muscles etc.
EDIT: Found it....
https://issuu.com/physio-network/docs/pn_dec_2019-christina_le_43fd273ba2d0e8
I've done it to both knees - first one 17 years ago when coming to the end of long football "career". Complete tear. Repaired via private keyhole surgery knitting in some hamstring tendon + blood supply then 6 months of physio to make it behave like a ligament. Never had any issues since, including skiing.
Other side went five years later, scan showed partial tear and recommended course of physio. Never been right, can't kick a ball to son side-footed without feeling it. Have to wear a metal-hinged brace to take it skiing with the other knee!
So not sure what the reasoning is behind the no op comments but my experience is that its the best option for getting it completely fixed and I'm guessing the surgery methodology has improved further since mine.
Total tear in mine, nothing left, didn’t operate as 20 years ago when they found it I had a physical job and they said up to a year off work
If I keep the muscles strong I’m good, I don’t do anything silly like ski or play football but other than that it’s pretty good
Now I must say the knee is starting to wear but my physio said he sees the same level in people who had the operation so it’s not clear that it won’t happen anyway
Yep!
Almost certainly did a partial tear that was never identified about 7 years before my knee fully exploded. Full ACL tear diagnosed and I was thinking I wouldn't have surgery having heard how tough it was. However, whilst waiting for my follow up consultant apt, my knee collapsed whilst out walking resulting in a partial MCL tear and calling mountain rescue. I hobbled back into see my consultant and signed there and then - it was clear my knee wasn't stable enough for me to have a normal life.
Took 6 months before I had the surgery due to the winter of 2018 NHS delays, and to let the MCL recover. Found the first post surgery 4 months hard - I got let down by limited NHS physio (this varies by location) and when I finally switched to private it took some unmuddling, but got there in the end.
The main thing is there is a very strict and well established protcol which you can't deviate from. It takes 12-weeks for the graft (I had a hamstring graft) to establish a blood supply and therefore you are limited to what you can do. I was on a turbo within a week, but didnt progress from that (well built up distance and time alot) until 12 weeks. You cant risk twisting the knee at that time, so if a kid/cat etc runs out in front of you and you have to rapidly stick a leg out, you risk ripping the graft.
After 12 weeks you can start more advanced physio and some directional work depending on your muscle recovery (muscle wastage is a bit problem). At this point some road/light offroad (e.g. canal/green lane) becomes possible, but nothing really properly offroad until 6 months in general. Then full 'training' development can start e.g. changes in speed, direction, twisting. It was 9 months before I was fully riding offroad again (confidence, leg muscles and physio guidance) and a year before I back to being fully normal.
This is a very typical trajectory. Don't look at elite sports people getting back in 6 months - they have 6+ hours of physio a day. Most of us have to fit it in round life and a full time job.
The upside:
- It gave me a reason to 'train' for a year, working with physios and PT's
- I now am stronger than I ever was (and keeping your muscles in shape is important for ever more!)
- I discovered weight lifting (be prepared to do a million squats!) which as a women you don't get exposed to and turns out I kind of enjoy (though havent gone back to the gym post lockdown)
I am now 2.5 years on. My life is normal. I cycle, walk 14 miles with a full loaded backpack etc. I dont run - but to be honest I didnt really before and my back isnt that keen on it either. I do have some clicky clunky feelings in it at times (today being one of those days) but I know i have arthritis in my knee as a result of the long term injury, and in really cold weather the screw in my shin that holds the graft in place can be sore.
However I really dont regret having the surgery. It is a really tough recovery, I am not going to lie, but I know I wouldnt have this lifestyle now if I hadn't had it. There is a good ACL recovery scene (!) on instagram which was a massive help to me, and I am still in touch with some folk. It is also worth noting EVERYONE is different - every recovery has its own ups and down. Mine was very slow initally - whereas local lady a bit younger than me had hers done two weeks before flew through the first few months goals - however after a year she still didnt have both quads the same size. By comparision mine was very slow at the start and I developed a bad limp, but I got full (nearly, my harvested hamstring didnt fully grow back - some dont) quad recovery and equal sized legs!
Good luck if you do go for it. Happy to chat more.
Oh and take time off work - I took 7 weeks as a University lecturer (i was told I needed a min of 6 and GP signed me off for another one) - I really could have done with 8-9, but circumstances made that impossible. Doctor will be able to advise for your job.
I did mine 5years ago, had surgery in Thailand, almost same as Pedlad's.
Did a lot of rehab, but its never been the same, most likely cos I slipped up in the early days, or jumping on bikes. Ive been afraid to fall on that leg,
I've done some pretty epic stuff since, but Im 60 now, and it does play up.
I wont be running anywhere, but I've no idea if its cartilege or something else, I should get it checked out but you know what its like with NHS at the moment
I did mine crashing at BPW just before I was forty. Tore cartilage too, could bend my knee at all. When cartilage done I could ride bike with no acl, physio advised me to have it done as knee would be more stable to protect cartilage that was also ruined. My acl hadnt actually snapped it ripped some of the bone off and was dangling about. No wonder I squealed. Took I reckon 3-4 months for gentle biking and 6 months to be better. I still wouldnt like to run on it though. Works ok 6 years later. Surgeon said most over 40's they dont recommend it but as I was active they would do it. Works better now than other knee but thats another story.
Reading various physio blogs it does appear that people fall into two camps, those who need surgery to resume activity and those who basically don’t and carry on without the ACL with little or no problems. Unclear what the differentiator is, probably type of sport and relative strength of surrounding muscles etc.
Its a common injury in women as we dont have the same muscle mass around the knee. And therefore if you have hypermobility and not enough muscle, you often can't manage without it, which is exactly my case. For men (or women) with more muscle mass; and/or lack of hypermobility people can sometimes carry on fine.
This is the standard NHS protocol
Like I said everyone is different, but you won't really deviate much from this timescale.
Don't compare with USA examples where it is a very common injury in basketball, American football - they use knee braces a lot more in recovery and therefore return to stuff a lot faster. This isn't really done here. And I think that is because they don't have the social security - they have to return to work a lot faster, and their medical care runs out.
Did mine in March 2019. No surgery. 4 months before I was back on a bike, but was very unstable for a good few months after that. Once I was able I did lots of gentle rehab. 18 months on its still not 100% and never will be, but I can do 95% of what I want to. Surgery seemed to be very much a pays yer money and takes yer choice type of thing ie will give you fuller recovery, but I was quoted 9 months recovery time which I didn’t fancy. Went skiing in Feb and it coped OK but was conscious it could easily have been aggravated.
Either way good luck and take it steady.
A friend of ours had a full ACL reconstruction but after months of rehab range of movement wasn't there. Turns out she had a 'Cyclops lesion' a rare-ish complication. Ended having surgery again to remove it and then more rehab. Finally sorted, but took about 18 months all in.
Did mine in March 2019. No surgery. 4 months before I was back on a bike, but was very unstable for a good few months after that. Once I was able I did lots of gentle rehab. 18 months on its still not 100% and never will be, but I can do 95% of what I want to. Surgery seemed to be very much a pays yer money and takes yer choice type of thing ie will give you fuller recovery, but I was quoted 9 months recovery time which I didn’t fancy. Went skiing in Feb and it coped OK but was conscious it could easily have been aggravated.
Either way good luck and take it steady
Given its taken 18months to get to where you are in hindsight would you have gone for surgery given its a 12 month recovery?
Did PCL, full tear plus some other ligament and tendon damage. Motorcycle accident about 15 years ago.
Other than what has been said above, the best thing I did for it (2 years ago when I was taking too many painkillers each day and had to do something about it) was too start weightlifting and went from 88kg to 73kg. Hardly any pain now, ever.
The docs said I couldn't improve my pain, but this has done it.
So, I recommend weightlifting once you can
Complete tear and some cartilage damage, did it 2 1/2 years ago at taekwondo. No op, had a physio who reckoned I could build up enough strength to not need it. I went back to mtb after 4 months and taekwondo after a year. Still do alot of squats and hamstring exercises but its good most of the time. Just a bit of cartlidge pain some of the time.
Mine was right on the edge of needing surgery- the verdict was essentially "if we had to decide today, there's no doubt we'd say to operate, but we don't, because you can work on it for a while and see if it's good enough to avoid surgery, and if it's not, operate then". Which worked out great for me as it ended up recovering much better than expected. That was a serious partial tear, I can't remember the correct name but it's the one that means "not totally gone, but not actually doing anything either, like a really old rubber band"
My leg's pretty complicated- broken hip with surgery, plus a twist in my lower spine means that it's basically just making it up as it goes along, but it works pretty well for all that and I've made as good a recovery from the ligament tear as it's really possible to. For that reason, I'm very glad we didn't operate. But that's not to say surgery couldn't have worked out great too.
Good luck
, I can’t remember the correct name
Partial tear is a rupture isn't it?
@trailwagger with hindsight I think I’d probably still not have the surgery - the difference being that although I still have to be careful with it my understanding was that the 9 months was no activity at all. Also maybe the 95% is a little pessimistic - it’s not so much that I can’t do what I want (running aside but I’ve never been much of a runner!) but more that I am super conscious of it and that holds me back. Having said that it was a close decision and, recovery time aside, I couldn’t deduce many downsides from surgery. That’s probably not a lot of help to you!! In some ways I’d have preferred a clean break - had a couple of those when younger (motorbikes) and they never give me any bother 😂
If you want to not have to worry about what you can and can’t do I’d say go surgery!
Had a full hamstring graft 8yrs ago, after tearing playing hockey.
3months of physio, back on the bike after that. 3-6months, gym, bike and normal activities. Back to hockey with a light, no metal support after 10months.
Have been playing hockey, MTB and skiing since.
Really helps if you have a physio that is sport based, they seem to be much more prepared to push you a bit further and understand the desire for it to be the best it can rather than good enough for day to day activities. It’s means physio sessions hurt, but they work!
Previous to surgery I tried it for 2-3months as normal. Seemed ok for day to day walking, but any slip or slight odd landing and you could feel it move!!
Opted to build up the muscles as much as I could in time frame and go for the rebuild!
It’s a long recovery, but if you stick with it then it works as a good training programme! Be prepared for you’re leg to start off at least half the size of your good leg, it atrophies very quickly!!
tore mine 18mths ago playing football. due to NHS and covid i didn't get my MRI until march this year, and results to 2weeks ago.
seen the consultant for the first time this morning.
total ACL tear
multicle miniscious tears
MCL tear
possible LCL tear
bone damage to the ends of both bones
since it happened i've returned to full mtb (probably at about 95% speed) but am concious of crashing on that side...
i can walk, run, do normal activies no problem.
can't play football - tried a few times and its just not stable enough and puts fear into me
consultant has left the choice up to me. he's sporting biased, but has said continue as u are and just adjust your sporting outlook... or go for surgery and be prepared to be pushed if u want to get back to the level i was
undecided as of yet. mostly due to probably going private due to NHS basically at a standstill, so cost, time of work, etc all adding up
philb88
Free MemberReally helps if you have a physio that is sport based, they seem to be much more prepared to push you a bit further and understand the desire for it to be the best it can rather than good enough for day to day activities. It’s means physio sessions hurt, but they work!
Absolutely. In fairness to NHS physio it's not really their job to get you back to doing backflips or whatever, they're tasked with getting you functional. I had great support from the NHS with both the hip and the knee but a little bit of private sports physio paid off too. I mean, if you gave me a £200 bill for my car at MOT time I'd pay it, so if you give me the same for my leg I'll bloody well pay that too.
If you want a bit of real world insight and are really bored, I kept a bit of a patchy photo journal starting from here
Scroll up and try and ignore how much weight I put on!
Whether to have surgery or not is a very personal decision and should be made on your symptoms. I waited 4 yrs before finally getting mine done and I wish I hadn't but my post op problems are very unusual.
I would always recommend trying conservative treatment first - worst case scenario is if it is still a problem afterwards then you're in a great place for starting rehab post-op.
Protocol post op is fairly rigid and do not be tempted to push too hard or start things too early.
Depending when your knee gives you problems then Donjoy and CTI/Ossur do good braces. Without my knee brace I couldn't play tennis, with it there were no problems.
Ruptured MCL here waiting to hear from the consultant about possible A/PCL damage. I'm in the doldrums (emotionally as opposed to geographically) at the moment.
I also feel that the NHS physios idea of strengthen and mine are different.
I also feel that the NHS physios idea of strengthen and mine are different.
That was my experience too but their requirement is for you too be functional, which I think it’s probably different to most of ours.
I wish before my surgery I’d done more on my strengthening my hamstrings and quads in prep - didn’t realise quite how important this was until after (as directed by your physio because as has been several times, everyone is different).
Thanks for all the replies so far they are helpful and insightful. It is both reassuring and frightening in equal measure.
I am three weeks post injury. Had my MRI this week and awaiting results.
My biggest issue right now is intense acute pain in the thigh of the effected leg. Its like cramp but worse and is almost continual throughout the day and even at night which is causing me sleeping problems.
Did anyone else experience this?
Partner completely ruptured hers in March, and is now only attached at one end, was due to have an operation but was cancelled due to Covid, did physio and is now running up to 5km again, and probably won't have surgery now.
and is now only attached at one end
isnt that a complete tear? which would make surgery essential wouldnt it?
isnt that a complete tear? which would make surgery essential wouldnt it?
She was already for the Op, which we thought was essential, but they cancelled it 12hrs before she was due in.
As she had no choice about the surgery she got some advice from a number of physios, and the advice was mixed between the physio being a stop gap until she could have the surgery and those that thought she might not need it, apparently the muscles around the knee can be developed.
Will she need surgery in the future - maybe but she's happy with what she can do on the knee at the moment
My wife did hers about 12 years ago and had it operated (keyhole, middle third of patella graft). It's mostly fine but it still bother her - she can't feel her leg position completely well so finds some walking (E.g. over uneven terrain) difficult, and can't ski as well as she used to. Supposedly the ACL is partially responsible for proprioception (joint position sensation) which may explain this to a degree. She wasn't as strict with the post-op physio as perhaps she could have been and she regrets that now - who knows whether that's the reason or not. But day-to-day it's absolutely fine.
Basically, it's a bit of a bummer and you will have some work ahead of you whichever path you take. Good luck 🙂
Re the cramping feeling I had it when I started straightening my leg after being effectively non weight bearing for 2weeks. I wondered if it was undoing a frozen shoulder. Did mine 5weeks this coming Saturday.
I didnt really have a choice, not to have surgery, as my knee felt like it would go sideways if I put any weight on it. Was it the same for the rest of us?
I had no pain. The MCL was torn as well
I didnt really have a choice, not to have surgery, as my knee felt like it would go sideways if I put any weight on it. Was it the same for the rest of us?
I had no pain. The MCL was torn as well
i was like this going up and down stair for about a month after i tore mine. i purchased a pretty decent knee brace and i was up and down stairs inside 2 days (if i removed the knee brace i couldn't for fear of knee giving way)
Turmeric !!!
Someone put me onto this, so I thought what the heck its worth a try. WOW! what a difference after just four days of taking it as a supplement. I would recommend it to anyone going through this, google it if you dont believe me.
Complete tear doesn't mean surgery is necessary. I was told surgery is only if you knee is giving way and collapsing a lot.
Complete tear doesn’t mean surgery is necessary. I was told surgery is only if you knee is giving way and collapsing a lot.
Surely with a complete tear there will always be a risk of this happening?
Surely with a complete tear there will always be a risk of this happening?
See post #3, some people can live without an ACL and don't need surgery.
alric
Free MemberI didnt really have a choice, not to have surgery, as my knee felt like it would go sideways if I put any weight on it. Was it the same for the rest of us?
That's exactly what mine was like but didn't need surgery.
onehundredthidiot
Free MemberI also feel that the NHS physios idea of strengthen and mine are different.
I've had great support from NHS physios, but only up to a point- I think it's really fair to say that their job is to get you functioning. Back to work, walking to the shops, a day to day usable leg and a basis for further improvement, rather than "as good as it can possibly be". And that's fair enough really- with the resource they have, trying to get every fit person back to full fitness would probably mean just not treating a load of patients at all. My physio plans were tailored for my activeness, but only up to a point, certainly there was no hope of the NHS side achieving for me what the sports physios did.
Can't recommend too highly seeing a good sports physio, and in parallel with not after the NHS, for a big injury. Even if just for early consultation rather than treatment. It's an investment in your leg that if you can afford it, you definitely should imo.
You can counteract the knee giving way issue by increasing upper leg strength and keeping your bodyweight low. That can avoid the surgery and all the risk/pain/recovery involved
Also, you do not get enough time with the NHS physios - too few appointments too infrequently. Pay for your own - the best money you'll spend.
Interesting point about body weight - I lost a reasonable amount over the first 3-4 months of lockdown, and definitely felt the benefit in terms of old injuries no longer being so problematic. I have put some of it back on now, but it’s deffo something I’m going to focus on again over the coming months. In a way it’s a free bonus is the way I look at it...
Just to update the thread and maybe get some extra advise.
I saw my consultant last week and he advised no surgery was necessary (woohoo!). So now its just physio and time. Things are improving albeit at a slow rate. I have started doing short session on the turbo (10-15 minutes at 40-50rpm and <100w)
There were some things on my scan result that i dont know what they are, anyone able to shed any light?
Subchondral bony changes medial aspect of patella
Heterogeneous signal intensity tibial attachment of the anterior cruciate ligament.