Returning to MX after torn ACL

Loomis077
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Loomis077
Edited Date/Time 2/1/2020 9:15pm
Hello all,
I’m a new member here but have lurked for a while. I’m sure that this has been addressed before so if I have not found the threads by all means point me towards them.

A little background, I rode MX for quite some time, 2000-2010. I got out of the sport after the 2010 season. I had just recently gotten married and started a new career. My intent was to take a short break and come back. I was gone for a lot longer but finally in December of 2017 I bought a left over ‘17 RMZ 450. I spent most of the 2018 season getting used to the bike and being back on the track. Once the 2018 riding season came to an end in Michigan, I began to hit the gym even harder. I was pumped for the following season, new bike, new gear, feeling good on the bike again. Fast forward to February 2019, I went to the church gym to play basketball instead of going to the gym for basketball. About 30 minutes into playing, I go up for a rebound, come down funny on my left leg, my knee buckled backwards, hear that infamous pop, and instant pain. Two weeks and a MRI later I hear “your ACL is shredded, meniscus is torn, and you need therapy, surgery, then therapy.

I had surgery on April 8th where the surgeon used the center 3rd of my patella tendon. I breezed through therapy quickly, about 5 or 6 weeks. I took all of the 2019 season off to heal up. I’m back in the gym doing leg presses and using the elliptical. So far everything feels pretty good. Once in a while if I unexpectedly step in a hole or something and that knee goes full lock I can still feel it! I got measured for a new CTI brace this past week and I’m waiting on that to come in.

Sorry for rambling but here are my questions. What or is there anything else I can be doing to get this knee ready for the 2020 season? What’s my best way to get back into the riding? What can I expect from my knee once back on the bike? Does that twinge feeling in the repaired knee ever go away?

I’m really curious as to what others have found when they returned. My ultimate fear is that my repaired knee can no longer take the jarring and constant flexing while riding on the track. My hope is that the CTI brace gives me great stability and restores my confidence in that knee.

Thanks
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Hudd_421
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Hudd_421 12/17/2019 10:08am
12/17/2019 10:08am
I'm on my second ACL reconstruction (6 weeks ago) so I feel your pain. They say about 6 months is really the time when you can come back to riding.

I'd continue to work it in the gym. Do more squats then leg presses to really strengthen the joint. Eventually, you should get to the point where you forget you ever tore it.

Don't worry about the durability of the new ligament. It should be really close to your original ligament.
StartedTooLate 12/17/2019 10:13am
12/17/2019 10:13am
You had a patella tendon procedure, which is still the best way to go. Get your braces properly fitted. Adjust them so you can not go full lock. This is something a doc or physio can not do for you, because you have to adjust it to how you ride. Finally, use an anti-rotation strap that locks to your boot. The strap keeps your lower leg from rotating outward. When the knee brace can not rotate relative to your boot, your leg/knee is WAY stronger. I heard both these tips from JT on the PulpMX Show years ago...and he was 100% right. Knee braces are way way more effective when you do these...and you will never notice when riding.

As for recovery...my right knee (ACL torn and repaired) now feels stronger than my left.. It just takes time.
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yz25
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yz25 12/17/2019 11:12am
12/17/2019 11:12am
Had MCL/ACL little roughly 2 years out. Also had some cartilage damage. I’m a gym rat, but the therapy really helped me concentrate on the legs a lot more than I had in the past in my weight lifting routines. Hamstring workouts is extremely beneficial. Squats, straight leg deadlifts. Not a single problem of discomfort during riding. The more strength you have in the legs the better off you are. I do wear knee braces and still find myself a little timid at time sticking that repaired leg out, especially when I’m late in motos. It’s just takes that one time when you plant the leg and nothing happens, that’s where the trust comes back. As for the “knee lock” can’t help you with that one.
kzizok
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kzizok 12/17/2019 11:34am
12/17/2019 11:34am
Hey guys,

Thanks for all of the replies. Anyone know anything else?

Thanks in advance!
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ehr400
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ehr400 12/17/2019 11:50am
12/17/2019 11:50am
I had a Cadaver ACL/ PCL graff March 29th and my Meniscus cleaned up because it was shredded too. I didnt have my ACl/ PCL for 15+ years with no issues. Since I got mine fixed it has taken more time for the muscles to rebound in those areas since the lack of use due to no ACL/PCL. I rode for the first time in September. Felt great, got a CTI brace for the RH knee. Took it easy. Rode 3 times since no issues. I feel my strength is at 95%, still working on the final amount. I think you need to make the determination on your personal case, wade into it and see how things feel. If there is pain or range of motion issues maybe put off riding and do more PT or exercise to get it back. Only you know your body and I think that would be the best starting point.
twotwosix
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twotwosix 12/17/2019 12:11pm
12/17/2019 12:11pm Edited Date/Time 12/17/2019 12:11pm
Lots of strength training, stability and range of motion exercises. That's my recommendation.
racerhansen 12/17/2019 1:05pm
12/17/2019 1:05pm
Go riding! I got my second ACL and meniscus operation in June and just started riding again. It feels weird in the beginning and you will think about the knee constantly, but it goes away once you get some seat time in.
moto551
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moto551 12/17/2019 1:11pm
12/17/2019 1:11pm
Surgeon told me best way to prevent knee injury is doing yoga. Yoga will help with building strength and hip flexibility.
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sandtrack315
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sandtrack315 12/17/2019 3:19pm
12/17/2019 3:19pm Edited Date/Time 12/17/2019 3:19pm
moto551 wrote:
Surgeon told me best way to prevent knee injury is doing yoga. Yoga will help with building strength and hip flexibility.
All of the empirical evidence demonstrates this is not true. You should certainly work closely with a physical therapist to get as much muscle around the joint as possible and get all of your range of motion back.
Luke_Richards 12/17/2019 3:33pm
12/17/2019 3:33pm
I tore my acl and meniscus Riding when I was 16, I was running everyday and in real good shape, it was an 8 month recovery for me, that was 12 years ago though, I lost a bit of range of motion both at full extension and trying to bend it all the way, they reconstructed mine from my hamstring and I have scar tissue that feels like a knot at the base of my hamstring, it will randomly ache for a few days, and I cannot run anymore and have a hard time even walking down hill. I also broke my femur very close to the same knee 3 years later, so not sure what Injury is effecting what, if that makes sense. I don’t notice much when riding but still am conscious of it. I can’t feel about 6” of the front of my leg but if something blunt hits it, it is pretty painful
motosmoke
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motosmoke 12/17/2019 3:45pm
12/17/2019 3:45pm Edited Date/Time 12/17/2019 3:47pm
Got ACL surgery with an Meniscus cleanip on Sept 14, 2018. Tore my LCL as well but it healed itself. I was riding in March. Mostly due to living in Canada, the season starts around then. Just grind PT and the results pay off. It’s not hard at all to come back from. First ride wasn’t bad. For me it was just knocking additional rust off as I went from broken scaphoid to torn ACL/LCL back to back.
For reference I was 19 when I tore it.


Gene Frenkle 12/17/2019 4:25pm
12/17/2019 4:25pm
I did mine at 50, take the FULL 12 months to recover (I took 14 months).
My surgeon said that with any reconstruction, the danger period is around 7 months when the knee moves to rebuilding the ACL itself as to relying on the graft.
Cycling, swimming gym work and time.
Stretching too.
Good brace.
Good luck!
Hoks
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Hoks 12/17/2019 5:30pm
12/17/2019 5:30pm
Your story is damn near exactly the same as mine. Timeline and everything. I had surgery in July and because of my job my focus has been getting back to running, so I’ve been doing a lot of specific exercises to help with that, but honestly I feel like I’m ready to get back on a bike. To not risk a reinjury i decided to buy a 110, beef it up a little, and just ride some trials with it. I’m just not in a position with my career to jump right back into motocross yet.

I’ve found that functional fitness exercises have helped me the most in every aspect. I bought a powerdot too, and I think that has helped greatly.
Loomis077
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Loomis077 12/17/2019 7:02pm
12/17/2019 7:02pm
Wow! Thanks for all of the responses and positive ones. It’s a lot easier discussing this with people who have actually been in this situation. I am definitely getting good braces for both knees before going back to riding. I will look into the anti rotation strap. I’m not sure I’ve ever heard of them.

Thanks again for all of the suggestions!
pbody
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pbody 12/17/2019 8:50pm
12/17/2019 8:50pm
I cycle and moto. Tore my ACL/PCL and meniscus while cycling...stupid trick gone wrong. Replaced ACL with cadaver. I did the prescribed therapy and as much cycling as I could, was back to doing most things in about 7-8 months. Doc and therapist said do as much cycling as I could handle. I'll never forget the first day I was able to get my first full rotation on a spin bike in therapy. Never had a physicsl problem with the knee, but took a couple of months to get my confidence back for gnarly stuff.
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WhipMeister
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WhipMeister 12/17/2019 11:12pm
12/17/2019 11:12pm
Well, welcome to the Drive (old timers know why it's called that). Had same surgery following getoff. I was cleared at 3 1/2 months, but it will take a good year or more before you feel completely comfortable. Your mileage may vary. Attack the PT. It's what makes it work.
Loomis077
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Loomis077 12/20/2019 4:43am
12/20/2019 4:43am
I’m looking more into these anti-rotation straps for knee braces. It looks like Asterisk is the only one that offers them? Anyone else with a different brace use one of these straps?
kevin.decker.125 12/20/2019 5:11am
12/20/2019 5:11am
For me, Spinning 3-5X a week. Cardio and leg day all in one, no impact, keeps the supporting muscle around my knees strong. ACL done in both, 1980 and 2002. Still moto and mtb👍
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sandtrack315
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sandtrack315 12/20/2019 5:43am
12/20/2019 5:43am Edited Date/Time 12/20/2019 5:44am
I would focus much more on getting your range of motion and strength back then getting a good brace. Not that they are mutually exclusive, but there’s a lot of evidence from football studies that knee braces don’t help at all.
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Shawnh
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Shawnh 12/20/2019 5:59am
12/20/2019 5:59am
I had my ACL reconstructed in 2006 (I was 35) with a cadaver tendon after about 15 years with a severed ACL. I was back riding after 4 months and pretty much feeling normal after 5 months. I would recommend 2 things. Go to a physical therapist, a good one will push you to do things on your knee that you won't think that you are ready for. This will give you confidence and trust in your knee. Also get a balance disk like this: https://www.walmart.com/ip/Black-Mountain-Products-Exercise-Balance-Sta…

Start out just balancing on your bad leg, then balance with your eyes closed (tougher than you think), then begin doing 1 leg squats as your strength increases. The amount of strength you will gain just doing these on the disk will amaze you. It strengthens all the muscles around the knee very quickly.

I also wear a DonJoy Defiance III and have been extremely happy with it. It fits better than the CTI2 I had prior to the replacement. My CTI would migrate down and become uncomfortable, the DonJoy stays in place.
CG118
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CG118 12/20/2019 7:42am
12/20/2019 7:42am
It takes about one year for maturity of the repair. Before that, you are risking damage to the repair (sprain, strain, rupture,...).

It sounds like you are already doing the right things so far.

If you were to ride, then dab your foot in a turn, you would be putting a massive force on your repair. Do you want to do that before maturity? If you are feeling lucky, then go for it. There’s no guarantee even after maturity, but hey, it’s your choice.
Hudd_421
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Hudd_421 12/20/2019 7:56am
12/20/2019 7:56am
Your surgeon and therapist will want to have you at full range of motion within a month of surgery. If you just do the exercises, recovery is a breeze. Physically, you'll be fine to ride in 6 months post, however if you haven't done a good job strengthening your leg, i'd take a month to build up your quad.
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CG118
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CG118 12/20/2019 8:41am
12/20/2019 8:41am

Loomis077
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Loomis077 12/21/2019 7:41pm
12/21/2019 7:41pm
CG118 wrote:
[img]https://p.vitalmx.com/photos/forums/2019/12/20/392922/s1200_1F4A0DC5_7D96_457E_81DA_77D94A0E5C7B.jpg[/img]

Thanks, that’s a pretty neat chart of the graft strength. I wonder if there has ever been any studies as to what the stronger graft is, patella tendinitis or hamstring and if the graft is stronger as your own or a cadaver?
Dtat720
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Dtat720 12/22/2019 5:47am
12/22/2019 5:47am
Do yourself a favor and rent a knee oscillator and have it ready to use when you get home post op. 6 hours on, 6 hours off until you start pt. I did this both times, my pt group was blown away each time at how much progress i was able to make in such little time post surgery.
My knee surgeon works on a lot of cyclists and nfl players, a few golfers. Post op equipment is a big reason you see athletes back on the field faster than normal people. Ask your surgeon who to go to to rent one, i was cleared to ride again in 8.5 weeks. I didnt, i waited 12, but i was cleared almost 8 weeks early. All due to keeping my knee in motion post op and not letting it "freeze" before starting pt
Hudd_421
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Hudd_421 12/22/2019 8:54am
12/22/2019 8:54am
I’m sorry, but range of Motion is the the determining factor for riding again. The graft is still weak for the first 3 months, and still vulnerable after. I have almost 100% ROM 6 weeks out and quad working great, doesn’t mean I can go ride. Also, I thought the knee oscillator machine is kinda worthless if you get up and get active within a week of surgery and work on your ROM.
Loomis077
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Loomis077 12/22/2019 9:14am
12/22/2019 9:14am
I walked on my own as soon as I got out of surgery with no crutches. Doctor said it was full weight bearing right out of surgery. I never needed any pain medication other than a couple Tylenol. I had surgery on a Monday and the following Monday I was walking and drove myself to physical therapy. At week 2 I could use an exercise bike. 5-6 weeks after surgery I was released from PT. I was within a degree or 2 or full ROM. Doctor said at that point I could do everything he could allow me to do at that point. I went back to the gym and was riding the exercise bike and doing the elliptical. I’m now doing all of that and then some. I haven’t leg pressed more than 500# yet. I was doing up to 1000# prior to injury. Right now I’m concentrating on lighter weights, no more than 500#, and more reps. I honestly feel like I’m doing really well. Most days I don’t even notice it but once in a while if I do a ton of walking at work or using it a lot I will get swelling in that calf. The knee doesn’t swell, just my calf. Maybe that is normal? 🤷‍♂️
MotoMo165
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MotoMo165 12/22/2019 9:38am
12/22/2019 9:38am
kzizok wrote:
Hey guys,

Thanks for all of the replies. Anyone know anything else?

Thanks in advance!
By far the most useless member on the board
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motosmoke
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motosmoke 12/22/2019 10:26am
12/22/2019 10:26am
I’m also gonna add, getting flexion back is easy. Extension is way more important. You’ll notice if you cant fully extend. Even if it’s just by a couple degrees.

I used to hang a 30lb weight to my knee with my heel resting on something so i could really pull my knee straight. It’s incredibly uncomfortable but if you do it early on it will straighten quick and cut PT time almost in half. I was full ROM 1.5 weeks post op.
CG118
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CG118 12/23/2019 2:24pm
12/23/2019 2:24pm
CG118 wrote:
[img]https://p.vitalmx.com/photos/forums/2019/12/20/392922/s1200_1F4A0DC5_7D96_457E_81DA_77D94A0E5C7B.jpg[/img]

Loomis077 wrote:
Thanks, that’s a pretty neat chart of the graft strength. I wonder if there has ever been any studies as to what the stronger graft is...
Thanks, that’s a pretty neat chart of the graft strength. I wonder if there has ever been any studies as to what the stronger graft is, patella tendinitis or hamstring and if the graft is stronger as your own or a cadaver?
There have been substantial studies and lots o’ research regarding multiple aspects of what you mentioned. Just do a little digging and you’ll find good info., and crap info. Be careful. You are pushing quite a bit of weight already. Impressive. Just remember that your knee is essentially a hinge joint which operates in one plane. Any twisting or movement out of that plane could put excessive forces on your immature repair.

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