UKC

Hi there

I'm sure this question has been asked plenty before but it would be great to hear some feedback. I'm nearly five weeks out from ACL repair and diligently doing my rehab according to my surgeon's protocols and getting good NHS physio supervision so far. I know the general timelines for each stage.

Looking ahead at the year I'm keen to have an idea of when I might be safe to get back to my usual stuff. I'll discuss this with physio/surgeon in due course. I have had negative experiences in the past with some health professionals passing judgement on the risks of climbing/going off to the hills on my own rather than offering constructive advice so it would be great to hear particularly from any surgeons/physios who are also climbers! I totally understand the process can't be rushed and that you can't make direct comparisons with others, and last thing I want to do is mess the handiwork and my hard work up.

What guidance did you get/can you offer re return to:-

outdoor cycling/cycling with feet clipped in
return to hillwalking (can see I would be advised to pick my hills carefully to avoid the rougher/steeper ones until next year)
climbing wall
seconding trad routes assuming the walk-ins aren't too dodgy
sport climbing - I think an October hot rock holiday is a reasonable target!
yoga - normally I do ashtanga but will need to modify this/avoid certain postures. It was a great help recovering from my original rupture but at that time I didn't have a precious graft to damage so I pushed things quite hard!

Thanks and best wishes to any others out there rehabbing from ACL or other injuries.

In reply to HamishTeddy:

I had mine done 10 years ago and had pretty intensive physio for up to 6 months afterwards. It was before I started climbing so a bit different to you but my recollection is:

Outdoor cycling - 6 months. This was due to risk of falling and twisting knee rather than cycling per se.
Hillwalking - easy walks at 4 months, just being careful. Poles help when descending.
Climbing - I started about 9 months after operation. Hadn't really climbed before.

Do not underestimate mental readiness. It takes a while to start trusting your knee again and overcome fear of damaging the new ACL.

Good luck!

In reply to HamishTeddy:

I had a hamstring graft repair 9 years ago following a knee dislocation, acl and mcl rupture and torn meniscus, it's fair to say my knee was trashed. I followed the recovery protocols to the letter and was paranoid about overdoing it or any activity that could set me back. I still avoid any open chain excercises on the repaired knee. As you point out everyone is different but at the 6 - 9 month period if you've looked after it you could feasibly be fully active again. I was super cautious but I was cycling and walking at 9 months (predates my climbing). At 12 months I was back practicing karate and judo and today I can pretty much climb, cycle and walk as I please. I get the odd twinges on sharp descents but nothing major. As I've got older I've concentrated a lot on prehab and quad strength to look after my knees. Still not mega keen on jumping off the top of boulder problems at the gym! My advice is to be 100% focussed on following the recovery protocols to get yourself back to where you want to be, it is achievable and hard work will produce reward....

In reply to Slarti B:

Thank you for sharing your experience - you're right about mental readiness. Never expected to feel quite so nervous about messing things up! Enjoy your climbing etc. Thanks again.

In reply to mnorm:

Thanks so much for your feedback. Yes, exercising to avoid injury in the first place is something I have become a bit evangelical about, nagging my kids. friends and family to build their strength and flexibility to protect themselves as best they can, regardless of their sport/activity level. Bouldering has been something I've generally avoided as I lived with no ACL for a long time and knew it wouldn't be a good idea to be doing too much jumping/landing! Thanks again., it's great hearing what folks get back to.

In reply to HamishTeddy:

Outdoor cycling pretty much immediately/couple of weeks depending on the swelling and how invasive the surgery was. I would actually expect it to be part of your rehab program (it was for my ACL rupture, but I got away without surgery).

Climbing, once your knee is sufficiently stabilized by the physio exercises. Do not rush it. Even then, there will be stuff you may want to avoid, drop knees, egyptians, etc., I would mainly worry about rotating your knee out (happened to me playing football) and damaging the graft. Same goes for the yoga. In any case, tape and/or neoprene knee braces are your friend!

I was back on a judo mat for full randori (with a knee brace) and climbing (without) after five months, but that involved >1h of rehab exercises each day, and I am lucky to be a "coper", i.e.among the 30% or so of people whose musculature is innervated such that it can, with training, provide sufficient stability even without the ACL.

CB

In reply to cb294:

Thanks, sorry I only just saw this. Getting right into gym-type exercise bike now and hoping to be on my road bike on my turbo soon - that will begin to feel more normal! I'm compensating for lack of outdoor cycling by having the handlebars right by the window and opening it wide! Will discuss outdoor riding with physio later this week. I was actually a "coper" for over ten years, knee was stable after rehab and was able to do masses of stuff in mountains, but it caught up with me last year when I had a major meniscus tear that locked the knee and had to be removed. After that I could not get my knee stable enough, hence the recent op.

In reply to HamishTeddy:
No worries! Good luck with the rehab,

CB

In reply to HamishTeddy:
Good luck with your knee and rehab.

I'm currently rehabbing my knee so I feel for you. I managed to tear my ACL, tear my meniscal disks, damage the cartilage and crack the bone.

Its taken three surgery's to get sorted but now by taking it really slow and doing loads of physio things are looking good. It was complicated by the two initial failed procedures which led to loads of muscle wasting and it being too painful to rehab after the ACL reconstruction.

Its almost bang on six months since the last op (a bone graft) and I'm walking well and toproping stuff. Post op personal bests are 10km with 700m of height gain in the mountains, 6c at the climbing wall on top rope and about forty miles on the road bike.

I'm hoping to get running and jumping in the next month or so. After this I'll consider easy sports leading. My physio is very supportive of climbing and seems very good on medical physio rehab to get back to sport.

The periods of parinoia when I have minor setbacks have been hard but there have generally been week on week improvements. As I did have problems initially things can go wrong. I found the original surgeon reluctant to accept my testimony that things were not right and had to get a second opinion. I felt there was a slight attitude of "you should be OK because I fixed it".

You know how your knee feels better than them so trust your feelings if its not right and kick up a fuss.

In reply to HamishTeddy:
It's not something I've had done, but perhaps start off with flat pedals first to let you shift your foot subtly on the pedal if you start to get feedback from the knee that it's not happy in certain orientations?

I used to have 'dodgy knees' and that was how I approached cycling, and now don't get any grumblings from them and am considering going clipped in.

In reply to HamishTeddy:

I had an ACL "transplant" and partial meniscus dissection about four years ago. I don' t cycle, but did supervised rehab as prescribed by the surgeoon, was walking with poles after a few months and leading moderate climbs after seven months. I hadn't used poles before but now don't hike without them.

I don't think I became fully unaware of my knee for two or three years. I gave up bouldering (which is how I did it in the first place) because of the fear of reinjury from jumping down. (Pads don't help; my injury was from a jump onto a pad.) I was 68 years old at the time, so recovery would be expected to be slower than for a younger person.

In reply to Brown:

Hi there, good to hear from you though not of your woes. What a nightmare but I get the feeling you will get there. I guess the good thing is that we are highly motivated to get back to the sports/activities we love and that helps us with the rehab though patience can be a hard thing and as you say the paranoia is grim - I'm with you on that one! Keep up the good work, and thanks for sharing your story. Good to hear you have a supportive physio. I see mine tomorrow and will post an update if anything worth passing on. All the best.

In reply to Timmd:

Hi, thanks! You've reminded me to make sure to use my insoles when I do start cycling with a vengeance again, they make a big difference but sometimes I'm halfway through a ride and find I've forgotten to transfer them from my other shoes! Yes, cycling A LOT was a big factor in my recovery and return to the mountains following my original rupture.

In reply to rgold:

Hi there, thanks for your story and glad to hear you made a good recovery in the end. Past experience from my original rupture showed how it takes time both for the physical and mental recovery to be complete - but it does come with hard work and the thing I'm not so good at, patience! Yes, I think I will avoid bouldering too, not too much of a hardship as I have never really got into it. Just want to spend long days in the mountains, do all the classic routes I've always said I'll do ... All the best.

In reply to HamishTeddy:

I'm on my second ACL reconstruction...
First time was hamstring... I was leading VDiff in 4 months, jogging after 6 and ran a half marathon in 12 months.
Second time was quad... climbing after 5 months but not falling or jumping off. Hill walking after 3 months... started with county tops and in 6 months scrambling up Tryfan. 8 months managed 30k across Dartmoor. 9 months on I'm just starting to jog up to 1k.

The thing not to underestimate is getting down... walking down a hill, getting off a boulder, scrambling off a cliff is so much harder than going up. I've found poles essential for walking down rough terrain.

In reply to HamishTeddy:

Having a supportive physio who is keen on the idea of sport is great. Today we did (double leg) hopping for the first time in a year. Then I top roped 7a, post surgery personal best.

On the subject of insoles, I've been flogged orthotic insoles. They took plaster casts of my feet and charged me lots of money. I've stopped limping but I'm not sure if its just a placebo effect as the placebo effect is strong when you pay £150 for insoles!!!!!!!

In reply to JIMBO:

Don't want to ask why this is your 2nd ACLR?! Bad luck. I agree re downhills - my plan is to concentrate initialy on hills with big tracks and avoid the steep stuff this year, it'll all still be there next year! Main thing I want to work out now is best hot rock destination for the autumn with lots of crags with easy access/flat bases as attempting rough descents with heavy sack is a recipe for disaster ... and will be investing in a pair of poles too. Best wishes with your rehab.

In reply to Brown:

Good stuff, well done but take it steady! Re insoles, yes, hideous price but they seem to have largely cured me of a back niggle I'd had since childhood so money well spent. Glad you have a supportive and sporty physio, mine is too (also of a similar age), though doesn't know anything about climbing and said to ask the surgeon ... not sure what response this will get! Think largely we just have to use common sense based on everything else we learn about rehab/safe and dodgy stuff.