Climbing after acl reconstruction?

It’s been about 6mo since this thread began and I’m curious how everyone’s recovery is/was?

I tore my ACL recently and am awaiting surgery. Could use some one else’s experience as a pick me up. 

Well here is a general update. I am approaching 7 months out from surgery and have been going to the climbing gym 2x per week since late December.
Started leading on the steep wall couple weeks ago below limit and have not fallen, high clip everything, and back off a lot. Top roping close to my pre surgery lead limit.

I have had my first two 'aggravating' incidences in the last week, once from high stepping climbing and another from slipping a bit on some ice. Climbing movement feels really good on my leg but just don't think it is strong enough yet.

Plan is to dial back climbing to 1x per week and back to the weights. It is very hard to convince myself to go do weights after starting to climb again.

Post surgery advice is endless icing and stretching for the foreseeable future multiple times a day everyday. If you don't own an ice machine buy a countertop one.

Parker H wrote: Well here is a general update. I am approaching 7 months out from surgery and have been going to the climbing gym 2x per week since late December.
Started leading on the steep wall couple weeks ago below limit and have not fallen, high clip everything, and back off a lot. Top roping close to my pre surgery lead limit.

I have had my first two 'aggravating' incidences in the last week, once from high stepping climbing and another from slipping a bit on some ice. Climbing movement feels really good on my leg but just don't think it is strong enough yet.

Plan is to dial back climbing to 1x per week and back to the weights. It is very hard to convince myself to go do weights after starting to climb again.

Post surgery advice is endless icing and stretching for the foreseeable future multiple times a day everyday. If you don't own an ice machine buy a countertop one.

Thanks for the input, I'll take your advice and at the very least invest in a bunch of those reusable ice packs. 

It sounds like you are on the downhill of your rehab/recovery. Hope you're back to 100% soon and best of luck the rest of the way.

I had a slight regression around month 7 (now 10 months post-surgery). I don't have an official diagnosis but I am guessing my popliteus keeps getting irritated (I also had a partial tear there as well). But, it seems to go away with massage. I also suspect my work shoes (danskos) are playing a part in that, and ordered some flatter shoes for the kitchen. Generally I feel 95% most days but sometimes it just gets irritated, especially after introducing new activities.

Climbing wise, I've been released to top rope since month 7. I'm climbing at about my pre-surgery level as far as that goes. Planning to return to trad in March, which will put me a year out. I backpacked 40mi over Thanksgiving break (a leisurely 5 days on the Trans-Catalina Trail) and did two simple 14ers in September. Climbed some ice this month, which felt fine.

Generally I have found that I not only benefit from a ton of myofascial self-release, but now I actually need it. I still dedicate two days a week to soft tissue work and a few PT exercises (I gym climb those days as well), and do heavy weightlifting twice a week.

My friend Tfish waited 4 months started off easy then messed it up again re surgery started all over again don't rush it.

Ryan Valentine wrote: It’s been about 6mo since this thread began and I’m curious how everyone’s recovery is/was?

I tore my ACL recently and am awaiting surgery. Could use some one else’s experience as a pick me up. 

There was a point in my very slow and frustrating recovery when I questioned the decision to do the surgery. I feel much better about it now, 11 months out. I was back to gym climbing in 6 months. I am going to Colorado on a ski trip in two weeks and I am hopeful/believe that I will be able to ski. Setback included subluxation of the hip on the affected leg due to overall muscle weakness that led to hip bursitis. And I somehow managed to break the sesamoid in that foot, perhaps due to poor gait or whatever. 

I’ve done PT all this time including two week of pre-hab and continuing to do it now. This has been my least favorite injury, despite having also experienced  fructured vertebra and spinal fusion, broken ribs, torn rotator cuff/labrum, etc. 

But it has to be done and will be ok in the end. Good luck!

I had reconstructive surgery April 2 2018. December 9th 2018 I was snowboarding green groomers. January I started on black diamonds. February I started going off trail. I am planning to start touring (we have really good base in Utah, and I signed up for an avy 1 course through work so easy entry, easy terrain, etc) in March. No pain or weirdness over bumps anymore. 

Still no crack climbing. Seeing a new PT that is more familiar with my activities.

I've also turned to FDN (functional dry needling) through the new PT to wake up my quad muscle which is being L A Z Y. I think the biggest issue really is still a feeling of loss of full control over that leg. I am regular on my board, and I have to very consciously pick up my right leg (injured knee) and force ankle motions. But for being less than a year out I feel pretty good. Still taking it easy in areas, pushing it in others. 

Beth Caughran wrote: 

Generally I have found that I not only benefit from a ton of myofascial self-release, but now I actually need it. I still dedicate two days a week to soft tissue work and a few PT exercises (I gym climb those days as well), and do heavy weightlifting twice a week.

A total game changer

Update: the ski trip I mentioned above went well. Skied blues gaining confidence over 4 days of skiing but avoiding black of bump runs. I am two weeks short of 1 year anniversary of my surgery. Main takeaways for me: ACL reconstruction recovery can take a full year. Just be patient. 

I'm 10 days out from surgery and really needed to hear some success stories, so thanks for sharing updates. Aside from the ACL reconstruction I also had to have my meniscus repaired, which to be honest I was not really prepared for. I'm now married to these awful crutches, and not being able to weight my leg or even drive for 6 weeks was a rude awakening for myself and my family. I was so focused on the ACL protocol that I went into surgery thinking I'd be waking up and focusing on ROM and rebuilding quad strength from Day 1. I misjudged the meniscus recovery, and this initial period of mostly sedentary healing has been really rough on the psyche. 

Good luck with the process.  My surgery was almost 30 years ago (both ACL and meniscus).  Repaired knee feels better than the other.  My best advice: follow your PT's instructions and don't hurry the process.  It took me a year to get back to full activity.  Cried like a baby the first time I took a jog -- not from pain, but from happiness.  That was at 4 months (I think -- long time ago now).

Day9 from surgery.  
Cadaver graft ACL and meniscus stitches for a tear. 

Off Percocets in 1.5 days.  Off ibuprofens (for pain) by day 3z
Post op appointment after 7days.  Doctor says I can do the following, and all seems good...
Walking in brace, unlocked, but carry a cane.  
Crutches were ditched on day 5.
Wear brace for 3 more weeks minimum.  Sleep without.  Can flex to almost zero, and a bit beyond 90deg.  
I am 44.  Climbing all over PA to Patagonia, 30 years.  Backcountry ski CO to Chamonix to Rainier, 20 years.

I am finding that everyone is so different.  Take peoples timelines with a grain of salt, and mostly listen to YOUR body and what it’s telling you!Having done stuff for all these years is probably a great help.  My muscles are already strong.  To prevent  atrophy of things I tried to progress to walking unassisted ASAP.
I know I’m at the upper end of the bell curve, (doc told me) but still know it’s going to be a long haul with many set backs, and delays.  In all the years of getting away with danger, this is my first injury I will really have to crawl back from...

Luckily I’m in Boulder, which has so many good doctors, PT folks.  My doctor is a skier, and grew up here.  The day I had my surgery I was #2 of 3 ACL surgeries he did just that one day!

Thanks for sharing everyone.  It helps us understand.  Keep the stoke up. Drink beer.

​Corknee

PS: here is some Tommy stoke for us all!
Edit to add: I was walking almost normal, and had no pain except for a few movements/tweaks before my surgery.  Swelling was present, but down/limited.  Range of motion was pretty good (better than where I am currently..)  I didn't go to the doctor until 2 weeks out from injury.  Surgery was a month out from injury.

Thank you for the encouragement and advice.

I really like that a number of people have now told me that years later they refer to their repaired knee as their "good knee". That still seems hard to believe, given my current perspective, but I'll take it as motivation to stay focused on the long-term success rather than the short term gains.

Ryan Valentine wrote: Thank you for the encouragement and advice.

I really like that a number of people have now told me that years later they refer to their repaired knee as their "good knee". That still seems hard to believe, given my current perspective, but I'll take it as motivation to stay focused on the long-term success rather than the short term gains.

That's so funny, and it's so true. Every time we measure my strength (hip, quad, hamstring), my new knee is the strongest :) 

Good luck to you, new ACLr-ers! I'm coming up on a year post-op. Have discovered some underlying biomechanical and medical issues probably underlying my injury (and others), but still overall doing well. I led my first trad route post-op last Friday, and it felt good! Was cautioned about cranking too hard on cracks by my PT, as one of those medical discoveries is hypermobile joints. I've also picked up XC skiing which has been awesome, but I doubt I will return to downhill skiing, just because I'm fearful that my party trick hips are going to land me on the surgeon's table again. But I am hiking, climbing (ice and rock, soon to be snow), and backpacking in an unlimited fashion. Feeling so good, some days I nearly forget I've had surgery.

Jeffrey Constine wrote: My friend Tfish waited 4 months started off easy then messed it up again re surgery started all over again don't rush it.

Messed up while climbing or sth else? If climbing, how exactly?

Chiming in to add my own experience! I'm 7 months out from surgery (ACL and meniscus repair), and my ortho (not the surgeon), who's a climber, let me start top-roping 5.5 and 5.6, once a week, just a month ago. She says now I can either increase the frequency or increase the grade, but not both, just like starting running.

A really useful site with lots of info is this one, from a climber: https://www.patchworkandpebbles.com/acl/

My graft was a quad graft, which means that it's hard to find other climbers with an exactly parallel experience. (Each time I step onto a new hold, pushing up hurts like hell!) If any of you had a quad graft or knows someone who did, please get in touch!

Also, since what I'm really looking forward to is bouldering again (which I have to wait several more months for), I'd love to get my hands on that copy of Alex Puccio's recovery plan.....

Hi everyone,

I'm 4.5 months out of ACL recon with hamstring graft. Started doing some top roping with no issues.

Just wondering if anyone has any experience on here with neuropathic pain? Seems like my saphenous nerve was damaged during the op, have lost sensation to most of my lower leg below knee except back of my calf and get neuropathic pain (kinda feels like electric shocks down my leg). OS said it would settle and it has abit but I still get it most days.

Just won't if anyone has any similar experience/help haha as it's abit grim!

Thanks in advance!

normajean wrote: Looking for dos and don’ts of returning to climbing after ACL reconstruction. I am 3 months post surgery. Thinking maybe I can something easy in the gym. What were you able to do and when?

Norma,  I had a cadaver acl replacement done and was climbing lightly in the gym after 4 weeks post surgery  

I also have an allograft (cadaver) reconstruction, so I do understand the eagerness from those with recent surgeries for timelines based on others' experiences.  My advice is:  don't do this.  The combined variables of pre-injury condition, injury mechanism and extent, surgical outcome, healing rates, and responsiveness to PT when added together mean that, unfortunately, no one else's experience is likely to be very relevant to your own.  LISTEN TO YOUR BODY.   For any physical activity, if it hurts that means you should probably stop (with the exception of your physio flexing your heel back to your butt to achieve full flexion).  

If you cannot jog a mile pain free and with confidence, then I would caution strongly against climbing for three reasons:

1.  You probably do not have the physical strength back yet in your surrounding musculature to adequately protect your knee

2.  As noted by others here, there are some physiological processes in incorporating the graft that take as long as they take; other than maintaining generally good health and doing (but not overdoing) your rehab, you just have to wait for your body to complete these processes.  Generally this can take up to 9-12 months but as we see here, there's a lot of individual variance in that.  One thing for sure:  if you cannot jog a mile pain free, these processes are not complete and you're accepting a significant risk of re-injury to climb on that knee.

3.  Also as noted by others here, the reconstruction does a number on your proprioception (i.e., your ability to tell what position your knee is in without looking at it).  Fixing this involves re-wiring your brain to your "new" knee joint, and also takes a while to happen.  Because climbing is relatively likely to place odd-angle stresses on your knee, having your subconscious brain be able to flag you about a bad angle on your knee while you're concentrating on hanging on to a greasy sloper is critically important to avoiding re-injury.

The good news is that we live in an age where first reconstructions for active individuals, if allowed to fully recover, have an extremely high probability of success.  I completely detached my ACL in my early 40's and I'm currently 51 and running, skiing and bouldering harder than pre-injury with no knee soreness, ever.  Be patient, let it heal, and you'll be fine.  The outcomes for second and subsequent reconstructions on the same knee are considerably less rosy, so don't risk re-tearing it just to start climbing a couple of months earlier.