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ACL Surgery Recovery and Training

Original Post
Dan Corcoran · · Kenmore, WA · Joined Aug 2013 · Points: 50

Tore my ACL all the way through. Surgeon says expect 6-12 months of no sports after surgery, PT concurs. I'm devastated but resigned to the fact that I can't climb for up to a year.

Those that have recovered from ACL surgery, what was your experience? What did you do to stay fit/sane? How was your return to climbing and how complete was your recovery?

Tell me everything. I have a lot of time to read now.

rgold · · Poughkeepsie, NY · Joined Feb 2008 · Points: 526

There are,several threads on this on MP and also on Supertopo and UK Climbing, so do some searching.

I ruptured my ACL in a bouldering jump when I was 68.  Had a (Achilles) cadaver tendon replacement.  (Whether you use a cadaver tendon or a piece of your own patella tendon or hamstring tendon is one of your first decisions.)  Was religious about rehab, both range of motion and strength---found that trail walking with a knee brace and poles was one of the best things, but did all the standard indoor exercises as well.  Leading moderate climbs after 7 months.  I'd say it was two or three years (can't recall exactly) before I stopped being conscious of having a "bad" knee.

My surgeon had to dissect some of my meniscus because of tears, and five years later I sometimes have some pain that I associate with that.  I can manage 6 mile trail runs, but have continued to use poles and wear neoprene braces on both knees for hiking and running (but not climbing).  I've lost a little range of motion in the repaired knee: I can't "sit" on  my heel on that leg as you might for a rock-over high step.

I've read of people getting back to pretty intense activity after 4 months, but that's risky, as the replaced tendon goes through various changes before being fully "incorporated," and during some of those periods the graft is actually weaker than the day it was installed. (this is true for cadaver tendons; I'm not sure about grafts from your own body.)

Assuming you're younger than me, I'd guess that, even being cautious, you'll be getting back in the game closer to the 6-month limit than the 12-month one.

BigNobody · · all over, mostly Utah · Joined Nov 2013 · Points: 10

Hike and climb 5.6's

PTR · · NEPA · Joined Aug 2009 · Points: 10

Had my ACL surgery about 25 years ago -- cadaver tissue.  Highly successful for me over the long term.  My repaired knee still feels more solid than the other one.  My advice is the same as above: 1. Do what your PT tells you.  I did not make enough progress on flexion on my own.  He finally gave me the bad news that he had to strap me down and stretch it for me.  Blindingly painful.  2. Do not rush back against advice of PT/surgeon.  The graft needs time.  Focus on long-term functionality.  And be careful with torquing, high-stepping, etc.  They may clear you for jogging, but they may not know what you intend to do with your knee as a climber.  3. Cycling worked for me, although my PT worried about my commuting (vs. getting reps on a trainer) and the risk of a fall.  Good luck!

Dan Corcoran · · Kenmore, WA · Joined Aug 2013 · Points: 50

Thanks, everybody, that is all great advice. As with climbing, it sounds like success is all about focus, diligence, and knowing your limits. And thanks, rgold, I will look through the forums for more info. Should have started there. 

Just for context: I'm 38, in pretty good shape. The surgeon plans to do a graft from my own patella tendon. Surgery is in two weeks, but I have been in PT or doing exercises assigned to me by PT every day since my first consult. My legs are pretty developed, so I am hopeful that will be a point in my favor. My surgeon is not a climber ("So tell me, what is bouldering, again?"), but I figure it is more important for him to be a good surgeon than a climber. I chose my PT specifically for their specialty in working with climbers. 

So glad to hear that everyone's recovery was successful and that you are back to your pre-injury lives. That is what I hope for as well. 

PTR · · NEPA · Joined Aug 2009 · Points: 10

One more thing: you might be appalled at how puny your leg will look post-op!!  I was amazed at how fast it recovered.  

rgold · · Poughkeepsie, NY · Joined Feb 2008 · Points: 526

For whatever reason, I had the most atrophy in my calf muscle, not the quadriceps, and it took the longest to build back up.  

Dan Corcoran · · Kenmore, WA · Joined Aug 2013 · Points: 50
rgold wrote:

For whatever reason, I had the most atrophy in my calf muscle, not the quadriceps, and it took the longest to build back up.  

Rgold, I am a week and a half post-op now and that is my experince as well. My quad was firing on day one, but my calf is taking longer to recover. 

I also experienced some nerve damage as a result of the surgery, which is kind of a bummer. I'm told it will heal but will take several months.

Mikey Schaefer · · Redmond, OR · Joined Jun 2014 · Points: 246

Was the nerve damage due to surgery or did you get a femoral nerve block done?

I'm 8 weeks post op on my ACL (done with patellar tendon graft).  Still don't have great ROM and walking with a limp.  But my bicep size has increased proportionally relative to my calf atrophy.  So there is always that.... If you don't currently have a strong core and fingers you won't have any excuse after this is done.  Hangoarding/training days are the highlight of my week.  

Dan Corcoran · · Kenmore, WA · Joined Aug 2013 · Points: 50

Mikey, the nerve damage came from the surgery. I did not do a nerve block, just general anesthesia. Pretty much constant low/medium level pain. I'm told that the pain is a sign that the nerve is healing, though. My range of motion is slowly getting better. I found a really good PT. 

And Yes, hangboard is my only outlet now, so I do it as much as I can. I never appreciated how good it feels to get pumped until I couldn't climb.

Tino F · · Unknown Hometown · Joined Nov 2008 · Points: 22

Hi all,
I’m prepping for a patellar autograft in about a week and I just wanted to see how you were doing now, since Mikey and Dan are both about a year post-op.

I’m 40, but I’m a head setter and an avid boulderer and trying to get as much anecdotal advice as possible.


Andrew S · · Unknown Hometown · Joined Aug 2016 · Points: 45

I had ACL surgery 11 years ago.  As a competitive ski racer for pretty much my whole life, I know lots of people who tore their ACLs.  My biggest advice is DO THE PT. Mindless hours of boring exercises like physio ball hamstring curls sucks but makes your knee strong as hell.  As Rgold mentioned above it is common for your knee to not feel 100% 'normal' for like 2 years (even though it is structurally better much earlier).  For what it's worth, I was back on snow 7 months after surgery and back to ski racing 8 months out.

Guideline #1: Don't be a jerk.

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