Can You Mountain Bike With A Torn ACL? A Recovery Guide

Have you recently torn your ACL but still have a burning desire to hit the trails on your mountain bike?

The fear of re-injury and uncertainty may be holding you back, but don’t worry, you’re not alone. Many athletes face the same dilemma after an ACL tear.

It is possible to mountain bike with a torn ACL, but it is not recommended. Mountain biking can put significant strain on the knee joint, which may worsen the injury and delay the healing process. Make sure to consult with a medical professional before engaging in any physical activity with a torn ACL.

So, if you’re eager to get back on your bike and wondering if it’s safe to do so, keep reading to discover the treatment and recovery methods so you can still enjoy the thrill of mountain biking while recovering from a torn ACL.

Function and Importance of the ACL in Mountain Biking

The ACL (anterior cruciate ligament) is one of the four major ligaments in the human knee and a vital component of the knee joint during mountain biking (1).

Here are the roles of ACL in mountain biking:

It ensures that the knee remains stable and supported as riders conquer challenging trails and rugged terrains.
Prevents the knee from buckling during sudden movements or impacts, allowing bikers to navigate uneven surfaces, roots, rocks, and drops with confidence.
Enables smooth movement, quick turns, and adaptation to changing terrain, enhancing control and balance.
Absorbs shocks and impacts during jumps and hard landings, reducing stress on the knee joint and preventing injury.
It facilitates power transmission, allowing riders to generate force through their leg muscles for climbing, accelerating, and maintaining speed.

How Does an ACL Tear Affect Your Ability To Go Mountain Biking

Your ACL is crucial for full knee flexion and extension during pedaling, especially during intense rides like uphill biking.

When you have a torn ACL, the limited range of motion, stiffness, and pain make pedaling inefficient and riding uncomfortable. It can really mess up your ability to navigate trails and could even lead to more injuries.

Apart from a limited range of motion, the injury also decreases knee stability while biking, which is crucial for sudden speed and direction changes.

Without proper support from an intact ACL, you may feel unstable on the bike, leading to reduced confidence and difficulty maintaining balance on rough terrain or technical sections of trails.

So it’s super important to do strengthening exercises, use proper technique, and wear knee braces to keep it healthy.

Common Signs and Symptoms of a Torn ACL

A torn ACL (anterior cruciate ligament) can occur during sudden stops, changes in direction, or jumping and landing. It’s a common injury, especially in extreme sports such as mountain biking.

Knowing the signs and symptoms can help you recognize the injury and seek proper treatment.

Symptoms of a torn ACL can include (2, 3, 4, 5):

A loud pop or a “popping” sensation in the knee
Severe pain and inability to continue the activity
Rapid swelling may occur within a few hours of the injury
Knee instability causes you to feel wobbly or give way, making it difficult to put weight on the affected leg
The limited range of motion caused by knee instability makes it hard to fully extend or bend the knee.
Inability to bear weight on the affected leg
Swelling, typically 6-24 hours after the injury

If you suspect that you have torn your ACL, immediately see a doctor for an evaluation.

Depending on the severity of the injury, treatment may include rest and rehabilitation exercises to help regain strength and stability, or surgery to replace the torn ligament followed by rehabilitation.

Treatments for a Torn ACL

If you tear your ACL, the treatment you receive will depend on how severe the injury is, your age, and what activities you want to get back to.

Non-surgical Treatment: For less serious injuries, you might not need surgery and can instead use methods like bracing, physical therapy, and gradually increasing your activity level. (6)
Surgical Treatment: If you’re an athlete or someone who wants to do high-intensity activities involving cutting and jumping, surgery is usually recommended. During the surgery, the torn ligament is replaced with a graft, either from your own tissue or a donor. Afterward, you’ll need to do rehab exercises to regain strength and stability in your knee. (7)

Not everyone needs surgery for an ACL injury, so it’s best to consult with a doctor to figure out the best treatment plan for you.

What Does ACL Surgery Entail?

ACL surgery, also known as ACL reconstruction, is a surgical procedure used to repair a torn anterior cruciate ligament (ACL), a ligament in the knee joint that helps provide stability. (8)

The surgery usually takes 2 to 2.5 hours and is done under general anesthesia.

The procedure involves several steps as below (9):

First, the surgeon will choose a tissue graft to replace the torn ACL. The most common options are the patellar tendon, hamstring tendon, or quadriceps tendon. The graft is usually taken from the patient’s own body.

Next, the surgeon will make small incisions to insert a camera and tiny tools into the knee joint. This allows them to visualize the torn ligament and surrounding structures.

The damaged ligament is removed with a shaver or other instruments, and a new ACL graft is inserted in its place.

Is ACL Surgery Painful?

ACL surgery can be painful, but the level of pain varies from person to person.

Here are some things to keep in mind (10):

Most people have some pain and discomfort for the first few days after surgery
Pain from knee surgery decreases with time
Swelling and bruising are also relatively common, and like discomfort, they’re temporary
Pain medications will be prescribed by the doctor and should be taken as directed
Acupuncture has been found to be effective in reducing intensified knee pain after surgery

It is important to follow your doctor’s instructions for pain management and to report any unusual or severe pain.

Recovering from a Torn ACL with Non-Surgical Treatment

For those with a grade 1 or 2 ACL injury, rehabilitation and non-surgical treatments may be viable alternatives to consider.

RICE Method

One commonly recommended approach is the RICE method, which stands for rest, ice, compression, and elevation. (11)

By resting the affected knee and applying ice packs to reduce swelling, you can help promote healing. Compression with an elastic bandage and keeping the leg elevated can also aid in reducing inflammation.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed by your healthcare provider to manage pain and reduce swelling. These medications can help alleviate discomfort while supporting the healing process.

Physical Therapy

Physical therapy is another important component of non-surgical treatment for a torn ACL. (12)

Through specific exercises and rehabilitation protocols designed to strengthen the muscles surrounding the knee joint, physical therapy can help improve stability and promote a safe return to activity.

Lastly, the use of a knee brace for stability may be recommended. A knee brace can provide support and help prevent further injuries by stabilizing the knee joint during activities like walking or light exercise.

Make sure to consult with a healthcare professional to determine the most suitable non-surgical treatment plan for your torn ACL.

They will consider the severity of your injury and develop a personalized approach to aid in your recovery and help you regain strength and stability in your knee.

How Long Does It Take To Recover From ACL Surgery

Recovering from ACL surgery is a process that requires time, commitment, and adherence to a rehabilitation program.

According to Hospital for Special Surgery (HSS) and UC Health, the recovery process may take up to 12 months.

Here is a general overview of the stages and milestones in the recovery process after ACL surgery :

Immediately post-surgery: The first few days after ACL surgery are focused on rest and pain management, mostly done with the RICE method. You may also be required to use crutches and wear a knee brace for stability.
First 2 weeks: During this time, the focus is on reducing swelling and gradually regaining knee movement. Physical therapy usually begins to help restore range of motion and enhance muscle strength.
2-6 weeks: As the swelling continues to decrease, you can begin to wean off crutches and may start light exercises to enhance knee stability. Physical therapy progresses to include more advanced exercises targeting balance, endurance, and muscle strengthening.
3 months: By this point, you may regain most of your knee function and can start more vigorous exercises to improve strength and flexibility. Low-impact activities such as swimming or stationary biking are usually permitted.
4-6 months: With continued commitment to rehabilitation, you can typically return to moderate activities such as running or cycling. Physical therapy focuses on further strengthening the knee and improving functional movements.
6-9 months: You may begin engaging in more demanding sports or activities, but caution is still required to avoid any setbacks or reinjury. Rehabilitation aims to fully restore knee function and improve performance.
9-12 months: By this stage, You should have recovered and regained full strength, stability, and range of motion. You can usually resume high-intensity activities or sports with proper clearance from your healthcare provider.

The above timeline for recovery is a general guideline and can vary based on individual factors such as the severity of the initial injury and your dedication to rehabilitation.

How Can I Recover Faster After ACL Surgery?

To recover faster after ACL surgery, it is important to follow a comprehensive rehabilitation program that includes physical therapy, exercises to strengthen the muscles around the knee, and proper rest and nutrition.

Adhering to the surgeon’s post-operative instructions and avoiding activities that could potentially reinjure the knee can help facilitate a quicker recovery.

Below, we will explore some exercises (starting from the least to the most intense activity) and tips to help you recover faster after ACL surgery and get back on the mountain biking trail as soon as possible.

Floor/Mat Exercises

In Week 2 of your ACL recovery, don’t underestimate the power of floor and mat exercises in rebuilding strength and stability in your knee.

These exercises, requiring minimal equipment, are carefully designed to gradually improve your knee’s range of motion and muscle control.

VeryWellHealth and Sports Injury Clinic recommended the following exercises:

Heel slides: Start by sitting on the floor with your legs outstretched. Slowly bend the injured knee while sliding your heel across the floor toward you. Hold for a few seconds, then slide your heel back to the starting position
Quad sets: Lie on your back with your legs straight. Tighten the muscles in the front of your thigh (quadriceps) and press the back of your knee down into the floor. Hold for a few seconds, then release
Bridge exercises: Lie on your back with your knees bent and feet flat on the floor. Lift your hips and thighs off the floor, keeping your shoulders and feet in contact with the ground. Hold for a few seconds, then lower back down
Hamstring curls: Lie on your stomach with your legs straight. Bend your injured knee and bring your heel toward your buttocks. Hold for a few seconds, then lower back down
Pilates exercises: Pilates exercises can help improve balance, coordination, and core strength after ACL surgery. Examples include the single-leg stretch, double-leg stretch, and spine stretch

Stationary Biking

Stationary biking can be an excellent low-impact activity during ACL recovery. It allows you to strengthen the leg muscles and promote the healing process without putting excessive stress on the knee joints. (13)

To start stationary biking after an ACL injury, gradually increase the resistance and range of motion. Begin with a comfortable resistance level and focus on maintaining a smooth pedaling motion.

As you become more comfortable, slowly increase the resistance to challenge your muscles.

To protect your healing ACL, it’s recommended to start with a limited range of motion. Start with quarter rotations, pedaling from 12 o’clock to 3 o’clock, and back.

This reduces stress on the knee and allows you to focus on engaging and controlling your muscles.

Once you feel confident and your knee is stable, you can progress to three-quarter rotations from 12 o’clock to 6 o’clock, and eventually full rotations.

Weight Bearing

Gradually increase weight bearing to ensure a full recovery while avoiding further damage to the knee.

As stability and strength improve, introduce partial weight-bearing exercises such as walking with crutches or using a knee brace.

Finally, progress to full weight-bearing exercises like squats and lunges, focusing on improving leg strength and stability.

Working with a physiotherapist is important for guidance and to prevent additional injury.

Walking

After focusing on activities like biking or swimming that don’t put weight on the knee, you can start gradually walking with the help of crutches or a knee brace, ensuring you don’t strain the ACL.

Working with a physiotherapist is important for proper guidance and form. As you heal, increase the distance and intensity of your walks.

Strengthening exercises like squats and lunges become essential for overall leg strength and stability.

Keep track of your progress by setting milestones, like being able to walk a mile without discomfort by week 6-7.

Outdoor Biking

When biking outdoors during ACL surgery recovery, it’s important to avoid hills at first.

Climbing uphill can put extra strain on your knee and potentially make your injury worse.

Stick to flat terrains until your knee gets stronger and more stable for a safe and comfortable ride.

Hiking

Hiking is a great activity while you’re recovering from a torn ACL.

To ensure stability and minimize the risk of re-injury, it’s crucial to wear a knee brace.

Start your recovery journey by tackling moderate trails that aren’t too challenging or steep.

This will gradually boost your knee flexibility and strength, allowing it to become more comfortable with bearing weight and maneuvering through uneven terrain.

Through proper rehabilitation and physiotherapy, hiking becomes a powerful tool for regaining the strength and stability needed for everyday activities.

Mountain Biking

We know that mountain biking is dangerous (even more dangerous than skiing). So, make sure to wait at least 9-12 months for recovery after ACL surgery before returning to the trail.

Here’s what Delilah has to share when she attempted to ride 6 months after the surgery.

When you are ready to get back on the trail, it is best to start with flat and relatively easy routes.

Start from the beginning and consider yourself a newbie. Steal my 18 practical mountain biking tips so you can ride safely.

Avoid hilly terrain or challenging trails that could put unnecessary strain on your healing knee.

By gradually increasing the difficulty and intensity of your rides, you can minimize the risk of re-injury.

As always, it is crucial to consult with a healthcare professional or physical therapist before engaging in mountain biking or any other physical activity after ACL surgery.

They can provide specific guidelines and recommendations based on your individual recovery process, ensuring a safe and effective return to the sport you love.

How To Prevent Tearing Your ACL as a Mountain Biker

To avoid tearing your ACL while mountain biking, you can take several prevention steps.

First, prioritize strength training by doing exercises like squats and lunges to build strength and stability in the knee joints.
Next, focus on flexibility training through stretching exercises to improve knee range of motion and reduce injury risk.
Correct technique is crucial, so maintain proper body positioning with slightly bent knees and balanced weight distribution between the wheels.
Engage in balance training activities like yoga to enhance core stability and control.
Lastly, wear protective gear such as knee braces, helmets, and knee pads to provide added support and safety on the trails.

My Verdict

If you have a torn ACL, it’s possible to still go mountain biking, but keep in mind that it can be risky and may worsen your injury.

Before making a decision, do yourself a favor by consulting a medical professional who can provide guidance on whether it’s safe for you to continue biking.

They can also recommend precautions, suggest modifications, and create a personalized rehabilitation plan to strengthen your knee and prevent further damage.

Remember, your safety is paramount, so prioritize your health and well-being when engaging in physical activities.

Frequently Asked Questions

It is not recommended to ride a bike with a torn ACL as it can put additional strain on the knee joint and may worsen the injury. It is best to consult a healthcare professional for proper guidance and treatment.

To avoid further damage to a torn ACL, it is best to avoid movements that involve sudden stops, pivoting, jumping, and twisting. These movements can put excessive strain on the knee and increase the risk of injury. Consult with a healthcare professional for specific recommendations based on individual circumstances.

After ACL surgery, you can typically start cycling again within 4 to 6 weeks, but this can vary depending on your individual recovery progress and the advice of your surgeon. It’s important to gradually increase the intensity and duration of your cycling sessions to avoid putting excessive strain on your knee during the healing process.

Yes, biking is good for ACL rehab. It is a low-impact exercise that helps to strengthen the muscles around the knee joint without putting excessive stress on the ACL. However, it is important to consult with a healthcare professional before starting any exercise program for ACL rehab.

To make your ACL stronger, focus on exercises that target the muscles surrounding the knee, such as squats, lunges, and leg presses. Incorporate balance and stability training to improve joint stability and reduce the risk of injury. Remember to start with a proper warm-up and gradually increase the intensity and duration of your workouts.

Can You Mountain Bike With A Torn ACL? A Recovery Guide

Function and Importance of the ACL in Mountain Biking

How Does an ACL Tear Affect Your Ability To Go Mountain Biking

Common Signs and Symptoms of a Torn ACL