Anyone else have ACL trouble?

[KnottedYet]

I would listen to the bike fitter.

did the PT actually LOOK at how you ride? Figure out what muscles fire at what time during the revolution? Hook you up to a biofeedback machine to monitor co-contractions of the hams and quads?

(knee issue folks in particular will need co-contractions so the hams can stabilize the knee joint itself during the quad contraction as you push the pedal down, unless you have massive hams that can do it just by bulk. we've had patients who did exactly that. overdeveloped hams can only help someone with ACL/PCL/LCL/MCL issues, never hinder) (mind you, that's overdeveloped, not overtight. gotta stretch and strengthen)

[Kathi]

No, this developed, withing the last 2 weeks, right after I finished PT. They do have the capability to do that now but the therapist who is trained is on vacation.

They have a maintance program that I can sign up for but I'm leaving next week for 2.5 weeks. I plan to do that when I return.

I had a lot going on that could have contributed to it. I rode with my saddle to low for awhile, including a 40 miler. I quit wearing my orthodics in favor of my sandals, and I cut down on my pt and stretching for a couple of weeks. My bike fit guy thinks I should work on my pt, stretch and ice and let things settle down.

Unfortunately, we're doing a bike tour in 2 weeks so I don't know how well things will settle down.

Since none of this has affected my strong leg, it appears that my injured leg needs more strengthening.

I may stop by the pt office tomorrow and if she has time I'll mention it to her.

[Flatlander]

Knotted--are you a PT? My ortho didn't refer me to pt; he just gave me a big brace and a little booklet. The exercises in the booklet involved ankle weights and not much else. I didn't find the brace or the ankle weight exercises particularly useful (the exercises were very minimal, and seemed designed for people who were either not very active to begin with or coming back from surgery), and at the time I was only running, so I didn't have too much trouble w/the ACL. as a consequence, I slacked off on the exercises (and quit wearing the brace).

Since, at the time, I had only gone to see the ortho to find out why my knee kept "going out" when I walked, and he didn't seem to think that it was a problem for me to keep running if it wasn't bothering me during that activity, and since I wasn't cycling at the time, we mutually decided not to pursueit farther. (Plus, he probably assumed I'd continue with my exercises.) Now I wish I'd been a little more proactive.

About two weeks ago I decided to do some weight training to see if it would help. I started doing hamstring curls, quad extensions, and squats. Are you saying that the hamstring curls are the best thing for the ACL? Should I concentrate mainly on those? Are the quad extensions or squats detrimental?

Also, should I position my seat so that I am using more of my hamstrings, or less?

It is interesting to note that the the hamstring on the "bad" leg is noticeably smaller than on the "good" leg...Could this be related?

[KnottedYet]

"I'm not a PT, I just play one on television."

It might be a good idea for you (Flatlander) to get a referral and a script for PT.

Open chain quad work is pretty much not the best choice (watch me dance around to avoid saying "fer gawdsakes, don't do that!") for post-ACL. Open chain is when you are firing off your quads in a non-weightbearing situation. (straightening your knee with ankle weights on, doing quad extensions on a quad machine)

Closed chain quad work is peachy. (leg press machine, squats) That's where you are using your quads while putting weight through the soles of your feet. Just don't bend the knee more than 90 degrees while weightbearing, at least until you get the all-clear from a PT.

For the hamstrings you want to do both open and closed chain work, and you can bend more than 90 degrees with that.

You really need someone to look at your firing pattern before you start adjusting your bike.

It's probably not the best sign in the world that your "bad" hammie is smaller than your "good" hammie. You need those hammies!

Doesn't matter how long ago you had your incident, PT now is cool. Depending on the laws in your state and your insurance, you may be able to go to PT without seeing the doc again. Try calling the ortho's office and ask if they can fax a script to a PT clinic. (ask around to choose a clinic) Sports therapy/ sports PT might be the best choice, if you have a good sports therapy clinic near you. They will have a good handle on the running and biking part.