Returning to the saddle following ACL surgery....

Hi fellow COTHers,
I had an ACL reconstruction using a hamstring graft just over 3 weeks ago. I sustained the original injury in March but my OS and PT decided I could try riding again and so I finished out the season before I had the surgery. I did a lot of ‘prehab’ so was quite fit before the surgery. I’m now watching my muscles turn to mush and it’s quite depressing! I know that return to sport following an ACL reconstruction is typically 6 months. However, riding isn’t as involved as say football or soccer so I was just curious to hear your stories. I’m a professional so I’m very interested in returning in a timely fashion, however I do realize I need my knee to work for the rest of my life so if I have to be out of the saddle for 6 months, so be it. I’m certainly not interested in going through this again!!!

Go for it. I had 1/2 my meniscus removed, have no intact PCL left, and a chronic ACL tear. I rode a week after surgery - against Dr. advice, but we are horsepeople, we just have to ride. Anyway, knee is fine, if it bothered me after riding I took Advil and was good to go the next day. Knee nevered bothered me while riding. Go for it.

A different opinion…

True, Six months is generally reserved for full cutting/pivoting/contact sports… however, there are lots of good techniques to keep you in reasonable condition and minimize the loss of “riding muscles.”

What is odd though…you should be on a post rehab program which should at least keep SOME degree of muscle tone…

A loss of physical size would be completely normal and expected at 3 weeks post surgery! Now if you were three months out…different story.

In terms of returning to riding, If you surgeon and rehab professional has done alot of riders, they should have a protocol (even unwritten) for you to follow…ie sitting in the saddle, no stirrup work starts “X” , walk without stirrups starts “X”, and so on.
This of course is based on the condition of the joint, how much work was needed to fix it, discipline, etc…

Generically it might look like this…
First 6 weeks is all off horse exercises
Sitting no stirrups after that
Progression through gaits, no stirrups after that
Can pick up stirrups after that
POSTING after 3 months,
JUMPING after 4 months

If you have any questions or would like to chat further you can PM me.

Regards,
Medical Mike
equestrian medical researcher
www.Equicision.com

You’re in good company! I had mine fixed at the end of July. No getting on a horse at all until mid-September, so about 6 weeks. From there, I was given permission to ride, but advised against doing any posting (I still posted a little, because my boy’s trot is like a pogo stick). Mine was somewhat complicated by the still-healing broken bones on the other leg. I had someone hold the horse for me to get on and off, and used a tall mounting block to get on and off. I’m now pretty much back to normal… I even jumped a few weeks ago! Okay, so it was only crossrails and one 1’9" vertical, but still!

Do what your ortho and PT tell you. In my case, I had everyone tell me different things (don’t ride at all, ride like normal, ride if you must but don’t fall off and don’t post). I eventually asked for clarification and went with the middle of the road answer–don’t post and be careful. If you tear it again and need another reconstruction, it’s not going to be pretty. Good luck!

I started riding without stirrups at 4 weeks post surgery but it isn’t the riding that is the issue it is the mounting, dismounting, falling and working around the large critters that is more the issue. I had a horse that was beginner safe and stand perfectly still while I ungracefully fell on him from a mounting block.
I had a cadaver repair that time around so it was a much faster recovery time than my patella repair on the other leg. I stayed away from the more challenging guys for a long time.
It was a couple months later before I put my weight in stirrups. I found it took me a long time to put equal weight and I had to keep them long for awhile for my comfort. Remember that at 4 months the graft is very very weak again.

I was initially told I could ride in 6 months. Thus, sold my horse. Was released to ride at 3 months, but didn’t feel ready due to muscle atrophy. So glad I had this surgery now though almost 2 years later - my knee is so stable now!

Thank you everyone for sharing your experiences! I guess the hard part is that riding itself isn’t so bad. It’s the falling off that is more likely to compromise the graft. Before the surgery when I was riding without an ACL, I mastered the art of mounting from the wrong side, although at the moment I can imagine it would be quite awkward. I see the surgeon again the first week of January and I hope he will have some more details. I wish I had a PT who understood riding more but I have shown her pictures and videos so she has a better idea. This is also not my first injury so she has worked with me before. Thanks again!

I was riding w/t 6 weeks to the day after surgery. I was cantering a week after that and jumping little gymnastics about 9 weeks post surgery. I did the pre-hab for 1 month before surgery.

Understand was not exactly the fittest rider at the time. I was 70-80lbs overweight.
I had the cadaver graft. As with most people it is pretty hard to only tear the ACL so I had a menicus tear and a small tear in the PCL. I strained my quad and bruised my femur.
I actually had problems during PT getting past the 90 degree mark. The surgeon was actually threatening to put me back under anesthesia to break up the adhesions. I could not tolerate the electric stim they wanted to use to get the quad muscles to fire. So it wasn’t like my PT was smooth sailing.

The funny thing was during my first jumping lesson my trainer commented that my leg was swinging back and that that would get stronger with time. (She had ACL reconstruction 2 years before I did). The funny thing was the leg that was swinging was the “good” right leg. I had done so much PT on the left leg it was actually pretty strong and stable.
Now my horse is a steady Eddie type.

I did post first ride and never really looked back.
Just use your head and listen to you body. Ride the safer horses first.

One of my vets went fox hunting 8 weeks post ACL reconstruction. I was told he self injected with Legend -IM shortly before the hunt. He said it burned.:eek:

I had my ACL repaired via my hamstring in October…
Don’t tell my Dr’s but I started riding about two weeks after. I lead my wonderful Tharapy Horse up to the wheel well of the flatbed trailer, lift my leg up and over… do the opposite to dismount.
I’ve only ridden two of my herd since the sx, since I am more worried about an unintentional dismount on the WBs then the QHs.
I’ve done w/t on Tharapy Mare (she was my first horse, older and an angel, so I’m not worried about her dumping me) out in the field and around the pond. I’ve done w/t/c on her son, my dressage mount. I ride in a western saddle, just in case, and it aggrivates teh ever living he!! out of me that my left leg is so weak/inacurate. I DO NOT POST. at all.

Do you think that I could claim hippotharapy to my insurance? No? :smiley:

I had a sx on my ACL and shattered patella. I was not riding quite so quickly but I was doing alot of work in the barn, making myself use the leg and knee.

Most important, watch how you walk. People have a tendency to walk on one side of their foot or the other to compensate. That help lead to more hamstring atrophy over time.

It will go smooth. Keep working at it!

ETA- I was 37 when this happened. 2 yrs later, still riding, riding babies, riding WBs. Be safe.

i will join on the conversation as I am also looking for advice…I originally tore my left ACL in Aspen almost 3 years ago. At that time I had a cadavar graft because the Dr said for my age and the fact that I am not a professional athlete it was the way to go. I was able to ride very well without pain 3 months after. I did my PT 3 days a week for the 3 months , then down to 2 days a week then down to 1, but to be honest, I was never 100% again. I had a PRP injection in March 2010 in the patellar tendon as well as where the quad inserts into the knee. This did not do much good. my pain was never at a point that it stopped me from riding, playing golf and skiing. I was skiing in Chile in August 2010 (40th bday!! :slight_smile: )and re-tore my left ACL. UGH…I had surgery September 1 with my own patellar tendon this time. The MRI also indicated patellar tendinitis which we knew about but the changes in the MRI were significant since the MRI I had in feb 2010, but the Dr still wanted to use my own tendon. Now 4 months out and I have stiffness/pain and my quad is not firing properly which is preventing my progression. I see my PT 2-3 days a week and I am faithful with all my exercises. I am very frustrated regarding my progress, but I am hoping my patience will pay off at some point. My dr gave me the thumbs up to “try” and ride 2 weeks ago. I tried about 10 days ago and it was miserable. I had considerable pain inside my knee and I only lasted for 15 minutes. I did not think about doing it without stirrups, but I will try that next time…Also does anyone have experience with hinged stirrups?

NO stirrups…

until otherwise IMO.

At four months with your present state, this may be the only way to go for a while…
There are a host of other considerations regarding technique.

Until your knee and especially your quad has some function back in it (riding being quad dominant until EMG study says otherwise), stay away from stirrups.
Continue to focus on G/S, hip abductors, hamstrings/glutes as these will need to be in very good working order to help make up the for the loss of quad strength.

This link may also be useful.
http://www.equicision.com/AllAccess.html
Far column, “Riding w/ ACL”

Best of luck.
REgards,
Medical Mike
equestrian medical researcher
www.equicision.com

Providence, Just wondering how your recovery is going. I am getting ready to have ACL reconstruction done in 2 weeks and have to decide what tissue to use for the graft. I just started a new thread, but was wondering if you have a lot of pain in the hamstrings after surgery. I guess it’s still a little early to tell?

ACL Surgery (BUMP)

How are all you post-op ACLers? I am 1.5 weeks post op, hamstring autograft.

I am so afraid of compromising the graft until it’s fully homogenized, I can’t even begin to think about riding. I mean I would LOVE to get on my old guy, but if he trips – or i do – it could very well mean the end of my long term riding. This graft needs to last until I’m a hundred, because I fully intend to be riding that long.

That’s why my OS chose the hamstring. Longer initial recovery, but better long term viability… especially for an equestrian; we have little tolerance for patella pain with all the posting and weight bearing the fronts of our knees must endure.

So how is the riding going for those of you who had the sx?

Returning to the saddle following ACL Surgury

After I tore my ACL 2 years ago, I was out of the saddle for about 2 weeks following the incident, and have now been eventing training level on two horses for the past 2 summers with out surgery. In addition, I ride about 2 horses a day, and have no trouble. I am getting surgery this fall just because there are many things - skiing, water skiing, sports - that I dont want to risk doing, but if you arnt worried about missing out on things like this, then you should be fine with just riding.

Hi everyone,
I see this thread hasn’t been active for awhile… was just wondering how everyone was doing? I was supposed to have acl replacement last december, got moved to february (yay canada health care), but got it anyways even though I knew I would be recovering during show season because i was in extreme pain.
Like all of you, I’m dying to get back in the saddle. But I’ve also been doing a lot of research on recovery time for this. There’s a “danger zone” in the 3-6 mo. period in which your acl is WEAKER than before you had the surgery. If you tear it again, game over, surgery again.
Now I know several of you have mentioned that riding is not actually that bad for your knee, and I agree. On the other hand, falling off is absolutely the worst thing for your knee, and we all know how unpredictable all horses are. Is it really worth it for a few months of riding, risking being plagued by surgeries and pain for the rest of your life?
Though it pains me to say this, I’m sticking to the 9 month guideline for “return to sport,” and it’s not like I have nothing to lose. I had sponsors lined up who were ready to buy me a horse and pay for my competitions, as well as a dynamo working student gig in Holland for the summer. But when push comes to shove, no way am I sacrificing a lifetime riding career for nine months of (cautious) riding.
There’s lots of stuff we can do: I’m going to go for my next level coaching, take some equine science courses, and get really good at lungeing I guess!
Good luck everyone on your recoveries!

My initial injury was almost 4 years ago and my surgery was about 3.5 years ago. I had a hamstring graft and did A LOT of physio. I rode again 4 months post surgery and haven’t looked back. It healed beautifully and only bothers me when I use the jointed type stirrups. Funny, since those are meant to help but I find them more uncomfortable. Happy healing!!

So nice to hear that I will eventually be able to ride again. I was tossed from my son’s cob when he was spooked and destroyed my knee. I damaged my meniscus, shredded my MCL and tore my ACL.

I am 4 weeks post-surgery and moving well. I’m doing PT twice a week and making good progress. My strength and quad muscle are great, but I’m still pretty stiff. I can get to 110 degrees of flexion but it hurts.

I’m having quite a bit of pain at night, but my PT explained that I’m working it pretty hard and walking more than most people are at this point. I have two ponies and a child who needs to ride so I was back at the barn less than a week after surgery. And since my son is young, he still needs help catching and leading the ponies, so I am walking all over the place.

My biggest hope is that I can get cleared to return to work within the next 4 weeks. I’m a nurse, so light duty is not an option.

I had surgery in April 2013 to replace my ACL and lateral collateral ligaments with donor grafts, as well as a big meniscus repair. The LCL repair had the more restrictive rehab protocol because it’s a bigger open procedure and the ligament is more delicate. I started back riding without stirrups and mounting on the off side 4 months post surgery, and added stirrups a month later. I started jumping in December and am back eventing now with no problems. I did wear a brace for the first 11 months, mainly in case I fell.

After ACL Surgery

[QUOTE=XOeventerXO;7267256]
After I tore my ACL 2 years ago, I was out of the saddle for about 2 weeks following the incident, and have now been eventing training level on two horses for the past 2 summers with out surgery. In addition, I ride about 2 horses a day, and have no trouble. I am getting surgery this fall just because there are many things - skiing, water skiing, sports - that I dont want to risk doing, but if you arnt worried about missing out on things like this, then you should be fine with just riding.[/QUOTE]

I see that this thread has been quiet for a long time. I am about to have ACL Surgery and hope to be back riding competitively in 3 months in Reining, so no WT or posting :slight_smile: Anyone out there made it back in that time frame. I am very motivated on the PT and will do what ever I can to expedite recovery and I am having a donated ACL fitted. Awaiting any comments