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ACL Injuries in other sports?

post #1 of 15
Thread Starter 

A lot of avid skiers do other summer cross training sports, such as biking.

 

Do they experience ACL related injuries during regular biking (training) in general.   The reason I ask is, it would appear that under certain loading conditions the strain to the ACL could be similar?

 

Just courious if anyone has noted this before and if there is any potential for this type of injury.

 

Sorry this is one of those Ah uh? moments, hopefully some of you can answer this one.  Thanks.

 

 

post #2 of 15

Most PTs and Orthos I have talked to have said that road biking is good training for the legs- none ever mentioned the possibility of blowing an ACL (other than during a crash) although 1 PT at Scripts told me that one of the Drs there said there was some (limited?) evidence that biking (even stationary) should not be overdone too early in the rehab process.

 

 

post #3 of 15
Thread Starter 

Thanks, I was interested as it feels the as the same type of stress and the angles are right for injury under some instances.

 

 

post #4 of 15

ACL injuries are closely related to the Q:H strength ratio. if your hamstrings are week compared to the quads you are at an higher risk for injury. now, sports like basketball and soccer could be more "dangerous" but more than the sport itself is the athlete's condition.

if you are afraid that you might suffer an ACL injury i would suggest trying other methods of conditioning such as biking, but also to work on the Q:H strength ratio by strengthening the hamstrings (plyometric exercises have been found to be very effective but be carful of the stress that they produce on the body)

post #5 of 15

I tore my ACL last April 17th Karate kicking the goalie square in the chest off a dead sprint while trying to score a goal during a soccer game. I didn't score, got a yellow card, and tore my ACL. That play was soooo not worth it. I think the tear would have happened no matter what age or shape I was in.

 

I was skiing 6 months to the day after surgery.  

post #6 of 15

I'd be surprised if bikes were a source of any statistically significant amounts of ACL. Hiking maybe a touch more from the odd fall, but still miniscule. Soccer, BTW, is the major source of ACL both in the U.S. and worldwide. Basketball is up there too, and I believe gymnastics. Not sure it's all about conditioning; some sports have movements that put the ACl at higher stress, and you see it even in higher level competition. Sudden plants or changes of direction on one leg in soccer, with the cleats in the grass, as someone bumps into you, for instance. Or landing on one leg with your COM moving backward after a rebound in basketball. 

post #7 of 15
Thread Starter 

I used to fence very competatively (WC) in the mid 90's and if I recall very few if any ACL, and the lunging would definitely be a prime candiate.

 

Primary injuries were either stabbings (usually broken blade related, sometimes fatal), ankles (twisted) or leg joint or bone from falling off an elevated piste (fencing trip) in finals with the occasional arm or head injury from same.

 

I found that I felt my knees more (similar to knee stretch for lack of better word) in biking than anything else.  Only speaking from personal experience hence the original question.

 

As I'm getting older (possible more sane) I am aware that injury has a great possibility and healling takes longer.  Getting old sucks.

 

post #8 of 15
Quote:
Originally Posted by beyond View Post

I'd be surprised if bikes were a source of any statistically significant amounts of ACL. Hiking maybe a touch more from the odd fall, but still miniscule. Soccer, BTW, is the major source of ACL both in the U.S. and worldwide. Basketball is up there too, and I believe gymnastics. Not sure it's all about conditioning; some sports have movements that put the ACl at higher stress, and you see it even in higher level competition. Sudden plants or changes of direction on one leg in soccer, with the cleats in the grass, as someone bumps into you, for instance. Or landing on one leg with your COM moving backward after a rebound in basketball. 


 

And football. Agree that it isn't conditioning, really. I guess if your hammy isn't "as conditioned" as your quad. Someone here on epic posted something interesting about physiology, the notch in which the ACL sits is smaller in some people than others, possibly predisposing them to ACL tears. Anecdotally, this rings true to me, just seeing people I know who have had multiples, doing almost nothing. I am in a very high risk group, and never had one, always wondered about that too. (Better knock on wood.)  

 

 

post #9 of 15
Quote:
Originally Posted by segbrown View Post


 

And football. Agree that it isn't conditioning, really. I guess if your hammy isn't "as conditioned" as your quad. Someone here on epic posted something interesting about physiology, the notch in which the ACL sits is smaller in some people than others, possibly predisposing them to ACL tears. Anecdotally, this rings true to me, just seeing people I know who have had multiples, doing almost nothing. I am in a very high risk group, and never had one, always wondered about that too. (Better knock on wood.)  

 

 


The sulcus - iriponsnow posted about that. My daughter broke her tibial plateau this spring, but had no ligament damage, looking at the x-rays and MRIs I was happy to see a very pronounced sulcus in her knee. Hopefully that bodes well for the future.

post #10 of 15
Quote:
Originally Posted by epic View Post


The sulcus - iriponsnow posted about that. My daughter broke her tibial plateau this spring, but had no ligament damage, looking at the x-rays and MRIs I was happy to see a very pronounced sulcus in her knee. Hopefully that bodes well for the future.



oooh, I just saw my own daughter's knee MRI the other day, should have looked for this. Darn. The good news is that her patellas sit in the trochlear groove properly, which mine do not, so she did not inherit that bad thing from me. Everything else looked good (except for an extensive bone bruise on the medial femoral condyle icon13.gif ).

post #11 of 15
If you understand the mechanism of ACL ruptures and tears, you can easily sort out how they happen, and in what activities they are likely to occur.
Quote:
Do they experience ACL related injuries during regular biking (training) in general. The reason I ask is, it would appear that under certain loading conditions the strain to the ACL could be similar?

How do you imagine someone tearing an ACL while pedaling a bike?

I can't imagine it. Bicycle training is one of the most time-tested methods for gaining knee joint flexibility while strengthening the muscles which support the knee. My last ACL reconstruction MD was psyched as hell when he heard that I'm a serious cyclist. "You'll have great success in post-op rehab because our PT people will put you on the stationary cycle the day after surgery." etc, etc, etc.

I've torn my right ACL 2x and my left one 1x. Both have been rebuilt.

First right tear was a mis-step while cutting in lacrosse practice. Second right tear was a clumsy inattentive back-seat moment on skis.

Left tear was a bizarre rotational torque on the knee when the leg was locked out (standing tall) while trying to trap and then turn with the ball when playing soccer. Don't ask why I was standing so tall, it was a poorly executed trap-and-turn and to this day I can't figure out why I did it.

I really can't imagine tearing an ACL while pedaling a bike. Maybe if you way-overgeared (too big a gear) a fixed-wheel bike and tried to fight the crank's turn... maybe... like in 0.0000001% of situations.

The discussions above about hamstring vs quadriceps fitness don't really apply to most ACL tears among athletes -- they seem to apply to rehab more than the mechanism of injury. That's what my various orthopaedists have told me, anyway. They'd apply to a person with an ACL deficiency, I mean... if you were ACL deficient you'd want to really beef up your hamstring & glute on the ACL-deficient side, because the hamstring/glute help keep the tibia from shearing forward relative to the femur.

As I understand things, at the moment of traumatic rupture, your knee is not concerned with how much training time you put into your hammies vs your quads. It's more concerned with the hyperextension, hyperflexion, twisting forces and leverage of the tibia. Avoiding the situations where trauma is likely will take you further than being concerned about whether you need to eke out 5% more strength from your hammies.

That's how I understand it anyway.

segbrown's point about anatomic/genetic predisposition is consistent with what my orthopaedists have told me... right after they observed that I have injury-prone joints. I've injured many of my body's joints!
Edited by GrizzledVeteran - 4/15/12 at 12:53pm
post #12 of 15
Thread Starter 

Luckily I have not yet had an ACL injury redface.gif just trying to make sure I don't get one if possible.

 

Having read a few posts, lots of member do understand more about the mechanism of the injury than I so I'm tapping your wealth of knowledge.

 

Thanks GrizzledV. for the info.

 

 

 

post #13 of 15
You're welcome.

If you intend to use cycling for training, I'd suggest finding a friend who is a serious cyclist and have that person help you with bike fit as well as cycling technique, especially pedaling. Most new cyclists don't bother with these things and to the extent you hear fellow cyclists whinging about their knees, it's due to poor fit, bad pedaling technique, and trying to He-Man a giant gear that exceeds the whinger's capacities.

Your particular anatomy will have a best-fit position related to optimal saddle height and optimal saddle location fore-aft, relative to the crankset/bottom bracket. It's good to sort that out before putting in any kind of intense effort on a bike. And it's also good to learn to use spin (smooth circular pedaling) rather than brute force to propel your bike.

If you can't locate a friend or reliable local bike shop to help with bike fit, or maybe if you're just curious anyway, check out Steve Hogg's website.
post #14 of 15
Thread Starter 

GV very good advice, which I've followed over the years.

 

Thanks for Steve's site, definintely something to look into (while biking is not a primary for me at least at this point).

 

To be fair on knee problems, I had them when I was about 11-12 and had a choice between surgery (strongly suggested) roughness under the knee cap or strength therapy.  I took therapy (don't touch my knees unless need).  Additionally, I broke my shin playing soccer at 16, which was not properly align by the doctor when set. about 4-6degrees out of alignment between knee and ankle joint.  I am full aware of it and work to ensure the I move properly.

 

That being said, I've made it to the WC's in fencing in my early 30's, have improved my skiing that that well into being an expert skier by my late teens, and have always done all sports to the extreme.

 

Now I'm a little older, a little smarter (not much), and instead of learning the hard way, ask a few questions (then learn it the hard way wink.gif)

 

The answers I've recieved here actually added insight and understanding as ACL injuries where never on my hit list.

 

Honestly, thanks for the feedback and the information is great (hopefully others that read this will appreciate it as much as I do)

 

 

 

 

 

 

 

 

post #15 of 15
If the mis-set tibia has created some asymmetry in your lower body, you will most likely want to pay close attention to Steve Hogg's site -- he's a wizard and has the most comprehensive bike-fitting experience of anyone on the InterWebToobz. I'm sure there are people in the world who might have more experience than he does, but if they exist, they're not keeping a website about it and discussing it at the levels of detail he is.

You'll also want to pay attention to where you position your cleats if you use clipless pedals -- where on the shoe fore/aft, and what amount of twist they create when your leg goes 'round the clockface while pedaling. A badly aligned (twisted) cleat can cause real pain for your knee. Think of it this way: how would your knee(s) respond if your ski bindings were mounted with some twist relative to the ski's longitudinal axis?

One way to know what is good cleat alignment is to sort out your seat height and fore/aft position, and pedal your bike for a while with flat (platform) pedals. Note where your foot likes to be, how much twist you naturally have relative to the pedal axis -- and then try to mimic that with your cleated (clipless) shoe/pedal combo. Don't be surprised if it requires some tweaking. Every time I wear out a set of cleats and have to install new ones, I go through the cleat alignment routine. It doesn't take much of an off twist to make my knee(s) hurt.
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