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Part 3, the New ACL

post #1 of 24
Thread Starter 

Thought I'd keep you all up to date...had ACL reconstructed on thursday....that really wasn't much fun at all. Hurts pretty good! (No more painkillers for me, though, they make me sick and give me hallucinations and nightmares.) Just to make him blush I gotta tell you that VK was with me the whole time and helped me SOO much, he'd have gone in the OR with me if he could, he was excellent moral support...

I already have full range of motion and can bear weight (still ned crutches due to bad bone bruising) and it only hurts when i breathe.

now, on to the grueling PT to someday soon get back to skiing. Its just so hard, especially wth the Olympics coming up, every time I turn around there is a show on skiing or a race and its kILLING me. I havent even wanted to Look at this forum but Ive got sme catching up to do....

post #2 of 24
But the operation is behind you, and you're on the road to recovery
<BLOCKQUOTE>quote:</font><HR> it only hurts when i breathe<HR></BLOCKQUOTE>

Glad to see you can still smile!

Just got this photo of VK:

Keep up the good work, and get Linda back up and skiing soon!

All the best for a speedy recovery

post #3 of 24

Hang in there, keep doing what you need to do---

VK sounds more and more like a keeper!
post #4 of 24

Then worst is over. Rehab will be a lot of work, but it will be rewarding as strength and mobility gradually returns. Just keep next ski season in mind to help motivate you.
post #5 of 24
Linda, if you pass through the pain of post-op days 3-5, you will easily survive the PT. Work it hard, you'll be surprised what a difference it makes when you are aggressive with the PT. Just ask LM, she knows how much difference it makes when you are really committed to strength and ROM improvement.

My caveat from personal experience with a very aggressive orthopod and PT -- don't wait for them to ask if you need more difficulty in your therapy. Keep telling them you're ready for more when you indeed are. They'll modulate the amount for you to ensure you don't damage the graft, but they can't read your mind or empathize with your sensations while performing exercises.
post #6 of 24
Thread Starter 

thanks so much for all the advice. I hope pt is brutal as I need it to be. Its good to know im not alone in my suffering....all i seem to be hearing about lately is acls....

I petrified that I may do my other one some day....

thaks for all the encouragement!
post #7 of 24
Congratulations on your new ACL! Glad your up and around, been wondering how you were doing.

VK what a nice guy you are. [img]smile.gif[/img]

No pain killers ouch! :
post #8 of 24
congrats on getting through that part LindaA

Take care and listen to the PT. Heal well.

I think just recently in The professional skier (see if one of your buddies get's it) there is an article about avoiding the dreaded ACL tear and what you can do to minimize the chance.
post #9 of 24
Linda, best of luck in your healing. And the PT is CRUCIAL!! Make sure you find someone who specializes in sports, especially ski related injuries. After PT, post rehab is also important. If your PT can recommend a trainer in your area who specializes in post rehab fitness, all the better.

I just looked at my continuing ed options for 2002. Based on all the ACL injuries I've heard about on this forum alone, I will be taking every workshop on that topic that I can!

Take Care, Linda!
post #10 of 24

and it only hurts when i breathe

Linda, the info sounds sensational...give it time.

post #11 of 24
Thread Starter 

you've changed your name!

thanks, things are coming along pretty well, PT says Im doing better than most people who have this surgery, if that is the case, then I feel REALLY bad for most people! Long, grueling recovery ahead and Im getting really FRUSTRATED not being able to move like I want to.

but support here in this forum has been great. thanks everyone!

- Linda [img]smile.gif[/img]
post #12 of 24

Congrats on the new knee. I had a new ACL installed 18 months ago. As an expert skier and level III instructor I made it a mission to take the helm of recovery myself. You can do everything at home. I'm not a fan of PT on this one, mainly because it's not necessary, however for the masses it's the obvious next step. It's great if you're not motivated or have little basic knowledge of conditioning. I can say this being a physician (no offense to PT's intended here). Let me give you a guide I developed. My own Orthopedic surgeon is now recommending this to his patients.

1. Hamstrings. Yep, you have to build the very muscle that keeps the tibia back under the femur. You can do this at the gym or at home. Face down curls at the gym or strapped on leg weights (discount sport store type) used in an upward curl standing up with hands on the wall.

2. Massage. Breaking up scar tissue is key to the joint's future mechanics. You'll be producing lots of it in the coming six-twelve weeks. Instruct the therapist to do "cross-fiber friction" massage at the bottom of the patella (patellar tendon). Also attention to the back of the knee is good (popliteal fossa).

3. Low force lunges. You'll notice in the next two months some muscle wasting/atrophy occured. I recommend getting a car inner tube and cutting out the valve stem. Tie a nylon zip tie up six inches from one end and fill the tube with 20-25 lbs. of sand. Put a zip tie up six inches from the other end. This becomes a soft weight you can drape around your neck. When doing your lunges, be careful not to go beyond 90 deg from lower to upper leg. Just make sure your knee does not go forward of your foot. You may need to get your butt closer to the ground in this type of lunge. You will see muscle mass return in about 12-16 months (sorry, this takes time). You can start this as soon as you can make the movement without pain (with no weights).

4. Biking. Very important. Use a stationary bike to get the knee moving. You can start this right now. Very slow, using the strength of the other leg to "power" the movement. Your new knee will be going along for the ride. Remember this... the knee is a closed capsule. The more you move/circulate the fluid and structures in the knee, the more you nurish it and discourage scar formation and adhesions. Waste products in the knee (synovial joints in general) exit faster with motion. So you will ensure proper joint health with this passive motion.

5. Nutrition. Vitamins, can't say enough.
If you smoke... don't! Drink lots of water. Generally, cut out the bad obvious stuff and treat your body like a temple for a couple of months.

I hope this was of some help. I ski today with the same abandon as before. I can do around 100 one-legged deep knee bends on the new knee without a problem. You can have it back too, with some conviction and attitude.

Best of luck! Go get 'em tiger!

Rock'n Doc

<FONT COLOR="#800080" SIZE="1">[ January 29, 2002 07:55 PM: Message edited 1 time, by Rock'n Doc ]</font>
post #13 of 24
Thread Starter 
Thanks RocnDoc!!!

cool advice, i really appreciate your sharing your experiences, because honestly, this is the most frustrating injury I have ever had. I hate it, and its good to hear how other people have survived it!

BUT...Its been four weeks, I have just about full range of motion (flexion = 140, 150 assisted)(and that was last week, it goes farther now...) I am in grueling PT with a tag team of sadistic bas@@#$# who delight in every sqeal and scream.

I do 15 mins on the eliptical trainers (great machine, for anyone actually!)im up to 100lbs 2 feet on the leg presses, and other machines (still at 30 though with that one leg.) and have been doing all kinds of excercises with Therabands, stability balls, flexible disks, they even use the stool they sit on....(laps across the room, pulling myself with my heels.) HUGE emphasis on hamstring strength and quads.

I have one of those TENS units but am doubting the effect of this. it seems silly, especially where I exercisse the hamstring and quads so thourghouly. thoughts on this?

it hurts. its painful, and im SICK OF IT!!! aaarruugh. and the PT says the swelling is going down but I dont see it. its still three times the size of my other knee. I stationary bike 20mins every morning......any suggestion on that? (i ice, elevate, compress.....all that.)


post #14 of 24
Linda, sounds like you're doing great.

My understanding of the TENS unit is that it works more on resting tone than on working tone. You are correct in stating that it would pale in comparison to the weight training, etc, for working strength/tone.

To be honest, I don't really believe in the propriety of TENS units in many applications. When I used to do insurance defense litigation, the TENS unit was the most over-prescribed therapy, followed closely by hydrocollator (heat pack) therapy.

I'm sure it has some legitimate uses, though.
post #15 of 24

TENS is great for involuntary muscle contraction (muscle damage or nueromuscular juction problems). Since the ACL surgery doesn't involve/create muscle damage, it's again, not necessary. The elipitical bike is great so are the Therabands. It sounds like you're doing a lot of proactive things! I can't stress enough the value of massage therapy. Did you donate your own tissue or have donor tissue (allograph)?
This makes recovery different. Donating your own tissue will be more of a involved/complex recovery than the allograph.

Wishing you the best!

Rock'n Doc
post #16 of 24
Thread Starter 
I had a soft tissue (hamstring) allograft. although the doctor prolonged therapy, pushing twisting motion up another month as an allograft takes longer to heal, i guess.(or become your own ACL...)but on the other hand if I had used my own tissue, then id have to heal from THAT too...and frankly, I have enough to heal from, thanks, and the cadaver wasn't using his anymore.

THAT was weird, it was snowing in atlanta the day of the surgery, the donated tissue was coming FED EX and they couldnt get the plane off the ground...I almost didnt have the surgery...(the salesman (cadaver salesman?) found an extra one in Boston, howvever, and the show went on...

makes you think about filling out your organ donor card, though.....Im certainly appreciative of the gift... :
post #17 of 24
Thread Starter 
oh, and my best friend is a massage therapist...or an aspiring one, she is in her second year of school and is always in need of practice patients....that makes me incredibly lucky...

besides cross-fiber friction, is there anything else she should do? I haven't let her touch my knee yet. (still very tender near surface of wounds...)
post #18 of 24

Good choice on the allograph. It doesn't make sense to me that skiers would deplete one structure (patellar tendon or hamstring) to replenish another. That's like replacing some shakes that blew off your roof in a storm with ones you rip up off another part of the roof. The allograph allows the surgeon a larger piece of material to work with. It also is a larger scaffold to matrix new collagen fibers onto (the new ligament).

Sounds like you'll be fine and that you made some good choices. Need to gripe? Let me know. It stinks but, it's over soon. Well 3-4 months soon...

Rock'n Doc

<FONT COLOR="#800080" SIZE="1">[ January 30, 2002 02:47 PM: Message edited 1 time, by Rock'n Doc ]</font>
post #19 of 24
Thread Starter 
Interesting thing I just learned, for all victims and future victims of ACL rehab:

if you push too hard and try to get back too quickly from acl reconstruction, there is a chance you will develop patellar tendonitis. they watch very carefully for that, apparently, and will slow you down. It is caused by repetitive motion (stationary bike, eliptical trainer) and too much of it, trying to get back quickly.

I am officially being held back in PT due to a chance I have this.

post #20 of 24
Could I suggest that you stay at home and play your guitar.
Just don't tap your feet too much

post #21 of 24
Thread Starter 
I would but it sounds like @#$%!
post #22 of 24
Awesome job with the rehab. Keep up the motivation. I tore my ACL two years ago in a freak ski collision (you can't always prevent everything!!). I had my ACL reconstructed and was in months of rehab. I have to say that that was the most painful experience of my life. It was very frustrating to be limited by an injury. However, I completed my rehab and continue to strength train on my own. I am now a better skier than I ever was before, and my knee is strong. I think my injury was an obstacle that motivated me to improve at everything. It sounds like you will be 100%+ before you know it! Hope this helps!
post #23 of 24

It has been about 3 weeks since you posted about patellar tendonitis, How everything going?
post #24 of 24
Thread Starter 
Well, I slowed down a little and it seems I got over it. the doctor's attitude towards it was "yes, s### happens" I guess it wasn't that big a deal. painful though.

Its going ok, i guess. I miss skiing sooooo much. it actually pains me when I pass cars on the highway with skis on the roof rack.

PT has started to incorporate some lateral and twisting movement...I have another three months of this.

want to ice skate, cant. want to ski, cant. want to climb a flight of stairs, cant. SICK OF IT.

Janica Kostelic (Croatia) had three surgerys on one knee. then tore all 4 ligaments in her other knee. back onthe hill 2 months after surgery. just Won gold in GS, slalom, and silver in Super G.

and I cant ski the green runs at the local speed bump. :
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