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ACL tear, surgery, & rehab diary - Page 3

post #61 of 245
Thread Starter 
Originally Posted by mmckimson View Post
By the time I ski, I want to be able to forget the knee
Yeah, me too. Right now, whenever I think of skiing, I cringe a bit thinking about my knee buckling. But I'm hoping as the knee gets stronger over the next few months, it'll start feeling normal again, and I'll stop thinking about it.

Today seems to be a "good" day (and I know the two of you know exactly what I'm talking about). It seems as if the more I do one day, the better I feel that day, but then I take a step back the following day.
Sounds about right! I had the same experience for the first few weeks post-op -- if I worked the knee a lot one day, it felt kinda crappy the next. But then better than ever the day after. Not unlike any physical activity or training.
post #62 of 245
Thread Starter 
9.5 weeks post-op

Down to 1 day of PT per week. It's all about doing strength and balance exercises, most of which I can do at home anyway. Doing lots of leg presses, squats (as far as my patellar pain will allow), bridges, one-legged standing, etc. Leg definitely feels stronger. Had some (unintentional) hard landings on the bad leg but they felt fine physically (mentally I was nervous).

At the end of the month I'll be dropping to 1 PT visit per month. My doc wants me to come back for more visits around September/October to work on some ski-specific rehab/exercises.

Also, did an interesting exercise the other day. Stood on the Shuttle (basically like an old-fashioned swing with a single flat wooden platform hung by four chains/ropes). Stood single-legged on the bad leg while throwing a ball and catching it on return. All the while, my PT kept hitting the platform from different directions so that I'd have to stay in balance on the one leg while catching the ball. Pretty interesting and hard!
post #63 of 245
21 days after surgery

Went to my first PT session. It went well, although I had to admit to some trepidation when the therapist wanted to work on flexion and extension of the knee.

The good news is that my progress was fine, and a little better than expected. I can get an extension to almost zero on my own and achieve it with his help, and the flexion was near 110 degrees (my brace is locked at 90 due to meniscus). I'm going to try and ride the exercise bike at the gym later today.

post #64 of 245
I just got back from the gym... it was very exciting to get on an exercise bike and do something ... yeah! I rode for 25 minutes and depending on how I feel tomorrow, will do 1/2 hour in the am and the same in the pm, along with the rest of my PT regimen.

post #65 of 245
23 days after surgery

I just got back from my 2nd PT appointment, and things are going well. I am achieving -1 degrees extension and around 110 degrees flexion. I've ridden the exercise bike 3 times and feel pretty good actually.

I'll report back at the end of next week.

post #66 of 245
Good to hear you're getting the PT ball rolling!

I had my appointment with my surgeon yesterday and he said I could probably ditch my brace but to keep it for another week just in case, but I have it unlocked all the time. And I have full flexion back in my knee! It feels good to be able to get back to some kind of normal again.

post #67 of 245

Full flexion ... hmm. I guess that happens sooner when you're 22. Since I'm 2 1/2 times older than you (53) it might take a little longer.

post #68 of 245
Thread Starter 
10 weeks post-op

The knee is actually starting to feel normal for short periods of time. Especially for a few minutes after doing my exercises, I can't tell any difference between my good and bad knee. I've ratcheted up my strength training, so that I'm just able to do 3 sets of 10 reps for any exercise.

Going up the stairs is actually starting to feel better with little or no pain. Going down is still harder, since my quad is still not strong enough to make a controlled descent while standing on the injured leg. But it is still better than before -- I can probably go about 25% of the way down before having to just drop.

My extension is good, although not as good as in my good leg (but I have unusually extreme extension). The doc said as my VMO gets stronger, the extension should come back.

My flexion is good, but not 100% back -- comparing my good and bad leg flexion, I'm off by about 3 inches or so (at the heel). Doc suggested really pressing the heel in, to get the flexion back. He wasn't too worried about it -- he said it should come back if I just work on it, although if I don't, then it may always be "off".

I know he was just trying to be positive, but it's great when the surgeon says that I'm doing way better than most, and that he could not expect me to be in any better condition.
post #69 of 245
26 days after surgery

I just got back from my third PT appointment and have we were able to get my extension to -2 (which he said is really good for only 3 appointments) and to 117 degrees of flexion. Getting it back is a function of getting the muscles to relax (especially my hamstring)

He suggests that in another couple of weeks I should be back to full extension and flexion. Interestingly enough, he pointed out that you don't want it to come back too quickly without also gaining some strength otherwise the leg will wobble.

We also added some additional exercises for balance (on the repaired leg) and stretches for the calf and hamstring muscles. I've also been riding the bike 2x per day for around 1/2 hour, and this seems to be the best thing of all the things I do.

post #70 of 245
I've been walking around my house without a brace and elsewhere with my brace unlocked and since I've been on it more its swelled up a bit, almost scary but my PT said not to worry its normal for it to swell when you start to actually use the knee again.

I'm not sure what balance things you are doing, but if you are interested try to do your other leg, its amazing how easy that stuff is with a "good" leg.

post #71 of 245
Yay! It's over! The surgery anyway. Had it today and was very pleased with the surgeon and the facility. The relief of anxiety is enormous.

I woke with a strong aching that I rated a 6, but a couple of shots of something in the IV knocked it down to a 2. They gave me a nerve block in my leg before surgery, mostly for postop pain, and it seems to be working. It's 12 hrs later and i'm practically pain free. They had me take a couple of oxycodone before i left the hospital, and I took another tonight, just in case I guess. Another effect of the block is almost no tone in the quad muscle, so although I am weight bearing as tolerated, if I tried it the leg would fold like a noodle. So I am totally on crutches for now (which I admit are kinda fun in a way) The block can last up to 24hrs and I kinda want to see where i am without it, although not neccesarily anxious to have more pain. I was sent home in an immobilizer, but the dr. told me to ditch it as soon as I got home. He's supposed to call tomorrow and hopefully I can start using the cpm machine.

It turned out that the acl tear was complete after all, but there was no meniscus damage which was of course lucky.

All for now. Looking forward to joining you all in recovery, and of course to skiing next season.
post #72 of 245
Good luck... keep us posted as you progress.

I actually had my 2nd post-op appointment, and am pretty much where I am supposed to be. I am walking without crutches, although with a limp and still need to work a lot on flexion/extension. I also started with some strength gaining exercises for the quads which should help quite a bit.

post #73 of 245
Day 2 and things are going well I think. Was basically pain free for the first 24hrs due to that nerve block. There is still a little numbness left in the skin now still. Took one percocet last night before bed because it was aching a bit. Today the swelling is quite reasonable and I'm getting a little discoloration on the inside of the knee and down the lower leg. I can walk! Really! Very carefully of course, but really without pain if I do it just right. The crutches are fun but getting a little painful. I'm using the cpm now at settings of -8 and 70 although I am not really getting my leg down to the -8 point I don't think, but I am stretching it at least.

Out for now.
post #74 of 245
31 days post op

I find it interesting that your CPM machine has a setting lower than -5, as that was as low as mine went. In my case, I got to a negative extension fairly quickly on the CPM machine, but now getting a full extension is the challenge.

What I am experiencing now is a good range of motion when working out (riding the bike, doing my PT exercises) but since the joint is still swollen the range of motion decreases after an hour or so. On the other hand, it keeps improving a little bit every day, and both my doctor and physical therapist say I'm doing very well.

More later...

post #75 of 245
Sounds good Mike. Yeah mine stiffens up quickly when I'm not using it too.

On day 3 here and walking is considerably easier now. Feels more stable than yesterday - I think it's all about the response of the quad muscle coming back. No real pain, just some soreness over the patellar tendon where the graft was harvested. And of course stiffness. The muscle twitching in the quads is the most annoying thing - it acts like a dog having a bad dream.

Went out shopping at the outlets and to dinner with my sister and mother yesterday (i'm being double-teamed on care) and walked around fairly well but sat on the benches when they went in the stores. Would probly have been more enjoyable if I'd brought the crutches for assistance. Was tiring I guess and I fell asleep like at 8 last night. Today I'm at the really bored stage already, this cpm is seeming silly (although I know it's not), and I want to go out and do something this afternoon. If I ever did something like break my leg where I was really laid up for a long time it would probly kill me.

post #76 of 245
33 days post op

This weekend seemed to be a breakthrough weekend for me. Whether it was the different exercises or the PT appointments or just time, my range of motion was much improved by last night my knee doesn't stiffen up as much between my doing my PT regimen or riding the exercise bike.

That dim light at the end of the tunnel is finally starting to glow a lot brighter and not look so far away!

post #77 of 245
Well, day 4 here and not a lot new.

Walking is pretty stable now and just the stiffness prevents it from looking quite normal. The damned twitching has abated. The discoloration is starting to turn yellow meaning it's started to retreat. Getting a little bit of swelling in the ankle region now which is new although the swelling in the knee remains moderate. Had skipped the cryocuff yesterday but am using it again the morning, along with the cpm.

Could/should go to work today, but had said I'd be back Tues or Wed, so it will be Tues :-). Want to go to gym this evening for upper body.

My surgeon said he works fast - he was in and out in a little over an hour I think - which minimizes trauma. Anyone else know how long their surgery took and whether this is particularly fast?

And I'll stop posting all these little details, lol. Just bored here.

Out for lil while,
post #78 of 245
My surgery was about an hour and a half I believe, he repaired my ACL and cut out a piece of my meniscus.

My knee is feeling pretty good, it stiffens up slightly here and there but overall its starting to feel normal, I just can't bring myself to walk down or up stairs normally. I can't get over how much smaller my "bad legs" calf and quad muscles are, especially my calf, its crazy that it can go down that much in that little amount of time.
post #79 of 245
Thread Starter 
My surgery was about 45 minutes I think. Just hamstring autograft, no other repair.
post #80 of 245
Well then that doesn't make mine particularly quick i guess.

Gym last night for back/shoulders. Little surprised at how tired I felt, like the blood hadn't flowed in a week, regardless of how far from my knee the muscle was :-). Didn't push it.

Work today. Swelling is annoying. Can sit at desk all day so that is good, I guess. Keep moving my foot around to try to get a little circulation going. Entire lower leg is yellowish now, lol. I will have to wear long sweats to the gym tonight.

So much for not posting little details, lol. Switch - what do you mean about stairs? I'm forcing myself to go up them straight without turning my leg, so that it has to flex.
post #81 of 245
Originally Posted by faisasy View Post
Yeah, me too. Right now, whenever I think of skiing, I cringe a bit thinking about my knee buckling. But I'm hoping as the knee gets stronger over the next few months, it'll start feeling normal again, and I'll stop thinking about it.

Skimming this thread, I caught this comment: Have you considered a knee brace for support and confidence builder?
post #82 of 245
I've been doing stairs by holding on and going one step at a time, just stepping up my good foot, I'm working on walking up normally is all, I can go down steps normally.
post #83 of 245
Originally Posted by SwitchSki View Post
I've been doing stairs by holding on and going one step at a time, just stepping up my good foot, I'm working on walking up normally is all, I can go down steps normally.
Ah, yeah, that is difficult. I'm able to do it normally going up and down, but it makes my quad seem pretty weak and it's a bit slow.
post #84 of 245
1 Week Update: First Post-op Dr. visit.

The visit was moved up by about a week because I had developed an infection in the small incision for the arthroscope (or whatever). It turned out to be thankfully minor and was already resolving itself by today, but painful enough that I had lost some sleep from it. On antibiotics now. I had read horror stories...

Otherwise he was really pleased with the thing so far. He said he was happy that I had managed to "not lose the quads". He also said I had nearly full extension already. Prescribed PT for 2x per week for 4 wks. He said most likely after that he would leave me to continue on my own at the gym. Next follow-up in 3 wks.

Otherwise kinda plateaued a bit I guess. Walking is painfree and nearly normal, sometimes, but many other times I hobble pretty good. Stairs are still somewhat painful if I do them normally, but I do anyway. Nearly all of the discomfort I get is at the lower end of the patellar tendon, which I guess is pretty much as advertised for that kind of autograft. Makes me think an allograft would be a breeze.

Started back at work Tues and it has been a zoo with 12 hr days and too much stair climbing. This plus the lack of sleep has pretty much exhausted me so I haven't been back to the gym since my monday outing and along with the infection has limited the amount of time I can spend working on improvement.

Enough for now,
post #85 of 245
5 Weeks Post-Op


Sounds like you're doing well. I find it really interesting how different our rehab protocols are... in my case (meniscus repair and ACL reconstruction) my doctor wanted me on crutches for 30 days (no full-weight bearing on leg). PT didn't start until my 3rd week due to the meniscus sutures needing to heal.

I shortened that up on my own to around 3 weeks, and am largely walking normally now. From a PT perspective, we are concentrating on range of motion first and regaining strength second. According to the therapist and my doctor, we should see a full range of motion in another couple of weeks. Because I was on crutches for so long, my quad is considerably weaker than the non-damaged leg, but I'm told this is normal.

Sounds like you're ahead of the curve. Keep up the good work but don't push it too hard!


PS - The first time I tried to go back to work I was so exhaused I only lasted about 3 hours and then went home and took a nap!
post #86 of 245
Hey Mike
Yeah, based on what I have read here I am concluding that the condition of the meniscus is a key variable in recovery time and protocol, along with the type of graft done. My dr. was happy because my acl injury was isolated without any collateral damage to other ligaments or the meniscus and I was a fit, motivated patient of a reasonably median age (46). He took pics and all during the procedure tho I'm not sure what he is using them for. Can't wait to see those . If I can actually recognize it as my knee, I'll probly puke, lol.

The incisions have been giving me problems the last couple days but have calmed down considerably today and I am trying to get my gait more normal. I may not have completely lost my quads, but I can certainly see a noticeable difference in the operated leg, despite my best efforts. I got caught up on sleep last night but I still feel physically tired today - all pretty much as advertised.

post #87 of 245
Well here I go, snatching defeat from the jaws of victory once again. I fell Friday night going down some weirdly built stairs with no handrails. It was a backwards twisting fall on my bad leg accompanied by a crunching sound (or feeling can't remember which - I think that's called synesthesia?) and blinding pain. After my friend told me the color was back in my face I tried to walk, and was ok for a few steps, then not. It hasn't improved since and am on crutches and percocet. I've left a message for my dr. to hopefully hear on monday morning. I really can't begin to tell you how disappointed I am with myself and this situation right now.
post #88 of 245
Thread Starter 
^^^ Very sorry to hear that! Hope it turns out better than it sounds.
post #89 of 245
Oh no... Like Faisasy, I hope it turns out OK. Keep us posted!

post #90 of 245
wow, I hate to hear that man...good luck!

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