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ACL tear - looking for thoughts on recovery time - Page 5

post #121 of 318

Badgalskier,

 

excellent post.  That's the wisdom of 4 acl surgeries talking. I hope I never speak a sentence that has the phrase 'compared to my other recons'.  1 is more than enough. 

 

I am 5 months out and almost released to sports.  There was a point, that I felt like I was never going to be the same and couldn't imagine walking with a normal gate.  I have to look back and laugh, because although I still have months if not more of work to be back to 'normal' its gone just as my doctor said and I am doing great.  Funny how he never seemed worried about my concerns. 

 

post #122 of 318
Thread Starter 

Badgal - wow - 4 ACL recons! You deserve some kind of medal for that - I can't imagine going through this four times. Out of curiousity, what grafts have you had and how do they compare? I have a hamstring autograft, with an expected return to sports at 8 months post-op.

 

You make some very good points, and I appreciate you taking the time to reassure me. Overall I know that my recovery is going pretty solidly and there are certainly areas where I'm ahead of the game (my quads didn't shut down, so my mobility and muscle strength is really good and my proprioception has come back very fast); the flex issue just gets me down periodically because it's the one area where I'm lagging.

 

Vermonte, I'm at exactly that stage at the moment - 6 weeks post-op and scratching my head thinking "I expected to feel better than this by now!" I'm gradually adding in more activities - I'm swimming 3k a day and cycling for about an hour a day - but the knee is still very stiff, achey, and full of odd little glitches as well as the stubborn reluctance to bend. From what I've heard, it takes till about 3-4 months out to start to feel "normal" so I just have to be patient. Unfortunately I'm not a naturally patient person. ;)

post #123 of 318

Cycling and swimming are the 2 best things you can do for your knee because they are low impact. The elliptical is also a decent for exercise. I try to cycle for at least an hour a day too. I did not do formal physiotherapy for my current recon because I already knew what to do. My doc laughed when I said that but he agreed that I really did not need to pay someone the 4th time around. I could actually make a physio protocol for other people even though I am not trained to do so. After my first recon I bought my a nice stationary bike and a muscle stimulator so I have the gadgets I need.  

 

For my first recon on my left knee I used my hamstrings and 2 years later I ruptured it. Now I have a patellar tendon allograft in my left knee and it fells better than it ever did with the hammy graft. I have slight hamstrings weakness in my left leg now but it's not too noticeable.

 

The first graft in my right knee was a tibialis allograft which I ruptured and this time I used my quadriceps tendon for the revision. I wanted an allograft for my right knee because the recovery is easier but I wish I would have used my quad tendon the first time. However, it may have still ruptured anyway.

 

There are some studies that indicate that using taking the hamstrings from a female may increase the incidence of re-rupturing the ACL. The hamstrings partner with the ACL to pull the tibia backward. My doc said we probably would have been better off not to use my hamstrings for my first ACL recon but it's too late for that now. This does not apply to males though.

 

I am not a fan of using my patellar tendon because of all the possible side effects. It is still considered the gold standard but with the other options available I have no reason to use mine. I am also not a fan of the "double bundle" recon. There is no scientific empirical evidence to suggest that it is any better than a single bundle recon and you have to drill 4 holes instead of 2 and use 4 screws instead of 2. My doc says he has done double bundle recons on very large males but that is it. If you have small bones drilling 4 holes my lead to fracture. He says if you need a revision it is a nighmare with all those holes and screws in there.

 

Truthfully, my knees look like they have been through hell in back and I wish I never injured them in the first place. However, I am not yet willing to give up skiing so I am sure they will get damaged some more.  

 

 

post #124 of 318



 

Quote:
Originally Posted by kcxd View Post

Wow - I'm at 5.5 weeks post-surgery, and cannot even imagine being able to bend my knees like that! I still have a fair amount of residual swelling, and my flex isn't good. It's frustrating as my muscle strength, control and proprioception are all excellent, but the lack of bend is really hampering my ability to move forward. My doc has just switched my regular NSAIDs for something stronger in the hope that that will help bring down the remaining swelling.

 

It's a long, slow process, this ACL rehab...


Swelling is probably the greatest variable that I have seen in ACL reconstructions amongst friends and myself. Activity is good for the soul and in many regards the healing process, however it also may aggravate the swelling. Whenever you aren't exercising, keep you leg elevated and use your hands to 'pull' the fluids towards the body. Place your hands below the knee and press and pull them up past the knee. This will help move the fluids to your torso and out of the knee.

 

As has been said, everyone's recovery is different. Look for progress in your own rehab and try comparing yourself less to others. Keep up the PT and know you will get to the finish line when the time is right for you.

post #125 of 318

I agree with MasterRacer in that you should only worry about your own progress. For me, the first 2-3 months post op, my PT was saying how he hadn't had a patient like me be on such a fast recovery pace in years. Well, after the 3rd month, my progress stagnated for the next 4-5 months, even though I was re-habbing on a consistent & almost daily basis. I was happy early on in the re-hab since I was progressing so well and then after I stopped progressing, I became a little frustrated.

 

The only thing you can control is the effort you are putting into your recovery. As has been stated many times in this thread, your body has its own schedule, so you have to find some inner peace knowing that you are doing all that you can do. Plus, I heard how fast many people were recovering, somewhere in the 8-10 month range. Well many of those people are in their early 20's and have a  full support system (University or Team). I have a support system too, although, I'm the one providing it to my 3 kids :) So don't try to to place yourself on a level playing field with some super athlete who is a WC skier or on a college basketball team.

 

An interesting part of my skiing, is that I actually became a better skier after my surgery, even though I lost a step of quickness running & also a little leg strength. How? Well, 15 months after surgery, I was back on the hill and my knee/leg was probably 85-90% back. On the 1st day at Snowbird & after @ the 2nd-3rd run on the Gad Lift with my friends I was completely spent. There was no way I was going to last another 4 days here with these guys. I had to change my skiing technique if I was going to last. So I had to adapt and change.  I had to have proper technique using less leg strength and became much more of a finesse skier and also learned to look down the hill further so I was ready any terrain changes.

 

Good luck and keep up the hard work, it will pay off!

post #126 of 318

Boys I have an another question,

I am 9 weeks post op now and i bike on a stationary bike nearly every day, PT told me not too push it too much, not to do more that 30 min, not to go higher level that 5....

but I feel fine going longer and on higher level 9-10 ( i know every bike is different)

I thought with biking I should not damage anything in this stage.

Do you think breaststroke swimming ( the leg movement) is safe ?

Thanks Giga

( I know its different for everyone :-) but....just wondering )

post #127 of 318

I still don't do the 'frog' kick after 8 years and 9 years respectively on my ACL reconstructions. It just doesn't feel right with it's lateral stresses. I do the old fashioned side stroke aka life saver's stroke. The flutter kick in freestyle wouldn't be bad, I don't think. It doesn't use lateral motions.

 

Please listen to your PT. S/he presumably has more experience than you in the healing process. It may be that they are concerned that overexertion will create inflamation and swelling. Both are things you need to avoid to maintain ROM. Talk to them about how you feel and what you want to do. They may adjust their thinking when they know more about your intentions and comfort levels.

post #128 of 318

Thanks

I have done some more research about breaststroke swimming for ACL its not recommended for some time.

I am going to be taking it still easy on the bike, PT said i can do longer that 30 min but not to push it too much specialy not doing high levels

 I had patella reconstruction, bone to bone takes some time to attach at least 3 months, I cant push that for sure.

Well, well.....I though after 9 weeks i would feel little better

post #129 of 318

try to think long term as if you worry about the short term, you will (probably) be on a roller coaster. just put your time in doing the pt and keep trying to move forward. everyone is different in terms of recovery. my wife who's had both knees fixed recovered much faster than me & she barely did any pt. 

post #130 of 318
Thread Starter 

I'm at 8 weeks post-op and my PT told me I was fine to bike as much as I wanted, and increase the resistance as I felt comfortable - I've had it at max since about 5 weeks post-surgery, and can cycle up to an hour and a half with no noticeable discomfort or increase in swelling. Now I'm hoping that's not too much!

 

Whip kick is definitely not recommended until you're much further on in rehab - it puts a lot of stress on the graft.

 

I still have some stubborn swelling in the knee that doesn't seem to be changing much, but it's feeling a lot less stiff now and my flex is better than it was - it's at around 130 now. Still a ways to go, but my PT reassures me that as long as the slow improvement continues it will eventually get there. 

 

Looking forward to the 12-week mark when rehab will get a little more varied!

 

post #131 of 318

Keep your bike riding on road.  My doc allowed me to ride on the street early, but warned against any off street riding.

post #132 of 318
Thread Starter 

I was allowed back on the road at 6 weeks, but my PT said the same - stick to streets and bike paths, and no standing up in the pedals. I'm doing most of my riding out and about now, but still doing some stationary biking on wet days (I figure slick roads and bad visibility are probably also not advisable.)

post #133 of 318

My doc didnt allowed me to get on regular bike yet,  its so boring on stationary bike.

I guess living in New York city they dont want you to go biking in crazy central park or I dont know what can be a another reason.

 

 

 

post #134 of 318
Thread Starter 

I set up my indoor bike in front of the computer, and watch ski movies while I'm riding. Helps the time pass and keeps me motivated. ;)

post #135 of 318

kcxd - Thats a great idea :-). I've started to think snow, i really want to go skiing :-)

post #136 of 318

I have not responded in a while.  I am now between 4 and 5 months post op.  The doc says if I keep it up he will let me ski, yippie.   I am running now about a mile.   I still take two steps forwards and one back.  Damned this age thing anyway.  I would just as soon be 25 again.   I have full range of motion and better stength then before injury.

post #137 of 318

June 22 to today is what - 12 weeks? I can't imagine running on it but biking is no problem.  I did 33 miles on my road bike recently and didn't experience any problems.  It was an organized ride with 10 and 40 mile options.  Next year I'll likely try the 10 on one of my unicycles but the idea of potential reinjury from a UPD (UnPlanned Dismount) has convinced me to leave the uni in the garage until after next year's Nationals at Winter Park.

 

I returned to golf a month ago.  It is such a nice feeling to actually be able to squat down to read a putt!  Ironically the right knee hurts more than the one that just underwent ACL reconstruction.

post #138 of 318
Quote:
Originally Posted by Pierre View Post

I have not responded in a while.  I am now between 4 and 5 months post op.  The doc says if I keep it up he will let me ski, yippie.   I am running now about a mile.   I still take two steps forwards and one back.  Damned this age thing anyway.  I would just as soon be 25 again.   I have full range of motion and better stength then before injury.

The jump from normal activity & working out to skiing is a big one. I was surprised at how much strength & energy it took to ski and only fully realized this out after my surgery. I sorta hit a mental wall @ 8-9 months post op, where I knew I'd been working out & doing my necessary rehab, but was also thinking I still have a ways to go. Then ski season approached and it gave me some motivation. So keep up the hard work, it will pay off!
 

post #139 of 318

JHoback,

 

What did you mean that you still felt you had a ways to go @ 9 mos. ?  I am 6 months out and my Dr. says I'm fine and can begin playing sports.  I don't feel 'normal' though.  I have been cycling like crazy and that's no problem, but mountain biking doesn't seem like the best idea still.  I feel like there is still some weakness, but I have been hitting the gym and biking consistently.  I feel like if I skiied now, I would have alot of discomfort and it would be difficult.   I am hoping I have the confidence and my knee performs as it should when the time comes.  Is there a point where you feel that the injury never happened?


 

post #140 of 318

After about a year your knee should feel completely normal. If you are still having problems after that then something else is likely to be wrong. I forget that my left knee had 2 ACL recons. It feels awesome. The problem is that no matter how good your knee feels you always remember that you had surgery which can put a damper on things. The mind is a powerful thing. I wear knee braces when I ski because I find that they give extra support and stop my knees from aching and hyper-extending. Without the braces my knees feel weak but that's likely a psychological thing. I am about 4 months out from my last reconstruction and during everyday activities even that knee feels pretty good. I plan on skiing by the end of January even though I have been advised not to.

 

Vermonte, in a couple of months you should be ready to ski like hell. There is not much to worry about after your first reconstruction since they generally hold up rather well. It's the ones after that that you need to be concerned about (hopefully that never happens).  

post #141 of 318

I was 13 weeks yesterday ( Patmoore you are 13 weeks too :-), remember we had the surgery the same day )

I tired running but I felt strange pain so I stopped right the way.

Can you tell me guys how long do you go to PT for ? I do all the exercises on my own anyway nearly every day, I feel that I can do ok without PT by now.

thanks 


Edited by giga1002 - 9/22/10 at 10:35am
post #142 of 318
Quote:
Originally Posted by vermonte View Post

JHoback,

 

What did you mean that you still felt you had a ways to go @ 9 mos. ?  I am 6 months out and my Dr. says I'm fine and can begin playing sports.  I don't feel 'normal' though.  I have been cycling like crazy and that's no problem, but mountain biking doesn't seem like the best idea still.  I feel like there is still some weakness, but I have been hitting the gym and biking consistently.  I feel like if I skiied now, I would have alot of discomfort and it would be difficult.   I am hoping I have the confidence and my knee performs as it should when the time comes.  Is there a point where you feel that the injury never happened?


 

 

Hi Vermonte, 9 months got me to @ 70-75%, which for walking down the street was fine. However, to play competitive soccer or to ski like I used to, I knew I had a lot further to go. Until I was 90 - 95% my good leg had to do the compensating in one way or another.  I didn't feel "normal" until after 2 years. I've been using neoprene knee warmers for many years as I am a bump skier and they sure helped before my surgery, so I still wear them now (only for skiing).

 

The confidence will come with your progression. Most of the pro athletes that have ACL surgery are able to come back and play the next season, but its not until the 2nd season that most begin to excel again. So keep working out and know you are on the right track
 

post #143 of 318
Quote:
Originally Posted by giga1002 View Post

I was 13 weeks yesterday ( Patmoore you are 13 weeks too :-), remember we had the surgery the same day )

I tired running but I felt strange pain so I stopped right the way.

Can you tell me guys how long do you go to PT for ? I do all the exercises on my own anyway nearly every day, I feel that I can do ok without PT by now.

thanks 


I would do the PT until you are released by your doc. He/She along with your PT person will know when you are ready. They will probably ask if you feel the need to keep going to them and as soon as you feel comfortable not going they will release you.

post #144 of 318
Thread Starter 

I'm at 11 weeks today. Saw the OS for my followup this week and he's really pleased with how things are going - he said the graft is "very solid" and if I keep making good progress, I should be ready to try skiing again in March. That feels a long way off from here and I'm not counting on anything until it happens, but great to know that I might get in a few turns this season after all. 

 

With regard to PT, mine has scaled back my sessions to once a month. He still provides direction and if I have any problems or worries I can email him, but at this point I don't need as much of the hands-on treatment and so we're just checking in when it's time for me to move to the next stage of rehab or try new activities. I saw him today for some new exercises and the start of my running program, which will begin next week (12 weeks post-surgery).

 

I'm feeling pretty good about things at the moment; my flex is still a bit behind where it should be but I can consistently get to 130 degrees, which is more than enough for functional activity. My PT isn't worried about the remaining 10/15 degrees; given how slow I was to regain flex after injury, he thinks that I will get there given time. I went back to work three weeks ago and that has gone well, though I discovered yesterday that six consecutive hours of meetings make for one cranky knee. (I still find sitting around difficult; the knee seizes up when I don't move it enough.) Now that I'm back at work I'm swimming less and in the gym more, and in the past couple of weeks I've noticed some strength improvements in both my quads and hamstrings. I had 4cm of quad atrophy at one point and now it's down to 2.5cm, so it's coming back.

 

Off to the Vancouver Snow Show this weekend. I can't decide whether it will be great motivation, or pure torture. ;)

post #145 of 318

Hello boys, how are you doing?

The season is nearly here, who is going to ski this season ?

I was told I may try slowely in january.

My doctor said if I am strong enought, easy skiing ok after 7 months post op.

giga

post #146 of 318

Skiing?  Absolutely!

 

I am about 6 months post op and feel pretty good.  I have been road biking about 10-14 miles or mountain biking 6-8 miles every other day and try to walk as much as possible with some swimming here and there.  I also try to incorporate leg exercises from time to time.  I would like to do more but am often pressed for time.  Walking is not 100% normal, but fairly comfortable.  Leg strength is still much weaker than my good leg but it is coming back (muscle becoming better defined each week).  Tried to run but, as noted in someone else's earlier post there was a pain that did not feel right and using the quad that way felt strange (not used to it).  This may sound all bad but it is not - it is part of the progression.  As Vermonte mention a while ago, I had many concerns and my doctor kinda blew them off and said that I was progressing nicely and was cleared for light sports this month.

 

I will be skiing for sure.  My OS had me fitted for a brace which I just got - so I will be wearing that in the beginning.  I plan on taking it easy for the first month or two and gauge how I feel before kicking it up a notch.  My skis are fairly stiff mid fats which was a concern but others here who had ACL recons went back to their original equipment so I too will give that a try. 

 

Looking forward to the best season of the year!  Good luck to all of you who plan on getting back out there this year!

post #147 of 318
Thread Starter 

Barring any catastrophes, I should be skiing again in March (8 months post-op). Both my PT and OS think I'm on track, and I already have a custom brace that I used after my ACL tear last season. I'll probably start off at Cypress on my old Silencers (nice forgiving ski) and hope to be back at Whistler and back on my Shoguns in April if all goes well. It will be a short and gentle season for me, but I'll appreciate it all the more for that.

 

I'm now at 3.5 months post surgery and started my running program about 10 days ago. After a rough start (I think the knee disliked the impact) I'm now up to 10 minutes at a time on the treadmill. Quad strength and flex are now only lagging slightly behind the good leg, although my muscle response time is much slower on the operated side. Cycling is doing really well - managed 70k on the road on Friday.

 

I hope all of the ACL rehabbers manage to get some time on the snow this season, even if it's brief. smile.gif

post #148 of 318
Quote:
Originally Posted by dskifanatic View Post

 

 

 My skis are fairly stiff mid fats which was a concern but others here who had ACL recons went back to their original equipment so I too will give that a try. 

 

 

Yep, get back on your favorite boards! They were your fav's for a reason. You may start off a little more cautious, but that's only because you won't have the same leg strength. However, I don't think your skiing style will change much.
 

post #149 of 318

I saw the doctor today and he has cleared me to ski. Yippie!!

 

I am to take it easy until the first of the year and then full bore if I want to.   My strength is much better than pre surgery right now. biggrin.gif

post #150 of 318
Quote:
Originally Posted by Pierre View Post

I saw the doctor today and he has cleared me to ski. Yippie!!

 

I am to take it easy until the first of the year and then full bore if I want to.   My strength is much better than pre surgery right now. biggrin.gif


sounds good! to me, strength is key. just keep trying to get stronger. many times people mention the mental aspect of returning from surgery. i was mentally fine once i was physically strong again. i didn't have a mental hurdle to get over, just the physical one of returning to where i wasl until then, the mental part for me was knowing that i wasn't physically strong enough, so i'd tell myself be smart & hold back. so keep progressing w/your workouts & good things will happen.

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