Post ACL reconstruction - lack of flexion

[Shenagh]

Back again. Had my ACL reconstruction about 6 weeks ago and experiencing difficulties in range of motion or flexion. Had my 1-month post-surgery appointment with my surgeon who was very unhappy with my ability to bend the knee and have another follow up visit in a month.

At 6 weeks post-op I have only 80-degree flexion which is terrible. Obviously I am concerned about arthrofibrosis and having to have corrective surgery. Wondering if others have been in the same situation and successfully avoided further surgery through physio and rehab? I see my physio weekly and was shocked at the response of my surgeon as my physio gave me no indication that things were that bad.

Doing my strengthening exercises, when I tense my quad and try to lock my knee by pulling the kneecap upwards I have pain in the muscle attaching to the top of the knee. Even doing ¼ squats is exceptionally painful. It is a muscular pain rather than internal knee pain. Should I change physio also? I was in my full leg brace (Zimmersplint) for 4 weeks which from reading various articles is way too long.

I’ve been doing some reading on medical journal and orthopedic sites and haven’t found any successes in rehab techniques, only surgical hence my asking this forum.

Appreciate any responses or tips from others.

[skasi]

I had my ACL reconstruction approx 11 months ago. From Day 1 of the operation of started my post operative exercises and even kept on doing them when I started seeing my physio. I printed an article from http://www.kneeclinic.com.au/papers/documents/ACLRehabProgramme.pdf - which is a rehabilitation programme for ACL injuries and referred to it when reviewing my progress with my physiotherapist. I too was concerned about my progress as I am a very active person. Hopefully it helps you...


Back again. Had my ACL reconstruction about 6 weeks ago and experiencing difficulties in range of motion or flexion. Had my 1-month post-surgery appointment with my surgeon who was very unhappy with my ability to bend the knee and have another follow up visit in a month.

At 6 weeks post-op I have only 80-degree flexion which is terrible. Obviously I am concerned about arthrofibrosis and having to have corrective surgery. Wondering if others have been in the same situation and successfully avoided further surgery through physio and rehab? I see my physio weekly and was shocked at the response of my surgeon as my physio gave me no indication that things were that bad.

Doing my strengthening exercises, when I tense my quad and try to lock my knee by pulling the kneecap upwards I have pain in the muscle attaching to the top of the knee. Even doing ¼ squats is exceptionally painful. It is a muscular pain rather than internal knee pain. Should I change physio also? I was in my full leg brace (Zimmersplint) for 4 weeks which from reading various articles is way too long.

I’ve been doing some reading on medical journal and orthopedic sites and haven’t found any successes in rehab techniques, only surgical hence my asking this forum.

Appreciate any responses or tips from others.

[Shenagh]

Thanks for the rehab program, it does help to gauge where I'm at, where I should be and where I could be! 9 weeks post op tomorrow and still can't get past 90 degrees flexion. I did change physio and have found improvement with other aspects of my rehab like quad strength and extension but flexion is still my major worry.

I can only persist with the rehab and hope the flexion comes with time...patience, the key thing you learn with an ACL reco!!

Thanks again.

[Shenagh]

Just an update, I'm in for an arthroscope and MUA next week to try and remove excess scar tissue and start again. After 6 weeks intensive physio, that’s 2 and half hours twice a week with the physio plus an hour and half worth of exercises at home every day, I could still only reach 98 degrees flexion and pathetic passive extension. Today, I am exactly 13 weeks post reco.

So, my advice to all those about to have or just had an ACL reco - get yourself a darn good physio for your rehab. Yes, a good surgeon is necessary, but so is a competent physio to get you back up and walking and doing the things you love.

I am very peeved off, frustrated and disappointed with my recovery and treatment from physio #1 in the crucial 4 weeks post op and very tempted to send my surgery bill to them (I wish!). I do not have private health insurance and I am livid that this prob could have been avoided had I been given a correct rehab program and guidance.

[Alla]

Hi there

I was interested to read your posts. Im 2 weeks post ACL reco and have been working at home quite hard to get the straightening thing happening mostly but also the bending thing, visiting a physio 2 times a week to also help.

While my physio said that he thought my straightening was pretty good, at my OS follow up today, I couldnt straighten it enough to satifsy the OS... bit disappointed. I can get a bend to about 90 degrees but it takes some work..... So Im a bit lost as to how well Im going now. Like you, the physio was quite happy with my progress, but the OS doesnt seem to be.

Alla

[Shenagh]

Hey Alla,

Keep working at it, yours is still fresh. I was always told extension initially was more important than flexion too, the flexion comes with time. Plus you don’t want to go to too crazy with the flexion and risk damaging the graft. Read the physio rehab program that Skasi posted in this thread as it gives you a real good guide to your progress.

All I can say, is if you have any doubts get a second opinion, there’s no harm in that at all. And generally, trust your OS. I think I read you had one of the best in Melb too. I left things too late, when I saw my OS 4 weeks post-op he almost had a fit and told me then and there if things didn’t drastically change I would be going in for a scope. That’s when I changed physios. Unfortunately, by that stage (6 weeks) the damage had pretty much been done. Do you have a good physio? Even ask your OS who they recommend, or a good Sports Medicine Clinic in Melb.

Good luck, it’s still early days for you so keep doing your regime and exercises, and never hesitate to get a second opinion as it’s your body that’s at stake.

Shen.

[Alla]

Hi there Shen,

Yeah, I had a physio visit today told him what was said by the OS. He asked me to jump up on the bed and straighten out my knee to show him what I did for the OS.... so I did.... the back of my knee was touching the bed, and when I pushed down he couldnt get his hand under the knee joint.... I think I was a little stiff after getting out of the car yesterday, but I also trust my OS's opinion so I've upped the workload and will get this straight enough if it is the last thing I do!! I have an awfully wasted Quad too.... it is horrific to look at knowing what my other leg is like and what this one used to be like. So I am trying to focus on getting this going too.... last night I saw it contract for the first time since I had the surgery... I cant get over how excited I was about that.... it only contracted briefly and I could'nt sustain it at first, but I've been working on it and now I can get it to contract on command, pull my kneecap up and hold it for some time before having to release.... I'm pretty happy about that. I tend to have a lot of fast twitch muscle, so it does build up quite quickly.... I know this will still be a long process, but hopefully it will get underway quickly and I can throw away those frustrating crutches soon!!! My physio says that my patella is fairly tight too... Im guessing because it is still quite swollen underneth, and that makes it a bit hard sometimes because it is quite painful...

Like you said... it is early days for me yet, but I am keen to get this going asap to try to aviod complications like you have copped. I dont actually live in Melbourne, but rather a 2 hour drive away in northern victoria.... and where I am there isnt much choice when it comes to physios... the one I wanted to see that is closest to our home is on 6 weeks leave, so I really didnt want to wait that long to see her..... The guy I am seeing Im finding quite good....he came recommended and I've seen him before for an ankle ligament tear...... got pretty much 100% movement back.... so Im happy about that. I think I have to work harder on my own too... although I was doing what the OS recommended... maybe I need to do a little more...... which is what Im trying to doing. It is such a long tiring haul though... I cant beleive it.....the surgery is nothing compared to the rehab.. .that is one thing I've noticed!

Alla

[Shenagh]

Hi Alla,

I did smile reading your post below as I remember how excited I got when my quad first contracted! I was stoked, it would just quiver and go all crazy but at least it was something and a start. Keep going with the contractions and gradually the straight leg raises (I take it you have to do those too). It's good that you're working on pulling the kneecap/patella up when contracting, that's so important for flexion when you get there as if the kneecap doesn't move up and down, you are restricted with the bending of your knee.

Yeah, it is a long process but you have some really positive signs so keep working at it, I know it seems like a chore sometimes, but it is so worth it. And don't try and do too much either, just what your physio/OS instructs you too and ice is your friend! Use it as much as you need to after exercises etc as it is a great pain reliever by reducing the swelling in the joint. You sound like you've got a good physio, so just keep doing your exercises at home religiously and never be afraid to ask questions.

Sounds like you'll be up and out of the brace or off crutches soon, but only once your OS gives you the go ahead. Although your knee may feel okay, you have to wait until everything around it gets stronger to support it, like your quaddies & hamstring. And I didn't think things would be this hard either, I thought the surgery would be the main hurdle and after that it was just a matter of healing. I haven't been able to walk properly since Jan this year and that's a looong time, so bring on the scope and good luck with your rehab, stay positive and keep working....stay away from the stairs too!

[Alla]

Hee hee.... stairs scare the bejesus out of me at the moment!!!

You are right.... Ice is my best friend at the moment..... but it is also one of those friends that if you hang around them too much you get really sick of them!! hee hee... I've lived in ice packs for the last 2 weeks or so.... Im so over them... but you are right, they are important to me when I'm trying to do the exercises..... At the start they were really soothing.... now they just burn my skin.... even with bandages etc inbetween my skin and the ice....

I discovered today that I can do a leg raise but there is a huge angle involved... physio said to keep trying as much as I can.

I was heading back to work on monday.... physio was shocked... I feel ok and can restrict myself to desk duties.... I thought I might see how I go.. if it swells too much or what ever I'll come home I think.... I was going to use smoko and lunch as exercise breaks.... and get laughed at, but Im also the 3rd person this year at work to have a reco.... so there is some understanding... most others took 5-6 weeks off though.... Im jsut so bored at home.... day time telly is driving me nuts!

Im hoping I can turf the crutches soon, and there was no brace to speak of. My OS doesnt brace his ACL recos apparently, which I think is a good thing... although it becomes risky if there are stairs and falls involved.... My physio and I dicussed the turfing of the crutches (thank god they are my mothers and I didnt have to hire them... she's had 2 hip replacements), but decided that I will muck up my gait if I go even to one crutch... I just cant rely on my knee yet.

I have 10 weeks before I get to see the OS next.... he's basically told me to graduate as I feel comfortable and that next time I see him I should be running. That seems so far away.....

Alla

[Shenagh]

Sounds like you're leaving the ice on too long if it feels like it's burning through bandages. Generally about 10-15mins tops should do it, and when you're icing it, do your static quad contractions at the same time to help move the fluid through and out of the knee.

As for work, you should be fine, I went back after a week and wasn't too bad. Try & keep it elevated as much as you can....I have a desk job too but sat at my computer with my leg on the desk and rearranged my whole office just so I could be comfy. The only thing I found was that the knee would get really swollen by the end of the day and the exercises were a lot tougher then. I would have taken 2 weeks though if I had the leave.

As for the leg raises, I know what you mean with the angle, you’re actually pulling up from the knee rather than using your quad to raise your leg. You need to get the quad and inner muscle strong, you must lock the knee before you raise too – if that makes sense. Static quad contractions will bring the muscle back, so keep doing those and gradually you’ll see an improvement on the leg raises. It took me weeks and weeks to do them properly because my quad was so wasted. Patience!

Your physio will work with you to slowly wean you off the crutches and when you’re ready they’ll have you walking with the assistance of them and gradually get the knee to weight bear fully. You have to wait for the quaddie too as this does so much of the work. The last thing you want is to try and weight bear on the knee and have it collapse…that’s almost as bad as falling down the stairs!

You just have to be patient but diligent. Do all your exercises, really work on your quad strengthening as that will help you further along in all the other aspects of your rehab….and don’t forget the flexion and bending, get the kneecap moving and flexible. Sit on the floor at work and do them all, who cares?! 10 weeks is a long time before you see your OS, but he must be happy with your progress otherwise he would want to see you sooner. I hope you are up and running by then too, and I won’t be too far behind you. After my scope, my physio reckons I’ll be running in a month – I’m so excited!!

[Alla]

Good luck with the scope.... I hope that you get to where you want with it...

Yeah, I'm beginning to realise that this whole deal is a long term thing and that Im not a patient as I thought I was!! I had some more physio today, which was the most painful session yet.... I had been at work all morning.. so swollen knee and no pain killers (I forgot) combined with physio was probably not the best idea. But he was happy that my knee cap was looser and we did some other stuff. He's happy that I can get about a 92 degree bend at this stage with out too much trouble... any further and my knee cap screams a bit.... he also commented on how straight my leg wsa for the extension... he said I'm almost hyperextending again...

I've been doing some pathetic quarter turns on the exercise bike... they feel lame but I think they are doing the trick.... Im feeling little by little Im getting my strength back in my quad... but it is very slow. I rocked for 7 minutes continuously last night.. a record (post op).... I can nearly do a step up onto a box.... but it is very assisted at this stage... getting less so thou... So I have to just be patient and persistant I think.....

I've decided that I might do some half days at work and then the other half at home. Im fortunate that my boss is pretty good about letting us work from home if we need to. I tried a ful day on monday, it was a little too much and I was just wreaked when I got home.... knee ached and was very swollen.

Alla

[injuryupdate]

I like this thread. It is a major physical and mental challenge doing rehab from big surgery like ACL recos, and discussing progress (or lack thereof) with others who have been through the same issues is very healthy and to be encouraged.

[Alla]

Im glad you liked this thread.... It has really helped me feel more comfortable bout where Im up to.... It is nice to have a little support from those that have been there before..... or are going through the same thing.... that is what I was looking for here!!

Alla

[deegee]

all i can say to those of you concerned with their inability to get a lot of flexion in their knee dont worry it will come... i had my reconstruction in june 03... my quads wasted quite badly and my flexion was quite poor... also extention wasnt the best either... cant remember the degrees of flexion at various stages but persistence is all i can say.. i did however have scar tissue build up which didnt enable me to gain full extension.. i had that removed last october... knee feels very free now... back playing sport.. confidence is almost fully there and it feels very good... so just keep at it.. put in the hard work and you will be fine.

[Shenagh]

I know, I have been told over and over that extension is more important than the flexion. However, my surgeon looked at my progress through intensive physio and the fact that I had remained stationary (in regards to improving flexion) for sooo long was the defining factor to do the scope. Let it be said that this was also my choice too. Also, he did mention that excessive scar tissue if left for too long can have an impact on the knee long term. I.e., if it's not moving and working as it should, it's putting abnormal pressure on other parts of the knee.

After my scope last Thursday my knee does feel more flexible but I have been warned by my OS that as my body is prone to building excessive scar tissue that the chances of it recurring are quite high. When I say that I mean building the tissue so quickly after trauma/surgery. I was only 13 weeks post ACL reco. Anyway, I had physio the Saturday after and started flexing exercises from the minute I was discharged every hour for 10 minutes, followed by lots of ice and the whole RICE thing.

I have my fingers crossed and am working my butt off so that I won't be needing to see my surgeon again and all you can do from here is stay positive, keep working and stay positive - that's the key.

[Alla]

Glad that the arthroscope went ok.... or at least sounds like it at this stage.....

I'm realiseing more and more that this is a patience and persistance game isnt it!!?!?! I had a bad day frustration wise yesterday.... and today I felt good enough to try dumping one of the crutches.... Yay!

PT yesterday I wsa told that my Extension and flexion is on track but strength is not.... and that if I can get in a pool and dump one of the crutches that will help as I have to use the muscles to get around then. So I bit the bullet and dumped one this morning. So far so good, but I have a tired knee..... it's working more then normal and I have that lactic acid feeling.... I figure that is good.... and minimal swelling at the moment.... I am noticing that I have to retrain my muscles... they dont want to concentrate well.... like bad school kids! I really have to focus on getting them to keep my knee straight.

I also got the courage up to watch some of the video of my surgery.... that was really weird seeing your own knee from the inside! Admittedly I had to look away for the scapal cuts and main works, but I was fascinated by the first minute "lookng around " in my knee..... I reckon I spotted the tattered remnants of my torn ACL hanging from my knee like a torn piece of material....all ragged and frayed,..... it was really quite interesting... to me anyway..... hubby stayed glued to the whole thing... he thought it was great!!

Alla

[Shenagh]

Oh yeah, patience is something that I don't have at the best of times, especially when it comes to getting back to doing the things I love. And I have to say that if I knew back then pre-reco what I know now in regards to recovery and rehab things would have been a lot of different. You just don't know what to expect, you think that surgery is the miraculous cure all and you'll be right just won't be able to play pivoting sports for 12 months....no one warns you or prepares you for the intense rehab and work that is involved.

I think there needs to be more communication from surgeons to patients regarding the rehab, or at least recommend that you see a physio pre-op to prepare you and have a program ready for you after the surgery. Did anyone else find this or did I just have a less communicative surgeon?

Saw my OS last Thursday, he was very happy and said he has glad he did it, said my graft looks perfect. My physio said the OS did a great job as the swelling is minimal. My knee's already starting to stiffen which is really worrying me, but I am working like a dog with my exercises, and physio 3x week plus my hour at home on my own each day.

Alla, I can't believe you had your surgery taped!! That's insane!! It is amazing what they can do through such small incision holes but there’s no way I would want to see EXACTLY what goes on! My surgeon took pics of me under my scope after the MUA to prove to me that my knee is capable of full flexion, it’s something to work towards and makes me smile!

[Alla]

I cant beleive it was taped either.... I didnt ask for it taped he just turned up with the video after I was waking up..... it is a fascinating watch.... and Im amazed at how many people have asked to see it!!

My OS was was really quite good at explaining that it was going to be a tough road back.... but I figured that I'd be able to cope (better then I have) because I've always been fit and quite muscular in the legs.... I didnt realise the wastage that would occur. To demonstrate the point even more, my PT and I measured the difference in my quad muscles last night.... the recovering leg is 40 cm in circumference around the quad about 10 cms up from the knee cap, and with the muscle flexed. My good leg is 49cm at the same point under the same conditions. I couldnt beleive the difference.... I knew there was a great gaping hole but now the measuring tape has quantified it. 9 cms difference..... that is a bit of work to do!!!! My calves have only 1 cms difference thank god!

I can now turn the pedals of my exercise bike a full turn.... got 110 degrees flex without any hastles.... although it is way easier if I warm up to it with some other exercises.... so hopefully now I can get some strength back a bit quicker. Oh... oh and I did one straight leg raise!! Well, sort of.... my physio helped me get there and finally I could hold it at the 0 degree mark... but it was totally exhusted and couldnt do a second.... I have a lag of 5 degrees, better then 4 days ago when it was 15!!

I'm glad that you seem to be feeling like you are travelling ok with your surgery..... I guess that you should expect a little stiffness as a result of the surgery.... Im guessing that will go as you get further away from the surgery date and get into that PT. I think we are doing about the same amounts of PT and exercise each day.... I'm contemplating getting down to the local hydro pool for some variety starting this week sometime.... still cant drive though so am a bit relient on others.

Hope it only improves! Keep me posted!

Alla

[Shenagh]

Fitness was never an issue for me either, at 26 I was a 5 times a week exerciser on the road bike, hockey field or jogging the streets. I thought I would breeze through it, another girl on my hockey team had her ACL reco 2 weeks after me and she is a heavy set girl, not overly fit but she bounced back so well and streamed ahead of me in the recovery. I don't think fitness plays that large a part in recovery, it's your dedication to rehab and as I have been reminded, my issue is body's natural response to injury and healing. Basically, I healed too well! The scar tissue was so vicious and quick, but that was my body's natural reaction to the surgery and healing itself. My OS says he sees 1 in 100 like me and his assistant surgeon after the scope said my knee was the worst they had seen in 8 years of surgery (in regards to amount of scar tissue and how quickly it grew post ACL reco).

Well done on the straight leg raise!! That's great news and a huge improvement for you, sounds like you're really coming along. Has your physio warned you about the 6-12 week period after the ACL reco? Basically, that's a really critical time for your graft and you have to be quite careful with the exercises and pressure you put on the graft. It's the time when the graft is most susceptible to being damaged as it's trying to get it's own blood supply and become part of your knee again! Anyway, have a chat to your physio but they sound like they're on the ball with your rehab.

Also, saw you on knee geeks too - that's a great source of info and I could spend hours reading around all the different posts. Sometimes, I actually find it depressing with all the bad hard luck stories, but it keeps you aware of other scenarios and what others have had to endure too.

Keep going with the rehab and stay positive!

Shen.

[Alla]

Hee hee.... can't hide anywhere can I..... I have found knee geeks a great source of info although they scared me a bit because there are so many bad stories there.... I had to keep telling myself that people arent likely to post there if they have no problems... I guess that is why I like to post a bit there... to give others hope that it isnt all bad... I really have been fortunate with my knee.... lucky that it was rather healthy in the first place, but also that the surgeons and PT have looked after me well and it seems to be going well.

It never ceases to amaze me that when people ask me what happened (because they see Im on the crutches) and I say that I had an reco and they all cringe and say something about how painful it must have been. They look suprised when I say that it has been quite good really... and insist that the physio is the worst bit.

Thanks for the tip off about the 6-12 week period.... I heard something mentioned about that... I think on knee geeks, but PT hasnt mentioned it. I dont see him for a little while as he's on holidays.... not till monday week.... which takes my past the start of that period. I'll be careful anyway.... although I dont know about you, but I find it really tough to tell when I've done too much and when I havent. I did 10 minutes on the exercise bike on tuesday night last week without breaking and within 2 hours I had the biggest swollen ankle..... I figured that that meant I'd gone for too long... although I had no idea at the time of exercise (the rest of me wanted to do more but my head told me that I'd better not over do it). Anyhow my ankle is still quite swollen... it isnt hurting or anything... and I find it weird that the ankle swelled, and my knee is not at all (or anymore then it was before hand anyway). So the next night I was very light on the exercise, but the following night thought I'd better do something or I'll end up too far behind. I went to the hydro pool and joined with a 10 visit pass to see how that went.... it was great.... could do all those exercises that Im not strong enough to do out of hte water... and enjoyed the change of activity.... but I still have a swollen ankle. So I dont know what to do about it. It's swelling also coinsided with my beginning to get around without any crutches.. although I can get around without them I am very slow and cant go far before kneesy gets tired. That might have something to do with it

I wonder if what you are talking about.... where the graft starts to gain its own blood supply...... is what is going on in my knee at the moment. I have a bit of pain around where I imagine the screw is located it is a pain a bit like a broken bone. When I feel the pain, the vein in my knee that runs across the site really stands out... it is really odd.... the pain isnt too bad... lasts a few minutes and goes... but it is something that I've noticed.

How does it feel to be such a rare person... 1 in 100 like you!! You'd have to be thankful under normal circumstanses that you respond to injury so well.... pity that it can inhibit your healing after surgery! I guess that we all heal at different rates and that is that. I have a friend who had a reco last october.... I was watching her walk the other day... poor thing still limps quite significantly.... Many are suprised at how quickly I got up and about.... I think most of that was thanks to modern medicine....

Hope that the knee is going well.... and tha tthat scar tissue is still at bay! Catch you soon

Alla

[Shenagh]

No problem, I saw the replies on Kneegeeks to your “danger period’ question and they’re spot on. It’s basically putting pressure on the graft through weight bearing exercises and open chained ones too. You’ll be fine, just prob get bored of doing the same exercises over and over again – I know I did!

I actually just passed my 16 week ACL anniversary yesterday which means I can start doing the weight bearing exercises, build my quaddie back up quicker, which means I’ll be on the road jogging quicker! This is very exciting for me. I’m joining a gym on Monday so I can get some variety in my routine and my physio is putting a program together for me with exercises and weights I can and can’t do. After not exercising since Feb, the weight is slowly starting to creep up on me and I’m dying to get back into things. Also, now I’m 3 weeks after the scope I can jump back into the pool as the scars have healed well and no chance of getting an infection.

As for the swelling you mentioned, I had the same. Fluid throughout the whole lower leg, my calf was solid but not from muscle, the fluid that was built up. Just refer back to what you did post-op and elevate, rest it etc and static quad contractions to help move the fluid back out. You’ll be fine, it’s pretty normal.

And the pain around the screw, oh no that’s normal too! It’s a weird pain but it’s basically just moulding itself into the bone and getting blood supply through the bone surrounding it. I had screw pain for awhile but it goes and isn’t too bad compared to everything else. I know what it’s like though, you fret every time who have a pain in the knee and wonder if the graft is okay. You’ll have lots of different pins and aches, but most of them should be ‘normal’ if that makes sense!

I hope this helps you and I enjoy being able to help people too through my own experience. Going through this kind of thing totally occupies your life for a while, well it has for me, and it’s comforting to hear from other people and their situations. I cringe every week though watching the footy and seeing the poor blokes do their knees…it’s going to be really tough to have the guts to get back on the hockey field and go in as hard for a tackle or run that extra yard on a lead. How did you do your ACL?

Keep at it, and show-off to your physio when he’s back from hols!

[Alla]

Oh my gosh.... Reading your posts and I see that you are saying all the stuff that I am thinking!!! It has so occupied my thought processes over these last few weeks. I was only thinking the othre day about how Im so unfocused at work because my mind is constantly thinking about the knee... and when I finally forget it enough to get stuck into work... someone walks past and asks how it is going. The thing that is really starting to get up my nose is the number of people that have commented on the fact that I am still hobbling around and say "shouldnt it be better by now?" It really hurts my feelings because I thought that I was doing quite well. I guess that people forget that even top level atheletes dont return from ACLR before 12 months. I must say that I am terrified of seeing the OS in another 5 or so weeks.... Im scared that he'll be cranky that Im not where I should be. I know that I am weaker then I should be.... He told me as I left last time that I'll be jogging when I next saw him... I actually laughed at him... and he said "Im serious!". I guess I have 5 weeks to get up to scratch. I still doubt that I will be jogging.

I actually am extremely concerned that the graft is loose.... I feel like I am still hyperextending, and to make it worse I dont have the muscle to stop it from happening. I guess that I still carry one of hte crutches around on long trips because as my muscle fatigues I cant control what feels like a hyperextension. I am so worried about it that I am almost crying writing about it. OS said that it was fine last time I saw him (some 4-5 weeks ago), but it doesnt feel right. Im not sure if it is just because I have no quad muscle (that is what PT says), or if there is something wrong.

Thanks for the reassurances about the screw and the swelling. IT is good to know that is normal, or at least experienced by someone else. and also thanks for your comments on the "danger period" You beat me to ask you about it..... I enjoy our conversations here about this experience.... knda like I have a friend who understands what Im going through! Thanks....

Alla

[Alla]

Hi there Shen,

Just wondering how you are coming along..... is the knee going ok after your last worries???

My PT says he doesnt want to see me any more. Not sure if that is a good thing or a bad thing..... I feel almost rejected!!!! He says that my extension is good, and I have a good ROM...and my patella has loosened up.... he had me going up and down stairs today... he says there isnt much else that he can do... and that I only need to go back if I have a problem or the surgeon says that I have to. I think I just have to get crackng on the strength thing and Im ok..... I guess I was a bit suprised that I have gotten out of having to go so soon.....

Alla

Ps... How was the holiday??

[Shenagh]

Hey Alla,

Yeah, been a bit quiet lately.

That's GREAT news if your physio doesn't want to see you anymore!! That means that everything has recovered nicely and there's nothing to worry about , just keep progressing. Well done on getting there so quickly too - it's a lot of hard work which has all paid off for you, which not many people could understand unless they've been there themselves.

I kind of cracked it last week and basically told my physio I was "over it". I didn't do my exercises for 4 days straight and just basically moped around feeling sorry for myself and drank too much red wine - just one of those weeks! I'm still trying to come to terms with perhaps having to have surgery #3 (see surgeon next Wed for his verdict) and also struggling to understand why this has been so hard. I'm 5 months post op and still can't do a perfect straight leg raise - it's pathetic. My quad just isn't firing because of the patella and last week my physio said my meniscus is getting in the way of my flexing....I mean every little thing that could go wrong, has gone wrong for me, but....at least I'm still alive and kicking hey?!

Question for you, you've mentioned water running before. Do you mean deep water running in a class or doing your exercises in the pool such as lunges etc? I need to get back out there and exercising, get the heart rate up at least and remember what it was like to break up a sweat! My physio said I can go out on my bike, on the road (oh happy days) but he's not happy with my clipped in shoes in case I fall (but I'll ignore him on that). I think he just let me this week because I was so down and he knew it would cheer me up.

Anyhoo, as I've kept saying to you all along ,stay positive and keep working...I should listen to my own advice!

Shen.

[Alla]

Hey there Shen,

Hey..... Chin up buddy..... you do need to listen to your own advice (something I dont do well either!!). Although I do understand your frustration to some extent. Keep doing your exercises.... you will get there if you persist buddy. I havent been deep water running although they have classes here for it. I was concerned that it becomes a dangerous exercise given that my foot isnt planted on the bottom of the pool (the open and closed chain thing) so I've actually been jogging in the water. In the deep end of the local hydro pool the water comes up to my shoulders so I get down there in the water and jog. I go for as long as I can.....and to add some variation I will also add in some high knees.... so I have my arms bent at right angles.... almost the same as if Im typing at the computer and I bring my knees up to touch my hands... have I explained that ok?? It is a nice streatch, but it took a while before I could do it.... I have enough flex now.

Funny thing is that Im starting to make friends at the hydro pool..... there are a few regulars that we get there and start chatting about how we are all going with rehab..... getting a bit scary really, there are quite a few hips and a shoulder, and stacks of bad backs. Im the only knee at the moment. And if you are into footy players it is a good place to be on a monday night! (pity Im not into footy players!) Last monday you couldnt swing around in a circle without hitting someone else...they left eventaually.... so I got to do my running (they hog the deep end!). Must have been a tough weekend to play footy.... it was wet.. so I guess it was.

So I like the pool for a low impact, tough muscle work out. Im thinking about a gym membership..... the centre is talking about doing me a deal for my rehab and cutting the price so that I can just use the equipment that I need, not the whole lot... hope that they come through with that.... memberships are way more expensive then I thought.... and I hate the gym...once I have my knee strength back.... I dont intend to go to the gym if I dont have to!

I had a reminder that I cant be too careless today aswell.... headed out for a walk this arvo between rain showers and sort of fell/slipped in a hole in wet grass. It hurt, but I dont think it did any damage.... just reminded me that I needed to concentrate more on where I was placing my feet. It is a bit sore tonight, but I think it is a bit tired too.

Well, I hope that you are feeling a bit better. As I said, chin up.... you will get there. Dont let that knee demon defeat you!!

Alla

[Shenagh]

Thanks Alla,

Yep, the water exercises makes sense - I'm really keen to give them a go. I have physio tonight and I'll ask him if it's okay to do the deep water running too as that's a class for 60 mins and guarantees that I can't slack off! I know it sounds all Grandma purple-hair rinse kind of activity, but I think it would be fun. I joined a gym, lasted 4 visits and haven't been back (it's a month by month membership so I haven't lost much $$ on it, thankfully)! I loathe it, I couldn't think of anything worse than being stuck inside, waiting for a machine etc...plus the exercise regime that my physio gave me I can do at home anyway, except for the upper body extra weights etc.

Need to get back out there though as the whole thing is really depressing, although I've only put on 1.5kg since Feb (not bad considering!) I feel sluggish, run-down and lethargic and it affects you mentally too. Sigh...enough whingeing - I'm getting off my butt and going to join the footy boys for a Monday night session ;) And hitting the road this weekend on the ole Cannondale red machine, weather permitting.

Thanks for the support, I don't really speak about the knee and recovery process with anyone....if anyone asks me how's it going I just say good, okay and never elaborate.

Hopefully I can make some buddies with other fellow rehab patients in the pool if my luck fails with the footy boys - keep ya posted!

Shen

[Alla]

Thats the spirit... get out there and start working that knee in the pool. Once you get going again you'll feel lots better about it all. It is interesting to see other rehab people out there.... there are some interesting stories out there. It'll do you some good. I've had some fascinating discussions at the pool... particularly about a broken hip one lady has.... the things some people go through. (I know, they dont sound fascinating but Im a human physiologist by training....these stories fascinate me)

Today's been my first backwards step day since I started going to the pool.... that is in over 4 weeks... so I think that was great. I was bound to have a bad day sooner or later.... I think slipping on the grass yesterday didnt help at all... my knee demon has screamed about that one a bit.... I've had a bit of pain under the top of my knee cap and it has swelled a little bit I think. I've iced it tonight and it seems heaps better... .so I dont think it is too much to worry about except that I have probably gone backwards a day or two. Thems the breaks... I'll just watch it for the next few days to make sure that it is ok.... PT might see me sooner then he expected and for a different reason (hee hee)

I hope that the weather holds out for you so you can get out on your Cannondale (I presume that is a bike???). I'm travelling down to Melbourne on Sunday morning to pick up my inlaws from the airport, so I have hours in the car... woo hoo... cant wait! Then my Mother in law is back in melbourne the during the week for her knee surgery (she needs a miniscus trim) and then next week Im back again for my 3 month check up..... going to see a bit of the hume highway in the next 3 weeks it seems.

Im a bit the same as you.... Im so sick of being asked how my knee is. I too usually just say "oh good thanks". Actually Im more sick of two other questions..... The " I bet you did that playing netball" and "oh are you still limping?!". I hate them both.... A) netball is a dangerous game, but not every knee injury is caused by netball as everyone seems to think....(I generally say... "actually I just slipped on a floor....... during a netball match, the netball didnt actually cause the injury"), and B) I dont think that people realise how difficult it is to get over an ACL reco! I had an 80 year old lady tell me last weekend "Havent you gotten rid of that limp yet... my brothre inlaw had a hip replacement and a knee replacement 5 weeks ago and he's already riding a bike". I couldn't help but was that I was actually riding a bike at 4 weeks, then she told me that he didnt limp like I do.... Im usually really patient with people.... particularly older people, but I really wanted to slap her for that. I guess the nice old dear thought she was being helpful....

So, I hope that you enjoy the pool stuff... I was in asking about gym memberships etc tonight.... they suggested deep water running too, but I wasnt sure given the closed chain thing, but I reread my notes from the OS and he has in there that I can start kicking in the pool after week 8!! my god how did I miss that!!! I'm 2 weeks behind!! I had asked my PT about that earlier and he said not to... his words were "surgeons dont like you doing that"... ahhh who knows. As I said... visiting OS in a few weeks... will ask then.

Alla

[Shenagh]

I'm sure your knee is okay too, it prob just got a bit of a shock from the uneven ground. They're sensitive little creatures aren't they?! As you say, it may just be a day or so set back and wait to see how it settles down.

Enjoy the in-laws whilst they're in town, hopefully they don't give you too much grief and drive safe on that highway - what a nightmare for you.

My physio cancelled me last night (bit of a role reversal) so I'm off to see him tonight after work, I'm sure he did it to interrupt my Friday night post-work drinking! Been doing a bit of thinking and a LOT of reading and before I believe my physio and go under the knife, I'm going to request an MRI and see what the devil is going on in there. Wait & see what OS has to say for himself on Wed (and whether the physio is being a bit too quick to react) and contemplate another OS, perhaps your recommendation.

I have the most incredible pain when I try and do a straight leg raise. Shooting, sharp and intense through the side and front - that can't be good. I'm still 10 degrees away from a 'good' SLR. Anyhoo, see what the PT man has to say for himself and will join the grey brigade / footy boys on Monday night.

Keep us posted on how your knee pulls up over the w/end and hopefully we'll both be deep water running soon.

Shen.

[Alla]

Sounds to me like you have a good plan there... there is no point getting too upset about it before you are sure about it. A second opinion may not hurt either.... Im due to see my OS late in the month... so in a fortnight or so..(oh darn... that means I have less then a week to get my strength up to something non embarrassing!!)...... The thing I liked about my guy is that he didnt make me have the MRI... he was convinced of my issue straight away. And to top it off he was right.

Anyhows, I hope that you get it sorted soon. My knee is still a bit sore. It swelled a bit last night.... but ice did the trick. It is quite sore to walk on today....and I think it is a bit swollen on the lateral side... although it is hard to tell.... it is up and down within reason a fair bit so I have no idea really. It still feels rather stable so I think there is minimal damage.... might have just had a little bleed inside... So we'll have another night of light work before back to the pool tomorrow for a good work out (provided it feels ok... in the water it isnt too bad)... Pools are a bit more empty on a saturday arvo.... footy players are off playing footy... so I get the whole pool to myself!

I still have heaps of trouble with the SLRs, they hurt me a bit too, but I can get a full extension to do it. I am only just able to do them at anytime during the day... before I could only do them first thing in the morning. Get the Pt to check it out for you.... MY PT put his han on my ankles the other night and pushed down on them while making me do a SLR.... I thought he was being unfair... but he thought my stength was ok considering. Ahh its all good.

SO I hope you have a good weekend.... dont work too hard at PT! And enjoy the beer after! We are picking up my inlaws after their first overseas trip.... so we've had a month of not seeing them (they live about 25 minutes away from us!)... so finally we can give the noisy cockateil back.... he's driving me batty with all the wolf whistles, singing and "what's baby doin'?" comments he makes!

Alla

[Unregistered]

hi... im frm UK..

had me ACL reconstructed with hamstring graft... just reading upon sites/forums and came across u guys - if u got any general tips.. lemme know - givemejuice@gmail.com - cheers!

PS wots this brace u talk about? my leg has been bare open frm about 4days post-op, and evn b4 tht it was just a bandage sorta fing around it.

its now been 2.5 weeks and i am on one crutch walking with not evn a plaster??

[Alla]

Hey there,

Hope that your rehab is going ok.....

I was never braced after my ACL reconstruction. All I had was a compression stocking.... so it has been pretty cruisy for me not having my leg locked at any position at any time. But there were the dangers of hurting it if I fell.... which I did in the early days.

the biggest thing that I've earnt through all this ACL reconstruction business is that you have to be really patient. It is a long process to get over and everyone recovers differently so you shouldnt compare yourself to anyone else really either. I took 6 weeks to get off the crutches, but I know others that were much sooner. I was really active before my surgery so realising that it was going to take time was a really big thing. I think it took me 10 weeks to work it out, and even now I occasionally go through stages where I want to try something I shouldnt and have to really tell myself no. But through all of that I can see myself getting better every day.... so that is a bonus.

Not really sure what tips you are after...... but feel free to ask us about our experiences..... if you need to. I'm about to go 4 months now.... and the time has gone really quickly. I think that it is a lot of hard work and patience that gets you back to what you were..... Im at the gym a few times a week mostly in the pool and do lots of bike work at home as well. Let us know how you are going

Alla

[deegee]

Just asking those ppl who are back playing sport after an acl reco what their flexion is like now. ie; after 1 year post-op. Coz i am just over 2 years post-op and still havent got FULL flexion, but i can touch my backside with my heel when i do a quads stretch (takes a bit of manouvering but it does reach :)

as for squating down on my knees, i cant really do that properly.

however, my knee does get a bit stiff in the mornings, and also whilst sitting at my desk all day at work. but once i do some bike and get myself warm a bit, the flexibility is much better.

so yeah, some insight from ppl that are around 1+ year post-op would be appreciated.

[Unregistered]

Hi degree.

Im not at 1 year yet, far from it at 4 months.... but I almost have full flexion and can kneal some degree..... not fully weight bearing on the bad knee but I can take a fair bit. Did you have a petella graft or a hamstring graft?? I beleive that there is some difficulty knealing if the graft came from the petella, that is one of the reasons I opted for a hamstring graft.

My knee doesnt take much to get stiff.... sitting at my desk sfor 20 minutes without moving will do it... but it comes good after a few strides.

Im not really much help to you other then that.

Alla

[Unregistered]

Hey peeps,
How are we all, I write you this from my hospital bed 2 days out from an AC recon. Leg in pain, think i am due some more pain killers actually, better press that buzzer again. Does anyone know much about pilaties or alternative rehap therapies to help with rehab. I want to do this properly without rushing things but I also want to look at alternative methods to try and help get it back up as soon as possible. I will be guided obviously by my physio but will look at other methods, get into some swimming, maybe some water aerobics, pilaties if thats how you spell it, some lady at the hospital talked about injections of sugar into the knee that helped her, doesnt sound like an option for me though. Obviously for the now ice, physio, exercises are the go for the next couple of weeks, luckily I have a desk job i can put my feet up at as well.
Any thoughts, advice for me and in particular in the early stages....mmm here is the next round of pain killers, signing off now...hahaha.

[Unregistered]

Hey there
I did hydrothereapy to help with my ACLR, but you will have to wait for clearance to do that.... your wounds need to be completely healed. I've also started deep water running and water aerobics, lots of fun, but Im not sure if they would be suitable early in the piece (Im at 6 months). There are some movements and exercises that you cannot do for some time after an ACLR (eg frog kick like your swimming the butterfly, general kicking in the pool, etc, anything where your foot isnt planted firmly on the ground basically) so you will need to clear anyhing you want to try with your OS and/or PT.
Alla

[Darko]

Hi all,

I had a look at your recovery stages-must say I freaked out. I did my ACL in August (had excruciating pain, swelling, moderately sprained ligaments and bone fracture). I decided to have reco, sometime next year (I want to enjoy the summer :-) ), but to be honest, I did not expect that the recovery would be that long and certainly memorable experience. I was really fit (played basketball and trained taekwondo) and believed that the recovery would be a breeze. At the moment, I am really down mentally and will probably hit the wall after the reco. Sob, sob...Hopefully, your posts will help me prepare for the lond year ahead.

Will keep you posted...

[Ella]

Hi all,

I had a look at your recovery stages-must say I freaked out. I did my ACL in August (had excruciating pain, swelling, moderately sprained ligaments and bone fracture). I decided to have reco, sometime next year (I want to enjoy the summer :-) ), but to be honest, I did not expect that the recovery would be that long and certainly memorable experience. I was really fit (played basketball and trained taekwondo) and believed that the recovery would be a breeze. At the moment, I am really down mentally and will probably hit the wall after the reco. Sob, sob...Hopefully, your posts will help me prepare for the lond year ahead.

Will keep you posted...

Hey there Darko,
Dont stress too much about it.... it really is ok... it is a long recovery process but if you work hard it is ok. Fortunately I only tore my ACL, no other damage, so went from being really active, several netball matches a week, tennis etc. to not being able to go at faster then a brisk walk without buckling. My reco has really been a breeze to be honest.... it is just hard to discipline myself to the gym work that I have to do to get back to my regular sports. Im not a fan of the gym by any means, I prefer team sports, but Im having to be behaved and attend gym more often.

Even AFL footy players are looking at around 12 months, although I read today that Luke Darcy is looking to return at the start of next season, even though he was done in May (same day as I was....by the same OS so Im told). Im 6 months in now and my knee is pretty much back to normal with the exception that I have lost a lot of my quad muscle..... hence the need to get into the gym. Once I have the muscle back (OS says 3 months solid gym work should do it) then Im back into my sport. So you can return in under 12 months, but you have to listen to your body and be prepared to work hard. I'll be honest, I have found it particularly hard, and frustrating not being able to be as active as I was, but now that Im able to run and do some more normal stuff (and I've dumped my limp!) it is a lot better.

Remember too that we all heal differently too.... some of us more quickly then others, and we all have different ways of healing. There are tonnes of success stories out there, I'd class mine as successful, although Im not quite there, my knee is fantastic. A large part of the rehab is getting your mind to trust your knee again.... you will be suprised at how much you will be affected by your head.

If you want my personal opinion.... get the surgery done as soon as you can.... and then get stuck into your rehab as soon as you can....it is worth it in the end. The sooner the better, cos if you leave it to long you will develop some habits that will be hard to over come afterwards (limping, favouring, etc!), and your muscle may begin to waste.

If you want to ask more questions, feel free to pm me.
Alla

[Unregistered]

A large part of the rehab is getting your mind to trust your knee again.... you will be suprised at how much you will be affected by your head...

...The sooner the better, cos if you leave it to long you will develop some habits that will be hard to over come afterwards (limping, favouring, etc!), and your muscle may begin to waste.

Alla


Huh, Alla,


Spot on!!! I think my head affects me already. Apart from being really depressed (don’t watch my sport mates playing), I switch to “limp mode” without any reason (guess it comes from not trusting my knee any more), over-protecting it, I also bare my fangs to people that I believe walk too close to my knee (especially if they are behind me). I guess I have to try to relax-I am sooooo OK with pain, but “mind games” is not really my forte.

But thanks for the advice and support, I do appreciate it.

[Darko]

Huh, Alla,


Spot on!!! I think my head affects me already. Apart from being really depressed (don’t watch my sport mates playing), I switch to “limp mode” without any reason (guess it comes from not trusting my knee any more), over-protecting it, I also bare my fangs to people that I believe walk too close to my knee (especially if they are behind me). I guess I have to try to relax-I am sooooo OK with pain, but “mind games” is not really my forte.

But thanks for the advice and support, I do appreciate it.

Sorry, forgot to log in for the post above.

[Alla]

Hee hee.... I keep forgetting to log in too!!

I know the feeling oh so well. I've over 6 months out, and no longer focus on trying to walk fine. Sometimes people tell me how well Im walking and quite often people say "oh your still limping" I honestly dont realise a lot of the time that I am, but usually when they mention that I am limping I then notice that my knee is pinching a little or feels uncomfortable. I guess that you get used to all the quirky feelings coming from your knee that you fail to realise that you are in fact compensating for it by limping. In my situation, most of my issues are because I lack quad muscle. Im busting to get into the gym and fx that but I've had a string of illnesses that have stopped me recently..... 2 bouts of the flu and I have gastro at the moment.... it is killing me!

Alla

[narellekv]

I am now at the end of Week 4 after my reconstruction. I had a complete tear of my ACL, also tore my lateral and posterior cruciate . My medial and lateral meniscus were torn and my femer was badly damaged.

I know everyone is definately different, although what I have been through in the first two weeks is not something I would want to go through again. The first 4 days was spent vomiting (aparently because I'm allergic to codeine). This put me behind in my exercises as I couldn't do them for that amount of time. The pain was excruciating - although funnily enough - was walking without cructhes 7 days after. I just couldn't get away from the pain (and this is coming from someone who has a high pain threshold - apparently not)?? Sleeping is still a problem and i, at the moment, have about 80 d flexion, which is still not good. Am going to physio every week and he thinks i'm ok. just hoping to get more mobile every day. Have learnt a lot in the last 4 weeks. These being: we are not invincible. reconstructions bloody hurt, and the thought of playing any type of sport again, nearly brings tears to my eyes. This, from someone who swims, runs, walks, plays netball, tennis and anything else thats good fun. Any comments would be appreciated.









QUOTE=Alla]Hee hee.... I keep forgetting to log in too!!

I know the feeling oh so well. I've over 6 months out, and no longer focus on trying to walk fine. Sometimes people tell me how well Im walking and quite often people say "oh your still limping" I honestly dont realise a lot of the time that I am, but usually when they mention that I am limping I then notice that my knee is pinching a little or feels uncomfortable. I guess that you get used to all the quirky feelings coming from your knee that you fail to realise that you are in fact compensating for it by limping. In my situation, most of my issues are because I lack quad muscle. Im busting to get into the gym and fx that but I've had a string of illnesses that have stopped me recently..... 2 bouts of the flu and I have gastro at the moment.... it is killing me!

Alla[/QUOTE]

[ngyh82]

Hi there, I am from singapore and i just had my ACL reconstruction 12 days ago. My ROM is terrible according to the Physio, my flexion is about 50 degrees which is far behind what some of the patients are having. She said I shld be going for 90 degrees but i CANT seems to do it. Everytime when I first started the exercises, my knee will be tight like hell. And after much bending of leg, then my knee will start to be able to acheive a degree of 50 degrees. And then I started to lock my knees for some straight leg raises and stuffs, the flexion of my knee will go back to square one yet again. I am tired of doing all exercise everyday especially when my physio instructed me to do it 3 sets 3 times per day. Each exercise period is toturouse to me, painful... I can't stand it. Anyone who had experiences care to share a little bit with me???

[Shenagh]

Hi there,

Narelle/Kev it sounds like you had some major injuries to your knee if you tore the lateral and posterior cruciate ligament at the same time as your ACL. The recoveries you would be reading about mostly here are generally just ACL so you shouldn't compare yourself too much. Your rehab may be quite different to ours due to the fact that you did tear the other ligaments around the knee as well. You shouldn't be beating yourself up too much at week 4 and be listening to your physio and surgeon's advice.

The most important thing after your reco is extension. They should be drumming that into you. Your flexion will come with time but extension is the most important aspect of your recovery initially. That's not to say you shouldn't work on your flexion at all, you definitely should be I'm just saying that at week 4 with all the trauma your knee has been through, you sound like you're not doing too badly. Your knee may be still quite swollen which could also be limiting your flexion. So keep icing and resting to help move the fluid out of the knee and if in doubt chat with your surgeon & physio. I presume you'd be having your follow up visit pretty soon with your surgeon?

I've moved from 120 to 140 and keep gaining a couple of degrees every month or so and that's without even focusing on flexion too much the last few months. I'm at 9 months post ACL reco and my physio is still getting me to work on my extension like crazy and said the flexion will come. He said it may take 18 months or 2 years but it will eventually happen. Extension is critical to be able to walk properly, for muscle development and that means getting back into the activities we love quicker.

So please stop beating yourself up so much, listen to your physio, keep doing your exercises and icing and try and stay positive. We've all been there and can help you through the darker times!

Shen.

[Shenagh]

Hi there,

When are you due to see your surgeon again for a follow-up visit? What is your physio saying may be the issue withyour limited flexion? I'd be asking them what their thoughts are and have a good chat to your surgeon next time you see them or make an appointment if you're not happy before then.

Try to keep doing your exercises as much as possible. I know it's tough but it has to be done if you want to get back up on your feet quicker. Maybe take some light painkillers like paracetamol to help you through your exercises so half an hour before you're due to do them. It may help you gain a little more movement in the first couple of weeks. Don't forget to ice too, ice is a wonderful reliever of pain and use it as much as you like. Keep the knee elevated while your dong it to help drain the fluid from the knee area.

If your physio isn't happy either, maybe pay a visit to your surgeon some time soon and get some more info from your physio beforehand as to what they think may be the problem.

Godo luck, and don't give up on the exercises.

[Hellbender]

I'm still to get OS clearance to start seeing a physio (appointment next Wed at day 11 post-op), but i'm really interested about your thoughts on extension v flexion. On the flexion front I'm at 90 degrees quite comfortably - but I have been doing lots of flex exercises. It as only after reading this thread this morning that I started really concentrating on extension... what specific exercises are you doing?

I'm simply sitting on the floor and trying to force the back of my knee to the ground (I can still slide one finger between knee and ground at this stage).

[SPK]

Hellbender, have a Captain Cook at this (http://www.aclsolutions.com/rehab_2.php) for a few different exercises.

[Hellbender]

Thanks SPK - I've been doing the last three but not the first one... until now!

Cheers

[Shenagh]

That first one is really good, I find it more effective than pushing into the bed/ground. I'm still doing the phone book one now 9 months down the track but weighing my knee down with 5kg - you don't want to get to that stage!

[ngyh82]

Hi there,

I don't understand y most of you guys can actually achieve 90 degrees flexion easily while I got to do about 8 rep sliding heels before I can acheive about 90 degrees of flexion. Wonder if this is normal for some of you? And after i rest about 3 hrs, its back to square one again. Are all these normal for someone who just had their operation 2 wks ago? Thanks for clearing my doubts...

[Hellbender]

I wouldn't worry too much. It does seem that there is a lot of variation with how quickly people recover. I don't think the very small sample size here is going to sway that!

I'm not sure if the kind of athletic background you have contributes to speed of recovery, but it my case I come from a strong cycling/running background. I'd actually ruptured my ACL 20 years ago so my muscles had been carrying a fair load over the years. Perhaps that has meant they have responded quicker? Who knows?

[Unregistered]

i have had two acl reconstructios ( My right in 2001 & and left 7weeks ago), i am at the 7 week mark post op on my left knee, i got my extension in about two weeks and had a bit of trouble getting to 90 degrees but now that i am past 90 i am really pushing the knee and have got 100 - 110 degrees without much effort.

Keep going guys, just as long as you improve every day it will come!

[Alla]

Hi there

It's been a while since I've been here,.... had two weeks holidaying in sunny north queensland!

Just to throw in my thoughts, other then that I agree with most of what has already been said..... please dont stress about if you arent progressing as fast as others.... we are all different, and this does take time. Take it from somone who thought she was going to be playing sport again easily within 6 months because she was so athletic before hand. What a rude awakening.... my recovery from my ACLR 7 months ago has been far harder then I thought it was going to be. Im fortunate in that I've not had much pain, and I gained my extension within 2 and a half weeks, and got my flexion not too long after that, but regaining the muscle is really tough for me. My muscles went on strike after my ACLR..... so as I think Shen has said... dont beat yourself up. You will get there.

Alla

[nfallon]

Help...does Anyone Understand? I Am At 5 Weeks Post Allograft Acl Reconstruction And I Have A Severe Pinching That Is Preventing Me From Returning To Work Because Of Severe Medial Knee Pain With Extension Of My Leg When Walking. My Range Of Motion Is Close To Normal. I Had Another Mri And It Showed A Large Bone Bruise. From What I Have Found On The Internet, It Appears I May Have Fat Pad Impingement. I Have Seen The Surgeon And He Doesnt Seem Concerned...i Am Determined To See Him Today Again....please Help!

[jellybean]

Help...does Anyone Understand? I Am At 5 Weeks Post Allograft Acl Reconstruction And I Have A Severe Pinching That Is Preventing Me From Returning To Work Because Of Severe Medial Knee Pain With Extension Of My Leg When Walking. My Range Of Motion Is Close To Normal. I Had Another Mri And It Showed A Large Bone Bruise. From What I Have Found On The Internet, It Appears I May Have Fat Pad Impingement. I Have Seen The Surgeon And He Doesnt Seem Concerned...i Am Determined To See Him Today Again....please Help!

Hi there,

If you are not getting any satisfaction from your OS, go and see a good sports physician who specialises in knees. Maybe the pain you are feeling is from the chondral bruising, maybe it is fat pad impingement (the worst pain from this is on extension), maybe it is something else. A good sports physician will give you a thorough review, hopefully an accurate diagnosis, and offer some solutions to your problems. If it is fat pad impingement (apparently pretty common after knee surgery, especially if the OS has gone in through your fat pad) a good sports physio will help get rid of that (treatment doesn't tickle but is effective).

Good luck, let us know how you go.

Cheers,

JB

[sheeps]

Reading all the replies I feel dreadful. I see my surgeon tomorrow - 12 weeks. Hes anything but pleased so far. I cannot straighten the knee fully, let alone bend. Yes I can do stairs up and down, and walking is still a bit of a struggle. What does the physio do? I stopped going as all it was, was massage and the machine with the electrical current. I do some exercises at home. Yes my legs are weak and yes I know I have to build them up again, but saying go to physio tells me little. What should they be doing for me?

[kjwilkin]

Reading all the replies I feel dreadful. I see my surgeon tomorrow - 12 weeks. Hes anything but pleased so far. I cannot straighten the knee fully, let alone bend. Yes I can do stairs up and down, and walking is still a bit of a struggle. What does the physio do? I stopped going as all it was, was massage and the machine with the electrical current. I do some exercises at home. Yes my legs are weak and yes I know I have to build them up again, but saying go to physio tells me little. What should they be doing for me?

Hi there,

It sounds like you're really struggling. As JB suggested maybe you should go and see a sports physician that specialises in knees. Whereabouts are you located ? I know of some good sports physicians and knee physios in Melbourne.

Although you say the physio doesn't do much the massage might help to free the knee up and get some more movement in it.

Let us know how you go !

[DaksGT]

I wouldn't worry about things too much. I had a locking sensation approximately five weeks post op whenever I would attempt to walk. 3 months post op I had excruciating pains in my shin and calf whenever I would try to run. All these things faded away.... I am five and a half months post op and my leg feels normal, as if nothing ever happened. I saw my surgeon two weeks ago and he stated that I will return to full contact sports at the six month mark, without a brace.

Some things that I did daily that helped: I would stretch my leg approximately every 15 minutes; calves, hammy, quad etc.... trust your knee, its a lot stronger than you think, and hit the weights hard.

I did some Cybex test where they gauge the strength of your operated leg in comparison to the non-operated one and the fron of my leg is at 83% while the rear is at 90+. Work hard and you will get there

[AndrewACL]

Hi,
I had my aclr a week and a half ago. Just starting to get back into things now... Found this forum very helpful. Just wanted to ask some of you aclr veterans a few questions. When i woke up from surgery, my leg was resting on 2 pillows located underneath my foot. This was causing a lot of pain! so i asked the nurse if i could move it to under my knee. She asked the surgeon and he said no. I presumed this was the best position for recovery so dealt with the pain as much as i could. When i got home next day i kept the pillows there overnight and for the next couple of days.

I was able to flex my quad after about 3 days, so was happy with that. Also my extension is pretty much 98%. The problems im having is buckling, for some reason the knee buckles out of the blue. This was happening before surgery but felt like the femur was buckling over (forward) the tibia. Now it feels like the femur is buckling behind the fibula/tibia. Im worried that either my pcl is now torn or the constant pressure on the knee caused by the pillows has caused damage.

I cant do a leg raise for all the tea in china, dont know why because i have my quad working and feels strong. I am going to a physio in next couple of days.

Is buckling expected?

Thanks in advance of any help and i hope all you fellow aclr's get better soon.
Andrew.

[AndrewACL]

the surgeon told me he had to remove some cartilege aswell.
Cheers
Andrew.

[Brooke]

Hi,
Just seeking people's opinion on return to work. When did most people head back to work, I work in an office job.

[Alla]

I returned to office duties after 3 weeks,.... I needed another week I reckon, and the knee really got sore at lunchtime. I came home and worked from home for the first 3 days back in the afternoons. I returned to field work about 3 months later as the knee began to feel a lot better.

Alla

[Chrisaus]

I thought I would share my experience with you all as it might help someone after this forum help me to be patient
I had a ACL reconstruction in November 2006 on my left knee
My surgeon was Julian Feller (fantastic man and surgeon)
I had alot of pain in my hamstring after they took the graft out and didnt start physio until a week after the operation and it was hard work
we worked on my extension and and was at -1 to 0 degrees resting in the 3-5 weeks and if we pushed we got it to +5
the bending was a touch harder and after 3 months I could bend comfortably at around 118 degrees and if we pushed we got it to 130
it was decided a few weeks ago to have scope to clear out some scar tissue
i had an anthroscope on the 5th of march and started doing bending and extension excersises the day after even though the knee was a touch swollen
i had my first physio session a few days ago and the knee bend was at 130 with no effort
we pushed hard and got it to almost 140 and we backed off
i am working hard and not losing faith so to all of you having small hurdles, just keep going and use your physio an surgeons for continual advice
i hope this helps some what

[Lethal]

Hi All
i thought ill share my experience like Chrisaus. I also was lucky enough to have Julian Feller as my surgeon and i agree with Chrisaus, Julian Feller has been very supportive and actually explains things to you in plain English.

I'm now 3 weeks post surgery and saw Julian last Thursday, I'm just behind of where he wanted me to be but very close to being on track, he seemed fairly happy with the way things are going.

My physiotherapist is fantastic. I'm seeing Jade Brodie at the Life Care Croydon Sports Medicine clinic. I started seeing Jade 1 week after surgery and we are nearly at full lock of the knee now. I Highly recommend Jade as a physiotherapist if anyone is looking for one out in the eastern suburbs of Melbourne - She really knows what she is doing. They also do Hydrotherapy there too which im starting tomorrow.

Cheers
Lee



I thought I would share my experience with you all as it might help someone after this forum help me to be patient
I had a ACL reconstruction in November 2006 on my left knee
My surgeon was Julian Feller (fantastic man and surgeon)
I had a lot of pain in my hamstring after they took the graft out and didnt start physio until a week after the operation and it was hard work
we worked on my extension and and was at -1 to 0 degrees resting in the 3-5 weeks and if we pushed we got it to +5
the bending was a touch harder and after 3 months I could bend comfortably at around 118 degrees and if we pushed we got it to 130
it was decided a few weeks ago to have scope to clear out some scar tissue
i had an arthroscope on the 5th of march and started doing bending and extension excersises the day after even though the knee was a touch swollen
i had my first physio session a few days ago and the knee bend was at 130 with no effort
we pushed hard and got it to almost 140 and we backed off
i am working hard and not losing faith so to all of you having small hurdles, just keep going and use your physio an surgeons for continual advice
i hope this helps some what

[Champlister]

Hey y'all,

I'm writing from Massachusetts in the USA. I had ACL Reconstruction surgery three weeks ago and found this thread to be exceptionally helpful. Things are going pretty well, as far as I can tell. My post-op visit went smoothly (my knee was a tiny bit more swollen than the doctor would have liked, but he said it was still within the realm of "normal.").

I started PT on Wednesday. The therapist said that everything looked great too, which was reassuring.

Interestingly enough, I had the same experience Alla did -- after my first ten minutes on a stationary bicycle last night, my ankle became quite swollen. Alla, your post really settled my nerves!

Needless to say, I've spent as much time as I could with my leg up and plan to do the same all through the weekend.

Thanks a lot for all of your posts!

[dukezone]

Dude

I would totally stay away from doing squats!

Regards
Duke

[bingobango]

hello. im new here and im from singapore.
like all of you here, i just had an acl recon on my left knee about 1 month ago and thought i could share my experience so far.
immediately after the operation, the physiotherapist came to see me, and briefed/guided me through several exercises i was to do the moment i reached home (day surgery). so in my groggy state, she taught me several exercises and said i had to get 90 degrees by the end of the day. exercises she told me to do were the pressing down of the knee, raising of the leg when straightened and bending of the knee gradually when lying down.
surprisingly, i managed to bend my knee by the second day and could actually put my weight on my left leg. i had crutches but i only used them to climb stairs or when i was groggy from the painkillers. in fact, i graudated from crutches in less than a week.
during this period, my knee (from slightly above the knee to the calf) was swollen and as expected, the hamstring felt horrible. a few times the knee lost control. this was due to the weakened hamstring as i was told by the physiotherapist.
also, my ankle turned purple. this is apparently due to the swelling and also cos i havent been walking, hence blood circulation in the left leg is poor. walking helps to circulate blood as your feet helps to pump the blood when your foot contacts with the ground.
so far i've only been to physio twice. told to do really basic exercises like leg raises, ankle pumps and knee bending exercises. really light ones. totally off crutches since the 3rd day and am walking fine now actually. there were some slight problems descending stairs (ascending stairs were much easier!) until the 3rd week. now i can walk fine without a limp but the knee gets sore and stiff. somehow, the knee gets stiff after being seated for too long too.
according to my physio, when i can run is determined by whether my left leg has regained strength i.e. at least 80% strength of my right leg. this shall be determined 6 weeks later.
thinking of not going physio anymore actually. at least not until the next 6 week mark when im assessed again. physio is actually quite expensive and i dread the trips to the hospital (time wastage and all that travelling on public transport!). that's where i chanced upon this site actually - finding rehab exercises to do on my own without consulting the physio.
this has been my experience so far. hopefully it did help or provide some insight!

[lumleys1]

I thought this was rubbish, until I tried it…………



Through my own pain I have discovered a treatment for arthritic joints that gets amazing results. I feel compelled to share this with you as it has worked wonders for me and many others. The above is about my knee but you can apply it to most joint complaints.


Some 18 years ago I had an ACL reconstruction by Parramatta RLFC doctor Dr Michael Johnston. Post operation I became very active again and regularly played pivoting sports etc.


Even so, I was a little crushed when Brisbane Broncos RLFC orthopaedic surgeon Dr Peter Myers told me some 6 years ago that I was now bone on bone and needed a total knee replacement. This was at the tender age of 35.


Dr Myers advised me to delay the surgery as long as humanly possible due to advancements in technology etc. This was music to my ears and I decided to temper my exercise pursuits to straight line stuff only to delay the procedure as long as possible.


In the ensuing years, as my knee slowly deteriorated further, my activities became more and more restricted. Several years ago I was flat out walking for 2 weeks due to severe inflammation and pain. I was constantly in a level 7/10 to 8/10 pain threshold every day.


Trying to delay the inevitable surgery as long as possible I researched tirelessly, websites far and wide, and then I stumbled on it. It sounded too good to be true.


After the research, I decided that the technology was either one of 2 things. It was either the best thing ever or the biggest load of rubbish I had ever heard of. I had to at least try it.


I am pleased to report that there is something out there that works. It is indeed the best thing ever. My level 7/10 pain simply went away during the first treatment. It did come back a little but after a few treatments the pain was just about gone. I do not even take glucosamine any more and am back at the gym regularly. I also do boxing training pain free.




Saying that, I was out playing touch football with the kids the other day. I was side stepping and displaying my blistering lack of pace and I simply forget that I have a sore knee.


Well, my knee did get a little uncomfortable after that game (about 2/10 pain level) but another treatment has got rid of that discomfort. This no longer surprises me.


The therapy is actually Russian Space Age Technology so it has a multi million dollar budget behind it. It is called Scenar Technology. If you want to know more you can Google “Scenar Therapy – racism”. (Scenar is an acronym for some unrelated racist group in North America so do the –racism to eliminate that stuff).


Alternatively, you can email me at lumleys1@tpg.com.au and I would love to tell you more. I can answer some of your questions and tell you where you can find a therapist if you want to try it. Highly trained therapists are now in most major centres including many larger regional ones as well.


If you are in Brisbane, I know one of Australia’s most highly trained and experienced therapists. His offer to new clients is “if you don’t feel significantly better when you walk out than you did when you walked in, don’t pay him”.


You can’t ask for much more than that……….


Anyway, you do what you feel best with this info. But believe me, it is fantastic

[peregrinite]

SCENAR (Self Controlled Energo Neuro Adaptive Regulator)

I thought it sounded pretty far out when I first heard about it, but when you actually look a the science of it doesnt sound too incredible after all. It is no more out there than the electric pulse machines that some physios will attach to your muscles.

This next paragraph sums up the theory of effect. Think along the same line of applying heat or heat/ice cycles to an injured joint to stimulate blood flow.

The body can get accustomed to a stable pathological state, which may have been caused by injury, disease or toxicity. The scenar catalyses the process to produce regulatory peptides by stimulation of C-fibres for the body to use where necessary. It is these neuropeptides that in turn reestablish the body’s natural physiological state and are responsible for the healing process. As these peptides last up to several hours, the healing process will continue long after the treatment is over. The large quantity of neuropeptides and C-fibres in the Central Nervous System can also result in the treatment on one area aiding with other chemical imbalances, correcting sleeplessness, appetite and behavioral problems.
http://www.scenar.info/scenar-information.html
http://www.megadisc.com.au/index_files/scenar1.htm

The info is out there, I had virtually forgotten about this until i came across this thread.
3 months post ACL Reco I still couldnt achieve full flexion. I was active in my physio and I had returned to my sport (climbing) but I was suffering from severely stiff muscles. After 3 sessions with SCENAR and simultaneous massage (which was sorely lacking in conventional physio treatment) I was able to achieve full, heel on arse, kneeling on the floor flexion.

But I am as skeptical as the next person so I think I will go back and see if it will help with my scar tissue and cavitation. I will keep you all posted.

[iclaytz]

Hi there, I've read most of the comments made in this post. But have you been working on the strength of your hamstrings? Flexion is obviously to do with the ability of the hamstrings to contract. I'm sorry if this sounds patronising. I made sure I incorporated a great deal of hamstring work into my rehab program as the stability of the joint relies more on this group especially on your return to sport. usually a ratio of 3:1 in quad strength to hamstrings is around normalish, but I feel a huge effort is needed to reinforce the synergsist and stabilising effects the hamstrings have on forward motion during gait.

[physiouk]

I'm still to get OS clearance to start seeing a physio (appointment next Wed at day 11 post-op), but i'm really interested about your thoughts on extension v flexion. On the flexion front I'm at 90 degrees quite comfortably - but I have been doing lots of flex exercises. It as only after reading this thread this morning that I started really concentrating on extension... what specific exercises are you doing?

I'm simply sitting on the floor and trying to force the back of my knee to the ground (I can still slide one finger between knee and ground at this stage).


hey all you ACL repairs!

firstly well done to all of you working so hard at your exercises, you all sound like dream patients to me! Just to say that your physio's completely right to focus on your extension, it's important to reach full extension as this affects your normal walking gait pattern more than a limited range of flexion. As we step through we need to be able to straighten our weightbearing leg so as not to limp - hope that makes sence! Also try not to be to disappointed with your ACL rehab achievement compared to each others - everyone is different your surgeons are different (therefore will have different techniques and skills) etc, the amount of damage you'll have done will differ from each other and your bodies will heal different. You all sounds like your doing well. Keep you chins up and your knees exercising.

Take care physio in the uk