Am I worrying too soon?

[Alla]

Hi there

Im not sure if I am worrying too soon or not. It has been nearly 4 weeks since I had an ACL reconstruction using hamstring tendon. As the swelling is going down Im able to get a fairly decent session of PT done several times a day, but I find that I have pain under the patella. It seems to bite me mostly when Im trying to get flexion. It bites at the height of the flex, but then continues to bite as I straighten. I can get about a 90-100 degree flex on my own (with no pain), about 120 with the assistance of the physio or my other foot to apply the required force. It bites every so often, not on every flex, I suspect that it occurs more often towards the end of the PT session when the swelling starts to set in, but I havent really taken enough time to take good notes on that.

My physio says that my patella is very tight, and at first I thought that it was because my knee is swollen still.... and I still think that might be the reason, but my PT is starting to make suggestions that I have something wrong with the petello-femoral joint. As a kid I had loose petellas and worked my quads to help tighten them up (now I have no quads!!)

Is it common to have this sort of pain after a Knee reconstruction?? (it is seriously the only pain I get so thats a bonus!!) The pain seems to occur in the same spots that I really felt when they pulled out the drainage tube... could this be related?

I also feel often that I am hyperextending, which seems weird because I cant see how I am able to with the swelling.... I'm worried that this may have not worked, even though the surgeon said he thought it was ok at the last visit.... I had the reco because I wanted to get rid of that hyperextension feeling... it is awful. I'm hoping that Im just feeling that because of the stiffness in my knee... but it scares me. Am I worrying too soon?

Alla

[injuryupdate]

It is very rare not to get almost full flexion after a knee reco, but it can take a few months. Remember you are only 4 weeks into a 6-9 month rehab.

As long as the surgeon at PT are happy the graft is stable, don't worry too much about range and pain at the moment.

[talia09]

Hey!
When I was only a few weeks post-op, I also felt like I was hyperextending and my leg just felt so weak! According to my physio, it was because my quads had wasted away quite a bit in the time since the injury and the operation. I found that gradually as my quads became stronger, the hyperextension feeling subsided, and my patella pain has reduced as well. As for any of the pain being related to the drain, I'm not sure. I'd say probably not, but far out-how much did that drain hurt when they pulled it out?!!

My physio said to me that pain when flexing is normal. I'm now 2 months post-op and I still get alot of pain when bending past about 130 degrees.

[narellekv]

Hi Alla,

The problems i had were also with my patella being too tight - or so my physio said. There ended up being no problem i just had to move it quite a bit. While lying down, which seems to happen a lot in the first few weeks he told me to just slightly move it across ways to give it a bit more leeway. I'm now 10 months post op - and no worries. Just whenever you think of it, give it a bit of a massage and get you kneecap moving. Hope all is well.

[Alla]

Hi there

Just thought I'd point out since I was the original poster...... that given the date of the original post, I have discovered that I was worrying too soon. Im actually 15 months post op at the moment and currently cleared to return to netball. The patella issues I had were all linked to the fact that my quad muscles wasted away so much (I had a 9cm deficit in my injured leg) and this was leading to some maltracking. Once I started to build up the muscle again, my patella settled down and things got back to normal. MY hyperextension issues were also related to lack of quad muscle.

However, I should let you know that having recieved the all clear to return to sport I was over the moon. I've not played netball yet, as I am currently 34 weeks pregnant, but I made a return to tennis at about 8-9 months. My knee feels entirely normal and I rarely think about it now. I have full extension, and full flexion (153 degrees in both legs which is apparently excellent). There is no pain or swelling, and it functions very normally. So there is good news out there for all...... there is a light at the end of the tunnel, but I remember from seeing this old post of mine, how frustrating and scary it all was at the time.

Alla

[Rob N]

Alla: Re: tight patella
My physio had me gently push my patella with my thumbs alternating from side to side to loosen it up after patellar tendon rupture recon surgery with a hamstring graft (started that 5-6 weeks post op). It gradually helped to loosen it up. Check with your physio to see if it might work for you.

Rob N