ACL Class of 2013

Well our surgery went well and she is back at home. They were able to stitch her lateral meniscus instead of trimming it away, 3 stitches total. Medial meniscus looked alright. MCL torn but they think will heal. Hamstring graft went great for her ACL and no cadaver tissue was needed.

In and out if sleep this afternoon, got her to eat a chicken and avocado wrap and not dealing with too much nausea. Drugs are working nicely. Feels good to have her on the road to recovery. She slept almost the entire drive home from Denver to Estes so that was awesome too. Got the ice machine cranking full blast.

Thought about doing some fruit smoothies for bfast tomorrow.

I'm showing up late to class

Me: 49 Yrs old
When: April 21st
Where: Kirkwood
What: Torn Left ACL and MCL
Surgery: May 7th, ACL reconstruction via allograft and MCL repair

I almost made it through the entire ski season without injury, but blew up my knee on the last day at Kirkwood. So much for backcountry and Mammoth late season.

Two days post-op the pain seems mostly manageable as long as I stay on schedule with the meds. Spending most of my time with the ice machine on the Aerobed in the living room so I don't have to climb the stairs to my bedroom. Stairs will continue to be a challenge with the crutches for a few days; I've only got toe-touch weight bearing on the repaired leg for 3 weeks. Because of the MCL repair, I'll be stuck at 0 degrees in this brace for a few weeks (in addition to the week before surgery) so I'll be starting PT behind on strength and range of motion.

It sure looks like a long road ahead, but I'm determined to work hard at recovery; I've been through knee injury PT before with an MCL tear in 1998 so I'm somewhat familiar with the program...though this time is of course a lot worse with the surgery and all.

I've appreciated reading about the progress of all you other class members, and wish you all best of luck.

Regarding hyper extension -
I have deep hyper extension naturally. My surgeon was thrilled I was at 0 on week 1 and he could force it past 0 at 6wks. But it is one of the more personally annoying things when my legs didn't straighten to the same angle when just standing around. It has slowly come back with time. Still feel "junk" when I straighten past 0, but it's much better now I'm at 11wks.
Early on I did a lot of downward dog just to get some lengthing going. I still wake myself straightening it out in my sleep.
My sister also had the same issue for both her ACL surgeries. She said it took a while to return and not feel like something was sticking, clicking, in the way.

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Wanted to write a little post-op inspiration for you guys in this years class.

Backstory - playing a pick up game of football in late Oct 2012, my knee gave out when cutting. Diagnosis was an old complete tear of the ACL, and a fresh partial PCL tear. My knee had been bothering me ever since college (had an traumatic event to the knee, but ignored that anything was wrong), but I was too stubborn to go in to have it looked at. My ACL had been gone for close to 5 years... I just never knew it - i just knew my knee would hurt after running/skiing/etc...

Anyways - had surgery Nov. 20, 2012 - same leg patella tendon graft. Rehabbed really consistently and hard for the first 3 months. March/April were busy, so I did not do as well - but I continued to ride the stationary bike and do exercises a couple of days a week. Still feel a bit of pain/tendonitis in the front of the knee (patella area). Knee is stiff in the morning and after sitting for long periods of time. Once I warm it up it feels pretty good though - some clicking when coming out of a deep squat... but little pain. Full mobility - working on lateral strength now, as I think quad strength is close to 80%.

Now for the inspiration... pretty happy right now actually. Just got back from a 2 mile run with plyometrics exercises at the end. Knee felt SOLID. Overall, I'm tired because I haven't run since Oct of last year... so I kind of expected that. Prior to surgery, I would finish the run, and my knee would give me fits the rest of the day... NO PAIN AT ALL TODAY. Feels great. First time I can say that in 5 years. I went into the run thinking I would have to baby it a bit... but I really didn't. Just focused on running balanced - and not favoring it at all because it felt good, trying to re-teach muscle memory of running normally. I'll probably ride the bike tomorrow - to loosen up - and run again on Monday. So happy and pleased to this point.

So - the moral of the story - is that shit gets better!! Work at it and it will pay off. Flexibility and ROM is more key than strength IMO. Strength will come and takes time, but if you forget ROM and flexibility - that is what will keep you from improving/healing. Good luck ya'll - and stay positive!

I'm back - and you will be too!

Anybody else rehabbing without a physical therapist? I went to the PT for the first 6 weeks, but then have been doing rehab on my own for the last month, due to a change in location. I feel like I'm working it as hard as I was with the PT - just on my own. Doing 30-45 minutes on the bike (stationary or mt. biking on flat roads) 5 days a week, and at least 3 days at the gym doing 5 or 6 moves the PT had me doing, plus seated hamstring curl machine, calf strengthening, light weight leg presses and adductor machine. Am I missing anything crucial (besides the massages/manual manipulation)? Any reason I should be back in with the PT if all seems to be going well with aggressive self-administered rehab at 10 weeks post-op?

You are missing progression. Look up the exercises you are doing and see what comes next. Side note, but make sure you do glute work with all that hamstring work or you'll just end up with an injured hammy post rehab. I don't know when in rehab you should switch, but at some point stop the machine hamstring curls and switch to sliding hamstring curls. Lay on your back on hardwood or a smooth surface, put a towel under your heels. Keep your body rigid and pull your heels under you, so at completion your knees are bent 90 degrees and only your upper shoulders touch the ground. Is recommend getting Advances in Functional Training to use as a guide for the end of your rehab. Remember that the last phase of rehab should also include getting your whole body back into shape and not just your knee.

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I only visited my PT twice a month after wk 3 and now do phone dates until I start to introduce running.
She felt I was capable and motivated enough to monitor my progression within the allowed/prescribed activities and visiting her would just be babysitting. She calls it the "boring phase" since the selection is narrow and it's all about sucking it up to do the exercises and then resting/icing.
But I've also had no complications thus far and I lift with a personal trainer x1 wk to monitor my form as I begin to graduate to full squats/ lunges at low weights.

Only time will tell if it'll work out the same. So far, so good. I'm happier to save time not going to the PT center during the day and hit at the gym before work.


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Wife is now about week post-op. Had our second session of pt yesterday. Going pretty well so far. Since they were able to stitch her meniscus instead of trimming it she is limited to 0-90 degree rom and is on crutches for the first 3-4 weeks. Limits our pt to some extent but I'll gladly take that for the fix they were able to do. She is off the pain meds now and is doing pretty well with her daily exercises. Her range of motion is as good as it can be for now and we are working on hamstring and quad strength. She never really had the "oh my god" pain moment so I'm not sure if we have the drugs or the surgeon to thank for that.

Another opinion of her right knee MRI indicates a tear in her ACL. We are going to meet with the doc again on Friday and see what he thinks. It was an independent review of her MRI. Really hoping for good news from that.

It's been six weeks since my surgery to reconstruct the ACL and lateral collateral ligament, plus meniscus repair, and finally some real progress! Today I got to bear weight, and to ride the exercise bike for five minutes. It's amazing how significant this felt. My knee didn't hurt and actually felt pretty strong, although different. My ROM is improving and is up to 135, and extension is still at 0, which is where they want it for now. I've lost a ton of muscle, and surprisingly enough I also found I'd lost about 10 lb when I weighed myself this week. Time to eat cake.

12wk appt today. All is good, other than some mild swelling. I was, however, gutted to learn my surgeon doesn't advise running until 6mos. Quite conservative.
But cycling outdoors and swimming are allowed this summer and a return to skiing this winter was promised.... guess got to keep an eye on the prize!!

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I followed up with another doctor and was told that my tear is not partial, but full and better get surgery if I want to ski aggressively again without fear. I'll be having surgery next Thursday.

They said I could hope to back road cycling at a good pace/distance in 12 weeks or so. I can't believe the turn this whole knee thing took, but reading through these forums and realizing that I will be back to normal eventually made my decision much easier. Keep with the updates, gives me hope! Sounds cliche, but I swear these doctors are more used to dealing with fatties who don't live an active lifestyle sometimes.

Hello - New to the forum and have enjoyed reading all of the posts. Me: 37 Years Old and a member of ACL2013. Tore my ACL & MCL & Meniscus after being taken out playing basketball. Injury on March 25th and have been doing PT since. Knee feels strong and almost back to full ROM.

Surgery set for May 29th. Still trying to decide between Petellar Tendon vs allograft. Dr say's both are great and if I don't have a preference he would go with my own tissue.

Last week was Mrs. Flounders one month mark. She got clearance to ditch crutches and only needs the brace outside the house. She's working on stairs, up is easier than down right now. She's been working full time the last couple of weeks an doing well. She's riding the bike with resistance now. Things seem to be going well. Four weeks of school left and then she will have plenty of time for strength training. Her goal is to be back climbing by late summer. Just have to make sure her leg can support a fall.

Her PT was very appreciative that she is actually doing all the exercises that he gives her. Who knew our lazy, over weight society tends to ignore doctors advice? Keep stretching and doing the exercises, they definitely help.

Fuck me...

5 days post op. First few days went great, stayed ahead of the pain, cpm'd ice'd and did post op exercises like mad. Pain was subsiding, extension was at -2, flexion up to 65 on my own 80 with help from the PT at my session on Monday. Was working on weight bearing.

Last night pressure and swelling started building in my calf. Had an appt. with my primary care doc today and he had an ultrasound done. Blood clot in my thigh.

Out of commission until Friday at least. Can't even use the cpm machine. So worried this thing is gonna lock up on me now. So pissed, but grateful we caught it though.

Miahw- bummer man. Blood clots are no fun. Just curious, but were you wearing a compression sleeve / tights? Glad you caught it.

Yes, I was wearing the compression tights.

This actually wasn't that big of a surprise. I have hyper-coagulative blood due to a genetic blood disorder. I had 2 DVT's in my earlier 20s. Have been on long term blood thinners for 10 years now.

Had to cycle off that medicine and onto a different form for the surgery. I def. knew that a clot was a distinct possibility . For most folks if you follow the docs orders and wear the compression stocks the risk of clots is very low.

I actually liked wearing the tights, helps to control the swelling which reduced that painful "pressure" from when you get up off the couch/bed and all the blood rushes down to you foot.

Got good news from the doc this morning though, at 5 pm today I can start using the CPM machine and start doing my rehab exercises as well. Psyched!!!

2 weeks post op for Mrs. Splitter and we are progressing nicely. Got some new exercises at PT yesterday. She still is restricted to crutches (toe touches) and 0-90 ROM for one more week. Mentally, she is ready to walk again since she already has the full ROM that she is allowed and is not in a lot of pain but cant risk damaging the stiches in her meniscus, so we wait. That will be nice when we can start transitioning her off the crutches.

Still a decent amount of swelling even though we have been icing and elevating at night which is surprising to me. That part seems to be the one area I wish we were progressing along better. I think being at work is slowing that process down. The PT guys are telling us we really need to get that swelling down as she approaches the date that we can start getting into some more impact exercise as that will limit her to some extent. The stretching, massage and exercises are helping though.

Nice rmnsp, all progress is good!!

With regards to the swelling your lady can't ditch. Does her PT use kinesiology tape at all?

From everything I've ready it is totally clinically unproven, and a lot of folks consider it a crock.

That being said my PT believes in it and has used it on me twice. The first time was about 2 weeks pre-surgery when I went in to get to know her and evaluate my ROM, etc. I had what's called a "bakers cyst" on the back of my knee that is formed when fluid from the capsule of your knee is released during injury. She did that kinesiology taping and I swear to god it felt better in 4 hours and the next day the swelling from the bakers cyst was down and never came back.

She also taped me on Monday to address some post op swelling at the bottom of my quad. Now the results haven't been as dramatic as the previous time, but the swelling is down. That could of course be from the normal RICE treatment.

My conclusion - might be that my results from it are coincidental, but since there really isn't any down side I'd recommend it as something to look into.

My wife also just reminded me that her sister had swelling issues post ACL repair that she couldn't get rid of, and that acupuncture did the trick. I believe she was farther down the post op road at that point though.

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Originally Posted by rmnpsplitter

Still a decent amount of swelling even though we have been icing and elevating at night which is surprising to me.

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I am 13wks post op and even I am still swelling daily. This is consistent with my ankle sprain experiences -- I just dont drain fast and fill up after exercise easily. Our bodies are all different in that regard.
None of the PTs or my doc seem concerned... they say it'll be quite a while before it stops. My cousin said it took him a full year for swelling to stop.

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Good to hear that others are experiencing similar swelling issues. PT didn't seem super concerned and they said her swelling is normal at worst. Its just that everything else is much further along, so I might be getting a little greedy if you will. As far as the tape goes we have not been using it. They did mention that we might some time later down the road but for now we aren't. They had her on the bike rocking which was cool, and gave us permission to start doing straight leg lifts without weight on the knee. Just little signs of progress that are good for her mental side.

I should add that although overall Mrs.Flounder is doing well she continues to have swelling at 5 weeks out. If she has a long day planned she does wear the compression stocking. She also ices at lunch and right after work. It's not the major post op swelling but it is noticeably larger than the other leg. She also has the nice mystery shooting pains down the leg on occasion. Overall she's doing well and making progress. Walked the dog all the way around the block last night for the first time post op.

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Originally Posted by Flounder

She also has the nice mystery shooting pains down the leg on occasion.

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Wife started getting these this past weekend too. Are they short duration but pretty intense? Therapist says it is the nerves coming back that have been dormant. She said it's hard to tell what's good pain and bad pain as a patient in the beginning but to not worry about those too much unless they don't go away.

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Originally Posted by rmnpsplitter

Are they short duration but pretty intense?

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Yes they are. It does sound like nerve pain. She's fine after a minute or so. Her PT didn't think it was a problem either. I think it's just part of the recovery process.

It's great to hear so many are doing so well. The PT folks do always seem a bit surprised that you are actually doing all the home exercises, I bet a lot of people are pretty lazy about it. The pt has definitely been paying off in that I ended my six weeks non-weight bearing last week, and was able to progress to walking first with two crutches, then one crutch, and within a week I was able to walk slowly across the room with no crutches. Yay! I'm now doing the Alter-G treadmill for 15 minutes with 70% weight, and then doing the exercise bike. The one big negative right now is that after having my leg in a full length immobilizer brace for the six weeks I've developed some adhesions on the patellar tendon, so the physical therapists have been working aggressively to try to get them to break up. They've been doing Grafton method (think scraping with giant curved butter knife) and cupping to try to loosen it up. My poor leg is now bruised and sore, but it seems to be helping. As they said, this is the non-fun part of pt. I have a pretty high pain threshold, but this stuff hurts!