ACL Class of 2013

[Chainsaw_Willie]

You are missing progression. Look up the exercises you are doing and see what comes next. ...snip... Remember that the last phase of rehab should also include getting your whole body back into shape and not just your knee.

This is my biggest issue right now. I feel kind of lost. Signed up at a gym and went for the first time today, rode the bike for 15 min then did some other leg exercises followed by some shoulder work (pre-hab for upcoming labrum repair in June) and ended with some leg presses.

Problem is, I don't really know which exercises I should be doing, in what order, with how much weight, etc. etc. I've been given tons of exercises by the PTs but if I was to do them all I'd be at the gym for 2 hours, and a lot of them don't even require you to be at the gym. I need someone to help develop a plan with a clear path of progression and help me set some goals, but I'm not sure who to turn to for this.

@ 7 wks post-op now the knee is feeling really good. Just a bit of stiffness, still a little swelling but I've been wearing a compression brace at work to keep the swelling down and at the end of the day when I take that off it looks basically normal. I can go up steps with no difficulties and down steps that aren't more than about 6". Taller steps still present issues but I'm getting there. Walked the dog about a mile the other night and other than being totally paranoid on a moss covered portion of downhill sloping sidewalk (it was raining), everything felt great.

There's some scar tissue buildup under my knee cap that's causing a popping sound and sensation but it's not painful. Need to aggressively work the knee to get rid of that so will be riding the bike religiously from here on out (been slacking on that).

Anyway, if anyone has suggestions on how best to develop a workout plan with a clear path of progression I'd sure appreciate it. One thing that's going to be a problem is that I get my shoulder done on June 27th and my left arm will be immobilized for 6 weeks after that, which is going to make working out difficult. I want to get as much in as possible before then.

[ate'em]

And finally, there is hope!
7+ weeks post op, its been slow, hard, painful. I went back to Vail last week for a checkup with LaPrade, and I was fearing the worst. My flexion didnt want to move much past 90, my swelling was still troublesome, and I still need the percocet to sleep and do PT. But the doc was nonetheless confident.

Doc thought my flexion was coming slower than ideal, but not a huge problem. Everyone heals differently so comparing to the norm isnt necessarily useful. Otherwise, he felt good about my healing, considering the severity of ACL, MCL, patellar and hamstring autografts, meniscus tear re-stitch, and tibial plateau fracture.

I stayed in Vail for 5 days to do intensive PT, got the clearance to start bearing weight, riding the bike, using the modified gravity treadmill. Sent me home with a CPM machine to wear while sleeping to mitigate the stiffness. The results have been fantastic! There is hope! Loading the knee with weight has really accelerated my stagnant recovery. The popping has gone away, and I am feeling the scar tissue yield and break during my flexion excercises. ROM is now up to 110, I can walk slowly with minimal limp, and I can ride my bike mom!

So I just want to share this to let others who are struggling know that it is a slow process to recovery from such major surgery. A simple ACL is nothing like the beast I am wrestling. You have to stick with the PT every day, because staying still is much better than losing mobility. And then, when the body is ready, the gains will come. Getting the immobilizer brace off and starting to bear weight is a real mental boost, but it also really effects the knee joint in positive ways.

Keep getting stronger, one day at a time!

[Chainsaw_Willie]

Way to go man, great to hear!

I rode an exercise bike for 20 minutes, did 2 sets of 15 leg presses with 75 lbs, and did a bunch of adductor/abductor exercises on Saturday. Yesterday I was feeling pretty good so took the dog for a walk around part of my old jogging route. Probably about 3 miles total with a ~200' climb up a bluff on a steep trail that's partially stairs and today when I woke up the leg feels almost normal. Just a little bit of stiffness but flexion is close to the other leg with no real pain any more and if I sit down and relax for a few minutes I can get the same extension as the right leg as well.

I know I've got to be careful at this point - with the leg feeling almost normal again @ 7 wks post-op I'll be tempted to overdo things.

[DictatorShooter]

Here are a couple links to ACL rehab protocols that I've been using to help guide the self-directed PT:

http://www.palomarortho.com/protocol...teligament.pdf
http://drmillett.com/downloads/rehab...b-protocol.pdf

Seems to be working pretty well for me at 11 weeks post-op. The only issue for me is the damn endobutton which is irritating the tissue around it and causing a lump of scar tissue to form there.

[Chainsaw_Willie]

^^ Good stuff, thanks!

[rmnpsplitter]

3 weeks post op today for Mrs. Splitter and she took her first steps since surgery. Leg felt great and she was able to bear weight without any problems. Very excited for our next PT session on Friday to see what kind of new exercises we can start doing. Today was the first day where I felt we have seen major progress. Pretty stoked that she is doing so well. Swelling is getting better by the day and she can do pretty much all of her allowed exercise with ease right now.

[ego7man]

I'm nearing 4 months post op for an acl and patellar tendon tear. Leg pressing 260 at 3x15s. I ran an 8 minute mile yesterday with minimal soreness. I'd estimate the strength of my bad leg is about 45%. Because I tore both my patellar and acl, I had to wait a full month before surgery, which really emphasized my emaciation. This injury has been absolutely killer for me, but I'm going really hard on my pt with the goal of getting to South America. I think it's critical that you set goals for yourself during the long road to recovery; the hope to ski this summer is really keeping me on track.

[MRG_girlwonder]

Adding to PT suggestions-
I've had trouble getting my quad back since a lot of exercises (squats, leg press, lunges, etc), my hamstring and my healthy leg can take over. I've found my healthy quad and injured leg hamstring would come out sore, but not the atrophied quad. These past 2 wks I've backed off the more traditional weight training/PT and cycling and done:
1. single leg press w/very light weight but holding it in straight position and flex the quad like crazy holding it for 20sec. Get in about 5-6 reps before burn out.
2. these simple VMO activation series: http://deansomerset.com/2011/01/27/t...-progressions/
3. squats w/kettleball in only left hand, then only right hand, trying to focus intently on good form (hip hinge) and prevent listing to one side or twisting.

I do them after warm-up and then go back to the rack for some regular squats of some sort and/or RDLs. But again, scaled back weight and volume.

I'm still in pool for 30/mins 2-3 days a week, 95% of the workout w/a pull-bouy in my legs to prevent kicking.

I'll report back soon to let you know if I think it's been successful in getting the quad back in the game. So far, I seem to have a very light soreness/stiffness in all the right places, so that's a good indicator.

And major bonus: my compounding swelling situation has gotten much better. Could be b/c I'm @14wks, but if I were really honest w/you all, I'd say it's probably b/c I've scaled back on the lifting and cycling enough to let it get a chance to calm down. Imagine that

[jcreight]

Now 3 weeks out from ACL+MCL surgery, I went to physical therapy today and it's "game on". Now I can start to bend the knee to improve from the 45 degrees of flexion that's all the ROM I have now. I went from toe-touch to weight bearing as tolerated, and can put all my weight on my injured leg just fine. I'm really enjoying the increased mobility. Still using crutches, but mostly for stability now. We added heel raises and partial squats with a chair to my program of leg raise homework.

[HStone]

Hello. I hope I'm doing this right - I just joined; found this through an internet search...

My story: 51 years old; female; complete tear of left ACL while skiing in March. I only ski recreationally (sorry, guys), but I'm extremely careful and look out for the pros! I was run over by a very young guy who was entirely out of control. Ughhh!!! My main sports are tennis, running, hiking and motocross (trails).

I"m 6 weeks out from surgery and having some issues. I thought I'd post them here and see if someone can help. My ACL was repaired using an Allograft. No other tears in anything (MCL, meniscus, etc.). I have not gotten full extension but am back to full pre-op flexion. I have tremendous pain in my patella tendon at about 15 to 30 degrees - like its off track - and occasional popping. I also have sharp pain on the inside of my knee - if looking directly at the knee, its at about 8 o'clock, two finger widths from the kneecap.

I've been walking with full weight, can go up stairs slowly but can't go down without intense pain. Going to PT a couple of times a week, but even the PT doesn't have any answer for the tendon pain. Any suggestions/ideas would be greatly appreciated.

Thanks!

[MRG_girlwonder]

I have tremendous pain in my patella tendon at about 15 to 30 degrees - like its off track - and occasional popping. I also have sharp pain on the inside of my knee - if looking directly at the knee, its at about 8 o'clock, two finger widths from the kneecap.

Thanks!

HStone -
I had patella pain for weeks, particularly downstairs, etc. PT's explanation was it was just b/c: 1)that tendon happens to be a particularly sensitive one in the body, and being bathed in swelling fluids daily really piss it off; and 2) the quad is weak and sluggish on the contraction. Ice, Advil and not aggravating it to the point of going down the tendonitis road was the protocol.
It took a while of strength training then ice/rest cycles. I'm 14 weeks now and don't have pain downstairs anymore. I'll still feel it a little in deep squats/lunges. But much better than a month ago.

Overall, after weeks of noticeable improvements weekly, weeks 8-12 felt like a plateau in comparison. Healing was happening, I'm sure, just didn't appear to be progressing. Then sometime in week 13, things began to start to click again. The mild swelling I learned to live with daily finally dissipated some more, daily activities got even easier and my quad is responding again. (But then again, I did make some adjustments in PT. see my post from earlier this week!)

[tjomball]

2013 inductee myself..
Went down on january 4. after only ten skiing days. That season..
Had beem bombing all day, and was dead tired. Stupid mistake.
Happened after the infamous "last run". I know there's a reason I stopped doing them on my DH rig during summertime. I never really thought I'd be stupid enough to do it during the winter.

Long story short.
I slammed.. Hard..
Almost dislocated my hip.
Banged up my lower back.
Did my knee in real good.
Nothing torn or broken.
But every single tendon lost its connection to the bone.
Everything was loose, and still is. I still have lateral movement in my knee, and also pain. It's now six months to the day.
Oh and I also broke my left foot and right ankle.
Now I'm "enjoying" the fun process of training myself back into shape. Ive done it before. In 99 after I dislocated my right knee.
Everythings doable. We might not be ready for the timeframe though..

[Wildman]

3 months out from surgery...major breakthrough. Knee / Graft is bomber / feels great. No pain. Went "jogging" and 20 mile mtm bike ride (with clip in pedals). So stoked to finally enjoy flying down a mountain again!!!

Still struggling with my extension but I have faith it will come without surgery. My PT analyzed my gait on the treadmill today and to my surprise she asked me which leg I had the surgery on (she notices a slight limp) . I have been so focused in getting my "new" knee back to strength that I have pretty much completely neglected my left.

Keep the faith my fellow Gimps. There are good times around the bend...

[meggers]

I'm about three weeks post op and progressing quickly. Got some turns on the bike last week and now I'm itching to get back riding.

My therapist is a bit more conservative than I'd like and won't ever give me a timeline for when I can and can't do something, the answer is always the same "don't expect much before the three month mark". I'm going through some major mental struggle with this, as I'm a goal oriented person, and always need something to look forward to to keep me motivated. So here's my question :

Can someone give me an idea of when I'll be able to ride short road rides or at least on the trainer? Or at least a general timeline for what you've experienced. I've read through most of this but haven't gotten a super clear answer.

Thanks

[pesto]

I was on the trainer almost immediately but it took a little while to get to the point where I could actually do a full rotation. They started me out pedaling backwards which is easier then peddling forward. I built from there as I felt comfortable. I don't think I ever got over 30 minutes on the trainer due to sheer boredom.

The PT had me wait until about 8 or 9 weeks before riding outdoors.

The PT also had me take it real easy the first 3 months.

[rmnpsplitter]

Mrs. Splitter hit the 5 week mark today. PT has her riding stationary bike with low resistance for 30 min/day and doing some wall squats and work with the ball. Also started with the balance board yesterday too. Which was scary for her but once she got over that was able to balance pretty well. Also got news last week that they wont operate on her right lateral meniscus. So stoked about that. Prescribed her 6 weeks of PT on that knee too. Swelling is getting a ton better and she is able to get to 137 degrees on the right and 132 on the left. Extension is almost to where it needs to be. Swelling is about the only thing holding her back on that. Definitely seeing progress!

[Flounder]

Meggers- mrs. Flounder was on the bike around 3-4 weeks but only on the trainer. Took a bit to get full rotations. She's now at 8 weeks and got clearance last week to ride outside. She's had to stay on flat ground, short rides, and no falls. With the end of her school year and the non stop rain the bike is still on the trainer. Looks like we will be able to get out this weekend. Like you, this is driving her nuts. Her rehab is conservative as well due to her hybrid graft.

Wildman- great news that you are back and hammering it outdoors. Can't wait until the mrs is at that point, of course neither can she.

[MRG_girlwonder]

My therapist is a bit more conservative than I'd like and won't ever give me a timeline for when I can and can't do something, the answer is always the same "don't expect much before the three month mark". I'm going through some major mental struggle with this, as I'm a goal oriented person, and always need something to look forward to to keep me motivated. So here's my question :

Can someone give me an idea of when I'll be able to ride short road rides or at least on the trainer? Or at least a general timeline for what you've experienced. I've read through most of this but haven't gotten a super clear answer.

Thanks

Meggers...don't expect to do much before 3 months. I was "riding" 15-20mins on my trainer early on, but it was really just to get it moving to improve flexibility. At 9-10 wks I was riding conservatively outside on a hardtail, flat pedals. No standing and pushing up slight hills was uncomfortable. 30min max and it would be stiff all day after. It was a mental victory, yes, but I see now now I really wasn't doing much.
Once I passed 12 weeks I seemed to be able to do real road bike rides and spin classes, 60-90mins in cleats.

[MRG_girlwonder]

So, here's an interesting development. I've been watching a tiny piece of suture along my main tibia scar, hoping it would surface enough for me to get it. 2 wks ago, it came to a small white pimple head and I tried, but it was still too deep. On Sunday I tried again....and it was over 1" long!

AND - get this - my residual swelling around the front, patella and p-tendon.... It disappeared in 36 hours after that even though I went on a 7 mile hike that day. Since then I kicked in the pool a lot monday, lifted weights Tues, hammered it in a spin class Wed and am lifting again today and it seems my swelling control measures are no longer needed. Who knew a tiny piece of plastic thread could cause such inflammation??

[meggers]

Thanks everyone! It's good to know that come August thing will start to look up a bit. I'm painfully bored of the gym and can't wait to get out again. After being hurt since early March, two months doesn't sound that bad.

[MRG_girlwonder]

Friday was 4 months. I'm able to do a lot discomfort-free (spin class, lift, hike, swim). I'm happier than last month for sure.
I just saw my PT and she feels I'm doing too much b/c swelling is still present, and I could stand to rest a whole lot more.

I'm almost at the point that I am not sure I care too much about over doing it since I'm happier getting outside than staying on the couch. And I'm currently pain free everyday. I'll see if I can get in some more 2-day rests worked in before I see her again in july.

I get the sense from my surgeon and PT that they see just as many ppl like me as ppl not doing their PT at all. They both seem to agree the knee will be great by winter, just wish they could see the kneecap as well as the healthy knee....

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[MRG_girlwonder]

For those wondering about strength checkpoints- From progression stand point, Hamstring is back to healthy leg level. Step-ups and leg presses almost equal. I still have work to do on eccentric quad movements. (like 1 foot on bench and controlling the dip until the other foot gently touches rather than crashes). Same lack of control still when stepping down deep stairs off the bus. Working on this with single dips this month.

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[Chainsaw_Willie]

11 weeks out now and the leg is feeling really good but I've slacked off the PT the last couple weeks. Just been damned busy and tomorrow I go under the knife again for left shoulder Labrum repair which is going to really put a dent in my ability to do things to strengthen my leg. Guessing I'll keep up with the walking, stair climbing, and squats as that's about all I'll be able to do until I'm able to use my arm effectively again, which probably won't be for another 3 months...

[MRG_girlwonder]

How is everyone doing?
I am at about 7 months post surgery. A lot of good things happened around my 6 month mark. I kicked the swelling cycles to the curb and my tibia pains on impact started to greatly diminish. I'm able to lift, cycle hard and start building up my running a little (up to 15mins in good form this week).
Confidence is gaining and looking forward to ski season!

[shekat]

I am 6 months post surgery and I accidentally waterski iced without my brace on Sunday. I was slalom skiing in a turn, happily, and realized I didn't put the brace on. So, I took it easy and after about 12 turns, stopped. Got back on the boat, and waited. No swelling, no pain! Not saying I won't use the brace, just think that was too cool!