Diary of an ACL

[Kempes]

Hyperextension is absolutely key. I went for 6 rehab sessions during the first seven days after the surgery. The first one was 12 hours after I got off the table.
I cannot do too much steching this days, as missing hammy can hurt a lot, while overstreched. I went through a lot of pain when I did it. Since you are on alograft, you should have less constrains I hope.
Good luck and I am sure you will be fine soon

[jenscats5]

I think the longer you wait to start with straight leg raises, the worse it gets. Luckily, with my first surgery my doc wouldn't even let me out of the hospital until I could do a few. It was insanely painful an hour after my hamstring graft, but you get those muscles to fire before they "forget" how. He told me I had to bend it to 90 then too. I remember thinking he was out of his freaking mind asking me to do that stuff.

But after that one, I've gotten my post op instructions that involve "go home and rest and ice and take painkillers, and we'll start PT in a few days.. a week, whatever." And I ask if I can start PT earlier to begin with, and if not, if I can do SLR's, calf pumps, gentle stretching, etc. and then I go and do lots of that until I get to formal PT. No idea why more surgeons don't insist on people starting those things right away.

But you'll get it back. It's just a pain - literally. And mentally, honestly - to see how hard it is to get a big muscle like that to just WORK DAMMIT. Keep doing little quad sets at home all the time. You don't want to overdo SLR's or other real exercises, but my PT's have told me that if you're just sitting there and contracting the quad enough to make it move a little bit - you can do that all day long. Plus that and calf pumps help promote blood flow.

I'm assuming they have you using the little e-stim machine while doing bigger quad sets at PT - that's designed to get your quad (VMO in particular) to fire correctly.

Nope - they didn't put the stim on me yesterday at all.....guess they will add that in later.....

Dr. appt tomorrow pm - I assume that is when the stitches will come out.....doing the PT movements yesterday felt like they were going to pop my stitches out - not a good feeling.....

The thing with the quad is - I had a leg block for my surgery so I literally had NO right leg for a little over 24 hours after surgery.....my whole leg was "dead" so to speak till it wore off....now it seems that my quad isn't being recognized at all as I can't do a leg lift....I've been doing the quad squeezes & gas pedal pumps at home....

I did get a sheet with post-op instructions, however they were impossible to read - I had to call the Dr's office to get them to decipher it...

[jenscats5]

Oh and I'm noticing now that any contraction of my quad that causes my kneecap to move causes an EXTREME amount of pain.....like - makes me cry type of pain....

The swelling right now is concentrated mostly in my knee - however my calf is slightly swollen as are my toes....

[altagirl]

For some reason the VMO (inside part of the quad) is the tricky part. So possibly, if only the other side of your quad is working, it's pulling your patella off to the side and out of it's normal groove - and that hurts. Patellar mobility exercises (manually moving your patella around and tilting it) help and your PT and doc should look at what your patella is doing when it's causing so much pain. Then they can tell you exactly what to do to fix it. Normally I'd say to just ask your PT, but if you're seeing your surgeon, get their opinion on it too.

It could also be swelling. Keep it really elevated (I know I've said this before, but after my first surgery, I just propped my leg up on a footstool with a bunch of pillows so it was equivalent to sitting in bed with it on a few pillows - it swelled up like a tree trunk and was miserable to rehab. Since then, I've gone to sitting on the sofa with my leg up over the back so it's well above my heart - that makes everything easier and less painful.

[truth]

For some reason the VMO (inside part of the quad) is the tricky part.

That's because they slice clean through it very close to the attachment point.

[jenscats5]

All right!! In doing my afternoon set of exercises.....I was able to do 3 sets of 10 leg raises!! Yay!!

Got my leg up on 3 pillows now....

[Kempes]

Excellent. I am sure it will be getting better every day.
It is a geat feeling to rise a lag by its own musels.

While elevating your leg avoid supporting your leg exclusively at the upper part of the tibia, just below the knee [excuse my English]. This may overextend your graft.

[jenscats5]

Did better in PT today & they gave me stim today.....got 102 degrees bend while doing wall slides....also got up to a 58 on the stim, which made my foot go numb.....

Saw the Dr. again today....I can sleep without the immobilizer now....but when moving about - I need to either be in my immobilizer or in my Donjoy brace, but I can't wear the Donjoy brace until the swelling goes down.....Dr. said today my calf & foot swelling is due to my ACE bandage & sock being too tight....the discoloration they said is not a big deal - leg looks normal.....They removed the stitches (regular thread ones) also - which means I can shower without a plastic bag!!....They wouldn't tell me where the graft came from (as in who) cuz they don't get that information....they took 2 X-rays and I'm to remain on crutches for now - or until I can walk without a limp.....

Oh they never told me or gave me an update on how much weight I can put on my leg for now - they said last time no more than 25lbs....PT will call for the info....

Oh and no: baths, soaking or hot tubbing for a few more weeks.....

Another thing is that they wanted to aspirate my knee today, offered to do it - but I declined.....well was kind of wishy-washy on it, so they put it off too....

[Kempes]

Excellent progress on your bending!
It is interesting how treatments vary. I am encourage to walk with no immobiliser/no brace in the second week after the surgery. But I am recommended to use immobiliser for sleeping for 6 weeks! According to my doc people can do treamendous moves with their legs while sleeping, so it is better to be cautiones.
There is also no restriction on putting weigh on the knee, except if it hurts, assuming ACL is the only sick part of the knee.
Good luck

[jenscats5]

Excellent progress on your bending!
It is interesting how treatments vary. I am encourage to walk with no immobiliser/no brace in the second week after the surgery. But I am recommended to use immobiliser for sleeping for 6 weeks! According to my doc people can do treamendous moves with their legs while sleeping, so it is better to be cautiones.
There is also no restriction on putting weigh on the knee, except if it hurts, assuming ACL is the only sick part of the knee.
Good luck

Hmmmm - that is interesting.....I'm sooo glad I can sleep without the immobilizer cuz it was very uncomfortable.....I assume my PT will call my Dr. to see about the weight restriction on my leg......



Went to PT again yesterday (yes 2 days in a row) cuz I was supposed to go today but couldn't as my husband had a business trip (day) & couldn't take me & I can't drive myself.....

Well I had a different PT than usual due to the time change & day change.....he had me lay on my back to do knee bends - which with his help I got 100 degrees - I had only been able to do 102 degrees via the wall slides....also I was able to do my 3x10 of leg raises and lower leg raises with my knee on a ball.....got the stim & ice as usual.....PT again on Monday...

One thing that is bothering me about PT - I don't know if this is a legitimate concern or not, but my PTs work on me with their bare hand, no gloves. Now my incisions (5 of them) are just 8 days out of surgery - not open or bleeding but just scabbed over & pretty ugly.....well in between working on me they work with other patients...back & forth - no hand washing in between....Now that just bothers me.....I may have to say something....or am I just being a hypocondriac??

[Kempes]

My incisions are still covered with bandades. PTs do not focus on this areas, rather below, above and under (while lieing on belly). I am sure your PTs know what they are doing.
I am already a good friend with my PTs and asking them every question that comes to my mind. I am going to meet them regularly for months.

[fez]

One thing that is bothering me about PT - I don't know if this is a legitimate concern or not, but my PTs work on me with their bare hand, no gloves. Now my incisions (5 of them) are just 8 days out of surgery - not open or bleeding but just scabbed over & pretty ugly.....well in between working on me they work with other patients...back & forth - no hand washing in between....Now that just bothers me.....I may have to say something....or am I just being a hypocondriac??

probably a bit of a hypochondriac, but it sounds like a valid concern to me.
my pt cut a little square of theraband material that she would cover my scabbed up scars with while manipulating my patella and massaging my scars.

im 5 weeks post op today, as of about a week ago i had better range of motion in my right leg (the one i tore) than i do in my left (good) leg. I've never been real flexible and have massive calfs and thighs. the pt thinks my good leg doesnt have much range of motion because the muscles get in the way and the right leg has atrophied some.

the best thing i did on my own for therapy was concentrating on walking as normally as possible (not limping) as quickly as possible.

[jenscats5]

probably a bit of a hypochondriac, but it sounds like a valid concern to me.
my pt cut a little square of theraband material that she would cover my scabbed up scars with while manipulating my patella and massaging my scars.

im 5 weeks post op today, as of about a week ago i had better range of motion in my right leg (the one i tore) than i do in my left (good) leg. I've never been real flexible and have massive calfs and thighs. the pt thinks my good leg doesnt have much range of motion because the muscles get in the way and the right leg has atrophied some.

the best thing i did on my own for therapy was concentrating on walking as normally as possible (not limping) as quickly as possible.

Well I wasn't sure if I should be concerned about it or not....but they don't cover my scabs with anything & are touching me with bare hands along with 2-3 other people....so I dunno.....

And I can't really focus on my walking yet - as, as far as I know at this point, I still am not to put more than 25lbs of weight on it yet.....

[fez]

And I can't really focus on my walking yet - as, as far as I know at this point, I still am not to put more than 25lbs of weight on it yet.....

dang you have had a tough surgery. i was off crutches two days post op and walking pretty normally within a week. except for down stairs. down stairs took a while.

[jenscats5]

dang you have had a tough surgery. i was off crutches two days post op and walking pretty normally within a week. except for down stairs. down stairs took a while.

Well my Dr. is a man of few, very quick words.....when I went to see him this past Wed. he didn't respond to the question of how much more weight I can put on it.....I'm really feeling the instability in my knee however, so when I do try to put weight on it - I feel like it's going to collapse...

And all I had done was an ACL replacement.....

[jenscats5]

Whoooooo!!! I was 2 weeks out of surgery as of yesterday & had my 5th post-surgical PT session today....Anti-biotics have been completed & I'm almost done the anti-inflamms.....Off pain meds, tho I have some left.....

Well today I got on the stationary bike for some rocking back & forth on the pedals & got 30 times around in a circle all in a row backwards....yay! Then was able to complete 5 mins + of pedaling forward, and they even adjusted the seat down 2 levels.....

Also when I got to do the stim I kicked into the iso-kinetic machine at a higher level than I did Monday.....

Making GREAT progress in PT and pretty quickly....

STILL on crutches tho with weight bearing restrictions on my leg.....so I still can't walk without the damned crutches....

[jenscats5]

22 days post surgery....

Went in with 118 degrees flex & +2 on the extension.....Need to come in, consistently at 0 to be able to NOT have to do the Prone Hang - this "exercise" if you want to call it that, I call it torture, is a real killer......OMG it's awful!!

I was able to also pass the foot dexterity test.....you sit on a low bench & you tap your foot back & forth across a 4" high stick....You need to be able to do 15 in 10 seconds to be allowed to drive. Well, I did 31....

Went to the Dr. today also - and I'm OFF the crutches!! Yay!! Can't do any load-bearing squats or load-bearing closed chain exercises. So walking will entail wearing a brace - which if I can keep the swelling down, will be my Donjoy with a sleeve underneath it......

[nancie2k]

is the prone hang where you roll a towel and put your heel on it and suspend your knee? i hate that one, it really really hurts .
congrats on no crutches!!!

[jenscats5]

is the prone hang where you roll a towel and put your heel on it and suspend your knee? i hate that one, it really really hurts .
congrats on no crutches!!!

No......but may do the same thing.....

I lay face-down on a table with my lower leg from the knees down off the table & they strap me to the table then strap a weight to my ankle.....Then I lay there for 15 minutes......Very painful!! If I can get to 0 lag on my own consistently, then I won't have to do it.....Incentive!!!


At PT today - they told me I'm allowed to ride the stationary bike - for as long as I want.....Drove to & from myself today with no problems...it was nice to be out....But I'm not allowed to do any closed-chain leg movements - so I'm still off leg work except for what they have me do. At home I'm to work on straightening my leg & stretching....

[jenscats5]

Ugh!! The prone hangs will continue - only got +2 on the extensions today - STILL can't get to 0 degrees and yes, I do work on it at home....I don't get it...


But got 129 degrees on my flex today....and I'm able to pedal forward around right away now on the stationary bike, which is good....

[jenscats5]

34 days post-op....

Still on activity limitations due to meniscus tear....

Got 0 degrees today extension (was -1 Friday & 0 last Wed), so today was the 3rd visit with NO prone hangs.....Yayyy!!! Got 129 on my flex - was 133 degrees with some manipulation....I'm 145 degrees with no assistance on my left leg, so I'm pretty close......

Still have a little swelling but my knee is starting to look like a knee again instead of a giant mushy grapefruit.....

[Mtn Man]

I haven't seen this thread in a while. I'll answer a few things here.

I would be a little concerned if the PT person isn't washing hands in between, my guy always did. He was extremely structured though, the other PT people in the place made fun of him all the time. But if you're even a day or two out of surgery, there shouldn't be any cross contamination.

Prone hangs are a bitch, it looked like medieval torture when I did it. I would sit in a chair with my leg up on the opposite chair. They would strap a contraption up to the leg and attach it to the floor, then contract it until I made funny noises. Then I had to hold it for 15 minutes....then they pulled harder and hold for another 10 This was one of the times that I almost passed out. During later PT sessions, they would hook up the electric stim while doing this, but my pain threshold was higher by that point. I did this for a while too, way past the 0 deg point.

If you have meniscus damage, you can't compare yourself to people who are walking fine after a couple weeks post op. I had the same issue, pointing out that I'm working this damn hard and people are walking before me.

It sounds like you're doing the bike before I was, so that's definitely a good thing.

The key is to keep on doing, don't get discouraged. You have your good days and bad days and you just have to roll with it!

B)

[jenscats5]

I haven't seen this thread in a while. I'll answer a few things here.

I would be a little concerned if the PT person isn't washing hands in between, my guy always did. He was extremely structured though, the other PT people in the place made fun of him all the time. But if you're even a day or two out of surgery, there shouldn't be any cross contamination.

Prone hangs are a bitch, it looked like medieval torture when I did it. I would sit in a chair with my leg up on the opposite chair. They would strap a contraption up to the leg and attach it to the floor, then contract it until I made funny noises. Then I had to hold it for 15 minutes....then they pulled harder and hold for another 10 This was one of the times that I almost passed out. During later PT sessions, they would hook up the electric stim while doing this, but my pain threshold was higher by that point. I did this for a while too, way past the 0 deg point.

If you have meniscus damage, you can't compare yourself to people who are walking fine after a couple weeks post op. I had the same issue, pointing out that I'm working this damn hard and people are walking before me.

It sounds like you're doing the bike before I was, so that's definitely a good thing.

The key is to keep on doing, don't get discouraged. You have your good days and bad days and you just have to roll with it!

B)

I be rollin' yo!!

Actually I haven't had to do the prone hangs the last 4 visits cuz I've been at at least 0 or -1 degrees hyperextension.......That is my incentive to do my work at home cuz I DON'T want to have to restart doing them....

I kept band-aids on my incisions until they completely closed up & the scabs came off......Plus I wiped my knee off with alcohol while at PT and still do.....I'm weird about stuff like that.....

I'm allowed to walk around, etc....but due to the meniscus damage can't do leg work, elliptical, treadmill, etc.....Hoping that will change when I see my Dr. again 5/22.......


37 days post-op:

Yesterday at PT after exercises & manipulation got 139 degrees extension and -2 degrees hyperextension.....They increased the reps on my exercises but kept the weights the same - tomorrow they may lower the reps & up the weight used....

[StokeSmack]

That extension sounds good. I've been stuck at 0 for that last couple of weeks (now 32 days post-op). Flex is 145, could've done more but the PT stopped me. Did you put weight on your knees in order to increase your extension?

One thing I didn't consider was after a couple of weeks I was able to quit the pain meds. But then when the PT ramped up, I sure wish I had some....

But it sure is great to be off crutches!

[jenscats5]

That extension sounds good. I've been stuck at 0 for that last couple of weeks (now 32 days post-op). Flex is 145, could've done more but the PT stopped me. Did you put weight on your knees in order to increase your extension?

One thing I didn't consider was after a couple of weeks I was able to quit the pain meds. But then when the PT ramped up, I sure wish I had some....

But it sure is great to be off crutches!

Well I didn't take all my pain meds post-surgery, cuz I wasn't in that much pain - so I still have a whole bottle left for those bad days.....

I haven't really tried to kneel down, no until the past couple of days.....I wasn't told not to, tried it & it didn't hurt....feels weird tho, cuz the whole front of my knee is numb....

Had a good amount of pain this past weekend due to having to haul the rest of my stuff out of my ski house + LOTS of rain.....the pain meds really came in handy!!