Yet another ACL thread

**lucubrator** · 10-08-2006, 08:03 PM

I guess I should have started this from the beginning instead of thread-jacking.

In September '05 I was sprinting down the sideline while playing soccer, stepped in a hole or something odd, hyper-extended and flipped over my knee. I heard a pop, but thought nothing of it. I dragged myself off the field, but having never really been injured before, iced it, and waited five weeks for the swelling went down.

After the swelling went down, I played soccer, and while trying to twist on the knee, fell over and it swelled up. I again waited 5 weeks, and then it was about time to hit the white stuff.

I skied mammoth through march without any issue, and while maybe I'm not as core as a lot of you, I was still hucking decent stuff, and hiking for powder in some places.

In march, I thought that since I'd done so well skiing that I could play soccer again, and hurt my knee in the first five minutes again. This time I called an orthopaedist to look at my knee.

I got an appointment 2 or 3 weeks later, and he lifted my lower leg and told me my ACL was torn. When he walked out I almost cried. He scheduled an MRI for the next week, and after that confirmed the complete disruption, he offered to operate. I asked if 2 weeks would be enough rehab time for an upcoming trip to Europe. He thought that three would be enough, but on my schedule I should wait until I came back. I was silly, and thought that I could just schedule when I got back, so I didn't before leaving.

I spent 10 weeks going through 15 European countries, climbing mountains, crossing major cities on foot, swimming in various seas, and didn't have one single issue. When I got back on sept 7, I called, and they said that the soonest I could get was October 2.

I went into surgery with a rough idea of what was going to happen, and they shaved my knee, laid me out, injected something to make me relax. Two hours later I woke up in recovery with a polarcare, donjoy and little bottle of local anaesthetic.

Day 1 was pretty easy, I didn't feel much of the pain.
Around 2 this afternoon the CPM machine was delivered - by the president of the company. The only incident I had was that I took an anti-nausea pill a little bit too late, and ended up taking another. I have percocet, and I've only taken two today. They also have a small line of Marcaine going directly into my knee, so that's probably why I don't have much pain.

I know it'll come, though. I'm looking forward to showering again.

Day 2: I went to class at 8am and was pretty okay with the whole thing.
I took one percocet around 8, and then felt fine for a long time, until everything started wearing off. Now.. it's fun. I've learned that one seven pound bag of ice is just the right amount to fill the PolarCare cooler. I went to back to the doc today because I had a pretty severe leak, or at least I thought it was severe. The bandage was red and wet from about mid thing to 6" below my knee, and the swatch was about 6" wide. He said not to worry about it, pointed out that it was following the catheter out my leg, and changed the dressing. He told me to take a aspirin every day starting yesterday, so that's the reason it leaked. I guess it's better to have a little leak than to have a blood clot, or to have to drain all the liquid from my lymph nodes. I've been sleeping with the polarcare and cpm running all night, and I think it's helping. I get maybe 15 hours/day with the cpm this way.

Day 3:
Went to therapy today. When I got there I could bend 0-65, despite the CPM doing 0-70. After 10 minutes massage and bending, she got me to 95, and was really impressed. It turns out that my PT assisted on the surgery, and said that the only issue they found was the torn ACL, and that there were no other injuries. I had her take the catheter out, and she said that it was good that it was leaking. More effusion means less fluid that has to be worked out via the lymph system. No real bruising yet, but I tend not to. Here's a picture from today, comparing swelling etc.

Day 5: I went to PT again today, and aside from the normal stretching and stuff, they did something called "Russian." A machine sent electricity through my quad, and I had to contract when it did. I'm not sure what the purpose is, other than to strengthen the muscle, but it's kinda neat to watch the muscle twitch. I have PT 3/wk for 4 weeks, and then I guess I'm good to go? I guess I'll find out in a month. Tonight I had the polarcare on a little too tight, but it looks like it squeezed some of the liquid out. It looks kinda cool, anyway.

Day 7: I've just been doing the exercises they gave me, along with the percocet for a little pain, though nothing too drastic. I felt a little of that detachment that I've heard is common for codones, and it was kinda fun, but not as much fun and drinking. I've been slowly upping the cpm range, and just pushed it to 0-105! This thing maxes out at 110, so in another few days maybe I'll be on a stationary bike. Here's hoping, anyway!

**flatlander420** · 10-09-2006, 09:00 PM

Looks pretty juicy! Your graft incision is more central than mine, mine is more to the inside of the knee at an angle.Good luck with the PT. I am really enjoying it and look forward to going in and using all the cool stuff they have. I just hit 7 weeks and my knee starting to feel somewhat normal again,finally!

**lucubrator** · 10-11-2006, 10:52 PM

It was pretty yellow looking yesterday, but the doc assured me that it's normal, and it'll spread down my leg. He gave me another scrip for percocet, and one for volteran to reduce swelling. Took my stitches out today, and put steristrips on. At PT I did some minor wall slides, and it felt good to be squatting again; feels like I'm headed towards skiing. I've also been cleared to walk without crutches, and to do light cycling, so I'll be setting up my trainer pretty soon. There's a bit of resistance at the top of the stroke, but it doesn't hurt, so I'll keep doing it.

At my last PT, the PT asked why my knee was so warm, to which I had no answer. The surgeon said today that it's normal, and it's hot because of all the blood flowing around inside? Seems to me that the PT should know why the knee is so warm. Is this what's known as the "burning shin," or is that only with patellar transplants?

I wonder how common this is. I have a numb spot down and to the outside of my knee cap. My surgeon has the same numb spot, and a friend of mine who also tore her acl but did a patellar replacement has the same one. She had her surgery 10 or so years ago, so I'm wondering if feeling ever comes back.

The first picture I took was inside and looked really yellow, so I took one outside.

**flatlander420** · 10-12-2006, 12:28 AM

I think you would know if it was "shin of fire". It hurts really bad when you stand up. Wall slides were key for me with getting rom back. Keep doing those,they work very well.The numbness is where they cut a nerve going for the graft. My doc said 50/50 chance of sensation coming back. At 7 1/2 weeks now, it has come back 90% so that's good! It is amazing after about 2 weeks of misery the healing speeds up rapidly and thing s become more normal. I go for my 8 week PO appointment next Tuesday.

**musicman** · 10-12-2006, 05:21 AM

Wow, you went to class on Day 2? I waited until the end of the semester to have my surgery. Good thing too, I could barely stand and was on crutches for a good two weeks. I must be more of a wuss.

Looks like you're progressing well. Keep it up. And as Flatlander said, the numb spot is normal. Basically the whole outside side of my knee was affected. Had my surgery on May 5th and feeling is slowly returning, even though I still have a nice sized area with virtually no feeling at all.

**LBSki** · 10-12-2006, 09:11 AM

Just do what the PT says. Rehab has its plateaus, and a valley or two. Pay attention to what your knee is telling you and don't overwork it. I had my ACL and meniscus done on June 1st and I'm looking forward to getting back to it in six to eight weeks. Good luck on the rehab!

**lucubrator** · 10-12-2006, 06:45 PM

Late last night I rode my bike in the granny gear, with the trainer on the easiest setting on the trainer for 25 minutes, and felt pretty good.
I had another PT session today, apparently I have quad and hammy strenght anomalous for someone who's less than two weeks post op, but I still have more swelling than I should. He also said that riding my bike was good, and that I could even lower my seat some to work the range of motion better.

I guess the big thing for now is to just lay down and try to get the liquid out of my knee, along with a bit more massage.

Originally Posted by musicman

Good thing too, I could barely stand and was on crutches for a good two weeks.

Day 3 was actually worse than 2, because the local started wearing off. I didn't have any pain whatsoever the day of and day after surgery. Even so, they have to set quad puller pretty high for me to feel it. There was a woman next to me doing the same electronic stuff, and her experience was completely different from mine. She felt like someone was massaging her muscles, and I just watch mine twitch.

**flatlander420** · 10-12-2006, 07:58 PM

Did you try eating pineapple for the swelling?

**lucubrator** · 10-12-2006, 10:50 PM

I did a couple of days ago, but didn't notice any improvement. I guess I can try another two or three, pineapple's tasty enough.

**flatlander420** · 10-13-2006, 12:50 AM

Originally Posted by lucubrator

I did a couple of days ago, but didn't notice any improvement. I guess I can try another two or three, pineapple's tasty enough.

I ate a whole pineapple a day for the first few days! When I got the dressing changed the nurse said "what ever you are doing keep doing it". I copied this from whfoods.com

Health Benefits

A Digestive Aid and A Natural Anti-Inflammatory

Fresh pineapple is rich in bromelain, a group of sulfur-containing proteolytic (protein-digesting) enzymes that not only aid digestion, but can effectively reduce inflammation and swelling, and has even been used experimentally as an anti-cancer agent. A variety of inflammatory agents are inhibited by the action of bromelain. In clinical human trials, bromelain has demonstrated signifcant anti-inflammatory effects, reducing swelling in inflammatory conditions such as acute sinusitis, sore throat, arthritis and gout, and speeding recovery from injuries and surgery. To maximize bromelain's anti-inflammatory effects, pineapple should be eaten alone between meals or its enzymes will be used up digesting food.

**lucubrator** · 10-13-2006, 01:31 AM

Good to know. I mentioned that I'd been eating pineapple for the inflammation to the PT, and she didn't even raise an eyebrow. I was told that the best thing for my knee is to get the swelling down. If pineapple will do that, I'm all for it.

**0BernhardFranz** · 10-15-2006, 06:30 AM

Originally Posted by flatlander420

I ate a whole pineapple a day for the first few days! When I got the dressing changed the nurse said "what ever you are doing keep doing it". I copied this from whfoods.com

Health Benefits

A Digestive Aid and A Natural Anti-Inflammatory

Fresh pineapple is rich in bromelain, a group of sulfur-containing proteolytic (protein-digesting) enzymes that not only aid digestion, but can effectively reduce inflammation and swelling, and has even been used experimentally as an anti-cancer agent. A variety of inflammatory agents are inhibited by the action of bromelain. In clinical human trials, bromelain has demonstrated signifcant anti-inflammatory effects, reducing swelling in inflammatory conditions such as acute sinusitis, sore throat, arthritis and gout, and speeding recovery from injuries and surgery. To maximize bromelain's anti-inflammatory effects, pineapple should be eaten alone between meals or its enzymes will be used up digesting food.

good tip to eat it between meals http://liwa.funtigo.com lists some in science or so pineapple isn´t the only bromelain source or antiinflammatory agent eating the stem is enough it is ONLY in the stem eat some stems give pineapple to family stem is the central round 5 cm fruit mass pillar in the pinapple

**lucubrator** · 10-18-2006, 11:19 PM

So I'm apparently progressing faster than most patients, and chalking that up to watermellon and 2 gallons of milk per week. The hormones must be doing me some good.

I'm up to -5 degrees extension and 125 degrees flexion. I rode my bike for 25 minutes back on day 9, until I remembered that little nerve that runs under your ass. Very scary experience.

Yesterday I got 45 minutes in, and I'm concentrating on the pull stroke more than the push to work the hamstring as much as possible without it hurting. The PT suggested that I use the "straps," and then I told them that I was using clipless pedals. He was sort of concerned about injury if I twisted my knee wrong, but I think I have that figured out.

I got a whole slew of new exercises to do with a swiss ball, like wall squats, hamgstring curls, scissors and pelvic thrusts.

**lucubrator** · 10-19-2006, 07:34 PM

Good news today. I was told that with the rate I'm progressing, I might be able to ski in early January!!

**lucubrator** · 10-27-2006, 12:09 AM

Update:
Flexion to 140 by one measurement, 137 on another. The other leg goes to ~145.

I've been doing bridges on a ball, lifting my butt and pulling my legs in, wall squats with ball, and scissors. Today the PT had me do lunges straight on, and slowly progressing to the side, on one of those half-swissball looking things. Then he wanted me to stand on the thing and catch a ball, but I my knee started vibrating, so I just tried standing on it for a while longer. That was a little disappointing, but now I have another goal to go for.

I've been riding my bike more, 1 hour every couple days. I think it's increasing muscle mass, but from the way I strap down the brace smaller and smaller, it seems like I'm still losing it.

**lucubrator** · 10-29-2006, 02:23 AM

So now I have a question. When I wake up in the morning, I do a reflexive full body stretch, and when I do I guess I contract my hamstring pretty hard, because the whole tendon feels like it's on fire.

Is it better to ice or not to ice this? It seems to me like icing would cause vasoconstriction and decrease oxygen/nutrients and lengthen healing time. Is that right, or is there something better for me to do?

**Spats** · 10-29-2006, 09:11 PM

Originally Posted by lucubrator

So now I have a question. When I wake up in the morning, I do a reflexive full body stretch, and when I do I guess I contract my hamstring pretty hard, because the whole tendon feels like it's on fire.

Is it better to ice or not to ice this? It seems to me like icing would cause vasoconstriction and decrease oxygen/nutrients and lengthen healing time. Is that right, or is there something better for me to do?

You're right -- only ice if it's swelling dangerously. The pain is just your body saying "Please don't do that."

**lucubrator** · 12-18-2006, 11:23 PM

Dear Diary,
Swelling's all gone now, and I've ridden ~200mi in the last few weeks, but the doc says I still can't ski until Feb or so. No real loss I guess, given that Mammoth has what, 2' of snow? Some sweet groomer action would have been nice though.

In the meantime, I'm now allowed to run,skate, and longboard once this storm passes, so that's a little more on the route to recovery.

Unfortunately, I've also whipped up a bit of tendonitis in the other knee, but percocet took care of that the one night it really hurt.

**flatlander420** · 12-19-2006, 08:10 PM

Originally Posted by lucubrator

Dear Diary,
Swelling's all gone now, and I've ridden ~200mi in the last few weeks, but the doc says I still can't ski until Feb or so. No real loss I guess, given that Mammoth has what, 2' of snow? Some sweet groomer action would have been nice though.

In the meantime, I'm now allowed to run,skate, and longboard once this storm passes, so that's a little more on the route to recovery.

Unfortunately, I've also whipped up a bit of tendonitis in the other knee, but percocet took care of that the one night it really hurt.

I am in pretty much the same boat. I think I am a few weeks ahead of you? Anyways I went to see my Doc on Monday, 4 month P.O, and she said that everything has healed nicely but my leg strength still needs work. She said to train hard for one more month and then give it a go. I actually agree with her and I thought that getting out the tele gear and doing some x country on mellow terrain would be a good way to at least get back out there, build some strength and avoid the chance of someone crashing into me at a resort. She concured and that is what I am going to do.There is a place in Running Springs called Rim Nordic that I want to try.TR to come!

,

**lucubrator** · 12-20-2006, 11:49 AM

Looks like you're about a month ahead of me, actually. My doc says that in Feb I should be able to start up again, but he'd prefer that I start out on snowboard.

I asked about doing some xc stuff, but he said that he'd be worried about me falling or something like that. It's almost cold enough here to pretend that I'm doing xc if I just bring some sticks with me.

There was a 4 page fold out thing in the Sept. Outside magazine on "Building Bombproof Knees." Worth checking out.

Heh, Nordic Rim is open with 9" of snow... awesome.

Edit: On the upside, I'm taking the LSAT on Feb 10, so Feb 15 I should be good to go, and mammoth might have some snow.

**flatlander420** · 12-20-2006, 09:35 PM

Its pretty interesting how you did you acl, due to the fact that I too also play soccer.The previous summer (august) I was playing in a tournament in Santa Barbara and had the ball at the edge of the 18 with my back to goal about ready to turn and whip in a cross and this A hole defender ran up a just whacked me in the knee. Zero attempt to play the ball, he just wanted to kick me. I crawled of the pitch in agony. There was no "pop" but it really hurt for about 10 minutes. I shook it off and came back in and eventually played 4 more games that weekend.We finished third
It swelled up bad so I took two weeks off and everyting seemed to be back to normal. Fast forward to April, Mt Baldy, soft rotten snow, buried tip,twisting fall, no toe release,"pop", I'm done. I think the kick I got might have been a pre cursor to the whole thing.