ACL repair yesterday- PT questions

**Stymie** · 05-30-2007, 07:36 PM

Had an ACL repair yesterday- home now... in some discomfort but I'll survive. Anyway, it was a clean tear- no other knee damage- patella tendon graft. I'm 39.

My question to you guys... I had a ACL repair 16 years ago. Right after the operation they had me in a constant motion machine- with PT to start bending my knee after a day or so. Wouldn't let me leave the hospital until I could get to 90 degrees. This time... I'm in an immobilizer cast (locked straight) and the only PT I was told to do was quad sets and ankle rolls until I saw the doctor in 5 days post-op. Why the difference in PT philosophy? Has recovery theory changed or is it due to seeing different docs. 16 years ago I had Russell Warren at the hospital for special surgery do it (he's the NY giants team doc)- deals with pro atheletes who need to get back fast. Yesteday, had Frank Maletz in Connecticut do it... perhaps his patient population is a bit skewed towards older folk.

What is the standard PT for a few days out? Should I unlock the brace and work on knee bending and other exercises besides quad sets and ankly rolls.

I'm gettting really bored sitting on my damn couch.

**Fuzz** · 05-30-2007, 08:22 PM

That's a little different from my experience. I also had just an ACL reconstruction (hamstring autograft) in March -- no other damange/repair). Used the CPM machine same day, getting up to 95 degrees by Day 3. Took the brace off on Day 2 of my own accord -- felt much better without it (felt great to bend the knee) -- consulted the doc over the phone later in the day and he was okay with removing it. Also did (as much as I could) leg raises, heel slides, ankle rolls, etc. Had my first post-op appointment on Day 4. Started PT on Day 5, right after the appointment.

**hemas** · 05-31-2007, 02:43 AM

Well, I've already posted this a few times... But I didn't start PT until week 3 post-op. But I did mangle and toar my meniscus, so my limitations were quite a bit more strict than when you just have and ACL-reconstruction (ie. walking on the operation day, where as I had to use crutches for 4 weeks).

But to be honest, on the 1st week I wouldn't even dream of doing anything as the my knee was sore as hell (lots and lots of fluid build-up). but i could foresee myself improving on the ROM from the 2 week onwards as well as doing excercises to upkeep the muscles (like my quad, which lost about 4 inces from the circumfence).

Anyway, I'd call your doc and talk about it instead of second guessing and trusting interweb dweeps. Oh, and talk to yer PT as well and see what he thinks.

**Stymie** · 05-31-2007, 04:43 AM

thanks guys... I will do as the doctor ordered. It's frankly tough enough getting off the couch/bed without tons of pain- let alone beginning rehab. I know what's ahead... I was only curious as to the state of the art thinking.

**hemas** · 05-31-2007, 04:57 AM

Originally Posted by Stymie

I know what's ahead... I was only curious as to the state of the art thinking.

Most likely it depends on the doc and yer PT...

My doc and PT are both used at working with world class athletes, so my PT schedule has been quite fast and relentless (though I'm far from a world class athlete)...

If I'd be you, it try to do as much as possible isometric quad excercises so it won't shrink that much and the road to recovery will be shorter or at least easier.

But after you're starting to feel good and think about doing some actual PT (like trying to get yer ROM back), call yer doc & PT and see what they think...

More often than not, docs seem to give pretty conservative estimates, but when they actually monitor your progress, they'll often change the "rules"... Depending on yer progress.

**skimasterflex** · 05-31-2007, 09:27 AM

It all depends on which method was used, how much damage, how well the surgury went, and how confident the doctor is in you and his work. With mine I was immobilized at 20 degrees for 3 days and then they slowly gave me more flexsion/extension over the next 10 days until they opened up my brace 45-180 as I recall.

I was dealing with an allograph and a miniscal cleanout. I was also on an ice machine more often than not that first two weeks. I think that for reasons of swelling reduction the postgame has slowed down significantly over the last few years. The idea being you have plenty of time to rebuild those muscles, whereas nothing good can come of it all until the swelling is down.

I was 22 for that surgury, my pt went well and I have never braced it in any way since recovery. I ski as hard as ever.

**Buzzworthy** · 05-31-2007, 03:23 PM

I am 6 weeks post ACL clean tear, Allograft (bone-patellar-bone with 9MM screws). Was in PT 2 days after surgery. In leg brace and barely moving it, but they started me asap.

6 weeks later, 2 days ago, out of leg brace now, no crutches anymore, but in my new custom Donjoy brace and walking (slight limp still).

Every doc does it different it seems.

Oh, no CPM machine for me, PT to get ROM and strenght back is my docs philosophy.

Good luck.