Robs ACL Allograft Diary - MCL & Lateral Meniscus Trim Also

[Rob_W]

Day 27 – 8/13/07:

I heard back from my PT about the little shifting feeling I was getting in my knee while walking (basically at the end of the stride when my foot would start to pop up, just before I stepped forward, I would start to feel this funny little shift in the knee as my muscles got tired from walking). He said this was normal and it was the knee cap giving me this feeling, and as my quads strengthened it would go away. He said to continue walking and working on my normal gait.

For my first set of PT exercises I took it a little easier today since my leg is feeling pretty worked – I did my regular exercises but skipped my 2 new exercises.

For my second session of PT I did 3 minutes of my rower and 5 minutes of my bike (1.4 miles). My knee felt pretty loose so I started off at 50rpms and worked up to 70 and then back down to 50 again (towards the end I got some slight pain in the knee/quads but never felt like I had any ROM pain which I had been getting in the first few minutes). I then did my regular PT but only one set each of the new exercises.

I measured my largest incision today (steri strips finally came off yesterday on this incision) and it is .5 inches long (this is the one on the medial side of the shin just under the knee – for some reason I thought it would be more like 1.5 to 2 inches long).

Ended my evening with a 10+ minute walk where I really focused on walking with a natural gait. Now that I have been told the little shifting feeling in my knee is normal and to just work through this I was finally able to really relax and walk normally (although slowly). I felt quite a few things in my quads loosen up, especially at the end of my stride when my injured leg was back and just starting to kick up (heel up off the ground and the toes just leaving the ground). By the end of 10 minutes I was walking what felt like completely normal - just slower than I usually walk. This really felt great!

[Rob_W]

Day 28 - 8/14/07:

Today marks 4 weeks and things seem to be really going great. The time has flown by - I feel like just last week I had the surgery. My life is getting back to normal very quickly since at this point I am walking, driving, going to work every day, coaching martial arts,.... I have plenty of more work to do but am looking forward to it!

I went to PT this morning and got 1 new exercise, got rid of one exercise and got a clarification on 1 exercise:

New Exercise: Standing calf raises – I did 2 sets to failure. This exercise is to replace the seated calf extension with the band that I have been doing (it was getting way to easy).

I also got a clarification on my terminal knee extension exercise – I was told to make sure I keep 95% of my weight on my good leg (I was doing it 50/50 and it was somewhat painful – this new way is not painful).

I did the bike at PT today and it gets easier each time.

Lastly we measured my flexion at 95 degrees. I am not pushing the flexion hard until I get to 6 weeks. I seem to be averaging about 10 degrees a week (although last week I was 92, but I have stopped really pushing it as I said until I get to the 6 weeks mark).

I did quite a bit of walking today and I worked on my gait about 50% of the time.  I got more of that shifting feeling in my knee today but worked through it (my leg was feeling pretty tired after PT today and that's when it seems to happen the most).

I also found it easier to walk up some steps today – I almost looked normal doing it too!

Did my 2nd set of PT later in the day.

[cassieoz]

Hey Rob,

Wow just read your diary but i must admit skimmed through a little as you've written so much. I agree it really helps reading up on other peoples experiences!

Your doing so well and i really hope i am just as motivated as you are? Rehab is the thing im most scared of at the moment because i know crucial it is. I want to push myself and go thru every procedure but scared i will slacken off and get lazy like i have done now not doing TKD! I was training 4 nights a week and now it 0. Been going to the gym but it's only building my quads and hamstrings up after a very noticeable decrease in size. Cardio has never been a strong point for me especially getting on a bike, but i know it will be my new best friend!

Great to see your positive 

Cassie

[Rob_W]

Thanks Cassie - I would be shocked if anyone read the whole thing!!

I bet you will do great. I was training about 5 days a week before my injury and I can tell you that you will probably be looking forward to the physio since that will be most of the physical activity you do for a while. Keep in mind that the PT will be crucial to your recovery and hopefully that will be a good motivator!

[Rob_W]

Day 29 - 8/15/07 (Wed):

Today my leg was feeling a little tired so I went lighter on both sets of PT (really light on the 2nd set at the end of the day).

Today was my day for lifting, and in addition I did 2 minutes on my rower (warm up the knee) and 8 minutes on my bike (1.7 miles).

I also walked for about 10 minutes today really focusing on my gait – Still getting that popping in the knee cap but towards the end of the walk it was almost gone (usually it increases as I get tired but not today).

[Rob_W]

Day 30 – 8/16/07 (Thu):

I went to PT today and after taking it a little easy yesterday my knee felt really good today.

We started with heat and estim, and then the bike for 8 minutes (1.51 miles) – It still takes about 2 minutes to loosen up but after that I was pain free.

Next I did the leg press but today I did it with just the injured leg (30 pounds) – He had me put my foot up a little higher than normal to shift some of the work off my quads and onto my glutes.

After this I did standing calf raises – today I did them standing right on the floor but only with my injured leg.

Next we did 3 new exercises:

Exercise #1: This was an exercise I did in pre-hab. I stand on a step (short one) and balance on my injured leg. I then slowly lower myself so my left leg (good leg) touches the floor, and then back up again to the starting position. I found I could only lower myself and inch or 2 before it started to hurt and I would come back up. He had me only do 1 set of 15.

Exercise #2: This time I put the step in front of me. Starting from the floor I would just step up onto the step and then back down again. I could do it all just using my injured leg, or I could pause on the step by putting my left leg down. I did 2 sets of 15.

Exercise #3: The last new exercise was heel walking. Basically just walk around on the heels of your feet with the toes pulled up as high as you can get them. You do this until the front of the shin is feeling a good burn.

We ended with straight leg raises. I used the ankle weight for the abduction, and no weight for the adduction. I then finished with the standard straight leg raise but this time he had me rotate my foot out a little and also hitched up the hand held electric stim devise to help really contract the muscles – he set it up so it hit the VMO (inside of the thigh) muscle more.

After PT today I am finding it much easier to walk up steps – I am no longer having to swing my leg to the side and then raise it onto the step – I just step up normally. Each day I do more and more steps and it is getting easier.

Finished the day with my home PT and did my new exercises – it felt good.

[cassieoz]

Hey Rob,

I've been reading more of your diary as i cant sleep. Im so drugged up from my op today im wide awake. Virtually no pain though only in my hamstring, actually im slightly worried about the pulling!!!

You sound like your going so well, your focused that's for sure.

Leg presses 30 pounds at 4 weeks sounds really good. I was pushing 80 kilo on my injured leg just before i went in but it's hard to imagine doing that again for a very long time........

When do you do these exercises, are you spacing them throughout the day, say every few hours?

Cassie

[Rob_W]

Cassie,

You'll be sleeping normal again before you know it - for me by 2 weeks I was starting to sleep normal again here and there and at 3 weeks I was just about back to normal sleep everyday.

I don't spread my exercises out over the day, I do one full set in the morning, and then one full set in the late afternoon. I was doing the quad sets (where you just contract your straight leg and hold for 2 seconds and then release) about once every hour or once every other hour (I would do 20 reps each time) - I was told you can't do too many of these so you could do 1,000+ reps a day if you wanted to (and I tried for at least that).

I know the feeling very well of thinking there are certain things you just can't imagine you can do and you think it's going to be months, or longer, before you can actually do them. What you will find however is one day you'll be feeling that, and 5 minutes later you'll do what you thought seemed impossible just moments before. The first time for me that really stands out was riding the stationary bike and getting the pedal to go around all the way once. I thought this was going to take me weeks of sitting on the bike and just sort of rocking the pedals forwards and backwards, and a few minutes later I was going all the way around.

You're almost through the worst of it and everything you are feeling right now will soon be a distant memory!

Rob

[cassieoz]

Hi Rob,

Thanks!

I also had to wear the same brace for my MCL over 2 months no restriction. Yesterday just before i went under they told me it was pretty good and had tightened up well. I'm no longer using the brace but cant tell as yet if my Medial side is hurting because of the op or if it is my MCL. Before my op the pain was fine but still could not bend 100% to my ankles. Could you tell the difference at first?

Cassie

[Rob_W]

Cassie,

I don't remember feeling any pain initially after surgery that made me think my MCL was still giving me trouble - just general aches and pain all over and around my knee. Now that my knee is feeling much better I would say I have no pain that is similar to the MCL pain I had pre-surgery.

Rob

[Rob_W]

Day 31 – 8/17/07 (Fri):

Not too much to mention today. I did both sets of PT today although I went light on my second set since I was going to be teaching later this afternoon and knew I would be more mobile.

I also went out this evening with some friends for dinner and drinks – this was my first time going out with friends since surgery (no crutches or brace and just made sure I stayed away from people while walking around).

Day 32 – 8/18/07 (Sat):

I worked my knee pretty good today.

In addition to my 2 sets of PT, I rode my bike for 11 minutes (3 miles – My knee felt great as soon as I started pedaling and I kept the RPM’s at 70 or higher for most of the ride) and I also did a lot of walking today (took my girls to their swim class, went grocery shopping, and also went for a few walks).

During my 2nd set of PT I was starting to get some pains in my knee doing my step-up exercises so cut those short.

During my long walk around mid-day I worked a lot on walking limp free. I was still getting some of the shifting feeling that I get in my knee and at one point I actually heard a slight ‘pop’ – this wasn’t painful and it was the first time I actually heard a sound from my knee. Immediately after the shifting stopped and I was walking much closer to normal.

By the end of the day my walking was feeling great – I was walking very close to my normal speed (which is pretty fast) and I was not getting any pain or the shifting I often feel.

[Rob_W]

Day 33 – 8/19/07 (Sun):

Today my knee felt pretty good so in addition to my 2 daily sets of PT I upped my stationary bike ride to 15 minutes, and 5 of those minutes I bumped the resistance up to level 2 (need to check with my PT and see if this OK) – I ended up riding for 4.2 miles and burned 50 calories. I also did my upper body lifting routine today.

In addition to the above I taught a 1 hour class today and ended my evening working some extra heel slides while I watched TV.

I would say at this point I walk upstairs the normal way every time – each day it feels just a little easier.

Day 34 – 8/20/07 (Mon):

Today I decided I would take things a little easier because my knee was feeling pretty beat up – I think it was the 15 minute bike ride and the extra heel slides.

I did my first PT routine the normal way (forgot to do my push-ups though) and for the 2nd set I just did one set of each exercise rather than 2 or 3 – want to rest the knee a little since I go to PT tomorrow and those are always my toughest sessions.

I took a few short walks at work today to loosen up my knee after sitting still for a while and just worked on walking without a limp – I still get that shifting feeling (knee cap not tracking properly due to weak quads) when I first start walking, especially after sitting for a while, but by the end of the walk (these are just 3 or 4 minute quick walks) the knee feels pretty good.

[Rob_W]

Day 35 – 8/21/07 (Tue):

Week #5:

I had PT today and did a little e-stim and heat to warm up the knee. I then did 8 minutes on the bike (1.65 miles) and my knee felt great right from the start. Afer this I did 2 sets of 15 of 30lbs with my injured leg on the leg press. I then did 3 sets of calf raises to failure. Next I did 2 sets of 15 on the step-ups and moved up to a regular size step. I ended the session with straight leg raises hitched up to the other e-stim machine that helps you flex even harder. I was also given the OK to start to add resistance to my biking.  I was also told I could start working on a marching type of motion where I lift my knee up in front of me as high as it will go while bending at the knee so the foot is just hanging down.

I later did my home PT routine and when doing the step-ups I got another nice ‘pop’ in my knee – no pain. I also upped my exercise to 2 sets of 15 where I stand on a step and lower and raise myself while balancing on the injured legs (I am using a step about 6 inches tall and don’t quite touch my good leg to the floor).

Overall today my leg felt great. Walking is getting better and better each day. I noticed a little shifting in thee knee cap but nothing dramatic.

Day 36 – 8/22/07 (Wed):

Today my leg was feeling a little tired so I did my regular PT session in the morning and for the afternoon I did my regular exercises but I did only one set each of the 3 different SLR’s. By the end of my second set of PT I was getting a little pain on the outside of my knee (I think this is from all the extra stretching I have been doing - it is similar feeling to the meniscus pain I got pre-surgery however?) so also cut down on my balancing exercises which seems to stress every part of the knee.

Walking felt pretty good but not as good as yesterday – I spent a lot more time sitting in my office chair today and I didn’t get up as often as I should to just move around .

I did my home lifting routine and then took it easy for the rest of the day (I’ve got PT again tomorrow so no point in overdoing it today).

[cassieoz]

Rob,

Your doing so well!!! Cant believe it your actually doing quite a lot of exercises on your knee! Must feel good to walk pain free. You seem to fit a lot in but i can imagine you really focus that time to make sure you do it all. I am going to strive to do that as well!

I have a question im going away over night, can your remember what you were like day 7 if you think i would be ok? I won't be walking around and will find ice when i can - not that im very swollen at all! I just don't know what it will be like and what my biggest danger is?

Thanks mate

Cassie x

[Rob_W]

Cassie,

I am definitely feeling really good so far.

At 7 days I was off the pain meds, showering, and just starting to feel more myself again. The biggest limiting factor was car rides - I was still laying across a back seat because I could not get into the front seat (or any seat) and sit upright. Not sure if you experience that - I think other than that I could have gone away overnight as long as once I got where I was going I could ice/elevate (and exercise) - I was still laid up on my couch 24/7 - but probably could have done more but wanted to take it very easy in the first 2 weeks.

I've been reading your posts too and all sounds like it is going great so far.

Rob