Robs ACL Allograft Diary - MCL & Lateral Meniscus Trim Also

[cassieoz]

Hi Rob,

Glad your feeling much better from your cold. And i know how it feels to be really busy...... Although mine was by choice and yours is studying!

When i read your post and you said you did something stupid i was expecting something went down with your knee but reading on it turns out you did really well and thats wicked. I was guessing it was not too stupid but when your PT says it needs to be 75% before a more aggressive motions well i thought it must be for a reason.

I was surprised to read you were at 58% i was thinking it would be around 70 or more the way you sound in your posts. Was this a surprise to you? Also how did he check the strength?

Well done though and im sure you will really excel after completely getting rid of the cold and start jogging next week. I was told i could start jogging in a couple of weeks too but i don't think i am ready for it. Not because my knee won't handle it, i just want to work on strength a little more and not rush into running. I don't enjoy it anyway.

Does your knee still feel loose when you walk or do various things? Mine does when it swells, although it is not swollen at the moment and im happy about that! Does your knee hurt at any exercise at all......including leg presses at a large weight or single squats? I found the stepping machine aggravated mine and single squats hurt a little.

In the last couple of weeks i really do understand that my knee won't be ready for TDK for a while. My progress at the start went really quickly and recovered so well but getting strength back to where i was is defiantly harder and will take at least 3 or 4 months for me and this is fine. I was offered steroids from a personal trainer who was a client of mine at work, this would be great to help me build muscle but i know its the wrong way and i will not gain anything more from this than becoming a man    Anyway i don't want to go back too soon and if i was to build up fake muscle (because potentially that is what it would be) i would think im ready when clearly and safety im not!

Glad i have talked myself out of that one, not that i considered it really.......On a whole i don't think aboput my knee until im at the PT class or at the gym. How about you are you feeling anything in your knee?

Anyway look forward to hear from you!!

Cassie x

 

[Rob_W]

Hi Cassie!

I wasn't too surprised at the 58% because I have heard it can take up to 1 year to regain your strength in the operated leg and I am still so early on in this process. Keep in mind I am also training my non-operated leg so they are both strengthening at the same time. My PT seemed happy with where I am and my knee feels great so I am not concerned. He tested it by just having me do the leg press and see what my maximum was for a set of 10 on my good leg, and then the same on the injured leg.

I just bought a treadmill today and it is being delivered on Friday so I will officially start jogging in a few days. I've jogged around a little bit here and there just to see how it feels but nothing prolonged yet (it has felt fine to do a few short jogs when going from my car to a store and stuff like that).

I feel no looseness at all in my knee, it feels just like my good knee. It doesn't seem to swell up either (I haven't iced in at least 1 month - maybe longer) but we'll see how jogging holds up (I'm ready to start icing again if needed). I think the plyo exercises have really been helping to get my knee ready for the impact of jogging. I still get pain when I do plenty of exercises (leg press, squatting, step downs from certain heights - although it is always the type of pain I can safely work through).

The toughest part for me now is my knee feels ready to do just about anything, but I know I have to resist and just keep working the PT program.

I'm glad to hear you turned the steroids down - I can't really imagine anything good coming of that (if it were prescribed by your OS that might be one thing) - I don't think the goal is to rush to get strength back so I think you are being smart. Sounds like things are going as they should for you!

Thanks for checking in,
Rob

[Rob_W]

Week 16

10/31/07 - 11/6/07 - Through Day 112

Started the past week off with a good session at PT (meaning a tough one). I was told that next week we would do another strength test to see how I am coming along and also at this point I will drop from a weekly visit down to twice per month.

Halloween was this week so did plenty of walking when I took my girls trick or treating (and stumbled a few times in the dark walking over uneven pavement where some roots had started to grow through on one street) - no pain and knee seemed to handle everything great.

I've been starting to incorporate some more of the solo ground movements from BJJ into my training now that I am feeling much more comfortable down on the floor on my knees. When I kneel there is still some pain and a sensation of numbness in the area touching the floor - like after you have nova cane and can't feel much. I've also noticed that I can finally go from the floor to standing up the way I used to do it and not have to modify it - the same for sitting down, I can drop down into a full squat and then just place my palms on the floor and go right to a kneeling position. I am so close to being able to touch my heel to my butt although not quite there yet (maybe a quarter of an inch or less).

In my home gym I have finally started to add weight to the squat machine I use (not much, but it's more than just doing my body weight plus the part that supports the weight which is probably 45 pounds or so - but now I am putting some plates on too). I feel very comfortable squatting down to where my thighs are parallel to the ground (the machine forces you to sit back and do a perfect squat).

This week I also purchased a treadmill so have started to add that to my program (I use the treadmill about 3 times per week, bike once per week and use my rower once per week - roughly). Jogging has felt really good - I have brought the speed up to 5.5mph but don't want to push it. I am alternating between quick jogs, fast walks, walking backwards and shuffling sideways while on it (all in one session). The jogging is definitely awakening some feelings (slight pain) in my knee and I think that is probably a good thing - starting to work some stuff that hasn't been worked (it never feels like a sharp pain or something to be concerned about).

That's it for this past week - my cold is basically gone so it has been nice to resume my cardio training again (now my kids are sick with what I had - fun stuff!!).

[Rob_W]

Week 16: - 2nd Update

Went to PT today and we tested my strength again using the leg press working for the highest amount of weight I can do 10 reps at with each leg. I hit the 75% mark with my injured leg today compared to my good leg (I pushed as hard as I could today - last time I did it I pushed hard, but I know I held back a bit).

At this point I am cleared to start on the 6 month Phase of my PT - the only real difference that I see is that I can start to work up to full speed running forwards and backwards (first 1/4 speed, then 1/2 speed, then 3/4 speed and then full speed if all feels good). Once I get there I can continue to the 9 month Phase (which is basically to work on cutting and pivoting motions and a return to partial or full sports).

I should point out that the protocol from my OS says that I only need the operative leg to be at 70% of the good legs strength before progression to the 6 month phase (and a few other things like Full Pain-Free ROM, No evidence of patellofemoral joint irritation...) - My PT on the other hand wanted me to hit 75% so we used his to be more conservative (about the only area his is more conservative than my OS).

My PT told me last week he was dropping me from once a week to twice a week but he said after seeing my leg today we can just drop to once per month.

Getting there!

[JamesOR]

Sounds great.  I'm a soccer player and one thing I learned after my first acl recon in 2004 is the need for deceleration work in rehab.  It's easy to burst into a sprint but slowing down can be troublesome.  My pt had me doing one legged jumps.  Jump with the good leg and land using the repaired knee leg and try to hold it for a few of seconds without any wobbles.  This helps quite a bit.  Plus doing quick declerating at the end of a sprint.

[Rob_W]

James - We are stressing that also in my PT (especially on the jumping exercises) - My lack of any deceleration when I landed from a running jump is basically what did all the damage to begin with!! 

[Rob_W]

Week 17

11/7/07 - 11/13/07 - Through Day 119

Not much of an update since I did a mid-week update last week when I did my strength test and found out my operative leg is 75% of the strength of my good leg. I was also told that I could drop the PT sessions down to once a month at this point.

The days following my strength test were not fun because every muscle in my body from my waist down was shot from the tests we did and I also pulled some muscles in my lower back too! I took about 3 days off after that before I was ready to start my exercises again.

Overall I am feeling great and at this point I am waiting to meet with my OS in a few weeks and I might be getting the OK to start some light boxing again at that point (as I mentioned in a previous update I played around doing some light martial arts workouts and everything felt great but still want to wait until my OS assures me I am safe to start some light training again).

[cassieoz]

Hi Rob,


Thats great im happy for you. It sounds as though your ahead of schedule and your lucky to return to what you love sooner.......I was hoping to be just like you at this stage but unfortunately my PT said i cant do any kicking until the 6 months mark and this mean forms as well. Said its their protocol on TKD as its very demanding on the knees even, though im doing well. Looks like my training is a long way away yet.

Glad your feeling stronger and it's good to read about your successful knee, keep it up!!!

Cassie x

[Rob_W]

Week 18

11/14/07 - 11/20/07 - Through Day 126

The past week was fairly uneventful although I slacked a little on my required workouts, but still did quite a bit of exercising overall.

I did my PT exercises only twice last week (I am supposed to do 5 sessions per week), and my cardio exercises (bike, treadmill, rowing) only twice also (I am supposed to do 4 sessions per week). I did do some extra gym workouts (entire body) and I decided that since it has been a month since I did some martial arts training that I would do a few light sessions so did some very light boxing and some very light grappling where I just worked from my back (felt great doing both). I still have not been given the OK from my OS (although my PT thinks as long as I am smart about it and go light it should not be a problem).

My knee is still feeling great but I need to step up my PT again since I slacked last week - don't want to get careless and gradually lose the habit of doing everything I should and start training to soon and screw the whole process up.

[Rob_W]

Week 19

11/21/07 - 11/27/07 - Through Day 133

This was another uneventful week. I pushed myself pretty hard on my PT exercises, cardio and gym workouts - my entire body is sore right now 

I am finding jogging to be tougher than I thought it would be - I jog on my treadmill a few times a week but I usually keep the actual jogging to about 5 or 6 minutes (and spread out by doing 2 minutes at a time). I should probably push more on this but once I feel myself starting to do a bit of a limp while I jog (not really a limp but the stride just doesn't feel right) I start to back off. I have been keeping the speed to 5.5mph or slower (I used to run as high as 10mph when using a treadmill so have a ways to go).

Next Monday I go and see my OS again.

I feel great and my knee does too.

[Rob_W]

Week 20 (I am posting 1 day early):

11/28/07 - 12/04/07 - Through Day 140

Overall this was a good week with 1 little scare.

I did all my usual exercises but had to take an extra day off due to some seminars I had to go to.

I also mowed my lawn for the first time in over 6 months. We were expecting snow and we had a ton of leaves in our yard. The landscape company that was doing are yard while I was injured wanted $200 to blow the leaves and do the final cut. I have one of those large 48 inch wide commercial grade walk behind lawn mowers and I decided to give it a shot (it cuts the grass and picks up all the leaves). I checked with my PT because this thing is not like using a small push mower - he said I should have no problems. It took me just over an hour and was a great workout (my entire body was sore for a couple of days after this but my knee felt great).

I had my scare that same evening as mowing the lawn. I was changing a light and I was up about 2 to 2.5 feet off the floor. When I was done I jumped down without even thinking. I landed on just my injured leg and felt a slight pop. The knee then felt funny the next 2 days (although it still felt strong and stable). Since I had my OS visit coming up in a few days I decided not to worry.

Went to my OS today. He said the graft felt very strong and the leg seems strong too. I brought my report from the PT showing that my injured leg was at 75% the strength of my good leg (about 2 to 3 weeks ago) and he told me he still wants me to hit the strength training very hard for the next 6 to 8 weeks and he also told me at this point I can basically do anything I want!! I can start all the martial arts training I was doing before but just not at the same level. I have to play it smart and just go easy and really listen to my knee 

That's it for this week.

[cassieoz]

Wow Rob was exciting news........im really happy for you and given the all clear must feel great!!

Gosh i was surprised at the pop and gasped when i read it but glad its all ok. Ha ha i can imagine you forgetting because i do the same up and down stairs. I have nearly fallen off curbs and tripped on the pavement because it rains all the time here in London but my knee is as stable as anything now.

I also went to see my OS today who gave me the all clear for open chain movements which includes Pomsey yippee...... but of course no kicking training but thats fine with me! Im going to my first training either wed or fri to check my patterns. Anyway i will update my diary tomorrow. This one was a quick hello to you....

Gosh its nearly all over for you.......but what a ride huh?

Cassie x

[Rob_W]

Cassie - Glad to hear you are doing well today!

[Rob_W]

Week 21:

12/5/2007 - 12/11/07, Through Day 147

This week was a good week for working out - I managed to do all the workouts I wanted to do and pushed them pretty hard. I took 2 full days off like I am supposed to.

I went to PT this week (it's been over a month) and that went well. We did leg presses, some step work and quite a few plyo exercises. My PT seemed happy with my progress since he saw me in November.

We checked my ROM and it is officially the same in both legs - and I can finally touch my heel to my butt!!! 

We also talked about my martial arts workouts - I told him that even though I got the OK from my OS that I was still taking it slow and wanted to gradually increase the level of workouts over the next 6 months or so. He agreed and said even though technically I can do just about anything, I still need to work my knee hard. He suggested that I keep pushing the PT hard until I am at 6 months and then I can start to get a little more aggresive with my training (he said 6 months is usually when you can start to work more pivoting motions - he said day to day stuff is not a problem, but sports related pivots should be around 6 months).

We also talked about my jogging. I told him I had not been pushing to hard on the jogging (just a few minutes at a time each cardio session) because once I start to get some pain and start to do a slight limp/jog I usually back down - I wanted to speak with him first before I pushed through the pain. He told me at this point push through the pain and see how quickly I can get to 15 minutes continuous jogging to start (he also said be smart and pay attention to how the knee feels but there is no real reason why I shouldn't be doing at least 15 minutes straight at this point - even if it hurts). So that's my next goal - quickly get to 15 minutes straight jogging (pain or no pain).

My lunges were causing me some trouble since I have been doing them - only when my injured knee is back. I had been waiting to speak with him at this visit about it but over just the past few weeks that motion has really gotten stronger. He added jumping lunges (it's detailed out in my exercise journal) during this PT session so I think I am doing well in this area now.

Since my visit with the OS last week and given the OK to start light training again I have done one light workout - I did some clinch work (think standup wrestling) and my knee felt great. I didn't push hard and only worked for about 15 to 20 minutes - no point rushing things.

That's about it - I am feeling great and my knee feels strong.

[Rob_W]

Week 22:

12/12/07 - 12/18/07, Through Day 154

This week I didn't do as much formal PT exercise as I should have because we got quite a bit of snow so I did alot of snow blowing and some shoveling which is quite a bit of work.

I started the week with a really good treadmill workout. Now that my PT gave me the OK to push through pain on the treadmill I did my first 15 minute jog today (some jogging and some running - I went up to 7 MPH). Surprisingly (to me at least) there was no pain at all - it felt great. I will gradually start working up to 30 minutes.

The next day I did some snow blowing and of course slipped and fell on a patch of black ice (I wasn't paying attention like I should have been and it was dark out). I felt some pain in my knee (the exact same pain I feel when I am working step downs) but I could tell no damage was done so finished what I was doing. I have had no pain since so feel pretty lucky - I didn't twist the knee when I fell so that helped. I did some more snow blowing this day and then again two days later, took my time and paid attention, and had no more falls.

I've started to do more core body workouts rather than weight lifting workouts now that I can move around more freely (I do alot of physio ball exercises and yoga like movements). It feels really good to start these again - my lower back had been bothering me but I can already feel that pain diminishing.

I did one light grappling (BJJ) workout this week and again my knee felt great - I only grappled for about 10 to 15 minutes because I feel I am still testing out what I can and can't do (I'm also mentally trying to do less until I hit the 6 month mark next month).

I hit the 5 month post-op mark this week - I can't believe how fast it seems to have got here (although I can still remember how slowly things seemed to go in the 1st 2 months)

That's it for this week!