Robs ACL Allograft Diary - MCL & Lateral Meniscus Trim Also

[Rob_W]

9 Months Post-Op:

The past month was my busiest month of the year at work (over a 12 month period from March 15th till April 15th is always my busiest then things smooth out from this point until about Jan/Feb again).

I still managed to get a weekly cardio session in (I did bike and treadmill and still going up to 10mph on the treadmill and started to add a slight incline to this) – I am finding that when I am doing a fast walk I can change very easily from frontwards, to spin around and walk backward, then side shuffles and cross over steps and keep changing directions every few seconds. I was also able to get in a weekly full body weight lifting workout, 2 knee specific PT sessions, some additional weekly core body workout as well as some martial arts training (at least one quick session per week).

Now that the weather is getting nicer I have been able to get outside and do some more exercising. I have done some mountain bike riding and it’s night and day from the last time I rode my mountain bike outside (which was probably about 5 months ago). I am still just riding on the streets but I feel normal – I have no problem standing up when I ride to pedal up hills.

I’ve also been doing some running races with my girls (my oldest daughter is very fast) and I find I can run pretty fast (pretty much a full sprint) but after all the running on the treadmill I feel awkward when running fast on grass. In addition to that my girls both play soccer so I have been playing with them everyone now and then and I am doing a lot of start and stop running and quick direction changes. Nothing seems to bother my knee except where they trimmed the lateral meniscus – after heavier lifting or some of the soccer drills we have done it usually aches a little the next day.

Today I hit a pretty big milestone – I took my first Brazilian jujitsu class (grappling/wrestling) since I injured myself in May last year (11 months ago). I have done many workouts like this over the past few months but I have only worked out with certain people that I really trust and I pick what we are working on so I can stay away from anything that I think might bother my knee.

The class was a very challenging class and the hardest workout I have done in the last 11 months. My knee seems to have had no problem at all with it although the skin on both my knees feels very beat up from all the kneeling and just mashing my knees all over the floor (the rest of my body feels the same way – it will take a couple of weeks before this goes away and I get used to it again).

We’ll see how my lateral meniscus feels tomorrow but so far so good. I plan to take this class once per week and do a hard workout like this for the next month and then after I see my OS next month I will jump it up to 2 hard sessions per week if he gives me the OK.

That’s about it for now – I will definitely update again at 10 months since I have my 10 month visit with the OS next month (my guess is that will be my last visit unless I screw something up of course).

[Rob_W]

10 Months Post-OP (2 days ago):

Things are still progressing very well. I won’t say I have been doing 100% of the exercising I would like to be doing but I am getting in at least 1 cardio session per week (bike and/or treadmill), 1 full body weight training session per week, 1 to 2 knee specific knee PT sessions per week and 1 to 2 martial arts training sessions per week.

The weekly grappling class that I started last month has been going great – it does not seem to bother my knee at all. This is a really physically demanding class and puts a lot of stress on my knee (I am still being careful and let all my training partners know that I had surgery last year and am still not 100%).

I’ve started doing more outside activities with my girls – playing soccer with them (and just running around in general) and some tennis too. I do notice that after playing soccer or tennis my knee is sore for the next 2 or 3 days – I think it’s all the start and stop running and the constant cutting and direction changes. It feels fine while I am doing it and even for the rest of the day, but then the following day I notice some pain in my knee (not sharp shooting pain but a dull ache).

My lateral meniscus (where it was trimmed) had been bothering me a little after hard workouts but lately I haven’t really noticed it. I am still having a little difficulty when I kneel down and sit my butt down on my heels – I can finally do this with my body straight up and down and all my weight going straight down onto my heels but it is still uncomfortable. I have also noticed that I can finally lock my injured leg out very hard (as hard as the non-injured) and it feels just about the same (I’ve had full extension, and hyperextension, for a while now but when I would lock it out hard I could feel some slight pain).

Today I had my 10 month post-op OS visit and the doctor (not my normal surgeon) seemed very happy with where I am. He started by physically testing how solid the graft felt with 2 different tests (pushing and pulling hard on my shin a few different ways) and told me it was very strong (seemed almost surprised at how strong it was). He then checked my ROM and it was the exact same as my good leg (he did say on the flexion he had to push a little to get them the same). Lastly he had me do a one legged long jump with both legs (I had played some soccer yesterday and my knee was a little sore today so I know I held back a little) – I jumped about 6 feet with my good leg and about 5 with my injured leg (about 83% and I feel that overall between strength, flexibility, explosiveness I am probably 80% recovered). I told him about the soreness after things like soccer and he said that is normal and how when I kneel down and sit my butt down on my heels I still have a lot pressure and slight pain and he said that is normal also and as the graft stretches out over time that will become easier (he said it’s good that it is that tight at this point).

That’s it for now.

[Rob_W]

11 Months Post-Op:

I will skip this month and do a real update at 12 months - everything is going great though.

[Rob_W]

1 Year Post-OP Update:

My knee feels great. For day to day activities/living I would say I am 100% recovered. For athletic sports I would say I am 85-90% recovered. There are still things I avoid like certain take downs in martial arts where I might get thrown hard onto the ground and if I landed wrong I’m not sure my knee is ready for that yet.

Aches and pains are minimal these days – even after very hard workouts. For a long time the area where they trimmed my lateral meniscus ached after hard workouts but that no longer happens.

Strength seems on par with my uninjured leg except I can tell when I do ‘explosive’ movements (certain Plyometric exercises) my injured leg is still behind. My good leg is stronger than it was before I injured myself and my whole body in general is stronger than it was before I inured myself so that is one positive from the injury.

Flexibilty and ROM seem on par with my uninjured leg especially once the knee is really warmed up.

At 11 months my knee was feeling so much better that I really increased the intensity of my workouts and training sessions per week (I'm working out more often and harder now than I was before I injured myself). I had worked very hard up until 7 months (primarily PT workouts) and then toned it down a little for the tax season when I am at my busiest. Starting at 11 months I increased my workouts to the following:

* 3 Full body workouts per week (weights, active yoga movements and plyometrics – plyo’s only worked into 1 workout per week) followed by Interval Cardio Training (I also do a light martial arts workout on 2 of these days).
* 2 BJJ classes per week (Wrestling/Grappling) – These are very demanding classes for cardio, strength, flexibility, etc.
* 2 days of rest per week.

I had probably put on about 7 pounds over the weight I was at before I injured myself. Initially I lost weight right after the surgery, but it slowly came back, and then when I was really busy at work for a few months I put on a few extra pounds. I am currently dropping about 1 or 2 pounds per week and am just about at the weight I was before the injury although I have more muscle now so am definitely in better overall shape than I was before the injury.

I am no longer doing dedicated knee specific PT sessions since my full body workouts seem to do a good job working the knee. There are a few exercises mixed in that were part of my knee specific workouts anyhow. If at some point my knee seems to not feel as good I will add more back in.

My OS initially told me it will take between 18 to 24 months before I am back to doing everything I was doing before my injury (he was really talking about full contact martial arts). At the time I can remember thinking that that was going to seem like a lifetime. The first couple of months it did but that quickly passed – especially when you really throw yourself into your PT (I made PT my highest priority for the first 7 months). I still have a ways to go but all is good these days and I no longer have feelings of wishing I could fast-forward time to get to the point when I am living life normally again!

[lenorem9]

Hi Rob,  Thanks for the one year update.  So glad to hear you're back to 85-90% for athletics.  You sure have worked hard at it.  Your workout regimen is pretty hardcore.  Good for you.  Hope you never have to go through this again. 

[Rob_W]

Hi Rob,  Thanks for the one year update.  So glad to hear you're back to 85-90% for athletics.  You sure have worked hard at it.  Your workout regimen is pretty hardcore.  Good for you.  Hope you never have to go through this again. 

I hope I don't either!! 

[Rob_W]

1 Year & 1 Month Post-Op:

Things are still going great. It’s nice to have my main focus be on overall health and fitness and not knee rehab!!

I have been sticking with my 5 day per week workout plan that I outlined last month. I am also eating better than I was – nothing crazy but I pretty much eat 6 times per day (3 meals and 3 snacks spread out about every 3 hours). I’ve cut my portion sizes down, drink plenty of water and do my best to eat healthier foods at least 80% of the time (I don’t mind cheating here and there). I continue to drop about 1 pound per week and I weigh less than I did when I first injured myself.

I can honestly say I am in better shape now then when I was at 30 years old (I am 41 currently) but do find I have to work much harder at it.

My knee feels close to perfect 90% of the time. I did recently grapple/wrestle with a guy who outweighs me by 90 pounds (and felt as strong as the Incredible Hulk!!) and the next few days following that my knee did feel sore so will do my best to avoid some of the larger guys for a while!

[cassieoz]

Hi Rob,

I was only reading your diary yesterday getting tips on Allografts lol.

Good for you!! It was a year ago we were both typing to each other what this day would feel like hahaha!!

Thats great news and knew your knee would be a success, only wish i could say the same thing. Being told its not my fault the graft failed still makes me think i went back to sport too quick, even though they said it was loose and it would have happened anyway.

Im going to follow your exercise journal for my rehab. Im taking it easy this time and have 5 months to recover and get on a plane to Argentina for a short holiday then back to Australia.

NO Taekwondo at all this time round, and im not even going to think about it. That dream has finished for a least a year or so and i mean it.

Im happy your feeling fitter and im guessing you look great even for a 41 year old hahaha Just kidding!

Well i know i wont have you as my knee guru buddy this second time but i'll keep you informed every now and then anyway 

Thanks Cassie x

[Rob_W]

Cassie,

Make sure you keep me/everyone up to date on when you get your surgery, etc.

I can only imagine what it must feel like to have the graft fail - I think that is all of our worst fears. I agree with you that you getting back to training to quickly did not cause the graft to fail but at least identified it earlier that it did - if you had taken it light and easy you might still not know that there was a problem possibly.

This next year will go quick for you - it's only 1 year and as you know the first few months will go slow but before you know it the surgery will be over, you'll be doing re-hab and soon enough back to doing what you love. By that 5 month mark I think you will be doing great (that's when I was given the OK to start doing everything I was doing before but just at a lighter level).

I'll ignore the 41 year old comment 

Your friend,
Rob

[cassieoz]

Hi Rob,

How are you?

Well im back in business.......writing a diary and reading through all the other knee victims here on KG. I never thought i would be on here as much again but i have lots time on my hands. Im enjoying it!! Still bored but that's part of it.

All is good but im in much more pain, well only in the knee area and not hamstrings so that is great! Waking to this time was terrible i had so much Morphine and pain that i was throwing up all day!! Next time i will say yes to the nerve block lol. Actually there will be no next time!!!!

My only problem is im not doing half as much as last time because im a bit paranoid of harming the graft and especially after i read allografts need a bit more care early on.

So this is more of a mental thing for me this time........

Your Aussie pal,

Cassie x

[Rob_W]

Cassie - I am doing great - I will do a 14 month update in about 5 days.

Glad to hear you made it through the surgery and are doing good - sorry to hear that you are in more pain this time but that will pass soon enough!

Your OS should have a pretty good protocol saying what you should and should not do for the allograft (there is a link to my protocol back in the 1st or 2nd page of this thread I believe). I stuck to my protocol about 99% (I did a few extra things like push-ups early on with my PT's permission - but other than that, I just followed the protocol).

They say with the allograft that it will gradually get weaker until about 12 weeks, and then start to get stronger again - and at 12 weeks you will probably be feeling very good - so that is when you need to be real careful and not overdo it!

Good luck and keep posting.
Rob

[cassieoz]

Hey Rob,

I went over your early stage diaries and it seems im more like at your 3 week stages rather than a week. Im not pushing any of the exercises because im already 90deg and hyperextension slightly which i wont go into, so all i can do is wait til i see my PT......until then its up in the air, i have always had loads of swelling and i think i always will. Not like you i saw. My pain is minimal now so all is ok.

Like always thanks again

Cassandra x

[Rob_W]

1 Year & 2 Month Post-op Update:

Things with my knee are still going great. I think my days of drastic improvements are long behind me so it's just slow and steady improvements at this point. As I mentioned before my focus is really on overall health than it is on my knee these days. With that said I have lost 20 pounds total since I really stepped up my workouts and got my nutrition in order about 3 months ago (still losing about 1 to 2 pounds per week).

We did a training drill about a month ago in a martial arts class where you had to hop on one leg and basically drive you training partner out of a small space (10 feet by 10 feet). I did it on my good leg first for about 10 minutes and when that leg got tired I switched to the leg I had injured. This was a tough drill but found I could do it. My knee was a little sore the next day but that went away quick.

On a down note I was grappling about 3 weeks ago with a guy who outweighs me by about 60 to 70 lbs. He was incredibly strong too. At one point he pulled really hard on my head/neck and I pulled my right trapezius muscle (mid back just above right shoulder blade). I took a few days off then went back and trained again and by the end of the session I realized I should have taken more time off. I have since stopped all hard training to rest this muscle. I walk every day for 45 minutes and do a very light fully body stretching routine twice daily to work on some muscles that are out of balance (screwing up my posture) and this trapezius muscle. Things are feeling much better but I know I still need some more rest time.

[Rob_W]

1 Year & 6 Month Update:

Wow – I can’t believe a year and a ½ has already gone by.  There are days when it feels like I just recently had surgery (however these are getting few and far between) and plenty of days that I actually don’t even think about it anymore (most of the time). It’s nice not having it on my brain 24/7 like I did the 1st year.

My knee feels awesome! It feels just like my other knee 95% of the time. I can’t think of anything I can’t do because of it anymore.  Most of my workouts are geared around just keeping fit and I no longer do specific knee re-hab related exercises (although my workouts are still aggressive on the lower body and have plenty of the exercises built in that I did as part of my post-op recovery – I just no longer think of it as knee re-hab).

The last things to improve for me was getting that last inch of full ROM back where I could comfortably kneel on the floor and sit my butt down onto my heels with all my weight on it. I’ve been able to do it for a long time, but it hurt. Now I can finally do it. I also have zero pain when kneeling on floors (even cement floors) – this was an initial concern of mine because the grappling workouts I do have me on my knees a lot. My lateral meniscus that was trimmed also seemed to be bothering me for at least 12 months after surgery after aggressive workouts. This too has gotten better and I can’t remember the last time I felt any pain in that area of my knee.

The only time I am reminded of my knee surgery these days is when I do a particularly aggressive workout for an extended period of time and the next day my knee is a little sore (it seems to recover quick – within 24 hours). Something like a lot of sprinting (with corner cutting) or kicking a soccer ball as far as I can for a long time could do this. I know my knee is still slowly getting better and assume it will continue to make tiny improvements over the next year (or more).

I’m 41 now and after getting surgery my weight slowly went up to the highest I had ever been at (not right after surgery but about 6 to 9 months later) – I hit 208 pounds which is my all time high (I’m 6’1”). Once I got to the point that I could really workout hard consistently I really shifted my focus to getting fit (including better nutrition) and I dropped down to 179 pounds (which I have not been at since my early twenties!!).

Hopefully these posts will help others who are thinking of getting surgery, or currently recovering from surgery. I know the first thing I did after injuring myself was hit the internet and this luckily was one of the first sites I found. I then read every journal on ACL surgery and post-op recovery and specifically Allografts that I could find. Once I had surgery I went back and re-read all of them again and continued to do that while laid up on my couch for the first couple of weeks. Thanks to all of those who kept detailed journals!! Posting about my recovery was also a big help in tracking my own progress.

Good luck everyone.

[lenorem9]

Great to see an update Rob.  You are a true inspiration.  Your workout regimen has helped so many on here.  You had such dedication to fitness and determination to getting healthy again.  Good for you!  I'm so glad to see you made it to the end.  I think we'll have to make you the poster boy for ACL rehab.  Waddya think? 

Keep on working out, staying fit, and most of all, take care of those knees!