Recent ACL tear...looking for some help!

[fritzrac]

Hello everyone,
I found this site while I was searching for info on ACL tears. You have all helped me tremendously with all the information...thank you. Here's my story. I am group fitness trainer and was teaching kickboxing (not contact) on 1/10/09. I went up for a jump knee, must have hyperextented on the landing and felt a pop. A sheet of pain brought me to the floor. I went to the er and they say it's just a sprain, no ortho consult. Even though they said I didn't need to follow up with an ortho I figured it would be in my best interest given what I do for a living. Clearly it was the right idea. The MRI showed a complete ACL tear, slight damage to medial and lateral miniscus, and adema to my tibia. After getting a second opinion, I decided to go with the OS that I was the most comfortable with. He only does allograft unless I  was a teenage boy, his words. He feels that even with my job, an allograft would  be a good choice so I am going with his advice. He feels that according to the MRI my meniscus tears are slight and may be able to heal on their own. I like that he doesn't seem so invasive since the other OS just told me I tore them and he would repair them during the ACLr. He feels with the bleeding from the ACL tear all the stem cells may heal this meniscus. Sounds good to me!
So, I have surgery next week, 2/5, and am  nervous. I'm a little scared b/c it's surgery and that's always just a little scary. I'm mostly concerned about getting back to doing what I do. I know it's a long road and I can accept that. I just want to be able to get back to work. I also teach cycle and a weighted bar class (power). OS said I would  probably return to cycle first, then Power, and then kick. That's absolutely fine with me, just whatever I need to do to get back. I guess I'm here just looking for support and encouragement that it is possible. I've read lots of success stories here so you all keep me hopeful! Due to the initial injury I wasn't able to do much with my knee b/c of pain.  Well, finally I started to really feel a difference about a week ago and now I am just trying to build back my stregnth before surgery. I started with heal slides and painful leg extensions. Now I am walking with 1 crutch (althought walked bout 20 steps tonight w/o any!), extensions are getting pretty easy, and have been working on the bike. I can't even petal fast enough to turn the thing on but boy does it feel good! And I can walk so much better afterwards! I will do that up until my surgery. It's kind of hard to see myself struggling in the gym when I teach group fitness and am a personal trainer but what can I do?  Just gotta push along I suppose and celebrate every milestone, right? I have lots of questions so I'm sure I will be asking away but here are a couple to start with...
How did you deal with the initial news? In other words, how did you stop yourself from getting wrapped up into the injury and keeping positive? So far, I think I'm ok. Between keeping busy with work, I'm still able to do my manager role, and 3 young children, it's hard to find time for a pity party(although I'm sure I could find some!)
And, what was your initial experience when you got home after surgery? Were the first few days miserable, baerable? How long before you didn't need the crutches? Or could drive?

Okay, I will stop there.
Thank you all in advance. Again, I am so glad I found this website...thanks to Dr. Google!
Looking forward to hearing from you!
Rae

[miss_sporty]

hi,
just a quick answer to some of your questions:

when i got home after surgery i was very tired from the anaesthetic but not in too much pain, first few days are the worst then it gets steadily better, although even my first few days weren't too bad compared to some.
i was fully off crutches after 3 weeks, which is quite a long time i think compared to others, but if you did end up having something done to your meniscus then it could be longer.
i wasnt driving before the op so cant comment on that, also it depends on which leg it is i think.
sorry to hear you tore your acl, hope the op next week goes well, it's on my birthday!!! good luck!

[patpalloon]

Hi Fitzrac - you've come to the right place for help and support. It's natural to feel apprehensive about a big surgery like the ACLR. I had a hamstring ACLR in the left knee in 2006 and had a very good recovery. Unfortunately I have had meniscal problems in the other knee - completely unrelated - and have just had my second surgery on the right knee yesterday.

I saw the ACLR as a challenge, or rather a series of challenges and if you are a fitness trainer I'm sure you will see it the same way. I was also misdiagnosed as a sprain in the ER, my GP was useless but I got referred to an OS who diagnosed it straight away. This was the most frustrating time for me. Once I had the correct diagnosis and a date for surgery, I felt better about it.

I didn't find the post-op pain too bad, I had a bad reaction to diclofenac though which was worse than the knee! They usually dop nerve blocks and put local in the knee, so the first couple of days afren't too bad. For me it was about days 4-7 that were the worst. The early stages are all about getting ROM back to the knee and I think the golden rule is achieving full extension as early as possible. You need to be careful how you move your op leg particularly in a lying position - you need to hook the other leg under it to support it. Leg extensions are a big no-no as they put stress on the graft.

My recovery was something like this - crutches for about 1 week, walking limp free within 2 weeks. Driving at 2 weeks. Started static cycling at the gym at 3 weeks. (I started road cycling at around 5 weeks and did loads of this post-op, it really helped my recovery. Rugby Nut also did a lot of cycling).
With the ACL it is a long recovery, that's why it's helpful to have a series of goals. 0-3 months the progress is rapid, 3-6 months is a bit slower and I don;t think you are fully recovered til 12-18 months.

There are lots of exercise regimes from old hands like Feeny and JB Knee Geek on this forum.

Good luck.
There is a lot of information on post-op exerc

[BigSkyGirl]

Hi Fitz, sounds like you are on the right track, have you seen a PT yet?  Although with your surgery in 3 days you probably don't really need to.  Just be careful, all these knees are different and some exercises can hurt more than help.  I would stay away from the leg extensions unless your OS told you to do them - and concentrate on quad sets and the heel slides but not pushing past the pain point.  This is not a "no pain, no gain" kind of thing, if you feel pain then stop.

Like Pat said it is natural to feel some apprehension about surgery but it sounds like your OS is experienced and knows what the treatment should be.  The bike is a good exercise and always made my knee feel really good, lots of icing is good as well.

As far as not getting ahead of yourself, that is tough but remember that this is a marathon, not a sprint.  Some top athletes get back in 9 months or so, some take longer.  You will most likely be back sooner rather than later.  I was a bit slow in my progress but I got there and that's really what counts.  And when you need a pity party just be sure to invite us fellow KG's - we love pity parties and are quite good at them now...    As a fitness trainer I know you know all about hard work and practice so I would loosely set goals (your PT will have milestones to measure) but if you don't get there on time don't fret - sometimes swelling or other complications can hold you back.  I'm not trying to be negative just realistic.

One thread you may want to look at is Jon Eames over on the post-op board.  He is a kickboxer and did quite well last summer.

Post-op you should do fine, with the meniscus you may be on crutches longer or have weight bearing issues but you won't know that until the OS gets in there and pokes around.  You will be pleased at the pace of recovery tho'. Take a look at Dancer49 or Nellsa's threads, they are doing very well.

Keep up on the pain meds even if you think you don't need them and get some stool softener - the pain meds will stop you up and that was worse than the pain.  I would say the first few days are rough, your body will be recovering from the anesthesia and trauma of surgery but after that things should be fine.

Post when you can, the posts when you are on the meds are the best.....

[fritzrac]

Thank you all for answering my questions and calming my concerns! I am getting nervous but for the first time last night I was frustrated. Mostly frustrated that my knee is still sore, that it is still an issue! I know that it's going to all start over after Thrusday, but I'm just tired of my knee! Does this make sense? I just want to go to bed w/o checking my position...just want to go to sleep! I have 3 little kids, I want to be able to help them, not ask  for help! I'm sure the next couple of weeks will be frustrating but I know at least every milestone is just that. RIght now I can tell I'm healing but annoyed that I'm starting all over again in a few days!

Right now I've been walking w/o crutches at home and one crutch when I'm out. My goal was to walk into surgery and I think I can handle that! I've also noticed that if I work really hard to not limp w/o the crutches my knee doesn't hurt as much. So, I really try to not limp at all and rest when needed. I actually made dinner tonight w/o having to ask for help. My kids could be kids!

I go tomorrow night to pick up the 2 machines I need. I forget the names but theone that is like a continuous ice pack and the passive movement one.  I will keep you posted on the recovery, even when I'm on my meds!!!

Talk soon...Rae

[BigSkyGirl]

Get it all out Rae 'cause it's just beginning.  This is going to slow you down for a while but really, in the whole scheme of life this is just a speed bump.  Don't dwell on what you can't do just focus on what you can do and the time will fly by.  Put that energy into rehab and you will do great!!

Be careful about trying to set high goals, if you have meniscus damage tread very lightly until the surgery, you can cause more damage if you twist or your knee gives out so use the crutch and just wait until Thursday - it's only 2 more days - and then you will know just what to do after the OS gets in there and fixes it.

Keep up your quad sets and keep in mind that the most important thing after surgery is getting full extension, don't worry - we will all remind you 

[fritzrac]

Hi everyone,
Just trying to get everything ready for surgery. Anything you would recommend that you couldn't live without while recovering? Just want to make sure I have whatever I may need!

Also, I'm still recovering from a painful sprain but I find most of the pain come from the sides of my knee, kind of starting just below the knee and stop midcalf. Is this normal? Mostly hurts wehn pivoting or rotating. I keep thinking maybe it's my LCL, which scares me, but I  had 2  ortho's both say its intact and the MRI confirmed the same. Just want to make sure this is normal discomfort with a tear? I really don't want any surprises when I wake up on Thursday!

Thanks everyone!
Rachel

[BigSkyGirl]

The ice machine will be nice, it will save you having to get up and down and the compression will help with the swelling.

Take you pain meds on schedule and get some stool softener.  Most likely you will be in a brace after the surgery but make sure you don't put anyting under your knee, it will be uncomfortable to keep it straight but you must get to full extension ASAP after surgery.  When is your 1st PT appt?

Just spend tomorrow getting things done around the house or at work or whatever.  I imagine you will be down most of the weekend but I think you'll be surprised how quickly you will start to feel better and begin rehab.

You will do fine, it will all be over soon and I am looking forward to following your rehab.

[dancer49]

Fritz- best of luck to you on Thurs!
Looking forward to reading about your recovery here!
Keep us posted.
Big breath...deeper...deeper...sigh....
You can do it!

[fritzrac]

Hi everyone....
Well, surgery is over! Thank goodness.... I went to the hospital at 6:45am and they took me right to the back. Everything went as scheduled,got my iv, sedation, and then my femeral block. I was really nervous about the blcok but the sedation really took the stress away. They took me into surgery which took about 2 1/2 hours. I had a medial meniscus repair that needed 2 stiches. There was what they referred to as a "pothole" in the knee which they drilled little holes in to promote scar tissue growth. They reconstructed the acl with a cadaver. the cadaver was too big so they needed to put a trench into the tibia,  and place the bone block with the graft there and used a "molly bolt" to place it. Then drilled smaller holes into the block and stitched the graft as well and tied to stitches to the bolt. I'm not sure I really explained this well but it's the best explanation I can give. If anyone else is familiar with this feel free to chime in with how this works. Anyway, the OS said everything went really well. Receovery has  been rough. I had a hard time waking up in recovery and apparently asked for more pain meds as I was crying in pain so they gave me morphine and it took forever to get out of the funk I was in. Surgery started at 9:15 and I didn't leave the hospital until 5pm! Last night was really tough. Just lots of patella pain, and I mean lots! I don't know why as they didn't do anything to the patella but that's were it's the most painful. I went to the OS today to have my drain taken out (needed for the holes they drilled from the "pothole") and they took xrays to see screw placement. I am to start ptas early as tomorrow and have started the cpm machine today.  I'm taking vicoden for pain and the OS let me go up to 2 pills at thetime if needed. So, i tried 1.5 and that did a good  job blocjing the pain. So, for  now,  I'm taking my meds, using the ice machine  and  cpm, and trying to rest. I will post more soon...right now the meds are kicking in again  and I can't really focus...you guys know what I mean
Thanks for the support...Rae

[dancer49]

Fritz!
Welcome to the 'other side!' 
I know things are a bit fuzzy and funky right now, but today is prob the worst of it. So there, you are done and you are going to start feeling better every day. Take your pain meds on time, don't delay and wait till the pain kicks in, just stick to the schedule. Drink water. Rest when you can.

Your surgery sounds similar to mine with respect to needing more pain meds and recovery time- pretty normal I'd say. 10 days from now you are going to feel completely different and so much better and you will be glad you did it. 

Remember, you've been through the tough part...you are now in recovery! 

[BigSkyGirl]

Ditto what Dancer said, rest and take your meds.  Glad all went well, you will be pleased as to how fast your recovery will go.  Post when you can.

[fritzrac]

Just wanted to ask...Dancer, are you in new jersey?
Ok, going back to sleep!
Thanks girls...

[fritzrac]

Post Op Day 3

So I've made it this far. I guess it's getting better. The pain is more managable although I am still taking vicoden just about every 4 hours. I was taking 1.5 pills at a time but one seems to be enough.  I'm doing the CPM machine and hope to get to 50degrees today. I've been up  to 45 without much challenge so I think I will try it a little later. I've been doing theCPM for about 6 hrs. a day.  The OS  said I could put some weight on the injured knee so I've been trying to walk heal toe  but not w a lot  of weight.  There's no pain so that makes me happy. OS didn't really give me exercises to do but mentioned once I could do a strong leg raise I didn't need to wear the brace so I ttried doing 10 last night and didn't have much of a problem. There wasn't great extension but at least I could lift without a lot of pain. Emotionally, today has been the toughest. My husband was suppose to go back to work tomorrow but I'm not capable of  being on my own yet and certainly not caring for my 3 young children. I spoke with my mom who can't come and I was feeling like a burden on everyone. I had asked my hubbyto help me wash later today and not thinking about it said, didn't we do that yesterday? I was so upset. I can't wash every day? We talked and he apologized and I feel better but it's still tough. I feel so much stronger already but I can't wait till I can get around again. Myaccident was a month ago and I was bed ridden for almost 2 wks and now I'm down again. I'm  getting frustrated laying here. OS said I  can drive once I'm ready (it's my left knee that's injured)  so I am looking forward to that. But today I Guess I will celebrate that I washed my hair and changed into fresh clothes!  Talk soon...rae

[dancer49]

Fritz/Rae,

You need help here. Can you find a local college gal to help you out for a few days?
Do you belong to a church? Can you put the word out there? Don't try to do too much too soon, or you may re-injure yourself and what is the point of that?

I wasn't able to take care of myself either for the first few days- let alone take care of anyone.
I hear you on the shower assist as well, got the same response once...showers do make one feel sooooo much better, especially mentally! We put those suction cup handles in our shower and I was able to stand on my 'good' leg and shower with a trash bag on my leg to cover my knee...awkward, but standing with my 'bad' knee balancing worked well for me. Handles don't take all your weight but perfect for balancing.

You have been through the worst of the discomfort now and will find that you will need slightly less pain meds as you go through the next few days...but do not feel guilty about taking them- your doc prescribes them for a reason- to aide you in your recovery. Don't drive until you are off the meds. Some days you may feel 'ok' on them, but trust me- they are having an effect! Just check out my posts up to 10 days post op!!! LOL! 

I still feel that 'I'm a burden' guilt even now 8 weeks post op. I can walk, but do so very slowly and my hubby always has to wait for me- or go get the car if it's too icy or snowy out and I'm so tentative around the bad weather...

But we have had an accident, and major surgery...so it's not something that gets well over night. Patience is required by everyone involved...the whole family. 

Yes! From northern NJ! Where the ski areas are!