ACL Recon (hamstring graft) & Staph infection complication

[Bigman78]

6 weeks post op!

Friday marked 6 weeks since my original ACL reconstruction operation and around 4 and a half weeks since the 2nd operation to clear the infection. I am feeling very positive about my progress particularly in the last 2 weeks and I am happy I am now able to walk around reasonably comfortably although my knee does swell up if I walk too much or stand for too long.

Some milestones from the weekend:
•  Walking up and down stairs ‘normally’
•  Getting out of the shower with no assistance (previously always had to use one crutch due to the step we have to get in and out of shower)
•  First pool session!
•  Walking / standing for a couple of hours whilst watching the team I play for (Beaumaris SC) participate in a pre-season tournament

After the big gym session on Friday night I did my exercises once again at night followed by a 12 minute ride on the exercise bike. On Saturday I went for my first pool session which was great! I did 10 laps of the 25 meter pool (500 meters in total) and in between did some exercises including calf raises, one legged squats and controlled leg swings.  I found it a lot easier to walk in the pool and also managed to go half way down for the one legged squats. I was wondering if I am now able to do lunges in the pool so I’ll need to ask my physio next time I see him.  I also went into the hydrotherapy pool for a little while which was relaxing. At night I did my exercises followed by a short 5 minute bike ride. It is also worth mentioning that I did 100 straight leg lifts on each day over the weekend.

On Sunday I did my exercises in the morning and then watched Beaumaris play in a pre-season tournament. It was great to get out and about and to catch up with the guys. Following this I did some more exercises in the evening followed by a 14 minute bike ride which felt great. I am looking to another good gym session today!

[Bigman78]

Awesome work! Sounds like you're well on the road to getting your quads and calves back to where they were before surgery.

In comparison, I lost 4cm off my operated quad and 2cm off the calf. I've gained about half of that back now, but the interesting thing is that strength is way ahead of bulk - there's currently only a 10lb difference in what I can do on the leg press with the bad leg and the good leg. My PT says this is normal, but it seems a bit weird to me.

Thanks snowy - I feel a lot stronger than I was 2 weeks ago so I hope I continue to make good progress. I'm looking forward to a full week at the gym to see how my knee holds up! So we are exactly the same then - I've lost 4cm off my quad and 2cm off my calf too! Not sure of the strength difference but hopefully I get to test that soon!

How is everything going with you? Any updates with the infection?

[Snowy]

Sounds like it's been a week packed full of milestones. I found the pool was absolutely essential during the first couple of months of rehab; the hydrotherapy was great and apparently the pressure of the cool water is also good for swelling, but more than anything I was just so happy to have an activity where I didn't have to hold back. Even before I could use my legs I was swimming 3k a day with a pull buoy.

It's kind of scary how fast the muscle goes, and how slow it is to come back in comparison. Still, at least it gives us something to work toward!

I think the sulfa drug is working for the infection - at least, the symptoms are definitely abating. I'm going to post a general update on my diary shortly, so more details there.

Keep up the great work!

[Bigman78]

Thanks again Snowy - appreciate your support!

Yep the milestones keep coming which is great You're spot on about the pool, you feel like you can really free up although you still need to be sensible of course! I was mainly in the lap pool (cool water) and then went to the hydrotherapy pool for 15 minutes. Looking forward to going again this week.

I found the 500 meter walk to and from the gym a lot easier today and my walking has improved noticably (people from the office have even commented on that which is encouraging!). I did a chest workout (I'll be sore tomorrow!) followed by 30 SLRs, 2 x10 calf raises, 3 x 10 single legged squats, 4 x 10 exercise ball on wall and did 30-40 sit ups. I'll do the same again tonight followed by a 10-15 minute bike ride.

I am glad the early signs are good using the sulfa drug.... hope it continues!

[mightyjack]

Hi Bigman78,

It looks like you are making great progress.  I hope I’m doing as well as you at my 6th week.  I went to the gym last week to get some upper body work in and I was amazed at how sore I was after only three weeks away. 

[Bigman78]

Thanks mightyjack. Appreciate your post!

If I hadn't had the staph infection followed by 6 days in hospital I'm sure my progress would have been even better! I'm sure you'll be even further ahead of me at the 6 week mark! My surgeon told me that whilst I would fall behind initially that by the 8-10 week mark I would have caught up to people at the same stage. I hope this is true!

I was sore all weekend after doing a fairly light session on Friday by my standards but was expecting it! I wasn't sure after Monday's session and going today to do back / triceps. The good thing is we should both get back to where we were before (upper body wise) quite quickly due to the muscle memory. Good luck!!

[Bigman78]

Latest update - day 48 (still a long way to go)

Yesterday was a good reminder that I still have a long way to go. After a good day on Monday where I went to the gym and did my usual exercises along with a 12 minute bike ride, yesterday didn’t go so well.  The day started in a rush as I woke up late and therefore didn’t have time to do my exercises in the morning – a bad start! I was then involved in a couple of meetings at work where I was sitting for long periods of time with my knee bent which didn’t help. I did manage to do my exercises during my lunch break which helped and I iced my knee afterwards. At this point I was doing ok.

However I had one further meeting after lunch (once again knee bent) and I then had a family dinner to attend after work. This is where the problems began! Standing waiting for my wife to pick me up for 30 minutes meant my knee had swollen up a bit (I did manage to find a seat at a nearby bus stop for around 15 minutes of the 30). Then an hour drive to her uncle’s house aggravated the knee further. We then stayed for around 2 hours where I was sitting for most of the time followed by a 40 minute drive to visit my grandma! After a quick visit it was off to my sister’s place to drop off a cake for my niece’s 7th birthday and we finally got home around 9pm! My knee was not happy!! I elevated and iced for 30 minutes before doing my exercises and a short 6 minute ride on the exercise bike.

I now realise how much further I have to go but then again it was a long day where I wasn’t really looking after my knee as I usually do. The previous day (Monday) was a good one where I did the following in the gym:

·        Chest workout – Incline bench press (3 x 10), seated chest press (3 x eight) & dumbbell flyes (3 x 10)
·        Straight leg raises – 3 sets of 10 (both legs)
·        Calf raises – 3 sets of 10
·        One legged squats (1/4) – 3 sets of 10
·        Exercise ball on wall – 4 sets of 10 (6 sec squeeze)
·        Ab workout (crunches) – 3 sets of 20

I also did my exercises at home (quad tense lying down, pressing knee down with ankle on towel, SLRs, lateral leg raises, hamstring stretch) as well as a 12 minute bike ride. Today I will be going to the gym to do my leg work as well as doing a back / triceps workout. Tomorrow I will be seeing my surgeon for another follow up and he will also review the results of the blood test which I had done this morning. Hopefully today is better than yesterday!

[mightyjack]

Hey Bigman,

Sorry to hear about the rough day at work.  I had the exact same thing going with work meetings and long hours. When I got back home yesterday my knee looked like a watermelon. Sounds like the upper body workouts are coming along for you. I’m going to start hitting the weights a little harder this week. Unfortunately I can’t hit the free weights yet.   

[Bigman78]

Day 49 - Good news!

A much better day today with some great news from my surgeon! As I walked in he had a big smile and said “I’m happy” referring to my blood test results. My infection reading is down to 1 (normal level is under 5) and he even joked that my level is probably lower than his at the moment! I was very relieved to hear that it’s dropped down to a normal level and he said I can finish off using the antibiotics after my next course to complete the full 6 week course. He also said that all the other key indicators in my blood test were all at normal levels.

He then had a good look at my leg and was happy with what he sore. He pulled the lower part of my leg and told me the ligament was strong and once again said he was happy! He said that I had basically caught up to the patients he had operated on 6 weeks ago and that now I would only have to concentrate on my rehab. 

Exercise wise I haven’t done much today apart from my straight leg lifts in the morning (3 x 10) and some quad tensing at my desk when I get a chance as work is getting busy! I saw my PT on my lunch break and he was pleased to hear about the good news after seeing my surgeon.  He was also happy to see me walking unaided and commented on how much better my knee looked saying it was “less angry”! I gave him an update on how I had gone with the exercises and he wanted me to continue with the same program for the next week as there is still some swelling there which he hopes will come down. He gave my knee a good 10-15 minute massage and that was pretty much it! He said if anything I might even be overdoing but he’s happy with my attitude and dedication. He also said not to do any more than 15 minutes a day on the bike.

I did ask if I could do an additional hamstring exercise and he said I could do a standing hamstring curl with no weight so I will give that a go tonight. Tonight I’m intending to do all my exercises along with a 15 minute ride on the exercise bike. I’m feeling positive about it all especially after the good news today!

[Snowy]

Fantastic that you're back on track! That must be a huge relief after having to make up the ground you lost to the infection.

How are you finding the standing hamstring curl? That's one I found really tough and still can't get the leg past 90 degrees, although I can do a set of 100 curls with a 10 pound with no difficulties at all when I'm lying down.

Hope the good news continues!

[roo222]

Hey glad to hear that you've progressed really well, must be really pleasing to be on track especially after an early setback. Let me know how the standing hamstring curls come on, ive tried a few and have been able to get to about 80* bit the tendons feel really tight, especially on the medial side of the hamstring.

Again, glad to hear of your progress, hope it continues.
Roo

[Bigman78]

It's been a busy few days for me but all is going well thankfully! I'll put up my most recent post from my blog shortly.

Snowy - it really is a relief to be back on track. For a short while I was down in the dumps and thought it would take a lot longer to get to the stage I'm at currently. It just goes to show if you're disciplined and stick to what you're told then progress can be good! The standing hamstring curl feels unusual but the hamstring itself feels ok. It's more of a restriction I have in my knee which makes it feel weird and I'm only able to get to around 100 degrees. It doesn't feel like it's doing much either but I'll stick to it for a while. I haven't tried the lying down variation but will have to give it a go. Hope all is going well with you, I'll have to read your post to catch up with the latest!

Roo - Thanks, appreciate it. Yeah I'm feeling good at the moment and I'm keen to step it up further if I'm allowed. I'll have to see what my PT says this Thursday as he mentioned he would show me a few new exercises. As mentioned the hamstring curls feel ok although I'm restricted by the knee probably due to some swelling still remaining. I'll have to see what the latest is with you also!

[Bigman78]

Day 53

Another week ticked over making it 7 weeks post the original op last Friday. The knee has progressed quite nicely since my last update and I’ve noticed I’m walking a lot better the last couple of days. I had an active weekend and each time my knee has pulled up well which I’m very happy about! After doing a 10 minute ride on the exercise bike on Thursday night along with all my exercises Friday commenced as usual with 3 sets of 10 of straight leg raises.

It was a busy day so I went to the gym after work and did a shoulder & bicep workout and then my leg workout. I did the following exercises:
•   Shoulders – Seated shoulder press (3 x eight), Seated lateral raises (3 x 12) & dumbbell front raises (3 x 12)
•   Biceps – Barbell curls (3 x 10) & Seated 45 degree angle dumbbell curls (3 x 8 each side)
•   Straight leg raises – 3 sets of 10 (both legs)
•   Calf raises – 3 sets of 10
•   One legged squats (1/4) – 3 sets of 10
•   Exercise ball on wall – 4 sets of 10 (6 sec squeeze)
•   Ab workout (crunches) – 3 sets of 20

Following this I went out for pizza on Lygon st with my wife and did a bit of walking. The knee felt fine and once we got home I did some further exercises along with a brief ride on the exercise bike (5 mins). On Saturday I commenced the day with SLRs and following relaxing in a cafe for a couple of hours before going to the pools to do some more rehab work. At the pools I walked approximately 15 laps at a faster pace this time. In between I did ¼ one legged squats (around 6 sets), one legged calf raises (around 6 sets) and controlled leg swings (around 6 sets again).

Some friends came over during Sat night but I still managed to excuse myself for 15 mins to do my exercises and to do 5 minutes on the exercise bike! I figured I didn’t need to do too much after spending nearly 1.5 hours in the pool during the day!  On Sunday I started the day with SLRs again and some quad tensing. We then had a really enjoyable Sunday in the sun spending around 4 hours in St.Kilda. I also saw Archie Thompson who had a knee reco 8 months ago and was happy to see both of his knees looking the same in terms of shape, size etc! It’s funny how you become obsessed with knees after you go through this! It was a morale booster to see how well he has done and he played his 3rd game on Wednesday for Victory although they lost

I thought my knee would complain after sitting down for approx 4 hours (mostly in the shade though) however I was happy to see it didn’t swell up too much and actually felt fine once we got home. After having the in-laws over for a couple of hours I did my usual exercises followed by 8 minutes on the bike. I did enough without going overboard on the weekend and it seemed to be a good balance for me. Things are progressing well.

[Snowy]

Sounds like you're making really good progress now that you're clear of the infection. I think pushing things just a little bit is key to making steady improvements - you have to make the knee work just a little bit harder without pushing it so hard that it objects and swells up. It's a fine line and very easy to wander over it every now and again, but it sounds like your weekend activities were exactly right. Around the 8 week mark is when a lot of people notice an overall improvement in the way the knee feels and ease of doing day-to-day activities, so you're right on track.

[Bigman78]

Thanks again snowy. I'll looking forward to finally getting off the anti-biotics this week after I finish my last round! You're right steady improvements are the key without pushing too hard. One of the key things which has stuck with my from seeing my PT for the first time for the knee is to not overdo it as the knee is still trying to heal. That's also evident from the swelling I still have..... I'm really looking forward to making further progress in the upcoming weeks hopefully!

Some other milestones which I've achieved in the last couple of days which I haven't mentioned yet:
1. I drove for the first time on the weekend. I felt ready to do this a week ago but my wife insisted I wait! It felt good to be back behind the wheel
2. Completed 5 kms on the exercise bike in one go for the first time last night (took me 15 minutes) and knee felt great afterwards
3. Caught the train for the first time yesterday. I couldn't get on the first two trains as it was standing room only but managed to get a seat on the third one! Luckily I got a seat first go this morning as I've worked out which will be the least busiest train as it stops most stations and is not express.