ACL Recon (hamstring graft) & Staph infection complication

[Bigman78]

Day 55

The last couple of days have been good despite the heat in Melbourne. Temperatures have hit 30+ degrees this week but thankfully the swelling in the knee doesn’t look like it’s increased.  Work has been quiet this week also which has enabled me to go to the gym on my lunch break which is great! I feel like my walking is getting better every day although I still have a slight limp which I need to keep working on.
Each of the last 3 mornings I have started the day with 3 sets of 10 of the straight leg raises which seems to work well for me. I am now able to sit at my desk for longer periods of time with my leg down but I do occasionally prop it up on another chair when it feels like it’s stiffening up. I’ve done the following at the gym in the last 2 days: 

Monday
•   Chest workout – Flat bench press (3 x eight), Incline chest press machine (3 x eight focusing on negatives) & incline dumbbell flyes (3 x 10)
•   Quad tensing & ankle pumps – 1 set of each
•   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

Tuesday
•   Back workout – Lat pull down machine close grip (3 x 10), Lat pull down wide grip (3 x eight) & Seated row machine (3 x eight)
•   Quad tensing & ankle pumps – 1 set of each
•   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

Today I’m planning to work on my triceps followed by my usual leg exercises. I’ll also do my usual exercises at home following by some more bike riding. I’ve actually stepped this area up and have done 15 minutes each time for the last 2 nights (just over 5 km each time). The knee feels great after this and it’s also nice to get a good sweat up!

I’m looking forward to seeing my PT tomorrow to see what he has in store for me – hopefully some new exercises!

[mightyjack]

Hi Bigman78,

It sure sounds like things are coming right along with your recovery.  I enjoy reading your workout posts. That’s one thing I am looking forward to getting back into when I can retire my crutches.
 
I sure wish I was in a warmer climate right now.  I was trying to shovel snow this morning.  There were two foot drifts in my driveway!   Keep up the good work.

[Bigman78]

Mightyjack - yep the progress has been good particularly in the last couple of weeks. I'm looking forward to stepping my rehab program up even further if I'm given the go ahead from my PT tomorrow! I have to admit I've been looking for some exercises already on the internet but I have to remember to follow what my PT says! I'm glad you are enjoying my posts, I'm sure you'll be into it in no time! Good to read that you're not far off getting off crutches (in your other post). Things move quite quickly once you start walking unaided again as more leg muscles are forced to work! Being in a warm climate is ok I guess but I am always worried about the swelling. Then again being in the cold would probably make my knee ache more so it's probably a good thing. Shovelling snow doesn't sound like a good idea at this stage!!

Until my next update take care.

[Bigman78]

Day 56

I’m in good spirits today after seeing my PT although I am a little sore on the lateral side of the knee (behind the knee) after he gave my knee a good 15 minute massage. It could either be that or a result of trying a couple of the new exercises he gave but at least it’s feeling better after icing and extending my leg on another chair. He was once again happy with the state of my knee and said that although there is still a bit of swelling he expects it to come down in the next 3 weeks. His rationale is that because I’m a big guy (6 ft 5) and have long limbs this is putting extra pressure on the knee which all makes sense.

Apart from the swelling he is very happy with my progress and wants me to continue doing the same exercises along with the additional two exercises:

•   One legged squat leaning against exercise ball which is against the wall. This will help build up my core strength in additional to the quads
•   One legged squat on rolled up towel or balancing on wobble board. He wants me to work on the stability of my knee

So I’m looking forward to giving these exercises a go at the gym tomorrow with my other exercises. Last night I did 12 minutes on the bike along with my other exercises (SLRs, quad tensing, calf raises, and 4 directions using sports cord) and I also had a workout at the gym consisting of the following:

•   Triceps workout – Skull crushers 3 x 10, Close grip barbell press 3 x 10 (superset doing one set of skull crushers followed by close grip barbell press), pushdowns 3 x 10 & single arm kickbacks using cable 3 x 10
•   Quad tensing & ankle pumps – 1 set of each
•   Straight leg raises – 3 sets of 10 (both legs)
•   Calf raises – 3 sets of 10
•   One legged squats (1/4) – 3 sets of 10
•   Squats with both legs (1/3 of the way down) – 3 sets of 10
•   Exercise ball on wall – 3 sets of 10 (6 sec squeeze)
•   Ab workout (crunches) – 3 sets of 20

[Bigman78]

8 weeks post op!!

I thought I would never come so far.... well not in a ‘short’ period of time anyway. I know it’s been 8 weeks since my original op (and 6 and half following my 2nd one to clear the infection) but just 3 weeks ago I was still hobbling around on one crutch! Amazing how quickly the body can recover although I still have a long way to go. Having said that things feel like they are returning to normal – I’m now off the antibiotics thank god so hopefully all goes well in that area and I’m sitting quite normally at my desk now only needing to raise my leg up every now and then. My walking is quite good although my wife still thinks I have a slight limp although my physio says I am walking normally! Personally I think my walking style has changed slightly to compensate for weak leg muscles on the right leg.

Last night I did my usual exercises (SLRs, leg side raises, quad tensing, hamstring stretch & calf raises) although I keep it to only 5 minutes on the exercise bike due to the achy feeling I had on the lateral side of my knee after my PT session. Today it’s back to normal though which is good. I’m planning a gym session after work (shoulders, biceps & legs) followed by some bike riding. Tomorrow I’ve planned to have a pool session and once again planning to take it fairly easy this weekend. So far so good!

[mightyjack]

Hi Bigman78,

It sounds like things are really moving along well for you.  It is amazing how fast the body can heal. Of course, it helps that surgery and P.T techniques have improved over the years.
 
I have a habit of trying to walk too fast and this has caused me to limp once in awhile.  When I take my time and think about what I’m doing, I can manage without a limp. I figure once the all the muscles are back to full strength, the normal pace and gait will come back.  I haven’t tried the pool yet. Are you just swimming as you would normally or is there some special PT?

[Bigman78]

Hi mightyjack,

Yeah things are progressing well thanks. You're spot on in terms of how well the body recovers... I just need to keep reminding myself that the graft still needs plenty of time to form and adjust as required in my knee! But each day the signs are better and my life seems to be getting back to as normal as it can be right now.

Walking wise I have found myself also walking at a reasonably fast pace but not as fast as I used to walk. You are right though the more you slow it down the less noticeable the limp seems to be. As you say once the muscles starting taking more shape I am sure this will improve for both of us. I have the added benefit of having to go up and down 2 flights of stairs in my apartment building every day and this seems to have helped my knee mobility.

As for the pool I'm not doing too much and not swimming at this stage....I was given the go ahead to start swimming with a buoy between my legs from my PT but when I asked what benefit that would have for my knee he said not much so I decided not to swim on Sat! At the moment I am walking laps in the 25m lap pool and in between laps I'm doing one legged squats, one legged calf raises, calf stretches & controlled leg swings. I also do the same exercises in the hydrotherapy pool. The pool is a great way to go and the knee always feels good after a session in the pool.

[Snowy]

Glad to hear that all is going so well at this point.

With regard to swimming, my OS told me to try a gentle flutter kick as soon as he cleared me to go back in the pool, which was when the staples came out at 11 days post-surgery. I found that the leg really couldn't manage it at that point, so I used the pull buoy for about a week and then started very gradually introducing the flutter kick - initially one length out of my regular 3k swim, then two a week later, then four a week after that, and so on. I ditched the pull buoy completely at about 7 weeks post-surgery. The early swimming wasn't doing much for my knee, but I found it completely essential for maintaining cardio fitness. My problem was that I was supposed to be doing a lot of pool walking and other hydrotherapy exercises, but I was so happy to have one cardio exercise where I could go as hard as I could that when I was in the pool all I wanted to do was swim.

Regardless of what you do in the pool, just being in the water is really good for the knee. I always found the cool water soothing and it made perfect sense when LARSknee posted that standing in water puts about ten times more pressure on your leg than the average compression stocking. That said, my swelling still took an age to go - but I'm one of those people who always swells badly after injury, and has trouble getting rid of it.

Good luck with your new exercises - hope all continues to go well.

[Bigman78]

Thanks for once again taking the time to write snowy and thanks for the support! This forum is fantastic in that way...

I have never been too keen on swimming although I am a decent swimmer. I guess I am trying to utilise my time in the pool to concenrate on the walking (hopefully jogging soon!) along with the exercises and I figure I can do swimming at a much later time in my rehab program once I am able to swim properly. I know what you mean in regards to cardio fitness... I've certainly lost a lot of that! The only way I am maintaining any sort of cardio fitness is by walking to the gym and back / walking to the train station and riding the exercise bike. I can't wait to start running down the line again when I can really start to work on my fitness. Thankfully now that I am back in the gym I am starting to get back into reasonable shape due to doing the upper body weights as well as my leg exercises.

I remember reading that post by LARSknee and it's spot on.... the water really does help the knee feel better. My swelling is taking it's time to come down also but I'm hoping now that I'm off the antibiotics it might improve further. As mentioned my PT expects it to come down in the next 3 weeks so I hope he is right! I've left myself 7-8 Naproxen tablets for my trip away to Bali (leaving this Sat and staying for a week) just in case the swelling gets worse over there due to most likely a fair bit of activity along with the humid weather! The good thing is the resort we are staying at has a pool so I will be in the pool everyday for a week!

Thanks again. Hope your recovery continues to improve.

[Bigman78]

December 3rd – 9 weeks post op!

It’s been a while since my last update but there aren’t too many major updates! I will most likely provide weekly and fortnightly updates from here onwards along with when I hit major milestones of course. I am getting all geared up for a holiday in Bali for a week (leaving tomorrow) and have ensured I am prepared for the flight there. I had one script remaining for the antibiotics which I was using and to be on the safe side I have bought an extra packet just in case there are any symptoms of infection whilst I am on holiday. My PT thinks this is a good idea along with getting tablets for the ‘Bali belly’ which I hope my wife and I avoid! I am also taking my remaining anti-inflammatory tablets.

Along with the medications I am also taking the ice knee brace which my surgeon originally supplied and will ensure I get it filled regularly with ice during the flight to keep the swelling down hopefully. Of course I’ll be walking up and down the aisles during the flight along with doing plenty of stretching to ensure I do not develop any blood clots. In terms of what I’ve done over the last week it has changed at all with plenty of SLRs being done, hamstring stretches, quad tensing, one legged squats (1/4) free standing and on the exercise ball, directional movements on the sports cord for stability as well as my usual program at the gym. In additional I’ve been riding my exercise bike 5-15 mins each night depending on how much energy I have left at the end of each day!

My PT has advised that I take it fairly easy whist on holiday so I’ll have no problem doing exactly that! I’ll be mainly doing my exercises in the pool as well as many more SLRs! Hopefully all goes well. I’ll provide more of an update once I’m back!

[roo222]

Hi Bigman,

Have a great holiday in Bali, nothing like a bit of time away to help you relax and forget about any knee problems I hope the travelling isnt too bad, especially the flight.

Sounds like your progressing well with the excercises, and managing ot fit a lot in the day as well. do you have any indication when you'll be able to run/jog yet?

Have a lovely time
Roo

[Bigman78]

Thanks Roo. The holiday was fantastic and the knee is feeling great. It was nice to get away, relax, and forget about the knee problems as you say! The flight to and from Bali was fine. The time my knee really swelled up was on the final day when we did quite a bit of shopping in Kuta & Seminyak.... I was pretty much on my feet for 7 hours! The swelling actually went down on the plane flight home once I got to sit down and stretch the leg for the 5 and a half hour flight.

I didn't do as much over in Bali but keen to get back right into it again now that I'm no longer in holiday mode  I don't have an indication when I can start jogging yet. My PT wants to see the swelling come down further before stepping up my program. I see him this Thursday so hopefullly will get the go ahead to do more! Hope all is well with you and others.... I have quite a bit of catching up to do to see how everyone is going!

Here is the latest update from my blog:

December 13th – Back from Bali holiday

So I came back from Bali yesterday and have to say I’m feeling quite relaxed. The knee is doing great as well and survived the humid conditions which always worried me. The flight to and from Bali went fine as well mainly as I was sitting in the emergency row on both occasions so I had plenty of space to stretch my legs! I did bring my ice pack along as well but in the end I didn’t need it on the plane. I used it a couple of times in Bali mainly after being on my legs for long periods of time. I found that being in the pool every day for a week helped my swelling go down a bit and the only exercise I did was whilst I was in the pool.

I did one legged squats, calf raises, calf stretches and controlled leg swings in the water. I found this to be enough as I did plenty of walking and with the footpaths being so uneven over there I got a fair workout everyday! Having said that I’m keen to get back into especially getting back on the exercise bike. I had a brief 3 minute ride late last night which felt good so I’m keen to have a good 15 minute ride tonight. I did get back into the gym today on my lunch break doing a chest workout followed by ankle pumps, quad tensing, straight leg raises, side leg raises, ab crunches, one legged squats & the squeezing the quad on the exercise ball against the wall. All of the exercises felt great and I feel my knee is stronger than it was 10 days ago. I’m seeing my surgeon for another follow up appointment this Thursday and I’m also seeing my physio on the same day. I’m looking forward to hearing their thoughts and hopefully to hear I’m on track!

[Snowy]

Glad to hear you had such an awesome holiday, and that you were able to work some knee exercising into your vacation. 

If I recall right, I had jogging on my rehab protocol at 16 weeks but my OS and PT ended up starting me on light treadmill work quite a bit earlier - somewhere between 12 and 14 weeks, I forget exactly - so hopefully you're not too far off. From the way things are feeling, it sounds like you're doing great.

Hope all continues to go well.

[Bigman78]

Thanks Snowy. I didn't do too much over there in terms of 'formal' physio but with all the walking and being in the pool was enough to keep me going! I'm coming up to 11 weeks this Friday so hopefully I'm not too far off jogging now. I'll see what my surgeon and PT have to say tomorrow!

I've done quite a bit of work over the last 3 days to get back into it including a 18 minute bike ride on Monday night followed by a 22 minute bike ride last night. The knee is feeling good although I feel a bit run down today.... perhaps I have over done it after getting back from Bali!

[Bigman78]

Latest taken from my blog. By the way I didn't mention I asked my surgeon when I would be able to jog and he said that although most of his patients start around the 3 month mark he wanted to be cautious with me due to the early complications. He said I should be able to jog in a couple of months and will give me the go ahead or not next time I see him (appointment booked for 24th of Feb).

December 16th – Cleared to do leg weights at the gym! (11 weeks tomorrow)

Today has been a very good one after seeing both my surgeon and physio who are both extremely pleased with my progress. My physio even joked with me that he has too hold me back otherwise I could overdo it! First off I saw the surgeon first thing this morning before work. It was a brief meeting but a good one. He took a look at my knee and was happy with how it looked. He mentioned there was still a little bit of built up fluid around the knee but said that was normal at this stage (2 and a half months post op).  He then tested the ligament and said it felt strong. He said I could stop using the anti-inflammatory tablets and that my rehab could continue as per any normal rehab program at this stage. Finally he said to do lots of cycling, swimming and leg exercises.

Next off I saw my physio on my lunch break. He was really pleased at how the knee was looking and gave me the go ahead to start light leg weights at the gym! Woo hoo! I was very excited with this news! He wrote me a program to concentrate on over the next month or so before I see him next (he is off until Jan 18th but is not concerned about not seeing me until then):

•   Hamstring curls - 3 sets of 15 (10-15 kgs)
•   Individual Leg press - 3 sets of 15 (20-30 kgs)
•   Exercise bike - 10-20 minutes
•   X Trainer (or Cross Trainer) - 10 minutes
•   Calf raises - 3 sets of 15
•   Swimming
•   Walking in pool (mentioned I can commence jogging only if the water is at least at chest level)
•   Other usual exercises – SLRs, one legged squats on exercise ball, sports cord 4 directions etc

I’m looking forward to getting into it tomorrow! He gave my knee a good 15 minute massage and mentioned that if it does flare up to take a day off the program especially if it doesn’t respond too well to using the X Trainer. He also said that I can stop wearing the tubigrip and that a knee brace with a hole for the kneecap would be a good option when training at the gym.

In terms of the last 3 days I got back into my usual routine of going to the gym on my lunchbreak and doing bike riding on the exercise bike at home after work at night. I’ve been doing around 20 minutes on average on the bike per night along with my usual upper body program & leg exercises at the gym each day. All in all a very good news day