New ACL with allograft - 1 Dec 2010

[pinotlover]

Hey Lawrence,

Seems like all is doing well with your knee. I am just to about to update my diary but quick version is that I am doing jumping in my physio sessions. (Theyare tailoring my sessions to netball for hopefully a successful return). I will try and find you on facebook, then I can show you the pictures!

Jen

[lwillson]

hi pl, just seen your photos, its quite strange looking at other peoples' knees with cryocuff on, bit like looking in a mirror and brings all the hospital memories rushing back.... looked like you have quite a big incision hole, how's it starting to heal now?

week 8 now....

saw pt yesterday evening, she has now upped the ante and got me going on the single legged stuff, apparently weeks 6-8 are the danger zone when the graft is re-vascularising, now towards the end of this stage, so she has taken to abusing me with one legged things...  wall ball squats, leg press squats, squidgy ball, and up to 20mins cycling now.  usual pt drills on top of this.  have been reduced down to three days per week fornthe one legged stuff, and lighweight exercise fillers on the remainng days, so one slot per day, alternating heavy-light etc... and a day off per week... at long last the nearly-fourteen times a week of pt is starting to relax into more intense but less frequent sessions.  and authorised to find a gym to help out with the leg press action...

 have tried the exercises over the last 24hours... one set yesterday and one today.... can feel the acl being a bit sulky this evening with the added pressure driving through it all.   will keep going....   gluts and quads of steel are the goal 

[chrisduffa]

Good to check in on your progress Lawrence - especially given you're only a week or so in front of me! I had a hamstring mishap a few weeks ago but the rest of my knee seems to be doing well, and fairly similar to you at the same stage. I've got my OS appointment next week and more physio appointments after that, so I'll be keen to compare their advice about leg press, etc.

iPads are great aren't they! Got the kindle app on mine, and that kept me company during the early weeks when stuck upstairs at my folks place It's way too easy to buy books though...

[lwillson]

Hi Chris, seems like we are both progressing on a similar track as you say.  I noticed your hamstring go wayward, owww, hope it is coming back better now and letting you get into the exercise regime more.  Nothing more annoying than just getting over the surgery, to find the body slowed down by unintended slipups.  Fingers crossed for you.  Look forward to hearing of the OS comments.  iPads.....  my bill on itunes just seems to climb upwards... and am slowly getting into Facebook and I can understand how it gets quite so addictive...

so, back of week 8...

First visit to the gym today since March last year  when the knee went twang in the hills in the Lakes.  Boy, it feels good to be back in control of some sort of exercise regime again.  Then of course it all gets hard work when the one legged regime gets going.  Noticed back of knee felt a bit stiff when I got home.  Think this is due to the poor little little ACL being asked to do some work all by itself.  So the afternoon is peaceful and focus is on teashop and R&R, with ipad in tow to surf around and see whats happening in the world 

[Snowy]

Finally catching up on everyone's threads! Sounds like all is going really well for you, which is awesome. Glad that the return to work went smoothly and you're well on your way to achieving those quads of steel. I completely endorse the value of the iPad as a rehab tool - having sworn that I wasn't going to get one (I have a rule about not buying first gen tech products) I cracked about two weeks before surgery and ended up being really glad that I did.

If you're on Facebook, check out the KneeGeeks group if you haven't already - you'll find a whole bunch of friends there.

I had my second day out on skis yesterday, and am rather stiff today but in a good way. It's amazing how fast the time has passed when I look back on it from here - those first couple of months seemed so agonizingly slow, and then at some point it just started to speed by. I'm almost at my 7-month anniversary, which will put me into the very final stages of rehab.

Take care and hope all keeps going well! Enjoy the gym and the one-legged exercises.

[hibiscus_tea]

Hey Lawrence!  Question: what kind of stuff are you doing at the gym?  I just read pinotlover's diary and got inspired to go to the gym again, but I'm not sure what I should do... when I used to go before the ACL tear, I was running a lot and doing lots of weights... I just want to make sure I'm being safe.

I can't find the KneeGeeks facebook group... hmm...
*edit* nevermind! found it~!

[lwillson]

snowy, hi again, saw your tale of the slide down the mountain on snowshoes, good to hear that the knee could take it, even if a little unsettling at the time... am jealous of your tales on skis, i will have to wait until next winter instead 

 tea, here goes...

beginning of week 9....
pt drill is 4 times a week in the gym, and light pt on remaining days (no cycling, no weights).

gym....mon, wed, fri, and once over the weekend.  need one day off to give knee a chance to recover.  full drill is...
leg press, single leg, 10 reps at 50-60kg weights, swap to good leg, then four sets (8 legs in total)".  make sense??
wall ball squats on one leg, 3 sets, 10 squats per go. utter murder, especially as the wall ball slides around behind you (all fun for balance...)
foam roller, 30 reps.  need to be careful on knee cap pain on this one.
cycling, 15-20mins, middle pressure on the bike, shouldn't spin out too quickly and have reasonable pressure going down
high setting on a reebok step, then 10 reps up on the duff leg, then 10 sets down on the duff leg. repeat the cycle four times.
then die quietly somewhere 

strictly no running in the gym (open chain) and a little wary of the cross trainer at the moment.

plus at work, take three flights of stairs all the time, avoid the lifts, and deliberately control the descent on the duff knee.

knee post gym is not swelling, but aches on and off for half a day or so, can feel a little pull on the graft fixation, especially after single  weight leg press.  slight ache and swelling on outer tibial plateau, probably due to cartilage trimming.

otherwise knee is broadly ok, stairs are a doddle up and down, walking is normal.

it has been good to

[lwillson]

posted too quickly, just meant to say that going back to the gym has been really good for the soul... nice to put a sweat on again, lose a few xmas pies, and generally feel like life is returning.  plus standing on a wobble ball in a public gym with your hands up like a ballerina over your hand makes you look really stupid (or keen) fellow gym goers 

[lwillson]

beginning of month 3 

saw pt today, so amended drills

basic per above, plus...
wobble ball and bouncing a tennis ball against the wall
standing on one leg to get balance just right, not using the wobble ball - need to kick a few bad habits out at the moment
 theraband walking side to side to help with bum muscles
abductor exercises

basic summary is heading right way, but glut muscles are quite weak and need lots of help to regain strength and control

[lwillson]

Hi all

Now getting into Month 3 - approx 67 days from surgery (lost count!).  And I managed to post this off the laptop rather than iPad so can find the shift key on the keyboard and write proper sentences again - the iPad is very good for short messages, but naff all use for proper writing unless you have the patience of a saint.

Physio/gym is steaming ahead well.  Getting 4-5 gym sessions in a week, and beating merry wotsits out of the gym machines.  Knee is coping well - seems to be a fine balance between gaining strength quicker than any incremental knee injuries.  So far, fingers crossed, have kept on the right side of this line. 

Typical weekly regime is four days a week in gym, and 3 days off (perhaps the odd walk near home at the weekend but not much more).  Gym regime is:

•   hamstring stretches for extension
•   exercise bike – 15 mins at start of session, another 15 mins at the end
•   single leg presses – 60-70kg a go (130-150lbs) * 10 reps * 3 sets
•   single leg wall ball squats – 10 reps / 3 sets
•   high steps off the box – gets upper quads and gluts going
•   cross trainer – 5 mins (does something strange to the ACL if done for any longer)
•   foam roller * 50 reps
•   theraband games – clam shells and other fun things
•   wobble ball – one leg standing / two legs and through a ball against a wall

Knee slightly aches after 2-4 hours at the gym, and then sorts itself out again by the end of the day.

So heading in the right direction.

Lawrence

[hibiscus_tea]

Thanks for the gym routine!  I'm going to the gym starting this week, so it's helpful to see what others are doing! 
I definitely need to work my quads... my PT can't believe how much it has atrophied.    The step-ups still hurt for me sometimes. 
The good thing, though, is that I don't really have knee pain afterwards. 

Happy 3 months!! I lost count of the days. hah!

[chrisduffa]

Hi Lawrence,

Great to see your progress - we seem to have quite a similar routine at the gym! I'm probably not at the same level of leg weights yet, and i'm having to do hamstring curls on top of everything else too. Those are quite hard - can barely do 5kg!

Still get a bit of pain behind my knee throughout the day, and my limp has crept back in recently. I've been a bit lax with icing so really need to get back on top of that again.

Looking forward to seeing how you go in the next few weeks. Any signs of running just yet?

Chris

[lwillson]

Hi Chris - know the feeling on how the knee starts to ache and pain again - I think the gym regime starts to tease out aches that still remain...

Hi Tea - yeah, the days are flying by, not sure if with fun and joy but certainly making progress now.

So...week 12 finishes today

Had a bit of a 'mare over the last week or so.  Was all really happy last Tuesday when I saw PT, everything all OK/perfect etc, full of the joys of being back at the gym, and then....

PT added some funky version of lunges to the gym routine to help up the ante....
And I hopped a fence in the local Tesco car park....

Got home on Thursday night with a lot of ache and pain...

Then the dreaded graft paranoia returned….  Argh, was it the fence, was it the new lunges, what have I done?  Panic ensued for much of the weekend and finally emailed the PT to see what was possibly up.  She was then away for a few days, so paranoia persisted.  Finally plucked up courage to go to the gym today and give it all a go, and the knee has survived.  Rang physio to share the glad tidings.  Would appear it is the lunges which annoyed the cartilage and probably irritated the new ACL.  Hence symptoms of general aches, mini-limp, and mental confidence has been a bit patchy.

Hopefully now moving on – though a week on from the initial flare up, it still aches if I do not do enough cycling done to help move the joint about – certainly one moral of the story here to keep going with the gym absolutely religiously otherwise the poor knee starts getting quite grumpy.

Hope all is well with respective knees out there

Lawrence

[tez27]

Hey Laurance thought I would pop in to see how things are going with you the last time you posted you were having a few problems, just wondered if things had settle down and you were feeling more confident with the new ACL.
Take care Tez

[lwillson]

hi tez, thanks for dropping in, trust all is well with your acl... must be near to the nine month marker now, how is it going?


month 3.5 update....
pesky ipad, really pants at writing proper text and rambling on for a while, and with appropriate capitalisaion as well.  oh well.

NEWS - wife is now 12 weeks pregnant, officially confirmed this afternoon in a scan    will have to get back to the surgeon and thank him for the special extra he must have loaded into the anaesthetic   or did Sonia simply take advantage whilst i was 'recuperating' ?

pleased to update that knee is well.  usual gym drills which haven't changed much since last updates. basically kicking the cr*p out pf the gym, leg press, cycling machine, wall ball etc.  knee feels strong and broadly capable of taking he same abuse as the normal knee.  my brain now treats both legs equally without consideration to protect the ex-duff knee so must be progress.  still find the knee aches a little if static under a work desk for too long - nothing a walk around the block cannot sort out.  gym doesn't annoy knee any more