ACLr and meniscus trim - 24 May 2011

[cgkrueger]

I love the exercise joke - you always have good ones. 

It sounds like you are doing really well! Squats and bridging - I was excited to get into those. Especially the bridging - it took me a while to be able to do it! My op leg couldn't really hold planting to the ground and would just slide out from under me. I am sure she will give you lots of variations to try. I was surprised at how much rehab my gluts have gotten - but they are important in protecting our legs. Who knew? Hang in there and keep your sense of humor. Keep stringing one day in front of the other and massaging those scars.

[chona42]

cg, as always, full of encouragement, thanks!  the world needs more people like you!

Week 5

And the countdown to the first major milestone continues.  I am 5 weeks post-op, that leaves 3 more weeks of hobbling about in a brace.  I am coming up with lots of crazy things to do to celebrate  the moment the OS clears me to move about without a brace. Take a guess on my first preference:

a) Hit the Alps and ski down a crazy glacier, in a bikini
b) “Borrow” a fiery red Lambourghini Diablo and race around the Silverstone circuit, at 300 kmh
c) Climb Mt Everest, in two days
d) Pop open a bottle of Champagne to enjoy with hubby, in a hot tub

I've had this brace on for sooooo long my main preoccupation now is getting rid of it!  Despite wearing it every waking hour for just over 30 days, I'm not getting comfortable with it. Part of me feels like a prisoner kept from bailing out.   

Having said all this, I must give this simple but effective contraption much credit.  It has allowed me to be mobile, albeit limited, and still protect a healing meniscus.  I've had my share of little slips and trips and up until now, the op leg has not suffered anything bad from these.  It has been well protected so far by this brace.  The brace has also allowed me to be crutchless from Day 4, which to me is very fortunate.  This has certaininly helped the op leg stay functional, even though it is relatively immobilized.

In fact, when the time comes for me to finally divorce the brace from my op-leg, I'll house it in an acrylic display case and show it off at the centre of the living room to honour its assistance (NOT!). 

I suspect once the brace is off, the op leg will feel weak and vulnerable.  Hopefully, it will get to some level of strength and stability in a period much shorter than 8 weeks!

Still doing the same exercises, though not as often as I should be.  Lots of things going on at the kids' school these days, so I've been quite busy with these.  I was on both feet quite a lot, so hope this makes up for the lack of exercise .

Knee is still swollen, I can't really tell if the swell has been going down.  When I get up in the morning, the achiness and stiffness is hardly noticeable. Possibly, it is getting  less swollen.  I wonder if (hope)  the swelling will get noticeably less when I can start more flex and strengthening exercises.

All bruises on the op leg are gone and the lumps around the wounds are getting smaller.  So this is good news.

Anyway ...

Three more weeks to a braceless leg!  A joke to put a smile on my face for this mini-milestone:

A priest was seated next to Ex-President Clinton on a recent flight. After the plane was airborne, the flight attendant came around for drink orders.

The Ex-President asked for a whisky & soda, and the flight attendant asked the priest if he would also like a drink. The priest replied in disgust, "Ma'am, I'd rather be savagely raped by a brazen whore than let liquor touch these lips!"
The Ex-President then handed his drink back to the attendant and said, "I'm sorry, I didn't know there was a choice..."   

[cgkrueger]

Chona, you are a riot - that is your best joke yet. I need to remember that one!!! I am cheering you on but the laughs I get from your jokes help me too - we are all in this together.

You will be out of the brace before you know it - the final countdown! You probably will feel a little vulnerable, but a lot of healing has been happening under that brace. I bet you are so excited to get a little more active - good for you! The more mobile I became the better my spirits were - much to my (and even more to my husband's) relief. Keep it up!

[chona42]

Week 9

It's been a long while …. haven't been posting as there was not much to say regarding the knee the past 3 weeks.  Also, I was a bit down as progress was really slow.  I was getting sluggish, usually neglecting my exercises.

However, I have passed the 8 week milestone and my brace is OFF! YES!!!

I saw the OS 4 days ago and he said knee looks fine, no longer swollen and I can take the brace off. Definitely what I wanted to hear.  My leg, however, is painfully weak as I must have lost half or more of whatever muscles were there 2 months ago.  This, sadly, is a consequence of saving cartilage (and some neglect on my part  ).  As to whether or not the meniscus repaired itself is yet to be determined, and this could take a while.  From what I understand from the OS, once strength is restored on the op leg, and the knee does not complain, I can assume it healed properly. Main thing now is to keep protecting the ACL graft.

Can't confidently say the knee is painfree as I still occasionally feel a twinge or ache in the meniscus repair site and stiffness behind the knee. I told the OS about this and he says it is normal.  I will see him again in 3 months time for possibly, if all goes well, my last visit with him.

OS gave the go ahead to slowly progress into straight line activities such as cycling and front crawl swimming. I still need to wait a few months before jogging/ running outdoors. The key thing at the moment is to regain op leg strength through PT, without pushing the graft too far.  Avoid kneeling and twisting on the the knee for now.

Today, I had my first PT session without flex restriction.  Not sure who was more excited about it, me or the therapist, as a whole new set of exercises got introduced.

First up, ROM measurements. She was pleasantly surprised to see I could flex to 130° despite being braced-up for 8 weeks.  I have to say as well, I was not necessarily exercising flexion in the last 8 weeks for fear of re-tearing the meniscus.  It somehow just started to improve as the swelling came down.

The extensions were not as impressive and I have to work more on this to get it to same level as my good leg.  This involved propping the leg on a rolled-up blanket and pushing knee down.

As the ROM was good, she let me go on an exercise bike for 5 minutes. No resistance at first, but she raised the level up a notch for the last 2 minutes.  This seemed fine, and she said I can proceed to progress on this exercise in the gym to start building muscle.

I then did step ups, forwards and sideways which looked and felt OK as well. Again, something I can start doing progressively in the coming days.  Best practice was stairs at home which I should start doing normally going up.

Next, wobble board, balancing with both legs. Tricky this one.  Then bridges, using both legs, using one leg, and using a Swiss ball.  This was followed by half-squats and balancing on op leg.

Finally, some exercises for gait which involved some form of exaggerated walking, lifting the knees high before stepping into the leg or kicking the heels back as you push out of the leg.

The session lasted about 40 mins.  Before I left, she said I could do also do more walking  to improve c/v fitness, but just need to be mindful of overuse. Knee could puff up now and then when doing exercises due to more strain on soft tissues whilst muscles are building up, just need to rest and ice if it does.

Can't wait to hit the gym tomorrow!

[chona42]

Month 5+


Wow, it’s been a long, long while since I last posted.  As soon as I was good to go to the gym to work on strengthening exercises, time flew by.

It’s been just over 5 months now and I can confidently say the op knee is feeling fairly close to normal.   No more aches and pains when I get up in the morning.  The meniscus doesn’t bother me, so it could have been a successful repair.  I walk without limping and do stairs up and down at a good pace.  No running yet, though …

Although I can flex the op leg to roughly the same degree as the good one, there is still discomfort when sitting with the feet under the buttocks.

I still continue regular sessions with my physio, on average seeing her every 2 – 3 weeks to add exercises and check progress.  The op leg is still a long way from being as strong as my good leg, but at least I can feel the strength and stability slowly coming back.  Currently, I am working on being able to bend/squat on just the op leg.  Squats, lunges and leg press were prescribed to help with this. I also do a fair amount of hamstring strengthening exercises.

Cycling (at the gym) became my new found c/v exercise.  Never did it before my injury, but now takes up the bulk of my time at the gym.  Can’t say I love it, but it does help a lot with the fitness.

I’ve just started a return to running program that starts with a minute or two jogging in between a few minutes of brisk walks, 6 sets, so roughly 30 mins a session.   The aim is to get to jogging continuously for 30 mins within 8 – 10 weeks.  Hope this works out well.

I just saw my OS for possibly (and hopefully) my last visit.  My physio has updated him with my progress to date and he is happy with the current results.  He cautioned, overconfidence could lead to problems later on … apparently 4 – 7 months from the time the tendon was harvested is when the graft is at its weakest … so I should refrain from overdoing activities.  He said that although the scars from the operation look small and faded by now, it generally takes about 9 months to a year for the knee to fully recover. It’s best to be cautious until this time.

So, still a long, long way to go before full recovery.  But, time does go faster now so I’m not complaining.

Christmas is just around the corner and it’s a welcome distraction!

[cgkrueger]

Yay, Chona! I was wondering how you were doing. Glad to hear things are going well - I cannot believe it's been over 5 months for you. It sounds like things are going great!!

Can you sit with your feet under your tush? I STILL cannot do that and it drives me crazy. Not that I need to be able to do it, but just that I can't that bothers me. There's fluid still in there that prevents me from being able to do it - but hopefully it will go away at some point. Good for you for keeping up with the PT - keep up the great work!

[chona42]

Month 9+

Can’t believe it’s just over 9 months since the knee surgery.  It feels like it’s been ages …

What can I say, so far so good.  I haven’t had any major screw ups on the op knee and I’ve managed to up the ante in terms of activities. 

Back to running now, not as great as I used to be, but progressing, albeit slowly.  Now doing 5K in 33 mins on the treadmill at 1.5% incline, 3x a week.  Knee pain is not the limiting factor, just lack of motivation.  I hope to join a few races in the next months to speed up the return to where I was about a year ago.

I am also able to lift more weights in strength training, all free weights.  Started carrying more weight in split squats last week and so far no pain in the knees.

My last physio session was two weeks ago and it ended with doing some change in direction exercises and hopping on the op leg.  The hopping on the op leg bit is still quite difficult. The therapist advised I continue exercising jumping on both legs and one leg at a time.

I have been cleared to play tennis again, even football, but only football with my kids in the garden  .

Looking back to the days, even weeks post op, it seemed I would never get to where I am now.  It almost seems miraculous, but really, all it takes is patience and perseverance. (Just, please, don’t let it happen again!)  The op leg is still weaker than what it used to be, but in time, I hope it will get as strong as the other leg. 

Also, I still haven’t really pushed the op knee’s limit yet, I think. So, with the return to tennis and outdoor running, we’ll see what it’s made of.