ACL tear - I start my long journey to recovery!

[PiotrS]

Hi,

My fat pad is still not perfect, but it is getting better. The swelling has basically gone, although I still have a bit of discomfort when I straighten my leg and then bend it under weight. I have been working very hard on the VMOs although to be honest I cannot see that great results for the work I am putting in, at least in terms of muscle, although the mechanics of the patella have certainly improved.

I also think I am doing a lot of compensating with my right (good) leg in every day activities, and it shows. My right quads are bulging like never before, while my left quads still look really feeble. I took off the kinesio tape that was pulling my patella medially, as it was starting to give me discomfort, which hopefully also means that muscles are now strong enough to make the patella track normally without the help of the tape.

I have been given a full gym routine to start next week, so I hoping that will start to make a difference to the strength of the muscles in the bad leg.

As for your accident I know how hard it is to get around in London without getting bumped or pushed - I was there just before Christmas, and I had to fight much harder for space than I do here in Warsaw. Funnily enough I found my swelling was worse in London then here, I wonder if the air pressure or humidity have anything to do with it. Winter is coming here next week, so it will be interesting to see how the knee copes with snow.

[grapplingdude]

Hey Piotr

My fat pad (back of the knee) is still a bit swollen as well and sometimes a bit uncomfortable causing it to sometimes "switch on" a split second late - weird and annoying!!! The general swelling seems unchanged and remains low but visible. There remains some grindiness and discomfort around the patella. I started anti-inflammatories again and I think this helps a bit.

My VMO used to be bigger on  the left but is now back up to roughly the same size and definition but still feels softer to touch... The alteral quad bulk and hamstring are still not there  but getting closer!

So what happened today:

Feeling a bit under the weather but went to the gym doing some 60 mins of easy low intensity cardio and a much reduced workout for calves, adductors and abductors only. Then some upper body and 40 mins of stretching.

Did deppm stretches again and despite some discomfort they felt OK! 

[grapplingdude]

Day 108: I described day 107 just below. So what happened today - had a clicky crunchy and uncomfortable knee, also still fighting off that cold!!! Did a morning session including some light cardio, full leg workout and the knee felt a bit loose at times when doing adductors - hopefully this is a muscular thing only!!! Also did my plyometrics and knee was quite painful when doing hopping (around patella). That did not seem to bode well for my treadmill jogging BUT knee was literally pain-free when running! I did 6 mins at 11kph followed by another 1 min at 11 kph and then 1 min at 9 kph and that was all fine! 

Did some stretching afterwards and relaxed.

Day 109: Knee was a lot less crunchy and uncomfortable today but still grappling with the oncoming cold....  Scrapped my planned 3.5k jog on account of this and will have another good session tomorrow. Knee / leg felt a bit funny today in a way thats hard to describe - kinda loose but not unstable 

[PiotrS]

I wouldn't worry too much about weird feelings in the knee. My knee feels different almost every day. Sometimes like today it feels as if nothing ever happenned. Other times it feels painful, sore, crunchy and all kinds of other strange sensations. I think I underestimated how long a process the rehabilitation is, and how much effort it will take to get back to normal.

In any case, today has been a good day, doing a lot of proprioception work with the physio, as the strength training I now do at the gym. After two gym sessions my knee feels a lot better than previously. In fact my fat pad problem seems to have gone, although I am also not forcing the knee in the way that it would affect the fat pad. In my case it is the tissue to the lower lateral side of the patella that is swollen and that was causing me all the pain and flexing issues. It still feels lumpy and I can tell that there is something there when I bend my knee in a particular way, but it no longer hurts, and does not inhibit exercises.

The proprioception work has moved to a bit of light hopping onto the mat. First time I have done that since the operation, in fact the first time I have done that since I tore the ACL in Feb last year. The knee did not complain at all, which is great. Also lots of balancing work on the operated leg trying to put the body out of balance with rapid movement of the good leg. A gym session this evening, and no more action for me this week, as I am on travels till Friday.

[grapplingdude]

Piotr

I guess youre right - day to day form is hard to predict! The residual swelling I still get is mainly at the lateral side of the knee and manifests itself in a narrow strip that pops out as I fully extend the leg. My physio examined it yesterday (I hate the rattling around with the kneecap - gives me the creeps big time - YUCK  ) The good news is that he thinks the swelling is significantly! improved over the last examination some 4 weeks ago or so. At least thats some good news 

He thinks that the grindiness is down to a rigidly stiff hip flexor and uppermost part of the thigh and I have been given more foam roller homework around that area. More good news is that he thinks my knee is now easily up to the rotational forces from boxing drills and that I can do that again. Fact is taht I am meant to start rotational work next week or so anyway!

Day 110: So the knee felt OK during the day and I went to the gym at night:

Did some light cardio to warm up and then addressed all the areas the physio identified this morning: gluteus medius and deep rotators mainly also hip flexor flexibility.

I then did full leg workout plus plyometrics. The hopping felt a bit painful around the kneecap again and I then went on the treadmill for 6 mins at 9.5 kph which was fine followed by 6 mins at 11.5 kph which felt more demanding on bothe the knee and my cardio than on the weekend. Then did 6 mins at 9kph which felt easy and so painful around the kneecap and then did 3 mins at 12 kph which was very demanding for my cardio and felt hard on the knee...

So mixed results in all today but it was quite a demanding workout and I am still fighting that cold off   

[grapplingdude]

Day 111: Utterly unspectacular - long day at work so no gym 

Day 112: Hooray!!! 16 weeks gone by!!!! Went to the gym early this morning doing some crosstrainer plus my basich glute activation and hip flexor stretches plus skipping and hopping.

I stepped up the hopping but my kneecap was crunchy and a bit painful throughout the hopping and skipping... It was a freakishly early session though so not sure about this 

At any rate I will have time tonight and plan on going for another session doing some more plyo and running - we'll see after trhat 

[grapplingdude]

Day 113: My session yesterday evening was pretty interesting in so far as there was much less knee pain / grinding on the hopping and skipping and I did a 10 mins run @ 12 kph !!!! Cardio is wanting but ZERO discomfort in the knee - almost like back to normal, muscle memory is still not there

Today I had an easy session with some skipping, cardio and lots of much needed stretching and foam roller for hip flexors and back of the knee - that was magic and the knee feels much healthier now!!!! 

[PiotrS]

Hi,

My fat pad related swelling is in the same place as yours, a small patch on the lateral side of the knee which pops out on extension. It is also where one of the portals was made. Luckily the aggravation is now completely gone, although after three days of no exercise my knee does feel a bit stiff generally.

Had a physio session this morning, and only now was introduced to the foam roller for the thigh. That thing is amazing! It eased a lot of the stiffness pain I was experiencing after all the travelling I have been doing. I need to get me one of those so I can use it at home. Otherwise I have a few pains, but generally the knee feels OK, just need to keep going on the strengthening exercises. Feel a bit wiped out today, so will just stretch and do a big gym session tomorrow.

Snow has fallen, but so far I have avoided any major slips.

[grapplingdude]

Hey Piotr

Yep the foam roller is really therapeutic - my knee was absolutely discomfort free today and almost no crunchiness! Only muscle memory still gets me. It all doesnt seem to switch on at quite the right time yet.

Had a tough session today but was good, only mild set back was that I did some abs and core work using TRX band with my feet strapped in and the heel got stuck as I tried rotating out and that was definitely a good twist onb the knee - not really painful as such and I dont think that there is any immediate damage to the graft but it is a bit aggravated.

Dont know if it was the twist or my ambitious session today 

At any rate keep your head up buddy - were almost 4 months and over the worst surely!!!!

Day 114: Knee felt really good and painfree today after yesterdays session and I did a tough session today:

Lots of intense cardio about 60 mins in all

2 running spells including 16 mins at 12 kph and the last minute at 13 kph - knee was painfree, cardio held up and had very good strides 

Did my circuits for core and upper body but twistedd my knee in the TRX band 

Then did my second running spell - started at 13 kp for 3 mins but went down to 10.5 for 7 mins because knee was a bit uncomfortable this time (strain of a long session? twist?). 10.5 was a cruise and I did my final minute at 13 kph which felt OK

Also did 3 foam roller sessions

[grapplingdude]

Day 115: Knee felt marginally more strained this morning but ok and swelling seemed unchanged so I did another big gym session including plyometrics. My hopping was mildly uncomfortable and i did 2x 100. Also did 12 mins running at 10 kph with 1 min at 13 kph in the middle. First, I felt mild discomfort then a bit less and there was definite discomfort at 13kph. The remainder was plain sailing and incline was 2 degrees.

Also, I did 15 mins skipping which was fine. Kneecap has been crunchy and uncomfortable since so there must be an element of overexercise to it...

[grapplingdude]

Day 116: Knee felt better than expected but I still decide to take it relatively easy. Did about 50 mins cardio on the bike low intensity and some skipping plus my basic glute activation stuff also did 3 rounds straight punches on the heavy bag. Did some upper body circuits and thenstretching an foam roller - nice little session! 

Day 117: Knee felt pretty good when waking up and I saw the physio this morning - he changed my routine to keeping the basic glute activation exercises but focussing on the right healthy side cause that is actually falling behind. He also added in those single leg half-squats where I push my leg against the swiss ball propped up against the wall!

He recommends to hold off on TRX stuff for now where I may get my heel caught for another 4 weeks till month 5 basically and to carry on with everything else!

Planning on doing a short strteching only session over lunch followed by boxing drills with my buddy at night - slightly apprehensive of how this may go!

[grapplingdude]

Day 118: Lunch time stretching did unfortunately not materialise yesterday but 1.5 hrs of boxing drills did. And again I pretty much overdid it on that one. It had been 2 weeks since my first attempt and I am in 2 minds about it. OS and physio have cleared me to do it but they may not quite understand the forces on the knee. Positives are: good relatively low impact agility including lots of sideways movement, (relatively) slow and controlled directional changes and some small but quick rotational movements. The latter ones I am not so sure about yet. Did some stretching afterwards and hit the steam room. At night the knee felt good.

When I woke up this morning the knee was not particulalry stiff or crunchy and swelling was maybe mildly puffier but it felt a lot stiffer than in a while particulalrly at the back. Now of course this is always worrying but there is no major change and part or all / most of that associated feeling of some laxity / instability may be psychological.

This is a tough call to make at 17 weeks and I think I ll see how things develop over the next 2 weeks and I will then maybe have another session nearer the 19 weeks mark provided all goes / recovers well which it did last time!

The one annoying thing today was that work overtook me and I could not have that long foam roller / stertching sessiion I wanted 

Will make up for it tomorrow!!!

[grapplingdude]

Day 119: 17 weeks today and I am ready to make up for yesterdays not going to the gym. I go very early morning and do all my activation exercises. My single-leg half squats are a bit grindy and painful on the kneecap as is kneeling but the foam roller stuff I do seeems to help. I also do some 20 mins light cardio and go to the office. The knee feels significantly less stiff afterwards but not as good as at its best which I reported about a week ago or so...

I have a late night session as well where I do my activation exercises again and the single leg half squats definitely feel better. I also do upper body circuits and foam roller again. I have a weird sensation around the kneecap when cycling for about 20 mins and it is hard to describe other than what I felt cycling in the early stages of my rehab when mobilising the knee cap but less painful 

Well at least the upper body circuits were improved. I also test some running doing some 4-5 mins progressing from 9.5 - 11.5 - 13.5 kph for about 1.5 mins each and this went surprisingly well with next to no pain and the leg only feeels a little slow to switch on...

[PiotrS]

Sounds similiar to me. My knee generally feels very stable, I don't have any issues with laxity. But I do get strange pains and pulls around the knee cap, sometimes when exercising, but sometimes just when walking. I can definitely feel the quads getting stronger now, and the control over the leg is also improving.

Still feel occassional pain around the back of the knee on extension, and I still struggle to get my heel to touch the backside. It takes a good deal of stretching. It sometimes helps me to massage the thigh, something then releases and I find it easier to flex the knee completely.

Right now doing two gyms sessions per week and two physio sessions, with a bit of stretching in between. Can't wait for the snow to clear to get on the bike again.

[grapplingdude]

Piotr

I have been fine to touch my heel to my backside for a while now but was already used to this from previous rehab. The scarring and swelling still makes it uncomfortable and feeling a bit unstable.

The pulls and pain around the kneecap are more worrying / annoying. Got rocked uncomfortably on the tube this morning for instance when my weight was on the left leg and it was fully extended against the forward pull - then suddenly the guy breaks like a maniac.... I suppose thats an advantage you have though we have no snow here...

At any rate yesterday was 4 months on the day so there is a minor reason to celebrate - 2 more months till return to more demanding sport specific activities or so I am told!

Day 120: I did my activation exercises for the leg and about 45 mins of very low impact cardio then stretching and foam roller - not much to report other than the ussual stuff - adductors on the left side are incredibly sore when stretching!!!!!!!!!!!!!