ACL reconstruction surgery & rehab

[Lee272]

Hi Madmary,

Yes, this site is addictive and I was reading posts every single night before my Op trying to decide if I was doing the right thing! Unfortunately I found that most of the posts on the cruciate ligament forum were quite negative, people only seemed to post when they had a problem or were in pain......that's the reason I started writting on here, I wanted there to be something more positive for people to read who were preparing for a reconstuction.

Having said that I still wouldn't say that I am 100% sure that having the surgery was the right thing to do but I'm slowly getting there. I am almost 6 months post-op now and unfortunately my knee isn't as good as 6 months post injury. I had to wait exactly 6 months from the injury until I had my surgery and in that time I had got my knee to a very good condition. As I have said in previous posts I could run, swim, cycle and even play squash (wearing a brace) before my op. I am still quite a long way off this level now. I can run but it is slow and very painful. I can swim and cycle no problems but I am some way off being able to play squash with or without a brace. Hopefully it will just take a bit more time.

I was signed off work for 8 weeks in total, but I 'rushed' back in 5 which was about when I started driving again. Simply because I was so bored of being stuck at home.

Good luck with your op and recovery, I'm sure everything will go great for you.

[Lee272]

Week 23

I had my 6 month post op evaluation earlier this week on the Biodex extremity testing machine, where you are strapped into the seat and do maximal leg extensions and leg curls at various leg speeds to compare the power generated by the operated leg with the healthy leg. It was very interesting!

The good news is that my hamstrings are almost identical in power at all speeds. This is probably as expected as my hamstring muscles are untouched in both legs. This is one of the reasons I chose the patella tendon graft because I didn't want to lose my sprint speed by compromising the hamstring muscles in my left leg.

The not so good news is that the quadriceps muscles in my operated (left) leg are much weaker than my healthy leg. At the slowest speed, which was 60 degrees a second, my right leg generated 90% more peak power than my left leg!!! I was amazed the difference was so much!!! My healthy leg is almost twice as powerful as my operated leg, or probably more accurately my operated leg has lost almost half it's power during maximal extensions. At the faster speeds of 120 and 180 degrees a second, where the quads don't have as much time to generate force, the weakness in my operated leg is not so obvious and the deficit was approx 60% and 30% less power respectively. 

These results are obviously due to the type of graft I chose. They took the middle 3rd of my patella tendon which has compromised the ability of my tendon to transfer the force generated by my quad muscles into extension of the lower leg. My physio says that my results are typical of someone who has had severe patella tendonitis as a results of this graft. The effects of the tendonitis are two-fold. Firstly in the gym I am held back by the pain and can't load the quad muscles enough to build strength, which is true. Secondly during the biodex testing the pain in my patella tendon causes me to stop generating force at a certain point, seen as a straight line on the graph which the machine produces. So actually my quads probably are stronger in my left leg than the results suggest, but because of the pain my body stops them producing maximum power.

At least I have a good benchmark for my training over the next few months! In the gym I have to move onto heavier weights to activate the quad muscles (now that my graft is 100% secure and my knee is stable) but not squat/lunge so deep to try to eliminate the patella tendon pain and swelling.

Now I understand my professional athletes opt to a cadaver graft. Without the pain from the graft site, my knee would be close to 100% now and I'd be back to playing sport. I never realised that it's not the graft healing that holds you back, it's the healing of the graft site.

Anyway, what's a few more months of hard slog! 

[Lee272]

6 Months Post-Op

Just a quick post to say that I've made it to 6 months post-op! Things actually seem to have 'clicked' and I'm starting to get much more confidence in my knee now. I'm back doing much heavier squats in the gym, I'm feeling good with the leg extensions now too. I've even played a very gentle game of squash this week which felt great (don't tell my physio though... )!

So all is good and my leg is getting stronger and stronger. I seem to have got over the worst of the patella tendonitis too so my knee is very rarely painful now. It still doesn't feel 'normal', but then I suppose this is to be expected for a long time yet.

[vinnic]

Aiye this post slipped by me.  There ARE positive posts on this site, even if the negative seem to weigh in.  You just have to dig deep and find them...and when you have a lot of time on your hands like acl recon or other surgeries, it's time spent well.  And, if the negative seem to reign, then simply focus on the positive posts and you will reach that goal.  Go to the various diaries on here in addition to the cruciate ligament board.  And best of luck!!   

[ricoshay]

Hi - have just read your diary and found it really useful, thank you. I have a hamstring ACLr in June and now the reality of what is going to happen is sinking in! First surgeon told me I'd be 2 weeks off work, the 2nd said a month - now it looks like it could be longer from what I am reading, but I have the advantage of being able to do quite a bit from home.

I am encouraged by your post op progress regarding rehab - there are a number of posts just describing pain  so good to see you were able to get on with things quite well

good luck with your continued efforts

ricoshay

[madmary66]

I had a hamstring acl reconstruction on May 9th and, like you, was given conflicting information from physios and my surgeon as to how much time I would need off work.  One said minimum 6 weeks and the other said 2 weeks! I actually got signed off by the hospital for 4 weeks in the end and do think that this amount of time was necessary to do exercises and rest as much as possible (and also enjoy the lovely sunshine we've been having  )!!

So far my rehab seems to be going well with things getting easier and easier, I hope to start driving this weekend which will be great as it has been very frustrating to rely on others for so much.

Good luck with your surgery - I am sure it will be fine.

Mary

[ricoshay]

Hi Mary!

how is your recovery going? I am 3 days post op, no pain (phew!) but slightly concerned that i might not be doing enough physio given others posts on their gruelling schedule! you back at work...?

regards
ricoshay

[Kaputt_Knee]

Those schedules are definitely not the norm! So have no worries about that  The most "gruelling ones are mostly "testosterone-driven"   

If it helps, by following my surgeon's schedule to the letter and working with some wonderful physios, I was back skiing 5.5 months after undergoing a major revision and additional reconstruction of the LCL ligament!

Golden Rule: stick to what real people want you to do and be guided only by them. The rest of us are internet weirdos and may not have done any rehab whatsoever because we were too busy posting our schedules online and comparing notes with other fantacists. 

But some of us are not that bad and can provide a support network when it gets frustrating because some of us have actually been there and worn out a T-shirt or two as well. 

Sue

[ricoshay]

thank you for your message Sue, its good to know that there's some calm and sense out there! I've started my diary and will try to keep it up to date with some other real stuff too 

regards,
Ricoshay

[madmary66]

Hi Ricoshay,  I'm now at 8 weeks post op and things are going really well.  I had 6 weeks off work in the end which I did feel bad about as I could easily have gone back before then but the GP signed me off so what could I do?        I too got a little worried by some of the gruelling physio schedules posted on her but keep telling myself that I have MY physio and I must do what HE says and ignore what I see elsewhere!    I was back on a bike by 2 weeks post op which was very scary when the leg reached its maximum bend but,as with so many things, the more I did it, the easier it became.  I started spinning classes 2 weeks ago (6 weeks post op) and apart from standing up in the saddle, I can do everything everyone else does.    I have a spin bike at home which I use twice a day for about 15-20 mins each session and I really think that this has helped me get back to spinning so fast.
I can now come down the stairs normally and fairly speedily which is great and sometimes I even forget I have a dodgy knee!   My main excercises at this stage (set by my physio) are hamstring strengthening (by doing something called a bridge on a step), squats and balance work - no more than that.   
It has, so far, been less difficult and painful than I had anticipated and I have been really pleased with my progression so far.   Don't worry about what everyone else is doing/not doing, just do what you are told by whoever is treating you as they will base your excercises on you which might not be the same as anyone elses.
Good luck - keep posting as it's always interesting to read...
Mary

[ricoshay]

Cool! Sounds like you're doing really well, Mary, great to read such a positive update! I will be getting the bike and turbo trainer out tomorrow! (actually, had a little go with the PT the other day but am waaaaay off getting the pedals all the way round yet  )

..ricoshay
ps we need a smiley with an umbrella I think for all us UK posters!!! 

[madmary66]

Hi Ricoshay, I didn't manage to get the pedals all the way around (and then only VERY slowly!) until 14 days post op. It was incredibly scarey the first time around which is why it's very important to only do it with your PT and not on your own as he/she will be able to assess whether or not you are at a stage where it is feasible to do this.   Like you, I wasn't in any pain post op which was great and quite unexpected really as when my surgeon told me the details of the op, it sounded like it would be very painful.    I hope things continue to improve for you, I remember that I felt in the early stages that I would never walk without a limp again and everything would be such a struggle but I'm glad to say it wasn't and I walk totally normally now.   How did you tear your ACL by the way?

[ricoshay]

Hi

I was playing in the snowpark in Les Arcs, doing little jumps on my skis, but landed badly, fell forward and my bindings didn't release. I knew straight away that I'd done something, because I heard a pop and it felt strange - but not hugely painful. My husband managed to get my skis off, and I walked about 100 yards down to a restaurant where I managed to get a pisteur to help. I was taken off slope on the blood wagon - backwards, head first on a stretcher, which was quite exciting! Ruined my holiday though, and the snow was so good this year, I was gutted   

Have got the pedals all the way round now, woo hoo!!! I am on a mission to be ski fit again for next Feb as we are hoping to go to Canada or America for OH's 50th birthday... When I read posts like yours about such good progress, it keeps me inspired to achieve this.

[madmary66]

Hi again, my accident was fairly similar in that my bindings didn't release when I fell as a result of a 5 year old out of control french kid careering into me!   The very frustrating thing was that this was the first year I had not taken my own skis for about 10 years as the cost of taking them on the plane for a long weekend was more than hiring them, however I'm pretty confident my bindings would have released on my own skis saving me the injury and months of rehab although of course I can never prove that!   Like you, I was totally gutted about my injury as I was on a long weekend (4 days) in Meribel with perfect snow and perfect weather and this happened 2 hours in on the first day  .  I didn't hear it pop but knew I'd done something fairly major as felt very faint and sick and everytime I tried to stand up, my knee kept on giving way - very horrible feeling.  Stupidly I didn't get a pisteur but side slipped down with all my weight on my good leg, to the next lift but now really regret that as I've always fancied the 'blood wagon' and the first opportunity to do it and I didn't go for it. 

Funnily enough I am also on a mission to be ski fit for February as I have a holiday booked in Les Arcs (had booked this pre accident!) so we seem to have a lot in common....   

Have you got a realistic time off work yet?  Make the most of it - I loved it despite the rubbish weather although having said that I did have that 9 days of sun (yes, remember that?!) during my first 2 weeks which was rather nice but it was all horrible after that.  Loved my time off though and realised that perhaps I could indeed be a lady of leisure    I didn't drive for 3.5 weeks if that's any help by the way.

Maryx

[ricoshay]

Good morning!

You'll have a great time in Les Arcs, there's some lovely runs! Where abouts are you stopping? We were in a little hamlet called Villaroger, which was quaint but a little too isolated for us, and it was a pain to get back to at the end of the day (we missed the last lift once and had to pole back up a long slow blue run to get home - exhausting!). But we were quite impressed with the resort, even though we never got to explore the far limits and go on the mega Vanoise Express double decker due to my fall!
We had an instructor for a day to get us out of some bad habits, and he wore a custom made titanium brace as a result of a very similar accident to yours - someone smashed in to him - but he broke bones too - sounded horrible...

I'm signed off for 4 weeks, but have started doing a little bit on the laptop from home - I manage a team of area managers and feel that I need to 'keep my hand in'. But i have to be strict with myself - yesterday I spent too long at the laptop and paid the price later because it made my knee sore. I have to go in next week for a day too, cos we have a day budgetting for next year, but other than that, I shall be trying to work from home. Our Company isn't great when it comes to this sort of thing - my boss told me that I could work from home from the off because 'there's nothing wrong with you'!
on the bright side, I go back properly at the end of July, and I fly to Portugal for 10 days 6 days later!!!!
Driving is the big thing for me - I do 45,000 miles a year - and hope to be able to drive short distances fairly soon. I think the hardest part will be getting in and out the car!

Lady of leisure, eh? I am already starting to wonder how I found time to work 12 hours a day, there's so many distractions when I'm at home, he he!