Cruciate ligaments :

ACL recon and a wonky knee cap. - - Posted by dillinga (dillinga), 5 December 2003

Hi,

15/06/03 was the day I entered a whole world of pain.

On that date I had my right ACL reconstructed and thought I would be on the road back to football.  Unfortuantly it's now december and i'm having days where i feel like i've just come outta of the op again.

My problem according to the hospital physio is my knee cap.  During the op they found my knee cap to be unstable and now i'm all zipped back up it's not flowing correctly.  I've been working extremely hard to rebuild my muscles on my right leg but have found that most movements are causing a problem/pain due to this wonky knee cap.  

Instead of my knee moving in a fluid up and down motion it is now moving up and then slightly to the right and then completes it's movement.  Because of this i'm getting some extreme pain and have been told that i really need to build my thigh muscles up to help support this problem.

Problem is, doing any exercises requires a bend in the knee and this can really hurt.  I'm also getting some strange pain/feelings from the large scar below the knee cap.  Could this be scar tissue?

What i really need advice on is if anybody knows what the best exercises are for building up the thigh muscles that won't affect the ACL recon.  The only one that I can think of that really builds up the inner thigh muscle is a led curl with weights but i've been told that that's not good for the ACL.

What can I do  I haven't kicked a football for nearly 2yrs now and i'm missing it.
Posted by koala (koala), 5 December 2003

Squats, squats & more squats.  On one leg if you can handle it, 2 if you can't.  Very very boring but, on two legs should be safe.   Please check with a PT, I'm not an expert.

But, as I keep saying on this board.  If your exercise is difficult on land, find somewhere where you can do it in water - hydrotherapy.  Brilliant if you are having pain bending the knee etc & squats are much easier (but still effective).

Good Luck,
Jo

Posted by hmaxwell (Heather M.), 5 December 2003

Actually, if you are having tracking problems (your wonky kneecap), then squats are literally the last exercise you should do.  They can be done 1/3 of the way in shoulder deep water, but only if you have no pain.  

You should talk to your doctor or PT about getting a brace and/or instruction in taping your knee to be able to exercise without pain.  I have the same problem you do--my knee tracks badly because of anatomy and weak quads, but any effort to build them causes sharp pain and swelling, leading to further inhibition of the quads.

You didn't mention if you are in a long-term PT program, but that's probably the best way to start.  Your doctor should be able to help you find a knee specialist PT who can help with the taping and exercises to improve tracking.

One final thing--have you been evaluated for the integrity of your ACL repair?  Or any complications of the procedure?  If you had a patellar tendon graft, you are at risk for tendinitis, patella baja, scar tissue, and so forth.  Even an arthroscopy can cause this, so it's a good idea to be evaulated for some condition underlying all of your current issues.  A simple x-ray can show things like patella baja; an MRI could show long-term or severe patellar tendinitis.  A hands-on exam and series of tests can help pinpoint the presence of excessive scar tissue.

Good luck with your knee.  If things don't improve, seek out another opinion from a specialist, as there are many possibilities for the symptoms you are describing.

Heather
Posted by koala (koala), 7 December 2003

Thanks for putting me right there Heather.  I didn't know about the effect of a tracking problem.  I'll remember that one.  

It just proves that ultimately it's best to get expert advice  

Jo

Posted by dillinga (dillinga), 8 December 2003

Hi,

I'm currently in a long term ACL class with the local hospital.  Unfortuantly I'm now finding it difficult to get too as it is early morning and it's conflicting with work.  The other problem with this class is that they have 1 PT to about 20 people with 1 hr to do the rounds so time spent with them can be little or none.  

We have tried the taping procedure a couple of times but it hasn't stayed in place so far whilst exercising.  This may have been due to my hairy knee cap so i've now shaved this area for another attempt.  Looks a bit funny now, good thing it's winter and no shorts are needed.

They have quickly checked my knee with different bends and twists when I reported the pain and have reported that their seems to be no damage to the ACL recon.  I think it will take a bit more moaning before they will look at a x-ray or MRI to see if their are any other issues.

The taping procedure, is this going to actually help or will this be something that I may be stuck with for now on.  I take it the taping will ease the pain to assist with exercising to build up the thigh muscles.

Can you get this special tape from anywhere?  Might be a good thing if i can get some so i can exercise away from the hospital easier.

Thanks for all your advice.

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