The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: heyannie on August 16, 2009, 08:45:56 PM

Title: Pop Felt when tearing ACL
Post by: heyannie on August 16, 2009, 08:45:56 PM
I was squatting down working on machinery and when I stood up, I couldn't straighten my left leg completely and the back of my knee felt tight.  I didn't think it was too serious until the swelling was really bad 2 days later and I felt like I had pulled my entire calf muscle.  So an MRI confirmed that I tore my ACL and medial meniscus.  Here is my problem.  With having this injury occuring at work, my company is investigating what happened.  They don't seem to be fighting me on anything since I am a dedicated employee and I am complying with everything they ask.  But now they are saying they think it is a previous injury since I never heard a Pop when it happened.  Almost every story you hear talks about the infamous pop.  So why didn't I feel it?  Also, they wonder how I done so much damage but the accident wasn't a traumatic one.  Any suggestions as to why I never heard a pop or how this could have happened?  I've never had any problems with my knees before.  Or anywhere else for that matter.  This is the worst injury I have ever had.  Could I have torn my ACL before and never known it happened?  Please help I'm so confused.  Thanks.
Title: Re: Pop Felt when tearing ACL
Post by: Mike1968 on August 17, 2009, 12:22:20 AM
Hey Annie....LOL "Heyannie"

I have gone through 3 ACL surgeries.  The first one there was a definite POP.  Second one there was a definite POP but was a feeling not a sound.  Third one was nothing at all POP wise.

From every OS I have spoken with (tons over the years) some people will feel a pop, while others will not.  So in MY OPINION, you most certainly could have had this be your FIRST ACL problem without having the POP sensation or sound.

There are also people that can function without an ACL.  There is a lot of reading out there that I came across years ago but have lost the links.  It is "possible" you could have hurt it before but from what I can gather from your post, I would doubt that you did.

Best of luck to you and getting your ACL/meniscus fixed!


Mike :)
Title: Re: Pop Felt when tearing ACL
Post by: heyannie on August 17, 2009, 03:36:38 AM
Thanks for your post.  I have been reading up a lot about this subject.  I'm worried about having my first ever surgery and I'm starving for information.  LOL.  I have read that anytime a person would tear their acl whether it be part or whole, that they would experience swelling and pain and problems walking.  Unlike what my workplace thinks, I'm only 25 and I'm pretty sure that I can remember far back enough to know that it has never happened until now.  I understand that some people can live without an acl but only depending on what kind of lifestyle they lead.  I work in a very physically demanding factory.  I carry up to 50lbs every day and do a lot of squatting and pivoting.  I do a lot of turns at the drop of a hat and I know that without an acl that would not be possible without, if nothing else, a lot of pain and possibly my knee giving out.  And like I said before I've never had a problem until then.  I think my job just doesn't want to pay for this because they believe it is impossible for freak accidents to just happen lol.  That would be my luck though hehe.  I just wondered if anyone else knew of cases where someone tore their acl and didn't hear a pop so I could know I wasn't alone.  Well I am scheduled for ACL reconstruction and repair of my medial meniscus on Sept. 2nd.  YAY 26 days before my birthday :(  I'm thinking of starting a diary afterwards so I can share my journey like so many others have prepared me for what I'm looking forward to in the next coming monthes.  Again thanks for the post and any more that come my way.
Title: Re: Pop Felt when tearing ACL
Post by: Mike1968 on August 17, 2009, 04:04:26 AM

I kept a journal and still do with regards to the surgeries I have had.  It helps you see from day one what progress or regression you have had.  It works wonders!  You can also post your information here so that you can share with others in a similar situation.  I hope that your work is not heartless and are looking for a way to "screw" you.  I would like to think that this is not the case.

Best of luck with your surgery and please keep us posted!


Mike :)
Title: Re: Pop Felt when tearing ACL
Post by: heyannie on August 17, 2009, 04:37:07 AM
I was mostly concerned with what peoples recovery times were like.  I am anxious to get back to work as soon as possible.  I would like to think that my company is doing okay by me so far.  They have been really good about approving everything but at the same time you can never be too sure.  So I'm just kind of covering my grounds.  I'm hoping that my progress is as fast as some of the ones I have read.  It's encouraging to know that there will be things I can't do right away but it should come with time.  So now I won't be so quick to get disappointed.  It's also good to hear that most people are getting off of the pain meds so quickly.  That is something that is scary to me.  I hate taking tylenol let alone a narcotic lol.  So hope I can tolerate as well as most.  Well I will definately keep posting once I have the surgery and keep you updated on my progress.  Until then I get to sit behind a desk on light duty YAY.  Haha.  Thanks again.
Title: Re: Pop Felt when tearing ACL
Post by: jathib on August 17, 2009, 01:22:35 PM
I tore my ACL in half and never heard a pop. I also had very little swelling. In fact, after the accident and a bit of rolling around on the floor, I got up and walked home.
Title: Re: Pop Felt when tearing ACL
Post by: mollyc on August 17, 2009, 04:47:38 PM
Hi there: Sorry to hear about your injury. Just wanted to respond to your time-back-to-work question. i think this varies a lot, but a lot of people are back to work by 2 weeks if they have desk jobs. I couldn't have done that, mainly because I had a lot of fatigue and have a job that requires a lot of intense concentration. I was back part time at four weeks, full time by six weeks.

If you have a physically intense job, it takes much longer.  There's a guy at my gym who is an Intensive Care Unit nurse, and thus on his feet all day. He was off until 3.5 months. But, perhaps if you can go back to work with light duty, you'll be more on the 2 or 3 weeks side of the spectrum.

Ask your surgeon.  They will ask you about the nature of your job and then make recommendations.

Good luck to you! Molly
Title: Re: Pop Felt when tearing ACL" th
Post by: luvmy4girls on August 17, 2009, 09:24:15 PM
Hello. I just wanted to comment on the "pop" issue.  I have injured my ACL twice in the same knee.  The first time was very traumatic b/c I tore both my ACL and MCL.....and I along with others heard the very loud "pop".  So, when I injured the knee for the second time, I had already decided that it was not my ACL b/c I did not hear the "pop".  I went back to the surgeon that did my first reconstruction for a diagnosis. He is an excellent doctor who has been a team physician for a major college for many years.  I was somewhat surprised when he told me I had injured my ACL again.   I told him that I did not hear the "pop" and he said that sometimes you don't.  So, I agree with everyone else that you can injure your ACL without hearing a "pop"....I am proof and am 8 months post op of my 2nd ACL reconstruction. 

Good luck in your upcoming surgery!!


Title: Re: Pop Felt when tearing ACL
Post by: heyannie on August 17, 2009, 09:26:52 PM
Thanks very much for your reply.  Unfortunately I do have a very physically demanding job.  I am on my feet on concrete floors for 12 hrs/day 4 days/week.  I work in the foundry end of a factory.  Very rigourous repetitive work.  So I'm hoping no longer than 6 weeks but we will see.

A new question has entered the equation.  I received my paperwork for my surgery today and it says they are setting me up for a peripheral nerve block.  I'm kind of nervous about that.  I would just prefer general anesthesia.  Will the Dr. leave that option up to me to make?  I don't like the idea of a needle in my back.  Thanks in advance.
Title: Re: Pop Felt when tearing ACL
Post by: vinnic on August 17, 2009, 10:01:29 PM
So sorry to hear about your tear...  Best of luck to you with the upcoming surgery.  As far as the anethesia, you should be able to have a choice before going into surgery.  I was able to choose general for both my scope and my aclr since I didn't want to remember anything.  You could always call the hospital/surgery center to ask ahead of time as well.  Again, good luck!
Title: Re: Pop Felt when tearing ACL
Post by: Lizn8r on August 17, 2009, 11:52:34 PM
I had an ACLr along with a medial meniscectomy, and I also have a somewhat physically demanding job ... 7.5 out of 8 hours a day on my feet ...concrete floors also ... and often lifting and moving 65lb and up around.  I went back to work after 2 weeks (light duty, so I had to get the guys to move the equipment around for me ... I NEVER had to ask for help before and I had a hard time with it!).  In retrospect, 2 weeks was WAY too early.  By the end of the day my leg was really swollen, stiff and sore, and then I had to go to PT.  If for some unforeseen reason I had to do this all over again (God forbid!!) I would stay out at least 4 weeks.

About the anesthesia ... you might want to rethink the nerve block.  They will more than likely give you a femoral block ... the needle goes in your groin area just below your hip bone.  I was HUGELY nervous about the block, but this is how the anesthesiologists convinced me to take the block over GA.
1.  You won't feel the needle going in to the nerve.  You get a sedative in you IV and a topical anesthetic before they poke you.
2.  You will still be asleep during the surgery, just not as deeply.  You will NOT wake up during the surgery.
3.  They do not have to intubate you (run a tube down your throat) to help you breathe. They still give you O2 but its through a mask.
4.  You can be released from the hospital a lot quicker ... like hours or even days if you have a bad reaction to GA ... because there's not so much anesthesia to expel from your body.
5.  The block will help immensely with the immediate pain after surgery.  It doesn't wear off for 24 to 48 hours after surgery (in my case it wore off after 36 hrs) so it helps get you through til the oxycontin, oxycodone  or whatever pain meds you are prescribed can really kick in.
In my case, everything that they told me about the block was true.  I didn't feel it at all, and I had a very easy time coming out of anesthesia.  I actually DREAMED at some point during the surgery!!

I wish you all the best with your surgery and recovery.  And don't rush yourself back to work ...

Title: Re: Pop Felt when tearing ACL
Post by: heyannie on August 18, 2009, 12:08:25 AM
Thanks for the reply.  I'm just so nervous about all of it.  Never had a broken bone let alone a surgery before lol.  I just worry about the possible side affects of the nerve block.  I guess everything has a possibility to have a side affect but I've never heard of GA causing loss of feeling permanently.  I tried researching peripheral nerve block and keep coming up with Femoral nerve block.  Not sure if they are basically the same or not.  I'm just weighing my options and hoping to find out what is best for me.  Its good to hear someone say that they had a good experience with it.  It makes it a little less nerve racking.  If anyone has any good links to read about the differences in anesthesia please feel free to link them.  I'm trying to get all my questions in order for my pre op appointment.  Thanks for all the info from everyone so far.  Information can be your best friend sometimes.  Thanks again.
Title: Re: Pop Felt when tearing ACL
Post by: kn33g33k on August 18, 2009, 12:14:18 AM
heyannie, I hear ya!  same boat here.  good luck.
Title: Re: Pop Felt when tearing ACL
Post by: vinnic on August 18, 2009, 12:52:34 AM
Be sure to look at the Info Hub on the website for more information regarding aclr - it's loaded with good stuff.  Also check out posts on the Cruciate Ligament board - it's a great resource full of supportive posters going through the same thing.  Again, best of luck!
Title: Re: Pop Felt when tearing ACL
Post by: Lizn8r on August 18, 2009, 01:14:45 AM
Its called a peripheral nerve block because they consider your arms and legs "peripherals".  A peripheral nerve block in your arm is called a brachial plexus block and the one in your leg is femoral.  And you're right, there are risks with a nerve block.  But there's also some pretty serious risks with GA also.  I figured that they were pretty much a wash, so I went with the block.  I don't like the side effects of oral pain meds, so anything that could keep the surgical pain away without affecting my stomach and my head was a bonus.

SO on to more decisions... have you (or do you get to) decided which type of graft you will use?  In my case, I got to choose.  My OS told me (after I had already made my graft choice) that if I had chosen anything other than the allograft, then he would have referred me to another OS in his group.  Even though he is competent in bone-patellar tendon-bone grafts and hamstring grafts, he specializes in allografts and believes that a surgeon should stick with what he does best.  Keep this in mind when you decide on graft choice!

Title: Re: Pop Felt when tearing ACL
Post by: mollyc on August 18, 2009, 04:29:28 AM
I had a femoral nerve block too.  I just want to echo what Liz said...didn't feel a thing. They gave me something first through my iv (which, I must admit, felt very, very good) and then the anesthesiologist inserted the block, checking withe me to see if I had any sensation down my leg. When I felt it (didn't hurt a bit, just felt something go down my leg), she was sure the block was in the right place.  She then put me under general, but a lighter form of general than would have been necessary without the femoral nerve block. It was really a piece of cake.

I had never had surgery before. Never had pain meds. Certainly never had a nerve block. But, all those things went very smoothly and I was glad that they had pursued that approach for me.
Title: Re: Pop Felt when tearing ACL
Post by: Ferris on August 18, 2009, 09:09:25 AM
I had a femerol nerve block when I had my ACLr in January 2005.  I would have it again anytime as no pain from the knee afterwards only ached once the block wore off - the hamstring graft site just below the actual knee actually hurt more than the knee from time to time once the block wore off.  Meant that I didn't have to take any narcotics for pain relief either in hospital or once I got home.  I don't even remember the nerve block being administered.  Would definitely recommend it.

Title: Re: Pop Felt when tearing ACL
Post by: heyannie on August 18, 2009, 10:15:08 AM
My Dr. suggested bone patellar bone but we are supposed to discuss it more at my pre op appt.  I am still reading up on all three kinds of grafts so I havent completely made up my mind yet.  I am also like you.  I do not like druggy side affects.  But I do want to take whatever route is going to be safest.  Like right now I am on pain killers but they are non-narcotic so I can still function lol.  I was glad to hear how soon most people were off of the pain medications and hoping that I can cope with the pain as well as they did.  I would like to think I have a pretty good tolerance for pain.  I am trying to get all of the information about every aspect of the surgery I can before my pre op appt. so I can be totally prepared for my pre op appt.  Like I said before I was totally unprepared with my first appt with my OS.  Until I seen him I didn't even know that I had torn my acl.  Thought I only tore my meniscus.  So I really appreciate all the help I have been getting from everyone.  Thanks to all so far and please feel free to keep sending me all the info you can.  Thanks again.
Title: Re: Pop Felt when tearing ACL
Post by: Lizn8r on August 18, 2009, 11:59:12 AM
Definitely do your research on graft selection.  I chose against the bone-patellar tendon-bone graft because kneeling is sometimes required on my job (although I haven't had to yet since my surgery ;)) and one of the possible "side effects" of the BPTB graft is the inability to kneel due to pain. 

Just realized that no one's really told you that this site is FULL of information for research.  Go to the "Information Hub" - you can find the link in the upper right hand corner of every page of this forum.  You'll find all kinds of information from the anatomy of the knee to arthritis treatment.  And also, you should visit the "Cruciate ligaments" board ... maybe even have the mods move this thread over there ... that's where most of us ACLr KG hang out most of the time.  Remember though, as you're reading through the posts ... ACL reconstruction surgery is and has been performed hundreds if not thousands of times a week worldwide and most people who go through it have no recovery issues at all.  Each OS has a protocol that they follow for surgery, recovery and rehab and if you follow his (and the PT's) advice, you will probably wind up with a well-reconstructed knee.

Good luck,

Title: Re: Pop Felt when tearing ACL
Post by: heyannie on August 18, 2009, 09:14:15 PM
Yeah I have really payed attention to the posts that talk about making sure to ice, elevate, and do the pt religiosly.  I plan to do whatever they tell me to in order to have a quick, smooth recovery.  I don't do any kneeling at my job really but I do a lot of squatting.  That is hard for me to do now because of the pain but I can still do it.  Like I said I wasn't prepared with those kinds of questions for my first appt.  I will continue to search the graft choices but frankly an allograft seems kinda creepy lol :D  Glad to hear that so many have had a good experience with the nerve block.  It's not as much the pain that I am worried about as it is what is better as far as possible side affects.  I will make sure to check out the information hub and see what all I can find out.  Thanks for all the advice so far and please everyone, keep it coming!

Title: Re: Pop Felt when tearing ACL
Post by: ex-gymnast on August 19, 2009, 05:58:14 AM
When I tore my first ACL i had no clue.  No pop was heard or felt.  I thought I had just twisted my knee.  I then spent the next 18 months learning to do a full twisting back flip.  (Which can easily cause a torn ACL.)  My second torn ACL did come at the same time a s a loud pop but that was decided to be my kneecap dislocating. 

In my experience recorvery time depends greatly on 2 factors.  1 Who is doing your PT and 2 How much work do you but into the PT.