KNEEtalk

DIARIES => Post op diaries (>300 posts) => Topic started by: ouch09 on June 26, 2010, 10:47:31 AM

Title: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on June 26, 2010, 10:47:31 AM
Day 1

I was up till 3am the night before the op, trying to clear as much clutter as possible so there would be no trip hazards. I managed to clear the majority but there are still some left.

I had 2 hours sleep then had to be up at 5am to leave home by 6.30am. I did my normal morning knee, hip and back (I have a bad back as well as a bad knee) stretches, then drank as much water as possible at 5.30, that being the last time I was allowed to drink water pre-op.
 
I got to the hospital at 8 and was asked to change into my surgery clothes : underpants (unlike Cosmicsnuffle, mine were not paper, but were cloth; imagine undies made like string vests, i.e. They hide nothing but hold your bits in place), anti-embolism stocking for the non-injured leg, gown with an open back, dressing gown with an open front to cover the back ... :), surgery slippers.

I was then seen by the surgeon who asked me to confirm my name and date of birth and which knee was injured. Clearly there have been mixups before, so this is now safety procedure. I was asked to sign a consent form, having been told the potential risks of surgery.

Next I was seen by a nurse who asked me if I was allergic to anything (no) and if I was on any medication (no). She took my blood pressure and pulse.

Next I was seen by the  anaesthetist who asked if I had general anaesthetic before, which I had when I was 19 to remove my wisdom teeth.

Then it was over to the operating theatre at 8.30 (I had been expecting to spend the morning reading a book, so this was a bit of a surprise). The anaesthetist put a needle in the back of my hand and then rather than asking me to count to ten, asked me where I lived and what I did for a living. By the time I finished answering the second question I felt myself feeling very sleepy ...

More to follow ... 
Title: Re: Deepak's ACL surgery
Post by: moz on June 26, 2010, 12:39:41 PM
I look forward to hearing your progress. I'm two weeks out and back to work  on Monday (mainly sedentary work). Hope all has gone well and for the future of your rehab. What were the details of your reconstruction in you don't mind saying?
Title: Re: Deepak's ACL surgery
Post by: Cosmicsnuffle on June 26, 2010, 11:42:01 PM
Hey Deepak,


Congratulations on getting through your surgery. I'm quite jealous of your assigned undies! Obviously upmarket  ;).

I hope you are managing to avoid the trip hazards and everything is going well for you. Looking forward to your updates.

 :)


Title: Re: Deepak's ACL surgery
Post by: tez27 on June 29, 2010, 08:11:45 PM
Hi Deepak
Good news your on the other side of surgery I hope all is going well and the pain is not too bad, look forward to your next exciting instalment of all things aclr.
Take care Tez
Title: Re: Deepak's ACL surgery
Post by: ouch09 on June 29, 2010, 10:11:15 PM
Hi moz, I had a quad autograft.

Hi Cosmic and tez, I'm doing well thanks. Sorry, I've been a bit slow with my update, will be putting that right now  :)
Title: Re: Deepak's ACL surgery 24-6-10
Post by: ouch09 on June 29, 2010, 11:09:11 PM
Day 1 contd.

Apparently I was out of theatre by 10.30, but didn't wake up till about 12.30.

The surgeon was sitting next to my bed (I hope he hadn't been waiting there long for me to wake up) and informed me that the surgery went well & that arthroscopy confirmed what MRI had told : there was no meniscus or condyle damage. The ACL reconstruction had gone without a hitch. I had expected to wake up in pain & was very pleasantly surprised to find that I was pain-free. I thanked him and then fell back asleep.

Next, I was woken by a nurse who informed me that I was in a brace, and that I could take off my dressings the next day. She gave me a info pack with details of when my stitches would be removed, what to do if I was concerned (ring my GP), my hospital discharge sheet, an exercise sheet (quad sets, heels slides, straight leg raises, RICE), and a rebah protocol schedule (partial weight bearing for the first 2 weeks in a brace locked between 0 degrees extension and 90 degrees flexion, and details of the usual physio exercises for the next year).

The nurse offered me a bottle to empty my bladder, which I hadn't thought about until she mentioned it, but now that she had I realised I was dying to go for a piss. Try as I might, nothing was happening. It then dawned on me that the reason I was pain-free was that I was heavily drugged-up, and either the pain-killer or the anaesthetic were preventing me from emptying my bladder. The nurse suggested I try doing it standing up (wow, what do mean stand up ? I've just got out of surgery !), but remarkably I was able to stand up & thankfully was able to empty my bladder, which was a huge relief. If I hadn't managed, the nurse was threatening me with a catheter ... :o I then fell asleep again.

Next, I was woken by a physio, who wanted me to get out of bed so she could show me how to use the crutches they had provided for me. ("They don't mess about here" I thought to myself !  :)) I really appreciated this because last year when I was given crutches in A & E, they didn't tell me how to use them and I ended up using only one & giving myself a shoulder rotator cuff injury to add to my ACL rupture. The physio led me to a gym where she showed me how to climb up & down stairs - again I didn't get this instruction last year, but luckily worked it out for myself. I was still groggy, so went back to bed and (you guessed it) fell asleep again.

By this time it was about 2pm, and it was about time for me to go home. I was asked to walk to the recovery area and then sit on a chair with leg supports. I was offered a cheese sandwich and a cup of tea to wake me up. I struggled to eat the sandwich and only managed a mouthful, although I finished my tea.

Soon, my parents and sister turned up to collect me, but I was still groggy, so I was left to sleep off the anaesthetic. By 5.30, all the other day-surgery patients had gone home and there was only me left. It was time to go, even though I was still groggy.

My sister called a taxi, but it didn't arrive for over an hour  >:( I had read from other people's post-op diaries that they vomited, so I had expected to do likewise, but so far had felt fine. However, while I was waiting for the taxi, my stomach decided that it didn't really like the sandwich or tea - I felt queasy, but luckily didn't actually puke.

I was supposed to go home to my flat with my dad to help me, but it was decided that I looked too groggy to go home (the nurses told my sister that I should have been wide-awake & that my sleepiness was unusual). I was instead taken to my brother's house (he has a bigger house than my sister or parents). There I managed to have some slices of water-melon, which were much easier to digest than the cheese sandwich.

I had a diclofenac (non-steroidal anti-inflammatory) and codeine tablet and went to bed.

 

 
Title: Re: Deepak's ACL surgery 24-6-10
Post by: ouch09 on June 29, 2010, 11:51:04 PM
Day 2

I woke up about 8am and had a breakfast. My stomach was feeling much better, so i decided to try some orange juice with bread, and some cereal. Luckily, it all stayed down  ;) I took another diclofenac & codeine tablet.

After breakfast, I felt tired and went back to bed. I woke a couple of hours later and removed the crepe bandage from my leg to reveal my surgery wounds : 2 each side of the knee just below the patella, 1 on the anterior medial side of the tibia (this I presume was where the drill was inserted), and then surpringly one on the lateral side of my quad ... this was when I realised that the surgeon had not used my hamstring as the graft site, but rather had used the quad - I'm not sure how common this is, since I don't remember reading about it on knee guru ...

By the late afternoon I felt confident enough to go for a short 10 minute walk (after strapping on my brace), which was problem free. I remembered that the physio said I should try to be up & about as much as possible, rather than lying in bed which would prolong my recovery. I then iced the knee since it had got hot.

Buoyed-up by the success of my first "solo walk", I decided to be all big & clever and sit at the dinner table without elevating my leg. I then spent a couple of hours sitting on a chair without elevating my leg listening to my 6 year-old nephew playing piano. At the age of 6, his playing is already way beyond my one-finger-at-a-time-with-the-right-hand playing.

I realised that I wasn't so big & clever when I was going to bed and noticed that my calf was throbbing : blood had pooled in the calf and the calf was swollen to the point that the skin felt painful due to being stretched. I lay on my back and stuck the bad leg vertically in the air and did some ankle pumps to try to pump the blood out of the calf. Some of it pumped out but alot was left, and I needed to take a diclofenac tablet to ease the pain, so I could sleep. I decided to stop taking the codeine since it was constipating me and my pain was manageable without it.
Title: Re: Deepak's ACL surgery 24-6-10
Post by: ouch09 on July 01, 2010, 09:46:38 PM
Day 3

Started doing my exercises, having got a rude awakening the night before with the swollen calf : ankle pumps, heel slides, quad sets, single leg raises.

The knee is now slightly painful - clearly the codeine was masking the pain yesterday.

Got a taxi with my dad back to my flat on the other side of London : a 2 hour journey in the heat with no air con, although I had a very interesting discussion with the taxi driver about world affairs (needless to say, he wasn't a black cab driver  ;) - for those outside Britain, taxi drivers in London who drive the classic black-coloured cabs are notorious for being bigots).

Although I'd been very well looked after by my brother & sister-in-law, it felt great to be home !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 01, 2010, 10:15:10 PM
You must be pleased to be home but that taxi ride must mave been dreadfull, how did you manage sitting through that??
At least now your home you can start your rehab. How much can you do at this stage being up and around etc?
I hope you settel back into being home without too many problems and your pain stays under control.
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 01, 2010, 10:16:13 PM
Day 4

I was finally able to open my bowels for the first time post-op - changealluyah !

I'm getting into the routine of knee exercises, icing and then doing it again in a couple of hours. Doing lots of ankle pumps.

My dad cooked a meal, which meant I was eating fresh food rather than ready meals.

I'm able to walk around in my flat without crutches or the brace. I do use crutches to walk up & down the stairwell in the building.

When I go out, I put on the tubigrip & brace, but my leg gets very hot (the temperature at the moment is 30 deg celcius).

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 01, 2010, 10:31:22 PM
tez, the 2 hour taxi ride wasn't as bad as I made out - we had the windows down and there was a bit of a breeze. The taxi driver really did make me forget about my injury with his conversation.

On the Cosmicsnuffle scale, I'm doing quite well : I've done 3 washes, but I wimped out on the ironing and my dad kindly did it for me. I've managed to sweep the floor in the kitchen & lounge where me & my dad have dropped crumbs on the floor  :) I've had 2 showers with no need for the shower stool.

My knee gets painfull if I spend more than 20 minutes standing/walking, or 10 minutes sitting on the sofa with the op leg elevated on some books on the coffee table, or even 20 minutes with my leg straight out on a chair while I use the computer (hence the reason for my slow diary). A laptop tray for use in bed is sounding like a very good idea ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Cosmicsnuffle on July 01, 2010, 11:22:46 PM
Deepak

Just checking the KG world is still there before I shut down for bed (Mr Vario at the gym has left me all adrenalised - that and cooking a risotto for a hungry 14 year when we got back from the gym at 10pm!!)....

........I had to post to you.... the Cosmicsnuffle Scale ... I love it - you've made my day  ;D ;D ;D :-* :-* :-* :-* ;D ;D ;D ;D.

Sounds like you are doing really well. Just take it steady, be religious about your exercises and be very careful on those stairs!!

Night night, hope you have a comfy night's sleep.

xx
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 01, 2010, 11:51:47 PM
Day 5

Went for a shopping trip with my dad (to carry the shopping  :)) to the local supermarket, which is a 15 min walk at my slow crutch-walking speed. In total we were probably out for about 45 mins.

Phoned the orthopaedic dept where my ACLr was done because I wasn't sure if I should be taking off the dressing on my surgery wounds. In the heat, I'm concerned that the skin is getting sweaty under the dressing, and therefore a source of infection. The surgeon told me that if I got an infection in the joint, it couldn't be cleared merely by antibiotics, but would require another operation to clean the joint - something to avoid if at all possible ! The orthopaedic dept tell me to make an appointment with my GP practice nurse. I get one for tomorrow afternoon.

After dinner, went for a 20 min walk. Felt fine while walking, but when I got home, I realised I had pulled slightly on the wound on the right of the knee and it had bled slighly under the dressing. My calf is also really swollen and is now killing me  :(

[artistic license begins]

A supermodel (who shall remain nameless) phoned me to ask if I would like to join her for dinner. On the menu is a slice of cucumber to start, a gram of cocaine for the main course, and a laxative for desert. I thank her for the invitation, but have to decline since I've already eaten and the menu didn't sound too appetising, except for the desert ... I promise to rearrange for another time.

[artistic license ends]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 01, 2010, 11:59:49 PM
Cosmic, glad you liked the name of your scale, which is currently under review by the ISO (International Standards Organisation).  ;D

Sounds like you're doing really well too - already at the gym ! I can't wait for my physio programme to start. Unfortunately, I have to wait 6 weeks before I can get back in the pool ...

Hope you have a good night too !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 02, 2010, 12:24:28 AM
Day 6

The GP practice nurse says she is reluctant to change my dressing without discussing it first with the orthopaedic dept on the phone. She informs them that there is a small area of fresh blood under one of the dressings. They tell her it is not significant and that the dressing is designed to be kept on until the stitches are removed. Even though the skin is sweating under the dressing, it should not be a cause for concern.

I feel like I've brewed a storm in a teacup, but I think its better to be safe than sorry.

Clearly I overdid things yesterday by going for 2 walks ( :P This would be a laughable amount of exercise normally but I've learned that you have to take it really slow after ACLr).

I've learned my lesson, no more food shopping trips. Time to do some internet shopping ! I feel like an invalid doing this (last year I never needed to resort to internet shopping but then I didn't have 4 surgery wounds) but I've realised my body's current limits.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 02, 2010, 02:11:08 AM
Sorry it's taken me so long to check in - have been mostly offline as my parents have flown in for a visit this past week. Glad to hear all is going so well, and that you're listening to your body and responding accordingly. I think that's probably the best thing you can do at this point. :)

Really interested to hear that they did a quad graft. When you have more info, I'd love to hear why your surgeon opted for that route - and how you find the healing of the donor site. I think it's a relatively rare option compared to hamstring or patellar tendon; I know only one other person here who's had a quad graft.

Keep up the good work! :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 02, 2010, 11:47:37 PM
Snowy, thanks for dropping in. Yes, I saw from Cosmic's thread that your parents were over and they & you seemed to be having a great time !  :)

I'm going to have my stitches removed on Monday, so I'll ask the surgeon about the quad graft - if that's what it is. It has subsequently occurred to me that the surgeon may have been able to take a graft from the hamstring arthroscopically and the quad surgical wound may be where the drill popped out from the femur.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 03, 2010, 12:11:20 AM
Day 7

Had my first shower post-op, having covered my wounds with cling film (as advised by one of the orthopaedic dept nurses) to keep them dry. It feels great to be clean again. I understand now what people meant when they described "straw" hair in their post-op diaries.

My bowels were still not right, so resorted to taking a laxative "lactulose", which finally did the trick. I can't believe that my bowels have been screwed up for so long even though I stopped taking the codeine on day 2.

The internet food shopping arrived - Yeah ! I was pleasantly surprised that I no problem lifting a box of 12 bottles of beer - nothing weight-wise compared to what I was lifting in the gym, but now this is a major milestone. Just got to make sure I don't develop a beer-belly ... :)

Did loads of ankle pumps, heel slides, quad sets, single leg raises.

Iced my calf since it was swollen. The calf has now turned a shade of yellow-green, which is apparently standard when the blood pools in the calf. I also have a black bruise on the back of my knee where the brace has been digging into my leg when I have been putting on & taking off my socks & trainers, and have been trying to bend the knee beyond 90 deg. In addition, I have another black bruise on the inside of my foot - my feet pronate so this may be the reason, although I do wear orthotics to control this. Perhaps my bad gait has caused me to pronate more & the orthotic fought back ... :)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 03, 2010, 12:36:06 AM
Day 8

My calf and achilles tendon are really tense and killing me today. Perhaps I overdid it with the knee exercises or perhaps icing the calf wasn't a good idea. On the positive side, the swelling has gone down on the calf.

I remembered I had this problem last year and a physio I saw recommended that I apply a hot water bottle to the calf to reduce the muscle spasm. I try this and it eases the tension and pain, although not eliminating it completely.

It seems mad to apply heat to a muscle in 30 deg C, but it works !

I remember now that vickyny has posted a question in the cruciate ligaments forum about stiffness in the calf - I wonder if this had been her problem and whether she ever got it resolved ...

I notice there is a small yellow patch on one of my dressings. I am concerned it may be pus, which indicates the presence of an infection. One of the info sheets I was given by the orthopaedic dept said you should contact your GP if there is any pus.

I get an appointment the same day with the GP practice nurse, who takes a look at the yellow stain and tells me that it is not pus. I am not convinced and insist that she takes a look under the dressing. She tells me that if she takes a look, she will have to change the dressing and the dressing she has is not as good as the specialist orthopaedic water-proof dressing I currently have. I agree to this, since I'm paranoid about getting an infection.

She turns out to be right - there is no pus, and all the wounds are clean. The yellow stuff turns out to be blood plasma http://en.wikipedia.org/wiki/Blood_plasma.

No more showers for me now until I get my stitches out, since the new dressing is not water-proof and the wounds should not get wet.

Another storm in a tea-cup ...  ::)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 03, 2010, 12:57:09 AM
Day 9

My calf and achilles tendon are still painful, so I'm not doing any knee exercises and not elevating the leg while sitting on the sofa, since even that is painful - it pulls the achilles tendon.

I'm not walking (outdoors) either, so basically reduced to staying in bed for the majority of the day.

I apply the hot water bottle to the calf and achilles tendon twice during the day, and as a result it feels better than yesterday.

I don't use any ice on the knee today, since the swelling seems to be manageable.

Even though I hate codeine for its constipating effect, I'm considering taking it again to kill the pain. The other problem with codeine is that it can make you completely unaware of any problems that may be occurring - nerves exist for a reason.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 03, 2010, 03:56:27 AM
Deepak sorry about the pain but from what I have read its important to keep on top of the pain meds so maybe you stoped taking the codine too soon, saying that if you find the codine has a detremental effect on the old bowel ask your gp for tramadol I find I have the same problem with codine but I am fine with tramadol and to be honest I think it works better.
When I had my scope the hospital nurse gave me these post op waterproof dressings so that I could change them whenever I felt I needed to, did you not get anything like that cos they were very good and they came in different sizes to cover different size wounds.
I hope you start to feel some improvement in the pain soon
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: kcknee on July 03, 2010, 04:46:05 AM
Deepak-

Are the codeine pills  in tablets that you can cut in half? I know I could cut the percocet pills in half so the pain was less, but I wouldn't fall asleep. Anytime I get near the narcotics, I have to take the over the counter stool softeners, not a laxative, or there's trouble. Have you tried having someone get those for you to take with the codeine? It will help you to move around more if the pain isn't as bad.

I was in an immobilizer for the first 10 days, so never flexed my leg at all. The pain was worst going to sit down and rising again - when the blood rush went into my calf. Try to keep your leg elevated and do the ankle/ toe pointing flexes to try to get the blood not to pool. My OS told me on the 10th day when I was allowed to start bending my leg and told to stop using crutches, that the muscle contractions in the normal heel to toe walking would help pump some of the fluid out of my leg and reduce the swelling. 

Good luck. I hope the pain starts to ease up.

Kristin
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 03, 2010, 07:33:04 AM
That's too bad about the pain levels. :( I'd try scaling the meds up a little at a time until you reach a level that gives you relief without sending you into a codeine stupor or making you feel like the pain is so numbed that you might do something you shouldn't. I'm not a big fan of codeine either, so I understand why you'd want to try and cut it out.

Like some of the others, I've heard that ankle pumps can be a great way of helping move excess fluid along. It might also be worth looking into lymphatic massage - this was a huge help for me in the aftermath of my original ACL tear (I had massive, very stubborn swelling) although I don't know how easy it would be to do it with the wounds still sore.

Take care, and I hope things feel better soon.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 03, 2010, 05:31:47 PM
tez, I think you're right about me stopping the codeine too early. I tried taking 2 paracetomol last night, but they had no effect, so I'm going to take the codeine tonight.

Thanks for the suggestion about the tramadol - I'll discuss it with my GP next week.

No, my orthopaedic dept didn't give me any extra dressings - I think they don't expect you to need to change the dressings before you have the stitches out. You have a good orthopaedic dept where you are !  ;)

After a sleepless night, this morning it occurred to me that I should try elevating my leg in bed, with a pillow under the foot - something I should have done as soon as I got home ... Anyway, it did reduce my pain, so I managed to get a few hours sleep in the morning :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 03, 2010, 05:55:56 PM
Kristin, unfortunately my codeine comes in capsule form, so its all or nothing. What's the difference between a stool softener and a laxative ?

Wow, in an immoboliser for 10 days ! That must have been tougher than what I'm going through, at least I can flex my leg. I also find that when I get out of bed I get a pang as the blood rushes into the calf.

I know that the normal advice is to do the foot point & flex (ankle pumps), but that may actually have caused my achilles tendon pain, so I've had to stop doing them. I'm now reduced to merely wiggling my toes, which has a similar effect but doesn't hurt my achilles tendon.

Alternatively, you may have hit the nail on the head : I haven't been walking heel to toe, but rather walking flat footed & using my hip to lift the bad leg. A physio I saw last year spotted this & told me I should stop "hip hitching" and instead walk heel to toe, which probably helped resolve the problem.

I'm going to have to make a concious effort to walk heel to toe, since I know I will hip hitch by default, since its easier.  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 03, 2010, 06:14:43 PM
Snowy, yes lymphatic massage sounds like it might be very useful, although like you, I wonder how it would be done given that I still have wounds.

Last year, the "super physio" who advised me to use a hot water bottle on the calf, and corrected my "hip hitch" gait, also gave me a wonderful calf massage, but I was lying on my stomach at the time, which I'm not sure I could do yet. I would have kissed that physio if she hadn't been married !!  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 04, 2010, 12:26:06 AM
Day 10

Felt better today than yesterday. Calf wasn't killing me anymore.  :)

Managed to do my knee exercises once & iced the knee (not the calf !) once.

Went for a 20 min walk (trying my best to walk heel to toe) to try to pump the blood out of the calf & foot. The bruising on the foot has increased on the medial & now lateral side. In addition, the bruising on the back of my knee has spread to the hamstring. This is why sleeping is so painful, lying on my back puts pressure on the bruised hamstring, and lying on either side puts pressure on the foot.

I'm giving in to the pain and taking a codeine capsule tonight. I have reached a state of inner calm and come to terms with my pain demons. We had a calm chat and agreed that in future we would discuss things rather than fighting  ;)

"It is a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to, than I have ever known." ... or so I hope  ;D 

[artistic license begins]

The super model called me again to ask if I wanted to join her in a new trendy bar, where only beautiful people are allowed. I expressed a concern that I would not be admitted since I wouldn't pass the beauty test but she said that wouldn't matter if I was with her. I said OK, sounds good, the only thing is I've got this knee injury and I can't sit with my knee bent for long so would have to keep getting up and walking around. She thinks about it for a second and then says maybe we should wait till your knee has healed. We agree to rearrange another time.

[artistic license ends]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 04, 2010, 02:02:24 PM
Deepak me thinks you have discovered that when people say its important to keep on top of the pain meds they aint kidding ;)
I hope you manage to find a comfy sleeping position, that's a bit of a worry for me cos I dont sleep very well just now so the chances of sleeping right after the op are prolly about nill :P
like the wee fantasy look forward to the next instalment!!
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 04, 2010, 04:25:46 PM
If you have artistic license, surely the knee should magically mend immediately after the op and leave you free to chase super-models? ;)

Glad to hear things are going better and the residual pain in other areas seems to be easing off. How are you finding the walking overall, apart from the gait issues? Does it hurt much?

Take care,

Kay
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 04, 2010, 11:58:23 PM
Day 11

Slept through the night for the first time in a week. The codeine really did work !  :)

Took some lactulose this morning to counteract the constipating effect of the codeine - that also worked :)

Did my knee exercises & iced the knee once today. Also used the hot water bottle on the the calf & achilles tendon, since the achilles tendon was still painful - as a result the achilles tendon is now only slightly painful to the touch.

I'm making an effort to walk heel to toe even within my flat. I've realised that I'm mentally trying to protect the knee when it actually is quite happy not being protected. Walking heel to toe engages the quads (and probably hamstrings) so hopefully will help to retain some quad, which is disappearing fast. Well, I was expecting the loss of quad muscle and if it didn't disappear it was going to be a bonus.

I went for another 10 minute walk in the evening (to try to pump the blood out of the calf - but you knew that already :)), however for the first time post-op, I didn't wear my brace and I was fine. To be honest, I think the brace is more of a hinderance than a help - I'll discuss this with the knee surgeon tomorrow when I have my stitches removed.

I forgot to say that my dad went home on Friday, since I told him I was able to cope on my own. I really needed him in the first few days when my leg was weak, but now its getting stronger everyday.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 05, 2010, 12:10:27 AM
Tez, you will probably sleep better after the op if (unlike me) you continue to take the pain meds. I was trying to be tough, when there was no need to be - a symptom of being male ... ::) ;)

Also, psychologically there's a huge weight off your mind once you've had the op, so that'll probably help you sleep better too. I remember thinking after the op - great, I've made it to the other side !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 05, 2010, 12:31:40 AM
Kay, the terms of my artistic license are quite explicit with regards to persons alive or dead - no creativity is allowed, one may only document what actually happened in a biographical style. Complete artistic freedom is however premitted with fictional characters. The terms are vague when it comes to interactions between persons alive and fictional characters. Violating the terms of the license may result in expulsion from the guild of knee geek writers.  ;D

Anyway, what do mean "chase super-models" ?! Its the super-model who's chasing me !  ;D

Meanwhile back in the land of reality ...

Today I had no pain when walking. I actually think I could walk outside without crutches, and I'm only using them for insurance, in case my knee were to give way, which seems a very remote possibility at the moment.

I do get tired if I stand for more than 20 minutes at a time, but I think this will improve in a few days time.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 05, 2010, 03:41:52 AM
Sounds like things are coming along really well, I tend to think the brace is a wee extra insurance as its very mixed weather or not your given one after the reconstruction, it seems to be about 50/50 from what i've read.
Good luck with the stich removal tomorrow or is that later today ??? anyway I hope it goes ok.... I also hope your right about getting more sleep after the op as its after 3.30am and I'm up and online when I would much rather be in bed asleep :P
So many rules regarding your artistic license makes me think you have too much time on your hands just now, as long as it helps pass the time you go for it,plus its always entertaining for us other knee geeks
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 06, 2010, 12:25:28 AM
Day 12

Took 2 codeine capsules last night, since the first one didn't completely kill the pain, however I still couldn't sleep most of the night. Codeine is clearly not an all-encompassing panacea. I think my sleep problems are partly due to the fact that I'm napping during the day & so not tired at night, and partly because my brain is not tired due to being under-stimulated. I'm used to having a job that tires me out mentally during the day and that's not happening now that I'm not working. I need to find a way to tire my brain ... suggestions gratefully accepted ! I've tried reading - that doesn't work - it just makes me nap during the day ...

I couldn't take the lactulose, since I had to travel to my hospital appointment in the morning, and I didn't want any "accidents" en route ... I now remembered why I hated codeine - because I was constipated, I felt nauseous - not something I enjoy.

At my hospital appointment had my stitches out. I've never had stitches before, so wasn't sure what to expect. It turned out to only be mildly painful, but the good news is that the wounds are healing well. The nurse put on new waterproof dressings (which she said I can take off in a few days & leave the wounds open to the air to heal) so I can now have a shower again ! :)

The surgeon asked me how things were going, so I told him about the bruising at the back of the knee & the foot, and pain in my calf & achilles tendon. He said the back of the knee bruising was to be expected : that's where they harvested the hamstring graft from arthroscopically.

So I didn't have a quad graft after all ! The wound on the quad is where the pin popped out - apparently they don't let the drill pop out, but rather use a pin to complete the tunnel, I guess like a needle & thread. I think more research is needed on my part ... e.g. how do they get the fixation screw in through a tiny 2 millimetre hole ?!

He couldn't explain the bruising on the foot, so asked me if I had maybe twisted my ankle some time in the last week. I said I didn't believe I had, but what I had done was turn my foot while trying to get my socks & shoes on & off while wearing the brace - perhaps that was the cause ... He thought the foot bruising was nothing to be concerned about & that it would clear up in a couple of days.

He felt the calf to see if it was tense & bloated - a possible symptom of DVT, but the calf was relaxed, so again he said he wasn't concerned about the calf and achilles tendon, and that a physio would be able to help me with these problems.

Which brought us on the fact that he thought that I should already have started my physio programme, but I said I hadn't heard from any physio. He advised me to chase my GP, in case my GP had not yet referred me for physio. It turned out when I got home that there was a physio letter waiting for me in the post - I just hadn't been checking my post for the last few days.

I also asked whether I needed to continue using the brace since I found it a pain (literally) to wear. The surgeon said I just needed to wear it to the end of this week, which is a relief.

I also asked whether I can ditch the crutches. Again the surgeon said I need to continue until the physio says I don't need them anymore.

I will see the surgeon again for a follow-up appointment in 6 weeks.

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 07, 2010, 12:27:37 AM
Day 13

Didn't take any codeine last night, but slept through the night !

I think my body was tired yesterday, which helped me sleep. Yesterday was the longest I had been outdoors for since my op : I left home at 9.30am and got back from the hospital at 4.30pm. Surprisingly, the knee wasn't killing me. In fact, I think walking for several hours (with sitting breaks) was very good for my calf, which today is less swollen. Clearly, the walking does pump the blood out of the knee.

I now have a physio appointment in 2 days time, i.e. day 15. I'm looking forward to it.

I did my knee exercises 3 times today. I've got to prepare my knee for the physio appointment when I will have to do much tougher exercises for an hour. The time for resting is over !

Went for a 20 minute walk in the evening to pump the blood out of my calf.

My bruising is indeed healing as predicted by the knee surgeon, and once again I wonder if all the walking I did yesterday helped ... or is it just coincidence ?

Just been reading Beda's post-op diary & realised that my pain is insignificant compared to hers. 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 07, 2010, 01:02:50 AM
If the walking's helping your circulation, it makes sense that it would help the bruising. Glad to hear that the extra activity seems to be helping rather than hindering! Are you mostly walking without the crutches now? Is it still slow compared to normal?

If you're feeling really brave, there are videos on YouTube where you can watch the whole op, including the screw insertions...they're not for the faint of heart, but I actually found them quite helpful in the sense that I now feel like I've got a really good idea of exactly what the mechanics of the repair are.

Beda is a truly amazing woman - I have no idea how anyone copes with the degree of pain, suffering, and surgical failures that she's been through. It really does put things in perspective reading her story.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 07, 2010, 08:26:44 AM
Nice work Deepak - I'm a week behind you and I'm not sure if I will be able to do as much walking.

Its obviously doing you some good and its good prep for the PT.

Good luck
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 08, 2010, 12:13:56 AM
Kay, I walk indoors without the crutches, and even go outside to take the rubbish out without the crutches. I'm probably risking an accident by going outside, but my knee feels stable enough that I don't think the risk is significant. I do use the brace & crutches if I go out for even a five minute walk - its tedious putting on the brace & using the crutches, but I think there is a risk when walking on uneven ground. Yes, I do think the crutches slow me down because I have to think about coordinating the crutches with the movement of my legs, and my crutch coordination is not as good as my leg coordination - the crutches have not yet become a "part of me", and hopefully never will.  ;)

Sorry to hear that Mara's got worse again. Hope she gets better soon.

Zaiem, I'm sure you'll be doing as much, if not more than me in a week's time. Your knee gets stronger every day post-op, but sometimes you don't realise until you try something that you didn't think you were capable of.

Tez, congratulations on getting a whole night's sleep last night ! As a fellow bad sleeper, I appreciate how good it is to get a whole unbroken night's sleep.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 08, 2010, 12:49:25 AM
Day 14

I can't believe its been 2 weeks since the operation. In some ways the time has dragged (being bored at home) but in other ways, its gone a lot faster than I thought it would, and having this forum with its support network and information exchange really helps. The act of writing this diary is useful for me to look back at where I was & where I am now.

Today was really the same as yesterday, so I won't bore you by repeating the same words.

My main achievement today was shaving. Yes, knee geeks I have not shaved since my operation & I was looking a bit scruffy to say the least with my 2 week beard. I felt so crap last week that shaving was not a prority, but now I'm feeling a lot better. One has to keep up appearances, doesn't one ? (to be read in a very posh accent) :P

[artisitc license begins]

I called the super model today to ask if she would like to come over to my place and watch some DVDs. She asked what sort of DVDs ... ? I told her I had just got a box set of the last 10 years of "Top Gear" http://www.topgear.com/uk - a hugely entertaining TV programme about all things of the wheeled kind, featuring reviews of some of the latest cars on the market. I told her we could have hours of fun watching them while drinking a few cans of lager. She said she would love to, but had a very important photo shoot coming up that she had to wash her hair for ...

She promises to rearrange when she next has a free slot in her diary.

[artistic licens ends]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 08, 2010, 03:23:15 AM
Deepak good for you getting all that walking in from what I have been told the earlier you start walkin the better as this helps with getting the circulation going which in turn will help with the blood pooling and the bruising.
I would think your right about using the crutches while walking any distance outside even if its just to warn others that you maybe a little slower or unsteady while out and about.
Unfortunatly for me the full nights sleep was short lived as its 3.15am and I am answering your post... oh well a week on Monday will be here before I know it and then hopefully iI will be getting back to some kind of a normal 2 legged life.
I'm pretty sure now your shaving again it wont be long before that super model and you hook up
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 08, 2010, 04:48:49 AM
But but but...couldn't you have told the super model that you shaved especially? ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 08, 2010, 07:41:46 PM
Tez - sorry to hear that you had a broken night's sleep again. I was in the same boat last night, couldn't sleep most of the night, and only got an hour's sleep in the morning. Yes, last year my physio told me that even if I didn't need the crutches, I should still use them as a visual sign to tell people to "give me space" - what we wanted to avoid was someone bumping into me with my fragile knee. This was in the very early days - maybe up to 4/5 weeks post-injury.

Kay - Unfortunately, I only shaved after I had phoned the super-model. Anyway, she's one of those women who prefer their men unshaven - something about liking the contrast between rough and smooth ...  ;) Good luck for your op tomorrow ! You're in much better shape than I was - cycling up mountains, no less ! You'll be fine. I'm looking forward to reading your post-op diary. I did exactly the same as you & cut my toe-nails the night before because I remember last year that I couldn't do it for months post-injury. I took your advice & watched some videos on youtube of the ACL op - I've got a better idea of how they drill the tunnel & pass the graft through the tunnel, but still haven't seen any videos showing how they attach the screws arthroscopically. The way that they do the operation arthroscopically just amazes me - very clever !

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 08, 2010, 11:58:11 PM
Those supermodels - they're such a fickle bunch!

I'll have to see if I can find you the video I saw where they were passing the screws in and fixing them into the tunnel. It is pretty amazing that they're able to do all of this through three tiny incisions - as one of my coworkers said last night, "When I hear stuff like that I'm so glad we live in the future!"
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 09, 2010, 12:05:24 AM
Day 15

Didn't sleep most of the night & only got about 1.5 hours sleep in the morning, before I had to be up for my physio appointment, which turned out to be a bit of an anticlimax.

I had expected to be doing an hour's workout in the gym, but today's physio session was just a history-taking session.

The physio asked me where on my body I was experiencing pain, what movements caused pain & what my pain levels were on a scale of 0-10. I told her that the knee was actually causing me very little if any pain, and the main source of pain was the calf & achilles tendon.

She suggested applying heat to the achilles tendon. I told her I had already been doing this, so she said I needed to continue.

She examined my bruises, and like the surgeon said they were not something to be concerned about. Except, I told her that the brusing pain was partly what was keeping me awake at night. She said I needed to take my pain medicines.

She also remarked on how little swelling I had. I told her I had been using RICE treatment.

On the subject of RICE, I told her that I found elevating my leg on another chair while sitting at the computer caused pain in the knee. She said this would be because I was forcing the knee into hyperextension and actually it wasn't doing me much good in terms of draining the blood out of the calf, other than stretching the hamstring and encouraging my knee to extend. I've had extension to 0 degrees from day 1, so don't really need to work on that.

She said there was a common misconception that sitting at a chair with your foot raised on a cusion on another chair was counted as "elevating". In fact, if the knee is not above the heart, the "elevation" achieves nothing, so the best way to elevate is to lie horizontally in bed & then raise the foot on a couple of pillows.

Which brought us onto the subject of me possibly working from home with my laptop in bed. She cautioned against this, because of the fact that I wouldn't be lying down while typing, so again no advantage to raising the foot on pillows, and there was the potential to give myself all kinds of back & neck problems, if I didn't take breaks every 30 mins.

Finally, the physio booked me in for another appointment next wednesday, when I will be able to start my rehab exercises. I asked her if I could start them on my own in the gym since I remember all the exercise from last year's pre-hab, and she said definitely not - I needed to be supervised & monitored while doing my exercises since the graft is very vulnerable at this stage.

So this means I have to find some other way to tire myself out during the day. I may have to resort to watching Top Gear DVDs ...  ;D
  
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 12, 2010, 02:09:30 AM
Hi Yulianichya,

I'm doing well thanks. My knee is feeling much better than it did in the first 2 weeks, although I still have swelling and pain at night for which I am now taking ibuprofen before I go to bed.

How is your knee after your meniscus repair ? From your sig, I see you've had a few knee procedures.

cheers,

Deepak
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 12, 2010, 04:06:14 AM
That's interesting that your physic wants to monitor your exercises - mine said he'll be checking my initial form, but then sending me off to do most of the work myself. Having said that, I feel an awful long way away from being able to do any kind of real exercises right now - it's hard to imagine being back at the physio regime in a couple of weeks!

How's that supermodel treating you now?  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: mypooracl on July 12, 2010, 10:39:24 PM
Alright Deepak

I had the same procedure as you on 22/6 (hamstring ACLr, no meniscus damage) and was just interested in how you have been told to sit during the day by your physios?  Are you always meant to keep it in extension or are you OK to sit normally on a sofa (as long as you do your heel props etc during the day)

I only ask as I started back at work working half days since day 12 (desk based job) and although my knee doesn't hurt, it does go stiff if I sit at the desk for 5-6 hours and I'm wondering whether you are keeping it extended when you sit or are you letting it flex etc.

Thanks.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 14, 2010, 01:11:45 AM
Yulianichya,

I'm impressed that you're already swimming & dancing less than 2 months after your operation. Congratulations !

I need to add a signature that says how & when I ruptured my ACL ...  ::) I did it playing football in May 2009 - the classic sharp turn whilst running  :)

How did you get your injury ?

cheers,

Deepak
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 14, 2010, 01:37:22 AM
Alright mypooracl,

You ask an interesting question, that I'm going to ask my physio tomorrow (or later today, since its already gone midnight).

I was trying to keep my leg extended while sitting, but last week at my first physio appointment, the physio said that it wasn't necessary, unless I kept my knee above my heart, which is nigh on impossible unless you're lying down.

Having said that I find sitting with my knee flexed painful after just an hour (I imagine because the blood pools in the calf), so I'm not sure what's the best approach.

I'm interested that you started work, even at a desk job (like me) at 12 days post-op. Did your physio or knee surgeon clear you to start work at 12 days, or were you pressured by work ? I went back to work last year after 2 weeks & I realised it was too early, so this time round I've taken a minimum of 3 weeks off.

How have you found working ? Have you been able to take frequent breaks to get the blood flowing in your leg & to ice the knee ? I found last year that I was very tired & couldn't work for longer than an hour or so without being in pain.

cheers,

Deepak
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 14, 2010, 11:56:31 AM
Hi Deepak

I hope your PT is a good workout today.

On the brace issue - mine needs constant adjustment the more I move around - as you are quite active I'm not surprised it keeps slipping down - its a pain.  Mine is really rubbing against the staples at my thigh - very uncomfortable.

I have been sitting with the knee flexed and at extension - staying in anyone position does make it stiffer.  I try and vary my positions and keep up with ankle pumps and heal slides to release any stiffness.

I've got a six week sick note, and will be taking as much time as I can before I go back - although I am office based -I'm out and about quite a bit.  The nature of my work also means that people will quickly forget that I have had an op and expect me to be upto full speed as soon as I get back.  I dont want to go back early and then end up going off again.

Take care
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 14, 2010, 10:09:08 PM
Hiya Deepak it looks like things are progressing well  for you... any more experiences with the super model I need more details of what the next instalment is please.. Do you think you will be ready to return to work after only 3 weeks?  when I asked my surgeon how long he thought I would be off work he said that he usualy tells folk a minumun of 6 weeks but because I stand all day [hairdresser] it would be a "fair bit longer" not exactly sure how long a fair bit is but I am thinking another 2 weeks so am hopeing to be back about 8 weeks post op.
Keep up the good work and take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: mypooracl on July 14, 2010, 11:35:34 PM
Hi Deepak,

When I first spoke to my OS he said that I would need at least 2-3 weeks off work.  However, as I didn't get to speak to him after the op I didn't get to follow up on itwith him.

Luckily for me my job is 100% desk based (luckily in terms of not too much strain on my knee!).  I work in recruitment search and selection so I can't really take too much time off work without it hitting my pocket!  If I was in a less pressured role then I would have probably taken 3-4 weeks off at least.

I'm 3 weeks post op now and the knee is quite comfortable at work now. I'm getting up to make tea and play the odd sneaky game of darts - funnily enough since my op I have become a legend at this game!  The knee is starting to feel better day by day.

However, I am finding the whole thing is getting to me a little now, I'm hearing so many stories of failed grafts and bad surgery that its hard to stay positive all the time, the paranoia about damaging my graft by slight movements is ridiculous. Today for example, I did a heel prop for 30 minutes and when I tried to flex the knee I felt a slight pop and stiffness and then spent another 30 minutes searching on the internet to see if it's a sign of the graft stretching!  Arrgghhh!

As for progress, I just started walking up the stairs one leg after the other today as the knee felt ok.  However, walking downstairs is still done one leg at a time as apparently its more dangerous than walking up the stairs.

I've got a lot of sensation back in the shin now, but when I move my knee suddenly I get a little twinge on the site of my main scar on my knee....it can be a little disconcerting!

Anyway, look forward to hearing how you are getting on in the coming days/weeks.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 15, 2010, 12:17:18 AM
Day 21

The yellow/green colour on the shin & calf has almost disappeared. Likewise, the bruising on the foot & back of knee has almost disappeared.

Been having problems sleeping at night for the last couple of nights, so I'm hoping that today's physio exercise is going to tire me out. Also, I didn't have a nap today - usually I get an energy low at around 4/5pm & give in to the seduction of sleep ... only to regret it at night when I can't sleep.

[startrek interlude begins]

Kirk : Bridge to engine room - I need more power.

Scotty : Cap'n, she'll no go any faster.

Kirk : Do your best Scotty, we've ... got ... to ... pull ... through !

[startrek interlude ends]

I also experimented with taking diclofenac before going to bed 2 nights ago and concluded that it prevents me from sleeping, whereas if I take ibuprofen before going to bed, I can sleep for 4/5 hours.

The physio did an anterior drawer test - I forgot to ask him what the outcome was ... He tested my extension (I was able to hyper-extend to about 5 degrees) & flexion - which he said was about 120 degress.

He then took off my dressings (I should have taken them off last week but was trying to make them last as long as possible). He said all the wounds look well closed now, so there is no need to put new dressings on and therefore I can shower without worrying about getting the wounds wet.

The skin is raised in the area surrounding each of the 3 wounds below the patella (the quad wound has been uncovered for over a week since the orthopaedic nurse said the wound was already well closed last week) - not sure if this is a problem ?

He showed me how to gently massage around the wound scars to prevent the skin from bunching up, which produces a bigger scar.

He also showed me how to do patella mobilisation (http://www.kneeguru.co.uk/KNEEnotes/node/1183), to prevent scar tissue developing.

We then moved on to my exercise programme :

1. 10 mins on static bike.
2. Quad stretch - http://www.kneeguru.co.uk/KNEEnotes/node/1192. I had real problems doing this standing up, so he suggested I do it lying on my stomach with a towel to assist with flexion.
3. Hamstring stretch - http://www.kneeguru.co.uk/KNEEnotes/node/1194
4. Calf stretch - http://www.kneeguru.co.uk/KNEEnotes/node/1210
5. ITB stretch - http://www.kneeguru.co.uk/KNEEnotes/node/1195
6. Mini-squat   - http://www.kneeguru.co.uk/KNEEnotes/node/1152 - 10 reps x 3 sets.
7. Gait re-education - the physio watched my gait while walking and informed me that I wasn't extending the knee to 0 degrees before the toe-off, so encouraged me to slow down my walk & concentrate on locking the knee just before toe-off. I realised then why it was so important to get extension :  without extending to 0 degrees, I was walking with a bent leg, which resulted in a limp.

I asked the physio if I could return to work at a sedantry office job, and he said I would be fine, although I should take frequent walking breaks to prevent blood pooling in the calf. I also asked whether I should keep the leg extended or flexed while sitting at a desk - he thought extended was better.

I asked whether I should continue with the brace, which I hate. He thought not, and in fact he believed that braces prolong recovery time. (I'm now as free as a bird, or a flightless bird that walks with a limp anyway  :)). On a related note, he wanted me to start weaning myself off the crutches. He did say that I should continue to use the tubigrip & RICE since I still have swelling.

Finally, I asked whether I could use the gym to try to rebuild my quads which have wasted, but he said not yet. I could use the gym to do upper body work, so I did  :) He also cleared me to walk in the pool, to improve my gait.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 15, 2010, 01:23:39 AM
The quad incision was where a pin popped out from the bone tunnel. The pin is used like a needle to pull the graft ACL (the "thread" in the needle & thread analaogy) through the tunnel, so it is taught before the screws are used to fix the graft in position.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 15, 2010, 04:47:27 PM
Wow - such a lot of progress! It's very encouraging for me to read things like this, as at 6 days post-op I can't imagine walking normally never mind being able to do all of those exercises! I suspect I'm going to have bad problems with the swelling, too; it took forever for the swelling from my joint effusion to clear after injury.

I'm not sure if after-surgery protocol is the same, but after injury I was told to keep the leg extended while sitting when I went back to work. I found staying in any one position for too long really hard (3-hour meetings were a killer) and my coworkers got used to me hobbling around the workroom with icepacks strapped to my leg (I kept a couple in the freezer) or sitting on my office floor doing stretches. Just do what you need to do to stay comfortable when you go back - you'll be happier and more productive if you're not in discomfort or pain.

Keep up the good work!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 15, 2010, 09:50:13 PM
Hi Deepak

Looks like your recovery is going well.

Your physio session, thanks for all the info, looks like the PT was quite thorough and went through a lot with you.  The important bit for me is the gait correction, having been for a walk today I am very concious of the limp.  I hope my Pt is as attentive to the detail - I didnt get that when I had the original injury.

Take care when you return to work.
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 16, 2010, 04:18:45 PM
I can't compete with Snowy's "frankenknee", but here's some photos of my knee at day 2 & day 22.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Cosmicsnuffle on July 16, 2010, 07:50:07 PM
Great photos Deepak - the body's ability to heal never ceases to amaze me!

It sounds like you have a really good PT - to have someone that looks so thoroughly at your gait is great.
 :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 17, 2010, 01:21:46 AM
Zaiem,

Re the brace, my foot bruising has virtually disappeared since I stopped using the brace 5 days ago. I am convinced it was the brace slipping down my leg & then resting its weight on my foot that caused the bruising.

[artistic license begins]

I have submitted a paper to the International Journal of Orthopaedics entitled "Foot bruising in post-operative ACL reconstruction patients due to brace use - a study", Deepak et al, Knee Geek University.

I think this will add significantly to medical knowledge in the field. ;D

[artistic license ends]

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 17, 2010, 01:33:22 AM
Great to see the pics - gives me hope that in the not-too-distant future I might have something more normal looking than my current alien head knee!

You should come join the gang on Facebook (look for the group "We are Knee Geeks") - we have lots more gory pics there.  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 17, 2010, 01:49:38 AM
Tez,

I'm not sure if I will be ready for work after 3 weeks, but I'm going to find out since I go back on monday. Will post update on monday to say how it went.

I think I know why your surgeon said you need longer than the standard 6 weeks off. I told my physio this week that my knee hurts if I stand still for about 20 minutes, e.g. cooking or washing the dishes. He said he wasn't surprised & that standing still is not good for my recovery. Walking is good, since you're using your muscles and this pumps blood out of the calf. However, standing still locks the knee, and the muscles stop working to support the knee, so the knee has to take all the load - hence the pain.

I don't know if in your hairdressing job, you keep moving or stand still for 20 minutes at a time ? If you stand still, the knee will take a battering :(

[artistic license begins]

The super model called me in a panic today. She had an emergency : she had to do a fashion show tomorrow, but her usual hairdresser was ill. She had tried getting hold of several of her backup hairdressers, but they were all busy. She didn't know what to do !

I told her I knew of a great hairdresser called Tez, who came highly recommended by her customers. We had to be quick though because Tez was due for a knee operation, and tomorrow would be her final working day before the operation. Time was of the essence ! Luckily Tez was able to squeeze the super model into her schedule. Panic over !

In return, I told the super model that I've been told by my physio that I need to work on my gait, and could she (being an expert in the art of walking "properly") give me some lessons ? She agrees. I tell her though that I don't want to learn how to swing my hips. She bursts into laughter.

[artistic license ends]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 17, 2010, 01:55:27 AM
Snowy,

You'll be surprised how quickly your knee heals. The body is working very hard to repair the "damage" done in the op, and this is why we feel so drained in the first couple of weeks, but it gets easier every day.

I've seen the entire photo album on the facebook "We are knee geeks" group, but couldn't see your "frankenknee" - am I looking in the right place ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 18, 2010, 11:02:19 PM
Yulianichya,

The incision (or puncture wound) on my quad is about 3 millimetres wide.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 18, 2010, 11:08:00 PM
mypooracl,

Great that you're able to walk up stairs now.

Yes, there are lots of potential problems that can occur with the graft, and I completely agree about being paranoid that the graft may have stretched. I worry about that too, but so far haven't had any cause to. Touch wood  ;)

How did last week at work go ? Any problems or any improvement as a result of going back to work ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 18, 2010, 11:20:57 PM
Day 25

Went to the gym again today. Did 10 minutes on the static bike, my stretches & mini squats, and upper body work.

Then went to the pool, and did some walking forwards, backwards, sideways - walking in the pool is so much easier than walking on land ! :) Hopefully this is going to improve my gait.

Swam 50 metres front crawl with a float between my legs. Amazing feeling to be back in the pool ! It feels both metaphorically and physically like returning to the womb. I've missed the pool, but now I'm back 8)

I carried my crutches in my hand in case I needed them, but for the first time, I walked to the gym & back without needing the crutches. In the evening, I got braver, and just walked to a local shop without the crutches.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 19, 2010, 12:14:46 AM
Sounds like a good Day 25. :) I'm so envious of you being back in the pool - I swam every day before surgery, and I'm really missing it. I'm crossing my fingers that I'll be cleared to swim again by the end of this coming week.

When you say mini squats, how far down do you go?

Hopefully this is the start of a new crutch-free phase for you.  :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 19, 2010, 12:47:22 AM
Deepak thanks for the info re standing that makes sense about the muscles etc I quite often would have to stand in one spot for 20 min plus so I guess the 8 weeks off work in more realistic...

Poetic License begins
The super model was so pleased with the wonderfull job I did to her hair she has promised to give George Clooney my number as  he is also looking for a hairdresser to tend his locks.....
Poetic License ends

Will be starting my very own post op diary soon so will see you there once I too have a shiney new hammy flavoured acl

Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 19, 2010, 10:39:00 AM
Snowy,

For the mini-squats, I was told by the physio last week not to go as far as 90 degrees flexion, so its probably about 120 degrees.

The exercise is also described as a "wall-slide", since I do this against a wall http://www.kneeguru.co.uk/KNEEnotes/node/1200
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 20, 2010, 08:13:34 PM
Day 26

Went back to work in my office for a couple of hours only. Took my crutches (just in case) although I didn't think I'd need them. I was carrying a laptop in a backpack.

Had to leave work because I was in so much pain after 2 hours, I wasn't taking in what anyone was saying.  :'( Was really glad I had my crutches when I came home, because I really needed them - the leg didn't want to support my weight any more. Perhaps carrying the laptop was a bad idea ...

Went straight to bed when I got home in a lot of pain, and completely exhausted.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 20, 2010, 08:21:45 PM
Day 27

Phoned my office to tell them I was in no shape to even work from home.

My leg is very painful. I feel like I've regressed to the first week post-op. I don't think the pain was this bad even the first week.

There is swelling above my knee - but unlike the previous swelling, which felt like liquid under the skin, this feels solid.

I've lost a lot of flexion. I can't do heel slide, quad flexes & SLRs without feeling a lot of pain, whereas these exercises were pain-free 2 days ago.

I also can't walk without a massive limp & can't stand for any length of time, e.g. to wash dishes. Spent a lot of time in bed. I feel completely drained and have a headache and temperature - basically, I feel like death warmed up.  :'(

I might have to take the hated codeine again to kill the pain.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 21, 2010, 03:31:31 AM
Deepak so sorry to here your having such a bad time maybe a bit of too much too soon though I'm not surprised at the pain cos now I'm on the other side of the sugery I know how painfull  my knee is now and can't see that pain decreasing enough to work in 3 weeks time. keep taking the paim med and ice ice baby and I hope you feel beer soon
Oh if your talking to your super model make sure she has passed my number on to lovely George as I haven't heard from him yet...
Take care and feel better soon Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 21, 2010, 07:11:43 PM
Hi Deepak

Dont be too downhearted - rather a regression its probably just your knee saying 'I'm knackered at the moment' - the stiffness at the top of the someone on KG told me was probably the muscles protecting the knee from over exertion.

Give the knee some RICE for a day, and then gently reintroduce your exercises again - RICE after very strenuous exercise.

Take it easy - it'll come back.
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 23, 2010, 09:48:13 PM
Tez & Zaiem,

Thanks for your supportive words. I should have taken your advice as you will see below ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 23, 2010, 10:08:51 PM
Day 28

Had my 3rd physio appointment in the morning. Turned up 15 minutes late to the appointment, which didn't make the physio very happy until I told him that my knee had got worse, since last week's session.

I told the physio that I had gone to the gym on Sunday & done the minimal workout prescribed at my last physio appointment, following by walking in the pool & swimming 2 lengths with a float between my knees. I also told the physio that I had returned to work on Monday & my knee had got much worse since then, and that I could not walk without crutches now, since putting weight throught the knee was painful.

She (I was seen by a different physio from last week) looked at the swelling & compared with the good knee. She felt the temperature of the swollen knee compared with the good knee, and could tell that the operated knee was hotter.

I asked her if she thought I might have an infection ? She thought not, since although it was hot, the knee was not red (which is an indication of an infection).

She advised to ice for 10 mins every 2 hours.

She also gave me a new exercise (which Snowy & kris_83 love  :P) : lying on your stomach, raise your lower leg to 90 degree flexion, then move the lower leg up & down through about 20 degrees of flexion & extension from 70 to 90. It's a killer !

I also told her I was in considerable pain. She advised switching my pain med schedule from taking ibuprofen during the night, to taking it during the day & taking codeine at night.

Since I had already taken 6 ibuprofen tablets in the last 12 hours, which were the max you can take within a 24 hour period, I had to wait till 9pm in the evening to resume.

Finally, I asked the physio when I would be able to fly on an 8 hour business flight, since I was being asked to commit to a flight date. She said if I was struggling to sit for 2 hours, there was no way I should commit to sitting in a cramped flight seat for 8 hours !

I went home & duly iced every 2 hours, which did reduce the pain level.

By 4pm, I felt well enough to try working from home. By 4.40pm I had to stop again because the pain was too intense.

Took some codeine at 11pm and slept through till 5am, which was the best sleep I've had in the last few days.  :)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 23, 2010, 10:38:52 PM
Day 29

Icing & taking ibuprofen was helping with the pain, but not eliminating it, and the heat from the knee was worrying me.

I looked in the info pack that was given to me by the orthopaedic dept when they discharged me, and saw that that one of the instructions was to call your GP if the pain became severe, which it definitely was.

After several hours of phoning, I eventually got to speak to a GP, who after listening to me describing my symptoms, said I may have a joint infection and therefore should go to Accident & Emergency at the hospital where I had my operation, since they would have my surgical notes.

I waited till 7.30, when I hoped the rush-hour would be over, to make the 1.5 hour journey across town on the tube. Got to A & E at 9pm and was seen by a doctor at 11.45pm.

The doctor examined the knee & (like the physio) compared against the good knee. She could feel that it was hot, but again as she noted not red.

After consultation with a colleague, she said their joint conclusion was that it was not an infection, since the knee was not grossly inflamed to the point of not being able to flex at all. I could flex to 90 degrees. Also I did not have a temperature, and feel generally unwell. I told her that was precisely how I felt on Tuesday. She felt I would not have recovered from a joint infection in 2 days.

She did however admit to not being an orthopaedic specialist, and said that I should see the knee surgeon who performed my operation for a definitve answer. I told her I had already made an appointment for the following Monday.

She advised that I rest and ice every 2 hours, and like the physio said, take ibuprofen during the day & codeine at night (& day if required).

Finally I asked her if I could have damaged the ACL graft, but she said it was impossible to tell without an MRI, which the knee surgeon would probably request on Monday.

Luckily I managed to get one of the last tubes home & got home for about 1.30am, iced the knee, took some codeine & went to bed exhausted, but slept till 10.30am
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 23, 2010, 10:56:46 PM
Tez,

I saw George Clooney in A & E last night. He was very busy as you imagine, but I managed to catch him for a few minutes, and asked why he hadn't phoned you. He told me he had, but your phone had been switched off - he must have rung you while you were having your operation - sod's law isn't it ?!  :P Anyway, he said he would definitely ring again & make an appointment with you once you're back at work. He also told me that word of your hairdressing prowess has spread throughout Hollywood, and there will be celebrities queuing at your door. Just be prepared for the paparazzi !  :o

You don't mind if George brings his friend Brad Pitt with him, do you ?  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 23, 2010, 11:15:51 PM
Deepak So sorry your  still having all this pain I really hope its just down to overdoing it and not any kind of infection but at least your seeing your O.S on Monday and I really hope he can put your mind at rest or find out what is causing the problems your having.
Please take it easy forget about work and take your meds and plenty of ice over the weekend and with any luck by the time Monday comes around you'll be feeling much better ;)
Just remember your work will still be there when your feeling better, I know we all like to think we are all indspensible but lets face it if your not there the work wil either get done by someone else or it will lie untill your strong enough to do it yourself ::) ::)ok thats mummy Tez's rant over with so back to the important part....
I f you meet up with George again tell him by all means Brad is welcome to come along to get a hair cut I'm sure I could even fit in  massage for both of them at the same time....
Take care and take it easy Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 23, 2010, 11:17:42 PM
Day 30

Did very little today besides resting, icing & taking my pain meds.

The swelling has reduced on the lateral side, but not on the medial side, suggesting that the inflammation is caused by the hamstring donor site. Also my hamstring is painful.

I have told my office that I will not even work from home until I know what is wrong with my knee, as I cannot risk futher (possible irreperable) damage.

Snowy,

Could you please send me some of the stuff you & Jen use to give you your super-powers ?  ;D I don't mind if I have to wear red underpants on the outside as long as it works !  ;)

Tez,

I suspect you're right - I am suffering from a mild case of the same disease that Snowy has : antsinyourpantsitis. It can be very debilitating  ;D

I've sent George a text, telling him that you have a "special offer" on at the moment of a free massage with every hair-cut.  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 24, 2010, 09:09:23 PM
Deepak just wondering how your doing today I hope your feeling a bit better and in less Pain... 
Oh and thanks for passing that message on to George I appriciate it ;) ;)
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 24, 2010, 11:13:49 PM
Day 31

Much as yesterday. The only difference was I didn't ice the hamstring, as a result the hamstring has now stopped aching, so icing it was a bad idea. Hope this is useful to others in a similar boat.

Tez, I am feeling better thanks, because I'm dosed up on codeine (at night) & ibuprofen (during the day). I am constipated due to the codeine, and I'm trying my best to counteract it with lactulose, but the codeine is winning at the moment  :) I suppose its a small price to pay for being pain-free.

The swelling hasn't reduced, so the underlying cause (whatever that is) still exists.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 25, 2010, 02:19:59 AM
Ack - have just caught up on your diary and am so sorry to hear of your joint troubles. My thoughts when I read your earlier posts also ran to infection, but it sounds like that's been ruled out (good!) It almost sounds like you've aggravated the site where the hamstring was removed; I know I was told that this takes six weeks to heal fully and it's very easy to tear or stress it in the early stages of rehab, especially as you add in more exercises. While not being any kind of expert, I'd be surprised if you'd damaged the graft; you haven't done anything that wasn't prescribed by the PT and your gym exercises really shouldn't have put it under strain.

Will keep my fingers crossed that it's just irritation of the hamstring harvest site. While very unpleasant, that wouldn't be such a bad case scenario compared to some of the alternatives.

I hope the OS will be able to set your mind at rest on Monday, and help settle the swelling down so that you can get back on with your regular rehab and recovery.

With regard to superpowers, I think it's the regular dunkings in the pacific ocean that do the trick. ;) You can't beat 'em!

Sending good thoughts your way,

Kay
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 25, 2010, 12:31:25 PM
Hi Deepak

Hope you're taking it easy and letting the knee settle down, for now.  It may be the weakness/strain in the hamstring has led to extra strain on the knee, causing the inflammation.

I was tempted to use heat on my hamstring when it was tight and painful, but was advised against it.  In the end all I did was rest it and do some slow and gentle stretches.  Its eased up, but when doing some stressful movements, it does twinge to remind me that it is still week and cannot compensate for over activity on the knee.  I'm not sure what physical condition my tendons were in prior to the op.

Take care
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 25, 2010, 11:42:20 PM
Day 32

Knee is feeling better today - less painful & less hot.

I've been icing, doing lots of resting (i.e. napping during the day, which I will probably regret tonight ... ) , some elevation & used the tubigrip for compression in the evening when the ambient temperature had cooled down.

Today, I've found that the "bed exercises" aren't as painful as they were a few days ago. I can now do heel slides without too much pain, and quad sets & straight leg raises are pain-free. So, there's been some improvement. I even managed to do the "leg curl (without any weight) on your stomach" exercise today.

Yesterday, I forgot to post that my calf had started to become sore due to being bloated with blood again, because I wasn't walking much yesterday, so today I went for a 30 min walk in the evening, which I hope will help to pump the blood out. Its a difficult balance between doing too much & too little ...

Yesterday evening, I also decided to try the diet I used in my first post-op week : lots of fresh fruit & veg. I'm a great believer in the healing power of anti-oxidants. So I had some strawberries with bio youghurt - what a combination, does it get better than this ?  ;D

Today, I've had strawberries, apricots & oranges. I am feeling better, though I don't know if this is due to the antioxidants or purely psychological ...

I also forgot to post a photo of my swelling that I took yesterday, to contrast with last week's photo of "virtually no swelling".
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 25, 2010, 11:46:30 PM
Hi Deepak

Good news - my sagely cousin told me that strawberries are a natural anti inflammatory, after I'd had my op.
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 25, 2010, 11:59:53 PM
Kay, Zaiem,

Thanks for your posts.

I'm also hoping I've just irritated the hamstring harvest site. I'll hopefully find out tomorrow morning & post the outcome.

Kay, don't you find the Pacific Ocean too cold ? I thought it would be really cold in Vancouver ?

Zaiem, just read your post re strawberries. Hah, so just by fluke, I was taking an anti-inflammatory - time to get some more !  ;D Did they work for you ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 26, 2010, 12:18:20 AM
I find the Pacific a little warmer than the sea of the Devon coast, where I did a lot of swimming back in the UK. I believe the ocean temperature off our westside beaches right now is 20 degrees, which is a really nice swimming temperature - cooler than the pool (which is about 24 degrees) and perfect for cooling off on these very hot summer days. Because we're right on the coast, we don't have a typical Canadian climate - we have lovely summers and mild winters with a lot of rain. The great thing is although we're on the coast, the city is framed by mountains to the north so I don't have far to go to find snow when ski season arrives.  ;D

Glad to hear things are improving. It sounds as though the hamstring aggravation theory might be the right track if things are settling down.

Garlic, chilli, turmeric and ginger are all fantastic natural anti-inflammatories if you like foods that include them. Curries are a good way of combining all the elements. :)

Take care and hope the swelling continues to go down.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 26, 2010, 12:39:08 AM
Kay,

I'm Indian, so garlic, chilli, turmeric and ginger are in my blood  ;)

I actually deliberately wasn't having spicy food because I thought it might be too much for my system, post-op, given the "eat as if you've had stomach flu" advice from mollyc.

Only one way to find out tomorrow !  ;D

20 degrees centigrade sounds reasonable. I know in the Pacific Ocean by San Francisco (where I used to live) guys I knew who used to surf, said you needed a wet-suit because it was too cold without - a bit like Devon  ;D The other thing the surfers said was you had to watch out for sharks - Great Whites & Hammerheads, any of those in your neighbourhood ?  :o
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 26, 2010, 03:59:57 AM
I think the "eat as though you have stomach flu" advice only applies to the immediate week or so post-surgery - I was told to go back to eating normally after the first week. So I would say unleash yourself on curries with abandon!  ;D

No sharks in our waters (they don't come quite this far north) but I quite often find myself swimming alongside harbour seals, and I've seen orcas near the ferry terminal at Tsawwassen, just south of Vancouver. We also had an amazing incident a couple of months ago where a young grey whale swam under the Burrard Street bridge and into False Creek, where he circled the Granville Island market and delighted the tourists. We're definitely not short of ocean wildlife here, though I'm quite grateful that most of it doesn't come with too sharp teeth. ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: mypooracl on July 26, 2010, 10:24:29 AM
Hi Deepak,

Just caught up with your diary after 2 weeks.  I had the same op as you 2 days before yours.  I've been back at work now pretty much full time for 2 weeks.  it's a desk based job and so far, apart from the odd ache here or there and a little bit of stiffness my knee has held up well under the desk.  I have the knee flexed mainly, but occassional extend it out just to stop it getting too stiff.

I haven't really had any significant knee pain since the operation....I stopped taking painkillers 4 weeks ago and I hadn't noticed any increase in pain.  However, I had a BBQ at my house yesterday and mowed the lawn so was standing for most of the day and my knee is quite sore today, mostly when it's extended...lessen learnt, put the feet up and let others to do the work!

How are you getting on with extension?  I am able to hyperextend the knee by letting it 'hang', but with my own muscle power I can only just about get the knee straight.  The PT said I need to work on getting the quad muscles and those around my knee cap stronger so that they can hold the knee in hyperextension.  She also pretty much bullied me into walking without a limp (which I've just about managed to do for short distances) as she said it is vital to get a normal walking pattern established asap.

I might take a leaf out of your book and go for a swim as apart from using the static bike for 5 mins a day and doing the usual tedious exercises  I haven't really done anything else!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 27, 2010, 01:08:02 PM
Hi mypooracl,

Thanks for letting me know how you're getting on. It seems you're doing really well - back at work and generally pain-free.

This confirms for me that where I am now is not right.

Do you need to ice or elevate or use a tubigrip now ?

Extension is zero degrees with a heel hang, but becomes painful quickly in this position. On a bed, immediately after I've iced, I can get to about 10 degrees off horizontal with pain, but once the swelling returns I'm back to about 30 degrees off horizontal.

Yes, my physio was saying the same thing to me about locking the knee before toe-off while walking, but all of that has gone out of the window, since the swelling has returned with a vengence.

If you go for a swim, depending on what your physio has told you re kicking, I would use a float between my legs, and not use the legs to push off on turns. Walking in the pool is great for getting your walking pattern back to normal.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 27, 2010, 01:39:42 PM
Day 33

The surgeon asked what had happened, since I wasn't scheduled to see him for another couple of weeks. I told him that things had been going really well & that I had started my physio programme. However, events took a turn for the worse, when I returned to work & had to leave after 2 hours because I was in agony.

He asked if I could think of anything that I had done at work that I wasn't already doing before. The only thing I could think of was the fact that I was carrying a laptop in a backpack & had travelled on a bus & tube to the office. I also told him that I had tried to work from home 2 days later, and had to stop after 40 minutes due to the pain. My knee had been flexed during the 40 min period. I asked him if he thought I should try working with a laptop in bed using a "breakfast in bed" tray. His non-commital answer was "sure, give it a go".

He looked at the knee, but didn't physically manipulate it in any way. He could see that it was clearly swollen, but was reassured that it wasn't red & "angry" - a sure sign of a knee infection.

I told him that it was hot though, although not as hot now as a week ago.

He advised me to continue icing, resting, and taking anti-inflammatories.

I also asked if maybe I had damaged the graft harvest site (since I was experiencing hamstring pain) or the graft itself. He didn't think so, but didn't request an MRI to confirm this ...

He did want to take a blood sample from my arm to eliminate the possibility of an infection. He said he could take a blood sample from the knee but that putting a needle in the knee actually increased the risk of introducing something, if it was clean to begin with, so he wanted to wait 2 weeks to see me again for a review.

I went for a blood test & travelled home. Once I got out of the tube, I heard a voicemail that the surgeon had left for me saying that one of the blood tests had shown an elevated level, so he would like me to come back in a week's time.

Now, I am worried, and frustrated that the process is so slow. I know why the surgeon wants to take a conservative approach, in case the knee heals on its own through icing, resting & anti-inflammatories, but I've also read that joint infections need rapid treatment to avoid permanent arthritic damage to the joint caused by the infection.

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 27, 2010, 01:59:19 PM
Deepak so sorry you are still having problems I know what you mean, you hear so much about how damaging an infection can be so I would also be worried about leaving it a week before going back to see your surgeon, I supose you just have to trust your surgeon to do what is best for you. What did he say about going back to work??
I hope you feel better soon ;)
Maybe its time for that super model to come and give you some gentle massage it may help with the swellin but it will deffo help you feel better ::)
Take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 27, 2010, 02:22:24 PM
Tez,

One of the things that annoyed me about the surgeon (and virtually every clinician I've seen in the past week) is no-one wants to commit to anything. I wonder if this is due to fear of litigation, but I've noticed that no-one has wanted to touch my knee in the last week, which I have found very strange. I feel like a leper - perhaps knee infections are very contagious, but then why does no-one want to actually do anything about it ?! Argggh !!!  >:(

I did ask him about returning to work, and he thought that I should avoid anything that aggravates the knee, e.g. sitting at a desk with my knee flexed. I have offered to help a colleague with work if he comes to my flat & I can talk him through the work - that's all I'm really capable of at the moment.

Ah, massage would be great.  ;D Even my physio won't give me lymphatic massage
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on July 27, 2010, 02:40:35 PM
Hi Deepak

Agh, what a bummer after you'd been doing so well. i am sure this is just a blip but how FRUSTRATING that no doctors want to commit to anything and get things moving. Forgive my ignorance but if there is a mild infection then do they treat via oral antibiotics? I guess you do have to trust your OS that a week of conservative treatment may well let things calm down, especially as you've seen some improvements over the past few days. I think not drawing fluid from the knee straight of is a good idea as it might introduce something else, so he seems to have a handle on things.

Hope the improvements continue. Don't attempt work - Lottie's prescription is chill in mind and body and perhaps some cheeky treats to while away the time....

Oh and cherries are great natural anti inflammatories too - my fridge is full of them!!  ::)

Take care

Lottie  :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 27, 2010, 02:59:25 PM
Hi Lottie,

I hope you're right that conservative treatment is the safest first approach.

Unfortunately, joint infections do not respond to oral antibiotics. The surgeon told me prior to surgery (when he was going through a list of possible complications of surgery) that if an infection did occur, I would need to have another operation, where they would flush out the joint.

I did a google search last night for "joint infection diagnosis", which lead to some scary articles, such as :-

http://www.uptodate.com/patients/content/topic.do?topicKey=~ppDv.6R7/5jRTk

http://www.ucl.ac.uk/~regfjxe/INFECTION.htm

Right, I'm off to get some cheeky cherries from the super-market - Thanks for the suggestion & the positivity !  ;D 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: kcknee on July 27, 2010, 03:14:02 PM
Deepak-

I have not looked at your diary in a while, but what I just read was way too familiar. I'm sorry you are going through this. I had a crazy painful half a grapefruit size swelling over my knee 3 weeks after my ACLr. I had a fever with chills and night sweats for a few days before the pain and swelling hit, but did not at first connect it with a knee problem since the pain came days later. I wrote up my experience here http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=49257.0  My joint was never red, but was/is hot. I was never diagnosed.

See if your OS will prescribe antibiotics or anti-inflammatories to get the swelling down faster. It is great he took a blood test, but I'm not sure why he won't prescribe you antibiotics now. I still am not sure what happened that weekend to my knee, but my most recent x-rays show that the joint space has significantly narrowed compared to my post-injury x-ray, this could have been because I did have an infection or it could be because I had 3 surgeries in 7 months.

One thing I would do differently if I could do things over is to not to jump right back into an aggressive rehab program with a leg that is obviously hugely swollen and inflamed. My OS kicked me of crutches days after the swelling while my lower leg was still twice as big as the other and told me that this was aggressive rehab. I did what I was told. My ACL has held up great, but I still have inflammation problems that in my instance have led to compartment syndrome and arthrofibrosis.

Good luck and I hope the swelling starts going down.  I do not think you have arthrofibrosis, or will ever get it, but the rehab posted here  http://www.kneeguru.co.uk/KNEEnotes/node/263 is probably good to do now while your leg is still inflamed. When the inflammation goes down , then I would go back to the normal rehab.

Kristin
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 27, 2010, 03:37:11 PM
Kristin,

Thanks for your support & thanks for the links. I need to get educated about knee infections fast, so the links will help. I also appreciate you telling me that you've been through a similar experience. It helps to know that I'm not the only one who's going through this.

I also started reading the link about arthrofibrosis treatment, and I can see how useful that is going to be too.

I've read your post-op diary & know you've been through a rough journey over the last year. I hope it get easier for you !

cheers,

Deepak
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 27, 2010, 04:24:58 PM
Ack, what a nightmare. I'm sorry you're having to go through this and that you don't seem to be getting enough support from the OS. If he's sure you have a joint infection, you'd think he would have called you in right away to begin treatment!

If you're not happy about the recommendation to come back in a week, call the surgeon back and ask for more information - he shouldn't be fobbing you off if there's a risk that this is something serious. And if he doesn't think it's serious, it would be nice for you to know why he thinks that to help out your mind at ease.

Best of luck - I really hope this settles down soon.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 28, 2010, 12:12:29 AM
Kay,

Yes, that's what I would have thought : if it was serious he would have called me in straight away.

I don't know if I'm being cynical, but this surgeon, like most surgeons, only works for the NHS one day a week, and works 4 days a week in private practice, so I suspect that even if my condition were serious, I wouldn't be seen for another week purely for that reason.

However, I may be able to get to see my records under "data protection" rules, since any medical notes he has made are effectively mine because they concern my health. Let's see if I can pursue this line of enquiry tomorrow ... ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on July 28, 2010, 08:28:43 AM
Hi Deepak

I would certainly pursue the medical records avenue, or maybe even contact the OS via his private secretary and say that you are worried. I am sure he would have got you in to see his registrar had it been urgent but I do know what you mean about that element of cynicism always creeping in. When he simply says one of the bloods has a raised level in it, it could mean anything and many of those are not serious and can wait a week. But of course, when its your knee you naturally worry. I don't think many doctors understand how stressful the whole process is. How is the knee feeling today?

Sending positive thoughts and cherries!

Lottie  :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 28, 2010, 02:53:58 PM
Hi Lottie,

The surgeon I've been seeing so far is the registrar - does that make a difference in terms of his availability as compared to a consultant ?

Your positive thoughts have already started making a difference !  :)

This morning I woke up & the swelling had gone down alot & my knee is less painful. The swelling has subsequently reappeared - possibly because I did my knee exercises or because I've had my knee flexed while having a late breakfast.

Something I did yesterday must have had an effect. Was it the blueberries I ate (I haven't had a chance to eat the cherries yet), or the elevation with a heel hang that I haven't done for weeks, or the can of guiness I drank last night (to replace the iron I lost on Monday after giving blood ...  ;) ), or the curry I had on Monday following Kay's suggestion ?

More careful research is required  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 28, 2010, 03:44:52 PM
Deepak so many questions as to why things have improved today, maybe a wee combination of everything could be the reason, whatever it is I'm glad your doing a little better, I just hope you get your swelling under control soon, are you getting your leg above your heart it seems to be the best way to get stubborn swelling sorted...
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 28, 2010, 04:05:47 PM
Hi Deepak

I think the rest and elevation (accompanied with everything else) is probably a good way to go to get the swelling under control again.  Take it easy and take a conservative approach to exercise till the swelling decreases.  Hopefully it is inflammation and not a joint infection.

Take care
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 28, 2010, 04:30:38 PM
That sounds promising - hopefully it is just inflammation and not an infection. Probably best to keep the exercises gentle while things are still sore, but at least it's a positive sign and hopefully things will continue to improve. Are you still icing the knee regularly?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on July 28, 2010, 06:22:45 PM
Ahhhh....glad its a better day....keep up with the ice and rest and gentle exercise.....Mystic Lottie's positive vibes transcend the universe.....

Not sure about the registrar versus consultant - I guess if they both work privately it won't make much difference. Who did the actual op? At least you haven't got a YTS trainee work placement person.  :P ;) :-*

I would think that the curry definitely had a positive effect. Our Friday night curry festival keeps me sane. We recently went to South Wales and stayed at Celtic Manor (golf haven etc etc) and I didn't want dumb ass over priced hotel food so they recommended an awesome curry place in the next village. They even dropped us there and picked us up in the Celtic mini bus for no charge. The food was AMAZING. I lived in Birmingham for many years and grew to love the curry mile, take your own beer, feast like a king/queen/transvestite for a fiver. Happy days.  ;D

So, Lottie recommends continued blueberries, heel hangs, ice, curry and guiness. I have also started to imbibe of Crabbies Ginger Beer (4%) as clearly ginger is good for swelling.  8)

Take care

Lottie x :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 28, 2010, 08:23:55 PM
One of the very few things I miss about living in East London is the amazing range of curries we had access to there...we have some truly awesome Indian restaurants in Vancouver, but they just don't do the kinds of tongue-searing vindaloos that I loved so very much. Oddly one of the best curries I ever had was in a restaurant way out in the Malvern Hills somewhere...I don't remember the name but I do remember that the naan bread was so huge that it was more like a naan duvet.

I'm curious...what are heel hangs? I'm wondering if they're a prone hang by a different name, or something else...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 28, 2010, 11:25:17 PM
Day 35

Rang the orthopaedic dept in the NHS hospital where I was treated in the vain hope that I might be able to speak to the registrar. Was pleasantly surprised when I was told by the consultant's secretary that "sorry I can't give the results of a blood test, but the registrar can call you on your mobile & tell you".

The registrar duly rang me back on my mobile, and explained that the blood test that was elevated was the CRP (http://arthritis.about.com/cs/diagnostic/a/crp.htm) that can indicate an infection or just inflammation, which is why he's taking a conservative approach in the hope that its just inflammation & if the inflammation disappears, there's no need to do further investigation. If the inflammation hasn't improved by next monday, then he would take a blood sample from the knee to determine what bacteria is causing the infection & therefore what antibiotic to use.

The reason he wasn't immediately concerned that it was an infection was that one of the other tests http://adam.about.com/encyclopedia/CBC.htm gave a normal result. Had this shown a high White Blood Cell count, there would have been more certainty about an infection.

To put my mind at rest (has he been reading my post-op diary ?), he said if I do get worse in the meantime, I should call him & he will get me in sooner. Well, I didn't expect that !  :)

I also spoke to one on my friends, who is a doctor, and he told me re "data protection", its not as simple as I thought. Yes, my medical records are about me, however, there are good reasons why even if I do request to see a copy of my medical records, some of it may be withheld for ethical reasons (e.g. child protection) and legal reasons (in the event of litigation, medical notes become legal evidence, so can't be disclosed to the prosecution prior to trial).
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 29, 2010, 12:07:03 AM
Tez - I've been elevating my leg above the heart, but not as frequently today as other days, since I've spent very little time in bed today which I think is a good thing. :)

Zaiem - Yes, rest & elevation does seem to be the key. I have found that heel slides, quad flexes and SLRs have become easier, so have been doing them, as advised by my physio last week. I've realised from Kristin that heel slides & patella mobilisation are really important to avoid arthrofibrosis.

Kay - Yes, I'm still icing regularly. I think this is the main thing that has reduced my knee pain in the last few days ... as well as all the natural antiinflammatories. On that subject, I only needed to take the ibuprofen once today ! Not sure if I'm using the correct term, but by "heel hang" I mean http://www.kneeguru.co.uk/KNEEnotes/node/1143, although I was sitting on a sofa with my heel hanging off a pile of books on my coffee table. I love the image of a naan duvet - very surreal  ;D Oh, I forgot to say, you're braver than me - i don't think I would get in the water with orcas - they bite too, you know !

Lottie - The registrar (plus some consultant who works in the same team) did the op. Ah, I haven't heard of the YTS scheme in a long time ... but I have a feeling its coming back, this time called the "Big Society" ("bit of politics, bit of politics"  ;D). Strange you should mention ginger beer, but I bought some a few weeks ago, as an impulse buy. Normally, I avoid sugary carbonated drinks since they're effectively junk food (high carbs, low nutritional value) but I did feel better afterwards. Perhaps its worth another try.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on July 29, 2010, 01:42:46 PM
Hi Deepak

I'm glad you had that conversation with the registrar and got some reassurance - it sounds positive.

Just take it easy and work on bringing down the swelling and clearing any adhesions with the patella mobilisations.

Take care
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 29, 2010, 04:49:58 PM
Interesting - under Freedom of Information regulations here (the equivalent of Data Protection) we're able to request any of our medical records.

Resident orcas feed on salmon and shouldn't have too much interest in people. I've also never seen one further in than the mouth of the Fraser, although I guess if we had the grey whale wander right into a downtown waterway then anything's possible. ;) I did have a seal bump into me once when I was swimming of Kits Beach; it's hard to say which of us was more surprised.

Ah, so that's a heel hang. I just didn't know the official name. ;)

Glad to hear that things are making progress, and fingers crossed that the inflammation continues to settle on its own.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on July 29, 2010, 08:25:54 PM
Deepak  Excelent that you got to speak to your surgeon and he explained why he is taking this more conservitive approach to the problem your having, I really hope it ends up inflamation instead of an infection and it settels down soon.
Hows the swelling coming alone? and did you have stiches as I got mine out today but the large wound where the graft was harvested from has been bleeding since they were removed so just wonderd if the same thing happened to you too?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 30, 2010, 12:56:55 AM
Tez,

Whatever it was that took the swelling down yesterday morning, I wasn't able to reproduce it today, since the swelling was back, but on the positive side, my knee pain is decreasing every day.

Today was quite tough on my knee since I was on my feet (on & off) for a couple of hours this morning, while a plumber fixed my boiler .... or I hope he's fixed it anyway ! Then one of my colleagues came over to my flat to discuss work with me for a couple of hours. I tried not to keep my knee flexed all the time, but it was flexed for a large part of the time. Despite that my knee feels fine now, after icing it a couple of times.

Yes, I did have stitches. One of my arthroscope "port hole" wounds (on either side of the patella) bled for a couple of seconds in hospital just when the nurse took off the stitches, but didn't bleed after that. The nurse put a water-proof dressing on each of the wounds (except the quad wound which she said was closed) to contain any further bleeding.

Do you have a dressing on the wound that's bleeding ? How long has it been bleeding for ? I wonder if you should go to A & E if the bleeding hasn't stopped, just in case. Oh, and George Clooney might be there  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 31, 2010, 01:50:46 PM
Day 37

Just managed to delete my browser tab before I had posted my entry, so let's see if I can post again, without hitting delete ...  ::)

My knee was quite sore & swollen from yesterday's activity, so I spent most of the day resting.

I was planning on spending the evening resting as well, until a calendar alert from my mobile phone reminded me I had agreed to meet some friends in the theatre.  :o

It turned out to be a great evening, and I was lucky in that the theatre had aisle seats so I could stick my leg out & even do heel slides during the play. I think a few people did wonder what I was doing, but they gave me the benefit of the doubt since I had crutches  ;D

The play was "Light shining in Buckinghamshire" (http://www.arcolatheatre.com/?action=showtemplate&sid=394) set during the English Civil Wars - highly recommended, and got me thinking about the New Model Army, the Levellers, the Diggers and how that relates to Britain today.

I got to see a new buzzing part of London as well. Although I've lived around London for almost 20 years, there are still parts that I've never been to, and its like discovering a new town each time I go to one of these new districts.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on July 31, 2010, 05:05:50 PM
ACLr friendly theatres...now there's something they should advertise! Is the Arcola in Hackney? It rings a vague bell, but I lived all over central, north and east London during the time I was there. I know just what you mean about finding what feels like new towns whenever you go to a new area in London. I gave up on the tube and bought a motorbike when I'd been there a couple of years, and it was amazing how different the city looked and how much more of it I got to know from the seat of the bike. I'd take a new route home from work at least a couple of times a month, just for the fun of getting to see different places.

The Levellers and New Model Army sure bring back some memories, too. I saw NMA at the Cavern in Exeter during their heyday and it remains one of the best gigs I've ever been to.

Hope the knee is feeling better today. How is the inflammation feeling overall?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on July 31, 2010, 11:03:35 PM
Hey Deepak,

How are things feeling today? Glad you enjoyed the play, I am having a VERY cultural expedition too to the theatre in a few days time.  :P

Sound of Music on stage. With my Mum. I have an aisle seat to stick my knees out into, as the theatre is not known for its cavernous seats and my PFS will not like being bent that long...

So, Lottie does culture.  ;D

New Model Army? Are they like the Tubeway Army?  ;)

Hope things are going OK,

Lottie
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Vickster on July 31, 2010, 11:33:56 PM
Oooh the Levellers, it was pogoing at their gig while at Uni where I think I slipped a lumbar disc and had my first foray into orthopaedic surgery aged 20... such fun (the gig, not the surgery, although I did get my first "taste" of morphine at that time and a lovely impressive 6 inch scar that looks like the stitching on a rugger ball lol)

Hope the knee has had a good day!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 02, 2010, 12:53:32 AM
Kay - The Arcola theatre is indeed in Hackney, Dalston to be precise. I heard people raving about this area years ago, but never bothered actually checking it out until now, and now that I have been there I can see why they were raving about it. I have to confess that although I had heard the names of the bands New Model Army & Levellers, I have never heard their music - something to add to my "To do" list. During the play interval, I was chatting to a friend, and she, like me, had no idea that the band New Model Army was named after an actual historical army.

Lottie - Sound of Music with your Mum should be a good laugh - are you going in the full Nun outfit ? I thought it was de rigeur  ;D Again, my musical ignorange is showing. I didn't know who the Tubeway Army were, so looked them up & saw that Gary Numan was in the band. Well I never ! Will have to add them to my "To do" list as well.

Vickster - Sorry to hear that you slipped a lumbar disc pogoing (probably should be added to the list of dangerous sports  ;D), but glad you enjoyed the Levellers gig. Ah, the exuberance of youth - I don't think any of us old fogeys will be pogoing with our dodgy knees in the next couple of months  ;D

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 02, 2010, 01:00:37 AM
Day 39

Woke up once again with very little swelling, despite being out for a couple of hours the night before.

Possibly what made the difference was that I didn't spend a couple of hours with my knee flexed in the evening reading & writing knee guru posts.

The pain contnues to decrease, so I'm hoping that when I go for my appointment with the surgeon tomorrow, he'll find that it was just inflammation rather than an infection.

[artistic license begins]

I called the super model to ask her if she would do some "lymphatic massage" on my leg to reduce the swelling. She asked me what "lymphatic massage" involved, so I explained it was a means of forcing the lymph from the area of swelling into the lymph nodes - in this case, performed by running both hands up the leg towards the groin. She asked me what kind of cheap girl I thought she was ! I told her that I didn't think she was any kind of cheap girl, and in fact I knew she had very expensive tastes. This didn't seem to placate her, so I decided to change the subject.

I suggested we go for a meal to a new restaurant that had just opened. It was a theme restaurant - the theme being the Rocky Horror Show. You had to dress up as a character from the show to be allowed in. Apparently, the advertising slogan for this place was "eat like a king/queen/transvestite for a fiver".

When the meal arrived, we were both overwhelmed by the presentation. It was served on a bed of rice, with a naan duvet and a couple of focaccia pillows. Delicious !

[artistic license ends]

Thanks to Tez, Kay & Lottie for the inspiration for this story-line, I was starting to run out of ideas.  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 02, 2010, 01:58:44 PM
Deepak so glad your swelling is improving I also hope it means it is inflamation rather than infection but best to see surgeon to get his take on it all. Good luck with your appointment tomorrow anyway!!!
Your meal out with the super model sound fun and the discription of the food presentation makes me think you have an idea of where you would like to have her next ;D

Let us all know how it goes with your surgeon tomorrow and take care
Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 02, 2010, 05:31:32 PM
Back when I lived in Hackney (when I first moved to London, so - yikes - about 13 years ago) it was still a really rough area, with very high crime and a lot of shootings. (In fact I remember when one of my US friends visited, she said "You never told me you lived in the ghetto!") The gentrification sort of spread eastwards but hadn't reached Hackney proper before I left, but I've heard from my friends there that it's now very artsy and cool. It's hard for me to imagine - I still think of it as the area where I saw a guy being beaten to a pulp by two men in balaclavas with baseball bats one morning when I went out to get the Sunday papers!

My teenage years wouldn't have been the same without NMA and the Levellers. :) The best NMA album is Thunder and Consolation; for the Levellers, it's harder to choose but I think my fave is Levelling the Land. Vicks, I'm impressed that you pogoed so hard that you slipped a disk - that's dedication!

Good news on the knee inflammation. Did you snuggle up under the naan duvet with the supermodel for some lymphatic massage? ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: mypooracl on August 02, 2010, 10:04:35 PM
Hi Deepak,

Don't mean to hijack the thread, but as we're pretty much at the same stage I think it's worth sharing my development!!  Here's where I am now:

- No real pain normally, just an occassional ache when the knee has been in one position or slight discomfort when walking for too long
- Walking fairly normally without limp...anything more than 1/4 mile and I start to feel it a little and the slight limp returns
- Still icing once a day as the knee is about 3 cm 'swollen' (over my other knee)
- Using tubigrip in the office to prevent further swelling from sitting down (itches like you would not believe though!!!)
- Still not able to fully hyper extend knee using own muscles, stopped doing heel hangs at PT's advice
- Able to lift left using hamstring to 90 degrees

My knee has been getting hot since the surgery, but as it didn't hurt or look red I haven't really thought much of it, I just put it down to the extra blood in the knee due to swelling.  MY PT got me to do some pretty intense exercises with the knee for the first time using the leg press....my ACLr knee is about a third the strength of my normal knee at the moment (can just about do 10 reps at 30kg with weak knee).

When doing some exercising i get a slight 'popping' feeling under the kneecap...hope it's nothing to worry about.

Keep it up mate, this thread is very useful!

Thanks.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 02, 2010, 10:29:29 PM
Day 40

The surgeon said that the reduced swelling & lack of heat from the knee meant that he didn't want to put a needle in the knee to take a blood sample (which I was quite glad to hear since I wasn't looking forward to having a needle in my knee), because as he explained last week, doing so could actually introduce an infection where none existed before.

Instead he took another blood sample from the arm to compare with last week's, to ensure that the C-Reactive Protein (CRP) level had reduced & the Full Blood Count still showed no evidence of infection.

Regarding activity, he advised against doing any weight-bearing exercise. He said that I could use the static bike, but without any resistance. The objective for me now is to continue resting the knee so the inflammation disappears, and then I can resume my physio programme. I really want to get back to the physio programme, because my quad is disappearing fast on my operated leg.

He will see me again in 2 weeks to review progress.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 02, 2010, 11:02:49 PM
Tez, Kay - Its far too early for that kind of thing, me & the super model are still at the "just friends" stage  ;) Apparently parts of Hackney are still very dangerous. I've been lucky in that I've never witnessed any violence, but even some of the locals there have warned me not to go walking round Hackney at night if I don't know where I'm going (I was about to walk around looking for a street with a map in hand, but was advised that I might as well walk around with a sign that said "mug me").  :o However, Hackney is being rapidly gentrified because Islington is encroaching from the west, Shoreditch from the south & the Olympic village from the east.

mypooracl - Don't worry, you're not hijacking my thread at all. I really appreciate your updates because they tell me where I could be once I get over this current inflammation. Great to hear that you're pain free & walking without a limp now. I'm interested to know why the physio advised against doing hell hangs ? Good news on starting the leg press - that was when I able to start rebuilding my quad last year. I remember what a struggle it was to do a single leg press with the bad leg.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: mypooracl on August 03, 2010, 10:17:21 PM
I don't really know why she said i didn't need to do them any more  ???  I guess it's because she wasn't concerned about my extension, although I have noticed it is a little more difficult to fully straighten my leg without discomfort, so I may start doing them again!!

The "do's and don't's" of knee surgery really start to boggle the mind after a while!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on August 04, 2010, 10:59:46 PM
Deepak,

Good news on the continued conservative approach, I think your doc has a good handle on this. The last thing you want is an unnecessary big prick in the doctor's office with the risk of infection..... :o  Bad news on the reduced rehab protocol, how fast do quads vanish? i think there is a reverse quad fairy somewhere that sucks them up at night. I never had especially strong quads (or at least they were not bulky, but did the job) and last year when I got told to "rest" for a month they went into invisible mode. I've just got some shape back after 3 months of new PT work and the leg press actually now feels like a press not a whizzy up and down sensation....

Keep up the hard work...... ;D

Lottie xx
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 07, 2010, 01:20:50 AM
Day 44

Some observations :

The day often starts with the knee unable to extend to 0 degrees, but with the aid of ice, heel hangs, heel slides, quad flexes, SLRs and patella mobilisation, I can get back to 0 degrees extension. What a relief !

The swelling has reduced, although its hard to say objectively by how much. My incisions are healing to the point where one of my port hole scars has almost disappeared !

On day 42 I didn't go out because it was raining. On day 43, I had no hamstring pain.

On day 43 I did go for my usual walk, and on day 44 the hamstring pain has returned ... I think I'll live with the hamstring pain. I need to go for a walk every day for my sanity & to prevent DVT.

The other remaining pains I have are :

1. The shin. This I suspect is caused by the tibial screw.
2. Deep inside the knee joint - bone tunnel pain ? This is aggravated by putting weight through the knee, e.g. trying to climb stairs by flexing the bad knee; climbing stairs by keeping the operated leg straight is fine.

Having read posts by Lottiefox advising to limit alcohol consumption & Snowy to limit caffeine consumption, to keep inflammation under control, I was prompted to do an internet search for "inflammatory food". There indeed was alcohol & caffeine. I don't drink coffee (although I do drink 1 cup of tea a day), so that was easy to limit in my diet  ;D but beer & wine are harder. Anyway, I've managed not to have any alcohol for a week, in the hope that this is going to help control the inflammation. Time will tell.

Some of the other inflammatory foods are interesting, as are the inflammation-reducing foods ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 07, 2010, 08:32:52 PM
Deepak while I was reading your last post and you were explaining all the different pains and where they were coming from I was agreeing with it all, so thanks for putting it down cos now I know we all seem to have the same aches and pains, and the fact that you had worked out where all the pains were coming from makes it easier to accept that its ok and not unusual to feel these things.

Good for you keeping away from the beer and wine but not to rub your face in it or anything but, I am sitting with a lovely glass of wine, with the rest of the bottle shouting to me from the fridge so my plan for this evening is to sit and chill out with my lovely wine, I may give the odd passing thought to you sitting beerless and wineless ;D
Take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 09, 2010, 12:11:47 AM
Tez,

I will reply with a plagiarised song :-

I'm all beered out
You took a whole lot of ACL rehabing for
a handful of nothing
All beered out
It's hard to give you something when
You're pushing and shoving me around

So don't look surprised there was no disguise
You know where I stood from the start
So stop - look around you
You're right back where I found you
Take back your cold and empty knee

With apologies to Alison Moyet  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 09, 2010, 12:32:47 AM
Day 46

Decided I was sufficiently better to attempt getting back in the pool again.

Did my usual walking forward & backward. Took it easy this time, last time I got carried away & was running forwards & backwards.

I skipped the sideways walking because I suspect that the lateral movement may have aggravated the hamstring last time.

Swam about 150 metres (with a float between my knees), which isn't much, but I'm going to take it a step at a time, to avoid any strain on the hamstring or the knee joint.

I've realised that I've been taking codeine every night for over 2 weeks now. One night this week, I tried not taking it, and couldn't sleep without it. The next night I took a lower 10mg dose, but that didn't kill the pain sufficiently to sleep, so I went back to 30mg. What concerns me is that there is a warning in the packet that says that codeine is addictive, and therefore should not be taken long term. How long is long term ?

I've also noticed that I get pain in the hip at the ball and socket joint, where the femur connects to the hip, when I do heel slides. Anyone else get this ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: zaiemk on August 09, 2010, 11:16:27 AM
Hi Deepak

I think you are doing the right thing - return to conservative rehab and keep up with painkillers whilst you need them.  I was going through the Info hub on the site and checked the intermediate Knee rehab phase and it stated that this is a time when some people can notice a regression in their recovery if they over do the exercise regime.

On the hip pain - if its right in the backside at the top of the hamstring - its hamstring tendinitis - where the hamstring tendons attach to the Ischial Tuberosity - I was suffering with this pre surgery.  Its a message to take it easy on your hamstrings - dont over work or over stretch.  Its also aggravated by muscle shortening around the lower back and hip due to misalignment - ie if you are limping or engaging the hip to move the leg. The only way it will recede is over time.  Have a word with your PT.  Hopefully if its at early stage (ie it doesn't constantly give you a pain in the butt when sitting and resting) then a little less stress on the hamstring will stop the pain recurring. Also some hip and back stretches will provide relief.

Take care
Zaiem
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 09, 2010, 01:54:36 PM
Zaiem,

Thanks for the info about hamstring tendinitis. I don't think I've got this, since the pain is not a muscle pain in the backside at the top of the hamstring, but rather a bone pain deep inside. It feels as if the ball is not rotating correctly in the socket, and catches resulting in a jerky movement, which I suspect causes some wear & tear on the joint.

I don't get the pain when doing anything else, besides heel slides, so I hope its at an early stage, and as you say will recede with time & rest.

I think your analysis is quite likely : I have been limping for 6 weeks now since my op, so the hip is probably not happy about being over-used  ;D

Yes, I'll discuss it with my physio, or knee surgeon if I see him before the physio.

I do this hip stretch every morning (except I do it with one leg at a time, and I keep the leg straight, rathen than bent)

http://www.youtube.com/watch?v=YWg2S3U6iBI

I just tried this with my good old swiss ball, and it seemed to help ... even though I didn't have a cat ...  ;D

http://www.youtube.com/watch?v=Qwj1yRt140M 

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 09, 2010, 04:45:36 PM
Glad to hear you're back in the water. :) Hopefully the gradual ease back into rehab will go smoothly.

For the hip pain, I wonder if it stems from the fact that if you're not bending the knee fully the rest of the time, you're actually asking the hip flexors to perform an unusual activity when you bend it to the maximum point in a heel slide. Do you get the same pain when you do a hamstring curl while lying on your front? This move doesn't engage the hip flexors to bend the knee, so if the pain is absent it may help narrow down where it's coming from and the trigger.

With regard to the codeine, I wouldn't worry about it too much at this point - managing the pain is probably more important. 30mg is a fairly low dose and I can't imagine that you'll suffer any withdrawal symptoms when you cut it out. I think I was taking T3s daily for at least a couple of weeks after my ligament rupture, and on and off for a while after and I didn't have any problems when the time came to ditch them - in fact I was just relieved to stop taking them!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 09, 2010, 08:28:14 PM
Deepak I enjoyed the song very much thanks for that you brightened up a dull grey day.
Excellent news your back in the pool just take it easy and work it up to the level you were at pre flair up and watch for anything that causes you more pain than usual :)
As for the use of codine I would think at this stage its more important to be pain free than to worry overly about taking it long term I will say though if you find the codine is not good for the old bowels then ask your gp for tramadol, thats what I have been using and I find it works very well, in fact Dougie has been taking codine for arthritis in his hip [years of digging big holes has left him gubbed lol] and the odd time he is having a bad flair up he takes my tramadol and feels it works much beter than the codine, also it dosen't seem to affect how regular I am the way the codine does.
No more tales of that super model I need my story time fix??
Take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 11, 2010, 12:04:11 AM
Kay - I hadn't been doing the hamstring curl lying on my stomach, since I wanted to avoid aggravating the hamstring, but I tentatively gave it a go this morning, and had no problem. In fact, the very gentle hamstring curl was useful as a quad stretch, since my quads are now quite tight because I'm not doing any quad stretches. Thanks for that suggestion  :). You're probably right about the hip flexors being over-worked. I used to have tight hip-flexors pre-op, and used to do hip-flexor stretches every day, but again that's all gone out of the window since my op, ... maybe I can resurrect that stretch since it can be done while sitting on the swiss ball, thereby not putting any weight on the bad leg.

Tez - Glad you enjoyed the song ! ;) Part of the reason I am concerned is that the codeine isn't constipating me anymore. Now this may be because I've increased the fibre in my diet by eating so much anti-inflammatory fruit, or it may be because I've become tolerant to it. The latter is more worrying. Having said that, as Kay says, a few weeks is not that long, so hopefully I haven't turned into a "codeine addict".  :) I'll discuss it with my surgeon next week at my next appointment.

 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 11, 2010, 12:28:22 AM
Day 47

I decided to try going back to the gym. Did 5 minutes on the static bike, with zero resistance. I couldn't pedal at any speed due to lack of strength, which shocked me to say the least. My quad on the bad leg has definitely been taken by the "quad fairy"  :(

My left shoulder has been giving me some grief due to my ongoing rotator cuff injury which I had been managing by doing regular rotator cuff strenghtening exercises, but I haven't been able to do any of those for the past 3 weeks. So it was with some relief that I did some rotator cuff exercises using dumb bells while lying on the floor. However, even carrying an 8kg dumbell from one part of the gym to another caused pain in the knee. I see now why the surgeon told me not to put any weight throught the knee ! Anyone have any ideas why putting weight through the knee causes so much pain ? I'm always interested in bio-mechanical explanations - they help me rationalise what's going on.

Both shoulders felt much better after the workout.

Next, I went to the pool, and did my usual walking forwards & backwards, and swam 550 metres with a float between my legs - I would have done more than 550 metres but I had to stop due to cramp in my foot.

A reasonable workout - no where near what I was doing pre-op, but I'm glad just to be able to do this now.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 11, 2010, 12:50:20 AM
Day 48

No negative reactions to yesterday's workout, which is good news  :)

Had a rest day today, to let the muscles recover from the gym.

[artistic license begins]

The super model called me to ask if I'd like to join her on a shopping trip. She's got her eye on a "gorgeous" hand bag and needs to find some matching strappy shoes. And of course, she would need a matching dress too ! After the shopping trip, we could have coffee & cake.

I tell her that I would love to, but I need to change the oil & air filter on my car, as I've nearly done 10,000 miles since the last oil & air filter change, and I don't want to risk damaging the engine. Also, the wheels need balancing.

I promise to re-shedule the shopping trip, once my car is in better shape.

[artistic license ends]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 11, 2010, 03:59:36 AM
Glad to hear the hamstring stretches were helpful. At this point you probably should be doing some gentle hamstring work - my PT got me on this as soon as I was able to manage it, with the caveat that I should stop if there were any twinges or pain from the harvest site.

I'm not sure about why you would have been advised not to take weight through the knee or what the mechanical effect is, as this isn't the same as my rehab protocol. I wasn't told to avoid this and have been schlepping heavy groceries around for a couple of weeks now, carried a large Ikea cupboard from one end of our condo to the other with J's assistance yesterday, and have been doing a variety of exercises that involve adding in weight (like the leg press) for about the past ten days. The heavier weights can be a little uncomfortable, but I think that's more from residual muscle weakness than anything else.

My quad and calf muscle on the left side are both firing well, but there's a very noticeable size difference now between that and the good leg - more so than after injury. I wonder how long it will take to build them back up again, given that strengthening exercise has to be balanced with what the knee joint is capable of? It's pretty scary how fast our muscles go when we're not using them...

Make sure that supermodel brings her own credit cards on the trip. ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 11, 2010, 09:42:35 AM
Deepak I was also told not to carry too much weight, basically he said a small shopping bag is fine but not to be silly and try to carry a couple of heavy bags or anything similar, he didnt explain why and I just took his advice cos it makes sense not to overload the knee at theis early stage of recovery.
I feel you and this super model may be doomed to every get together there is always something of greater importance to be completed whenever she wants to meet up with you, oh well never mind maybe next time she calls you wont be washing you hair or cutting your toenails or contemplating your navel ::)
Take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 14, 2010, 11:50:32 PM
I think we're seeing an example of the classic different approaches to ACL rehab between different surgeons. Some tell you to put weight through the knee immediately post-op & others tell you to be non-weight bearing for a couple of weeks !

I can't imagine carrying a large cupboard at the moment, or pushing weights by doing a leg press. But then, my rehab is a little behind schedule to say the least ...

Kay - I'm glad to hear that even superhumans like you lose muscle mass post-op. It gives me a warm feeling inside  ;D  Not only has my quad been taken by the "quad fairy", but some of my calf has been taken by the "calf fairy"  :'( Seeing the shocking pace at which the muscles atrophy has made me have morbid thoughts of how fast my muscles will atrophy all over my body when I am too old to exercise ... You make a good point about the credit cards when/if I go on the shopping trip with the super model. That's the problem with super models : they're such high maintenance and so tempestuous, which is why I usually go for actresses, musicians or dancers who are much easier to deal with  :P

Tez - I think you're right, the relationship between me & the super model seems to be a comedy of errors. Oops, just gave the plot away  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 15, 2010, 12:06:38 AM
I was actually curious to see how bad the muscle atrophy was this time, so I measured my leg - I've lost 4cm from the quad and 2cm from the calf, which is slightly better than post-injury. I hope that will start to come back now that I'm cycling more and adding weight to the leg press, but realistically I think it's going to take a while; I just can't exercise aggressively enough at this stage of rehab to compare to the kinds of things I was doing to maintain muscle mass before surgery. On the plus side I've gained about 3cm on each bicep from all the swimming!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 15, 2010, 12:33:59 AM
The men are restless. We have been at sea for over 60 days. We only have a few days worth of food rations left. The water ran out 2 days ago. And there appears to be no sign of land. A few men have developed scurvy. There is open talk of mutiny ...

Whoops, sorry, wrong diary  ;D

Day 49

On the 49th day did Deepak rest. And lo the sheep did come from the mountain to the valley, and the fish from the river to the mountain, and the lamb did lie with the ostrich. And Zebedee did lie with Ermintrude.

I was supposed to go to the gym today, but decided to check out knee geeks before going to the gym. Unfortunately, my ISP (Talk Talk) was down, so I thought I'd quickly (...) watch a DVD before the gym. The DVD was Monty Python's "The meaning of life", hence the nonsense above. My good intentions went out of the window after I'd spent a couple of hours watching the DVD with breaks ...

Day 50

In a way it was a good job I didn't go to the gym yesterday, since I would have been tired today, and I needed to be on my feet for a good few hours.

My mum, sister and her little 3 year-old daughter (3 generations of my family) came to visit me and check that I was still alive. My niece enjoyed seeing the geese and ducks in the canal next to my block of flats. She also enjoyed playing my keyboard - another budding musician in the family !

Day 51

Having a break from my usual boring routine of RICE and knee exercises yesterday did me a world of good. :) I can now get to almost 0 degrees extension first thing in the morning even before I ice the knee !

I made it to the gym today without any diversions. Managed 15 minutes on the bike with resistance at level 1, which is much better than on Day 47. No pain in the knee after the bike either.

Stretched the quads and the calves to try to avert the foot cramp I got in the pool last time. My flexion has improved to the point where I can actually do a standing quad stretch on the bad leg, which I couldn't 3 weeks ago.

Did my shoulder rotator cuff exercises, and then did my pool workout. Managed to swim about 800 metres with a float between my legs - I say about 800 because I lost count after 600.

Because the weather has cooled, its possible now to wear my tubigrip (knee compression stocking). It does seem to make a difference to the swelling.

Glad to report that the codeine has no effect on me mentally ...  :P
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 15, 2010, 12:58:18 AM
Kay,

I just measured my own atrophy levels. Comparing good with bad leg, I've also lost 4cm on the quad, but only 1cm on the calf, although my measurement may well have a good degree of error.

It took me about 3 months last year to regain the muscle mass I lost in the first month.

I can see how you would gain bicep muscle mass from the swimming with a float. I never did much swimming with a float between my legs when I've been injured several times in the past - I would swim a couple of hundred metres at the most, but swimming about 800 metres as I did yesterday is a good workout for the arms & shoulders. I'm feeling it in my biceps today !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 15, 2010, 01:17:31 AM
In addition to the float, I've also been swimming with extra large resistance paddles on my hands to make it a better upper body workout. Apparently it's working! :)

I regained most of my muscle mass in about two months after my injury, but I was back to long-distance cycling (100k+) after a month, and skiing with a brace at six weeks. Realistically, I don't think I'm going to build any muscle until I get to about the 12 to 16 week stage of rehab, when the exercises ramp up a bit. For now I'll be happy to maintain tone, and hopefully have a decent foundation to build on when the time comes.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 15, 2010, 10:32:53 AM
Deepak your coming alone nicely now it would appear which is excellent news, just wondered if you have tried going back to work again yet? cos I was in the salon to have my own hair cut and coloured on Fri and the girls were very bust so decided to help them out a bit probably spent an hour blow drying etc and really paid for it on Sat with loads more pain and swelling so I now have realised that no way am I anywhere near ready to return to work :o
There is no point me measuring any of my muscle groups are they have never been measured in their lifes so wont have anything to compare it too ;)
I hope your having a good weekend and not getting to distracted for doing your excersises by your DVD collection...
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 15, 2010, 11:48:01 PM
Tez,

I haven't gone back to work under strict instructions from my knee surgeon, who told me to rest until my swelling had disappeared (which it hasn't). I see the knee surgeon again tomorrow, so we'll see what he says about me returning to work.

I've been reading your diary, and when I saw that entry about you going back to work, it was deja vu. I know exactly the temptation to "get back into it". If you enjoy your job, and I suspect you do, it's natural to want to get back. And then there's the social aspect of work - its fun being with your colleagues ! :) Although you know you shouldn't stand for long, you think "what harm can it do ?". As you & I have found to our cost, it can do quite a lot of harm. I am glad that you are doing the sensible thing and not trying to return to work early.

If the pain doesn't settle down, I would make an appointment with your physio or surgeon to review the problem.

My advice, based on my own experience, is

1. Stop doing house work, or at least only do what you need to feed yourself during the day when your family can't help you.
2. Stop carrying shopping bags.
3. Ice the knee several times a day.
4. Spend as much time as you can resting by lying on your back with the leg in the air doing ankle pumps. The danger with spending too much time resting is that the knee gets stiff, in the worst case leading to arthrofibrosis, so its very important to keep the knee mobile by doing heel slides, and try to keep the quads firing by doing quad flexes and SLRs.
5. Use a tubigrip.
6. Get in a cool swimming pool and do some gentle walking. This will provide cooling and compression. As Kay & I have learned from Shelli's post-op diary, the water provides 10 times more compression than a compression stocking !

7. Cut out the inflammatory food from your diet, and make sure you're having plenty of the inflammation-reducing foods.

Hope this helps and that you're back on track soon.

Yes, I did have a good weekend thanks. I went out yesterday for my mum's birthday, but perhaps I'm paying for it today because I've been exhausted and not been up to going to the gym & pool as planned.

cheers,

Deepak
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: LARSknee on August 16, 2010, 02:56:51 PM
Hi Tez
sounds as though Deepak has written a great summary of how to look after your knee.

Hope you follow it and it works well for you .......

Cheers
Shelli :>)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 16, 2010, 06:49:33 PM
Deepak so pleased your taking your doc's advice about going back to work, your right about me I love my job and i'm missing the staff and my clients and just the whole buzz of work but have learned like yourself the hard way that we cant push to get back too soon.
I have had a read at your list of dos and donts and I will try to stick to it as much as possible, thanks for that, who knew you were so wise ;)
I hope things are going alright for you take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 16, 2010, 11:25:08 PM
Tez,

Reading your diary today, it sounds like you're doing fine, so don't worry too much about following my "7 steps to that knee you've always wanted" (available in all good book shops for only £9.99)  ;D

If I have any wisdom, it is because I was brought up in a monastery in China, where I studied with my Master "the way of the knee". I learned the importance of eating grass and hopping ...  ;D

Day 54

The knee surgeon told me that the blood tests from 2 weeks ago showed no sign of infection, so its a huge relief to know that I won't need to go through another operation to clean an infection from the joint. Phew !

The swelling still hadn't disappeared as he had hoped, so he said he had to drain the fluid from the knee with a needle. I wasn't looking forward to having a needle in the knee at all, but in the end it wasn't too bad. The needle was only inserted just under the skin on the lateral side of the thigh just above the patella. It felt less painful than having a blood test.

He explained to me that the colour of the fluid was positive : a clear light yellow. A dark colour would indicate infection. There was also some residual blood from the operation that hadn't been absorbed by the body. The fluid will be analysed for any infection just to be 100 percent sure.

He told me I need to give myself one day to recover from the needle, and then I should resume my physio programme. Maybe by the end of this week or the beginning of next week, I should be able to return to work, although I should definitely not sit with my knee flexed for 8+ hours a day. I should sit with my foot propped up on another chair and take frequent breaks.

Re the codeine and ibuprofen I am taking every day, he said I need to start weaning myself off them, since I should not need them at almost 8 weeks post-op.

He will see me again in 6 weeks time.

He wasn't kidding about giving myself one day to recover from the needle, because by the time I got home, my knee was killing me and I had to lie down to relieve the pressure from my weight on the knee. Its a bit better now, but I think I'm going to have an early night for a change.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: LARSknee on August 17, 2010, 04:03:47 AM
Hi Deepak

Good news that there is no infection in the knee,i think draining the excess fluid and blood should help in speeding up the recovery.

Does it feel better today ?

I had my best nights sleep since my op last night after taking 1/4 of sleeping pill,its amazing what a good nights sleep does for you.


Happy knee day

Shelli :>)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 17, 2010, 04:20:36 AM
Deepak oh wise one I hope the fluid removal helps the knee to feel much better, and brillient news on the infection or I should say lack of it ;D yipeeee I say to that  ;) I hope the pain from the needle improves and dosen't cause you any problems.
When you return to work would it be possible to start with half days even for the first week or so to give the knee a chance to get used to being back? It may be a better idea rather than throwing yourself into full days especially after the reaction you had the last time you tried to get back to work.
I am having a knee related night of not sleeping cos it's after 4am and I am online when most sane folk would be in there beds, It's not exactly pain thet woke me up more a feeling of restless legs and no matter what position I tried I couldnt get back to sleep, I may have jinked myself cos when talking to a friend earlier in the day he asked me how I was sleeping after the op and of course I responded fine and how great it was now that I was getting full nights sleep ::) wish i had kept my mouth closed lol.
Anyway you take care and be good to your knee Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 17, 2010, 06:24:02 PM
Shelli - Yes, the knee is better today thanks, although not completely pain free. As the surgeon said I need to rest for another day before the pain subsides. I think getting to sleep at a reasonable time last night for a change made a big difference. I woke up this morning much fresher than I have for a good few weeks. Glad to hear that you got a good night's sleep too. May you have many more in the coming months of ACL rehab !  :)

Tez - You're right I should start with half days when I go back to work, given as you remembered, the negative reaction my knee had to going back to work at 3 weeks post-op. I was telling the surgeon yesterday that I'm not very good at saying "No" to colleagues when they ask can I do XYZ at work. I'm going to have to get better at that ... Like with the exercise, part of the challenge for all of us ACL rehabers is pulling back from trying to do things just as we did before the operation. I'm going to reply on your thread about the restless legs ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on August 17, 2010, 06:41:20 PM
oooooohhhhhhhhh big needles......ooooohhhhhhhh  :P

Great news that there is no nasty infection in that ole knee of yours. Excellent news. Keep up the good work and a gentle return to work sounds like a good plan. Lottie suggests substituting the codeine and profen with Crabbie's alcoholic ginger beer (our local shoppie has 3 bottles for 4 quid if you want a trip to the countryside....) and a large chicken saag or bhuna. Works for me.  8) Also suggest painting hideous form of spots/rash over face and neck to ensure collegaues give you wide berth at work and don't ask for any assistance. Cough a lot too, and drool on the keyboard.

Lottie's guide to work rehabiliation now available - only 6,000 Nigerian pounds. Please send to Account Number in Geneva 987-0684445 by return.  :)

I may be having a big prick in my knee too in September. Inception not deception though....

Take care xx

Lottie  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 17, 2010, 07:36:39 PM
Lottie,

You've just made me laugh with your post - thanks !  ;D

Maybe I will make a trip to the countryside to sample some Crabbie's. I just checked out their website, and it sounds much better than most ginger beers which are actually just carbonated sugary drinks.

I may also take on board some of your suggestions re makeup & acting for the return to office duties  ;D

Do you accept Italian Lira for your guide ? I'm making the account transfer now and looking forward to receiving my copy  ;D

Good luck for your "big prick" (ooer missus !) in September.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 19, 2010, 12:26:10 AM
Day 56 (8 weeks post-op)

The pain from the needle on day 54 has almost disappeared, but I've been resting for the last 2 days, minimising the amount of time I spend on my feet.

Tonight I'm going to start weaning myself off the codeine by reducing the dose from 30mg to 10mg. I've also only taken 1 ibuprofen tablet today.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 19, 2010, 05:46:39 AM
Deepak good luck with reducing you pain meds I hope all goes well with it.
I am up at stupid o'clock again still have that twichy restless leg feeling but when I thought about it I didnt drink much water yesterday even when I came out of my rehab class so I'm thinking that could be the cause, so here I sit at 5.45 am chugging water nice and cold out the fridge.
Any date for your return to work yet?
Take care Tez 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 19, 2010, 08:29:14 AM
Good luck on the codeine reduction. I've been off the analgesics (apart from two T3s) since a week after surgery, but am way behind you on NSAIDs - I was on naproxen 3x daily until my GP switched my meds a couple of days ago, and am now on diclofenac 2x daily instead. I'll be on this regime till the swelling's considerably reduced, so for a while yet.

How is the knee feeling now? Remember when you go back to work...the knee comes first. Your coworkers will just have to learn to live with that. :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 20, 2010, 12:04:18 AM
Day 57

Saw the physio this morning for a brief appointment. The physio team were expecting me to do a standard exercise routine, picking up where I left off, but I told them that I wasn't sure I was capable of resuming my programme and wanted to be reviewed first.

The physio who did review me was quite shocked by my quad wastage and my loss of extension. I can get to 0 degrees extension with the leg on a bed, but it was painful when the physio tried to pull the knee into hyperextension. On the good leg, there was no pain when he pulled the knee into hyperextension.

On the positive side, he said that the patella was quite mobile, since I have been doing patella mobilisations.

He said I was basically going to have to start my physio programme from scratch at 8 weeks post-op, which is very late. Normally, ACL physio rehab starts at 1 week post-op ! The worried expression on his face made me wonder if there's any risk of permanent damage ... that paranoia creeping in again  ::)

He will see me in a week's time. In the meantime, I need to do the following :-

1. When resting, try to get the knee into hyperextension by doing heel hangs. This is a real priority, so should be done as much as possible.
2. Quad flexes,  3 sets of 10, twice a day.
3. Patella mobilisation.

I forgot to ask him about the crutches that I'm still using. I don't feel I can ditch them yet since my knee gets painful after walking more than a few minutes without the crutches.

I did remember to ask him about returning to work. He thought there should be no problem with returning to a sedantary office job, but that's what they told me last time, and they weren't quite right ...

I managed to sleep last night with just 10mg codeine, and haven't needed to take ibuprofen today. Hopefully, I'll be off the narcotics within a week ...

The bruising in my foot around the ankle has returned (if it ever completely disappeared) indicating that blood is once again pooling, so I need to resume my daily walk to pump the blood out of the calf.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 20, 2010, 12:21:31 AM
Tez - Another thought that occurred to me about the twitchy leg, if it's the quad that's twitching, a quad stretch may help. I used to get quad twitches after football games when the muscle was still tight. Also, the other cause may be adrenalin in your blood stream from the exercise. Its important to try to calm down mentally before going to bed, but I know that's easier said than done ...  ::) I've agreed with my colleagues that I will return to work next Monday, but will only work half a day and from home (to avoid carrying a laptop and commuting on the bus & tube).

Kay - You may not be able to do this with the heatwave you're currently experiencing, but I'm finding now that it's cooler and I'm able to wear a tubigrip, I believe that reduces the inflammation far more than the ibuprofen does. The knee is actually feeling quite good. One of the things that struck me today was that when the physio asked me if my knee was painful, I said yes, a little. Then he asked me if the knee felt unstable, and I said no ... It struck me afterwards, the profundity of what I'd just said. For the first time post-op, I don't feel like I've got a wobbly knee  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 20, 2010, 12:11:43 PM
Deepak congrats on the unwobblienss of you knee, funnily I was hopping on the trampaline thing at my rehab class this morning thinking how unwobbly my knee now feels too ;D so even though the pain and swelling is still there at least the stability that was missing is now there.
Good news about going back to work, working from home  should give you the best of both worlds, just take it slow and steady, that goes for physio as well at least you had the sense to get yourself reviewd first rather than just throwing yourself in to where you left off.
The whole twichy leg thing could be so many things its hard to pinpoint what is causing it but just wish it would pass soon >:(
I may try using a tubigrip again next time I will be walking or standing for any legnth of time and see if it helps.
Hope you have a good weekend take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 20, 2010, 04:20:19 PM
Thanks for the tip - it's actually due to turn cooler here tomorrow, so I'll give the tubigrip a test run. It wouldn't be super comfortable in the heat, but on the other hand if it helped with the remaining swelling I think I'd grin and bear it.

Glad to hear your knee is completely stable now. :) This is where my pre-surgery experience diverges a bit - apart from a couple of weeks immediately after my ACL tear, I never had any instability in the knee at all. Probably strong evidence that I would have been a "coper" had I chosen to live without the ACL, but given my existing knee problems I wasn't prepared to take the chance on more drastic injury during a future tumble, or further degeneration of the OA due to ACL deficiency.

Here's to non-wobbly knees!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 21, 2010, 09:38:15 PM
Day 58

Well, I spoke too soon about my knee being stable, because I was sweeping my floor today and the knee wobbled, so the fact that it hadn't wobbled recently probably just meant I hadn't been challenging the knee. Not that sweeping the floor is what I would really call "challenging", so this means that my knee is still as unstable as it was pre-op  :( I think the fact that I have very little quad won't help with the stability. It just goes to show that even a functioning ACL on its own isn't enough to provide stability, you need the supporting muscles as well.

My knee felt pain-free enough today for me to go back to the gym and do 15 mins on the static bike, my upper body workout, and my pool routine. I managed to swim 1000 metres (+/- 100 metres since my counting isn't very accurate after 500 metres) with a pool buoy between my legs.

Decided to try going cold turkey and didn't take any codeine. Slept fine without it. Hopefully, I can kiss the codeine goodbye !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: LARSknee on August 22, 2010, 01:29:33 PM


Hi Deepak,

sorry about the wobbly knee episode today,but good news about sleeping without the aid of codiene.

And glad to hear the knee was happy enough for a return to the gym well done :>)


Keep up the good work

Shelli :>)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 22, 2010, 05:10:16 PM
I suspect your wobble was caused by lack of muscle strength from the unexpected rest you had to take due to the inflammation. Hopefully that will go away fast now you're back in the gym. :)

I hope it's not too frustrating to have had to take a step back with your rehab, but at least now you're going in the right direction again. It sounds like you're doing rather better than going right back to the start of rehab if you're at the gym and in the pool. Are you going to try adding a gentle flutter kick in the pool, or leave that for a while?

Congrats on the reduced codeine levels. :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 22, 2010, 08:10:35 PM
Deepak sorry about the wobble but as Snowy said it could be more to do with the muscle stregnth rather than the acl i really hope so.
Good for you doing without the codine I wish I could stop taking the tramadol but every time I try I end up with more pain, usually because I have done too much so I guess thats my own fault :(
Well done on the gym and the swimming you will be back to  where you should be rehab wise in no time.
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 23, 2010, 12:58:22 AM
Shelli, Kay, Tez,

Thanks for the encouragement on kicking the codeine habit. I'm really happy I'm off that stuff, since it is an opiate, if taken long term it does have similar (although much milder) effects to opium, and causes similar withdrawal symptoms.  :o Although I've gone back to the gym, I haven't yet done any strengthening exercises for the leg, since I haven't been cleared by the physio to do so.

I'm philosophical about where I am rehab wise. I'm not where I would like to be, but that's where I am, and there's no point wishing otherwise. A former girlfriend of mine taught me a great life lesson : accepting where you are leads to contentment, wanting to be somewhere else leads to stress. It isn't easy to put this into practice, but sometimes I manage ...  ;) I'm just very glad I didn't have an infection, and can get back on track now.

I'm not going to add a gentle flutter kick yet to my front crawl, since again I haven't been cleared to do it. I did actually try a week ago (before the surgeon drained the knee) and found that my swelling limited my knee flexion, so I couldn't kick. Of course, swimming with the arms alone is alot tougher than using the legs as well. Hopefully, its going to pay off with some upper body development to compensate for my skinny op leg  ;)

I realised why the physio wanted me to concentrate on doing quad flexes to work on my extension. The action of pushing your knee into the bed and flexing the foot is precisely the action required at pushoff during walking where the leg must hyperextend. I've also noticed that immediately after doing the quad flexes, walking is less painful - now there's an incentive to continue doing the exercises  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 24, 2010, 02:40:02 AM
Day 61

Returned to work (for the second time) and so far haven't had any negative reaction.

I only worked half a day from home, to avoid commuting and carrying a laptop. I kept my foot supported on a pillow sitting on another chair, so my knee was hanging free (i.e. I was doing a heel hang) to keep my op leg elevated and to force hyper-extension in the knee. I also took short walking breaks every 30 mins or so, to give my knee a break from the heel hang which gets painful in the back of the knee after some time.

[artistic license begins]

The super model called to ask if I would be able to give her some fashion advice, which I was somewhat taken aback by ! I told her that I knew nothing about fashion, so was not really qualified to provide advice. However, she persisted, and said all she was looking for was an opinion to help her make a decision. She had started taking belly dancing lessons, and needed some fashion accessories : definitely a coin belt, but maybe also a navel ring. If she went for the navel ring, she would need to get her navel pierced first. So the question was, should she get her navel pierced ?

I told her this was a tough decision for a guy to make, and that I would have to think about it and get back to her tomorrow morning. So I spent the rest of the evening contemplating her navel.

[artistic license begins]

Thanks to Tez for the inspiration for another story-line  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 24, 2010, 01:40:48 PM
Deepak good luck on the return to work I hope it continues to go well and at least the fact your working from home means you can still baby your knee a little.
If and when you put all these artistic licence mini stories together as a collection and you start making lots of money I expect at least an acknoledgement my artistic imput ;D
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 24, 2010, 11:27:25 PM
Glad to hear the return to work went well. It's great to have the option to work from home - if I find going back full-time tough, I may end up working from home one or two days a week. In some ways I hope I don't have to, though - after so long off it will be nice to be back in the office with all my coworkers. They're a great crowd and I have really missed them while I've been off work.

Hope you're enjoying the navel-gazing. ;) Remind the supermodel that she'll have to take the ring out if she ever needs an MRI following a knee injury, however. (It's easy to almost forget...)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 25, 2010, 12:58:48 AM
Work has been going well thanks. The back of my knee does get sore after doing heel hangs for 4 hours though, so I don't think I could do this for 8 hours. I've had to blow some cobwebs off the old cogs in my head, but some of them are slowly turning  ;) It feels great not to be bored out of my brain during part of the day !

Tez - when this collection becomes a "made for TV mini-series" your name will be in the credits. There may even be some cameo appearance opportunities if you're interested  ;)

Kay - Sounds like you may be able to help me with my fashion decision for the super model, since you have experience in the "field" (magnetic field, MRI - geddit ?)  ;D The navel gazing has been a life changing experience : I thought about the nature of the universe, which came first the navel or the mother, space, time, infinity, destiny, ... and it made realise that the super model holds the answer to every question I ever had and ever will have.  ;)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 25, 2010, 01:13:07 AM
Deepak your a star you've cheered up yet another boring night when I have been unable to sleep ;) ;D ::)
Thank you!!
Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 27, 2010, 01:35:11 AM
Day 63

Slept badly last night. I think my 2 mistakes were not going out for a walk during the day so I wasn't tired at night, and doing my quad sets just before trying to sleep. My lower leg was twitching and keeping me awake. I think the muscle responsible was the tibialis anterior (http://en.wikipedia.org/wiki/Tibialis_anterior_muscle). I was finally able to sleep once I'd done a stretch on it.

I finally broke tonight, and decided that I needed to have a couple of beers to make sure I slept properly. I've been avoiding alcohol for about a month to try to get the inflammation down.

Day 64

Luckily the beer worked and I did manage to sleep last night AND no extra inflammation as a result of the beer  8)

Saw the physio who was glad to see that my knee has very little swelling left compared to last week. I think the tubigrip is making a big difference, as are doing more quad flexes. I know alot of people here are complaining about it not being sunny, but I'm actually happy about it because it means that it is cool enough for me to wear the tubigrip most of the day.

The physio was also happy to see that my knee can now hyper-extend, because I have been doing heel hangs for most of the day since I saw the physio a week ago.

Next he looked at my gait, and said I was leaning towards my good leg. He said I need to stop doing this and walk putting weight equally on both legs. I told him that I still have pain in the knee, which is why I'm trying to keep the weight off. He said that if I continue doing that I will never get better. I have to work through this pain to make progress. This is why he said I'm still on crutches at 9 weeks post-op.

My objective for the next few days is to walk heel to toe without crutches as much as possible and carry one crutch only, in case the pain becomes unbearable. The single crutch should be used on the side nearest the good leg, which provides better stability than using the crutch next to the op leg.

I've been given a new exercise to encourage me to put weight through the op leg :

Balancing on op leg, use the foot on the good leg to point to 9, 12, 3, 6 o'clock on the floor.   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on August 27, 2010, 04:02:06 AM
Deepak glad the beer helped give you a good nights sleep, a bottle of wine tends to help me sleep as well though thats not always the reason I enjoy one ;) maybe thats what I should be doing now having some wine instead of posting on here as its silly o'clock and I cant sleep, [more to do with a Son who is a pain rather than a knee thats being a pain ::)]
It sounds like your physio is really helping you and I'm sure before long you can ditch those crutches once and for all, I still have mine and though I dont use them often I did take one with me last Sat as I knew I would be walking quite a bit and I was so pleased I had cos I ended up in a lot of pain and may not have managed round the whole car boot sale without it.
I hope work is going well and you are enjoying getting back into the swing of things.
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 31, 2010, 09:28:15 PM
Day 66

Went swimming and did a few hundred metres with the pool buoy, but then thought I'd try following in the footsteps (or should that be the slipstream  ;)) of wonderwoman Snowy.

Last time I tried kicking with my legs, the op leg couldn't do it due to the swelling I had. Now the swelling has decreased significantly, the op leg managed. I swam just a couple of hundred metres to avoid overdoing things, as I'm prone to, and I found that if I kicked too vigourously, the knee complained, so I'm not yet back to pre-op kicking, but it feels great to be able to swim front crawl normally again.  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 31, 2010, 09:49:12 PM
Day 69 (ahem)

I've ditched the crutches as advised by the physio. He said last time that when I came in for my next appointment (today) he didn't want to see the crutches. Nothing like a bit of pressure to motivate you, is there ?  ;)

He gave me a new programme :-

1. static bike - 5 mins
2. rowing machine - 5 mins
3. trampette - balancing on op leg
4. bridging - 3 x 10
5. mini squats - 3 x 10
6. heel raise - 3 x 10
7. lunge - 3 x 10
8. balance on rocker board - can't remember how long for ...
9. hamstring curl (no weight) - 3 x 10
10. hip abduction with bent knee - 3 x 10

I did this and my shoulder rotator cuff workout in the gym, and now I'm exhausted, but very happy to be doing some exercises that will rebuild my glutes, hamstring, quads and calf on the op leg.

My knee wobbles when I do exercises 5, 6 & 7 because the muscles are weak. I need to get these stronger before I can move on to weight machines. 2 months ago I was squatting 100 kg, now I can't even squat my own torso weight without shaking ... Ah, c'est la vie !

I can now also walk up stairs with a bit of push off from the good leg. Walking downstairs is still a problem.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on August 31, 2010, 10:03:05 PM
That all sounds very good indeed - the swimming and the exercises. :) I'm impressed that you're doing lunges, as well - they're not on my protocol until 16 weeks!

Now that you're regularly doing strengthening exercises, hopefully the muscles will firm up pretty fast.  It's amazing how long it takes to build them up, and just how quickly it goes...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 31, 2010, 11:23:30 PM
Tez, yes work is going well thanks. They gave me a grace period last week to ease back in by just catching up with what's been going on while I've been away, but this week I have to actually do some work !  :o Today was tough because I had my physio appointment in the morning and then had to work in the afternoon - it was a battle to stay awake, and I actually had to take a 20 minute "power nap" at one point because I just couldn't keep my eyes open. This is one of the many advantages of working from home. I can take breaks when I need to, and I can elevate my leg on a pillow - my office wouldn't allow such a thing !

Kay, I just checked my protocol and it doesn't mention lunges, so I don't know when it should be in the rehab schedule. My protocol does mention "dynamic stability" at 6-12 weeks, so maybe lunges come under that category ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: LARSknee on September 01, 2010, 11:51:13 AM


Hey Deepak

Well done on ditching the crutches and the new exercise regime....

Keep up the work with the stairs,with me it just seemed to happen from not being able to do it till a few days later it all changed.

I think progress after surgery is very unpredictable and its a great feeling when we climb over another hurdle :>)

Keep up the good work

Cheers
Shelli :>)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on September 01, 2010, 02:27:32 PM
Deepak good for you ditching the crutches it will feel a little strange for a while but before you know it you will not even miss them
The excersise regime sounds pretty good its not unlike mine and I'm sure befor you know it the wobble will be no longer and you will be back feeling stronger and stronger.
Pleased the return to work is going well, I am also a great believer in the art of power napping a favorite pass time of mine ;)
Keep up the good work and take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 03, 2010, 01:28:12 AM
Day 70 (10 weeks)

I managed to walk downstairs bending the op leg for the first time. The op leg is still not able to walk downstairs normally because its not stong enough, but it's a start.

I think yesterday's physio exercises made a big difference !

Day 71

Went for my post-dinner walk round my local park that has been my usual daily walk since my op. With crutches, this route used to take me about 45 minutes. Now without crutches, it takes me 20 minutes, so I had to walk a bit further to make it worthwhile. Today, for the first time, I feel like I'm almost (but not quite) walking normally.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on September 03, 2010, 01:38:27 AM
Sounds like things are coming on in leaps and bounds - ditching the crutches was obviously the right thing to do. :) Fingers crossed that this great progress continues!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on September 03, 2010, 12:58:02 PM
Deepak yipeeee walking normally is fantastic especially after all that time on crutches it would apear things are going really well for you, I hope it continues to do so, what is happening about work are you still working from home? and when do you start back at the office?
Take care Tez 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 04, 2010, 12:32:39 AM
Tez,

Yes, I'm still working from home and still only doing half days. My manager has asked me when I'm likely to start doing full days (he obviously would prefer that I did whole days not half), so I've told him that I will get back to him once I've discussed it with my physio at my next appointment. He is understanding, because he knows what happened last time when I tried to rush back into work when I wasn't ready. And he really doesn't want me to be off work for another 2 months  ;)

So my situation is a bit like you in that they need me to do full days, but I'm not about to be rushed into it if I'm not ready. I can get another job - I can't get another knee !

Re going back to the office - interestlingly, since I had my op, the company now has a policy of saving money by having less office space, so we have been told that we have to work from home. We only go into the office if we need to physically meet. So far, I've managed just fine with internet chat and email.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on September 05, 2010, 12:04:26 PM


Re going back to the office - interestlingly, since I had my op, the company now has a policy of saving money by having less office space, so we have been told that we have to work from home. We only go into the office if we need to physically meet. So far, I've managed just fine with facebook and Knee Geeks


 :o ::) :P

Glad all is going well.......take it steady....

Lottie xx
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on September 05, 2010, 12:08:38 PM
Deepak....Lottie... LIKE very much lol
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 05, 2010, 05:46:25 PM
Lottie,

I like it, very subtle  ;)

I was just telling a mate yesterday that Knee Geeks has been a life saver for me post-injury. He had a back op about 10 years ago and said he wished there had been a similar support forum for his injury. It's so much harder to make a recovery if you don't have anyone to compare notes with and provide a shoulder to cry on.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on September 05, 2010, 08:19:21 PM
Hear hear!

You guys have definitely been the silver lining to this whole experience. :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: LARSknee on September 06, 2010, 10:07:25 AM


I agree with Snowy,Im so glad i found all you wonderful  kneegeeks before my surgery and have been able to share experiences and stories with everyone,and having the opportunity to offer advice and support to other people.

I was chatting to 1 of the personal trainers at my gym today who is having ACL surgery in 2 weeks,told him about the website and gave him a few tips for after surgery.
The poor guy says he will be back at work 1 week post op because they pay fees to the gym to be able to train clients so cant afford not to be at work.
I said realistically i dont think you will be able to.

Thanks again to all you wonderful kneegeeks :>)

Shelli xx
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 07, 2010, 09:18:59 PM
Shelli,

I agree with you. I don't see how that guy is going to work as a personal trainer, which is a physical job, 1 week post-op. I hope we're wrong and look forward to reading his post-op diary.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 07, 2010, 09:36:07 PM
Day 76

At physio today, some exercises from last week's programme have got easier : static bike, hamstring curl, rowing machine, bridges and hip abduction. Mini-squats, heel raises and lunges are still not easy, although at least I'm not wobbling while doing a mini-squat. Heel raises are the most difficult, which probably indicates that the calf is the weakest muscle in my op leg.

I asked the physio if its OK for me to do a straight leg kick during front-crawl, and he said not yet ! Oops, since I already did over a week ago ...  ::) So today I was back in the pool with the pool buoy. I had a funny conversation with a woman in the pool who told me that I was never going to learn to swim if I insisted on walking on the pool floor ...  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 13, 2010, 11:31:30 PM
Day 82

My leg is getting stronger. At physio today, static bike, rowing machine, hamstring curl, squats, lunges and even heel raises have got easier. The physio pointed out that I was doing the side-lying hip abduction incorrectly : I wasn't keeping my feet together and I was rolling my hip; keeping the feet together and the hip stationary really works the gluteus medius !

I can now internally rotate my knee so that I can put my left foot (from the op leg) on my right knee, which means that putting on & taking off socks has become less of a drama ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 16, 2010, 12:22:52 AM
Day 84 (week 12)

Well, I've reached the magical week 12, which means the ACL graft is less fragile now ... I hope  :)

At physio today, got 2 changes to my physio programme.

1. Lunge on flat ground was easy, so I'm now doing lunge onto trampette to provide more of a challenge to the knee.
2. Added a single leg squat to my programme. I found this one painful and I can currently only do this while holding on to a solid object (e.g. door frame) while doing the squat, but as I'm learning in the game of ACL rehab, its really "no pain, no gain" as long as its under supervision by a physio who knows what is acceptable pain & what is not.

The physio analysed my walking gait, and the sad news is that I am still leaning onto my good leg. She said I need to use my glutes when I walk to support my weight. When I consciously made an effort to engage the glutes, she said my gait was better. So my homework till the next appointment is to keep thinking about engaging the glutes while walking, so that I put weight through the op knee.

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: LARSknee on September 16, 2010, 05:38:07 AM


Great News on reaching the magic 12 week mark........

Your progress should really take off now,and squeeze that butt when your walking !!!!!!

This time next year all our hard work on rehab will be a distant memory :>)

Cheers

Shelli
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Lottiefox on September 16, 2010, 10:14:43 AM
Deepak,

Yay on the 12 week mark! How times flies.... ::) :P

Another trampette user - I have a plan. It involves you and Cosmic and your trampettes, some Scissor Sisters CDs, some cheerleader bobbly things to shake and a routine.....whaddaya reckon?? I think after a few weeks practice we can enter you on the next Britains Got Talent.  ;D

Keep up the good work.

Lottie xx

PS Single legged squats - ouch ouch. I have those to do for my PFS. Only very slight dip. I get put off by the violent and loud noise that arise from the kneecap which my PT says is "fine" and usual as I have little cartilage left. Strangely my BAD knee is getting quite good. My GOOD knee (ha ha ha ha) is pathetic with them. I tried doing them on the Power Plate at the gym too, much to my own entertainment. Good job its near a wall and floor.  8)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 18, 2010, 12:23:50 AM
Shelli - thanks, I hope our hard work is going to be a distant memory in a year too ! Now though, I've got to a stage where I'm actually enjoying the physio.  ;) I'm trying (when I remember) to squeeze the glutes, quads and abs when I'm standing or walking, but it is a mental effort to send a signal from my brain to 3 parts of my body.

Lottie - Yes, I'm on for the trampette routine with Cosmic ! I think we'll look great in those short skirts with our tight glutes ... I'm currently sewing my cheerleader outfit, and I've choreographed a preliminary routine including some high kicks especially for Cosmic ...  ;) Yes, I think we would do very well on Britiain's Got (Knee) Talent - I always wanted to be famous when I grow up, you know all those adoring fans, the high-life, travelling round the world, being on the front page of the gossip magazines, going to show-biz parties, bathing in ass's milk ...  You're a brave woman to try doing single-legged squats on a Power Plate, the thought of it makes me shudder  ;D

Day 85

Did my first whole (8 hour) day at work from home. I managed fine, with no ill effects.

Day 86

Went to my office for a meeting in the morning. This is the first time I've been back to the office since I had my inflammation in week 4. I commuted on the tube after 9.30am to avoid the rushhour and any consequent risks of being accidently knocked or pushed by a fellow cattle commuter. Again no ill effects. It was actually very useful to meet face to face, we were able to brainstorm with a flipchart, which is much harder over the phone/internet.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on September 19, 2010, 06:41:28 PM
Wow - I have to say that braving the tube is probably more demanding and scarier than any rehab exercise! I took a bus once about six weeks after surgery, and that was enough for me to know that I won't be using public transport again until I'm at least at the 16-week mark. The lurch as the bus pulled away seemed custom-made to test the strength of a new ACL graft...

Sounds like you're making up the lost ground in weeks and bounds now. I find those single-leg dips are great "killing time" exercises - I can often be found dipping away in the lineup for coffee, or in my office when I need to give the knee a little bit of a stretch. Like Lottie, I only do a very small dip - it probably works the VMO more than the quads, but is great for loosening the knee.

Hope all keeps going well!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 20, 2010, 12:36:01 AM
Kay, thanks for posting on my diary. Having just read your latest diary entry, I wonder how you had the energy to post ... You & J really have been going through it. I just hope things turn round for you both soon !

The tube actually wasn't too bad. I can now cope with the lurch of the tube while standing, outside rushhour. But I'm not sure if I could cope with it at rushhour when everyone's packed-in like sardines, the train suddenly comes to a halt, and some idiot who isn't holding on to anything suddenly leans against you to break their fall ...  :o >:(

Thanks for the tip about dipping. I might try the dipping during the day to get my knee stronger, since I'm still finding single leg squats hard.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on September 20, 2010, 11:08:10 AM
Hiya Deepak congrats on the 12 week anniversary of your new acl ,and also on the getting back to full time work and the tube journey it all sounds like things are progressing well for you :D
I'm so pleased that you are getting on with you life and that everything seems to be moving in the right direction for you.
Take care Tez 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 21, 2010, 12:05:49 AM
Tez - Thanks for the congrats. Glad to hear that you had a rejuvinating holiday and have come back de-stressed.  :)  Good luck for your return to work this week !

Day 89

My physio programme got bumped up a gear today  ;D

1. Static bike - increase max resistance from 5 to 8.
2. Rowing machine - increase resistance & pace.
3. Lunge on trampette.

Exercises 4 to 8 are done with the assistance of "balance poles" (don't know what the technical term for them is) :-

4. Single leg balance on rocker board, rocking forward and backward.
5. Single leg balance on rocker board, rocking side to side.
6. Single leg balance on wobble board.
7. Single leg squat with foot of good leg balancing on a swiss ball behind you (this is tough !).
8. Single leg heel raise.

9. Bridge with single leg.
10. Hip abduction.

11. Hamstring curl - 30kg using both legs.
12. Leg press - 50kg using both legs.

13. Calf stretch
14. Hip flexor stretch

I'm finally pushing weights - Yeah baby ! Now, hopefully my quad can be rebuild.  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 25, 2010, 12:33:42 AM
Day 93

Worked my first whole day in the office, and carried my laptop to work. This was a psycholgical hurdle that I got over, since I suspect it was carrying a laptop to work last time that caused my inflammation at week 4 post-op. I felt reasonably confident that I could carry a 3kg laptop with power-supply and paper documents, to make a total of 5kg, given that I am now leg-pressing 50 kg  ;) However, at the back of my mind was still the fear that I would put myself back where I was at week 4. Luckily, my fears were unfounded and I was fine.  ;D

I'm wearing trainers to work, to minimise the impact on my knees. I did get a few strange looks from people in my office, since the dress code is "busines casual", i.e. shirt, trousers, ... and smart shoes.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on September 27, 2010, 06:55:37 PM
Congrats on your return to full time work and being able to carry the laptop and all the other stuff you need for work without any problems, it looks like we are all moving forward and starting to get back to normal after what feels like ages of living half a life..keep up the good work
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 28, 2010, 12:23:54 AM
Tez, thanks for the congrats. As I said to one of my colleagues who asked how I was - I've been away from the office effectively for 3 months - that I was back from the "dead", and I wasn't joking. It did feel at times that, as you say, we were living half a life.

Day 94

I went to see my podiatrist to get some hard skin removed from my feet. While I was there I mentioned that I had had my ACL reconstructed. I have been wearing orthotics in my shoes for over 10 years to compensate for the fact that my feet "pronate" (fall inwards due to a lack of an arch in the foot). The podiatrist said that as a result of the ACL recon, I may not need to wear orthotics anymore since the tightness/looseness of the new ACL can affect the angle of pronation in the feet, and may mean that I have no pronation at all ! So, I'm now wearing insoles that cushion the feet but provide zero degrees of compensation for pronation. I will go back to the podiatrist in a few weeks and he will then determine if I need orthotics or not.

Day 96

Saw my knee surgeon for a review 6 weeks after aspirating the fluid from my knee. He tested the graft and said that it was fine, but that my lack of quads was not fine, and that a knee without strong supporting muscles leaves the graft vulnerable. Conversely, as I was told last year by another knee surgeon, if you have strong muscles around the knee, you don't need an ACL ! He said rebuilding my quads has to be my priority, and that I need to resume doing quad flexes and SLRs in addition to my physio appointments. He will review me again in 8 weeks time.

I mentioned what the podiatrist had said re ACL recon affecting angle of pronation, and asked his opinion. He referred me to the physio on that one.

I returned my crutches to the orthopaedic dept. since they can be given to other patients. I also tried to give back my brace, but they said that they wouldn't give it to another patient and didn't explain why. So I have a spare brace if anyone wants it - just send me a Personal Message to arrange pickup from London, where I live. I don't know what make it is, since there's no company name on it, but it looks similar to this http://www.ossurwebshop.co.uk/Knee-Braces/Innovator-Post-Op-Knee-Brace/prod_56.html. If I don't get any takers in the next few days, it's going in the recycling bin.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 28, 2010, 11:23:17 PM
Day 97

I mentioned to my physio that the knee surgeon had said that I need to resume quad flexes and SLRs to build quad strength in addition to my physio appointments. She said that it would be much better to do the functional exercises, e.g. single leg squats, whenever I have a spare moment. What a relief ! I am soooo bored of doing quad flexes and SLRs  ::) Also, she said I need to be going to the gym on my own once a week, in addition to the twice-a-week hospital physio appointments, to increase the pace of muscle rebuilding.

I also asked her about foot pronation, foot orthotics, and the relationship to knee biomechanics. She said that she didn't actually know and that I should wait till the senior physio is back. I'm glad she had the honesty to admit she didn't know rather than giving me incorrect advice ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 03, 2010, 04:22:59 AM
Day 101

It seems I have become an old fart. I have had to tell people in 2 different flats in my building to turn it down at night.

On the night between day 96 and day 97, the couple who live next door were shouting, screaming and banging doors all night. Finally at 7am, I rang the police, who turned up at 8am, and since then I haven't heard a peep out of them. I should have done this more than 3 months ago. These neighbours moved in just before the week of my op, and they've been making a racket ever since. I did politely ask them once during week 2 post-op, to keep it down, but they clearly didn't care less.

Tonight, I've had to go over to another flat in the building and tell the occupants to turn down their (bad) karaoke singing at 3am. They've turned their music down, but now I can't sleep ...  >:(

After 3 months of not sleeping well due to knee pain and not being tired when I wasn't working, I really really really need some sleep. I have to go to the gym tomorrow and I know I'm going to feel crap  >:(
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on October 03, 2010, 06:31:19 AM
Ouch - big sympathy on the noise issues. It sounds like your building is awfully similar to our old building. We spent 3 years in a wood-frame condo building (i.e. no soundproofing whatsoever) with neighbours from hell. One one side we had a family of four, with two children under the age of five, in a 530 square foot one bedroom condo. When they finally moved out (I sincerely hope to somewhere larger) they were replaced by a young couple who threw raging parties on the nights of every single Canucks game. We had to watch our movies with the subtitles on and our pictures literally shook on the walls on the party nights. It was so bad that we ended up with other buildings in the street filing complaints against our building.

Even that, though, was better than our neighbours on the other side. They were an elderly couple in their late eighties who had what can best be described as a tempestuous relationship. He was an alcoholic who started on the vodka for breakfast, and she had quite advanced Alzheimer's. The end result was that they would have screaming arguments for hours and hours at a time, hurling the same two insults back and forth until he eventually passed out. Then she would come and knock on the neighbours' doors in the early hours of the morning to tell them that she thought her husband was dead because she couldn't wake him up. It was absolutely tragic, and horrible to live next door to. The final straw for us was one morning at 5am when they were still going at it hammer and tongs after a long, sleepless night of fighting, and we finally snapped and hammered on the bedroom wall and yelled at them to shut up. There was a moment of silence, and then Bud yelled back "You just don't understand our relationship!" We put our condo the market the next day.

In our new building we have a corner unit and only share one wall with a neighbour, and never hear a squeak from him. It's quite blissful.

I hope that you're able to get some sleep tonight, and more tomorrow...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on October 03, 2010, 01:42:01 PM
Deepak sorry your having these hassels with your neighbours its a horrid situation to be in when you have no choice than to put up with them but I think you have been very patient to leave the calling the police untill 7am, I hope the arrival of the police at their door will be enough to put them off making that kind of noise again.
As for the sleepless night I sympathise totaly with that I also spent many night's awake because of the knee, and now that the pain has more or less gone I thought I would be sleeping like a baby but unfortunatly I think I am in the bad habit of waking up every night, then lying unable to get back to sleep that's when all the crap things going on run through my head, especially since Gordons death I dont think I have had a whole nights sleep since then, its funny how you can cope during the day with everything but its another story when your awake at night. 
Take care and I hope some good night sleeps are coming for you ;)
Tez 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 03, 2010, 11:32:28 PM
Kay & Tez, thanks for the sympathy. I gave the gym a miss today - I just didn't have the energy to go. I need to move out of my flat, not only do I have noisy neighbours, but the landlord isn't doing any repairs.

Tez, sorry to hear that you're still not sleeping well. I can appreciate that it's not easy coping with the death of a good friend. I'm actually sleeping much better during the week (since the neighbours have got quieter) because I am mentally tired from work. I wonder if Yoga would help you - I know that you couldn't do most of the positions yet due to your knee, but one that I found really useful years ago when I had sleep problems was Savasana (http://en.wikipedia.org/wiki/Savasana). You need a Yoga instructor to tell you what to do, since it's not just a matter of lying on the floor, but about ralxing the mind as well as the body. The first time I did this, I was drifting off to sleep in the Yoga class  :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on October 04, 2010, 04:45:49 AM
Thanks Deepak for the Savasana sugestion I had a wee read and it sounds like the way we used to relax after a yoga class I went to years ago, going from the tips of your toes relaxing every part of the body bit by bit, it always made me very sleepy while in class in fact most often someone would let out a wee snore while we were all concentrating, I will give it a try when I go back to bed as its stupid o'clock again and I have been lying awake trying to think what I could say at Gordons funeral and even if I will be able to stand in front of loads of people and say anything at all,I feel its just far too long between his death and the funeral, far too much time to think and worry about everything.

It sounds like you do indeed need to find another flat if the neighbour situation is an ongoing thing and as you said the landlord wont do repairs, I would think it's time, the fact that it's having an impact on your life to the extent that you dont feel as if you have the energy to do things like go to the gym because of being kept awake would give me the incentive to look around for something else.
I hope the knee is behaving and your managing a better sleep tonight or should I say this morning.
Take care Tez       
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on October 08, 2010, 08:49:30 PM
Hi Deeak just wondered how everything was going for you how's the knee behaving and have you settled back in to work ok?
What about the flat and your annoying neighours have they been giving you any more sleepless nights lately?
I hope all is well with you take care
Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 08, 2010, 10:24:28 PM
Tez,

Hope you've been sleeping better this week. I don't know what I'd say at a funeral either. I've never had to do such a thing, but I can imagine it would be very nerve-wracking.

Thanks for asking about me. I feel a bit guilty saying this, seeing as most of the knee crowd seem to be going through hard times the last couple of weeks, but I'm doing well thanks.

Luckily, the neighbours have been behaving themselves this week. Let's hope they continue to do so over the weekend ...

Unfortunately, I haven't been able to even view any flats this week. The London rental market has gone mad apparently, and you can't find rented flats for love nor money  ??? I was told yesterday by a rental agent that I might be better off looking further out of town, where there is actually a hope in hell of finding something.

Work is going well thanks, although I've got a couple of deadlines approaching over the coming weeks, which means things are going to get hectic ...

This'll make you laugh - I think I may be going through the male menopause !  :o I've been having night sweats for the past year, and I had put it down to the whey protein I'm using to help me put on muscle (this is a known problem with whey protein). However, doing some research on the internet, it seems this can be simply due to hormonal changes in the body as men get older. I did think 44 was too young for this, but apparently the changes start happening around the age of 40. I really am becoming an old fart  ;D

Day 107

In physio, my propioception has improved. I can now balance on the op leg on a rocker board without assistance from the "stability poles". I still need one "stability pole" to balance on the op leg on a wobble board.

As a result of the improved propioception and muscle strength, single leg squats with the good leg balanced on a swiss ball behind me, have become almost easy.

I've increased the weight for the hamstring curl from 30 to 35 kg, since 30kg had become too easy.

I'm still doing 50kg on the leg press. Hopefully, next week I can bump it up by another 5kg.

Lunge onto trampette is easy now, which means my knee no longer wobbles when doing his exercise.

Earlier on in the week, I had what felt like bone pain beneath the horizontal incision, which I suspect was from the interference screw, but after the physio session that pain has gone  :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 08, 2010, 10:37:31 PM
I may need to fly on a long-haul flight for a business trip in a couple of week's time and was wondering if anyone knew what the risk factor was for DVT (or any other problem to do with the knee) at 15 weeks post-op ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Vickster on October 09, 2010, 11:20:32 AM
Cosmic flew to SA and was fine.  I was told that 3 months + after any knee surgery should be ok, but wear flight socks and ask your airline to get you into a bulkhead seat if not flying business :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 10, 2010, 11:15:06 PM
Thanks Vickster. If I do fly, it will be business class, which means I can elevate my leg (I'm not sure I'll be able to get the foot higher than the hip though). My physio said that I also need to walk every hour or so, to avoid DVT, so I can't sleep for the duration of the flight, but then I don't sleep very well on planes.

I did some research on the internet, and the advice there was to wear thigh-high compression stockings, rather than just flight socks.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: BlueTopaz_ZA on October 11, 2010, 01:08:56 PM
Hi Deepak

You're approximately twice as far along as I am, I am day 52.
Sounds like you are doing REALLY well, funny how I just posted how difficult single leg squats are  ::) and they are easy for you!!!  ;D

As for travelling, I really think you would be past any time of real concern, but all the precautions are worth it. I flew 6 weeks (from SA to Australia) after my first ACL and had no issues.

And those pesky neighbours!!  >:( Hope it stays quiet from now on. You sound like you have been VERY patient!!! More so than I would have been.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 12, 2010, 12:22:08 AM
Doreen,

You'll be surprised at how quickly you improve from week to week, exercises that seemed impossible the first time you try them, after a few weeks become easy, and you long for something more challenging !

Thanks for the reassurance about flying post-op.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 21, 2010, 01:00:39 AM
Day 119 (week 17)

Got clearance yesterday from my physio to start gentle running, although I haven't actually tried yet. I might try the treadmill at the gym tomorrow, if I'm not working late. I'm not going to celebrate yet, since this is the stage last year I got to when my knee gave way again.  :o

Luckily, one of my colleagues is going on the business trip involving the long haul flight instead of me, so I don't have to worry about my knee stiffening up during a long flight and missing physio while I'm away. What a relief !

In terms of exercises, the static bike has got easy on the current resistance level of 8, so my physio may increase that when he next reviews my programme. I'm now leg-pressing 55kg and my propioception is improving. The rowing machine is still hard work, but as Cosmic said it's a great workout for those of us who are used to "punching forward", i.e. those who work the muscles on the front of the body because that's what we see in the mirror, but neglect the back. The rowing machine is really helping my rotator cuff injury on the left shoulder by working the rear deltoid. I'm going to keep doing this exercise even when my ACL rehab is over, since it's a great all-over workout.

<artistic license begins>

I've been feeling very down recently. No matter what I do, I can never keep up with the super women on here.

I decided to go for a walk in the rain to try to lift my mood. Rain has a wonderful cleansing effect, washing away worries, but on this occasion all that happened was each rain drop seemed to be mocking me, reminding me of my inadequacy, saying "you're a failure, you'll never be able to do what the super women can do".

I pulled the collar of my jacket tighter against the cold rain. There had to be some way I could get myself up to their level. Maybe, if I got 5 kittens, I would also be able to cycle 70km like Snowy. Maybe, if I could get hold of some magic beans, I would also be able to play badminton, train taekwondo & kickboxing, and do star-jumps like Cosmic. Maybe, if I could get some land and then get a mountain of mulch delivered, I would also be able to lift other people a few months after my operation like LARSknee.

But I was deluding myself. I knew none of those things would ever happen, if I was honest with myself.

Then it occurred to me : the super model was also a super woman ! Maybe, she could tell me the secret to achieving super-human feats ! She was probably sworn to secrecy by a code of honour in the society of super women, but if I did something special for her, maybe, just maybe, she might let me in on the secret.

Now I just had to think of something really special that I could do for her ...

<artistic license ends>
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on October 21, 2010, 05:51:17 AM
Hey - running clearance is exciting! (Even if you don't especially like running, like me.) Glad to hear you don't have to do the business trip - I still find that sitting for long periods is the worst thing I can do for the knee, so I'm sure a long haul flight wouldn't be the greatest thing at this point.

Good news on the rowing machine, too. I've been on it a few times, but it's a huge aggravating factor for my PFS so I've kept it fairly minimal. It's too bad - as you say, it's an awesome upper body and shoulder workout.

See - even so-called superwomen have our weaknesses. You could probably row me into the ground at this point. ;)

I'd suggest buying the supermodel a three-toed tree sloth. They're almost as cute as kittens, and way less work since all they do is sleep.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on October 22, 2010, 02:58:35 AM
Deepak excelent new your released to run, I have never quite understood the need to run unless from something trying to get you or for a bus or train but hey at least you know you can if the need arrises unless you find running something you enjoy, I now watch folk running thinking what sort of damage could they be doing to their poor knees.
Good news you dont have to do the long haul flight I'm sure it would have been doable but possibly not the most comfortable journey so soon after your op, I did the 3 hour flight to Spain 8 weeks post op and found that a bit uncomfortable.
Good news also that the shoulder is improving sounds like th rowing machine could be your new best friend.
Ahhh the super model havent heard much about her for a while I didn't like to ask how things were progressing on that front incase there had been another opertunity for you two to get together that hadn't worked out, but the fact you are considering approaching her about the super powers all us woman have [some are just better hidden than others by the way] it woud appear that particular ship has not sailed yet, so just go out and buy her a pair of shoes preferrably really expensive ones and she may be willing to impart some of her super woman secrets.
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 23, 2010, 11:55:41 PM
Kay & Tez, thanks for the encouragement. I don't feel so down now  ;)

Kay, thanks for the suggestion of a three-toed sloth ! I went to several pet shops today, but they all said they were out of three-toed sloths - apparently they're all the rage at the moment. So I got a bear cub instead - he's so cute and cuddly, I'm sure the super model will love him !

Tez, unfortunately it's been difficult for the super model & I to see each other recently - both our work schedules have become very busy. Being a super model she has to travel abroad often for weeks at a time. Currently, she's working on a project in a Pacific Island modeling beach-wear. Rather her than me - who would want to stand in the sun all day  ???  ;)

I actually love running, the feeling of "flying" is like no other ! Having said that, I've never tried skiing, and I suspect the thrill of skiing has something to do with that feeling of "flying" as well - I'm sure Kay could fill us in here.  ;) The other thing I love about running is it's a great ab workout, and helps to keep the waistline under control - I'm missing that at the moment  :-[

Tez, I know you're also a super woman who can stand for 9 hours continously while working, but you've never given any hints as to your secret - care to share ?  ;)   Thanks for the suggestion of shoes. I've never understood what it is with women and shoes, but she did ask me a while back to go on a shopping trip with her for shoes and a handbag, and at the time I couldn't make it because I needed to get my car serviced, so I suppose I could make it up to her by buying some posh shoes now. I hope it works and she does tell me some of her super woman secrets ...  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 25, 2010, 12:04:21 AM
Day 123

Managed to try gentle running on the tread-mill today. Got up to 7 kph for 10 mins. Felt a slight twinge around 8 mins, but it passed. I have some swelling now - my swelling had basically disappeared, but impact exercise I'm sure is going to cause some swelling. The good news is there was no pain as a result of the running.

My gait is wrong, just like this time last year in my rehab : I'm leaning on to my good leg, causing an imbalanced jog, which can lead to all kinds of problems later, so I need to run more centrally and use those glutes on the bad leg. No rest for the wicked ...  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 26, 2010, 09:57:41 PM
Day 125

It's time to party !  ;D ;D ;D ;D

My physio programme today moved to the next stage : functional exercise. I've been waiting for this day since my op - I'm going to make up for the 2 months I had of inactivity & utter boredom !

1. 5 mins bike - level 8
2. 5 mins rowing machine

3. leg press - 55kg
4. leg curl - 40kg

5. balance on wobble board - 1 min
6. trampette - 3 alternate fast steps & stop - 1 min

7. gentle jog on treadmill - 10 mins (the physio analysed my running gait, and said it needs a lot of work ...)

Plyometrics

8. mini-hurdle jumps - jump over several mini-hurdles in a line, stopping between each one. The important thing here is to not let the knee wobble despite the impact of landing.

Agility

9. ladder - 2 steps inside each square walking forward.
10. ladder - 2 steps inside each square & outside each square, zig-zagging forward.
11. short shuttle runs between 4 cones - this involves some pivoting on the knee.

I'm happy to say none of this gave me any grief, even 8 which is high impact or 11 which involves the notorious pivot !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 04, 2010, 11:15:56 PM
Day 133 (week 19)

It's time to party again !  ;D ;D ;D

I've been cleared to do straight-leg kick with front-crawl ...... and dolphin kick with butterfly !

I won't be able to get to the pool until the weekend due to work, but I can't wait !  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on November 04, 2010, 11:45:27 PM
Congratulations!!!

It's funny, but your last two posts really do bring home how different rehab protocols are. My OS told me to try a front crawl flutter kick 10 days after surgery, but I won't be doing shuttle runs or hurdle jumps until 24 weeks (6 months) - way after you.

Happy swimming!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: LARSknee on November 05, 2010, 01:29:29 PM


Great news on the swimming, have fun when you get in the pool on the weekend :>)

cheers
Shelli :>)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on November 05, 2010, 07:15:54 PM
Hey Deepak now you have no excuse you and the super model can fly to some far away place and swim in a nice blue ocean together.  ;D ;) :P
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 07, 2010, 11:40:04 PM
Kay - Thanks ! Yes, it is surprising how different the rehab protocols are. I was amazed that you were allowed to swim front crawl with flutter kick 10 days post-op. I just looked at my rehab protocol re swimming straight-leg kick - it says 6 - 12 weeks, but I suppose it is dependant on how much muscle you have left, and in my case at 6-12 weeks I had very little. My protocol also says Plyometrics can be started at 3-6 months again dependant on patient strength.

Shelli - Thanks, I did have fun today. More on that below.

Tez - Ah, that's a great suggestion ! It's been a long time since I swam in a warm blue ocean. The super model is still working on her beach-wear modeling project on a Pacific Island, so maybe I can join her. I'll have to make sure though that I don't disturb her while she's working ...

Day 136

Went to th gym today and leg-pressed 80kg for the first time post op. My quad is developing on the left (op) leg, but is still not as strong as the quad on the right leg. I think it's probably going to take another month for the quad to get back to it's size pre-op.

Swam front-crawl, back-stroke and butterfly. Swimming front crawl felt strange - I felt so light, as if I was weightless, because my legs weren't a dead weight that I was dragging behind me. I think the pool buoy also provided resistance.

Back stroke felt great - I haven't done this stroke since my op. Like the rowing machine, back-stroke is good for those of us who tend to work the muscles at the front & neglect the back

Butterfly was good too, although I only managed 50 metres. Butterfly is my weakest stroke, but one I enjoy for its feeling of moving like a dolphin - and it happens to be a great workout.

I staying away from breast-stroke, since the kick is not great for the knee. 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on November 08, 2010, 12:26:32 AM
Woot on the swimming! Your routine is actually more varied than mine - I hate backstroke and have never been all that good at butterfly, and given that breaststroke is a no-go for the time being I still almost exclusively to front crawl. I remember how great it felt to finally have my legs contributing again - isn't it an awesome feeling?

I think it's actually quite unusual to be allowed to do flutter kick that soon. Apparently I had huge hamstring tendons (the surgeon said it was really unusual in someone my size) which made a really strong graft, so that may be why - I should ask next time I see him.  He did say to keep it gentle and for fairly short distances initially, which was why I took my time working it back into the routine. It was about six weeks before I ditched the pull buoy completely during my swims. One disadvantage of being able to try flutter kick right away is that my leg was still in that post-surgery trauma phase, and I almost had to relearn how to kick with it from scratch - it just didn't remember on its own.

Glad to hear things are going so well - long may it continue!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 08, 2010, 11:49:09 PM
Deepak and all,

I have been reading this thread for the last couple of days since I'm newly registered and just want to say thanks for providing informative and entertaining reading! I can relate to a lot of what you have all gone through particularly the earlier posts as I am only 40 days post my knee recon and 30 days since my second op (developed staph infection).

Good luck to you all and I'll continue to follow this thread!

PS thanks for the information on flying as I'm planning to fly from Melbourne (Australia) to Bali on the 4th of December which is just under 4 weeks time. I hope I'll be ok on the flight!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 10, 2010, 06:16:07 PM
Kay - When I last tried straight-leg kick about a month ago (it may have been longer ago, but I forget) my leg had forgotten how to kick, but this time round there was no problem. The physio did say that the swim kick is similar to the movement in the plyometric exercises, so perhaps that's why my leg cooperated this time round.

Bigman78 - Thanks for reading my thread and glad you found my attempts at humour entertaining  ;) It's tough being a keyboard-comic without audience feedback - oh, how I've suffered for my art, all those years in drama school, and for what ?   ;) :P Sorry to hear that you developed a staph infection. I've had a look at your great blog, but haven't had time to read it in detail due to work pressure. How long is the flight from Melbourne to Bali - will you be able to walk in the aisle every half hour or so ? All the best for your rehab !

Day 139

The physio has added 2 new exercises to my programme :-

1. Single-leg extension on leg-extension machine. This is to speed up rebuilding of the quad.
2. Single-leg hamstring curl on Swiss ball. This is to improve strength in the hamstring and improve propioception.
 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on November 10, 2010, 08:05:20 PM
Deepak it really sounds like things are going very well for you now, what with all that swimming and swiss balling  :D
Do you still have any pain in your knee at all? after excersising or sitting for two long or anythig like that.
Keep up the good work and take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 10, 2010, 08:56:17 PM
Tez,

Yes, things are going really well for me now thanks, however my knee still wobbles and I do get pain in the knee if I sit for hours at a desk with my knee bent. I know from last year's rehab that the pain will not disappear until I rebuild the muscle, which is why I am so determined to do my exercises.

Another motivation for me to do my physio exercises is that when I don't exercise - last week due to work pressure I could only do one physio appointment in the week - the knee complains.

How's your knee doing now ? Has the pain from using the step ladder subsided ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on November 10, 2010, 11:20:03 PM
Hi Deepak sorry about your continuing pain and wobbles but it seems you know what to do to help things improve, My knee is still a bit painfull though I am trying to do a bit more physio at home than I was, but I think a lot of the pain I am having could be coming from the cartiledge degeneration rather than the aclr recovery or maybe a bit of both, funny thing is standing at work etc is no bother I can stand all day without any problem walking on the other hand causes a fair bit of pain after a while.
As you had said in the past I really need to get the muscles as strong as I can and if after that I still have a problem then I will go back to see my o.s as see if he can find what is going on.
So what about the plans with the super model  I would think a wee flight out to join her should be a priority now that you can join her swimming in that warm blue ocean, and if work are a bit off about giving you some time off then just remind them it would be sooooo good for the health of your knee :P
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 11, 2010, 04:09:26 AM
No worries Deepak and I always get a good laugh when reading your posts! Keep up the good work ;)

Thanks for taking the time to have a quick look at my blog.. hopefully it will help others who go through something similar also. The flight from Melbourne to Bali (from memory) is approx 4 hours. I have booked a bulk head seat there and back to ensure I have enough leg room and I'm planning to prop my leg up on the other seat or on my carry on bag. I'll ensure that I'm up every half an hour or so to go for a walk and will also keep my legs moving constantly!

Great to hear your continuing good progress. I just saw my physio for the first time and I'm excited that I can take my rehab to the next level. I'll post about it more in the post which I started about my rehab.

PS what's the latest with the supermodel?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 12, 2010, 10:44:38 PM
Tez,

Sorry to hear that you still have pain when walking. I was surprised that you were discharged so quickly by your knee surgeon, but since I've never been through this process before, maybe I'm a bit late being discharged due to the amount of muscle that I lost while inactive for 2 months. Maybe, have a word with your physio to see if it would be worth seeing your knee surgeon again. Cartilage can be a real pain (pun intended), it seems from this forum  :(

Bigman78,

I'm sure your blog will be very useful to those going through similar experiences now or in the future. When I thought I had a post-op infection at weeks 4-9, I found very little information about infections related to ACL reconstructions - I've subsequently found alot more by searching for "staph infection ACL" ! Good luck for your flght to Bali ! I read about your new physio exercises in your thread - congratulations ! It feels great to be doing some exercise after being inactive for a while, doesn't it ?  ;D I felt like a caged bird while I couldn't exercise, and now I feel that I'm slowly regaining the use of my wings.  ;)

Tez & Bigman78,

I took on board Tez's suggestion and took a flight to the Pacific Island where the super model is working. I can't say the name of the Island for security reasons. Being an international house-hold name, the super model has to be very careful about keeping her whereabouts secret. So I have become an IMM (International Man of Mystery). We had a wonderful swim in the Pacific Ocean today, snorkelling around the coral reef and saw some beautiful fish. We're now sitting in a bar sipping cocktails. The super model tells me that it is paradise, but she misses the cool weather back home. I agree, it's OK for a holiday but I wouldn't want to live here.  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 23, 2010, 11:23:09 PM
Day 153 (virtually 22 weeks)

The physio changed the leg-press & hamstring curl machine exercises from 2-legged to 1-legged.

1. 35 kg single-leg leg press  - 3 x 6 on each leg (this is easy on the good leg, but bloody hard work on the bad leg).
2. 25 kg single-leg hamstring curl - 3 x 6 on each leg (see above).

Also, she corrected me on my foot placement on the leg press - I had my foot too low. Apparently if the knee goes over the toe in the line of sight, this puts a huge amount of pressure on the knee ... and can lead to Patella Femoral Syndrome ! The same rule applies to doing squats - the knee should not go forward of the toes. To help visualise this, she said you should think of keeping your knee stationary, while lowering your bum.

Also when doing the leg press, I haven't been letting the weight rest on the top to the stack, before doing the next rep - apparently, this is cheating, and not simulating real weight-bearing exercise, where the knee is maximally loaded when lifting a dead weight.

Well, I'll go to the foot of our stairs ! You learn something new every day, don't you ?  ;) ;D

Also, yesterday for the first time, I braved the cattle truck known as the "tube" before 9am ... and survived ! Luckily, no-one fell on me when the train stopped suddenly.  ;)

Sorry I don't have time to post to anyone's diary at the moment, but I'm still reading them every so often.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 23, 2010, 11:44:35 PM
Good to hear from you again Deepak!

Thanks for the information regarding the position of the foot on the leg press machine - I'm sure this will be very useful for me and others at a later stage in rehab. Sounds like tough work especially with the bad leg. I can not wait to get back into the squats and various leg machines. How long before you were allowed to commence with the leg press machine and curl machine?

Now that you're 153 days post op how are you going in terms of muscle? Have you gained a lot back in your back leg and what's the comparison with your good leg like?

I'm only 100 days behind you ;) Keep up the good work!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 24, 2010, 11:58:32 PM
Bigman78,

I was only allowed to start the leg press & hamstring curl machines at day 89, so basically 3 months post-op.

In terms of muscle, I have regained 2 out of the 3 kg of muscle I lost. My quad now curves out from my knee rather than in, however the quad on the op leg is still much weaker than the good leg, so there's a lot of work still left to do.

I also can't wait to be able to do free-weight squats & dead-lift with a bar bell, but the physio hasn't cleared me to do those yet. I think once the op leg can leg-press & leg-curl the same weight as the good leg, I'll be allowed to move on to free weights.

From your diary, it seems you're doing well too ! All the best  :) 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 25, 2010, 01:03:53 AM
So not long to wait before I can do leg presses and hamstring curls..... hopefully! Obviously I'll go with what my PT says.

Good to hear you have regained nearly all of it back! I guess it's bound to be weaker than your good leg for a little while longer but hopefully when you're cleared to do free weights you will get it back quickly. I can't wait to get back into the squats!!

I know what you mean regarding the curving out from your knee rather than in.... I've still got that inward curve and I figure my knee is still swollen as it just doesn't have the support it requires from my leg muscles. It is frustrating but at least I feel like it's getting stronger. I even had a 'slight' pump in the quad of my bad leg a couple of nights ago and my wife even mentioned that's it looking bigger than it did a few weeks ago.

I'll have to do another measure up when I'm at the gym next..... what's the difference in the size of your legs? Done a measure up lately?

Also (another question I know) I noticed that you raptured your ACL playing football (I'm assuming this is European football).... are you ever planning to play again?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 25, 2010, 09:38:09 PM
Yeah, I'm sure you'll be cleared to do leg press & hamstring curl soon, but the temptation with ACL rehab is to rush it, and as I heard on the Cruciate Ligament forum again & again, the thing to remember is that "ACL rehab is a marathon not a sprint", i.e. the tortoise wins because the hare gets injured by rushing his rehab.  ;) If you're used to rushing, going slow can be very hard mentally & emotionally (as I found), but it's necessary.

Just measured my quads, and my measurement is probably not very accurate, but there was a 4 cm difference between the good & bad leg. That's still a fare amount of muscle to make up !

Yes, it was European football that I was playing when I ruptured my ACL. I would like to go back to playing, since I love the game, but I've got to think seriously about the repurcussions if I rupture my ACL again. I don't want to go through the last year again if I can help it. Also, I've been talking to a few mates about my injury, and they all tell me that I need to consider whether I can afford to be off work for a few months and take time out from work to go to physio every week. I've been lucky that the companies I've worked for in the past year have allowed me to come in to work late on the days I have physio appointments and make up the time by working late, but I know from this forum that not every company is so accomodating ...

I don't want to put you off if you're considering going back to playing football, since they have been many successful returns by Knee Geeks. Feeny on the Cruciate Ligament forum springs to mind.

I just saw from your signature that you ruptured your ACL playing football as well. I imagine you want to get back into it, right, and who can blame you ?  ;)   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 25, 2010, 11:19:23 PM
Hopefully I'll be cleared to do them soon. I am a fairly patient person and dedicated with my rehab so hopefully that will keep me in good stead. I know it will be a long road back but I'm prepared to put in the hours.... well I say that now ;)

The tough part will be watching the guys from my team play next season plus missing out on the current cricket season (I play cricket also) has been tough already! What makes the rehab so difficult is that after a while you start to feel ok and think you can push it whereas in reality there is a long way to go and you need to slow yourself down as you mentioned!

4cm difference hey... I'm sure it's a matter of time before you get that back. Much difference in the calves? I have the same difference in my quads as well btw.

Football is my passion so it will be tough to give it up. I'm temporarily retired but I might just think about giving it one more go as you are a long time retired! I figure I won't be able to play next season and by the time the 2012 pre-season comes along it will be nearly 1 and a half years since the op so the legs should hopefully be strong enough by then. I know what you mean about work... I was lucky this time as I just finished a long stint on a client site (3.5 years) and I am on the 'bench' currently which means there is not too much pressure at work. This has given meplenty of time to get to the gym and leave work early if I want. I ended up taking 3 weeks off work due to the infection I also suffered.

Anyway lets see how it all pans out hey! Keep us updated on your progress and good luck!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on December 03, 2010, 12:25:19 AM
Bigman78, there's only 0.5cm difference between my calves, so my calf on my op leg seems to have grown faster than my quad ... hmm, I wonder why ? Yes, I can empathise with you on watching your mates play while you have to sit it out, but just think that this is what the professionals have to do as well. I often joke that I've got an injury that only the professionals get, despite being a crap player  ;D

Day 161 (23 weeks)

We've been having snow here for the last few days. This morning I slipped on any icy pavement while walking to the tube station on the way to work. Luckily, it was a clown fall straight out of a slapstick black and white comedy film : my legs went straight out in front of me & I landed on my bum, my right glute to be precise. My knee swelled up, the back of my knee became painful and I lost alot of flexion. I was limping again. Unfortunately, I kept my knee flexed at my desk in the office all day. When I got home, I elevated the leg with a heel hang. I was quite worried that I had damaged the ACL graft.

Day 162

The physio examined my knee and thankfully confirmed that the graft was fine. He thought the loss of flexion and extension (the knee would no longer extend to zero degrees and definitely not hyper-extend) was due to the body reacting to the knock, and trying to protect the knee by tightening the hamstring. He did some PNF stretching (http://en.wikipedia.org/wiki/PNF_stretching) on the hamstring to make it release a little, so that I could hyper-extend the knee again. I am now no longer walking with a limp ! The physio did say I need to do heel hangs on my desk at work, to maintain the extension.

He told me to avoid the weighted hamstring-curl, since the best way to get a muscle to relax, is to work the antagonist muscle : in this case, the quad, so leg-press and leg-extension were fine. No plyometrics until the knee settles down.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on December 04, 2010, 05:39:31 AM
So sorry to hear about the slippage, but kudos to you for managing to fall in a way that didn't hurt the graft. Being a total klutz I've done a few things that have caused me to panic over the course of rehab, and what I'm learning (at least at the stage we're at now) is that if the knee doesn't twist, it's very unlikely that the graft will be damaged. My PT was telling me on Monday about one of his ACLr clients who also slipped on ice and sat back all the way on his heels, busting through what had previously been a 30 degree ROM deficit. (This guy was only about 6 weeks out of surgery.) The client was totally convinced that he'd blown the whole thing, but one MRI later it turned out his graft was completely fine. The moral of the story was that if he'd twisted even a little rather than falling down straight, things could have been very different.

Hopefully if you just bruised yourself, things will settle down in a week or so. Sending you good thoughts while you recover from the slip.

On a tangent, I'm exactly the same on calf/quad regrowth. Down to 0.25cm between the calves (mostly thanks to a brutal heel raise regime) but still 1.5cm between the quads. Quads seem to be the hardest thing to build...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on December 06, 2010, 11:16:42 PM
Kay - Thanks for the sympathy. I think I did just bruise my bum, and no harm was done.  ;D

Day 166

Saw my knee surgeon for a scheduled 5 month post-op review. I told him about the slip on ice last week. He examined the knee, and confirmed what the physio said last week that the ACL was fine. He asked if I had any problems with my knee, so I told him that the knee is still unstable and moves laterally, and that I still have some pain in the knee. He said the pain was to be expected at this stage as the knee is still healing.

He was disappointed by the pace of quad muscle rebuilding, and said I need to get the op leg quad the same size as on my good leg. I'm working as hard as I can on this, but progress is slow. I'll ask my physio for advice re increasing the pace.

The surgeon will see me again in 3 months time, by which time he expects me to have put back all the quad muscle I lost. No rest for the wicked !  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on December 06, 2010, 11:25:59 PM
Deepak so pleased your slip didnt do any damage to your new acl, its pretty scary walking in all this snow and ice just now so its good news that no harm was done ;D
Looks like you have a bit of hard work to do between now and your next O.S appointment to get those quads the same size, maybe get the super model to help with your work out.
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on December 07, 2010, 12:00:47 AM
Tez,

Quote
Looks like you have a bit of hard work to do between now and your next O.S appointment to get those quads the same size, maybe get the super model to help with your work out.

That's a great idea ! I will ask her when she's back in the country. She's now working on another project in Siberia, modeling winter wear for next year's winter season, although given our current arctic weather conditions, she could have modelled the clothes here.  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on December 12, 2010, 12:57:31 AM
Day 170 (week 24 or 6 months)

I told my physio that the knee surgeon wants me to increase the pace of quad rebuilding. My physio moved my programme on to the next stage :

1. 5 mins bike at level 8.

Strength

2. Single-leg leg press - 35kg. 3 x 10
3. Single-leg leg extension - 35kg. 3 x 10
4. Single-leg hamstring curl - 25kg. 3 x 10

Propioception

5. Single-leg balance on wobble board.
6. Run on the spot & then stop, balancing on op leg, on trampette. While balancing only on the op leg, catch a football that is thrown by the physio & throw the football back to the physio. Repeat for 1 min.

Plyometrics

7. Jump on the spot (like a basketball jump). Start by squatting to increase the height of the jump, then try to jump as high as possible, reaching for the sky with the hands, and land back in a squat.
8. Jump forwards, backwards, and to the right and left, landing only on the op leg. I found my balance was poor jumping back & to the right.
9. Jump over mini-hurdles. (The physio noticed that I am still putting most of my weight through the good leg, so I need to think about putting more weight through the op leg).

Agility

10. 2 steps in each square through a ladder.
11. Zig-zag through each square in the ladder.
12. Zig-zag through a line of cones.
13. Run between 4 corners of a square (marked with cones) in a Z shape.

The physio said I run very heavily, so on the agility exercises, I need to think about trying to run on my toes, rather than on the whole foot.

What struck me about exercise 8, which is an easy hopping exercise, is that Tez was asked (very incorrectly) by her physio to hop at around 6 weeks post-op, whereas I've only been allowed to hop at 24 weeks post-op.  :o

The physio cleared me to do dumb-bell bent over row with my op knee, kneeling on a weight-training bench. However, he didn't clear me to do bar-bell squats, because there is still a significant difference between the strength of the quads on both legs, which would be dangerous from a balance perspective, since serious injuries can occur if you don't keep the bar horizontal while squatting.

The night sweats have stopped now, partly because it's cold at night, and mostly (I hope) because I've stopped eating late at night, which apparently is virtually guaranteed to cause night sweats.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on December 27, 2010, 10:29:37 PM
Day 186 (26 weeks)

I went on the treadmill for the first time in over a month, and noticed a real difference.

The strength, propioception, plyometrics and agility training are paying off. Today, for the first time post-op I felt that I was almost "flying" again, i.e. I was almost running normally, rather than limping fast, which was what I was doing on the treadmill before.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on December 28, 2010, 12:23:23 AM
Deepak congratulations sounds like all your hard work is paying off and things are really improving for you, what a star you are, keep up the good work and take care Tez 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on December 28, 2010, 05:00:04 AM
I think 24 weeks is actually 5.5 months - I just hit that marker on Christmas Eve. :)

Your program actually sounds pretty impressive - you're doing some fairly hardcore plyometrics and agility work. The only thing I can see that's different from my own regime are the trampette exercise (I do single-legged exercises on the wobble board while having balls thrown at me, plus single leg dips and squats on the wobble board) and the amount of weight you're doing with the single-leg extension. My PT is encouraging me to keep extensions at a very low weight (but high reps) because it puts direct strain on the graft. Have you tried holding wall squats for several minutes? That's another really good way of building the quads.

Really glad to hear about the progress on the treadmill - that's great news. How do you find the agility exercises now that the quad strength is improving?

I think I got to start quarter-turn hops at 16 weeks, and have now progressed to half-turn hops. I still can't believe poor Tez was told to hop at six weeks!

Hope all continues to go well - sounds like a normal knee is getting pretty close. :)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on December 31, 2010, 08:40:03 PM
Tez - Thanks for the congratulations !  :)

Kay - You're right about 24 weeks being 5.5 months. That'll teach me to try to do date calculations after the witching hour  ;) I had calculated it based on a 4 week month ... the Gregorian calendar has alot to answer for ...  ;)

I've actually dropped the weight on the single leg extension to 15kg on the bad leg and 25kg on the good leg. 35kg was too hard.

I haven't tried holding wall squats for a few mins. I will try that & let you know.

The agility exercises aren't too difficult. My two main problems are

1. Lack of fitness (it's much better than when I started, but still not back to the level I was at pre-injury).
2. The fact that I've been running all wrong all my life : I run on the whole foot whereas I should be running on my toes, so some significant re-education is required ... I've realised this is the point of Agility exercise 10.

By "quarter-turn" and "half-turn" hop, do you mean you turn through 90 and 180 degrees respectively while hopping ? That sounds pretty impressive ! I'm sure I couldn't do that yet.

I went on the treadmill again yesterday and realised that I'm still way off from normal running. I know my propioception is still poor, and the result is that I can't fully control the movement of the knee and the foot during the running cycle - I'm aware of the the bad leg "flapping", i.e. not staying straight in the vertical plane. Hopefully, this will improve as the muscle returns, and I work harder at the propioception exercises ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on January 07, 2011, 03:26:11 AM
Hi Deepak,

What's the latest? How's your rehab going these days and have any added anything new to your program?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 08, 2011, 10:50:38 PM
Bigman78, yes there are some new exercises in my programme that were added this week. Details below. How's your rehab going ?

Day 195

The physio added another exercise to my programme :

Carioca (http://www.kneeguru.co.uk/KNEEnotes/node/1257 http://www.youtube.com/watch?v=Lj1V3DjA3ZE), although I'm doing an easy version that doesn't involve crossing either foot behind the other foot, only in front.

Also, my physio has started me on a 10 week graduated running programme to return to running, with the objective of being able to run continously for 30 mins at the end of the 10 weeks.

Day 198

Today, I went to my local sports centre, which includes a sports stadium with an athletics track. I prefer to run on a track than on pavement, since there's less impact that way.

I started the first stage of the running programme : run for 30 seconds, walk for 2 mins. Repeat 8 times. It felt much better to run in the open, than running on a treadmill, and I could really open up my stride. Now, I can start to get back to "flying" again  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on January 09, 2011, 06:52:31 AM
You mean you didn't get enough flying with the pterodactyl?  :P

Congrats on the running program! Glad to hear you're feeling so much better running out of doors. I spent a lot of time on the treadmill in the early stages of my running program because the weather was so awful, but I found the whole thing much easier once I was able to go outside. That said, I'm not a big fan of running at the best of times and will be glad to give it up once my rehab is over.

Those agility ladder drills look awesome. I think I might have to get one of those...

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 09, 2011, 11:13:22 PM
Flying with the pterodactyl, although a great experience, doesn't compare with flying under your own steam.  ;) :P

I think the treadmill is a great rehab tool, which allows you to run in a restricted space and with minimal impact, but I find it boring running with no change of view. In my gym, they put several screens of TV channels in front of the treadmills in an attempt to alleviate the boredom, but given the content of the TV channels, I'd rather look at a blank wall ...  ::)

Yes, the agility ladder drills are great - If you haven't already, check out some of the other youtube videos of ladder drill exercises. There seem to be an endless variety.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on January 10, 2011, 12:21:33 AM
Good to hear about the latest with you Deepak and the running program. I'm looking forward to commencing running next month hopefully! My rehab is going pretty well in general and I'm able to do more and more every day. I'm just focusing on the leg weights at the moment which I'm doing twice a week and hoping to go up in weights. Since you've been there done that when did you know to up the weights and how regularly were you going up? I guess I'm a bit cautious especially with my hammy as don't want to do any damage which will set back my rehab program. At the moment I'm doing 4 plates on hamstring curls (or 20 kgs), around 8 plates or 160 lbs on the leg press machine (or 80 lbs when doing individual) and 4 plates (20 kgs) on standing calf raises. I feel like I can do more as I've been on the same weight for 3 weeks. What do you think?

Good old carioca, we always do that as part of our warm ups before training or a match! Can't wait to be able to do it again... always felt like some sort of dance :D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 12, 2011, 12:49:35 AM
Bigman78, glad to see from your diary that you've started on the weight-training and that it's going well  :)

I personally don't increase my weights, without checking with my physio, just in case. As you say, given you've had a hamstring autograft, you want to avoid straining it while it's still healing. When do you next see your physio ?

Carioca is a great warm-up, and one that if I had done before playing might have prevented my injury ... but then again maybe it would've happened anyway ? Que sera sera ...  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 22, 2011, 12:57:10 AM
Day 210

I can't describe how happy I am ! The physio said I'm ready to start football training, so modified my programme as follows :-

Warmup

1. 5 minutes on static bike.

Propioception

2. Starting with one foot on the ground and the other foot balancing on a football, swap feet. Repeat for a minute.
3. Standing on the bad leg, rotate the football forward, backward, left & right by using the bottom of the foot of the good leg. Repeat for a minute.

Plyometrics

4. Jump over min-hurdles, with a 90 degree twist in the air.
5. Hop on bad leg forward, backward, left & right.
6. Hop on bad leg on trampette, with a 90 degree twist in the air.

Agility

7. Carioca
8. 2 steps in each square through a ladder.
9. Zig-zag through each square in the ladder.

The following exercises are now done alternately with a football (which then makes it a dribbling exercise), and without.

10.  Multi-directional shuttle run between 4 cones in a fan shape.
11. Zig-zag through a line of cones.
12. Run between 4 corners of a square (marked with cones) in a Z shape.

Strength

13. Single-leg leg press - 35kg, 3 x 10
14. Single-leg leg extension - 15kg on bad leg, 25kg on good leg, 3 x 10
15. Single-leg hamstring curl - 25kg, 3 x 10
16. Squat with a bar bell - 20kg

Having not kicked a football for 14 months, my ball control was poor, but it felt amazing to be running with a football again !  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on January 22, 2011, 01:15:20 AM
Congratulations! That's great news. Knowing how it felt when I finally got two planks back under my feet, I can imagine exactly how happy you were to have a ball at yours. :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: kcknee on January 22, 2011, 03:11:20 AM
That's great news!! I'm really happy that all your hard work has paid off and you can get back to the sport you love.

With all the posts and stories of complications on KG that newcomers see and read through after an ACL tear, you and Snowy should start a thread on the Cruciates board for successful recoveries with pictures of your return to your favorite sports. There are a lot of other success stories out there too that could add their pictures. It would help a lot of people that are just starting on this journey.

Congratulations again and have fun.

Kristin
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on January 22, 2011, 03:37:08 AM
Congrats Deepak!!  ;D ;D That's great news and I can imagine your excitement! The latest program is great and I can not wait to be doing something similar!! haha I'm not surprised that you're control is not there yet but it will come back no doubt. Are you still part of a club and are you going to start proper training? Or undecided yet?

I went to soccer training on Thursday night and have to say it was extremely difficult to watch the boys train although it gave me a lot of motivation also. It will be even harder to watch them play in a pre-season cup game tomorrow! Not much I can do apart from keeping at it and being patient. Off to the pools now to do some more rehab!

BTW missed your earlier post - I saw my physio on Thursday and he said just to gradually increase the weights when I feel the current weight is getting too easy as with any weights which you do. Common sense advice I guess. He has also cleared me to this shuffle type jog (not quite jogging) which I will be doing for the next 4 weeks to prepare me for jogging!

Looking forward to your next update.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 23, 2011, 05:41:30 PM
Thanks Kay, Kristin & Bigman78 for the congratulations !

Kristin, that's a great idea re starting a thread about successful recoveries. I was actually inspired to work hard at my rehab because of the stories I read on the Cruciate Ligaments forum of people who had made successful recoveries.

As Sue (kaputt knee) has said, the reason we often read the tales of woe are that the people who make text-book recoveries feel no need to ask for help and advice and so don't post on Knee Geeks. I was really just following in the footsteps of some of those who inspired me like Sue and Feeny.

Bigman78, I was never in a club. I was a very amateur player, who just played a friendly kickabout 5-a-side game with 9 other lads who wanted to kick a ball for an hour each week. So, needless to say, I didn't train. ;D I'm actually training more now than I ever did pre-injury, which is one of the many positive outcomes from my injury.

What I've learned from the physio treatment is that I should really have been doing the strength and agility training, even if I just wanted to play a kickabout once a week, to prevent injury.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on February 09, 2011, 12:05:39 AM
Day 223

Squatted 50kg using the Smith Machine for the first time post op. Using the Smith Machine is easier than squatting with a free-weight bar bell because the Smith Machine doesn't allow the bar to tilt off horizontal, and I suspect the Smith Machine provides some mechanical assistance.

Day 225

Completed week 3 of my running programme : Run for 2 minutes, walk for 1 minute, repeat 7 times. Do 3 times a week. (I should really have completed week 4, but I lost a week when I rested for a week after week 1).

Day 226

I'm exhausted ! I'm sure this is doing me good, but it's killing me  ;D

Day 229

The increase in squat weight is paying off. I've bulked up the quad on the left ACLr leg, although it's still smaller than the quad on the good leg.

Squatted 40kg with a free-weight bar bell. The bar does tilt off horizontal slightly while I'm squatting, but that's good, since it's challenging me more than the Smith Machine.

I discussed the exhaustion I felt at the weekend with my physio, and she reassured me that it's normal. I'm pushing my body hard, but it will adapt & over the weeks get fitter, so I won't feel exhausted. That's the theory anyway, let's see if my body sticks to the script ...  ;)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on February 09, 2011, 06:17:15 AM
Good to hear from you Deepak and awesome to hear the left leg is building up even more now that you're doing squats regularly.

I can't wait to do squats but not quite there yet.. I've been told by my physio I can start on them once I am running again. That's some impressive weights which you're doing at this stage. I've noticed you are not doing calf raises currently. Any reason for that?

I know what you mean about being tired. I was lucky in that I was training a lot pre-injury anyway with soccer training, matches, gym and cricket in the off season so my body is used to a lot of activity. Despite all that I have my ups and downs and have more energy on certain days. Earlier this week I had 2 days off just to give my body a break but now I'm back into it! Just have to keep going at it I guess.

Didn't realise you don't play for a club... probably better as it can be too much pressure sometimes! Enjoy the training and I hope it continues to go well for you.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on February 10, 2011, 12:38:33 AM
Bigman78,

The only reason I'm not doing calf raises is that they're not in my physio programme. I'll ask my physio at my next appointment if I should be doing them. Thanks for the tip !

Since I didn't train as much as you pre-injury, my body is finding getting back to a decent level of fitness tough. It's hard to gain fitness, but so easy to lose it again if you stop exercising for 2 months ... or it is for me anyway  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on February 19, 2011, 01:14:54 PM
Day 240

This week has been a write-off in terms in ACL rehab.

It started out well : on Sunday, I went to the gym and did a good strength workout, as well as started on week 4 of the running programme (I didn't run last week to allow some skin on my feet to regrow from where callouses were removed by my podiatrist) : run 3 mins, walk 1 min, repeat 6 times.

On Monday morning I didn't feel very hungry (very unusual after a workout the day before) & couldn't finish my bowl of muesli with whey protein. At lunchtime, I got some new custom orthotics made for me, to replace my current 6-year old orthotics, which have developed holes in the forefoot where friction has caused them to wear out. The guy who made my new orthotics assessed my gait, and found that I'm leaning foward even when standing still, so has put in more support in the forefoot. Hopefully, this will reduce the callouses.

By the afternoon, I felt quite queasy. To cut a long story short, I went to the doctor on Friday morning when I was still feeling queasy, and the doctor said I have a stomach bug that's going round at the moment. There's no medication I can take for it, and I just need to let my body fight it.

At least I know it's nothing serious.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on February 20, 2011, 02:32:56 PM
I hope you feel better soon those bugs going around are not very nice, though could be a good time to call the super model to come and take care of you I think all super models learn how to make chicken soup as part of their training.
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on February 21, 2011, 12:41:51 AM
Sorry to hear about the bug - that's too bad. However sometimes giving the muscles a break to recover from hard training helps with the program, so as long as you start to feel better soon it may not have a negative impact on your rehab.

I've been doing calf raises for quite a while now, and my left calf is very close to the size of the right again - they worked really well. I'd recommend them if your PT okays it.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on February 21, 2011, 05:19:26 AM
Sorry to hear about the stomach bug as well Deepak. Hope you get better soon and that you're back up and running in no time.

Seems like soem PTs seem to forget about calves! Even my PT forgot to include them in my program until I mentioned it! In regards to fitness everyone is different dependent on many factors. Consistency is the key when it comes to fitness and I'm sure you'll get and feel fitter in the coming months if you keep at it!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on February 23, 2011, 12:15:14 AM
Day 243

Tez, Kay, Bigman78 thanks for the sympathy. I think I'm over the stomach bug. Time to get back on track with my rehab !

Tez, the supermodel rushed back from a big fashion show abroad to be by my side when she heard I was ill. She's been giving me something better than chicken soup ... asparagus soup !  ;) Being a fashion model, she felt she couldn't nurse me in ordinary clothes, so dressed up in a nurse's uniform ... from one of her previous "work wear" fashion shows.

Kay & Bigman78, my physio said I could incorporate calf raises into my bar bell squats, i.e. do a heel raise at the top of the squat. Also, she cleared me to do deadlift, which I will try later this week.

Deadlift made a huge difference last year in my pace of muscle rebuilding, so I hope it'll do the same this time round.   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on February 24, 2011, 01:26:35 AM
No worries, that's what we are here for I guess... to support each other through this as well as find out some good info!

haha... sounds like you received some 'extra special' support from the supermodel ;)

Anyway back to the physio :) I was also told by my physio that when doing leg presses I could extend my foot on extension (at the end of the press) to give the calves some extra work. But in addition to this he also wanted me to calf raises separately. Great to hear you've been cleared to do dead lifts, that's fantastic news and I'm sure it will make a big difference!

I've just been cleared to start running which I will write about more in my thread :D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on February 25, 2011, 12:11:56 AM
Day 245

Bigman78, congratulations on being cleared to start running ! You're doing much better than I was at your stage of rehab !

Today I had my final physio session. I have now been released back into the wild, although it will inevitably take some time for me to readjust to the new environment.  ;)

The physio got me to do some zig-zag hops on the operated leg, and said my knee was stable, although my upper body was not, so I need to do some core (transversus abdominis) work to strengthen the abs.

The physio said I can now play a football game, although I'll have to ease myself into it by building up my fitness, and practising multi-direction turns.

I know I still have a lot of strength work to do, because the quads on the operated leg are still smaller than the quads on the good leg. The physio checked my form while I did a deadlift today with just the bar bell, and pronounced it OK.

So, my rehab continues, with the objective being to play a football match again.

I still have some pain in the operated leg, which I will discuss with my knee surgeon when I see him for a review in a week's time.

I can't thank the physios at my hospital enough for all they've done for me over the last 20 months : 6 months physio post-injury and 6 months physio post-op. And I can't thank you Knee Geeks & the owners of this website enough for supporting me & reading my drivel.  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on February 26, 2011, 08:33:38 AM
WOOT! I think you and I have been on identical protocols, as you had surgery about 3 weeks before I did and my release to full activity is about 3 weeks away.

That's really awesome news that you're cleared for football.  Do you have any plans to try one out in the near future, or are you going to wait until the strength has improved?

Your drivel hasn't reached anything like the volume that mine has, and has been far more entertaining. You're not allowed to forget about us now that you've been released into the wild. ;)

Congrats again. :) You've worked really hard for this, especially given some of the setbacks you had early on, and it's awesome to hear that you've finally reached the light at the end of the tunnel. :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on February 26, 2011, 07:07:41 PM
Deepak congrats you should have a party or something to celebrate the return to all the wondefull activities that can trash your knee once again ;) ;D :o ::) :P
but seriously good luck with everything and as Snowy says just cos your  physio has released you we have not so dont think you can just dissapear on us, I want to hear the happy ending of this super model story where you get together and sail into the sunset for a wonderfull life together.
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on February 27, 2011, 11:19:32 PM
Kay & Tez, thanks for the congratulations. Don't worry I'm not going to disappear. My journey won't be over until I actually play a football game, and I know at the moment my fitness (or lack thereof) would mean I wouldn't be able to last 60 minutes of running round a 5-a-side pitch. Also, despite what the physio said, I don't feel confident playing with weak quads on the operated leg.

I will try to start doing some gentle passing exercises and repeat the agility exercises on a pitch (my physio sessions were done on a laminate floor), as recommended by the physio. I also need to complete my 10-week running programme - due to periods of rest, I'm still at week 4.  ::)

I'm always on for a Knee Geek party ! It could be in London or further north since you're up in Scotland. It's a shame we can't have a virtual party over the internet, since we're spread across the planet. When are we going to get those energizers that were promised in the "future" back in the 1960's in Star Trek episodes - it's 2011 now, isn't that "future" enough ?!  ??? ;) ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on March 01, 2011, 09:55:58 AM
Congrats Deepak, that's fantastic news!!

It must be a great feeling knowing it's your final physio session! I know what you mean in terms of not feeling confident until improving your quad muscles on the operated leg. I feel I won't be ready to step back on a football pitch until my operated leg is a lot stronger and hopefully not too far off the other leg strength wise. How are the multi-directional turns going? Feel ok? And what type of pain are you experiencing?

No worries with being a bit support (although I've come in late compared to Snowy & Tez). All of you have been an absolute inspiration and the encouragement that we get from each other is brilliant! Hope to hear more about your progress soon.

Take care!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 07, 2011, 12:30:52 AM
Bigman78, thanks for the congratulaions.

I haven't actually got round to doing any football training on a pitch yet. It's been a hectic week at work ! When I do get to try the turns, the physio said I should try to simulate the same kind of turns I would do when playing, e.g. zig-zag forward, but also turning behind when you're being marked and you're trying to get away from your marker. The idea is that you should have practiced all the variants in exercises before trying them in a game.

Your question about the remaining pain got me thinking, and I'm not sure I've accurately captured all the types, but here's my attempt :

1. Deep inside the knee at the top of the Tibia. I feel this when I do a standing hamstring stretch, i.e. standing on the bad leg and stretching the hamstring of the good leg. I also feel this when running.
2. Patella tendon pain. This may be caused by using too much weight when doing leg extensions.
3. Pain behind the patella.

Pain 1 has never disappeared, but 2 & 3 had - they've returned since my stomach bug episode. I lost 4kg that week, most of it I suspect being muscle - I know because my quads have visibly shrunk and I can push less weight. This proves the theory that most of my knee pain is caused by poor muscle strength.

On the positive side, the pain that has disappeared since the early post-op days is :

4. Hamstring pain from the graft site.
5. Bone pain at the site of the fixation screw below the knee. Having said that pain 1 above may be due to the bone tunnel still healing.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on March 07, 2011, 07:25:11 AM
No worries. I'm happy to see you've got to this point!

Ok it will be interesting to see how you go with that. It makes perfect sense that you simulate the turns and runs you would make in a match on the training pitch first. Hopefully despite your recent stomach bug and the muscle loss as a result your knee still copes with the turns.

Interesting what you wrote regarding the knee pain. I've experienced the same pain you describe in point 1 when doing a standing hamstring stretch. Wonder how long that will last for? I also get a little pain on the odd occasion when doing a heavy leg press.... usually at the start of the press movement.

Looking forward to hearing how the turns go when you test it out. Good luck!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 08, 2011, 12:25:11 AM
Day 256

I saw my knee surgeon today, and he has also released me back into the wild.

He advised to do hip abductions and adductions with light resistance against the lower leg to strengthen the quads on the operated leg. This is in addition to pushing weights.

He also advised that I should wait another 6-8 weeks before attempting to play a football match, to allow the muscles to grow, and for the bone tunnels to heal.

Again, I can't say thanks enough for the surgical team who performed my ACL reconstruction. They did a fantastic job !  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on March 08, 2011, 10:03:05 AM
Released back into the wild has a lovely ring to it ;D congratulations and please! for me, be carefull when you do return to football, I still dont get the whole need to get back to doing something that caused the injury in the first place but hey what do I know ;)
Good luck with everything anyway... and take care
Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on March 15, 2011, 01:12:42 AM
Great to hear you also got the all clear from your surgeon Deepak! Congrats again :)

Interesting in regards to hip abductions.... I'll have to look into that myself at a later point. Seems fair enough to allow a bit more time for the bone tunnels to heal. It's for that reason I'll be waiting a full year at least before playing in a match.

Tez - Like snowy it's all about getting back to something which you enjoy and love! For me yes football was the reason for the ACL injury but considering how much fun I've had playing for 20 odd years I do not feel unlucky at all. For me personally it's a tricky one as I realistically only have 3-4 seasons left in me at a decent level but the old saying "You're a long time retired" always sticks in my head! I will hopefully go out on my own terms when I retire from playing but time will tell I guess. I do know that I still want to play though as I have missed playing football a lot!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on March 15, 2011, 02:09:53 AM
Bigman I think because there is no sport that I feel as strongly about as most of the folk who post on here, I didnt think I  got it I just want to get back to a llife with no more pain especially when I'm working so I think that is a similar feeling to you wanting to get back to football or Snowy skiing, I love my job and even though standing for 9 hours a day is not the best thing for my knee I wont be giving it up any time soon, also the fact that I did my acl in wearing heels will not mean I plan on living the rest of my life in flats [too short for that nonsense]either so maybe I do get it after all lol
Take care Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on March 16, 2011, 11:17:38 PM
:) I like your response Tez especially regarding relating to it by via shoes!

But I'm glad you get it... at the end of the day we all want a simple thing - that is to get back to life as we knew it (if possible) and to continue to enjoy the things we love!

I'm still quite a way off completing my journey, I ran around 2km last night and the knee is grumpy today!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 28, 2011, 12:41:00 AM
Bigman78, thanks for answering the question regarding why I would want to go back to playing football. I agree that it's the desire to be "normal" again, i.e. get back to life before the knee injury. In that respect, I can relate to Tez' desire to go back to wearing heels. As I've written before in this diary, I do wonder though whether I should risk going back to football.

Congratulations on running 2km Bigman78 !  :)

Day 276  (9 months post-op)

The supermodel and I went away for a much needed 1 week holiday, 2 weeks ago.

Unfortunately, I ate and drank too much and put on quite a bit of fat. I've put back on the 4kg I lost due to the stomach bug, but the muscle to fat ratio has changed for the worse !  :o  It's frightening, how quickly you can put on fat, and then it's takes much longer to lose it ...  ::)

I thought I wouldn't put on the weight because I went to the gym in the hotel 3 times in the week, but obviously I consumed more calories than I burned ...

The gym in the hotel was very basic. There was no static bike, rowing machine, treadmill, leg press, hamstring curl or leg extension machine.

I was reduced to just doing dead lift with a bar bell and lat pull-down. One of the unexpected bunuses of this "reduced equipment" gym was that because there was no flat weight-training bench, I couldn't do bent over rows with a bumb bell while kneeling on the bench, however I could do bent over rows with the bar bell. I've now changed this permanently in my routine; the advantages being that I don't need to kneel and it's actually quicker, since I don't need to do 3 separate sets on each arm.

The main observation from the week was that the knee is not happy if it doesn't get to use the bike, rowing machine, etc.

My knee was painful after the holiday, and the pain only resolved when I went to the gym here at home this week. The static bike in particular seems to loosen up the knee after it's become stiff.

I now understand why people on the Cruciate Ligament forum said that ACL rehab was for life, not just until the physio discharges you.

Today, I started on week 6 of my (oft-interrupted) running programme : Run for 8 mins, walk for 2 mins, repeat 3 times.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on March 29, 2011, 05:40:44 AM
Thanks Deepak  :)

I'm sure you will work extra hard over the coming weeks to get back to where you want to be! Bent over rows with a barbell are great. There is another way you can do bent over rows with dumbbells without kneeling on a bench. The way I do them is by standing up (not using a bench) and placing one hand on a dumbbell I'm not using (which is on the dumbbell rack for stability) whilst bending over. Put one foot out in front and one behind you whilst doing the dumbbell row. If this doesn't make too much sense let me know and I'll find a photographic example for you!

T-bar row is also great if available in the gym and you can also do barbell rows on a Smith machine.

Back to discussing knees...... I agree as I also found that true. If I don't do the stationary bike, cross trainer or go for a run for a couple of days my knee definitely gets grumpy! I've accepted that's what I need to do from now on and have scheduled it into my daily workout!

Good luck with week 6 of your running program. Looking forward to seeing how you progress.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on April 05, 2011, 12:27:24 AM
Bigman78, thanks for the tip about doing standing bent over rows with a dumb bell. I've actually seen this in a book, but never tried it myself. I didn't know you could do bent over rows with a Smith machine - I've learned something new there !  I'm not sure I'll get a chance to try this on a Smith machine, since we only have one in our gym, and it seems everyone wants to use it - mostly for doing bench press. I've also seen T-bar rows in a book, but my gym doesn't have a T-bar.

Day 284

Started on week 7 of the running programme : run 10 mins, walk 2 mins, repeat 3 times. Do 3 times a week.

Last week killed me because I had had a break for 2 weeks and lost fitness. The transition from 8 mins to 10 mins is minor, compared to nothing to 8 mins.  ;)

On the strength training, my right leg continues to be stronger than my left (ACLr) leg. I think the imbalance is due to the fact that my right leg is shorter than the left by 1cm (I've known this for the last 10 years), so any weight-bearing tends to be done disproportionately on the shorter leg. My left leg is bulking up, but at a slower rate than the right.

I have to find a way to balance out the muscles on both legs ... Any suggestions are very welcome !

I've managed to lose some (but not all) of the fat I put on holiday. Running undoubtedly helps ... as does not eating big meals with beer everyday.  ;D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on April 05, 2011, 08:52:13 AM
No worries Deepak and glad it helps. I guess you're limited to the equipment at your gym but I'm sure you can put together a decent plan even with limited equipment.

Wow 30 mins of running, congrats! How many kms all up?

In terms of balancing out the muscles on both legs I guess it will just take time. One technique which you can use is to do 'extra' on the weaker leg. Do exercises which isolate the muscles and simply do more repetitions or sets on the weak leg. I'll be taking this approach later down the track but have not done it up to now.

Glad to hear you've lost some of that holiday fat :D
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on April 05, 2011, 11:36:14 PM
I'm not sure exactly what the distance was during the 30 min run, but it was over 3km.

I'm actually not too concerned about the distance, it's really about developing the stamina to run virtually continously for 1 hour during a football game.

Even when I complete week 10, which is running continously for 30 mins, the physio said I need to also simulate the change in pace that happens in a game, i.e. jogging for 30 mins, interspersed with short sprints including changes of direction.

The other thing the physio said I need to do is continue with the agility drills, plyometrics, and propioception exercises. I've been very undisciplined, and not done any of those exercises since my last physio appointment. My knee is definitely not in the same shape it was when I was doing those exercises.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on April 25, 2011, 12:10:56 AM
Day 304 (10 months post-op)

A week ago I completed week 8 of my running programme : Run 12 mins, walk 1 min. Repeat 3 times. Do 3 times a week.

Today I completed week 9 of my running programme : Run 15 mins, walk 1 min, run 15 mins. Do 3 times a week.

Next is the final week 10 of the running programme : Run 30 mins. The programme doesn't say, but I assume you do this 3 times a week.

I can now run up & down stairs ! ;D (Superwoman Shelli (LARSknee) was doing this about 6 weeks post-op  :o) Just like walking up & down stairs in the early post-op days, going up is easier than going down.

My knee pain continues to decrease as my muscles get stronger around the knee.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on April 27, 2011, 02:15:35 AM
Hey Deepak,

Just read your latest update. Congrats on running up and down stairs!! That's a great achievement. I reckon I'm not far away from doing it myself but will wait until my PT gives me clearance to do so.

Also congrats on being in your final week of your running programme. Let me know how it feels to run 30 minutes straight. I'm overdue for a run, haven't done one in nearly 2 weeks due to being sick recently. Hopefully will go for one tonight or tomorrow night as miss it already.

Where to next after your running programme?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on April 28, 2011, 12:32:12 AM
Thanks for the congrats Bigman78 !

Day 307

Today I ran 30 mins straight  ;D, which actually wasn't such a big change from running 2 lots of 15 mins ! I expected it to be really tough, but it was just a matter of keeping going for a bit longer. My fitness has clearly improved because I wasn't completely exhausted after the run, like I was at week 6.

Those physios know what they're talking about ! It is just a matter of following the physio programme to the letter & anyone can do it ! Taking a break for a week & lazing about (like I did on holiday) is not advisable, since it's almost like starting from scratch after the break.

To answer your question Bigman78, next is doing what my physio advised at my last session :

1. Incorporate short bursts of sprints in the 30 min jog.
2. Agility drills.
3. Plyometrics.
4. Propioception exercises.
5. Continue with strength exercises.
6. Practicising kicking a ball with reasonable force for a long pass, or shooting at goal.
7. Practising with a training partner : give & receive passes in a triangle (the classic 1,2), turns to lose your marker, ... the list is endless, basically practice all the skills needed to play a game.

8. Play Brazilian-style including bicycle kicks (This one is optional)  ;D ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on April 28, 2011, 08:52:11 AM
No worries and further congrats on running 30 mins straight! That's a great achievement and something which you must be happy about.

I'm hoping to go for a decent run tonight myself. Kicking a ball around and doing some limited training must be exciting also. Can't wait to get to this point!

Take care and all the best for your next phase of rehab :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on May 19, 2011, 12:40:55 AM
Day 328 (nearly 11 months post-op)

I've been getting some pain in my patellar tendon towards the end of the 30 min run. Having checked on the internet, I found that patellar tendon pain is also known as "jumper's knee" because it is caused by repetitive jumping. Running is a plyometric exercise, i.e. it involves jumping, so I'm going to back off the running for a while. This week I used the cross-trainer in the gym rather than the treadmill (I moved back to the treadmill from the athletics track because I could feel the impact in my knees on the track) and the patellar tendon pain has disappeared.

So my journey is a long way from being over !

Just as Snowy has reported, my operated leg still doesn't move as naturally as the good leg, and there is a lag in the response time of the muscles on the operated leg. I should do some propioception exercises to get the motor neurons working better ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on May 19, 2011, 02:12:52 AM
Sorry to hear about the patellar tendon pain Deepak.

I've avoided running on an athletics track or other hard surfaces during rehab. I found that running on soft grass (running laps around an oval) helps ease the impact and was encouraged to do so by my physio. Have you considered doing the same?

Head up... I'm sure you will get over this little hurdle!

PS how's the football going?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on May 19, 2011, 11:31:09 PM
Quote
PS how's the football going?

Ah, I haven't actually done any football training since my last physio session. I need to get out on the grass in the park now that the ground is relatively dry. Also, I need to buy some trainers that don't have any studs - I suspect that my astroturf boots may have been responsible for my injury because my foot got stuck in the astroturf.

How's your rehab going ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on June 27, 2011, 12:46:44 AM
1 year (+ 2 days) post-op

I think (touch wood) I've got rid of the patellor tendonitis. Resting on it's own was getting rid of the tendonitis, but what helped was elevating the leg. I should've iced (i.e. used RICE treatment) when the tendonitis first appeared, which probably would've meant a swifter recovery. I found that even doing leg press too fast, so that it became a "plyometric" exercise irritated the tendon.

Having learnt my lesson, I've decided that discretion is the better part of valour (or even velour), so I'm not going back on the treadmill (yet). I'm sticking with the cross-trainer for the time-being, which gives me the cardio benefit of running, without the impact.

On the muscle front, the calves are equal, but the quad on the bad leg is still 2 cm smaller than on the good leg. I've been trying out Creatine for about 3 weeks, to see if it helps to bulk up faster. I haven't noticed any increase in bulking speed due to the Creatine, although I have noticed, I can push more weight when I use it. I've also been trying Hemp protein (in smoothies or juice) as an alternative to Whey protein, and have to say I've had good results with it, and find it's not as heavy on your stomach as Whey protein.

Last week for the first time post-op, I tried a yoga routine at home. I still can't do any of the positions which involve rotating & simultaneously flexing the knee, or flexing the knee to 180 degrees, e.g. sitting on your heels. Still, I was pleasantly surprised that I could do an hour's workout pain-free.

My knee still aches when I stand for long periods or sit with the knee flexed for hours on end.

I still have a tiny amount of swelling on the knee and crucially my knee still wobbles at times.

I think the knee instability is partly due to lack of muscle around the knee, and partly due to motor neurons not firing : my walking gait is still not normal & I know that I don't have complete control over my lower leg, which is why my calf is constantly tense (it's having to compensate for the lack of stability in the knee).

So, in summary, I'm not where I expected to be 1 year post-op. I can only hope that if I continue with the rehab exercises, my knee will become stable and pain-free, but I am aware that there is a possibility that my knee will never be the same as pre-injury.

The positives out of this injury & rehab are that I've learned stuff about my body that I never knew before, I'm eating better (since a good diet is essential for bulking up, while keeping the fat down), and I'm sleeping better because I don't eat late at night, like I used to.

I can walk, cycle & swim - that's not a bad place to be !  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: impishgrin on June 27, 2011, 04:35:22 PM
Hey Deepak,

Thought I'd call in and see how you're getting on. I've been using creatine for about 6 months now and I really did notice the difference. I've been using Whey protein as well which has been a great help, but only as a recovery drink. I have to say though I've never felt it sat heavily in my stomach. What brand / flavour were you using? What sort of price are you getting the hemp protein for?

I'm glad to hear you're getting rid of the tendonitis. Have you tried doing squats or deadlifts rather than the leg press? I've seen a sizeable increase since making that switch.

I've got to agree with you on the whole positives of injury. I've learn't an awful lot that I would never have known, not just about knees but about fitness and nutrition in general and I'm probably healthier all round than I've ever been.

Keep us up to date on how you're getting on

Pete
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on June 27, 2011, 10:52:10 PM
Hi Pete,

Thanks for calling in !

Re the creatine, have you had any side-effects ? I've deliberately avoided it so far because I heard there were dangers of damage to your kidneys. They do say on the tub that you need to keep yourself well hydrated when you use creatine, to avoid any kidney problems.

I've used a couple of brands of Whey protein - I started out with Maximuscle, but hated the artificial taste of their banana flavour & wanted to stay clear of the sweeteners they use, so have been mainly using un-flavoured whey, which I have with milk. It may be the milk that makes it heavy - originally I was using semi-skimmed, but now use skimmed milk. Of the unflavoured whey brands, I used bulkwhey.co.uk (who seem to have gone out of business), and now bulkpowders.co.uk. I get the Hemp protein from http://www.bulksupplementsdirect.co.uk/khxc/hemp-protein-powder.html, which I thought was the cheapest source of Hemp protein - much cheaper than some of the brands I saw for sale in the health food shops.

Yes, I'm doing squats & deadlifts, and they do increase size fast. The reason I was doing leg press as well, was to try to work the bad leg in isolation, so it doesn't allow the good leg to do most of the work.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on June 28, 2011, 06:49:42 AM
Hey Deepak,

Congrats on hitting the one year milestone! Although sorry to hear about some of the ongoing difficulties you have had with the patellar tendon. I've been told that most of the healing within the knee should be done by this stage (from memory healing from the op takes up to 18 months) so that's got to be a positive sign.

You sound like you're taking the sensible approach in doing activities which don't impact the patellar as much. Thankfully I haven't had those issues up to now. The knee wobbles would be a concern no doubt and I haven't had that instability myself. Is it worth using strapping or a knee brace whilst doing any activity to give you further support?

Keep at it and I'm sure it's a matter of time before you feel more confident with your operated leg. BTW I've used creatine myself in the past and I've managed to get good results. I'd recommend only doing one 4-6 week cycle per year otherwise you may have potential kidney issues as you've mentioned.

Cheers
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: impishgrin on June 28, 2011, 02:22:52 PM
Hey Deepak,

As far as creatine goes, no side effects at all. Though I drink about 2 litres of water every day. I take one 5g portion first thing every morning and then I'll eat about 15-20 minutes later. It does make your muscles retain more water so if you don't stay hydrated it will certainly put a strain on your kidneys, but none of the research I've managed to find has found any real issues. Just to be on the safe side I do 6 weeks on, 2 weeks off to give my body a rest. I'd also avoid it if you've had Kidney or Liver trouble before and I did read once that it's not good for asthma sufferers so if that's you I'd give it a miss as well. As bigman says there are suggestions it can cause kidney trouble so I'd get some research in before you make a decision in case you find something the 2 of us have missed.

As far as protein goes, I've been using this stuff, though I only ever take shakes straight after a workout for recovery

http://www.myprotein.com/uk/products/hurricane_xs

It's pretty good and you can get it completely unflavoured to avoid sweetners / flavouring / colouring. I use the vanilla one and while it's sweet it's drinkable and mix it with water post-work out so it gets in to my system asap (the fat in milk slows absorbtion). It's also got other bits an pieces mixed like carbs for glycogen replacement, glutamine, HMB and creatine. I'm not sure how effective the glutamine and HMB are but the protein content is only 1.5g short per 30g compared to the hemp protein so at £32 for 2.5kg its not too bad.

Just reading over the issues you've been having, have you tried single leg deadlifts?

http://health.howstuffworks.com/wellness/diet-fitness/exercise/leg-exercises-tb6.htm

They work you're balance quite a bit, especially if you do it on an aerobic step with your free leg off the side or on a slightly unstable surface like a foam mat. You can start off doing them unweighted then move on to dumbells / medicine balls / bar bell if you so wish. I tend to do these in a circuit with bulgarian split squats and backwards lunges or single leg pelvic bridges.

There are a few decent ones in this link as well.

http://exercise.about.com/od/lowerbodyworkouts/ss/deadlifts_10.htm

I've found the cable machine to be useful as well, strapping the cable to my ankle and doing rear glute extensions, hamstring curls, driving my knee up and forward and a slightly exaggerated kicking motion. These all work the muscles on your tethered leg but really work your balance on your standing leg as well, though if you're experiencing a little instability still it might be best to leave this until you're feeling more confident.

Bit of a ramble but if I think of anything more I'll let you know

Pete
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on July 10, 2011, 12:38:50 AM
Bit of a late reply, since work has been hectic recently.

Thanks for your input Bigman78 & Pete.

This week I've not had any creatine, and I've got to say I haven't noticed any difference without it. Perhaps, it lingers in the body after you've had it. Anyway, I'm going to follow Bigman78's advice and leave it for a while, since I used it for a 4 week period.

What I did notice this week, is that after drinking 2 bottles of light lager, the next morning I didn't have a hang-over, but my stomach didn't feel right. I wonder if the creatine is having an effect on my kidneys & is reducing their ability to process liquids ?

Pete, thanks for the links. I tried the one-legged deadlift with a medicine ball - it was a suprisingly difficult exercise, comparable to the one-legged throw & catch of a medicine ball on a trampette that I did with my physio. I also added a balance exercise on a Bosu to my workout.  Hopefully, this will get those motor neurons firing !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 16, 2011, 12:50:40 AM
Day 417 (nearly 14 months post op)

I successfully walked up & down Mount Snowdon in Wales at the weekend, although my patella tendon started to hurt 3/4 of the way up the mountain. I went up the Pyg track, but I didn't think I could manage the Pyg track going down, so took the Llanberis path.

I rested, elevated, iced the knee & did some patella mobilisation (which I've found is really good at relieving patellar tendon pain) when I got home, and now after a day of rest, my knee is pain free.

I'm considering trying Mont Blanc next, but not sure if I might be pushing my knee too hard, too early. Any advice on this from experienced mountain walkers would be appreciated.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on August 16, 2011, 02:56:14 AM
Great to hear Deepak!! Congrats! I don't know how high Mount Snowdon is but it sounds impressive none the less  ;D

How many kms up and back down? Are you planning to play football in the near future?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 16, 2011, 11:35:22 PM
Bigman78,

Thanks for the congrats ! Mount Snowdon is 1,085 m tall, which is relatively small on the scale of world mountains, hence a good mountain to test my knee on.

The Pyg track is 3.25 miles (5.2 km) at a relatively sleep ascent, whereas the Llanberis path is 5 miles (8 km) but at a gentle gradient.

http://www.mountainwalk.co.uk/walkingsnowdon.html

http://en.wikipedia.org/wiki/Snowdon

I would love to play football, but my knee is still not stable, so I wouldn't feel confident playing. Even the mountain walking stressed my knee - I think the lateral movement required to balance on uneven rocks caused the patella tendon pain. However, there was no such pain in the good knee suggesting that there is a deficit of control in the operated knee.

How's your knee doing these days ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on August 17, 2011, 03:22:59 AM
No worries :)

13 km in total, nice work! Sounds like it was a good test for the knee and at least you know we're you at now exactly. Fair enough, I've been lucky in that my knee feels really stable at the moment although I haven't tested it too much apart from when sverving between cones when running.

My knee is great overall although I've fallen away with my rehab due to being overseas for 6 weeks. I'm really looking forward to getting back on the bike, running again and hitting the weights!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 18, 2011, 12:09:00 AM
Today, I spoke to one of the physios who treated my knee during rehab, about the advisability of doing Mont Blanc.

She said, given that I have patella pain (contrary to my earlier post, it hasn't disappeared) from one day of mountain hiking, and Mont Blanc is much tougher than Snowdon, it would be unwise to attempt a 14 day climb up & down Mont Blanc.

She said it would be better to build up the difficulty of climbs gradually, rather than going straight from a easy climb to a relatively tough one. Makes sense when I think about it - I wouldn't go straight into a football game without building up my fitness gradually first, so why do the same with mountain walking ?

Also, what occurred to me about my patella tendon pain, is that I have now proved that the pain is not caused by high-impact exercise (i.e. running) since walking was not high impact.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on August 18, 2011, 05:44:10 PM
Hi Deepak,

You took the time to post on my thread to congratulate me on being discharged from the hospital after 3 and a half years and was 21 months post op yesterday. I was reading through my latest post yesterday and realized that I forgot to mention your name along with the other 2 members, so quickly added your name as I some how missed it out on Tueday when I posted on my thread.

Glad you are making some good progress after your knee injury and just shows we can overcome our knee problems. It is good advise to build up slowly and gradually increase the high climbs. I am not jogging too many miles in one go at the moment and will gradually increase the miles over the next couple of months.

My goal is to one day do the London Marathon and your goal is to climb up Mont Blanc and think we will both be able to do it in the not too distance future!

Nick :) {2011} :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on August 21, 2011, 09:42:03 PM
Hi Nick,

Don't worry about not mentioning me on your thread, but thanks for adding me anyway !

Thanks also for the encouragement for climbing Mont Blanc - I think the comparison with running the London Marathon is apt, although I suspect you'll run the London Marathon before I climb Mont Blanc.  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 12, 2011, 11:54:32 PM
Day 445 (almost 15 months post-op)

Last week I went against my physio's advice (a little) by walking on some easy mountains in the French Alps. Don't worry, I didn't attempt Mont Blanc - that's a serious climb that involves playing Russian Roulette with random avalanches and rock falls.  :o I don't think I'll be doing Mont Blanc in this lifetime !  ;)

My patella tendon was painful on the first day, but then improved on subsequent days, only hurting when I was walking downhill.

Today I saw my physio, who said my technique for squats and deadlift was the probable cause of the patella tendon pain - the knee was going forward of the ankle during the flexion, therby putting lots of strain on the patella tendon.

She advised that I stop doing squats & deadlift, and instead stick to single-leg leg press, leg curl, leg extension and standing knee bends (for propioception).

She also advised that I restart the 10-week running programme, but stop if I feel patella tendon pain.

I'm looking forward to getting back into running, because the week of walking really showed where I was lacking in fitness.   ::)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on September 13, 2011, 05:30:33 PM
Hi Deepak,

Glad you had a good time walking over the French Alps and would have done the same not taking your physio's advise as mine told me not to run on a hard surface straight away and ignored him and starting road running.

The patella tendon pain can be kept under control and will soon be able to run again. I can jog 5 miles in 30 minutes and pleased about it and think it is a good speed and time any faster and would tire myself out too quickly and best to go the speed you feel comfortable at. 6 minutes a mile is no a bad time for someone who had knee surgery and was unable to run for 3 and a half years and may even improve on that time.

You are 15 months post op and I am 22 months post op already and my right knee is holding up well.

It will not be too long before you can start to run again and we do know it is bad for our knees. You are like me do not care if it damages the knee joints if it is something you enjoy doing and keeps you fit and healthy.

Nick :) {2011} :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 22, 2011, 01:00:06 AM
Nick,

Congratulations, 6 minutes for a mile is not bad at all !  :) I actually do care if I damage the knee joint because I don't really want a Total Knee Replacement. What I was trying to do was push my knee to see what it was capable of, but deliberately didn't do any walks as tough as the Pyg Track on Snowdon. The positive side of the week of walking in the Alps was that my quads have got stronger on the bad leg.

Day 454 (almost 15 months post-op)

I restarted the 10-week running programme last week, and the patella tendon pain came back.

Today, when I saw the physio, she found that when she tested my knee for patella tendon pain, I told her that I could feel none. She suggested that the pain may not actually be from the patella tendon.

However, she placed some physio tape horizontally on the patella tendon (to take some of the strain off the patella tendon), and I found that running on the tread mill was then less painful ! I asked her if I should buy a Cho-Pat strap as Kristin suggested, but she thought that the tape would suffice for the timebeing.

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on September 22, 2011, 05:52:14 PM
Hi Deepak,

I think I could improve on my time to 5 minutes a mile but would wear myself out to quickly and its best to run at a comfortable pace rather then sprinting it all the way and burning yourself out. A good marathon runner goes at a steady pace they feel comfortable at.

You right about not wanting to damage the knee and should not force the knee through pain as you will wreck it. I do not feel that much knee pain while running so will carry on for as long as my knee can take it.

Patella tendon pain is tricky to get right again and hope it does not set you back with your 10 week running programme. It would be wise to strap your knee while running as it seems to be easing some of the pain.

Nick :) {2011} :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 30, 2011, 10:24:54 AM
Day 462 (just over 15 months post-op)

Given that my knee is unstable, I was starting to worry that my ACL graft may have failed, but the physio did a Lachman test and said she could feel resistance.

She got me to demonstrate how I do a single-leg knee bend. Here was the problem : my knee wobbled as I bent the knee.

So to improve propioception, I need to do 3 sets of 15 single-leg knee bends every day, while trying to control the movement so that the knee doesn't wobble - I can stop the knee wobbling if I concentrate.

Basically, she said all the strength training in the world won't get my knee stable, if I don't work on the propioception as well.

Controlled knee bends (without a wobble) will lead to patella-tendon-pain-free running. That's the theory anyway :)

In other news, the super model and I have decided to separate due to irreconcilable differences over whether one should have jam or marmalade on toast. I am firmly in the jam camp, whereas the super model prefers marmalade.

We have provided a press release to the media, and are available for separate interviews. We are both currently in negotiation with separate book publishers.

We would like to take the opportunity to thank our fans for their support over the last year.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on September 30, 2011, 11:00:27 AM
Oh Deepak so  sorry to hear about you and the super model, but your right these differences are something you just cant overlook, good news is I have heard there is one of the athletes heading over your way for the games who is very interested, she has heard of you through the grape vine and the whole wobbly knee thing really does it for her, so keep a look out for her.
Sorry your still feeling the knee is unstable have you been back to see your OS to have him check it out, it might be worth a visit even though it sounds like your physio has some good sugestions to help you, I am still in shock about my failed recon I didnt think for a min that was the case, but you just never can tell.
Take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on October 01, 2011, 12:04:18 PM
Hi Deepak,

I hope your knee gets stable soon and seem to have a good physio giving you some useful advise and if it still does not improve can see your OS again as Tez has pointed out. Feel a bit guilty saying on my other post that it does not matter if you damage your knee as you rely on it and was not really thinking straight that day!

Nick  :) {2011} :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 06, 2011, 12:09:58 AM
Tez,

Thanks for understanding, it means alot to me. Some of my friends have said I'm mad to be leaving a super model, that I've over-reacted, and that I could still patch things up by offering to try marmalade on toast (even though I hate the stuff). Sure, I could try marmalade, but I know this would just be the thin end of the wedge, and eventually I would have to give in to all her demands - eventually I would just end up being her lapdog. I am a man - I will not be a poodle !  :P

Now I'm torn - I would like to fix my wobbly knee, but if this athlete likes men with wobbly knees ... hmmm ....  ??  ;)

The physio said she will try a few things, but if her ideas don't work I will probably need to make an appointment with my knee surgeon.

Unfortunately, the post op diaries & cruciate ligament forums are full of stories of people whose ACL grafts failed. Apparently the common reasons for failure are :

1. The bone tunnels were not drilled in alignment, i.e. they were not straight, instead they were slightly angled towards each other.
2. The tension on the graft was too great, causing the graft to snap like a rubber band.
3. The patient resumed normal activity too early, before the new ACL had grown over the graft "scaffolding".

Before you have an ACL revision, I would ask your knee surgeon what percentage of his patients have failures of their ACL grafts, and what the reasons for failure were. This is not an unreasonable question to ask, and one that he should feel comfortable answering.

Nick,

Yes, my physio is excellent - I have a lot of respect for her. Don't worry, I didn't take your comment badly - I just wanted to set the record straight in case anyone thought I was being reckless by deliberately trying to screw up my knee.  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on October 06, 2011, 02:56:48 AM
Deepak interesting to read about the usual reasons for a graft to fail and it just makes me more certain that mine i something to do with the bone tunnels being in the wrong place, why else would my OS be talking about having to do a two stage revision, also I dont want to worry you but neither my OS or phsyio ever felt any problem with my graft when doing any of the test, if I were you I would be booking an appointment with your surgeon now rather than leave it to long especially after reading all the gym stuff you have been doing, I hope I'm just being a little panranoid because of what has happened to me and you will be fine but just in case :P
As for the athlete if pretty sure once she has a chance to get to know you whether or not your knee remains wobbly will become unimportant in the big scheme of things as long as your both on the same page when it comes to the big things in life like the what you spread on your toast in the mornings..and you and the super model were kinda doomed from the start lets face it two  such beautiful people would have produced extremely ugly kids, tis a known fact if the genes are too perfect then they mutate when mixed together to give you very unattractive offspring.
and on that profound note I shall say good night xxx Tez
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on October 06, 2011, 05:16:32 PM
Hi Deepak,

You done what you thought was the right thing to do and does not matter what other people think as beauty and looks are not always important as long as they have a nice personality and half decent looking.Think you should take Tez's advise and get your knee checked out by an OS rather then leaving it just to put your mind at ease as he/she may say there nothing to be concerned about.

Nick :) {2011} :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on October 10, 2011, 08:06:51 AM
Deepak - I don't have time to write much but just want to wish you all the best and hope your graft hasn't failed as well. Let us know once you've had it checked out. And time to get another supermodel I think ;)

Tez - sorry to hear what you went through and hope you come out even stronger than before

All the best everyone!
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on October 28, 2011, 12:05:54 AM
Day 477

The physio has given me 2 new exercises to work on the propioception, and start gently loading the patella tendon :

1. Decline squat, i.e. a squat with your feet on a negative gradient.
2. Lunge. She corrected my form : I was moving the leading knee forward of the ankle, which stresses the patella tendon, instead I should only flex to 90 degrees, and then return to 0 degrees extension.

Day 486 (16 months post-op)

I sucessfully completed an introductory course in indoor "rock" climbing. My knee was absolutely fine, even when I jumped off the climbing wall from about 5 feet above the ground - there was a foam mat to land on, so it wasn't like landing on concrete.

Tez,

I agree with you, it is worrying to hear that neither your physio nor OS thought that the graft had failed. I think I will stick with the propioception exercises for a bit longer before I contact my OS, because my single-leg knee bends are becoming less wobbly, although my knee is still not wobble-free. In my case, progress is slow but steady ...

Luckily I'm not beautiful, so if the super model and I had had kids, her genes would hopefully have won out on mine  :P

Nick,

Thanks for your understanding too. That's what I love about this forum, other knee geeks support you when you're going through tough times. I'm currently going through a bit of an emotional roller-coaster.  :'( :P

Bigman78,

I think I won't be going for another super model this time. Everyone thinks it must be really glamorous to go out with a super model, but the reality is you don't see her much because she's always jetting off round the globe to her next photo-shoot or fashion show. Now I'm looking for stability - more of a "girl next door" type.  :P 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: kcknee on October 28, 2011, 04:56:51 AM
Deepak-

I had spent the time between when I had my ACL stump removed at the beginning of June until I had my ACLr in late August trying to get my muscles strong enough to compensate for the missing ACL. My leg strength and proprioception became so good during that time that I was doing lunges, one legged squats and even squats while balancing on the bosu ball with the round side down. As long as I was actively engaging my muscles, my knee was stable. If I stood with my knee relaxed or stepped sideways without tightening my muscles first, my leg would buckle.

I really hope that your graft is still in good shape, but it does sound like your muscles are strong and may be compensating a lot. Keep working on the proprioception but if the knee is still unstable, I would have a different OS check it out and do the x-rays and manual test to see if the graft was placed right and if the graft is still strong.

Kristin
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 13, 2011, 10:20:40 PM
Kristin,

I'm going to see my physio this week to review my progress with improving propioception. The good news is that my knee bends are less wobbly, although not yet wobble-free. The bad news is that (like you) when I'm not consciously contracting the muscles, my knee does feel "loose".

When you say your knee would "buckle" - do you mean that it would completely give way, or was it more subtle ?

How did your knee surgeon determine that your graft had failed ?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: kcknee on November 14, 2011, 12:59:33 AM
My ACL graft thankfully has never failed.

The time I was referring to was between when my torn ACL was removed from my knee in June 2009 and then replaced the end of that August. My tear had been misdiagnosed for 6 months before I found a new OS who read the MRI correctly. Because my leg was inflamed from having the stump stuck in the notch for months, my OS was doing my ACLr in two stages. He made me rehab hard all summer in the hopes that I could get strong enough to not need the replacement graft. Before my ACL was removed, I couldn't get full extension, but the stuck torn ACL was keeping my knee stable.

All that Summer, I obviously knew that I had no ACL remaining in my knee. I had rehabbed hard the 6 months prior to having my ACL removed and worked even harder after. My leg would feel like I was balancing the bones on top of each other when I stood with the muscles relaxed and then would just give out. When my muscles were consciously being contracted, my leg was really strong and stable.

I hope you get good news at your PT this week and your knee is becoming more stable. Your experience had just reminded me of when I was doing the hard rehab with no ACL.

When I first started with my current OS when the first signs of AF appeared, he did all the usual twisting/pulling tests and x-rays with my leg in 3 different positions to determine if the graft tunnels were in the right place. I then had an MRI to look at the state of the graft.

Kristin
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 14, 2011, 04:17:38 AM
Hey Deepak,

Just checking in to see how it's all going. Hope it goes well with the physio appointment.

Keep us all informed!

Cheers
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 17, 2011, 12:42:04 AM
Day 511 (nearly 17 months post-op)

Yesterday, I fell about 5 feet off an overhang wall while indoor climbing. Falling off is perfectly normal for climbing, and since you land on a soft mat, you don't hurt yourself. Unfortunately, I didn't land on both feet - I think I must have landed on the left foot first, and then the right foot followed. The left knee didn't take the landing well, and I had to stop climbing due to pain in the lateral side of the knee. When I got home, I iced and elevated the knee, which brought down the swelling and pain.

I saw my physio today for my scheduled appointment and told her what had happened. She examined the knee and did lots of manual tests. Again, she said she could feel the ACL, although the MCL felt a little lax.

She did notice that there was more lateral-medial movement in the left (operated) knee than the right. She theorised that this may be due to the knee surgeon deliberately keeping some laxity in the ACL graft - apparently if there is too much tension in the ACL graft, this can lead to early onset arthritis. If this is the case, my knee will always be loose, and this is "as good as it gets".

She reluctantly agreed to write to my GP to request an MRI, to put my mind at rest that the ACL graft hadn't failed.

She thought that as far as physio is concerned, I've done all I can to get the knee strong. Now, I can contnue with trying to improve the propioception, but my knee may never be as good as is was prior to the ACL rupture and playing football or indoor rock-climbing would put me at risk of another ACL rupture ...
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 17, 2011, 05:57:31 AM
Sorry to hear about the rough landing whilst climbing. Hope the MRI shows there is no major structural damage to the knee. Seeing as though the physio can 'feel' your ACL that's always a good sign.

In regards to the laxity in the ACL graft that's an interesting point... you've mentioned on a few occasions that your knee feels 'loose' which hasn't been the case for me. You've worried me in terms of too much tension in the graft leading to the onset of early arthritis. The surgeon who performed on me is one of the best around so I trust that he did a good job!

All the best.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on November 17, 2011, 05:30:39 PM
Hi Deepak,

Once you have a knee problem and think you getting some where you have another accident involving the knee and do hope your injury is only minor and not a trip to the OS and operating table. It is a wise move to have an MRI scan done as it better to make really sure that there is no damage inside the knee.

Was 2 years post op yesterday and doing really well and run 3 times a week at a good pace and will join a running club in spring 2012 as I feel I am competitive enough to join. Can run 1 mile in 6 minutes and aim to do it in 5 minutes by the time I join a club.

Nick :) {2011} :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on January 05, 2012, 11:52:43 PM
Happy new year Deepak!

How's your knee going these days? Hope all is well.

Cheers :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 09, 2012, 02:43:22 PM
Nick,

Glad to hear that you're doing so well. Joining a running club sounds like a good plan, both from a social point of view and because people can give you advice about running technique. I was talkig to a guy in the cafe at the top of Mount Snowdon (!) who was in a running club, and he was telling me that everyone in his running club has an injury of some kind, so they all give each other advice about how to avoid their injury.

Happy New Year Bigman78 and everyone else !

My knee is doing OK thanks. It's still loose, but I can do alot despite that. Last week I played an easy round of golf (golf was not a sport I played before, but now I may start since it's low impact) and had no knee pain. I was also playing with my nephew and sprinted, again with no knee pain. Maybe, I can get back to running ... ?

The physio has come up with an interesting possible diagnosis : she's been also treating my left shoulder (a problem I've had for over 10 years) and found that both shoulder joints are more lax than they should be. This led her to theorise that I may have a general problem with lax joints throughout my body. So, the laxity in the left knee may not be due to the surgeon leaving the ACL graft lax, but due to naturally lax ligaments. http://en.wikipedia.org/wiki/Ligamentous_laxity, http://en.wikipedia.org/wiki/Hypermobility

Hopefully when I finally get my MRI, or see an orthopaedic surgeon, I'll get a more definite diagnosis.

How's your knee doing ?

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on January 19, 2012, 05:20:19 PM
Hi Deepak,

I will join a running club in the spring as it still gets dark ealry this time of the year and rather run in daylight then in the dark. I have met a girlfriend from a dating website and we was in a relationship with in 9 days after meeting for the 1st time and so far its going smoothly. I might not be able to get a model as a girlfriend like you did but we love each other and that all that matters.

Glad you had a good round of golf and think it wont be too long before you get back into running and can take a while to get back into it after a knee injury and can maybe run shorter distances to begin with and see how well the knee takes it all. It best to get your shoulders and knees looked at by an OS and hope the MRI spots a problem that can be fixed easily.

My knee does swell slighlty after a run and do get some pain at the bottom of the knee and will not late it put me off running as the pain is not too intense and can take it as it not all that painful.

Hope you have a good 2012 without too many hospital appointments.

[email protected]  
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on February 07, 2012, 10:23:39 AM
Hey Deepak,

Hope you are nearly back to running and good to hear you may have a reason for the knee being so loose. Did you end up getting it checked out?

My knee is great, thanks for asking. It survived the cricket season well (even if I personally didn't have a really good season) and I've started going to soccer training the last few weeks. I've even participated in some small pitch matches and have a decent level of confidence with it. I'm still hesitant to tackle (I'm sure this will take time) and I'm still not sure if I will actually play competitive games of soccer. I may be better off just training to keep fit...

Let's see how it pans out!

Take care
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on February 29, 2012, 12:14:17 AM
Day 614 (1 year, 8 months, 4 days post-op)

I finally got to see a knee surgeon, who did some manual tests and took an Xray of my knee (which showed no obvious bone damage, although he did say there was less space between the femur and the tibia on the lateral side, possibly indicating early onset arthritis). Interestingly, the Xray showed that I do not have a metal fixation screw in the tibia, implying that the surgeon used a bio-absorbable screw. This leaves me wondering why I feel pain in the tibia on the medial side - I had assumed it was from the screw, but this can't be the case ... ?!

I asked him if he thought, given my shoulder problem, that I had hypermobile joints. He did the classic hypermobility test with the hand, which was negative, so hypermobility has been ruled out as the reason for the laxity.

I now have to wait for an appointment to get an MRI. Once that is done, I will have to wait for another appointment with the knee surgeon to review the MRI ... Ah, we're back to the bad old days of the NHS with long waiting times  ::)

Nick,

Congratulations on meeting your girlfriend, and hope things are going well for you both. A word of advice from the wise : Just avoid any arguments over jam or marmalade on toast !   ;)

Bigman78,

Great to hear that you went through the whole cricket season, and are soccer training. I know exactly what you mean about being hesitant to tackle.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on February 29, 2012, 02:54:32 AM
Hi Deepak I have been wondering how the knee was doing, from the sound of things not brillient I hope your wait for the MRI is not too long and your OS gets to the bottom of whats going on sooner rather than later.
I am waiting for a date to start the 2 stage ACL revision I saw my OS last week and he had a good look at the mri and x.ray and has decided that the original tunnels were too big to use again so he will do a bone graft first then when that has taken go back in and do the whole thing again, aint I the lucky one ::)
at least I now have a better idea of why it failed in the first place.
I hope you get some answers soon take care
Tez xx
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on February 29, 2012, 10:21:00 PM
Hi Deepak,

I have already split up with my girlfriend after only going out with her for 6 weeks and was her choice not mine to end our relationship and will now look out for a new one. I was a really good boyfriend to her, so cannot understand what I had done wrong!

Sorry you are having ongoing problems with your knee and shoulder and have to have a MRI and hope it can be fixed easily by your OS. I am doing ok with my knees and stll running 3 times a week, my right knee getting more painful again so need to see Dr Brown for more IMS sessions as the last one really helped and due for another session!

Good to see you back posting again and wish you had some better news about your knee and shoulder.

[email protected]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 01, 2012, 11:17:06 PM
Tez,

Sorry if I'm being a bit thick, but what was the actual reason for your ACL reconstruction failing ? I've never heard of a reconstruction failing because the bone tunnels were too big.

Nick,

Sorry to hear that things didn't work out with your girlfriend. Well not to worry, there's plenty more fish in the sea ! I read your thread, and I do wonder if you should take it easy with the running. I understand exactly why you want to run, because I do too, but I don't want to become a cripple due to running !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on March 01, 2012, 11:28:21 PM
Hi Deepak,

I already have another lady in mind as a potential girlfriend so not the end of the World and as you said there are plenty to chose from. I think you may be right I do like to run fast when going for a run and the knees can only take so much before they give permanent problems and know I am too stupid and thick skinned to ease back a bit and may pay the price. Its my choice and can only blame myself if I wreck my knees.

[email protected]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: tez27 on March 02, 2012, 04:30:45 AM
Hi Deepak all I know is its something to do with the placement and size of the tunnels according to my surgeon, and from what I can gather on here its the most common cause of the graft failure, why? I dont have any Idea, my surgeon says that one in a hundred acl reconstructions fail for whatever reason, whether there is any fact in that or thats just his opinion I'm not sure, all I know is its just my luck that mine was that one in a hundred ::)
Take care Tez   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 20, 2012, 10:56:04 PM
Tez,

Thanks for giving me more information about why your graft failed. I'll be interested to know what the reason was for mine failing, if it has indeed failed.

The NHS knee gods have been kind to me (although I think sacrificing a plump aubergine helped ;)) and I will now be having both my MRI & an appointment to see the knee surgeon in a weeks' time.

If anyone has suggestions for questions to ask the surgeon, I'd appreciate them.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 28, 2012, 12:16:49 AM
Day 642 (1 year, 9 months, 3 days) post-op

I got my MRI & the knee surgeon reviewed the MRI today.

The good news is that the graft is still in tact ! Incidentally, the Xray I had about 2 months ago was lying - I do have a metal fixation screw in the tibia.

The knee surgeon tested the knee movement manually, and agreed there was too much free movement in the joint.

He offered the possibility that I'm one of those people who always have loose joints, although I know my knee was not this loose before my ACL rupture.

He told me that there was a surgical option to tighten the knee using an autograft from the Iliotibial band to provide further mechanical strength, in additon to the ACL, but this would obviously entail another long period of recovery from the operation.

Alternatively, I can try a conservative approach, which is to continue increasing muscle bulk around the knee, improving propioception, and try gently going back to playing football, with the mechanical assistance of a hinged knee brace.

No prizes for guessing that I'm going for the conservative approach.  ;)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on April 05, 2012, 07:02:07 PM
Hi Deepak,

I do not blame you going for the conservative option 1st rather then straight in with surgery to see if it helps or not as it not good to have too many scopes on one knee that increases arthritis. I hope you enjoy the Easter Weekend Holiday and glad you want to compete in sports again.

[email protected]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on April 10, 2012, 02:47:41 AM
Glad to hear the graft is still intact Deepak!

Given the same option I would also go with trying to strengthen the muscles around the knee over an additional op. I guess it all depends what your goals are going forward though.

All the best with it! What type of exercises are you doing at the gym at the moment and what has your PT advised (that is if you've seen your PT)?
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on April 15, 2012, 12:15:25 PM
Nick,

Yes, I did enjoy the easter bank holiday weekend - it felt so good to have 4 days off work. I also played another round of 9-hole golf, which felt easy, but then I was aching the next day - playing golf must work different muscles from going to the gym ... How do you find playing golf - does it cause you any knee pain ?

Bigman78,

My physio discharged me before Xmas. She advised me to stop doing bar-bell Squats & Deadlift, because they were causing patellar tendon pain. So my current leg workout is :

1. 5 min warm-up on static bike.
2. single-leg leg press.
3. single-leg leg curl.
4. single-leg leg extension.
5. 5 min rowing machine.

I'm supposed to be doing these as well, but haven't done so for about a month :

6. decline squat with low-weight dumb-bells to lightly load the patellar tendon.
7. single-leg unweighted squat to improve propioception.
8. lunge to improve propioception.

Incidentally, the knee surgeon said that it was common to get patellar tendon pain when returning to sport following ACL reconstruction, and the solution (as correctly advised by my physio) was to temporarily back-off any exercise that was causing the pain.

What are you you doing in the gym these days ?

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on April 18, 2012, 05:14:34 PM
Hi Deepak,

Hope your knee improves soon so you can play a round of golf without being in knee pain and is good that you are keeping op top of your PT. I no longer go to the gym and saving money and also can get very boring and rather go outside for a run 3 times a week and will be joining a Running Club at the end of the month as I really want to get into long distance running and happy with my running speed of 6 minutes an mile and like to cut it down to 5 minutes ideally.

I really cannot stand golf and working on a course anymore and will looking for a new job working with adults with Asperger syndrome in a Residential Home as I have the condition myself in a milder form and would understand what they are going through after going through it myself in 2005 and spent 7 months in a Residential Home. I am already planning to set up my own Asperger syndrome Social Group and will set up my own website and publish a book about how I live and cope with it.

[email protected]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on September 11, 2012, 12:46:11 AM
2 years & 2 months post-op

I'm a bit late with my 2 year update, but better late than never ...

I've been having pain in my left hip (the same side as the reconstucted ACL) for over a month. I've found that going to the gym reduces the pain, but does not eliminate the pain. I believe that swimming helps, since I went swimming yesterday and the pain is better.

I've been trying to avoid going to see a physio about this, since I thought I could resolve it myself, however I think I need to because I'm concerned I may be causing long-term damage to the hip.

On the positive side, I can now do deep (un-weighted) squats, so can get out of the pool without using steps, and can now swim breast-stroke again. I am trying to ease myself back into running on the treadmill - I'm up to 15 mins, and so far no patella tendon pain, so it's looking good !  :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on September 12, 2012, 06:14:03 PM
Hi Deepak,

Time fllies by and I will be 3 years post op in November and now starting to have problems once again but it is my own fault as I do lots of road running. It often common to have hip pain when you have had knee problems and best to avoid long term damage.

Great you are running on the treadmill and can do squats again without too much knee pain.

[email protected]

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Bigman78 on November 27, 2012, 06:27:41 AM
Hi Deepak,

Congrats on passing the 2 year anniversary! I just passed that mark myself last month :)

Happy to hear about the deep squats and running! Hope the hip pain improves but maybe you should check it out?

Take care
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on December 13, 2012, 01:01:21 AM
2 years & 5 months post-op

Yesterday I played a game of football for the first time since my injury in May 2009.  ;D ;D ;D

I played badly, but I was just so happy to be playing again, and even more happy that I survived the game without the dreaded recurrence of the ACL rupture.

I deliberately avoided any tackles (luckily this was just a friendly kick about, so no crazy sliding tackles).

I wore the knee brace recommended by my knee surgeon, but even with that my knee felt loose. A mild sideways bump from another player made my femur move laterally relative to the tibia. I was able to make lots of pivoting moves pain-free though.

Worryingly, today my knee feels a bit looser than it did before the game ...

Thanks Nick & Bigman78 for your replies.

The hip pain comes and goes. What seems to cause it is actually sitting at a desk for long periods, so this should encourage me to be more active.

On that note, I've restarted indoor climbing for the last couple of weeks, and so far so good. I did learn in the first week not to try landing on the left foot alone, which causes the knee to buckle - if I jump off the wall and land on both feet I'm fine.
 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Snowy on January 02, 2013, 05:55:22 PM
A late response here - I missed your last update when it was posted.

That's GREAT news about the football match! Congrats for making it through in one piece. How are you feeling about the movement in the joint? Do you think it's something you can live with, or are you going to consider the surgical strengthening option?

With regard to the hip pain, it might be worth having an ergonomic assessment of your work area done. My physio suggested this when I was having shoulder issues last summer, and some of the adjustments were very minor (not sitting with my legs crossed; putting in a keyboard tray) but made a big difference.

The climbing sounds really fun. :)
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on January 10, 2013, 06:32:29 PM
Hi Deepak,

Sorry also to reply back late I am trying to re organise my life at the moment and spend less time on KG reading members posts. Glad you are doing ok and your knee is holding up ok.

I am very much into running long distance now and do a 9 mile run 4 times a week and feel 36 miles per week is a good distance and can manage it ok with just a few twinges and pain in he knees that one would expect running regular.

[email protected] 
 
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 15, 2013, 12:50:40 AM
Snowy,

Thanks for the congrats on the returning to football, and likewise congrats to you on returning to skiing although you made your return about 2 years ago (so I'm a tad late)  !  :-[

I think I'll live with the instability. I don't think I could go through another rehab - 2 was enough for me.

I think you may on to something with the ergonomic assessment. I know how I'm supposed to sit, but it's hard to maintain good posture for 8+ hours a day. I've been putting it off, but I think I do need to go back to see a physio for my hip.

The climbing is fun (although also scary), but the main reason I'm doing it is because it is strenthening my leg muscles more than the gym does. It's also for the same reason helping with my shoulder.

Nick,

Good to hear from you too, and that you're progressing well with the running. I know what you mean about trying to re organise your life. I've also been spending less time on KG.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on January 27, 2013, 10:06:52 PM
I finally saw a physio for my hip pain.

He didn't have a definitive reason for the pain, but thinks I haven't done any permanent damage.

He's advised me to do the following :

1. Stretch the ITB & massage it with a foam roller.
2. Single leg dip in front of full length mirror, to see if the knee is moving laterally or medially during the movement.
3. Clam exercise to work the glutius medius.
4. Side-lying leg raise to work the glute.
5. Front-lying eg raise to work the glute.
6. Plank exercise to build Core (abdominal) strength.

7. Look into the possibility of getting a shoe wedge that will the balance out my shorter right leg.


Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 04, 2013, 11:32:24 PM
Since I've been doing my glute exercises, I've achieved an awareness of how weak my gluteus medius is and the effect this has on my gait when walking.

My left hip often "gives way" (as in my torso will bend to the left and my hip will move to the right) when I step with my left foot.

Imagine what my gait is like when running ... !  :)

No wonder I've been getting a painful hip !
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on March 05, 2013, 11:58:28 AM
Hi Deepak,

I too have a weak gluteus medius and been told PT and orthotics will benefit me and seeing a PT tomorrow for an assessment and advise. My gait is not great and still can't run since fall on black ice onto my right knee 6 weeks ago.

Should be able to sort it out for you and will find that you be in less pain with the correct type of therapy treatment.

[email protected]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 15, 2013, 09:16:57 PM
I'm a bit late with my update, but a week ago I saw a podiatrist, and asked her if getting a shoe wedge to correct the leg-length difference would help with the hip pain.

Interestingly, she didn't think there was any signifianct difference in leg length.

She had a look at my orthotics, and suggested that the orthotics may be the source of the hip pain (!) so I should try taking them out of my shoes, and see if my hip pain gets any better.

I've yet to try removing the orthotics, so can't report on whether it's made any difference.

I'll try this weekend, and report back after a week or so.
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on March 20, 2013, 05:15:05 PM
Hi Deepak,

Hope the Orthotics ease the pain for you and also find I get hip pain as well as knee pain and also been told regular PT can be beneficial if your muscles are tight and knotted that can cause a lot of hip pain and tightness in the buttocks.

[email protected]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on March 30, 2013, 11:38:52 PM
Well, it seems that the podiatrist was right, and that if I remove my orthotic and replace it with the original insole, the hip pain disappears !  ;D

The only problem is that because the orthotic is no longer correcting my over-pronation (http://www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/overpronation) I get pain in my heels - it seems a lot of weight is being transferred to my heels, rather than being evenly distributed throughout the foot.

One massive advantage of not wearing the orthotic in the gym, is that I don't get hip pain while using the leg press.

This suggests that the biomechanics of my leg were being changed by the orthotic to push my femur up into the hip joint causing irritation of the joint capsule. Well that's my guess anyway ...  I suppose I should submit another paper to the Knee Geek Journal of Orthopaedics.  ;)

Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: kcknee on March 31, 2013, 12:03:34 AM
That's great news that the hip pain is now gone once the orthotics were removed. If you search for overpronation shoes or sneakers on the internet there are certain brands/styles that may help more gently to support your foot without trying to push your femur up into the hip joint. Maybe just wear them for working out/sports.

It's good to hear that things are looking better.

Kristin
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on April 03, 2013, 05:40:43 PM
Hi Deepak,

Glad to see a member with some positive news to post for a change, pleased for you that the orthotics are helping to ease the pain for you and hope you carry on feeling the benefits.

[email protected]
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: ouch09 on November 09, 2013, 11:27:32 PM
I'm 3 months late with this update ... :-[

Back in the end of July I went on another mountain walking holiday. Unfortunately I twisted my left (reconstucted ACL) knee slightly when descending, and then had to limp down the trail. Luckily, it was near the end of the trail, so I only had to limp for about 20 minutes. I RICEd the knee, which helped with the pain & swelling but didn't resolve it.

When I got home, I saw my GP because I was concerned that I may have torn my ACL again. She was relunctant to send me for an MRI, since the Anterior Drawer test was negative. Instead she said I should take Ibuprufen for a week to see if it settled down. Well, I'm happy to report that it did settle down, although it took 4 weeks.

On the hip, my last report about the hip pain disappearing if I didn't wear the orthotic was over-stated.  The sensationalist tabloid reporter in me was lazy and looking to grab your attention with a simplistic head-line.  ::)

The broadsheet reporter in me can give you a more balanced view. The hip pain is on-going. I've found that it is better to wear the orthotic than not. I've been to see another podiatrist who said that this is a common problem with orthotics. He added a temporary section to the heel on the left orthotic, which has helped to reduce the pain. I'm seeing him again this week & he said he will make another adjustment to the heel.

I'm continuing with the gluteus maximus & medius strengthening exercises to better support the hip.   
Title: Re: Deepak's ACL reconstruction 24-6-10
Post by: Clarkey on November 19, 2013, 05:18:58 PM
Hi Deepak,

Glad your knee injury turned out to be ok, hips can become a problem if you have previously had knee problems. Orthotics can be very beneficial for hip and knee pain. Do you do any stretching exercises as I get hip and knee pain due to a tight IT band and knotted up muscles.

PT can reduce the pain as long as you stick to what you been told to do by your PT that I am sure you would do anyway. I have been given some stretches to do by my PT, I am unable get back to running again since fall on black ice in January 2013.

[email protected]