The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Gaurav on September 16, 2018, 04:48:13 PM

Title: Not confident while walking on uneven surface (11 week post op acl)
Post by: Gaurav on September 16, 2018, 04:48:13 PM
Hello everyone,
Can anyone please guide me or tell there experience after acl recon,  I am 11 week post op acl surgery, but still not confident while walking on uneven surface. I am doing my phsyio regularly,ROM is good, extension is normal not same as other leg.  So can anyone tell me how much time is needed more to walk normally outside home?

Thanks in advance!
Title: Re: Not confident while walking on uneven surface (11 week post op acl)
Post by: BornToRun on September 16, 2018, 08:39:26 PM
Iíd say a while yet! Iím at 22 weeks and still not fully confident on uneven ground. Iíve only just lost my limp, though it does pop back in if Iím tired or my muscles are stiff from exercise. I still feel my hamstring graft site and hamstring tightness when Iím walking as well.
I completely understand your frustration, it feels so debilitating to struggle with such a basic thing. But just to reassure you that itís perfectly normal. Recovery just takes a very long time unfortunately. Different people also have different problem areas, and walking was definitely one for me because of my hamstrings. All you can do is continue to do your physio religiously and be patient (easier said than done, I know).
By the way, just to clarify - did you mean you do, or donít have full extension in your leg?
Title: Re: Not confident while walking on uneven surface (11 week post op acl)
Post by: Gaurav on September 17, 2018, 11:39:52 AM
Thanks for sharing your experience, it is always very helpful for me.

Regarding clarification,  I have full extension means 0 degree, but not the hyper extension equal to sound leg.  But when I am doing any excercise to increase hyper extension, then it improve for few hrs then again back to 0 degree.

Walking is really trouble me, on uneven surface I am taking baby step, got some hope after reading your answer, that you got slight improvement, walking without limp.

Can you please tell me your excercise schedule? Means how many times in a day you are doing excercise and which are those? 

For now I am doing work from home, so get more time to do excercise, but now want to join work again, so is it enough if we do excercise once in a day?

I know my phsyio or doctor is appropriate person to ask, but just want to hear your thoughts or your experience.

Thanks in advance.

Title: Re: Not confident while walking on uneven surface (11 week post op acl)
Post by: BornToRun on September 17, 2018, 02:50:01 PM
Hi Gaurav, the hyper extension/ 0 extension is a tricky one, definitely something you want to talk through with your surgeon. I don't hyperextend so it's not an issue for me, but I know that ACL grafts are generally "set at zero" so to speak, rather than at hyperextension. There's some debate whether it's a good idea or not to push to hyperextension. Some think zero extension could make the knee more stable. Your surgeon will know best what he/she has done inside your knee and what's best for you. If your surgeon has told you it's OK to push to hyper extension, do. But if not, best check with him/her first.

On the exercises, yes, you've guessed it, I was going to tell you to talk to your physio  :)

My own experience was that my physio moved me from several short sets of exercises a day to one longer session a day at around week 5. That definitely did make life easier with going into work. From about week 8, as the exercises got harder, I was told to start taking two days a week off to rest the muscles. So I did three days on, one day off, and so on.

The exercises have varied. It started off with the usual leg raises (no heel slides, my physio wasn't bothered about those), squats sliding on a cushion/ball against a wall, two legged hamstring bridges, the usual. Then I started something called vascular occlusion training with wall squats and static lunges (split squats). This explains a bit about what it is, but it involves restricting blood flow to the exercising leg to build fast twitch muscles Definitely not one to do unsupervised though!

I also did one legged bridges lying on the floor with the operated leg up on a chair, hamstring curls with a resistance band, step downs, a sideways squat hold called a McConnell squat to work on the VMO and medial hamstrings, single leg calf raises, and a number of exercises for the hamstrings, like a cobra stretch and a single leg Romanian Dead Lift. I did body weight only exercises until about week 17, when I started adding weights- first 3kgs, then 5kgs. I also did an assortment of bike intervals for about 20 minutes at a time at the end of each exercise session, including some standing up on the bike from week 16.

At the moment (week 22) my schedule has changed a bit again. I do exercises at home on Mondays and Fridays, and a 45 minute static weights class at the gym called Body Pump on Tuesdays and Thursdays. I used to do it pre surgery and the physio sent me back to it a couple of weeks ago. It's only squats, lunges and deadlifts on the lower body side, and all static - so very controlled. The physio told me to use 2 x 5kgs on the bar for now for the lower body. I do one longer (40 minute) intervals session on the bike during the week, and another one at the weekend. Wednesdays and one weekend day are off. The exercises at home take me about 45 minutes to do and are squats loading the operated leg (just the toes of the good leg on the floor), a wall sit squat raising and lowering my heels, and Bulgarian split squats, all with weights. I also have the McConnell squat holds, step downs, one legged chair hamstring bridges and calf raises for the VMO/hamstring. I also do an exercise called a superman for the hamstring, kneeling on all fours, squeezing a ball behind the bent operated knee, and lifting that leg up behind.
All going well I should start some very short, very light running in a couple of weeks or so.
Again, this is all just to give you an idea of what it's been like for me. Don't try doing any of the above without checking with your physio first  :) :) :)
Title: Re: Not confident while walking on uneven surface (11 week post op acl)
Post by: Gaurav on September 19, 2018, 02:45:51 PM

Thank you so much for sharing your experience and clearing my doubt regarding walking and Yes I will not try all those excercises, just want to know what you are doing at this stage, so i can get some idea  :).  Thanks once again.