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Author Topic: a question for late in the stage rehabbers....5 months plus  (Read 6200 times)

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Offline sparkle999

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Hi there

my question is really how does the knee feel. As in pain and 'normalness' and responsiveness. The reason is that after being told to take a rest from strength work and keep a 'symptoms diary' I have become much more aware of what is still wrong in there. The ACL rehab is as much a mental challenge and ,like lots of people here, I have worked the knee hard and tried to ignore minor niggles, tweaks and twinges. I have made excuses for soreness like' yes but i really went for it in the gym yesterday' and have pushed on regardless.

Anyway. I need to know if how it feels now is the same for others.

Most pain is medial meniscus, but this has improved since acupunctute

I get pain in the morning when I first stand on the leg(only for 4 or 5 steps and not since acupuncture last week)

I get pulling twinges going up stairs.

I get pain weightbearing after sitting in flexion for a while(eg at the computer)

IT hurts for the first few of static quad contractions until the knee is comfortable in hyperextension.

Occasionally it feels like it's too far in hyper extension (eg when I get off the prone hamstring curl machine and first weightbear on it)

It never hurts just walking around and i am regularly on my feet all day with no symptoms.

I find walking downhill difficult

I cannot just run spontaneously.

I cannot hop without support

I can jump two legged very carefully

I twisted the knee a little out for a walk on Saturday and it recovered easily by Sunday.


Woah this is a long post but I really need to know what's unusual and what's par for thecourse. I know I have trouble because of my damaged kneecap, but even so I could dowith getting an idea of what is from the ACLR and what is just 'there'

xx
35 y/o
ACL rupture
loose body under kneecap
impaction fractures
injury 19th march 2005
scope 9th may
recon 24th october 05

Offline kevc

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #1 on: July 03, 2006, 10:13:44 AM »
Alot of things you have said sound familiar Sparkle however most of this stuff has resolved itself for me in the last two weeks.

I now feel I could runs spontaneously.  However admittedly first few strides would feel wooden but after that it wud be fine.  The only pain I ever get now is when the knee is cold after sitting for long periods in flexion.  I can hop without support but it feels wooden and not as strong as good leg.  I can jump two feet no trouble at all.  Going upstair is perfectly fine.  Going down is sometimes difficult - mostly ok now though.

I got the same issues with the prone leg curl.  I never use it now.  I always use the sitting leg curl instead.

Since doing agility work 2 weeks ago alot of my issues have resolved and I have noticed that my muscles are learning to fire up properly.  This in turn is making my leg perform much better when cold.  All in all i'd say my knee feels 80-85% now.  I have a physio review this morning for first time in 8 weeks so it'll be interesting to hear how she thinks im doing as she always finds something or other to criticise about.

Cos Ive been off work and rehabbing hard every day I think I am a little ahead of others on this board on a similar timeframe to me.  If I was in a FT job there is no way my progress would be so advanced.  My leg feels stronger now than it did two years post-op first ACLR!

So I think you are doing great Sparkle.  If I were you i'd be seeking permission to start aggressive strength/agility/plyometrics training now since you are on your summer break.  You could get loads of work done now and be 100% by September.

All the best
07/01 ACL rupture, left knee
08/02 ACL reconstruction (patellar tendon graft)
10/05 Re-tore ACL graft
01/06 Scheduled for ACL revision using hamstring graft

Offline henri

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #2 on: July 03, 2006, 11:43:13 AM »
I am 5 months and 2 weeks post op or so.I havent done the best exerciseses post op,have done things wrong,i havent had PT and have had some nasty falls.Still,my doc says everything is ok,atleast the stability.I got the flexion without no problems,i havent really worked with it,it just game back easily,atleast for me.
I dont have pain,mabe only if i make some sudden twist or strike my leg on the ground.Going up and downstairs hasnt been a problem for me like after 2 or 3 months post op.Hyperextention hurts on the hamstring part,i found it out like yesterday,because i just discovered i hadnt done any hyperextention ,because i was kinda affraid and stuff.Being on my feet it kinda strange still,if i have to stand on my legs,i dont feel the best,it doesent hurt,but its kinda strange still.
I cannot run spontaneously,but i can skate quite a long time,3 months post op did like 2 hours in a row or so.
I can jump normaly i suppose,not like as before the injury,i certainly wont go jumping on a trampoline:P but still,jumping is ok.
I think,i could be doing better,if i had done all right and by the book as kevc said,but still,i am ok with the results,it could be better,but it could also be worse.If you have any specific questions,go ahead.
unhappy triad

Offline kevc

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #3 on: July 03, 2006, 03:04:08 PM »
Hey Sparkle.

Im just back from PT.  My operated leg is fine - she thinks everything is well and good.  Instead the whole PT session was spent focusing on my right knee.  She diagnosed me with jumpers knee.  I have been told strictly no running or jumping activities for next two weeks.  It took her 15 mins to persuade me to abstain from these activities as I was not happy at the prospect of not doing them for a couple of weeks. To be honest it looks like I could require even longer rest.  Im gutted im going to be held back now.  I hope it resolves itself within the two weeks.
07/01 ACL rupture, left knee
08/02 ACL reconstruction (patellar tendon graft)
10/05 Re-tore ACL graft
01/06 Scheduled for ACL revision using hamstring graft

Offline sparkle999

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #4 on: July 03, 2006, 05:21:35 PM »
Kev

You WILL find it wierd, but it's quite liberating AND a learning thing to find other ways to exercise. my arms and shoulders are now in pretty good shape and I've got back to some of my social exercise classes I used to do with my friends. Like I said earlier, write down ALL your symptoms for a while and you will discover loads of things that may help your PT treat you. There's still lots you can do. eg I never bothered with the rowing machine as it wasn't leg focussed enough for me, but it does use the legs and in a slightly different way. I'll throw your own quote back that variety is good. If you do rest it totally 2 weeks may well be enough!

Good luck
xx
35 y/o
ACL rupture
loose body under kneecap
impaction fractures
injury 19th march 2005
scope 9th may
recon 24th october 05

Offline kevc

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #5 on: July 03, 2006, 06:14:42 PM »
Cheers Sparkle.

I think i'll cross train with cycling/rowing/eccliptical.  Squatting seems to be good for runners knee so i'll wait a few days and resume those.  Im sure after rest it will resolve.  What im worried about and what has happened in the past is once I resume activity the problem reoccurs.

After talking with my PT we have agreed I have been overtraining.  So when I do resume activity it will be at less intensity.  A lesson for everyone else: balance is key.  Dont do too little but dont do too much either!
07/01 ACL rupture, left knee
08/02 ACL reconstruction (patellar tendon graft)
10/05 Re-tore ACL graft
01/06 Scheduled for ACL revision using hamstring graft

Offline rocketman

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #6 on: July 04, 2006, 02:48:26 AM »
The only symptoms I can relate to from your post Sparkle at this point in my rehab are the walking down stairs and running spontaneously. Walking down stairs is better if I do it quickly.  If I do it slowly, it feels funny.  The runnning I believe is more mental.  My good knee has been hurting more lately, on top inside of the kneecap. Strange?  What does jumper's knee feel like KevC?  The one thing I think I'm lacking at this point is quad development on the inside of my knee right by the knee cap.
ACLR 1/16/06 w/ Lateral Meniscus trimming

Offline sharshar

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #7 on: July 04, 2006, 05:47:36 AM »
I'm 5.75 months post-op. Like you, I still have pain for the first few quad contractions until the knee is comfortable in hyperextension. It also sometimes feels like it's too far in hyperextension. I really want this to go away! Arghh.

I can hop without support, but my vertical leap is SOOOOO short. My explosive muscle groups are not very well developed at this point, but I do run or use the elliptical for at least 20 minutes every day.

Stairs, spontaneously running, and the other actions you mentioned aren't holding me back at this point.

Rehabbing this injury is REALLY teaching me patience! I hope you're faring well. Hang in there!
January 2006 - left knee: ACLR (allograft), partial lateral meniscectomy (~20% trimmed)

June 2007 - left knee: lateral meniscectomy (~5% trimmed), medial meniscectomy (~5% trimmed)

Offline kevc

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #8 on: July 04, 2006, 09:28:08 AM »
Its basically patella tendonitis Rocketman and it is extremely painful :(  I dont know why the condition has so many different names.  Its an overuse injury but it can turn into quite a serious problem if ignored. 

Conservative treatment includes ultrasound rest and then strengthening exercises.  I have to take two weeks off from running ang jumping activities to see if things improve.  My pain is at the bottom of my kneecap right in the middle of the patella tendon. 
07/01 ACL rupture, left knee
08/02 ACL reconstruction (patellar tendon graft)
10/05 Re-tore ACL graft
01/06 Scheduled for ACL revision using hamstring graft

Offline zengirl

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #9 on: July 04, 2006, 09:35:20 AM »
But Kev I have exactly the same pain - which is what stops me from extension, and I'm seven weeks post op. How can it be..?
Feb '03 Ladies badminton, bad fall, detached ACL
May '06 - ACL reconstruction & meniscus repair
Complications - swelling, pain, lack of flexion/extension, 50% graft failure
Jan '07 Arthoscopy, debride, removal of adhesions & 50% of graft
Attempting to rebuild muscles so can continue sport & life

Offline feeny

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #10 on: July 04, 2006, 02:37:15 PM »
Sparks-

Good question.
My knee doesnt feel normal - but depsite its abnormality it is also not holding me back from the things I want to do.
I cannot hop on it as long or as high as the other leg, my quads are bigger than ever but still not the same on both sides, and my hamstring is still weaker, my ROM (flexion) is not quite back yet... and I have a damn adhesion that makes my knee knock every step... Its probably this adhesion that bothers me the most simply because its so damn tactile and audible... that and my medial meniscus - like you - if I am going to have pain it seems to be in there.

I can run spontaneously and break into sprints in all directions... I actually dont ever find my knee troubling me mid exercise... well thats not true - but certainly not mid soccer game.. I forget about it when playing soccer - which I hope is a good thing.
After my last soccer game (Sunday) my knee troubled me a bit - but I went back to basics, stopped running for a few days and hit the bike etc and it seems to be alright again.

Lately I have been working in an office which has a right hand turn into a staircase... for some reason this combo pivot / descend onto stairs makes my knee click and grind every time. I find this disturbing too.
...oh and sometimes I tweak still when walking down hill! :)

A bit rambly, but thats how I am finding it. Some days it annoys me and reminds me its not quite my original knee. Other days I wont even think about it. But the main thing is it does not limit me - and I am *rarely* worried about hurting it in considering what I might do.


Sparks - it hasnt been a year yet - remember it is at least an 18 month cycle - you are doing great (dont forget this!) - and there is more knee-settling ahead for all of us.

Kev - remember that article I posted on drop-squats as a treatment for jumpers knee?
Sep-05 ACL rupture, Medial mensical tear, MCL rupture
Oct-05 Had it all repaired (hamstring graft, meniscal rivet)
-and then-
4.5 Months post-op Snowboarding like a demon
7 Months post-op Successful return to indoor soccer (YEH!)
-and then-
Mar-2015 Arthroscopy to fix meniscus

Offline kevc

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #11 on: July 04, 2006, 04:15:16 PM »
Judging from my first ACLR I think you are 100% correct about it being an 18 month cycle Feeney.  I remember a year post-op I had all the issues you describe apart from the tweaking.  Then at around 18 months it all disappeared and the knee felt normal.

Yeah I looked at the drop squat article again.  It is very interesting.  I will definitely incorporate those into my routine.  I was only doing two-legged squats 1 day a week.  I was doing one legged stuff all the other days.  So I might do two legged again.

Ive been told to strictly rest for next two weeks but I dont think i'll be able to do that.  I will keep working my aclr leg I think.  Then gradually reintroduce all other things.  I think my trouble in my good leg could be muscle inbalance.  My quads are much stronger than my hamstrings. 
07/01 ACL rupture, left knee
08/02 ACL reconstruction (patellar tendon graft)
10/05 Re-tore ACL graft
01/06 Scheduled for ACL revision using hamstring graft

Offline kevc

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #12 on: July 04, 2006, 04:31:16 PM »
Hi Zengirl. 

I just seen your post - I almost missed it.  I dont think you can blame lack of extension solely on tendonitis.  The surgery is obviously the main culprit in your case as it was in mine.  I had kneecap pain on my injured leg post-op but it wasnt the same as tendonitis.  It was behind the kneecap not on the patella or patella tendon.  It usually occurred when I did extension exercises for too long.  Thats why I suggested that rather than trying for one long stint try to break up your extension exercises into sets of 5 mins and build up from there.

You are still very early in the process.  My extension/pain/discomfort issues took 4.5 months to resolve.

I hope yours doesnt take that long. Im sure it wont as I had two major ops in 4 years.  I suppose Im just attempting to reassure you that what you are going through is normal enough for some of us.

Good luck
07/01 ACL rupture, left knee
08/02 ACL reconstruction (patellar tendon graft)
10/05 Re-tore ACL graft
01/06 Scheduled for ACL revision using hamstring graft

Offline celinenj03

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #13 on: July 04, 2006, 04:51:35 PM »
This is a great thread. Definite REALITY check for all of us. I agree that it is an 18 month process  total turnaround time and we just all have to darn well accept it. I mean it's great to be back to sport at 7 months, but we shouldn't get down if it isn't quite perfect yet. I say that for myself believe me cause I know how I get with my expectations at barely 9 weeks. We have to allow ourselves to still hurt and tweak and swell. This is MAJOR surgery we had.

Anyway, I had patella tendon pain pretty bad from what I believe was doing too much way too soon without having adequate muscles strength. I couldn't do wall sits they killed (should have worked my way up more to them). Then going up stairs started to hurt in the kneecap very painful throb every time. I decided for myself to STOP for a few days. It's been about 5 days of resting it from those certain exercises and stairs are fine again. So I'm definitely sold on the rest for awhile thing with knees. Kev is right you can still exercise and get strong but this patella tendon/kneecap thing is really touchy. You have to be careful with it.

Kev, I appreciate your posts so much because you didn't have a perfect recovery, you had the most realistic recovery and that is what I can relate to and it encourages me that just because you have a problem this week, doesn't mean it's for life! Thanks a lot for your posts and please take care, you are doing GREAT.

Terrible Triad - 1/16/06 - Basketball
3/15/06 - Scope/Cleanout of to achieve full ROM
5/3/06 - Surgery-ACL Reconstruction-Allograft
9/12/07 - Large Loose body removed;Grade 4 Lesion on LFC
9/17/08-Microfracture, Lateral Release (all right knee)

Offline kevc

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Re: a question for late in the stage rehabbers....5 months plus
« Reply #14 on: July 04, 2006, 05:17:45 PM »
Right back at ya Celinen :)

I think your approach and attitude to ACLR is great.  I have learned alot from my first ACLR.  I reckon if my last op had have been my first ACLR then I would have made similar mistakes and I would have been much more frustrated and perhaps would have given up.  Not this time though!  This is a minor setback but like you say its only temproary.

My trainer rang me this afternoon.  He laughed and said 'you know this is sort of good news'.  I said 'what'.  He said it tells him that I have been working damn hard at the rehab.  He has had 11 aclr cases in the last year all with complete success.  He told me to completely rest for two weeks cos I am 4 weeks ahead of where I should be in terms of progress.  So that lifted my spirits.  I still cant get my head around resting and there is no way I will be doing nothing.  I'll see how it goes.

Thanks Celinen
07/01 ACL rupture, left knee
08/02 ACL reconstruction (patellar tendon graft)
10/05 Re-tore ACL graft
01/06 Scheduled for ACL revision using hamstring graft















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