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Author Topic: Slow and Discouraging PT after PCL/MCL Surgery  (Read 3207 times)

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Offline amandaberry

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Slow and Discouraging PT after PCL/MCL Surgery
« on: May 19, 2011, 05:24:52 PM »
I had a skiing accident February 27th where I ruptured my PCL and MCL.  I had surgery 8 weeks ago to reconstruct the PCL and repair the MCL.  After 2 weeks of PT, I cannot gain full extension and only have about 70 degrees of flex, after painful stretching and with the therapist pushing hard.  They may need to put me under and forcibly push my knee bent.  I still have a lot of swelling, which is painful and inhibits ROM.  Is this normal? 

I am so down and discouraged and in a lot of pain.  I work hard at my exercises, but am starting to feel they are useless.  Then I start to think that if I just worked harder and could tolerate more pain I would have more success with my ROM.  I'm beating myself up for being a wimp.  My boyfriend tries really hard to be encouraging, but there isn't much he can say or do to help.  He tells me I'm doing great and making progress, but it's starting to sound hollow.

Can someone put any of this in perspective for me?  I know it's only 2 weeks into PT, but the therapist seems baffled as to why my joint is so tight.   :'(

Thanks for any help you can give. 

Skiing accident February 27, 2011.
Fully ruptured MCL and PCL.
MCL repair and PCL reconstruction March 25, 2011.
LOA/MOA June 30, 2011
PT PT and more PT

Offline Ironjill

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Re: Slow and Discouraging PT after PCL/MCL Surgery
« Reply #1 on: May 20, 2011, 02:23:22 AM »
Sorry to hear you are in so much pain and feeling down. This whole knee injury & rehab process really is a bugger! Two week is a really short time after such a major surgery. I think I was only at 90  degrees rom, if that, by then so I don't think you are way off the mark. Do you have a rehab protocol from your surgeon? It should give you some general guidelines around what rom and activity levels you should be at for the different phases as you progress through rehab. It's key that your physio follows your surgeons guidelines to the letter.

The PCL & MCL rehab (and there are not many of us) is very slow with a controlled rom progression and post op bracing.  If you have any concerns please refer it back to your surgeon, he or she is the only one who can truly provide the right advice for your situation.

Stay in touch.

Jill
April 4 2010 skiing accident :
R. Knee ACL rupture, grade 3 MCL tear, tibial plateau fracture, separated meniscus, meniscus tear.
L. Knee PCL rupture, grade 3 MCL tear, meniscus tear
Aug 18 2010 R. Knee ACL reconstruction with allograft.
Oct 15 2010 L. Knee PCL & MCL reconstruction with allograft.

Offline amandaberry

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Re: Slow and Discouraging PT after PCL/MCL Surgery
« Reply #2 on: May 20, 2011, 08:36:49 PM »
Thanks so much for the reply and the help, Jill.  PT was better today - bent to 75 degrees without too much pushing.  I wish I had more patience and wouldn't get so frustrated!  I meet with my OS on Tuesday and will discuss my progress with him. He and the physio are in the same building, so I think she is going to meet us at my appt so we can make sure everyone is on the same page.  I think as long as I can keep progressing 5-10 degrees a week I can make it through this. 

Skiing accident February 27, 2011.
Fully ruptured MCL and PCL.
MCL repair and PCL reconstruction March 25, 2011.
LOA/MOA June 30, 2011
PT PT and more PT

Offline amandaberry

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Re: Slow and Discouraging PT after PCL/MCL Surgery
« Reply #3 on: June 25, 2011, 04:31:32 PM »
Hi Jill,

Just an update.  PT continued to be slow.  We got to about 80 degrees in late May, and then stayed there for the next three weeks - most frustrating time of my life!  I saw the OS and we decided to do LOA/MUA, so we have that scheduled for Thursday June 30th (soon!).  I'm looking forward to it, but am trying to keep it in perspective.  The surgeon makes it sound like it will be a magical cure.  I think it will help, but I know that afterward the real work begins!  I have PT scheduled for the Friday directly after and hopefully I'll be able to get a real sense of where I'm going from there. 

For now I'm continuing my extension exercises - stretches and quad sets. 

Keep your fingers crossed for me!

Thanks again for your help!

Mandy

Skiing accident February 27, 2011.
Fully ruptured MCL and PCL.
MCL repair and PCL reconstruction March 25, 2011.
LOA/MOA June 30, 2011
PT PT and more PT

Offline Ironjill

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Re: Slow and Discouraging PT after PCL/MCL Surgery
« Reply #4 on: July 16, 2011, 03:56:38 PM »
Hi Mandy

Sorry to hear your progress has continued to challenge you. How did your manipulation go? I hope it has managed to give you some more ROM. Sounds like you are doing everything right and staying on top of the physio. I know how frustrating it can be, and very boring too, but gotta stay with it.

I had a bit of a relapse myself recently, I went from being able to bike 100k to not being able to walk 100m! Turned out to be a loose body in the knee. Trouble is it has either dissipated or is hiding someone so we don't want to do a surgery at the moment. I am continuing to improve from it and back to riding the bike. If it rears it's ugly head we go get it out but otherwise I'll just continue the rehab. My doc said it takes 2 years from this surgery to reach the max recovery and he wants me to continue lots of biking and gym sessions 5 times a week until then to get optimum results.

So I guess we are both in it for the long haul. Keep working it, don't give up.

Take care

Jill
April 4 2010 skiing accident :
R. Knee ACL rupture, grade 3 MCL tear, tibial plateau fracture, separated meniscus, meniscus tear.
L. Knee PCL rupture, grade 3 MCL tear, meniscus tear
Aug 18 2010 R. Knee ACL reconstruction with allograft.
Oct 15 2010 L. Knee PCL & MCL reconstruction with allograft.

Offline amandaberry

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Re: Slow and Discouraging PT after PCL/MCL Surgery
« Reply #5 on: July 31, 2011, 03:09:09 AM »
Hi Jill,

Thanks for the reply.  Sorry you're having trouble!  I'm still trying to wrap my head around how long and trying this recovery is.  It's hard to balance set-backs with staying positive.  Hope things are going well with recovery and that your pain is minimal. 

My second surgery went well - they removed A LOT of scar tissue, and then were able to flex my knee to about 125 or 130 degrees while I was still under anesthesia.  I had a lot of swelling and soreness after this surgery, but am having some success.  The day after the surgery I was able to flex to 90 degrees on my own.  Considering I'd only gotten to 70 degrees or so prior, this was a great start.  We are now at about 115 degrees on my own.  I can go around on the stationary bike, so have been using that at PT and at the gym on my own.  We have started more aggressive strengthening and continue to work ROM.  The joint is still really stiff, but at least we are making solid progress every week.  For the first time, I feel like I might actually recover from all of this! 

Take care of yourself and best wishes.

Mandy
Skiing accident February 27, 2011.
Fully ruptured MCL and PCL.
MCL repair and PCL reconstruction March 25, 2011.
LOA/MOA June 30, 2011
PT PT and more PT















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