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Author Topic: 2nd knee Surgery. ACL Reconstruction. Denovo. Hopefully Meniscus Repair  (Read 8879 times)

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Offline icarus

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Re: 2nd knee Surgery. ACL Reconstruction. Denovo. Hopefully Meniscus Repair
« Reply #45 on: August 17, 2017, 12:06:56 AM »
I'm able to run a 8 minute mile without pain now. Today was the last day of Physical therapy with appointment. I can always call in within the next few months to schedule something, but otherwise I am good. I took a single leg vertical today and my right leg got 13.5 inches while left leg got 12 inches. This means they are about the same strength. For horizontal single leg, my right was a bit behind the left, but around the same. We talked alot today about return to activities. For free-weights, there may be evidence that suggests that some shear forces is good for cartilage growth. However, need to make sure that the weight is always on the center of the foot when doing squats. Front squats are probably better than back squats.

For cutting sports, the most important thing is to never twist the knee. Knee twisting happens most often during fatigue when the foot is planted on the ground. The weight should always be on the front of the foot and the heel should always be off the ground. One good exercise is double tap side-to-side hops. However, the cutting motion is very hip-dependent

Today, Physical therapist showed that I could be getting back pain due to back rounding during the Single Leg deadlift and the standing clamshells. The fix is to do the Single leg deadlift with a stick on the back to prevent back rounding, which means that I may not go as low when reaching down (may be caused by hamstring tightness). For the clamshell, I now do them laying down on the side, both legs bent and both feet touching. PT put a finger on my right hip and had me push into the finger to make sure that the back had good alignment, this also caused the clamshell manuever to be alot harder. This means that the hip should be perpendicular to the bench. Elbow should be out as in plank maneuver.

PT also examined my running, for the most part the running form is good. PT noticed that my foot shakes a little when coming off the ground, and this is present in many runners, and may not indicate anything serious, but some theorize it could be due to IT band tightness.

I showed PT my single leg squat, and PT mentioned that I do not have to go that low (so that I prevent my back from rounding too much and I should also keep my butt out), and also that I was “cheating” with my hip by making it go outwards to get my knee to not bow inwards.

For exercises, I should be moving up to hopping and side stepping and a lot more jogging. I was given a program to follow for this.

Had physical therapy on the 30th of June. Did Chinese cupping therapy along the IT Band. I had been walking to and from Bus station (30 minute walk each way with ALOT of hills) and found that I would get pain along the outside of the knee sometimes. I would also get pain there when trying to do a squat at around 30 degree bend. After the cupping therapy, the pain with the squats was gone. I have not tried walking that route to see if that pain is gone yet. During the assesment, PT found that my hip muscles were alot weaker on my right side and musculature overall was alot smaller though they all fired sufficiently. She suggested that I start weightlifting to get back the musculature otherwise it would remain the same. However, for IT band treatment, the usual cause is not recruiting the hip muscles, so I was given exercises of Single leg dead lift (4 sets of 10) and standing clamshells (3 sets of 15).
Another Hip Abduction exercise I found online called Walt-Reynods

Today realized that right knee has valgus or inward rotation when doing lunges, one leg squat etc. This is very bad for knee, and left knee has no valgus. Found that if I stand with knees straight, I can rotate right knee outwards to practice varus and activate vastus lateralis which is much smaller on right knee than left

05-20 Meeting with OS
1) What about ACL Tunnels from first surgery?
Not a problem. The bone should be filled.
2) Sometimes when walking uphill or downhill, pain on lateral side.
He says to monitor the pain
3) What frequency for pt now?
No need for PT now
4) When can I start sprinting full speed and jumping?
Can start.
5) Kicking a ball? Shear force?
Alot of shear force in the whip motion during wind up.
6) Will the cartilage underneath the meniscus repair get filled with fibrocartilage?
Hopefully so
7) Will the ACL graft get worn out?
No. ACL will either break completely or be fine. Does not get worn out.
8) More of a comment from my side:When lying on side with right leg on top, if I bend the knee, there may be locking. Sometimes when there is locking, when I force it to unlock, there will be a protrusion pop. This hasn't happened in a while. If I push down on my quads like a massage, that will help unlock
9) What kind of pain would I feel if meniscus repair failed?
Same as cartilage pain, it would be on the lateral side of knee along the incision of first time meniscus repair
10) What is the status of the meniscus repair?
The suture points should hold, But these are the strong points in the repair. Basically not much blood goes to that region of repair, so the most that the tissue will do at the tears around the suture points are scar over on the surface to hold the meniscus in place. If the suture fails, then these scar tissue will also fail.

Today is the physical therapists last day. I asked for an up to date report, and I will have to find another PT.

Today he showed me how to roll out hip flexor. Find the hip bone and then underneath it closer to the groin is the hip flexor. Roll perpindicular from proximal/medial to distal/lateral. Also need to roll out quads from proximal/medial to distal/lateral near the knee.

For lunges, can start doing them without weight, but take very long strides to feel the stretch on the trailing leg and also hold for 10 seconds each.

Ran at the gym. Went up to 6.2 Speed without much pain. Had to stop to tie shoelace and when restarted, went back up to 6.2 too quickly, so there was tightness.

Went up to 6.2 speed today with absolutely no pain for 1.3 miles total (walking in the beginning).
Before running, did reformer one leg press, step ups on 1 ft. platform, and 2 leg jumps on 6 inch step. Jumping with two legs is not bad on ACL because there won't be any twisting.
PT said I can start running on concrete, go slowly downhill. Downhill will use more ankle by using forefoot strike rather than heel strike. Make note of any pain so that we can train to prevent it.

Went up to 6.0 today  at around 0.25 miles for total of 1 mile

Went up to 5.7 at 4 minutes, and went in total for 12 minutes and 1.0 miles. There was some mild pain when I tried to adjust the landing. If I don't land with enough knee bend, it will hurt.

For lunges, need to be wary of back position. I am leaning too far forward, so I should keep my back straight similar to how i do the hip stretch by pushing through groin area.

Jogged at 5.5 speed. Only thing that really hurt was calf getting tight.