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Old 08-10-2007, 01:47 PM   #1
Rex Hansen
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Hey all.
I hurt my knee on 7/23. On 8/3 a MRI revealed a total tear of the ACL and 75% tear of the MCL. No other damage.
I'm working on getting a consult with a surgeon, but this may take a while and in the meantime I want to make as much progress as possible. My current doctor is pretty worthless so I'm asking if anyone with info or experience in this area can tell me:

Should I be working on increasing my range of motion now (pre surgery)? I currently can't bend the knee 90 degrees or fully extend.

Should I be isolating (like in a split) the joint when walking or try to get as much motion out of it as possible (without causing more damage/pain)?

Is the prescribed ibuprofen 600mg 3x daily necessary to keep swelling down or is that just for pain relief?

Do I continue to Rest, Ice, Compress, Elevate or is that something you just do after the initial injury?

Any tips on post-injury but pre-surgery treatment would be appreciated. Thanks!
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Old 08-10-2007, 03:43 PM   #2
Lisa Fairclough
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Hi Rex, I have the exact same injury as you right now. I had an arthroscopy the other day to check what the damage was and to unlock my knee because I couldn't fully extend it either, I injured it over a month ago. So far my physiotherapist has just had me trying to strenghten my quad on the damaged leg simply by lying it flat, pushing the knee down and tensing the muscle for a few reps. I have just moved onto straight leg raises too, and resting my foot on a basketball and rolling it back and forth.

It took me a few weeks after I injured it before I could resume any sort of exercise, but I am limited to mostly upper body training and low impact cardio for now. Cycling was recomended to me but its not yet in my range of movement, but as everyone has told me so far the stronger your leg is before any reconstruction the better.

I'm still pretty new to this injury but from what I have seen so far there are pleanty of people on here who have recovered from it.

Good luck, hope you get help soon!
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Old 08-10-2007, 05:14 PM   #3
Derek Maffett
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Yeah, people who mention ACL problems usually seem to talk about them in the past tense, so hopefully, you should recover just fine too.

Edit: Oh, yeah, and you too Rex! There I go again, forgetting the OP.:doh:

(Message edited by Benedict on August 10, 2007)
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Old 08-14-2007, 07:25 AM   #4
Nick Cruz
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A post surgery fellow myself. I too had the exact same injury. Fortunately the surgeon was able to leave the MCL alone to heal on its own. I hear that the way the MCL attaches makes it very difficult to replace without losing ROM. The ACL attaches at a single point, wheras the MCL looks like a fan with multiple attachment points.

But I digress. I got the same pre-surgery excersize protocol that Lisa got. Focus on contracting the quad in order to help build up strength. There will be a lot of swelling and that will make it hard to accomplish this but it gets easier as the swelling goes down.

I was also told to ride a stationary bike as much as I could. If you cant complete a full revolution because of lack of ROM, then just concentrate on moving the pedal back and forth using as much ROM as possible.

By the way, have you started looking at the different replacements available? Allograft vs autograft? I had a allograft done with an Achilles tendon. This is what my surgeon recommended for me because of my size (6-2). I have not had any issues with mine other than it being pretty tight for a long while. In fact, I didn't get full ROM on my knee until after I started with Crossfit and doing lots of squats and Oly lifts!

To sum up, strengthen the quads now before going into surgery. Work on your ROM now. Research your replacement methods and your surgeon.

One more thing to keep in mind. the surgeon will likely want to wait until your swelling is down completely before doing surgery. It was nearly 6 months from injury to surgery for me.

Good luck with your progress! If I can do it anyone can!

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Old 08-14-2007, 11:06 AM   #5
Rex Hansen
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Thanks Nick and Lisa (oops, forgot to thank Derek!:harhar00:).

Haven't even considered surgical options yet, waiting on my doc's appt. I'll start researching that soon.

Found this site:
http://www.kneeguru.co.uk/KNEEtutor/...uciate_rehab06
which seems to have a pretty good plan for pre-surgery rehab. So for now, I'm just moving through the stages on that site (I'm at stage 2).
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Old 08-14-2007, 11:20 AM   #6
Rex Hansen
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I see cycling is recommended for everyone. What about rowing? Seems like you could make it work even with a limited range of motion and all the movement is in a straight line.

(Message edited by rex on August 14, 2007)
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Old 08-17-2007, 09:38 AM   #7
Lisbeth Darsh
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Another ACL replacement vet here. Cycling is really the best thing to do. Better range of motion than rowing and exactly what you will need to do after surgery. As my physical therapist said, "Even if all the doctors were kidnapped by aliens and you still just rode your bike for an hour a day, you would be all right."

Ride now. Ride after. 2 days after surgery, I crutched over to my road bike (on a trainer) and began the road back. A month later, I was back on the road. Within 9 months, finished another triathlon. The bike will save you . . .

Good luck!
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Old 08-17-2007, 02:25 PM   #8
Derek Maffett
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Haha! Good one.
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Old 08-21-2007, 01:38 PM   #9
Rich Stackon
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Re: ACL tear -PRE surgery physical therapy

Pre-op, you should only be working to minimize pain and swelling using the RICE method. I had the same injury you have, and trust me- any pre op exercise you do will be gone after your surgery. Don't place too much weight on it of work it too much, you can damage the meniscus and set yourself up for long term joint injuries. Just stay off it and keep it isolated.
After the operation, get on the bike, use the leg press machine, and strengthen the quads.
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Old 08-21-2007, 08:17 PM   #10
Gant Grimes
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Re: ACL tear -PRE surgery physical therapy

I had a 100% ACL + meniscus tear playing rugby. I also jarred my SI joint on the hit, which affected my rehab (because I didn't know about it).

I was stupid. I knew I was going to have to wait for surgery, so I played a season of softball (at pitcher) with no real problems. I asked the doc about going to a rugby tourney (it was already torn, right?), but he said no. He also said I didn't need to do much pre-hab because my leg would be wiped out anyway. He was right.

Nick's advice about seeking different alternatives was spot-on. My doc drilled through the femur. He said it would make a stronger graft and enable me to keep playing contact sports. It destroyed my quad and caused a great deal of pain for 2-3 days after surgery. The rehab took longer as a result of my non-existent quad (it's still smaller to this day).

Having SI joint problems resulted in the legs being different lengths (and developing differently). I just started retraining my leg a couple weeks ago--4 years after surgery. It was not a great experience.

The good news is that I found mountain biking as a result. I started CF several months ago, and it was the first time I squatted or sprinted since the injury.

Just keep on top of it.
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