ACL Reconstruction Recovery

[Mike Kelley]

well I had physical therapy again today

my PT was stunned to say the least

he put me on the bike so I could work on my range of motion and I got my leg going all the way around in about 20 seconds...so he lowered the seat to make it more difficult...same thing. I peddled pretty easily for about 10 mins (he didn't want to take the seat down any lower)

then I:
pushed myself around with my heel on a rolly chair
weight shifting exercises
step ups
partial squats
balancing on one leg

I think I was just as surprised as he was at how much I could do with no pain at all...people keep telling me not to rush things and it's getting annoying because I know I shouldn't rush and I don't plan to. They somehow think because my rehab is going very well that I'll jump back into things too quickly, which isn't the case.

Oh well...good day...I need drugs..and a nap

[Mike Kelley]

had another PT session today

straightening my leg is only off by 1 degree
and I can bend it to about 113 degrees

I can also walk around with out a brace on (I won't be testing this out that much, but for the 1hour PT session it was no big deal)

all after having surgery 1 week ago...

[Caz Berkowitz]

Mike,
On Sat I did 10x 3mins on the exercise bike, no resistance. On Sun, 4x (was kinda busy and not near the bike).

I'm confused on the purpose of the brace. It seems like it keeps the leg stretched out at night, prevents twisting when walking and prevents over extension if you slip. That about it?

Not trying to rush things but I was walking around without the brace on Sun. I also accidentally took the dog for a walk without it. Changed clothes and just forgot to put it on. I'll try to be more careful....

I see my surgeon today for the first time since surgery. Any questions you forgot to ask yours that I should ask? I'm going to be asking him what I can do to heal as completely as possible. I'm guessing he'll just say give it time and do PT.

I want to compare PT notes once I get going. My guy didn't seem real gung ho when I saw him for 8 sessions pre-op. But he was friendly and let me increase the leg press weight to where it was doing some good. I have a feeling that I'm going to be managing my post -op therapy more than him, but don't really know where I should be going yet.

[Mike Kelley]

Caz

not sure what kind of graft they used for yours, but mine was my hamstring...basically my hamstring and quad are both weak right now so the brace prevents the knee from hyperextending which can happen with little quad and hamstring control

even though I don't need it, the Ortho said it's better to keep it on for 3-4 weeks just to make sure everything heals properly...def. don't want to be in a rush now if there's any potential it could slow healing and screw things up in the future

as far as PT goes...the ortho said to be conservative with it...probably no real lower body lifting until 3 months out, but what it really comes down to is what you're comfortable with...the big thing is just taking it slow and trying not to convince yourself that you're doing better than you really are.

The PT will help you get your ROM back and then after that focus on strength and balance stuff. I'm only going 'til the end of December and then they said they'd give me a plan to follow on my own (since I'm graduating and my parent's insurance stops covering me in January).

sometimes it's sketchy because the PT will say "ask your doctor this" and the doctor will say "it's up to the PT" which does no good...you might have to take some liberties and just start "being your own doctor" during some of those points and decide what hurts/what doesn't and what you really can do

[Caz Berkowitz]

Mine's a allograft. Donated ligament from a cadaver, so no issues with me needing to heal up my own doner site.

I'm sure I'll be dropping out of PT fairly quickly as (unfortunately) mine was a Worker's Comp issue and State Law limits the number of PT visits I get.

I've already got a little of the "ask your doctor/ask your physical therapist" routine. So I need to go into my two appointments this week with my PT guy prepared to "guide" him. But I really don't know what limits I should be working up against - I'm really, really, really hoping he does and can push me up to them!

[Lisa Fairclough]

Good work guys, I have my second post op PT tommorrow. I was never given a brace at all after my operation, which did worry me at first when I had to start walking about but I was just fine without it, now this does not mean you should not wear yours!

I'm sorry to hear you both won't be reciving PT for much longer than december, I will have full PT till the end of my recovery. So if there is any further questions any of you need to know after your PT has finished I could always ask mine!

[Mike Kelley]

sounds good Lisa

I really just needed a list of what NOT to do because I don't want to take the chance that I'll tear it again

this is basically what they said

weeks 1-6
basic ROM work, some balance, little strength
within this time period the screw/staple are being surrounded by new bone (and "locked into place" so to speak) so it's important not to overdo anything

weeks 7-12
balance, lateral motion, strength (start back LIGHT weight training around month 3), and continue ROM/flexibility (ex. slide board, one-leg press, bosu ball work)

3-6 months
ACL is at it's weakest so avoid cutting/pivoting and continue working on balance/cooridnation, strength

[Caz Berkowitz]

It’s great being able to compare notes on this!

Saw my surgeon today for the first time since the operation 6 days ago.

He said:
He used an Achilles tendon for my replacement ligament.

In 3 months the allograph bone plug will be fused to my bone.
In 6 months the allograph tendon will be absorbed and replaced by my own tissue.

The purpose of the brace is just to provide support if I slip. Its purpose is not to keep the leg stretched out while I’m asleep like I had thought. So I’m NEVER sleeping in it again. He said wear it for two more weeks or so more and keep the flexion locked at 70 so it won’t totally hyperextend the leg if I do slip.

He found a small 9mm tear in my meniscus that didn’t extend through the depth of the meniscus so he didn’t repair it as it should heal on its own.

He said the ACL PT therapy is pretty straightforward and that my PT guy would know what to do without further instruction from him.

I told him I took a 2.5 day fight seminar last May that involved a lot of running, tackling, kicking and punching and I wanted to attend again this May. He said I was free to go, and that I should take lots of notes cuz I wouldn’t be doing any of the physical stuff.

He showed me photos he’d taken of the operation.

He said the ACL was about a 4 in terms of difficulty with a total joint replacement being a 10. He said my operation was completely routine and uneventful.

I’ll start physical therapy tomorrow and will check back in after that.

[Caz Berkowitz]

My first PT was pretty disappointing.

Therapist took some measurements (I have 115 degrees of flexion), asked me some questions about pain, stability, etc. and then put me on a bike for 10 mins. Put me on the hip abduction machine for 3x15x75 to both the side and back and then hamstring curls at 3x15x10. Then he iced my knee. Boooring.

I understand he wants to start off slowly and see if my knee has a negative reaction to exercise. That’s probably good policy and I’m probably going to have to be cool and give my body time to heal, even though I feel ok. Knee is still swollen and there is probably internal turmoil that I should give time to simmer down before I get overexcited about working out.

I kept talking to him the entire time about overall goals and got a copy of the protocol he will be following. I have to look at it in detail but it ends up a year from now with me hopping on one leg. It does have a clear set of steps to follow and tests that must be met before moving on to the next step so the time frames can probably be ignored (once you account for the time it takes for the grafts to heal).

I’ll email a copy to anyone who wants one.

He did say I was in a far more advanced state than he’d expected I’d be. Not bragging, since I have nothing to do with how well the surgery went, but I do feel lucky to be pain free and fairly mobile and he has treated a lot of ACLs so he has an idea of what the typical healing progression looks like.

I see him again in two days.

[Mike Kelley]

Caz, check your PM (I want a copy)

also...anyone else notice bruising on your foot at all? The Ortho was asking me if my foot was swollen (which it wasn't) but today I noticed some bruising (doesn't really hurt) on my heel