ximian's ACL reconstruction journal

Discussion in 'Health & Fitness' started by ximian, Jun 16, 2010.

  1. ximian

    ximian Rookie

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    Hello everyone. I had the unfortunate pleasure of tearing my ACL about 4 weeks ago playing basketball. 10+ years of tennis with no hint of knee or ankle problems, then one month of basketball and here I am with a blown ACL. Don't do drugs, and don't do basketball kiddos!

    Anyway, I'm going to chronicle my ACL surgery and physical therapy journal here since I'm sure I'm not the first and won't be the last tennis player to deal with an ACL tear. A little about me:

    Pre-injury stats:

    Age: 24
    Height: 5'11"
    Weight: 160
    Body Fat: < 10%
    Playing level: Collegiate / Open Level

    Injury details:

    Clean ACL tear with the characteristic bone bruise. No Meniscus or MCL / PCL damage. I was on a fastbreak, and tried moving left and jumping off to the right to avoid a charge. As I jumped up I felt a pop down the right side of my right knee and hit the deck. Ice was on the injury literally 20 seconds after it happened. Just a dull pain, no swelling, and almost all ROM (range of motion). Next day there was a little bit of swelling, still no significant pain, just a dull throbbing feeling.

    I visited an OS and he ordered an MRI. After a few weeks of waiting for insurance and such I took the MRI and got my results two days ago. Leading up to the MRI I was in a knee immobilizer when walking around or doing anything active.

    Goals:
    Regain 100% confidence in the right knee. Take as much time as the knee needs to be completely rehabbed and strengthened. Then work on tennis and getting back into game shape. Tentative schedule puts my first time back on court likely around December / Jan.

    Currently I'm shopping for a good surgeon and have two great options to choose from. I also need to decide what sort of reconstruction I want. I'm pretty sure a cadaver is out, so I'm trying to decide between a hamstring graft or patella tendon graft. I'm leaning toward the latter, and will make my final surgery and surgeon decision this Friday.

    Wish me luck!
     
    #1
  2. surfsb

    surfsb Rookie

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    That's like verbatim what happened to a friend of mine playing basketball. But he also tore the meniscus. He also went with a graft (and took longer than original estimates to recover) but I hear a cadaver is the better choice if you want a faster recovery.
     
    #2
  3. onehandbh

    onehandbh Hall of Fame

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    Sorry to hear about the injury! The good thing is that it happened to you
    in your 20's rather than in your 70's so you'll heal faster. Check with the
    Portland Trailblazers to see if they have any recommendations on surgeons.
    Knee injuries are pretty common in basketball. Many of my friends that have
    played basketball for 10+ years have had major knee and/or ankle injuries
    at some point.

    Thanks for making a chronicle of your recovery (and search for a surgeon).
    Have a speedy and full recovery.
     
    #3
  4. fantom

    fantom Hall of Fame

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    Best of luck to you. I had ACL reconstruction about 2.5 years ago. You are doing the two things that I always recommend. Carefully pick your surgeon and graft type. From there, just make sure you follow the rehab protocol 100%. It gets monotonous, but it's important!
     
    #4
  5. chollyred

    chollyred Rookie

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    My brother tore his ACL swinging an easy 7I at the driving range. He opted for the patella tendon graft and did all the rehab. He did lose a slight bit of range of motion, but plays golf and tennis at a pretty high level (A4 ALTA Champions in 2008 ).

    Sorry you're experiencing this. Knee injuries aren't fun. I injured mine three seasons in a row playing softball and spent six, eight, and twelve weeks in therapy. I have an attic full of crutches and knee braces to show for it. My wife made me swear off softball (but I still get to play tennis :) ). I never tore the ACL, but stretched it badly. When it snapped back into place, it formed a huge knot on the tendon. When reading the MRI, the doc thought it was some sort of tumor, only to get in there and find nothing but arthritis and gout.

    Best wishes for a speedy, total recovery!
     
    #5
  6. ProgressoR

    ProgressoR Hall of Fame

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    i had my ACL reconstructed a while back, i was about 23, back in '94. Had patella graft. Rehab was long and hard, and i got bad advice along the way, so needed another (eventually) 2 clean up operations.
    But after about a year, i played all sports, and still do, no problems. ROM is restricted at the extreme, i cannot touch heel to butt, but strength is about the same as other leg, after hard work outs or exercise, its a bit sore. But has not stopped me doing anything, like snowboarding, surfing, soccer, cricket, and recently tennis.

    Best of Luck.
     
    #6
  7. OldButGame

    OldButGame Hall of Fame

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    Couldnt agree more with this,....Had The ACL blown myself,....(no surgery...went pure rehab route),.....The physical therapy and rehab is VERY important!!!!!....and something You probably will want to pay attention to for the remainder of Your tennis career. (eg take a few of the primary physical therapy exercises to do periodically to keep the knee healthy and stable).
    Good Luck!!!!!!!!
     
    #7
  8. onehandbh

    onehandbh Hall of Fame

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    Curious if those of you that had knee injuries were overweight
    or carrying extra weight at the time of the injury?

    Basketball seems to be like a wrecking ball for knees & ankles.
    I've been lucky to only have 2 major ankle injuries from it.
    Pretty much stopped a few years ago and decided to play
    tennis again instead b/c I didn't want to risk getting gimpy again.
     
    #8
  9. OldButGame

    OldButGame Hall of Fame

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    Yeah,...i've always been in very good shape,...and lean,....but about 30 years ago i was playing basketball,....planted a foot,..tried to pivot,....foot stayed....body pivoted,....ACL..."POP"!!!!!!!,......got better ...no big problems till last fall,...blew it out again...(doing some wifes 'honeydo' list,...:mad:...)....this year im playing tennis in a brace after doing physical therapy all winter.
     
    #9
  10. couch

    couch Hall of Fame

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    Never been overweight in my life and tore my acl while playing basketball about 12 years ago. Some guy just took me out in a YMCA league while on a fast break. I promptly retired from basketball!!:evil: I had more sprained ankles and knee injuries from basketball than any other sport.

    I was 28 when it happened and I ended up going the patella tendon graft route and used one of the University of Louisville's team physicians to do the surgery. I followed my rehab to a "T" and continue to workout and stay in great shape and, knock on wood, haven't had any trouble since.

    Since you are young and in good shape my advice would be to go the patella tendon graft route. It's a harder and longer rehab but I think it's still the best and longest lasting graft. Also, make sure you follow your rehab to a "T". I think the biggest mistake people make is going too hard too fast. Take your time and you'll be glad you did.

    Keep us updated on your decisions and progress. Good Luck!!
     
    #10
  11. surfsb

    surfsb Rookie

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    I talked with my friend and he said the reason he didn't do a cadaver is because it was going to cost $2000 out of pocket. However he said the graft was botched because they took it from the hamstring and that it was too short so they had to take it from the patella tendon. He said he feels less power comparatively pushing off with that knee and that he can also feel the scar tissue inside where they took it off the patella.
     
    #11
  12. ximian

    ximian Rookie

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    Thanks for all the encouraging words. I'm going to give an update, and chronicle my Surgeon and graft choice options. Surgery should be in a week or so!

    To date I've visited with four different Orthopedic Surgeons, and I'm glad because I've gotten four different opinions.

    Graft Choice

    3 of the 4 were strongly against a Cadaver since it's not my own tissue, and there is a greater chance of re-tearing it. One of the surgeons explained that it should also be a longer rehab, since evidence suggests your body needs to fully accept and transform the tissue, which takes a few months longer. However, during that time the ACL will feel fine, and so there's a tendency to rush the rehab.

    3 of the 4 also suggested a Patella Tendon graft, considering it's probably the "best" graft. The firmest and tightest one available. It's also a bone to bone graft, which is preferable.

    However, one of the surgeons, whom I picked to do my surgery (more on that later), advised me to reconsider the Patella tendon. There's approximately a 10% chance I would develop Patella pain down the road, and if that happens there is nothing to stop / prevent it. It's just something I would have to deal with. And given my history of Patella tendonitis (I had a small case of jumper's knee in my left (non injured) knee two years back), I need to reconsider this risk. Developing Patella pain would not be fun, and the OS said there's really not much I could do to prevent it. Even with a perfect rehab, it would either develop or it wouldn't.

    Added to this is the fact that tennis is specifically intensive on the Patella tendon. I remember from my jumper's knee bout that it can really be a pain to deal with. This would likely just increase any chance of Patella tendinitis or Patella pain. That's not really something I want to risk.

    All 4 said a hamstring would also work well. One of the OS's I saw is the surgeon for the University of Oregon athletes, and he will often let the athlete pick which graft they want, since their success rates are similar. Only for certain athletes would he specifically advise one path over another. The difference between a Patella graft and a hamstring is mainly an increased laxity with a hamstring graft. It can stretch a little more than a Patella and become a little loose. So often for athletes its a better idea to go Patella just to ensure a snug, tight graft. On the flip side, the hamstring is a stronger graft, but that is not that big of a deal.

    However, through visiting these OS's, I've been informed my ACL is naturally a little loose. And this is not necessarily a bad thing. First off, an ACL that is too tight causes more problems than something that is too loose (increased chance of arthritis). The only real concern with an ACL that is too loose would be an increased risk of tearing the meniscus. Additionally, building up the quads, hamstrings and calf muscles will minimize the "damage" a loose ACL could inflict. So really, a loose ACL would not be that big of a deal.

    Finally, if I follow my rehab to a T and don't rush it at all, it will give the hamstring graft time to fully "graft" with the bone and become tight. After 6 months, the chances of the hamstring graft stretching or becoming a little more loose are drastically reduced. So provided I follow my PT regimen perfectly, the issue of a loose ACL with the hamstring graft is minimized. And the "issue" really isn't a big deal anyway should it happen.

    Considering all this, I'm leaning toward doing a hamstring graft. I just don't want to take the chance with Patella pain, even if that graft might be a slightly better option for an athlete.

    Surgeon

    Of the four OS's I visited, 2 were general surgeons without a stellar resume, while the other two were Sports Science surgeons. Dr. Hoellrich was one, and he is the surgeon for the University of Oregon athletes and works out of a very well respected clinic in Eugene Oregon. Dr. Bollom is the other, and he is also a Sports Science surgeon and likely has the most experience with ACL reconstructions in all of Oregon. Furthermore, he previously worked with the Denver Broncos, Colorado Rockies and the U.S. Men's and Women's Alpine Ski Teams. Two excellent options to choose from, but I think I'm going with Dr. Bollom.

    The surgery date should be set by this Wednesday, and I'm going to shoot for June 29th. That will leave wednesday, thursday and friday to work directly with a recommended Physical Therapist and begin the healing process.

    Next up is to make a final decision on my graft choice, research PTs and figure out what the first week or two post-op will be like. To maximize my chances of success I'm currently doing PT to regain ROM and strengthen my right leg as much as possible. I've already seen a lot of improvement in one week, and I think I'll be in ideal shape going into surgery.

    Wish me luck!
     
    #12
  13. couch

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    ximian- sounds like you've done your homework. I definitely agree with everything you posted. Sounds like the hamstring graft might be the best option for you given your past problems with jumper's knee.

    Either way, I think the surgeon and your rehab is going to make a big difference in your long-term success. Sounds like you are headed down the right path.

    Good luck!!
     
    #13
  14. fantom

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    ximian,

    You did yourself a huge favor with all of the research and surgeon interviews. Way too many people just do whatever the first surgeon the speak to tells them.

    Good luck!
     
    #14
  15. ajmack

    ajmack New User

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    ACL surgery 20 years later

    I commend you on getting a number of opinions. This is obviously an important decision. You want to be comfortable with the surgeon and the procedure.
    I was in high school in 1990 when I also blew out my knee playing basketball. I wasn't in great shape, but definitely wasn't overweight either to address one post. Anyway, I had the patella tendon graft and wasn't given another option. The cadaver procedure was very new at the time.
    The rehab was long and difficult. I had a pronounced popping in my knee that eventually required arthroscopic surgery to clean out scar tissue.
    I lost some range of motion and jumping ability, but was able to return to sports with the help of a brace fairly quickly after the second surgery.
    In the 20 years since, I've played competitive softball, taken karate for two years and just started playing tennis again last year (now at the 4.0 level).
    My gait remains slightly off due to the injury, but I have no real problems with the knee. I play tennis three tiimes a week and haven't worn a brace since high school.
    Interestingly, I was recently told by a prominent local orthopedic surgeon that my PCL was torn. He could tell by the alignment of my fibia and knee as a sat down.
    This wasn't conveyed to me 20 years ago. It's not worth 'fixing' if it isn't a problem, according to the surgeon.
    Like others have said, follow your rehab religiously but don't overdo it.
    Hopefully, my situation and experience from the injury 20 years ago gives you some comfort.
    Good luck.
     
    #15
  16. ximian

    ximian Rookie

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    Thanks for the encouraging words!

    Surgery is tomorrow!!

    I'm not nervous, just anxious to get it over with and begin my rehab and get healthy. This whole thing already feels like its been awhile. And it has – I'll have surgery almost 6 weeks to the day after the initial injury.

    A few notes:

    • I've decided to do the hamstring graft. My surgeon should be very capable and ensure no extra laxity (my only real concern).
    • I've been doing A LOT of PT since I got the results of my MRI. About an hour every day actually. 30 min biking, followed by various leg strengthening exercises outlined by my physical therapist. I've been upping the number of sets as I feel comfortable as well, and right now I have all but 10* ROM and my strength is pretty good. The knee actually feels semi-normal, even though it still feels like buckling and there are twinges of pain here and there.
    • In addition to the PT, since I've been in the gym every day I've taken it upon myself to do some extra cardio and some extra weights. I mean, why not? I'm in the gym, lets make use of it. On a four day cycle, I swim a pretty rigorous set (no kicking of course) one day, do a complete upper body workout the next, then a rest day, then swim again and start the cycle over. I hope to use this rehab period to get into some great shape and to learn about nutrition and taking care of my body. When life gives you lemons....
    Anyway that's a quick wrap. Wish me luck for my surgery! I'm gunning for the end of December to get back on the courts.
     
    #16
  17. BillH

    BillH Rookie

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    Good luck with your surgery! - I had a hammy graft in right knee in 2002 and hammy in left knee in 2004. Both surgeries required 1 year of wearing a brace post surgery during sports and about 2-3 months of formal PT and another 3-4 months of self supervised PT. In both cases, it took about a year before I felt I was 100% on the tennis court. Also keep in mind the studies show that after a couple years both graft types have similar strength ans only slight differnces in laxity. As everyone else said, do your PT religiously and you'll be back playing tennis in no time. Also, make sure you use a passive movement machine and cryro cuff in the days immediately folowing surgery - their use will greatly reduce swelling and pain and get your ROM back sooner.
     
    #17
  18. kslick

    kslick Rookie

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    Good luck!!! Nice to see the positive attitude...that will take you far!!!
     
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  19. couch

    couch Hall of Fame

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    Good luck ximian.
     
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  20. fantom

    fantom Hall of Fame

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    Best of luck! Stay on those meds and the pain won't be bad.
     
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  21. charliefedererer

    charliefedererer Legend

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    Good luck with your surgery.

    Best wishes for a speedy recovery.
     
    #21
  22. ximian

    ximian Rookie

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    Thanks for all the good wishes! The surgery was a success!

    Turns out there was also a small meniscus tear that he took care of, but other than that the ACL reconstruction went "very well." I should know more about the meniscus tear on my follow up visit on the 12th.

    I had the first surgery of the day at 7:30am, and the proceedings were (I assume) fairly typical. I got a quick chat with the anesthesiologist and Dr. Bollom himself before going under, and I felt very relaxed and in capable hands. I woke up I think around 10:30 or 11:00 to a very sore and painful leg. Mentally, I was gone. I felt like I could think straight but couldn't express my thoughts coherently, and kept asking the same questions and telling the nurse my leg hurt. At one point she answered my question and said: but you won't remember this so don't worry. haha, apparently I did. Anyway, the pain really was not and is not too bad. Just a dull ache, but any movement would set it aflame. Especially my shin.

    One of the things Dr. Bollom explained to me during my initial appointment was that he likes to treat his patients as if they are Drew Bledsoe himself. I found that to be true since included in this surgery is the home rental of a Constant Passive Motion machine and a Cryo-Therapy cold water / ice pack. Both have been very helpful and I think I'm getting some excellent care. Dr. Bollom also hooked me up with arguably the best Physical Therapist in town, so I'm feeling pretty good about my prognosis.

    First day post-op was rather uneventful. I went home all juiced up from pain pills and the anesthetic wearing off. I was very tired too but somehow couldn't get myself to actually fall asleep, I guess just too busy playing video games and surfing the net and other various activities. Later in the night I finally hooked up the CPM machine (the leg was feeling pretty good) and found that my ROM was surprisingly good. I got it up to about 95* before deciding that was enough. I could've gone beyond that, but figured its the first day post-op so what's the rush. I've got 6 months and I really don't need to push anything right now. I ended up sleeping with the CPM machine set at 95* and woke up in time to watch Murray / Nadal.

    2nd day post-op (today) was also my first PT appointment. It was pretty striaghtforward, he explained some exercises for me to do (and to continue to do) and I feel like I'm in great hands. All my pre-op therapy is going to be a big help considering I spent a good 2-3 weeks doing nothing but strengthening my leg and working on ROM. He took some measurements and I'm at about 94* Flexion on my own, and I'm already close to 0 on extension, just a few degrees off.

    It looks like for the next week or so I will constantly be doing something to my knee. Either cryo-therapy, CPM machine, or Physical Therapy. I'll probably end up doing 2-3 sessions of PT each day, with cryo-therapy in between and just sleep with the CPM machine on. My PT tells me that, based on the pre-op work I did, where I'm at post-op and the strength of my leg, I'd have to almost deliberately screw things up to not fully recover. Number one priority right now is gaining complete extension and building up my quads.

    So here we go, I'm excited to start the PT process! Due to the small meniscus tear I'm going to be non-weight bearing until my follow up visit with Dr. Bollom on the 12th. So it looks like I'll have a lot of time to do PT!

    Also, the best thing is that at this stage, every day truly will be a small recovery for my knee. During the past few weeks my knee saw a lot of improvement, but I knew it wasn't going to fully recover until after surgery. So that mental block is over and the real progress begins. :)

    Let's hope the rest of my posts are as good as this one!
     
    #22
  23. ximian

    ximian Rookie

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    Day 5

    Surprisingly, the knee feels excellent. The past three days I've been doing the exercise where you flex your quads and push down on a rolled up towel a couple hundred times a day (working on extension). Also SLR (single leg raises) a bunch of times too. The work is paying off!

    At my PT appointment they took off the dressing for the first time and everyone at the Physical Therapy center was stunned how little swelling there was. I also have full extension and my quad strength looks really good. All in all, I'm on the fast track to recovery, everything looks excellent. I should even be able to start cycling this week!
     
    #23
  24. charliefedererer

    charliefedererer Legend

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    Glad to hear you are doing well.

    Your being in great shape going into this mishap, and your attititude and ability in pursuing the rehab hopefully will make you a "star" patient.
     
    #24
  25. chollyred

    chollyred Rookie

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    Glad you're doing well so early after surgery. It's great that you have full extension. How much ROM do you have on contraction? (that's where my brother lost a little ROM) You only get out of physical therapy what you put into it, but don't push too hard too soon. This is one of those times when slow and steady is better than brute strength.
     
    #25
  26. fantom

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    Extension is the most important thing to regain after the procedure. Flexion will always come back, but if full extension (matching that of your other knee) isn't achieved within a number of months, scar tissue will make build and make it impossible.

    Glad to hear everything went well. Just stick with the therapy...it can become monotonous.
     
    #26
  27. ximian

    ximian Rookie

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    Day 13

    Saw the Dr. for the first time today. Stitches finally got removed (thank god, they were getting annoying!) and I can take showers normally again. One more week until I can get in a pool and swim! Dr. said everything looks great and I feel pretty good too. I've got full extension, and 108* flexion. I've also started biking on a recumbent bike. Well actually I'm not sure if you can call it biking since I'm really just making the pedals go around for about 5 min. But each day that should get better and better :)

    Next step it to ditch these crutches once and for all. Hopefully in about a week or two I'll be ready for that.
     
    #27
  28. Jim Hendricks

    Jim Hendricks Rookie

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    I hated the crutches. Found a cane was much easier to get around with.
     
    #28
  29. BillH

    BillH Rookie

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    Crutches are important - not for support of the surgical knee but to help restore normal gait. I hated the crutches too but then my therapist explained how they helped establish a swing through of the foot and heel-toe walk that will be important in the early phases of rehab. Don't ditch the crutches too soon!
     
    #29
  30. ximian

    ximian Rookie

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    Day 24

    Its been awhile since I've updated, I guess the time flies! The knee feels pretty good, I've noticed strength starting to return and its beginning to feel more "normal." I've almost completely ditched crutches, and I'm beginning to do some squats and other more difficult exercises in PT. I've been out and about much more regularly this past week, with no pain or swelling or problems at all in the knee. I guess I'm beginning to adopt a much more normal lifestyle, albeit with a slight knee limp and being extra careful walking on uneven terrain :)

    I think my ROM is above 120, but I haven't measured it in awhile. It was 115 over a week ago, and it feels significantly better than it did then :) I'm doing one tough set of PT each day with all the exercises on my list (takes >1 hr) and then another set later in the day working on more quad strength and various other muscle groups. I'm also cycling about 15 min each day and its getting easier and easier. In other news, I'm finally able to swim! That will be my cardio for the next 5 months.

    Things are going well!
     
    #30
  31. ximian

    ximian Rookie

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    Day 35

    Time flies! Kinda. Hard to believe I'm already 35 days in, but I've still got another 150 days to go. Ha.

    Things are going very well. My PT says I'm the furthest along of anyone he's ever seen at one month post op. I'm walking close to normal (still have a bit of a limp), my PT exercises are more intense (single leg squats, lots of hip-stability exercises, biking pretty hard) and the knee feels very strong and secure through it all. I have about 125* flexion and full extension, and I feel like in a month or so the knee will feel pretty close to normal.

    I think the big secret to my success has been a combination of devoting 3 weeks pre-surgery to strengthening the leg muscles, and doing everything right post op. That would be using the CPM and cold-therapy machines excessively, hitting PT the day after surgery and being extremely devoted to the exercises for the first two weeks, and then making sure to do one or two sessions of PT each day, every day, pushing the knee as hard as possible. I guess being young doesn't hurt either :) But over the course of these 35 days, I've only missed my PT exercises once, and that was because I attended a wedding and was on my feet for 8+ hours! So the lesson here is, be smart and do your PT a lot.

    My daily regimen involves an hour or so of PT-specific exercises (lots of quad strength, and some dynamic, hip strength stuff as well), but I also make sure to bike every day. This past week I've been cleared to really go after the biking, getting a good cardio workout from it, so I've been on the bike for about 15 min each day going as hard as possible. Next week I think I'll up it to 30 mins. In addition to this PT, since I'm already in the gym I'm just adding in some upper body stuff 2-3 times a week and swimming in the pool (with a pull-buoy) 2-3 times a week as well.

    It's all going well! And actually, as a bit of a surprise, my PT today suggested that I hit some balls against the wall to keep my various arm and upper body muscles familiar with the forces involved in the forehand and backhand. This must all be done with extreme caution - I absolutely cannot make any cutting motions or running movements, and I need to be careful not to apply a twisting motion to my knee when I hit the backhand. But common sense goes a long way, and it's perfectly reasonable to hit against the wall in a controlled fashion without damaging the knee. I just have to be smart about it and make the knee priority number one.

    So its not like I'll be playing tennis, or even hitting the ball hard or anything, but at least I can feel the ball off the strings again! I'm going to give this a shot tomorrow, hopefully it all goes well.
     
    #31
  32. ximian

    ximian Rookie

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    Day 67

    Well I let time fly a bit. Things have gotten a little monotonous. Everything is still doing great, the knee feels strong and almost normal. The kneecap occasionally does not track properly coming out of full extension, but that will get better as the quads and hammys come along. It's seen some improvement, and I have no doubt it will be normal in a few months. I'm walking around without a limp, and most of my daily routine doesn't involve a brace at all. I guess I'm just too lazy to put my special DonJoy brace on, but I will for anything rigorous or long amounts of walking.

    My PT has gotten monotonous. I'm still doing it every day, but I've missed more days than I'd like. I think I'm doing about 5-6 days of PT a week. My exercises mainly involve single leg squats and balance exercises. Biking and a little bit of stretching thrown in as well. I've has full extension and almost full flexion for awhile now.

    I think this is week 9... But its definitely in that time period where the knee feels great but the graft is at its physically weakest period so I need to exercise caution with any sort of activity. At 12 weeks I should be cleared to start some light running / jogging, but we'll see. That will feel good!

    I also managed to hit against the wall for about 10 mins. Everything felt good, I got into a bit of a rhythm and it was nice to feel the ball off my strings, but in the end I'm just going to wait. It's like a giant tease -- you can hit the ball but its not really tennis. And when I'm on the court, the urge to push the limits is always there. I think I'm safer just staying off the court until I'm totally cleared for tennis.

    Welp, 2 months and some change down, 4 months to go. Weeeeee...
     
    #32
  33. couch

    couch Hall of Fame

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    ximian- you are right, this is the most dangerous time when it comes to your rehab. The knee feels great but the graft is still healing. Do yourself a huge favor and stay off the court until about 3 1/2 -4 months and keep up with your rehab. You'll be glad you did in the long-run. Waiting a few weeks now will more than make up for a successful recovery later.

    As always, good luck.
     
    #33
  34. NLBwell

    NLBwell Legend

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    Hope things continue to go well. Glad to hear of a success, so far.
     
    #34
  35. NoSkillzAndy

    NoSkillzAndy Rookie

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    Sounds like you're doing a great job with your rehab! Please resist the urge to get on the tennis court though, even if it's just hitting stationary :D I tore my ACL in February this year so I know what you're going through. Two more weeks and I'll have my final post-op doctor's appointment, where my doc will make a pronouncement on whether the recovery was a 100% success or not...

    BTW, I went with the cadaver graft and it's been great so far. Quick recovery after surgery, and I've read of some collegiate & pro athletes that went that route as well. Surgeon wise, the one I chose does most of the operations for the University of Texas athletes, so I figured that was good enough for me ;)
     
    #35
  36. ximian

    ximian Rookie

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    Day 110

    Well... things since my last update have changed. Right after that last post I started to develop a little bit of patella-femoral pain, and a little bit of pain deeper in the knee. It came on gradually, but progressively got worse until I could no longer do any squats or step-downs. Even walking has become painful to some extent on some days, and I've had to cut a lot of exercises out of my rehab regimen.

    I just spoke with my Dr and it's relatively common. As your quads get stronger, they start to cause problems with the kneecap tracking properly and it can disrupt a lot of small things. So its nothing serious, but for now I need to do everything I can do develop my quad muscles without causing any inflammation or pain. So no baby squats or running or anything else that would cause pain, and I'll be taking a lot of ibuprofen.

    It's a setback, thats for sure. And in fact the Dr said that it could take up to 2 years for this sort of tendinitis to fully disappear. It all depends. For now, I know what I need to do and I've still got 3 months or so before the graft is strong enough to handle any sort of tennis.

    Here we go!
     
    #36
  37. Darko

    Darko Rookie

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    New guy alert. I tried to find an introduction section, but there doesn't seem to be one.

    I had my ACL reconstructed in December '09, and am now in my 10th month.

    I feel your pain bud, as its the toughest thing I've ever experienced in my life. Especially the showering bit. Its so debilitating.

    Anyway, I spoke to my physio and he told me that I could resume light tennis. I was no professional before, but I played 4 - 7 times a week socially, coaching and league.

    I had my first lesson back last night, and I can't tell you how good it felt. I had my knee in a sport brace as was advised, and I didn't do any hard directional changes.

    Hope you heal well!
     
    #37
  38. ximian

    ximian Rookie

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    10 months and you're just now back on court? wow, did you have some difficulties in your rehab or something? What sort of graft did you do?

    My surgeon still plans on clearing me for tennis around the 6-8 month mark, I wonder why you're taking so long.

    Also, I'm not sure what you mean by the showering bit... Anyway, best of luck to you and welcome to TT!
     
    #38
  39. Darko

    Darko Rookie

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    I was very slow with my recovery. As I mentioned, I am no tennis pro, as it was always a sport I did after work, I just loved it so much. I didn't have to rush to get back on the court.

    I only started bending and flexing with the physio after 2 weeks. I slept with a knee brace for 2 months.

    You are way ahead of me in terms of recovery, and thats awesome. I wish I had your pain threshold and strength.

    Also another reason is that I'm a software developer by profession, and I was assigned to a project that worked long hours and my training basically didn't exist for a month or so.

    I should have been on the court sooner, but I don't mind. Getting back into it as summer begins is a great time.

    Oh, the showering thing, I thought I read that you posted that showering was hard at first? My shower extends over my bath, and I have sliding doors that sit on top of the bath that i close when I shower.

    It was very hard to get my leg over the bath the first few weeks so I could stand and shower properly.

    Thanks for the welcome :)
     
    #39
  40. Darko

    Darko Rookie

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    I can't seem to edit posts yet...

    I had a small complication as I was a little allergic to the stitches, so I ended up getting a weird bubbling rash around my main incision, then I was also allergic to the antibiotics I was given to remedy that. Finally after 3 weeks I was back to normal.

    I have some pics if you're keen to see. I don't want to hi jack your thread though.
     
    #40
  41. badcook

    badcook New User

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    hey

    firstly good luck with your rehab n i hope u get back on the court asap.

    1st of november would mark the end of my 2nd month after patellar graft acl reconstruction of my left knee. everything that could go wrong before, during and after surgery has happened.

    now the same knee pain that you mention is breaking my spirit to continue exercising - literally only manage a squat or 2 and i give up. still walking though - i go for an hour long walk outside with steep inclines. i cannot seem to jog and lunges are as impossible as squats.

    if its not too much to ask i'd really appreciate some information on how you are tackling the knee pain issue it to continue exercising if you are. what sort of exercises or regimen do you follow? do i just bite through the pain and continue?

    thanks for any help!!
     
    #41
  42. ximian

    ximian Rookie

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    Do you have a PT that you're seeing? They should be guiding your recovery. You mention running and squats but you're only 2 months out from surgery, and I've never heard from any PT that you should be jogging or lunging just 2 months out - especially since the graft is at its physically weakest point between the 8-12 week mark... So what's going on?

    Personally, the pain I'm having is actually rather common among people who fly through the first few months. It's apparently just a little bit of a kneecap tracking issue and lack of VMO muscle activation and strength. So I'm currently avoiding ANY sort of exercise that will cause any pain or subsequent inflammation and doing everything I can to build my quad / VMO contraction and activation. That, and a boatload of ibuprofen and I think if I give it enough time I'll be able to get back to a regular rehab regimen soon. I hope.

    But in the end, ACL reconstruction is a very long rehab process. I'm not really that worried since the graft isn't ready for sprinting / cutting for another 3 months anyway, and it won't really feel natural probably for another year. It's a slow road, but I'm not going to rush it. Giving up another month or two of productive rehab to get rid of tendinitis and inflammation will be well worth it in the long run. And if I did just bite through the pain and keep rehabbing, well the inflammation would never really go away so that's just pointless.

    Best of luck to you -- what exactly went wrong before, during and after your surgery?
     
    #42
  43. ximian

    ximian Rookie

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    I've heard that waiting this long to bend / flex the knee can and usually does result in some scar tissue complications and loss of ROM... any signs of that with you?
     
    #43
  44. badcook

    badcook New User

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    yea on physiotherapy (once a week) and doing the exercises as advised by the PT but it doesnt seem hard to do. what i mean is that it doesnt feel like an effective work out after doing the exercises. maybe its not meant to?

    i was trying on my own, not asked to by the PT (was gonna ask her on my next visit), to work my legs harder with lunges (cant even do 1) and jogging (cant go past the first step) and i was scared why i wasnt able to. so came on here to look up ACL threads n commented on your one. so if its normal not to be able to - then i'll just take it easier not be stupid.
     
    #44
  45. ximian

    ximian Rookie

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    Yeah, don't be stupid :) The workouts should be relatively easy -- you won't be dripping in sweat or anything. Anything vigorous will damage your graft! It's not physically strong at this point, it literally takes 6 months before it's back to what's considered a "normal" strength. Until then its much easier to retear your new ACL or even just stretch it. Stick to your routine! Don't do too much! Jogging and lunges would be really stupid at this point. Give it time.
     
    #45
  46. badcook

    badcook New User

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    thanks man. trying not to be stupid is hard but only taking walks now on level ground. is biking ok, on level ground (nice bike path near my house)? - the physio puts me on the exercise bike. havnt sat on it yet but given it for servicing when it comes back...
     
    #46
  47. ximian

    ximian Rookie

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    Well, it's a month and a half before I'm cleared to play tennis again, and I still can't run.

    There's a sharp pain that on the left side of my knee, clearly above the joint line, that keeps me from doing any sort of polymetrics, short squats, or anything let alone running. It's been very frustrating, since this pain first showed up at the 2 month post-op mark and I honestly can't say its gotten any better. It still even hurts to walk if I try to walk normally. It's not a very strong pain, but certainly strong enough that if I try to run I'll get a pronounced limp very soon.

    I saw my OS about this recently and he's stumped as well. Everything points to a soft-tissue issue, and nothing to do with my graft or the structural integrity of my knee. But when he doesn't know, it's unsettling. The plan right now is to transition into more cardio-based exercises instead of strength training and see if that helps. If not, in a month I'll get an MRI and then injected with steroids to calm everything down. He says that should knock it out, but on the whole I'm very disappointed and a little bit fearful that I'll need a second surgery.... ugh. I just want to get back on court, or hell just run for a bit. I guess I'll just have to keep playing the waiting game.
     
    #47
  48. onehandbh

    onehandbh Hall of Fame

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    Hope the pain gets sorted out soon so you can get back on the courts.
     
    #48
  49. Marius_Hancu

    Marius_Hancu G.O.A.T.

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    #49
  50. NoSkillzAndy

    NoSkillzAndy Rookie

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    Badcook, it's way too early for you to do anything like lunges or jogging. Stick with some stretching and extremely light strength-gaining exercises (such as hamstring curls w/no weights). Your doctor or physical therapist can tell you what you can and can't do -- until then, play it safe.

    Ximiam, that's terrible news about your knee pain. Sounds like there might be some meniscus damage in there or something. Hopefully your MRI will come back negative.

    As for myself, I'm 8 months out after my ACL surgery. My doctor has cleared me to do anything I want, but I'm still avoiding any sort of heavy weight training. My early rehab consisted mostly of walking and swimming. Mid rehab was even more walking, some jogging, lots of swimming, and some stationary bike. Once I was cleared for tennis though, that was obviously my preferred means of exercise :) I still go for a walk everyday and try to jump rope a little bit too. I'm almost back to full speed and my change of direction and explosiveness is continuously improving. I managed to play some 5.0 doubles last night without missing a beat besides letting a couple overheads bounce that I normally would have tried to smash (that might also be a mental thing because that's how I tore my ACL in the first place -- hitting a tough overhead).
     
    #50

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