I have been humbled by this experience but have a enhanced faith in my profession. I don't think that recovery process was explained very well and had I not been PT (or had I not worked in outpatient orthopedics)I don't think my recovery would be as good as it is. I know a lot of people have questions and concerns pre and post op so I just wanted to put this out there : if anyone has specific questions for me as a PT and someone ( of advanced age ) who just had an ACL reconstruction, I would do my best to answer them particularly if the questions had to do with the rehab process. Good luck to all going through it! It is tough but get soooooooooooo much easier with time and work.
The ACL Repair Forum Firsthand accounts of ACL surgery and recovery
About this topic
- Posted by Dafco 9 months ago. There are 25 posts. The latest reply is from morpheus.
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I haven't had my surgery yet---I am still going through pre-op PT. How difficult were the first few sessions for you after you had surgery?
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Hi Shana, your pain level will depends on when your first post-op PT visit is but I won't pretend that it did not hurt! The first 5 days after surgery were very difficult so what I did in PT 10 days later was relatively easy. Keep in mind I started my therapy day one after surgery because I knew all to well the importance of early motion, ice, elevating your leg, doing ankle pumps ( moving foot up and down from the ankle) and doing quad sets (which were virtually impossible) and get up with my crutches and moving around regularly. Most importantly you should work on your knee extension ( straightening it )after your surgery. This hurts but is so critical! Hopefully your MD will prescribe a CPM- I used it 4-6 hours/day and increased the bending 5 degrees/day as per my MD recommendations. In other words your pain in PT post op will depend on what you did before you got there... Good Luck!
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I have a question for you, Dafco. I think I qualify as "advanced" (but not old yet) age at almost 49. I am 8 weeks post ACL reconstruction and meniscus (medial & lateral) repair. I am wondering why it is soooo difficult to go DOWN the stairs? I can go up w/o any problems, but can't go down. I have a good PT--didn't start until week 7 per dr. instruction (not sure why he wanted me to wait). What is the best way to strengthen my quads?
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Hi kbriceno,
I was also surprised how long it took me to be able to descend stairs using my operated leg(about 7 weeks) and it still often hurts! It is much harder on the quads to do an eccentric (lengthening) contraction which is required for going down a step with your operated leg as the trailing leg as opposed to ascending stairs which is a concentric activity for the quad ( shortening of the muscle). The best way to train for this is squats, leg press, wall slides with hold for endurance and step ups. Your PT should take you through these according to your MD protocol. Since you started PT rather late it might just take a little longer because your quad is just not strong enough yet. I have assumed that you have enough ROM (range of motion)to descend the stairs although that also could be a limiting factor. You need more knee bend to go down that to go up also. Hopefully you are riding a stationary bike several times/week for motion and strength as well as doing a regular home exercise program. Your balance on the operated leg is also a critical component to successful rehab. I might have given you more info than you needed but hopefully I answered your question. Good luck, Dafco -
Hi Dafco,
Your insight as a PT is very helpful. I am still pre-op (after 3 months…I tore my ACL, sprained my MCL, flipped a meniscus). I have been in PT for about 5 weeks now. I am off crutches and my ROM is within 5 degrees of my unoperated leg. I see the surgeon next week, at which point I hope to get a surgery date. The doctor suggests ACL reconstruction with the patella tendon. I am going to the sports medicine department of a major hospital. Post-op, I will be in a CPM for 23 hours a day for a week. I would guess that PT would start right away. My question is this: how long can I expect recovery to take? I know everyone is different, but do you think it will be 6 weeks or 16 weeks to get back?
Thanks
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Thanks so much, Dafco! I agree with MikeM--it's really helpful to have advice of a pro! I figured it was a combination between my lack of range of motion and lack of strength, but I didn't understand why going down is harder than going up. Your explanation makes perfect sense. My range of motion is 115 on the PT table (passive), but less on my own. I just started using the stationary bike on my off PT days--love it! It always takes about 5 minutes to get going. I have to start with the seat high and gradually lower it until it is at a normal height and pedal comfortably. I have only been using light resistance to this point--just enough so the pedals don't spin out of control. Maybe that's not enough resistance to strengthen my quads.
What range of motion is necessary to be able to go down stairs? To ride a bicycle?
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I forgot to add that I am still having swelling issues. I am wearing a compression stocking on my left leg per PT--that helps. As I am now mostly brace-free, that helps too. But my entire leg is still bigger than my right, and I can see notable swelling in my ankle and the top of my foot.
I wish you all luck in your surgeries and recoveries!
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Hi Mike,
In regards to your question : "how long can I expect recovery to take? I know everyone is different, but do you think it will be 6 weeks or 16 weeks to get back?" It depends on what you mean to get back.. to get back to what??? everyday activities? sports? and which sport. It also does depend on your prior fitness level... and what your stength and ROM prior to surgery. I would not have surgery until you have full ext if possible and a good quad contraction. Often a meniscal tear can prevent full ROM but usually you can get the knne extension back. I got to a point where I did not feel like I needed surgery because it felt so good but my knee was unstable. Back to your question... generally speaking- one to two weeks using cutches ( I used them 5 days ), 5-6 weeks to walk without an obvious limp, good relatively pain free work out in gym ( bike 20-30 min with mod resistance, wts etc after 5- 6 weeks, most docs don't want you to run until 3-4 months, and full sports 6 -8 months provided all is well. Keep in mind some docs are more accelerated, others more conservative. Sometimes I feel like I can run now at 8 weeks post op but my doc do not want me too yet. I hope this helps. Good luck!!! -
Kbriceno, you definitely have enough ROM to go down the stairs and ride a bike. You need at least 90 degrees to go around but with modifications ( also a recumbent bike requires less flex) . I think approx 120 deg. is needed to be comfortable on an upright but I honestly don't know for certain. It will depend on height of seat and foot position on the pedal, Also flex needed to descend a step depends on how steep the step is.
As for your swelling, I also wore the compression stocking to help with that. As long as I had swelling I also used the neuromuscular stim for quad sets and still iced regularly. I think also gentle massaging helps (milking the fluid upward) starting from your toes up towards your thigh in your case. I still do all of it regularly when my knee gets irritated after a work out... -
Mike , I did not mention that I had a allograft which is a bit faster recovery that a patellar tendon graft, at least initially.
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Thank you so much for answering all my questions! Good luck with your recovery and have a HAPPY THANKSGIVING!
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my daughter is about to undergo acl op and wants to talk with people who have shared the experience. She is only 19 and injured her knee following intensive sports activity. She hopes for a full recovery where she can get back into a full range of sporting activities. It would be nice to share some positive comments as well as the difficulties that people have had. Many thanks
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Dafco- I am having a cadaver graft and the doctor said he doesn't think pt right after is necessary b/c it causes unecessary pain. He is sending me home with exercises to do at home in the meantime. I believe my 1st post-op pt session will be a week after surgery. should i be concerned it isn't right after?
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Hello and happy new year!
I have my surgery on Jan. 20 and am getting my apartment ready. One question I have is that after surgery, I will be in a CPM for 23 hours a day for 7 days. I live in Boston where it is very cold now. Will the machine work if it is under the covers?
Thanks,
Mike -
Hi Mike- I am not sure why you would use the CPM 23 hours/day. Sounds like overkill but if that what the doctor ordered you should comply, but I would double check that...Perhaps you lay down scar tissue easily?? As for it working under the covers -sure it will. Just make sure the blanket or sheets does not get caught in the moving parts:)
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Hi Shana- good luck on your surgery. I would agree that PT does not need to start until one week post -op but you MUST do the exercises they instruct you to do post-op day one including: working on your range of motion especially trying to straighten it all of the way ( hurts like hell and that is why some go to PT right away b/c they are unable to inflict the pain on themselves), ankle pumps ( moving foot up and down for circulation/control swelling) and quad sets (trying to tighten thigh muscle even if it feels impossible).Just do as instructed and practice before surgery so that you are clear on the exercises and you will do great!
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Hi Hazz, please tell your daughter that she has age on her side and will do great!! I am 43 years old and am 3 months post-op. Most activities I am doing without a problem or little to no pain: bike, yoga,dancing,swimming. I have not returned to skiing or ice skating but otherwise I have no limitations(things are not yet as easy as they were but it is still early in the rehab process). I can run 15 min so far but I was never a great runner to begin with. There first 6 weeks are tough, I will not lie but as long as she can stay focused on rehab she will most likely recover 95-100%.
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Thanks Dafco! I am getting super anxious and am wondering if I'll actually be able to handle the pain. I'll soon find out though!
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Hi Dafco,
Thanks for the message. Yes, it is 23 hours a day. This is what the surgeon told me several times. I am really not looking forward to it. My first rehab session is 5 days after surgery.
Hi Shana,
I am also getting super anxious. My surgery is in 2.5 weeks. I am almost 5 months post initial injury. I would have gotten the operation sooner, but the holidays messed a lot of things ups. Good luck. When is the big day?
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Hi Mike,
My surgery is on Jan. 28th. I decided to have it done out in Arizona where my folks live so they can help me out for the month I am out there. I am lucky that my employers are letting me work remotely for a month and equally as lucky to have my folks help me out!I keep wavering and wondering if this was the right thing to do. My ROM is 98% normal and the only thing I can't do yet is kneel down on the floor. However, whenever my knee almost gives out I know this is the right decision.
Good luck and keep us informed regarding your progress!
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dafco
i do boxing, and brazilian jiu-jitsu, wrestling. competitively. im 27. im suppose to have surgery this fri. my dr's want to use a cadaver. but im worried it wont be strong enough. should i go with the patella? also getting back to doing jiu-jitsu asap is very important. how long can i expect til i can do this and what kind of PT can i do, and how soon( dont care if hurts-pain wise) cani start. any specific PT for doing something like jiu-jitsu or wrestling?
thanks doug
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Hi Dafco-
Im very glad you are here and can help us out with your expertise.
Im a bit like you, 27 yo, had an allograft, and pretty good about the rehab thing. Since Im a professional athlete I have been around physical therapist long enough to know some things about it. However, I have never had surgery so, cant really say much about that.Im writing becasue I was a little concern about PT post-op. I had my surgery last Wednesday (1/27) and was told to start the CPM the day after. However, Im surprised that Im not going to do any therapy until this Thursday that I see my MD for the first time after surgery. I was reading one of the post that said it is important to be able to have full extension of the leg because being able to bend will eventually happen,so maybe thats why. I can help but wonder if I should be doing something while at home. He didnt give me any exercises to do, just CPM and the ice cuff.
My trainer and I were working to strenghten the hamstring because I was thinking of using the hamstring autograph and I changed my mind to days before surgery so my hamstrings are strong (I was practicing up until 3 days before surgery) and I was able to stretch my leg all the way as well as, do squats with light weights. I feel really good post-op. I only took 1 percocet up until 4 days post-op. I have had pain but I think its been minimal. I just dont know if I should be so inmobile for this long.
I know everyone is different and maybe the surgeon knows my muscles are strong enough to wait a couple of days until PT.
Any thoughts? Thanks in advanced!
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Hi Doug and wpgirlpr, I hope you are both doing well post-op . I am so sorry that I did not read you posts earlier. I wish we received email when someone wrote. I have not visited this site for some time now. I am back to work full time so I am not at the computer like I was during recovery. I am now almost 5 months post-op and my knee feels great. My doc wants me to wait one more month until I play soccer or any other cutting sports but my knee feels stable and strong with my allograft.
DOUG- I hope you felt good with whatever decision you made re : graft. I know it must have been hard because I agonized over it for months. I went with allograft mainly because of my age and healing ( 43 y/o) but i think it's a hard decision because both auto and allografts are good options. The surgeons argue about it all the time in their conferences. Now the allografts are so much stronger than they used to be because of the way in which they are now sterilized does not breakdown the tissue very much.
As far as jiu-jitsu, when you return depends on how your doc feels. At your age prob sooner than 6 months. The best way to get back to it is to of course work on obtaining full ROM esp extension, stength and balance is critical. Also, practice the jiu-jitsu moves at a less intense levelwpgirlpr- now you are one month post-op I am sure you have full ext. I hope you are doing well! I am sure as a professional athlete they will have to work on slowing you down!
Good luck to you both. I am am thrilled at this point abouthow my knee feels. I was not always so optimistic. If you work hard without overdoing it, you will feel the same!
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Hi Dafco, I would like to have some information either from you or any one else. I have had an injury 5 days back playing Basket ball in my knee. I did hear a little popping sound. I was asked to go for MRI by the doc which i did. Looking at the MRI he told me that i need to go for the ACL reconstruction and this was the very 2nd day of the injury. The 3rd day i saw another consultant who refused looking at the MRI and suggested me to have a clinical examination. He made me lie down and made me leg bent a little bit and held my calf and pulled it towards him. Doing that he told me that he does not feel i was having an ACL rupture and i may not require a surgery. Then he suggested to suck all the blood out around the knee which was causing swelling and he did. He looked at the MRI and it says evidence of ACL rupture but not sure. Advised me some rest and some knee exercises. Now my question is how do i really find out that i do have an ACL rupture and do i really need to go for the surgery. I dont have any pain now. Had it only for the first 2 days. Swelling has reduced but i am still using support to walk as advised by the doc.
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