The ACL Repair Blog Firsthand accounts of ACL surgery and recovery

My recovery from knee surgery pressed on today with a six week post operative visit to my orthopedic surgeon. I told him about my fall a couple weeks ago and he quickly brushed it off after i described the motion of the fall.

After a quick exam of the knee he announced that he thinks the ACL is in great shape. He was pleased with the amount of muscle mass that i have gained back and thought i was in an average position with regard to range of motion.

Another thing that he noted was that since this acl reconstruction was done with allograft tissue and it was also a revision (the second time i’d had it repaired) I am particularly at risk of re-injuring the ligament in the next six weeks. During this period my up until now brisk recovery will be a hindrance as I’ll feel like i can be more active than my still recovering joint can handle.

The doctor recommended that I continue to be strict in wearing my brace when i’m not at home or in the office. He also said that i should reduce my PT to once a week but continue to go for 6-8 more weeks.

He definitely approved of riding a bike on a trainer, but cautioned me to keep the resistance low for a couple more weeks.

I finally got my borrowed trainer yesterday and set it up in the garage (A trainer is a little device you can strap a bicycle into to make it a stationary bike). I was most surprised by how different the action felt than riding the stationary bike at PT. The seat height is different, but on a real bike you’re also in a more aggressive position with the pedals more directly below you than in front.

I rode for 10 minutes before i started getting a little sore and decided to get off. For starters I didn’t wear my bike shoes, but i think when i go back out today I will. It seemed that clipping in would help align everything in my knee more correctly.

So anyway here I am six weeks out from surgery. I can walk quite well, my range of motion is getting close (although i do still need to work on extension) and can ride a bike on a trainer. For me, getting on the trainer is a really big deal. Riding a bike has been such an integral part of my lifestyle for a long time and being away has effected mind and body in more ways than you’d think. Getting back on the bike is a huge step towards getting back in physical shape, but also a symbolic step back towards the freedom i feel when i’m riding.

Here I am wearing my knee brace on the beach in Mexico last week. As much as I hate that thing, it does bring me a little pleasure to see that it’s covered in sand and sunscreen while i’m sitting at my desk in rainy, windy seattle.

I should be getting rid of it for good next week. It’s time!

I’ve mostly convinced myself that Monday’s fall will not result in any permanent damage, much to my relief. That allows me to get back to the important business  of building my strength and range of motion in the knee. 

If there is one thing that has frustrated me about this injury it’s the 10 weeks i’ve spent off my bike so far. Pre-Injury bicycling was not only a passion and a hobby, but my primary mode of transportation.  Since I got hurt i’ve been forced to commute by bus which has had negative effects on body and spirit. 

My PT says I can start riding on a trainer with no resistance as much as I want. It’s not the same as the wind in my hair and the rain on my face, but anything on a bike is a huge step forward for me.

Luckily I’m feeling much less sore today, so hopefully the scare of a re-injury will pass.

Yesterday I was getting ribbed at the office for squeaking while i walked down the hall.  I think it’s time to lube my brace!

Off to PT now.

Between the holidays, travel, work etc i’ve been a horrible blogger.  Many, many appoligies.

So, recovery in general is going quite well.  Between christmas and new years i spent a week in Mexico swimming and walking on the sand.  My knee was feeling quite strong and I’ve been ditching the brace when I’m inside.

However, I’m now kind of freaking out after a scary incident yesterday.  In a rush to get off  i took a tumble on the wet bus floor.  This tumble involved my knee (in it’s brace) flexing back all the way.  In any case I’ve been sore all day which is terrifying.  The thought that i’ve injured something in there when I’ve been doing so well is truly disheartening.  I’ll have my PT look at it tomorrow and am going to the Doc on Monday.  Here’s hoping that all is well.

Guess I’m feeling better. It looks like Henry and I haven’t written in awhile. Today, I stopped using my crutch. The Doc said I could have stopped last Tuesday, but I waited until today (Sunday) because most internet info recommends 6-8 weeks of 50% weight for microfracture surgery and tomorrow is 6 weeks. (Other doctors do say 4-6). What I wish the doctor had told me (or the PT) is that I was supposed to be doing 500 leg motions per day (motion machine, leg slides, or stationary bike) for the microfracture to work best. I have been riding the bike for 40 min per day for the last almost 3 weeks but wish I had known earlier. For athletes, they recommend 4-6 hours of stationary bike per DAY! I go crazy after 30 minutes. Oh well, I hope its enough. 

Feels weird to really walk again and I took the better part of the day getting my gait back. While I still have pain, this is the least pain I have had in my knee since September when I hurt it. Not bad. Seems that the worst of the early recovery (especially hamstring) is behind me now. Except that I still have a numb area about 2 inches wide from my knee to my ankle from the nerve damage. But thankfully, the pain there has mostly disappeared. I see the doctor for my 6 week postop on Tuesday so I’ll see what he says. 

I can’t wait to see what new tortures, um, exercises my PT will have for me this week now that I have two legs.

I seem to be doing about the same as I did from my allograft at this point in recovery. But up to now has certainly been worse due to the stress of the hamstring and the nerve issues (from the hamstring cutting). We’ll see if my autograft is stronger. My allograft is good so far (it didn’t tear when my other one did) after 5 years.

Incidentally, my scar from the hamstring hasn’t completely healed because a ball of blood blocked and lodged in a (very) small part of the scar line. While I was looking at this I noticed a small thin piece of dead skin elsewhere on the scar. I pulled but couldn’t get it. I pulled harder and an nearly inch long thread pulled out of my leg (and the hole started bleeding). It wasn’t the same color as my stitches (black) so I have not idea how or why it was left in my leg.

Maybe its just a holiday funk, but it seems that my ACL recovery is depressing me a little. Its not that I haven’t made great progress. I ride the stationary bike for a half hour each day (getting a free bike the day before surgery was the best thing I could have done), do leg lifts, and continue my physical therapy with all sorts of leg presses and stuff I couldn’t even think about a couple of weeks ago. It might be that I still am required to use one crutch to get around because of my microfracture repair, or that I feel like a recluse working from home and hemmed in by the cold outside. (I hear from my PT that microfracture repair is all the rage with FL surgeons and everyone down there is doing it). 

I guess depression is not to be unexpected when you go from being a very mobile person who lives to hike and is very active to a recovering ACL patient. The winter usually gets me a little depressed anyway. But I can’t even do things around the house like change the air filter (requiring standing on a chair) or bringing out the laundry basket to hang the laundry outside (which I normally do unless it would freeze) or carrying my son to the other room. I don’t know when I can bear extra weight yet. 

Ah well, its not like a am a big fan of Christmas anyway. All I want is my pre-injured knee back. Except I know that its not going to appear under the tree. Instead its many months of hard work away. And I know from experience I will get there. I just don’t remember being depressed last time and I had cartilage pain until a second surgery then. Maybe its just the crutch and the feeling that I can walk but it wouldn’t be good for me. Maybe its the painful and numb nerve damage in the shin (although it has improved some). Alright, enough whining. I’ll get over this feeling. Soon, I hope.

Today I had my first Physical Therapy appointment for recovering from my ACL Reconstruction.  As I expected we started by taking measurements of how far i could bend and flex the joint as well as measuring the size of my quads, calfs and knee.

We then moved to a stationary bike where i was quickly able to go all the way around with no resistance.  This is the one activity I remember from my previous recovery.  It felt so, so good to be back on a bike even if it was stationary with no resistance.

Following the bike my therapist put me on the “total gym” which is a contraption that allows you to do a kind of diagonal squat.  This was harder, but it felt truly fantastic to be bending my joints and using my muscles which have atrophied so much.  After five minutes my knee felt loose and my leg muscles were delightfully tired.

Following this the therapist helped me with some stretching, another sensation i’ve been missing. Getting the back of my left leg stretched out felt simply fantastic.  She assigned me some stretches to do at home.

Following the stretching she showed me some variations on leg lifts which will help to strengthen my whole leg and protect my healing joint.

That last thing was getting some electrodes attached to my knee, having my knee packed in ice and sitting still while the elecricity passed through my knee for 15 minutes.  This was really an interesting sensation and i’ll try my best to get pictures of it next time it happents.

I mentioned that 1 week after surgery I was allowed to shower and go down to one crutch.

What could I do this week (day 14) that I could not do on day 7? (some things were probably more avoided for pain reasons than actually precluded)

actually use 1 crutch to get around 

ride a stationary bike (although I overdid it the first two days)

drive a car (but not a stick-shift

lift my son in and out of the crib/high chair

saw down and drag a (little) christmas tree to the front door

cook and wash dishes

sleep on my stomach! (for a little while)

Things I still cannot do (or fear to do or it hurts a lot to do)

walk without crutches (3 more weeks!)

carry my boy while walking

the laundry (the machines are down a long scary flight of stairs)

Physical Therapy without pain

long shopping trips

sit for > 1 hour without elevating my leg

go to the circus (I didn’t think it was a good idea)