Thread: Acl "Pre-hab" questions

My ACL reconstruction is in 4 weeks, but my injury was 9 weeks ago. I am wondering if the pain I am still experiencing is normal.

My injury happened back in April and I have been going to PT and doing the prescribed exercises at home. Right after the acute injury, which was a complete ACL tear, 75% MCL tear and significant bone bruising, I had almost no range of motion. I experienced a lot of pain bending (heel slides) and had a marked arc of pain between about 80 degrees and 110 or so. This was fairly excruciating and lasted for 6 weeks or so. My PT thought I had meniscus damage so my surgeon re-visited my MRI. He said the meniscus looks good so the answer is scar tissue and to just push through the pain.

I bought a stationary bike which I get on 2-3 times a day with the seat as low as it will go. I can now touch my heel to my butt and my flexion is about 1-2 degrees. I can get it to zero with work but it stiffens up when I'm at work.

I am thrilled with my progress, but I am concerned about the pain I am still having. I've only just started to go down stairs normally instead of one at a time, but it hurts pretty bad. Going up is beginning to feel much more normal but I still get a tweek every now and then. My gait is finally starting to return to normal but only in the last week or two.

I know I have to start healing all over again after surgery, but I'm curious if this is the normal progression for the acute injury healing. 9 weeks seems like a long time to still have these limitations and significant pain.

When I bend to 140 or more, it feels like my knee cap is just going to pop off and everything will just come flying out. Weird, I know.

don't expect to have much stability until months post-op, and try not to push your knee too hard, it could end up tearing cartilage/other ligaments if it goes out. i fully tore my mcl last year and partially tore my acl, and it felt really unstable until it got cut open and fixed. bottom line- if it hurts, don't do it, its not worth chancing another tear.

The whole reason you are having the surgery is to fix the knee. I think you have to expect some pain. The pre-hab is to get yourself in shape, which it sounds like you are doing. you could be possibly overdoing it slightly--but if you are consulting with a PT, then probably not. Your doc isnt going to know exactly whats wrong until they get in there--you may have some meniscus issues that just cant be seen on MRI too.

Thanks for the replies. I'm trying not to over do it. I actually think I was overprotecting too much and my knee stiffened up and developed scar tissue. The bike has been a huge help. I don't have any pain spinning at all now. I'll be more careful with the things that do cause pain.

I realize there is still a chance he will find meniscus damage, but I am feeling much more optimistic now that I am progressing. After his second look at my MRI, he said the meniscus looks pristine. I believe that's the word he used. I'm keeping my fingers crossed.

As far as my PT goes, he told me "sorry, but frankly we don't care if it hurts. We want full range of motion". I wasn't bothered by his remark. I have knowledge in a lot of areas, but that's not one of them. I need to trust him.

I do have full range of motion now. And I have a whole new appreciation for pain. I suppose it will make the days immediately following surgery a little easier.

I really hate taking drugs. They gave me Vicodin, which I took none, and Percoset which I took for a day and a half after my injury. Since then, I have taken an Advil here and there. I'm actually terrified to go under a general anesthesia, want nothing to do with Morphine and doubt Advil will get me through post surgery. I guess I'll have to cross that bridge when I get to it.

Originally Posted by Lost Boy Knee

Thanks for the replies. I'm trying not to over do it. I actually think I was overprotecting too much and my knee stiffened up and developed scar tissue. The bike has been a huge help. I don't have any pain spinning at all now. I'll be more careful with the things that do cause pain.

I realize there is still a chance he will find meniscus damage, but I am feeling much more optimistic now that I am progressing. After his second look at my MRI, he said the meniscus looks pristine. I believe that's the word he used. I'm keeping my fingers crossed.

As far as my PT goes, he told me "sorry, but frankly we don't care if it hurts. We want full range of motion". I wasn't bothered by his remark. I have knowledge in a lot of areas, but that's not one of them. I need to trust him.

I do have full range of motion now. And I have a whole new appreciation for pain. I suppose it will make the days immediately following surgery a little easier.

I really hate taking drugs. They gave me Vicodin, which I took none, and Percoset which I took for a day and a half after my injury. Since then, I have taken an Advil here and there. I'm actually terrified to go under a general anesthesia, want nothing to do with Morphine and doubt Advil will get me through post surgery. I guess I'll have to cross that bridge when I get to it.

you are on the right track for sure.....I think the best thing you can do is ride the bike, and lift weights for your rest of your body. In general your overall fitness level will speed your recovery. Focus on the bike, some upper body lifting & core 2-3x a week, and some protein-recovery drinks immediately after.

I was at a huge disadvantage because i did not prehab. In essence my post surgery rehab was also a fitness level increase for me, and i was always tired. I did a accelerated rehab protocol.

I can't wait to have my surgery behind me, but I'm kind of glad that I have almost 4 more weeks to get strong. July 14th was the next available surgery date that my Dr. had that didn't conflict with my husbands travel schedule.

Now that I have full ROM and less pain, I am working it at every opportunity. I do quad sets all the time, wherever I am. In line at the grocery store, at my desk, even for the 15 min. I'm in the tanning bed (I know, I shouldn't tan).

I get on the bike before I leave for work, even if I only have 10 minutes to spare. Gets it loosened up to start my day. I should be ready. Physically. I still need to get my head in the right place, but that's another story.

My husband, by the way, makes a mean smoothie with whey protein. When I make them, they taste like chalk. Bleck. His are terrific.

Your PT is trying to keep ROM, strength up and scar tissue to a min. before the cut.

The "don't care if it hurts" comment was rather dumb on his part though unless it was in passing.

2 knee surgeries and one ankle full recon, my PTs told me to go till it "hurts" then back off a tiny bit.

Pain in PT is relative. But if it is TRULY hurting, then stop.

im experiencing all the same symptoms post injury. i tore my acl and partially tore my mcl last monday and still cant walk on it without my crutches with the exception of a couple steps with a major limp. i have a feeling i prob did some damage to my meniscus too.

i started pre-hab this week and of course the therapists emphasize regaining ROM and full flexion. flexion is not so bad but bending my knee past 80 degrees is almost unbearable. how long did it take you to get ROM back and when did the swelling start to decrease.

im hoping to set a surgery date at the end of the month but im skeptical i will be ready in time. i hope i dont have to wait 9 weeks to have surgery. seems like a long time...