ACL Class of 2013

[ate'em]

two weeks post-op today-

Returning the icing maching this afternoon, boy the Game Ready has been a godsend. There were days I barely took the thing off, day and night. The cycling lets you sleep straight through without having to turn it on and off. The compression cuff sometimes felt weird at first with lots of swelling, but was a good option to have. Can you tell I like this device?

Been doing lots of gentle massage around the knee, seems like this really helps to keep things from getting stiff. As time went on and the swelling went down, the ice seemed to increase stiffness, so I have shifted over to more massage.

Pain still a force to be reckoned with, almost ran out of meds this morning but thank god for a timely post delivery of a new script. I sure didnt think I would be still hurting so much, but Doc assured me at the time of surgery that I would. Man knows his stuff.

ROM slowly improving, extention is really good, pretty much same as my normal knee. Quad sets can lift my heel up off the ground, which feels good. Flexion is pushing up on 90, which I was restricted to until today. Now I can try to push on. Slow steady progress, sure a lot of patience needed.

Getting these crazy burning electrical sensations around the inside of my knee as the nerves wakeup. Like nothing I have ever expereienced before. But the numbness is minimal in my skin, so I am glad to be getting back the sensation, bizarre and painful as it may be on occasion.

Almost jealous of all you with simple ACL repairs, but still real grateful that I am headed for a full recovery. Just a bit slower. Crutches are lame, down time is torture, but I see the (tiny) progress every day.

Stay positive, it's the only way...

[valli]

Glad it sounds like everyone is doing well, too bad Mrs. Flounder had the double whammy of auto and allograft. I'm pretty small as well and they didn't think they would get enough for an autograft, and being over 40 the docs all recommended allograft. Dr. LaPrade told me he hasn't has any allografts fail once his patients get past 2 years, just have to get that far.

I'm now fifteen days post surgery. I'm very fond of the game ready, and I'm thinking of buying a used one. Found someone who's willing to sell a first generation one for $600. I'm cutting down on the pain meds, but still need it for physical torture sessions and at night. I have full extension and today got to 100 ROM, after being limited to 90 for two weeks. Doing lots of quad sets, leg lifts, and today got to add in wall slides and supported leg raises, along with the arm bike for cardio. The steristrips were removed and I'll have some impressive scars, although my doctor was awesome enough to do a plastics closure on the big incision for the LCL. He knows I'm vain. It's sad watching my leg muscles start to atrophy, I did a lot of pt before surgery and they got pretty muscled. My back and hip are killing me, all this sitting is not good. I'm getting some zingers on the inside of my knee as well, amazing how sharp they can be.

One positive thing is how great our friends and our kids friends have been at helping out. My kids (ages 7 and 10) have play dates after school for the next month, I don't think they've ever been so popular. I have several friends who have volunteered to take me to pt and bring dinner, it's making the time go faster. My younger daughter has just collapsed dramatically after falling in our living room and announced she needs crutches and a pillow.

[Wildman]

Had to make an ice run this morning because the ice maker in the fridge can't keep up. .

Flounder- I had the same problem. A food solution is to go buy a 12 pack
Of 7oz plastic water bottles. Freeze and rotate 6 and 6 ino the game ready. That way you always have cold water. Worked like a charm for me.

[Rosebud]

Crutches are lame, down time is torture, but I see the (tiny) progress...

Felt the same for the first six weeks. Once I could start putting weight on my leg I noticed I improved significantly at PT... Not to mention my mental/emotional outlook day to day was much more positive.

I'm at 8 weeks with 110 extension and about +10 progress per week. Should get rid of my last crutch in the next few days. Out of my 3 reconstructed ligaments, only the mcl barks a bit during stretching. No issues with either repaired meniscus. Electric sensation feeling is mostly gone but some numbness which I'm sure will be around for a while. My knee still looks like a grapefruit compared to my other but I noticed massaging works best by breaking up scar tissue and lots of patience. See LaPrade for a followup next week.

Hang in ther, gets better.

[brual]

Hi all!

I joined the class after a stupid fall at Stevens Pass on a blue run while trying to record a big group of people.

Got hamstring autograft 2 weeks ago, menisci were perfect, can't complain. Although it was scary how I did got huge apnea episodes after the anesthesia and had to sleep in the hospital, my oxygen levels were dropping to 70s!! I was asked to stay of narcos pretty much from day 2, I'm so glad it didn't hurt too much! I started on the bike from day 9, and now got 130 flexion and >0 extension and it starts to feel normal when walking!

This weekend I started getting the middle of my calf pulled and it hurts quite a bit. It happened a bit on Friday and I managed to stop it before it got fully pulled, but today after a missed step on the stairs I fully pulled it! Does anyone have similar issues? I'll be talking to my PT tomorrow!

Hang in there!

[MRG_girlwonder]

Friday was close of week 8 post surgery. Big break through since week 6 and earlier. I dont get stiff sitting at work anymore. I have more strength and flexibility and enjoy hikes and outdoor bike rides again ( no clips yet) and don't get swelling an hour later. I'm aware that my knee and quad is not up to par of the healthy one, but I no longer feel I'm doing much in the way of accomidation to make up for the gimp leg. Now I just wait another 2 mos to get the full strength and healing for running!

Hang in there, all! It gets better sooner than you think!

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[Flounder]

Flounder- I had the same problem. A food solution is to go buy a 12 pack
Of 7oz plastic water bottles. Freeze and rotate 6 and 6 ino the game ready. That way you always have cold water. Worked like a charm for me.

Dug out some old take out containers that are doing the trick now. The solid blocks seem to last longer. First follow up was today along with first PT. went well and everyone is pleased with the progress.

[valli]

So I'm now 19 days out, and things are steadily improving. My pain level is diminishing and I am now at full extension and 115 ROM, and getting bored out of my skull. My pt session was cancelled today because my therapist got sick, and all I could think was, what about my arm bike time? I found a used game ready with the knee attachment for $600, since I'm not quite ready to give it up yet. I also think I've found a type of custom brace that may work for riding, since all the ligament braces I've seen so far are too bulky in the medial area. Ossur makes a custom ligament brace called the Extreme for motorcycle riders and equestrians, and while their website says it's only available in Canada, I called them up and they said they can make it for the US market as well. I do three day eventing, kind of like motocross on horses, and I've been trying to find a brace that you can ride in, so this is a surprisingly big relief.

On a more mundane note, how long are you all wearing the oh so sexy ted stockings? My doctor wants me to wear them for six weeks, but it's almost 90 here now and I'm moving around a fair amount and doing the arm bike for cardio, so I'm wondering if I can ditch them sooner?

[spindrift]

Will fill in more on my gig later - today is 3 weeks post op. But regarding that question - I dumped the stockings after maybe 4-5 days (doc wanted it longer). Wish I'd done it sooner. Poking around the net, there are a number of studies that call into question the efficacy of the stockings. I made a point of using all those muscles as much as possible as my "insurance" on that front. Do some googling and see what you think and make an informed decision as makes sense to you...

I do hate how the sucky brace rubs on a couple spots (like my bigger incision). I have some tubigrip and just cut a length and put that on under the brace...

[Wildman]

The stockings are worn to prevent blood clots. Which can be deadly. You can do all the research you want, but the bottomline is while uncomfortable, they really help. I wore mine all day for 2 weeks taking them off for sleeping.

[spindrift]

FWIW, my doc's office emphasized wearing them at night

[Wildman]

I wore mine all day for 2 weeks taking them off for sleeping.

...good catch spin.

I began taking them off at night after two weeks. I wore them both for two weeks. But since the injury was to my right leg, I ditched the one in my left leg and wore the right one only for another week or so.

I guess it all depends on how quickly you heal. Everybody's different.

[MRG_girlwonder]

I did not have a stocking at all. They wrapped ace bandages tight for compression and didn't take them off until stitches were removed, 1 week after surgery. Never was told to do anything special after that for clots.

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[Chainsaw_Willie]

I did not have a stocking at all. They wrapped ace bandages tight for compression and didn't take them off until stitches were removed, 1 week after surgery. Never was told to do anything special after that for clots.

Same here. My bandages were removed 4 days post-op and they never said anything about compression or doing anything for blood clots. I've got quite a bit of bruising on the back of my thigh & calf but it's receding. Have been massaging it regularly and that really helps.

Things have been progressing pretty rapidly but I'm starting to get pain at the back of the knee now when straightening out the leg. Will see the PT again this evening, then we're going down to once-a-week appts. as my insurance doesn't cover PT very well and it's expensive. Going to join a gym later this week so I can start riding the exercise bike and working out on the machines with light weights.

[ate'em]

3 weeks post-op for the ACL, MCL, meniscus triple combo special-

ROM -5 to 100, although it sure is tight before I get warmed up. Quad control excellent.

Swelling is still pretty bad around the MCL, I massage it gentle and feel the whole mass of fluid moving around my knee capsule. not a nice sensation.

Muscle massage has been really good to reduce the stiffness in my leg. Still love my ice machine as well. Knee brace sucks though, the metal rods dont feel too good and the angle of immobilization never seems quite right. That's life for now.

Pain is a bitch. Off the oxycontin, but still have persistent shooting pains in my knee. 31 different flavors of pain, the diversity keeps me on my toes. Percocet definitely helps, laying down to sleep not so much.

Halfway to getting off the crutches, cant come soon enough. Sad to see my leg wasting away, loosing so much muscle mass. There are bad days and good, no pattern really. Positive attitude and willingness to endure never hurt.

Strength to all the rest of you healing up. Some of you are just charging through the rehab, good to hear about that! I am so excited about riding the excercise bike out on the back deck, someday, someday soon...

[Chainsaw_Willie]

ate'em - Given the amount of damage you did I guess the slower pace of your recovery is probably to be expected. Must be super frustrating. If you lived near me I'd bring you some beers to wash down the percocets and we could talk shit about skiing. Stay strong and focused man, it'll come.

Closing in on 3-weeks post-op. Most of the swelling is gone in the mornings but after being up and around all day it's still swelling some. I have most of my range of motion back, still working on that last little bit of flexion.

Joining a gym tomorrow so I can get on the exercise bikes and weight machines.

Overall the knee feels good and I'm getting frustrated by my lack of mobility, but the strength and coordination aren't back yet and there are still weird pains when I try to do certain things that the PT says is related to where they extracted the hamstring tendon. For example, from a standing position I can barely flex my leg to lift my heel behind me. Get pains in the hamstring and down the inside of the knee when I try and the leg just won't cooperate. Also, loading the leg at anything other than a straight position hurts.

I too am amazed at how quickly things have atrophied. My left leg was always the dominant leg. Doc commented on the X-rays that you could clearly see the bones have more mass in the left leg than the right and the musculature in the left leg has always been bigger. Not any more. The left quadricep has shrunk dramatically. I want to stop this as much as possible, but doc & PT don't want me doing any strengthening exercises 'til the internal sutures have healed and the bones have started filling in around the graft, so 6 weeks before I can do much about it. That'll be right about the time I get my shoulder fixed, so not sure how much I'll be able to do about the leg with my shoulder out of commission for another 6 weeks...

[valli]

Hey Willie, maybe your legs will end up equal after this, or at least close to it. My left side is my weaker side, and the atrophy is pretty dramatic already. I've been doing sets of quad contractions, leg lifts, calf exercises at least four times a day, but not being able to to put any weight on it is a real bummer. I find myself looking at other surgeon's rehab protocols for the posterolateral corner longingly, since my surgeon is definitely on the conservative side, but I guess it's safer to stick to his protocol. My ROM and extension is good, but it's painful and stiffens up quickly. Although I know they are viewed very unfavorably on TGR ("gaper city"), I've been wondering if it would be helpful to pick up a used Skier's Edge someone has locally for rehab before skiing next year. I already have a pretty big collection of used home gym equipment (stairmaster, exercise bike, weights, bosu, pilates stuff), but I've heard the skier's edge is decent at exercising the ski specific muscles, despite their ridiculous ads. If I put it in front of mindless television or a ski video I actually use the home gym equipment, although Mr. Valli is starting to complain about the sheer volume of the stuff. Any thoughts on whether it's worth picking up a cheap used one?

[Chainsaw_Willie]

I don't see how it could hurt (other than your hubby might go bonkers), but ask your doc first.

The wood steps leading down from my porch get really slick when it's wet. I was going down the steps very slowly and carefully yet my right leg slipped out right at the crucial moment on the slick-as-snot wood and I went down hard. Didn't bang the knee, but twisted it up pretty good and now it's stiff and sore as hell. Didn't hear any popping or crunching so hoping nothing's been re-injured. I just freak out and worry about the worst-case scenario, like the graft pulling out from the end where it's just plugged in...

Guess we'll wait and see how it feels in a couple days.

[spindrift]

Bummed to hear that CW. Hope its is just annoyed and gets back on track ASAP.

[rmnpsplitter]

3 weeks post-op for the ACL, MCL, meniscus triple combo special-

ROM -5 to 100, although it sure is tight before I get warmed up. Quad control excellent.

Swelling is still pretty bad around the MCL, I massage it gentle and feel the whole mass of fluid moving around my knee capsule. not a nice sensation.

Muscle massage has been really good to reduce the stiffness in my leg. Still love my ice machine as well. Knee brace sucks though, the metal rods dont feel too good and the angle of immobilization never seems quite right. That's life for now.

Pain is a bitch. Off the oxycontin, but still have persistent shooting pains in my knee. 31 different flavors of pain, the diversity keeps me on my toes. Percocet definitely helps, laying down to sleep not so much.

Halfway to getting off the crutches, cant come soon enough. Sad to see my leg wasting away, loosing so much muscle mass. There are bad days and good, no pattern really. Positive attitude and willingness to endure never hurt.

Strength to all the rest of you healing up. Some of you are just charging through the rehab, good to hear about that! I am so excited about riding the excercise bike out on the back deck, someday, someday soon...

Mrs. Splitter just got the same diagnosis, ACL MCL and lateral meniscus. Surgery in 10 days. Been pushing her on the stationary bike pre surgery. What type of repair did they use in you? She's young so they want to use some of her own tissue for the graft. Choices are hamstring tendon or patella tendon. Thoughts on either?

[Chainsaw_Willie]

both docs I saw said they use patellar grafts in young athletes. Both those docs treat real, competitive athletes - one for the UW and the other for the Seattle Sounders. They said it creates a stronger repair but is a longer, more painful recovery. For non-competitive athletes they'd go with hamstring as the recovery is faster. Potential downside is some permanent loss of hamstring strength, which shouldn't be a big factor in skiing but could be in some other sports like swimming or soccer.

[pesto]

Patella autograft, no menicus damage. 7 weeks out and so far so good. The PT had me take it easy the first 6 weeks mostly working on ROM, swelling, maintaining muscle tone, balance and bike. I feel like the PT may be a little bit conservative in his approach but he has a ton of experience and what he's been having me do seems to be working, so I won't complain.

Even taking it easy I've over done it a few times and paid for it with sleepless nights ... pain and worrying that I'd damaged the graft.

Last week was big. I survived DIA, ATL and 3 hours sitting in the middle seat of a plane and on Sunday I walked nearly 10 miles. Huge since I normally walk everywhere and it's good to be able to get back to that mode of transportation.

Stairs ... since that seems to be causing some issues (cw, I hope the fall didn't cause any real problems). The PT told me not to use the operative leg on stairs until last week. Gimping up and down stairs for 6 weeks was a pain but when I started doing them at week 6 I had the strength and flexibility to do them normally right away.

This is my second ACL reconstruction and it has gone much quicker and smoother then 18 years ago. There's still a long way to go and I have my fingers crossed that I won't have any big setbacks.


Keep healing, everyone.

[valli]

Ten miles, pesto, I'm impressed! One of the hardest things about the recovery process is that feeling that you (or at least the graft) are fragile, I doubt it's the way most of us normally think of ourselves. I've definitely has a few moments of oh shit what did I just do to my leg. So far it seems to be ok, but it seems inevitable that there will be that slip or awkward movement.

With respect to graft choice, I just had dinner with a friend who did patellar tendon autograft, and she still has patellar pain ten years after. I did patellar tendon allograft because I'm over 40, but if I was doing autograft I would probably do hamstring. The studies I've seen show equal success rates and less chance of residual pain, especially patellar tendinitis.

[ate'em]

Mrs. Splitter just got the same diagnosis, ACL MCL and lateral meniscus. Surgery in 10 days. Been pushing her on the stationary bike pre surgery. What type of repair did they use in you? She's young so they want to use some of her own tissue for the graft. Choices are hamstring tendon or patella tendon. Thoughts on either?

Dr LaPrade used my hamstring tendon to reconstruct the MCL. Then patellar tendon to reconstruct the ALC. So both autografts. I am 33 and fit, so autograft seemed like the obvious and correct choice for me. Plus I am a bit weirded out on using part of a cadaver in my body.

Recovery is slow, a bit brutal in fact. Give the lady loads of time, patience, and support. Prehab the mind more than the body is my advice, staying positive is not easy. Enjoy what you enjoy before the surgery, things get a bit worse before they start to get at all better.

I spend about 8 hours a day icing (including at night while sleeping), massage my leg for a few hours daily, and try to do three 45 minute PT sessions daily. Recovering is like a really painful full time job. Use the pain meds, they allow you to get the PT done and to sleep at night. Plus the pain can really wear you down mentally, even if it isnt excrutiating, it gets to you after a while.

And dont skimp on the icing setup. I rented a GameReady for three weeks, and now am using a DonJoy Iceman. A cold knee is a happy knee. It is amazing how fast the heat builds up and the swelling increases.

My best to you and yours as the surgery approaches.

[Wildman]

RMNP - there is a very good discussion about hamstring vs. patellar tendon in the class of 2012 thread as well as earlier on in this thread.

It really comes down to what your doctor recommends and is most experienced at doing.

I went with patellar, and am feeling good albeit healing slowly. But im
In no rush...One thing of note is that I would not go patellar if my profession was construction or painting, anything where you have to kneel a lot.