Thread: ACL allograft surgery report thread

Wow, huge improvement at the 12 week mark. My formal PT sessions ran out 2 weeks ago, but in some ways it's a good thing: I never really felt pushed at PT and now I can push myself all I want. Man, I hate the gym, but I'm dragging myself there 3 times a week, really focusing on hamstrings (curls on a ball and regular curls) quads (squats, leg press, lunges, biking, et.c), and general balance stuff. And boring cardio, of course. Its paying off, things are finally starting to feel pretty good.

I've also been walking backwards on an inclined treadmill to help with extension and to get my VMO working. I love it...I love the weird looks I get from folks, especially from the New England gym bunnies. It's funny.

My patella still bugs me now and then, but really only after a weight lifting session, so I think its mostly due to my fatigued muscles not holding their own when tired. It has definitley gotten better and continues to improve every day. Which is amazing- three weeks ago I thought it would never go back to normal. Hope for those out there worrying about similar issues!

Other small issues include a grinding feeling every now and then when I step forward with my repaired leg. And some clicking. And I can't quite get my extension equal to my other leg. But everything else feels pretty solid.

I can't even remotely imagine jumping, sprinting, or cutting right now, but hopefully the confidence will come as I keep working at it.

3.5 month check-in with the Ortho on January 16th, so I'm just trying to get things as strong as possible in prep for that...hoping he'll clear me to start running. And I'm wondering if he'll start the process for getting a brace. We'll see.

I might try some light (super light) XC skiing this weekend...and I'm definitley going snowshoeing tomorrow. Haven't been cleared to do either, but I can't see them causing problems if I'm uber careful.

So that's the latest in this lovely journey. I've learned a TON already and its only been three months.

HAPPY HOLIDAYS and HAPPY HEALING everyone!

Thanks! this is really helpful. My surgery is scheduled for March 7--may push it off till end of march though--not by choice--just a better time for me to take time off and rehab without worrying about work.

I'm 2.5 years post-op, allograft (with other non-op injuries). Haven't visited the gimp board for some time, but figured you (and others) may want to hear from someone who believes the injury is behind them...

- in the begining the bike is your friend, ride, ride, ride.
- this takes time, more for some less for others, be patient.
- the 6 months milestone is b.s., 1 year is real, after 2 years you'll stop visiting tgr/gimps
- ride, lift, ride, lift, plyo's, hike, run, climb, ride, etc. use this as an excuse to become a fitness/gym rat (if you're not already).
- get a custom brace for year 1 skiing.
- don't worry; eventually you'll be 100%.

I blew mine at 47; I'm 50 now and plan be to jumping into avy chutes next week with my teenagers.

work that knee!

thanks Here2Day! Always great to hear from recovered folks....its really helpful and keeps the hope/motivation levels high! i hope you stomp those chutes!

another weird (but minor?) issue i forgot to mention in my last post: my entire groin on my repaired leg is incredibly tight and has lost a ton of flexibility. i'm naturally pretty flexible so this is pretty weird. i feel like a teenage boy when doing the butterfly stretch...and it's only on my repaired side. strange.

anyway, time to ride the bike. la.

Originally Posted by here2day

I'm 2.5 years post-op, allograft (with other non-op injuries). Haven't visited the gimp board for some time, but figured you (and others) may want to hear from someone who believes the injury is behind them...

As a two time PTBB recon person, currently waiting for spring to get a third recon (method TBD), I'll comment based on my experience:

- in the begining the bike is your friend, ride, ride, ride.

Absolutely, the more the better provided you don't get pain.

- this takes time, more for some less for others, be patient.

Again, absolutely. Don't rush it.

- the 6 months milestone is b.s., 1 year is real, after 2 years you'll stop visiting tgr/gimps

I'm going to disagree and say the 6 months for both of my knees was about right. With the first one I didn't quite feel 100% at six months (probably 8-10 months), but I was able to do everything (in skiing) I wanted to and had previously. Air worried me at first, but after the first few landings it was fine. I think if your surgeon/PT clears you at six months you can go for it. With my second one I skied at almost exactly six months and within a day felt back to normal.

- ride, lift, ride, lift, plyo's, hike, run, climb, ride, etc. use this as an excuse to become a fitness/gym rat (if you're not already).

I'd add skating--ice or roller. Great for the smaller muscles around the knee you need for skiing, and somewhat dynamic movements (very similar to skiing--even for those not rehabbing, I think skating is one of the most effective exercises for skiing).

- get a custom brace for year 1 skiing.

Disagree. Should be completely unnecessary, and won't do anything to help your ACL. Didn't use a brace for anything after either of my recons--I'm using one now just because I'm skiing without an ACL and want to try to minimize damage to other structures if I have a problem, but I'm not even sure it's very useful for that.

- don't worry; eventually you'll be 100%.

Yes. That's the only really good thing about having ACL recon, you should have a full recovery and be back to how you were pre-op.
Good luck to you gimps.

Dex - vibes to you. Going through rehab 3 times is heroic - good luck this spring.

Agree about skating. I used a slide-board in the gym to good effect.

Re. 6 months, I may just be a wimp who doesn't heal fast. I wasn't "strong" until 12 months.

And finally... the brace, well I suppose it's just peice of mind. Though it does seem it would prevent a hyper-extension.

I'm reading the forums getting stoked about the storm approaching the Sierra -heading to Mammy tomorrow with a nephew from New England - he's gonna experience something special.

Happy, healthy New Year to all current and former gimps!!

Hey all! Happy New Year! I'm so psyched that its no longer 2007- Year of Plan Wedding and Blow ACL. And I'm even more psyched that its now 2008- Year of Quit Job and Move West!

This update is just to say that at 12 weeks (today) my knee did fine on a 4-5 mile rambling snowshoe through some rolling hills in Vermont. It's a little puffy right now (knee hangover) but felt great and stable all day, even during and after some spectacular tripping over my own snowshoes...I had a a bit of a hazy head this morning...

Anyway, thanks to all for the advice. I'm gonna ask my doctor about skating when I see him in a couple weeks. And Conner...

Originally Posted by connersw

Is it just your groin or is your whole leg tight? I'm pre-surgery (tore it on the 11th), but I've been riding the bike and doing one legged squats in hopes of skiing again next week. My whole leg is incredibly tight though (especially my hamstring). I'm worried about stretching too vigorously and hyper-extending in the process. Should I just stretch like normal or is the something different I should do?

My groin is really the only tight thing on my repaired leg. I've got tons of lovely knots all through that thigh, but they don't impede my motion, whereas my groin isn't really letting me move much at all. I'm no expert, but it sounds like you're just tight and sore from your exersices and I'm pretty sure you'll be fine if you keep stretching. Getting full extension back is super important pre-surgery, actually. So I say stretch away. Slowly and gently, of course.

I hope you all have an awesome, healthy and safe 2008!

Originally Posted by ikkin

2008- Year of Quit Job

Shh don't tell my boss but me too.

10 weeks out and I'm starting to focus on the hamstring. It's weak as a kitten

It's funny, usually I'm the one bugging everyone to do winter things now I keep getting calls from all the folks I've dragged places and loaned equipment to.

Erin

Originally Posted by ikkin

2008- Year of Quit Job and Move West!

West? You mean like Chicago? I hear you have friends there.

Had my (barely) 4 month post-op appointment today and the doc was really encouraging regarding my progress. Cleared me to run and sent me off with a script for a brace (Donjoy Defiance in orange) so I can start side-to-side movements. He tested both legs and said my repaired knee is more stable than my non-repaired knee, which I could feel myself as he moved them around- my “normal” knee had way more play in it. He was also impressed with my extension and flexion and dismissed my concerns about each, saying the remaining few degrees will come back as I continue to gain quad strength.

He also said if I keep building strength I can cross country ski in a month or so, which will be mid February and 5 months post surgery. And he said regular skiing in March shouldn’t be a problem as long as I take it easy and my muscles are strong enough. So I'm nervous and psyched about that goal...I don't want to push things too quick, but if he says so...maybe I won’t miss the entire season!

All that aside, although I haven't tried cutting/hopping/pivoting yet, it really is feeling pretty good these days. I can FINALLY lower myself down stairs without just dropping halfway. And I only have patellar tendon pain after tough workouts now…one of which should be tonight….for the first time in my life I actually can’t WAIT to run! (I am so done with the elliptical and stationary bike!)

So now I just need to figure out what sort of side-to-side exercises to do…my insurance cut me off from PT and I don’t have a protocol. Any suggestions from the ACL vets out there?

I've learned a ton so far, most notably that patience and persistence are really helpful during the recovery process. No matter how bleak it seems after surgery, things really do improve if you just keep working at it. My knee feels closer to “normal” every single day. And although I sometimes have crazy recovery expectations, it improves at its own pace. It gets better slowly and gradually- and not overnight (like I originally wanted ).

So anyway, that's the latest. I'll let you all know how it goes with the treadmill tonight. Hope everyone is recovering well!

Hey Ikkin

so I had my allograft done 10/5/2007 - I guess 2 days after yours!

Anyhow, I saw your post so I thought I would tell you the side-side stuff my PT was having me do when my visits ran out:

mild
-----
side lunges - just step out to the side 2 shoulder widths plant foot aligned with knee and bend; looks like a "horse stance" from martial arts aka shiko-dachi (sp?); the usual 3 sets of 10

medium
-------
cariocas - these are the ones where you step to the same side repeatedly alternating whether you step in front or behind when you alternate the stepping foot - they made me go 20' and back 5 times

slide board (probably can't get one w/o a PT but seems pretty similar to roller blading on a REALLY smooth surface) - they had me do 2 mins at a time on the slide board, no idea what roller blading equivalent is

spicy
-----

rapid lateral movement - basically you hop from side lunge position to the same position shifted ~4' over; you go the same way 4 hops then reverse direction hard and go back - be really careful with the reverse; they made me set a timer and do as many as I could in 20 seconds 5 times



Hope that helps


My own question - anyone our there have the tibial screw out post acl? Dr says mine got's to go and I was hoping to be skiing 7 days after that (screw out Feb 1 ~ 4 months post op, first ticket to Utah Feb 8). People think that's crazy?

Thanks

Steve

Good post steve.

Three weeks behind you two and just started hips and controlled side motion. Goal of March 7 for some 3pin x-country. Everything is crusing along with only one hiccup during the first week of hamstring work.

Originally Posted by telemarkerSteve

My own question - anyone our there have the tibial screw out post acl? Dr says mine got's to go and I was hoping to be skiing 7 days after that (screw out Feb 1 ~ 4 months post op, first ticket to Utah Feb 8). People think that's crazy?

Thanks

Steve

I just talked to a girl I know who had the surgery in the spring and she is having her screw removed because apparently it was backing out by itself. Is that the case with yours? That was the first time I had heard of such a thing.

Yeah, I've heard that 2-10% of the time the screw works loose in the tibia and has to come out, so it's not super rare. It's supposed to be no big deal - walk out of the hospital the same day, no crutches.

I actually don't think that's exactly the deal with mine - my screw isn't loose but it's causing irritation anyhow. From what my (very pithy) doc said, the cadaver patellar tendon graphs come in sizes different enough relative to what you need that sometimes you wind up with the screw head protruding from the bone instead of flush and then it can irritate things - in my case the hamstring tendon attachment point medial and just below the patellar tendon.

BTW I just tried roller blading today for the first time since the surgery and it felt totally fine. Seems like it hits mostly the same stuff as the slide board was so it might be a good lateral exercise work in - only medium aggressive too.

It was also good for me because it hit my hamstrings but didn't bother my gimpy tendon - I guess the forces in that situation mostly stress the other hamstring tendon attachments.


Steve

well, at the suggestion of dexter and H2D, i grabbed my skates and hit our local town pond today (16.5 weeks post-op). it was quiet- i was the only one there- and the snow was falling, making for an awesome sunday morning. skating was super fun and it was almost stupid how much fun it was to be sliding on something outside again. i was pretty hesitant at first, but loosened up after awhile and was skating about 80% after 20 minutes or so. crossovers and backwards and everything, just slower than my 100% speed. other than a couple twinges here or there the knee felt great! brace is comfy too, i can hardly tell i have it on. thanks for the suggestion guys!

17 weeks today...shot a basketball around and did some easy cutting/dribbling with the hubby playing light D last night after my workout (which included steves side lunges, thanks!). it was fine, i just lack confidence planting off the repaired leg, but our shootaround sessions get more aggressive each time, so confidence is certainly improving. i also did some jumping stuff last night. muscles are sore today, but knee feels fine, just a little tight.

brace is so low profile that it doesn't get in the way at all...pretty sweet.

looking to add some yoga to the routine...i'm gonna check the gym schedule for the basic classes.

Originally Posted by ikkin

looking to add some yoga to the routine...i'm gonna check the gym schedule for the basic classes.

Sounds like its all coming along well, congrats. I'm about 7 years off my surgery, full recovery, no brace anymore (unless I'll be doing something really stupid). There is hope

A word of warning on the yoga - definitely go easy in there. As dumb as it sounds, if you get too deep into some of the stretching you can actually 'overstretch' some of the muscles/ligaments/etc, especially on your knees, which can hurt your overall stability. Shouldn't be too hard to figure out the healthy/dangerous threshold in there, just wanted to throw it out there for ya.

Originally Posted by ikkin

17 weeks today...shot a basketball around and did some easy cutting/dribbling with the hubby playing light D last night after my workout (which included steves side lunges, thanks!). it was fine, i just lack confidence planting off the repaired leg, but our shootaround sessions get more aggressive each time, so confidence is certainly improving. i also did some jumping stuff last night. muscles are sore today, but knee feels fine, just a little tight.

Congrats on your progress. The biggest mental hurdle I had to overcome was doing that first one-legged hop onto the injured leg. It took a while to gather up the courage to do it -- I would literally stand there, willing myself to do it, but just couldn't (even though I'd already been running, the standing hop seemed to be more "extreme" or something).

I pulled the trigger today at work. March 6th is the last day.

I'm free to do what I want any old time (queue music)

X-country on March 7th 4.5 months post op and then me and my bicycle will do the US corner to corner starting sometime in the summer.

i would just like to report the following:

I SKIED TODAY!!!!

(just short of 5 months post op)

yeah, it was slow easy turns on flat easy groomers and yeah, i was being super careful, but it was still skiing. linking tele turns and everything! my knee felt great. patellar region a little aggravated as it usually is after a quad workout. but who cares about that?

happy me.

it's the day after the big skiing experiment and everything seems fine, so here's a more descriptive update:

it'll be 20 weeks (5 months) on wednesday and my lovely knee is feeling good. i'm still taking most things relatively easy, but my confidence jumping/hopping/running around improves daily. i'm up to a mile on the treadmill at a 9:00/mile pace. also biking and hitting the weights 2-3 times per week. snowshoeing, skating, cariocas and side to side movements feel almost normal now. haven't tried spinting yet.

overall, things seem to be going really well. i have a little theory on why:

i've been regular about my rehab, but not ridicuously psycho about it. i get in there regularly, i do my thing, but i don't push my knee beyond what it tells me is okay to do. i take days off. i think this is actually helping my recovery. i'm pushing but not rushing into activities, and when starting new activities i take them slowly and easily. (skating, running and now skiing)

time will tell if this works for the long-term, but the bottom line is my knee, muscle mass and confidence keeps improving without dangering my graft, and i'm starting to be really hopeful (vs. skeptical) about the future. hooray! i hope its the same with all of you.

Originally Posted by ikkin

it's the day after the big skiing experiment and everything seems fine, so here's a more descriptive update:

it'll be 20 weeks (5 months) on wednesday and my lovely knee is feeling good. i'm still taking most things relatively easy, but my confidence jumping/hopping/running around improves daily. i'm up to a mile on the treadmill at a 9:00/mile pace. also biking and hitting the weights 2-3 times per week. snowshoeing, skating, cariocas and side to side movements feel almost normal now. haven't tried spinting yet.

overall, things seem to be going really well. i have a little theory on why:

i've been regular about my rehab, but not ridicuously psycho about it. i get in there regularly, i do my thing, but i don't push my knee beyond what it tells me is okay to do. i take days off. i think this is actually helping my recovery. i'm pushing but not rushing into activities, and when starting new activities i take them slowly and easily. (skating, running and now skiing)

time will tell if this works for the long-term, but the bottom line is my knee, muscle mass and confidence keeps improving without dangering my graft, and i'm starting to be really hopeful (vs. skeptical) about the future. hooray! i hope its the same with all of you.

thats awesome! good for you. must have felt great to get out there!!

thanks WC! it felt AWESOME!

Awesome!

Is a UT trip this spring now in the budget?

Thats so sweet that you went skiing!!

Major jealousy....congrats...