ACL'ers - How's running feel?

[Big E]

For those of you that have this fresh in their mind or remember it really well or play an expert on the internet -

7+ months after ACL surgery (patellar tendon), my knee generally feels good - flexibility is good, strength is around 90% except for the quad, which is maybe 80, no problems generally, doesn't bother me biking, etc. BUT... running still feels lousy. I just feel every impact more. The other knee (ACL 5 years ago) isn't like that. The problem is, I can't remember how long it took for that one to feel normal running-wise.

I also, very occasionally for certain motions, feel a little hitch in the knee's motion. I'm actually a bit more worried about this than the running, although maybe they're related. Best example is if I'm sitting on the ground with my hands behind me leaning on them, and my leg bent but foot flat on the floor, I notice it if I straighten out the leg.

I should call the doc, but just wanted to get some opinions from internet quacks first

[altachic]

Running for me feels like shit and i'm a year and a half out of surgery.

My doc says that's the worst thing i can do for my knee. I love trail running, but it hurts too much afterwards to do it anymore like i want to.

He says it's all about riding a bike. 3 out of my 4 siblings have blown their knee at least once and we all stick to skiing and riding a bike, oh and hiking.

All depends on how you feel...if it hurts, don't do it.

[basom]

i get fitted for my brace tomarrow. and have been cleared by my doc for light jogging. i'm holding off for a few from the advice of my PT. i'm expecting it to feel like shit.

the hang up you are feeling. is it a pateller tracking issue? sometimes i get a bit of that when on the bike, and was told it can be caused by swelling under the kneecap, it doesn't happen that often, but feels wierd when it does. my PT said as the swelling gets down to zero it should go away.

do you have any swelling in the area or is the operated knee the same as the un operated? (er.. less recently operated?)

[teledave]

In general full knee extension is harder to attain post ACL surgery than flexion.

I run 2-3 times a week but always on either trails or treadmill. No more hard surface running for me.

Edit: I run mostly 4 miles with an (very) occasional 6 miler thrown in, 39 y/o, patellar graft 1/96.

[Vinman]

Originally posted by Big E
running still feels lousy. I just feel every impact more.

I also, very occasionally for certain motions, feel a little hitch in the knee's motion.

I notice it if I straighten out the leg.

Describe lousy, are you actually having pain?


As far as the hitch in the motion? does it happen when walking, running or climbing stairs? or only whne you are doing that specific stretch, is it painful? Does it click or grind?

[Big E]

Thanks guys n gals, lemme see if I can answer all the various questions...

Running first. There isn't any pain when I run, but I notice 2 things - first, that I feel each impact much more on the just-repaired knee, and second, that I don't have as much spring as I do in the other knee. I guess you could say the lack of "spring" also feels like the knee isn't quite as stable, but it's not the kind of instability you feel with a torn ACL. I should mention that running is more a means to an end than something I would go out and just do. Meaning, I want to get back to playing basketball, which obviously means running, but I'll never just go out for a 5 mile jog like teledave. Ack. I was cleared by my doc and PT to run a few months ago, but it felt so lousy that I wasn't very gung-ho about it. I'm thinking now that maybe the fact that I haven't been running much at all is actually something to do with it, like I haven't built up the exact little stabilizing muscles that you use with running, and this is resulting in the less-than-wonderful feeling.

Ok, next, the "hitch." I only feel it when I do a couple of specific motions, not really stretching, just during normal stuff. As another example, if I'm sitting at a bar stool (see, now I'm going to the experts), and I sorta cross my feet right at the footrest height, with the foot attached to the leg that's attached to the repaired knee behind the other foot, when I uncross them, a lot of times I'll feel it then. It's not painful really, but it's not a nice smooth motion like it should be. Also, doing leg extensions on a machine (which I don't do anymore) or just sitting on a chair and straightening the leg out in front of me, keeping leg parallel to ground), I feel it then. I'd say it's a couple of clicks, as opposed to a real grinding.

Wow, that might be my longest post ever.

[basom]

never do leg extensions! you were doing those post op?????

[teledave]

My knee makes an audible grinding noise whenever I extend it after flexion greater than 90 degrees. There is no pain associated with the noise. 2 docs have told me since there is no pain associated with it no too worry about it, the cure is probably worse than the problem. They think it is scar tissue around the area of the tendon harvest which scrapes on the inside of the patella. They've also told me not to be surprised if I develop arthritis later in life. Still, working on 9 years post-op and I feel like the operated knee is sturdier than the other one even if it is noisier.

Edit: I also would prefer to get in more time on my bike but life has cut down on my workout time and it's hard to beat a 40 minute run for a workout.

[Big E]

Originally posted by basom
never do leg extensions! you were doing those post op?????

A source of constant confusion

Yes, I was for a bit, did them after the first surgery and never had a problem, then did them a bit after this one (including in PT hooked up to some machine that controlled the speed - don't remember the name), until this doc said, well, pretty much what you just said.

[basom]

go punch you PT guy in the face for letting you do those. BAD.

[Vinman]

agreed with Basom go smack that guy in the head, never, never do knee extensions with weight post op for at least a year.

Now with the running thing as well as the knee extension hitch, there are several things this could be.

1. it "COULD" be that you have some tightness in the hamstrings which can effect how your patella functions, basicall tight hammys cause your patella to be compressed into your femur during extension/flexion and can cause a click/stutter sensation during motion.

2. COULD be scar tissue formation

3. Could be result of meiscal repair

4. COuld be tightness of the IT BAND

COULD be lots of things. If you think it is something bad go get it looked at for nothing more than peace of mind so that you can get on with training.

[teledave]

Or are they only bad if they are done to full extension?
My understanding is that the problem is with hyperextension putting a cutting/pinching force on the ligament. The ligament also fits in between a groove and notch between the tibula and patella. When my surgery was done the doc ground out the notch to a larger size to decrease the risk of the above effect.

But I don't do leg extensions just because I hate lifting weights in any form, so for me it's a moot point.

[Theodore]

Originally posted by teledave
In general full knee extension is harder to attain post ACL surgery than flexion.

Tell me about it! F-in ROM. I still feel a bit more shock with my left knee while running than my 'good' knee. When I just started running after surgery it was alot more noticeable. I ran on treadmills alot at therapy, and that takes some of the impact out, but as a whole I despise running for fitness. Passing the frisbee or football, or playing any sport I can sprint all over the place, but tell me to run 3 miles and I'll about die.

[Vinman]

Originally posted by teledave
Or are they only bad if they are done to full extension?
My understanding is that the problem is with hyperextension putting a cutting/pinching force on the ligament. The ligament also fits in between a groove and notch between the tibula and patella. When my surgery was done the doc ground out the notch to a larger size to decrease the risk of the above effect.

Yes and no. The notch impingement risk is associated, but the real reason they are not done at any angle for quite some time is that that particular motion places a shear force on the graft. Not good. Shear force is less closer to full extension but then you get that nasty little risk of notch impingement so basically don't do it.

Also everyone with an ACL recon gets some notch grinding (notchplasty)

[Tyrone Shoelaces]

So do any of you guys who have had full ACL repairs run w/o pain? Seems like everyone who posted here says it bothers them in some way. EDIT: oops, except for TeleDave who had his surgery more than a few years ago.

I enjoy running and want to keep doing it with my new ACL. I'm already looking at goals for myself and want to know how unrealistic it really is if say I wanted to set my sights on a marathon or 1/2 marathon 1 year post-op (actually have my sights on the CaliMan 1/2 IronMan Triathlon Oct '05).

My primary goal is get back on snow sometime in March, April, or May...but longer term, am I freaking nuts for even thinking about running a bunch on a new ACL within the first year?

EDIT: Just did some more research on rehab times and what-not....and am realizing that running like I want to above might be pretty unrealistic if I want everything to heal on up...just curious if anyone has any more first-hand experiences.

[Honc]

Tiring.

Sorry. Not funny.

I have a strange sensation when I run on pavement sometimes. It's kind of tingly, as if my ligament were "asleep" Only slightly noticable, but still there.

Also, I've gotten chubbier and lazier since my surgery but I chalk that up to lousy surgeons.

[Vinman]

Originally posted by Tyrone Shoelaces
My primary goal is get back on snow sometime in March, April, or May...but longer term, am I freaking nuts for even thinking about running a bunch on a new ACL within the first year?

Ty, many high level athletes are back to full go particiaption at around the 6 month mark give or take a month or so. SO mid to late April would not be out of the question but there is really no way to know how you are going to feel. But, by May or June you could probably be ready to do some swim, bike, run training provided you have not had any set backs. But being up to competitive level but then would be tough. Maybe shoot for tri's later in the summer.

[Tyrone Shoelaces]

Thanks Vin....those timeframes are kinda what I've been coming to grips with as I do more and more research. Thankfully the season is super long in Tahoe & the Eastern Sierra so I'm thinking at the very least I'm going to set my sights on getting some spring touring days in.....and at least that would probably be easier on a new knee that repeatedly bombing down stuff at the resort.

Sprint distance tri's late summer is probably a more realistic goal than anything longer too. I'm not worried about being competitive at that time....but just want to be able to participate to stay sane.

Is it too early to book a South America ski trip for next August/September?

[Vinman]

Originally posted by Tyrone Shoelaces
Is it too early to book a South America ski trip for next August/September?

Is it ever too early?

[KneeKnowledge]

Running is no longer the same after ACL reconstruction.

From the studies that I've read, there is a bit more tibial rotation than in normal knees, so this may will lead to irritation and swelling. Over time, long distance running may have a very negative effect on reconstructed knees and lead to very early arthritis.

[drmark]

Everyone is talking about the study. I read the entire thing twice. It was done with people doing a test in the lab. Whether or not there are consequences in the activities of ordinary people is unknown.

[telepariah]

I had a patellar tendon graft along with 70% menisectomy, microfracture, and chondroplasty 3 years ago. I can run totally pain free and have been doing so since about 6 months post surgery.

I supppose I was fortunate with both my surgeon and PT. Bill Williams in Boulder did an unbelievable job of reconstructing a knee the inside of which looked like fringe after 23 years of running, climbing, skiing with no acl -- he also put my shoulder back together when it was in 17 pieces in 1986. My PT listened to me when I talked about my goal of skiing at 4 months and got me there. She also wanted to see me run but would not release me to do so until I could hop three times on the reconstructed knee with each hop being no less than 85% of the previous hop distance. I didn't bear weight for 4 weeks, walked without a limp at 5 weeks, ran at 4 months and skied at 4 1/2 months. I attribute it to being motivated, goal oriented, and lucky with the result of surgery and rapport with my PT.

I don't run really high mileage anymore but probably that has more to do with my job hours and commute than the injury. I can still tick off a 30 mile week whenever I want to. I run only on trails or track. Slower than I used to be but what the hell... I am 50.

[Long duc dong]

I had a patella graft done three years ago, and it took me up until about 6 months to start running. It still did not feel good for a while. If you still have pain right now I would not worry about it. I still had pain here and there for about a year after surgery. One thing I like to do is run sprints up stadium steps, It took me nine months to do that after surgery.

[altagirl]

Feels pretty much like shit to me too. No specific pain when I'm running, just... not the same as it used to be. And I get a lot of IT band problems when I do run (which is rare). So I don't bother running.

FWIW, the former ultramarathoner who teaches some of my spin classes basically quit after her ACL surgery and now does mostly biking and swimming. She said it's never been the same since.

[KneeKnowledge]

Feels pretty much like shit to me too. No specific pain when I'm running, just... not the same as it used to be. And I get a lot of IT band problems when I do run (which is rare). So I don't bother running.

FWIW, the former ultramarathoner who teaches some of my spin classes basically quit after her ACL surgery and now does mostly biking and swimming. She said it's never been the same since.

What type of graft did you use?
How many months out of surgery are you?
How is your hamstring and quad strength?
Have you had any other knee surgeries?