Prehab for ACL tear but with bad ROM & torn meniscus???

[flyman683]

Meeting tomorrow with the Doc for first time after getting MRI results back on my knee. It's been ~1 week since the injury, and it still hurts/swells decently during the day (still taking lortab every 4-6 hours when I can afford the sleepy/loopy feeling).

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I've got "complete proximal ACL tear" and "large bucket handle medial meniscus tear w/ complex horizontal tear" and some crap displaced into the interchyrondal (sp?) notch, whatever that means... Doc already wrote a script for 3-4 weeks of "prehab".

Except: I still can't straighten my leg all the way, and I'm limping around with 80 year old man shuffle steps, and it hurts even if not too unstable. I'm also starting to get new discomfort in my lower leg, hip, and back of knee (I'm guessing from the limpy/gimpy nonsense all day). Almost feels like bad shin splints down low now...

How the crap am I gonna do squats, dead lifts, and other crap people have on here/interwebs for their prehab? Is the meniscus tear & whatever "displaced fragments in the notch" making this different than other cases I'm reading about? I'm reading about people going to gym and doing quad/hammy workouts for like 1 hour @ 3x per week, but it seems like they must have a different injury than I do.

I'm worried about going 4 more weeks gimping around, giving myself back pain, and really having my leg wither down simply b/c ROM isn't there at all.

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Am I missing something? Planning on asking the doc this tomorrow, but might as well ask the Maggot vets for the patient perspective.

Thx.

[snow gypsy]

Take it from someone who has been there - these things take time.
I was pretty gimpy for the first week of my prehab. The best thing to do? Move your knee. I was doing a daily regime of stretches, knee bends (basically just wrapping a band around my foot and pulling on it to try and get my knee to bend and then straighten), and hanging knee bends (sitting upright in a chair and presses the injured leg back with my other leg. Massages were also important - just rubbing out the muscles, getting them to relax. The following week, I moved on to strengthening exercises: straight knee raises, a bunch of stuff with bands, and we practiced walking - a lot - to get the kinks out. The key is to do your PT in short amounts but multiple times throughout the day so you don't stress the injury. You have a lot of things going on in there and one unhappy knee, but I can assure you that the worst thing to do is nothing.

Don't get discouraged. My close friend was skiing prehab to strengthen his knee while I was on crutches for a week and could hardly walk up a flight of stairs. Everyone is different. And anyone who says that his/her recovery regime is universal is full of it.

If you want more info, I'd be more than happy to share. Just message me. Regardless, this is just my experience. You NEED to see a professional physical therapist. Trust me. They work wonders.
I know it seems pointless now, but the little things work. I went from 3-63 following the injury to -2 to 140 the day before surgery.
Find yourself a good PT that you trust and who understands your expectations.

[Mofro261]

Noooo. Prehab with a BH meniscus tear is not the same as straight up ACL prehab- i've been through both. Bucket handle meniscus tear trumps any attempts to do knee exercises like squats, knee bends etc because the meniscus tear is physically restricting knee mobility and attempting to "work through the pain" and regain more ROM can result in increasing the size of the tear and the amount that will ultimately get removed, as well as possibly damage the articular cartilage.

Concentrate on exercises that will help strengthen the muscles without worrying about ROM at this time- quad sets and straight leg lifts are the best for this. Try and see if you have enough ROM to spin on an exercise bike as this is one of the best things you can do for prehab.

[flyman683]

Sorry for the late reply, but I did end up with a PT visit that pretty much echoed what you guys were saying. Info was still useful though, as it made me feel a bit better about what the Doc was saying about getting prehab in before surgery.

Only problem is trying to find the ~2 hours it seems like it would take to actually do the 30 min of legs elevated, exercise ball stuff, 2x15 minute bike rides, etc while still getting work & life done (tiny violin).

Surgery on for the 19th.

[flyman683]

So 2 days post op (~48 hours). Ended up being menisectomy (no repair possible) to go with my hamstring autograft.

First day was ok, relatively speaking.

Today has been much worse, pain wise, with the block fully worn off since yesterday. I woke up in middle of night with pain at the 8/9 level, even though I've had an alarm set for every 4 hours like clockwork. Switched to every 3 hours (doc said 3-4 hours, 2x oxycodone) and doing a bit better, but damn its rough at the "transition" to the next set 'o pills.

Also makes me way loopier this way....

Normal? Also - it seems a little bit longer than some other people's post-ACL/menisectomy but I'm essentially locked at 15 degrees until Monday (5 days post op). With the way it hurts, I guess I wouldn't be moving much anyway, but my doc is a no CPM guy, so I guess I'm just curious what it'll mean being immobile for three more days.