WTF?! No ROM machine and no PT for a month!

[penguin Lancer]

I had an ACL recon using allograft and had some Lateral Meniscus damage which was fixed. My doc said I didn't need a ROM machine and would start Phyical Therapy in a month. Am I wrong to think he is being too conservative?

[Yard Sale]

I just had a ACL autograft and outside Lateral Meniscus damage which has two nails in it. I also had a teir 3 MCL. I started PT on day five after surgery. Today is day eight and I can walk with a limp.

A month seems a bit long to me I would ask for a second opinion. I herd the sooner you start pt the better.

[penguin Lancer]

Same here. I expected to start today to be honest with you.

[amyzilla]

I had a lateral meniscus scope and an ACL allograft recon. They were separate surgeries, but I was in PT and using the CPM machine the day after each one.

[Yard Sale]

what day did you have surgery? I'll tell you what they told me.


Get one of those surgical tubes for resistance and tie to some thing stable at the same hight as your knee when standing.

Then wrap it around your knee and you can work it in all four directions.

Your not supossed to use resistance below your knee. Example of this would be putting the tubing around your ankle.

Lie on your back but some weight around your knee and lift your leg up. Keep your knee in at the same angle during exerise. Then lie on both sides and do the same. Lieing on my recon leg took until today for me to lift with any resistance. Due to my MCL is the most likely the reason.

lie on your back again and push you ankle into the ground do this at multiple angles.

while stand, lift your foot behind you by bending your knee while leaving your thigh straight.

besides stretching thats about all I do. They say its most important to stretch your leg into a straight postion. I'll be doing PT on my own for the next 2 weeks.

Good luck. This sucks doesn't hah.

[penguin Lancer]

Yeah, it does suck. But I had my surgery yesterday

[fantastic_damage]

1 month????????.......I had the exact procedure done (ACL hamstring autograft) and meniscus repair.....I was at PT 2nd day after surgery starting with the basics such as leg raises etc.

[GoNads]

I've always hit up physio the day after surgery... if you don't your knee will get ridiculously stiff, and more muscle will atrophy. Physio will get your ROM going again, so you'll be able to walk sooner, and they will most likely hook up a muscle stim to make sure your vastus medialus doesn't waste away, it's the first to go, along with your glute medius. If these go, then you wont be able to control your isocentric contractions and you're in trouble. When my knee got infected with staphylococcus epidermidis after my ACL reconstruct I was bed ridden in hospital for 2-3 weeks and had 2 more surgerys, I didnt receive any PT and as a result my leg wasted away to nothing and I completely lost all range. It was much harder to come back from than the rest of my surgeries.

From personal experience I would highly reccomend NOT listening to your doctor, and seeing physio stat. Get on a spin bike ASAP, whenever your range allows. The bike will be your new best friend. Make sure you do your strengthening regime at least once a day, your knee will thank you for it.

[Researcher]

I had a severe left knee injury: acl (hamstring gft) mcl (screws) meniscus (trimmed) and partially torn PCL. Doc had me locked out in a brace for 4 weeks after surgery- Doctor said he wanted to build scar tissue as to bond to the pcl and surgery sites. It sucked breaking it loose and getting back my ROM- however my knee is strong and I ski 100 days a year on it still. I would ask your doctor why he wants you to wait for rehab before you take matters into your own hands. Let him know you are an athlete etc. If he can't answer your questions, you should find a new doctor. Just saying he might be looking out for you - the last thing you want to do is go through all the surgery and rehab to end up with a loose - low functional joint. Heal well.

[penguin Lancer]

I have an appt with my doc in about a week now. What should I ask him when I go? I want to be ready so that he can't BS me at all. TY for the help.

[penguin Lancer]

Also, how weird is it that I could walk the day of surgery? I had to go to the bathroom, had no crutches and physically could not piss in that urinal thing they give you, so I just hopped up and walked to the bathroom without pain.

[altagirl]

I have an appt with my doc in about a week now. What should I ask him when I go? I want to be ready so that he can't BS me at all. TY for the help.

Personally, I'd just ask why you can't start now and push to get started immediately. This is something I'd ask my doc about before surgery - what their thoughts are on rehab/pt/etc. I've heard of some who say that since you can't do as much at PT early on, that since many insurance companies only cover so many visits, they try to save them for later. Find out what your insurance company does cover and if necessary, how much it will cost to pay for a few visits on your own if it comes to that. I'd rather start PT early and space the visits out a little more than start more than a couple days post-op.

[penguin Lancer]

Personally, I'd just ask why you can't start now and push to get started immediately. This is something I'd ask my doc about before surgery - what their thoughts are on rehab/pt/etc. I've heard of some who say that since you can't do as much at PT early on, that since many insurance companies only cover so many visits, they try to save them for later. Find out what your insurance company does cover and if necessary, how much it will cost to pay for a few visits on your own if it comes to that. I'd rather start PT early and space the visits out a little more than start more than a couple days post-op.

Cost is not a factor. My school is paying for anthing I need. But ty and I will ask that.

[GoNads]

Also, how weird is it that I could walk the day of surgery? I had to go to the bathroom, had no crutches and physically could not piss in that urinal thing they give you, so I just hopped up and walked to the bathroom without pain.

They probably injected local anesthetic into the joint cavity, and along your graft harvest site. I heart Marcaine! It makes that first day awesome, and that day after oh so... not pleasant.

[drmark]

None of our ACL patients ever use cruches. Its all in the surgical technique and the harvest of a patella tendon graft from the opposite knee.

[Vinman]

you really don't need a cpm. If you are good about staring your ROM and quad sets right away a CPM is not necessary.

[drmark]

Since we 86ed the CPM machines our ACL cases have better ROM. The CPM covers from 10 of flexion to 110 degrees of flexion. (ain't that terrific)

Without the expensive machine a guy can go from 5 degrees of hyperextension to 140 of flexion. Way, way better!

We do start rehab with the trainer or PT the day of surgery though

[penguin Lancer]

So..When can I start to bend my knee again? I'ts been in a straight leg brace for the past 4 days.

[drmark]

You have to do what your doctor says. My patients are given instructions on motion exercises before their surgery, and by four days, can nearly touch their heels to the a**es.

Perhaps you should inquire from your doc?

[penguin Lancer]

he said not to move it....

[smolakian]

he said not to move it....

Your doctor doesn't sound so up on the current trends of ACL recon. As far as I know almost all modern post-op rehab for ACL concentrates on keeping ROM and movement to prevent atrophy and scar tissue formation.

[penguin Lancer]

Agh. He said I had to heal before I had PT. He didn't go any more in depth than that. I'm thinking of going to another doc for a 2nd opinion...but I don't know if I would get a differernt answer. I mean, will a doctor go against what the surgeon said?

[smolakian]

Agh. He said I had to heal before I had PT. He didn't go any more in depth than that. I'm thinking of going to another doc for a 2nd opinion...but I don't know if I would get a differernt answer. I mean, will a doctor go against what the surgeon said?

Is your doctor old and set in his ways? They are like a lot of other people. Sometimes, slow and resistant to change. The outlook on postop rehab has changed a lot in the last 5-10yrs.

[altagirl]

I know this isn't all that helpful, but you've got to talk to your surgeon about this BEFORE you have surgery. None of us knows exactly what he did. Maybe there's a perfectly valid reason for something that needs to heal before you do PT, and maybe he's just very old school and there's no good reason for it at all. But only he knows what he did in there and why, so I think letting another surgeon take over your case at this point is risky as well. The guy who's seen inside your knee and did the work is really in the best situation to make the call on what you should be doing for recovery and rehab.

All I can suggest is that you call him or go back to see him and be a little more aggressive. Ask if there was anything other than a standard ACL recon done. You said he "fixed" lateral meniscus damage - did he "repair" it or do a partial menisectomy? I'm guessing this is related to a meniscus repair - ask how he repaired it? (sutures, darts, etc.) Where is the tear? How big? Can you not work on ROM at ALL or is he just concerned you'll bend your knee too far and mess up the repair? Or is it a weight bearing issue?

[smolakian]

Good point AG. I was looking at it as a straight-up ACL recon. If there was meniscus work he might have a valid reason to restrict weight bearing/PT.