The snowHeads ACL rehab club !

A snowHead

@margaret, sounds like you are doing OK -
numbness - just like going to the dentist - that is how I described it aswell.

A snowHead

@barney2
Went to the physio today, he thought I had the op 5weeks ago, not three, and was very pleased with me. Have to stop "hanging my knee" extension is fine for now. I have over extended joints and I have been told not to do that yet. Have been given the green light to ride my static bike as much as I can face. And to clean my teeth standing on my operated leg to help my balance. Very Happy

my hamstring exercises are tough though!

Well, the person's real but it's just a made up name, see?

@margaret, - 5 weeks - no - no - can't have you getting ahead of me. That just ain't right.
Suppose now the difference of a week between us is neither here nor there?
So today biked to swimming pool - big event! Makes you laugh that things once taken for granted now seem like such big milestones.
I have been rocking/standing on one leg then other and that seemed to help with balance and confidence putting weight through the knee.
Still extremely careful with knee and treat it like a piece of porcelain! I am not too bothered how slow I progress - so long as I don't go backwards with it.
Sick of the sight of frozen peas!

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@barney2, I think that you must still be ahead of me. There is no way I could cycle to my swimming pool, but it would be uphill there! Back to ski sits though. I too am probably treating my leg too cautiously, my surgeon made me prove to myself just how strong my knee is, but I don't want to risk anything. I am only going this way once. I am now walking down stairs properly but with my heart in my mouth. I guess that the leg needs to build up for when the graft weakens, isn' t it 3-6months that is dodgy? I spend most of the day standing on my bad leg. I bought a cryo cuff, it is magic to have cold water envelope my knee. Am also using a knee hab. How people work and manage all this I have no idea! I do tend to look at people now who do not exercise (or even walk) and think use your knees, you have no idea how lucky you are to have a pair that work😀 oh well, back for another spin on the bike!

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@margaret, my office became very used to me regularly taking breaks to do the Physio exercises.

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@margaret, I am not sure about the 3-6 months - my understanding at the moment is that at about 6-8 weeks the graft should be taking more of a hold - grafting on i suppose? (don't know the technical terms - and whilst I have been told under no circumstances to twist/rotate that knee - that period is particulalry important not to - At 4 months I can start to work muscles lifting lower leg but not before then. No use of that leg on breaststroke etc etc Maybe at the period of 3-6 months there is more risk of problems if pushing rehab too hard?
Various aproaches as @22 dropout, is suggesting - and at 16 weeks still not out on a bike -- yet I seem OK on both bikes - but struggle walking without a limp? - which interestingly is entirely in my head - Not pain related as I can walk fine when the physio is giving me a good telling off - Yet when not thinking about how I walk or given any opportunity I revert to the old habit - did this pre op aswell -

After all it is free

@barney2, whenever I am walking I am continually telling myself heel to toe. (But only on the one side) when I don't concentrate I have a funny flat foot walk. If I am asked to look at something whilst walking, I have to stop and look, I don't trust my footing. How long were you on crutches after the initial damage? I feel tonight as if I have a very long way to go. (Ps I had an allograft, given my medical history of my knee, my hamstrings were not strong enough for the graft given my size and inactivity since last November.) was not very happy to have to travel that route but had no option. But onwards and upwards😀

@barney2, @margaret, the graft is most vulnerable between the 6th and 12th week is what I've been told by numerous surgeons and physios. This is when the main vasculariztion takes place and it is really settling in place. Every patient is different though, some heal faster than others, so everyone's protocol is in a way unique.

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@Samerberg Sue, yep - thanks for that - seems to fit (vasculariztion -now there's a new word)
@margaret, Can't remember exactly but around 6 weeksish - using both crutches outside, - then about a week or so onto one. Wore brace up to about 10 weeks when outside - knee was pretty wobbly and it just did my head in when it wobbled.
My take on my own injury from the begining has been that it is pretty pathetic really- nothing to look at - no blood/bones sticking out - hardly any pain - not much swelling (Not that I want any of those of course!) You can't really see where the surgeon has been digging about in there - looks like I have scratched it a while ago on a bit of barbed wire maybe.
You would think that nature could have come up with something a bit more robust than a knee? I mean - attaching some big important bones together with some stringy bits - whats all that about?
I do know what you mean about a long way to go though- another 6 months ! aggh!
But then i think - well it is just a knee - not serious - I can now walk (ish) bike, and drive -carry 2 cups of coffee- just keep looking after it - get through the day without doing any damage-
Whats another bag of frozen peas in the grand scheme of things?

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@barney2, I like your way of a day at a time with no extra damage. I shall adopt it😄 I am aware of week on week of improvement, so it's all good. Off on my bike now!

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@margaret, It does get better as the more load it can take, the quicker the progress. But you can't rush to get there. I agree with you, just make everyday count, even just in a small way. The way I see it there is the swelling flexion phase (almost no load), the moving about phase (body weight or less i.e. walking, swimming, floor work and cycling), the light load phase (bosu, stepper, light squats) and, I guess, heavier loads but I have not got there yet. What I do know is that once in the light load phase things start to move on quicker as the leg really gains responsiveness and strength. Until then, it was a very dark tunnel at times… with just the knowledge that others had got there pepping me up.

I don't know much about allograft being a hamstring person myself. I would bow to @Samerberg Sue as the expert on different types after what they must have gone through, especially as the person that introduced the thread to Vascularization!

@22 dropout, I had 2 artificial fibre grafts back in the days when they were supposed to be the Bee's Knees (pun intended). Since then I've had 2 x patella tendon autografts and a hamstring autograft. Allografts are rarely if ever used here in Germany/Austria. The surgeon who carried out the last revision told me that he had "lots of possible sources" of material for grafts from my own body so he did not need to even think about allografts as they were difficult to get hold of as well as get the insurance (Gesetzliche Krankenkasse) to OK.

You know it makes sense.

Hi everyone,

very new here. read this thread before but only recently tuned in with more attention the last week or so. Just looking for some advice tbh

I had my ACL reconstruction (also had an anchor? placed for my MCL) middle of february this year so its been almost 6 months. Surgery seemed to be successful, i barely felt any pain afterwards, off crutches within 7-9 days etc. so things seemed to go quite quickly for me. (i had alot of swelling but i think i managed it well with ice and elevation etc).

What i'm looking for advice for is how i should be going about things now. I feel like the recovery has plateaued the past 1/2 months or so and i'm not really sure where i should really be. I try to go gym fairly regularly, try to do the physio workout when i can (been told mainly "control work" are the exercises i have been doing) and have recently done a bit of running (without too many issues other than my own fitness) but have avoided stuff like sports so far.

what were everyones position around the 5-6 months stage?

I'm just worried now that i'm maybe not progressing much and dont know how to help it.

appreciate all the comments on this thread so far, took alot of the advice during the early stages etc and thanks for any inputs Smile

Otherwise you'll just go on seeing the one name:

@adao, welcome to the thread. I am at about 4-5 months post op, 3 months post manipulation so effectively 3 months into exercise. This is not as far in as you and I am certainly not able to look back to the same point with confidence. But actually, to me you sound ok.

This is how I look at it though. What are the best exercises you can do if there were no issues? Cyclng/running, lunges and floor work. The best you could be would be the level you were at before the accident at 9 months post op. So that becomes my goal. Working against me is the lack of exercise over a period of time, the swelling and the loss of power and flexibility in my hamstrings. I also know from this thread and other conversations that 10ml of fluid will stop my muscles from firing properly and that I will be getting swelling and icing at 6 months and beyond as I work the knee, so I must be gradual and keep making sure I am keeping the swelling down. I also know that professional athletes can return to training but not sport at around 6 months and might be back to sporting levels at 9 months, but will have frequent physio, icing and assistance to do so. Finally I know that at 9 months I will use a brace, still get swelling and it will probably be about 15 months before it is a full leg again with no issues

Therefore, I will not be worrying at 6 months that I still have issues. My (hamstring) graft will just be starting to strengthen which means I can start to load up more and more. That would give me confidence to keep focussing on my return to skiing at the 9 month mark. My hamstring strength is shot - my surgeon got a big graft from a relatively light person so I am finding the hamstring work hard, progress slow and easy to create swelling but that also means that the graft will likely be really strong, and I will push the bits that are easier and going well and then I will be able to concentrate on other aspects later as they settle down.

What has made a huge difference is two things:

1) Getting some rubber band and making sure I am doing floor work every day to counteract any atrophy. 20 mins on getting up, 20 mins, even 10 just before going to bed and stand on one leg when cleaning teeth or lunge. A little and often really helps.
2) Using a watt bike. This has enabled me to ensure I am working my bad leg as much as my good and not to compensate. Since then, progress has been much quicker as it makes the cycling time more productive.

I am interested, however, in why you feel you have plateaued. Is it something measurable, what were you expecting to be able to do that you can't, or is it the sheer repetitiveness that is causing you to question your progress?

A snowHead

@22 dropout, hey! i appreciate the whole post. alot of things put into perspective.

I'm able to do some jogging and cycling seems to be fine but i've not really pushed myself. i've been told that i should be ok to do both by the physio and just to keep at it with the exercises i've been given. but tbh i feel like i should be doing them more! Guess with work and not having much time makes it a bit difficult for myself.

Lunges and exercises like that are generally ok, i have a bit of an issue kneeling/sitting on my heels - it seems to be really tight around the front of my knee etc.

I think its just mainly the case that summer has come (and almost gone) without me being able to play sports has impacted me a fair bit. By no means am i the fittest person (far from it actually and thats why I only do some jogging!) but im someone who just enjoys getting involved with sports as much as i can. I guess this is the main reason i feel like progress hasnt really moved on. It may have but maybe its psychological.

About to go on holiday so getting good break away from work at least not sitting in an office!

A snowHead

@adao, you'be said it twice yourself. ...you need to do more exercise

Well, the person's real but it's just a made up name, see?

So now at week 6 post op. Week 5 was a bit of a roller coaster. Great to get out on the bike - swimming pool same - can even bike to physio now -great to have a bit of fast movement - all good - But had a a period of about 3 days when swelling was about as bad as its been - couldn't fully straighten and lock due to this - and it was a pretty good excuse for my still rubbish walking and limping about. Went back onto Ibuprofen - and don't know if this helped but certainly swelling reduced - could have been a coincedence of course.
Whilst in the pool I have had to stop a few times to take a look- felt like blood running down the bottom of my lower leg - aint even got any scars there? very funny feeling - Physio said its normal to have these strange sensations - lower leg still numb but seems to be waring off a bit.
Hows everyone else doing with rehab? and Lizski have you had second opinion yet?

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My knee is five weeks old today. Some days are great, others not so. Still numb below knee, but feel that may be improving. Have not reached the pool yet, scabs just dropping off. (Nice!) have been on my static bike most days, but sometimes feel that I could be overdoing it. When on my bike the knee frees up, any pain disappears and it feels good to get going. Later on in the day my knee feels sore. But not swollen.If I have a "day off " of biking knee feels good again. Limp now and again, but on the whole walking is good. Standing on my bad leg getting easier. Have decided to try and give up painkillers, have been waking up with headaches, and am wondering if it is the drugs. Appointment with physio on Monday. Am looking forward to that to see how I am doing. If I have a day on my feet, I sometimes use tubigrip to help knee not to swell. Husband knows I am getting better, have been cooking, baking cakes, ironing and hoovering!! And nagging.... Very Happy

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@margaret, Sounds good and very similar experiences - I agree about the static bike freeing knee up and by far the simplest exercise. ( Though I realise 22 dropout was finding this not to be the case yet)
Physio has given me a whole bunch of new exercises -bits of elastic round table and chair legs - cords for pulling my leg - I have some cardboard to help slide - plastic step -rolled up towels - House looks like we are getting ready for a jumble sale!
Ironing and hoovering - Now I think my physio said that these were exercises that I should not be undertaking post opBut it is good to get back to doing some normal stuff I know what you mean.

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@barney2, Ironing and hoovering - Now I think my physio said that these were exercises that I should not be undertaking

I should have tried that excuse!

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@margaret, If it is sore but not swollen then persevere (within reason). Sounds promising. Swelling is your gauge. Lie on your front and gently stretch the quad with your other leg assisting.

I watched Lindsey Vonn, The Climb yesterday. Not a LV fan but it is quite inspiring as it follows her rehab from and MCL/ACL/leg break to an additional ACL operation and back to skiing. I would especially recommend it for @adao, as it made me realise that I could up the gym work and intensity and be a better skier for it. I would recommend watching it (fast forward the couple stuff with Tiger W and the bits where she says she doesn't want to do publicity stuff. YWe all believe that!).

After all it is free

@22 dropout, @barney2, well, my physio thinks that I am doing well. I am not to worry about the slight swelling that is always there, it will go eventually. He would just like me to have no new swelling. On a pain scale of 1-10 I should not go beyond a three ever! New exercises for me, I had a problem finding my hamstrings, so now have to do my hamstring exercise on one leg. I know that I have one now!! Ski sits to 90' and then raise one leg, hold for ten and repeat on the other side without coming up. Getting tougher now. Gym induction in three weeks, when all will be ramped up significantly. He was surprised at my leg strength, and said that it was not inconceivable to ski again this winter if my improvement continues. Having watched Lucy Vonn's injury ( similar to mine but no helicopter involved just a dog), and her re injury I will take it slowly. But it has cheered me up. Back on the bike😃

@margaret, All sounds good to me -I think you are probably ahead of me at the moment - except for the biking.

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I think that my progress is down to lots of hoovering and ironing😉

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@margaret, -Nice one

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Just started reading this thread ............

I completely ruptured my ACL and detached my MCL last January skiing...............I had a lot of pain, restricted movement and swelling, thought I'd always walk with a stick .......... after a lot of research I elected NOT to have any surgery................relying instead on ice packs to bring down the swelling , physio 2/3 times a week for 2 months and daily gym work/exercises to build up all leg muscle groups and stretching exercises every few hours .

After 3 months on Physio's advice I bought myself a Reebok Step to use at home for plyometrics and cardio - knee was painful and stiff to begin with but got better the harder I pushed it.

It wasn't easy and there were times when I thought I would need the op - glad I perservered.

I can now swim, run, cycle and use most gym equipment and my golf has improved !

Saw my consultant after 6 months and he pronounced me fit to ski - he only wants to see me again if I'm in pain or leg breaks down. I'm over the moon - never thought I'd ski again .......can't wait for the winter

I'm not a doctor but my advice ........don't rush into an ACL op - instead find a good physio, really build up your strenghth and work those muscles harder than you did before the accident. There's a good chance you won't need an op. At worst you'll waste a few months but go into the operation a lot stronger than you would otherwise, which should aid recovery.

@kneejerk, Interesting to hear from someone that has gone the non op route. There are others in this thread that have gone that route and are doing fine - Reading through all the pages on here and elsewhere - peoples experiences and routes to recovery are so varied - and then when you look at the info on knee guru - info from Wimbledon Clinic- NHS info - Your physio and your consultant - Mind boggling amount of stuff to read and digest. I suggest your experience will help those that have a fairly stable knee after injury and are unsure and maybe they will put off having the op?
However - At 6 months you are signed off to ski - - - at 6 months my knee was still unstable just walking even after all the physio - exercises - Compex - etc .
Not advised- if atall possible to put more work into the knee without doing potential damage - -
-So back skiing in 6 months for my injury was never a realistic goal that could be achieved - even though it seems I did less damage than yourself.
Anyway - pretty exciting for you to start thinking and planning for 15/16 season - good luck getting back to it.

You know it makes sense.

barney2
thanks - yhope you see a real improvement soon
my only advice and I'm not a doctor is to do as much exercise/stretching as often as you can
I sit behind a desk all day and made myself exerecise/stretch every 30 mins for a few minutes at a time in addtion to other daily exercises i.e. keep mobile
Also make sure you've good footwear - I lived in a pair of Saloman trail running shoes for 4 months- very light , good support under the arches and a thick sole - no so bad with a suit and tie !
I also bought some nordic walking poles which meant I could walk hard and fast with long strides confident that my knee was fully supported
One of the reasons I didn't want the op was that it seems to take even professional sportspeople 9 months plus to recover from an ACL and sometimes longer to get back to full fitness AND they are fitter than I will ever be and have the benefit of trainers and physios 24/7 - and even then some don't fully recover
Most have us sloths are faced with the problem that we need to exercise to be fit but we need to be fit to exercise !!
We need (within reason being sensible) to quickly build up our exercises push oureselves to the limit
Our own bodies - not any doctor/physio will tell us when we've reached the limit or exceeded it.
My wife thought I was overdoing it and she is always right except when she's wrong !!
Good luck - I'm sure the op was right for you - now really hard graft starts - you can do it!

Otherwise you'll just go on seeing the one name:

@kneejerk, wasn't it Tim Rodber who decided to not to have his ACL fixed and continued to play rugby for England. Adam Meakins was the same if I recall. I skied decent powder in Grindelwald all day before my op after loads of gym work and there was no weakness, but I decided to go ahead with the op in any event. The reason for me was I do a lot of sport, a lot of ski touring and mountaineering and I was concerned at either getting into a worse situation in a very awkward place, and/or the long term effects of additional wear on my knees from not having the ACL. If you can get stable without surgery I agree there is a lot to be said for not going down the replacement route.

A snowHead

@kneejerk, I went for about 5months without realising that my ACL had gone, some of that time immobilised with a broken leg. I went skiing too, but then when walking experienced a horrendous crack, and I could not stand up. My MRI in November disclosed the lack of ACL but my fracture doctor did not think it important enough to tell me. My fall in April broke my leg again. And damaged my cartilage. I have now had a reconstruction and do not regret it at all. As an older lady (61) I couldn't commit to gym work for the rest of my days, every case is different.@barney2, I went to Dorset for a week, husband drove to the top of a ridge, and I walked( with walking poles) for about an hour and a half with the wind in my face, hair blowing everywhere, the sun was shining and I could see for miles. It felt so good, even though I could not walk up or down. Roll on the future😄

A snowHead

@margaret, Yep - good to be out I agree - although I am still not up to walking very far - gait is a hell of a lot better now - even my physio was impressed -
Bike is giving me so much freedom and some speed - there are lots of easy routes through the woods and hills near to us - So much better than static bike - Started in gym this week = Treadmill = rowing machine and cross trainer - cant say I am impressed - Exercises are so monotonous/repetitive and gym same - but needs must
So week 8 and swelling is now reducing - only meeting the garden peas after exercises now - lower leg still has some numbness -
Noted your not walking up and down - I can walk up as easy or easier than the flat - downhill -no way.

Well, the person's real but it's just a made up name, see?

@margaret, so pleased to hear you are doing so well

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@barney2, I can walk up the hills , although I note that I have lost fitness. However I was under the impression that walking down hills is bad at this stage because of the loading on the knees. I still have numbness, and swelling. If I do a lot of exercise my knee lets me know! I see my surgeon on Tuesday for a checkup. I shall ask about hills😃 and biking. I am surrounded by hills so cycling from my house is not so easy.

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@holidayloverxx,

I've done some whilst i've been away in the gym at the hotels i've stayed in. plenty of walking (most days 5/6 hours +) sight seeing etc. seemed to be ok some swelling after long days but just iced it down when i could.

but when i tried swimming it was a real struggle. Cramp kicked in fairly early on after a few lengths but was manageable by taking my time and small breaks. but the next day there was alot of soreness around my knee especially bending. Maybe couldve been an accumulation of all the walking and some of the exercises i've tried.

Physio tomorrow so will see what he says. I just really want to kick on, get better and see some progress really!

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@barney2, the doctor was very pleased with my progress. I am allowed to walk up and down hills, albeit small ones I think not the Lake District! It is the terrain that I am walking on which is more important, I am not allowed to fall over! He was not bothered about the little swelling that I have now, he says that it will go. The little pain, usually after exercise, that I have is normal My quads and hamstrings are good, VMO not so and needs work. The numbness could go eventually. Went out with my dogs for a nice walk today, using two walking poles for security. Oh, and my bike can come off of its stand. Go to the gym next week for an induction, and have to have physio weekly to really shift things on. He said that in three months time when I next see him, I will look back and say that it was all worth it. I think that I am at that stage now, although it's been tough at times. Mind you, I hate gyms......far prefer to get fit outside. Very Happy

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@adao, do you swim breast stroke? That's pretty heavy on knees.

After all it is free

@adao, good luck. Regular physio under supervision is much better than doing it yourself in my experience. Progress is much quicker as they know when to push you harder than you would push yourself

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@margaret, Good news again for you - falling over not allowed? Well why onearth didn't someone tell us that several months ago??? would have saved a lot of time.
Seems we are pretty much on the same track - symptoms after op seem pretty much the same.
I have a break of 3 weeks before going back to physio - she has given me lots to work on till then - Totally agree about the gym -
Bike- took me several rides out to get the confidence - physio said to use good leg onto the ground when stoping - and I took all the quitest/level routes to begin with - But now for sure it is the the most rewarding/intersting exercise I do - and the only one that isn't boringly repetetive.
I invested in a mountain bike - spent time at the shop getting the right bike - and getting seat and handle bar heights exactly right - got them to put in puncture prevention liquid to help avoid having to walk home! and because the choice of low gears it allows me to keep in saddle on the slopes - Physio has said OK for me to bike up slopes - but not get out of the saddle to do so.
Enjoy your riding

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The snowHeads ACL rehab club !

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