The snowHeads ACL rehab club !

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@Homey, my understanding is that it's very hard to completely isolate the VMO to exercise it by itself. The exercises I've been given are to get it to fire together with the medial hamstring and calf, to support my knee cap on the medial side.

With the usual caveat about checking it with your physio first, as it might not be safe for you, etc etc. Mine are all to be done slowly, focusing on pushing the knee cap out through an inner rotation in the shin and an outer rotation at the hip: McConnell squat holds
http://youtube.com/v/_j99ednCD2o ; one legged hamstring bridges on the operated leg, with your body on the floor and your foot up on a chair; lateral step downs with the operated leg on a step, and focusing on pushing the knee cap out http://www.cornell.edu/video/lateral-step-downs ; single leg calf raises, on the outer side of your foot as much as possible; and split squats with the operated leg forward, again focusing on the knee cap pointing outwards. The latter progressed into Bulgarian split squats - with the caution that they can be very evil on the knees if done badly, so to really watch out for any anterior knee pain.
One big element though has been the physio checking my form on all of these, and if I'm doing them correctly to activate the right muscles and not to injure myself. At the beginning he literally kept his hand on my knee to check that the muscle was firing. So do run them past your physio and check them against any restrictions, etc. before you do them.

Grizzler's post above has some very good tips on activating the VMO through the full range of motion as well.

Foam roller: I use it on my ITB, which is tight as anything. Essentially I sit on my side on it, propping myself on my arms and good leg, and roll my body up and down, but not rolling the actual knee structure, just the muscle. Concentrate on the sore points- it's painful, I won't lie, but in a way that brings instant relief. I was told no more than 2 minutes, but some people do it for longer. The physio must have spotted I'd go crazy on it if given the chance! And I'm strictly not allowed to roll the medial hamstring/ hamstring graft site, as that's still too sensitive.

Here's a handy guide from Runners World https://www.runnersworld.com/health-injuries/a20812623/how-to-use-a-foam-roller-0/

How long are you post op by the way? I'm at 4 months now.

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@BorntoRun, Swiss balls are great, um, 'fun' for 1-legged bridges ( even 2-legged) and hamstring rolls. Also good to squeeze to strengthen inner thighs and to sit on when knackered Very Happy

Often, I am told - although you are surgical and I am not - not enough emphasis is put on the hammies and too much on the quads. The first thing which my physio niece ( a boarder) advised me: get the hams strong and they'll hold your knee together for you.

What holds, reps and sets are you doing with your exercises? The vids you listed show pretty constant movement as opposed to, say, split squat and hold for 10 secs, repeat x 10 and repeat x 3. Has anyone commented on this aspect to you?

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@Grizzler, you’re spot on about the split squat! You’re a true expert. I do exactly as you said, 10 reps, 10 second hold, repeat 4 times, and now holding two dumbbells. Ouch! My legs are blancmange afterwards. The McConnell wall squat is also a hold, 10 secs x 8. Another semi static one is a wall sit with heel raises, 4 sets of 50 reps. I also do cobras for the hamstrings, which are also holds, 10 secs x 6 and repeat 4 times. It seems such a basic exercise but it’s made such a difference to the hamstrings since I started it.
Also spot on about the hamstrings, or so the physio tells me too. I wonder sometimes if I’d have torn my ACL had I paid more attention to the hamstrings. My weights used to consist of body pump classes, which have a lot for the quads but not much for the hamstrings (and zero for glutes). Apparently women often over rely on their quads vs hammies. One more reason why more women tear their ACLs?
For the hamstrings, other than the cobras and bridges, I also do one legged Romanian deadlifts with weights and hamstring curls with a resistance band. The RDLs are to lengthen as well as strengthen them, as mine are short apparently. On the bike I also push up with the ball of my foot, toes pointing down, rather than using the heel, to activate the hamstrings too.
Good tip re the Swiss ball, I should really invest in one. It’s more of a question of space though, our flat is small and already looks like a branch of Fitness First! The chair for the hamstring bridges is in fact the physio’s substitute for a Swiss ball. He said to pick one I could push forward- but try not to. As you say, great fun! The first time he got me to try, at 4-5 weeks post op, I literally couldn’t lift my bottom off the floor. Then for a few weeks all you could hear was the chair scraping against the floor, and me cursing it. I did get some satisfaction though, as he recently got me to also do the hamstring exercises on the healthy leg. A lot more involuntary chair pushing on that side now Very Happy

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@BorntoRun, I am by no means an expert! Just been there, done the research and trying out. Perhaps some thinking and analysing: but according to some SHds that isn't a good thing Laughing

(Unless a dispensation is granted for rehab?)

I started very much doing holds, now finding I want to put in more slow repetitions throughout the ROM. Both have their place of course. Again, caveat that I never had the graft to worry about.

I didn't get given 1 set of exercises per se, nor ongoing monitored physio advice as such, just a few bits gathered together from a few people here and there and a lot of internet research. Talking to my physio niece yesterday and got ad hoc advice on a neural stretch that may help the aches and restless legs bit.

I know what you mean about the fitness clobber clutter! I'm luckily enough to have a small spare room for it, but end up with therabands, squeezy balls etc in other rooms too.

I discovered that the sofa is excellent for the bridges cum ham curls - chairs would just go sliding for me, but feet up on the sofa is great: in the conservatory I can look up at the clouds; in the lounge I get a warm back on the log burner (we don't have huge rooms either). The recliner's leg bit also gets used as a ham curl machine (push down, raise back under control).

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@Grizzler, believe me, I’m well aware how lucky I am on the physio front. The private health insurance I have through work is very good, so I’m lucky enough to have an excellent physio and enough time with him to have a properly tailored exercise programme. So I thank my lucky stars and do exactly as he says, to the letter. And of course there’s the extra incentive of protecting the graft. I feel he’s taking that seriously, but pushing me at the same time. So I don’t feel any temptation to rush or do things I’m not allowed too soon. Once the official rehab covered by the insurance runs out, I think I’ll pay to see him once in a while anyway- just to check the muscle balance, that everything is working as it should etc. I’m beginning to realise ACL rehab is pretty much for life.
Sounds like you’ve done extremely well in putting a programme together for yourself and persevering with it. Takes a lot of grit to keep the rehab up by yourself. No such thing as too much thinking and analysing in my book. But then I would say that, I’ve been accused of much the same myself Blush

I like your thinking on recliner leg = hamstring curl machine. The resistance bands I ordered on the internet came with a door anchor. I didn’t see any point in it at the time, but I use it for all it’s worth now.
By far our clunkiest piece of rehab kit is an exercise bike we hired. It’s huge, and seriously evil on the resistance. A 2 on that is about a third of full resistance on a sprightlier gym bike. And it’s a lot easier to use if it’s had a “warm up” - i.e. if my husband has been on it first. Which suggests all is not quite well with its inner workings Very Happy

It’s currently competing for space with a clothes drying rack by the window in our bedroom...

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@Grizzler, I dont know if you know this but the point of doing the bridges on the chair is to do them without the chair moving. Doing them on a static sofa is too easy

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@BorntoRun, yep, I have an evil old exercise bike too; definitely old ( think it was my Mum's about 20 years ago). Can set it so stiff that it takes all your leg push just to get 1 rev! Belt drive needs a bit of adjustment occasionally, and I dread the day when the belt or other bits go as I've tried new super duper bikes in the shops and they're wimpy pants! It's also sturdy enough that you can hook your toes under it for sit-ups! (Don't forget those core muscles...)

Never found a door strong enough that I trusted it. Once tried looping resistance bands round an old solid bed leg and a very heavy old sofa. 2 scratched wood floors later I was banned from trying that again. But I'm only a weak and weedy (mature) gurly...

Now all I need is something to trap my feet into or under so that I can do those lovely hamstring reverse sit ups ( lean forward, pull self back upright). Any ideas?

Must admit, I did a fair bit on the daily exercise programme, interspersed with gentle to steeper and longer hill walks, for 5 1/2 months, then a house move took over and I've only recently done anything formal again at all. Never went near a gym. However, lots of kneeling, unpacking, carrying and 6 months of constant heavy manual labour, serious weightlifting and digging in our new gardens have seemingly kept up something positive, combined with some good UK skiing over winter to spring.

For what it's worth, I think that steep hill walking is one of the best all round rehab and strengthening exercises - quads up, hams down - and maybe most enjoyable, time permitting. Can you get out to the N Downs or other suitable up and down places? The longer the better, I reckon. Climbing might also be good if permitted; indoor climbing wall?

After all it is free

I know what you mean about the resistance band and the sofa leg. I tried the same, and much to my surprise it moved. I say to my surprise, because it was at the "can't lift bottom off the floor" stage, so my curl attempts were seriously weedy. But it seems to work with the door, especially if you are on the side where the curl movement would shut rather than open the door, if you see what I mean.

Eeek, reverse hamstring curls look hard. I dread the day when I get moved to those. Could you stick your feet under a sofa, or would you end up lifting it? Or can you bribe a family member or friend to sit on your feet?

I do miss long walks, including over the Downs. There's a book of walks near London, within a two hour train ride roughly, and we used to do lots of those. I also walked a lot round the city just in every day life. I have to build it up slowly though, I'm currently doing 2-3 30 minute strolls a day, but my gait isn't yet perfect and the hamstring graft site still gets uncomfortable by the end of that time. Slowly, slowly I'll get there. And I'm still amusingly insecure about hills! It's probably psychological, not trusting my quads enough and fearing I'll miss-step and twist the graft. It's a bit silly, because I don't feel the same way about going downstairs, and I can do it no problem. I do hold on to the banister though, just in case of a klutz moment!
How are you finding the psychological aspect of the ACL injury(es)? Do you worry about falling/twisting, or is that something specific to having a graft? I'm still very neurotic about it. I did the smallest of hops forward to adjust my position in a split squat today, and I've been worrying about it ever since. I didn't twist, I didn't hyperextend, didn't lose balance, or slip, and there was no discomfort. There was probably no more impact than a heavy step forward. But I know I'll obsess about it until I see the physio on Wednesday and he tests out the graft. He'll probably also give me a gentle ribbing for being such a Scaredy Cat!

@BorntoRun, I think there must be much more fear and psychological issues when you have a graft, and the need to take it easy, be patient, not do what you're not meant to, etc. You're probably very sensible to take it in little steps at present. TBH, one reason why I really hope I'll not need a graft is because I just can't see me being able to avoid or stop doing the things which you have to for 3, 6 or 9 months to protect the graft; and, yes, I'd feel very very worried about harming it. Rehab is OK, but taking it easy, not pushing it and physically stopping yourself from doing certain (maybe essential) movements? No: not for me if I can avoid it. I hope that you are better at coping with that side of things.
I just have to be fearful about trashing my knees more in general without there knowingly being anything to hold them together rolling eyes

(Or maybe the ACLs might have reattached to some other structure and can be pulled off again?) So, still a fair bit of worry about any time when I have to, or accidentally do something which stresses them. Great caution especially around anything slippery - wet floors, ice, mud etc. On the positive side, I have lost balance, stumbled, gone over on my foot side etc many times when walking, both more recently and nearer injury time, and had no problems, also had a few ski falls now too: but somehow that feels different to slipping and having the leg go off from under you at an unpredictable angle. That did happen to me whilst punting along on my snowboard this year, free leg slipped, and it did hurt and I was worried that I'd done more damage.
But I hope that the stronger things get, the more you do and try, the more confidence you get. I can only talk about recovering function and dealing with pain and stiffness as I don't have that graft, so maybe surgical people are different and others will be better placed to advise you. I hear many say that once their 9 months are up, maybe a ski season too, and they're as good as new. Research also suggests that many people, including top sports people, never return to where they were before, and that could be that few % points of holding back 'just in case', maybe. We're all different... The psychological stuff can take a long time for some people, I guess; and it won't be a problem for others. I was terrified when first skiing, still am less adventurous than I was and am always conscious that my knees could so easily rip themselves apart again (and they or the soft tissues are often not ache or pain free, either). Also conscious to stop as soon as the muscles feel tired as I don't want to make mistakes which they're too tired or slow to correct.
The other personal thing is that I still carry memories of 2 very very painful, tender and swollen knees, and I am terribly keen not to do anything which might hurt like that again. Lots and lots of knee padding, but it still affects my motorcycle riding and climbing/scrambling - I know how much it could hurt if I get it wrong and impact them again. That's a bigger fear than twisting for me.

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If you ski, board, ride a motorcycle, climb and scramble, you're doing exceptionally well in my book. Clearly whilst the thought of the knees is there at the back of your mind, you're not letting it get in the way of actually doing these things. And as you say, the stronger you get, and the more time passes since the injury, the less you will hopefully think about it.
I think learning to stop when muscles get tired is probably a positive rather than a negative (one of the few!!) from this injury. That, and keeping muscles strong enough to withstand the activities you're doing are two things I think we all should do, ACLers or not. That said, it sounds like neither of us can blame our injuries on tiredness. You can definitely blame it on somebody else, and on very bad luck. In my case it was also pure, sheer, random bad luck. The only thing I think I could have done, besides not be there at that particular time, is tested my bindings' release, and/or asked to have them set more loosely. And maybe have stronger hamstrings, but in reality once the bindings didn't release I think the writing was on the wall anyway.
I also hope you don't need the op(s), obviously. Holding back from some every day movements actually I think happens almost automatically - you don't have to do it actively. Subconsciously you move very, very gingerly post op because your sense of balance is totally shot, your muscles are mush, your knee is so sore and unwieldy, and you feel so vulnerable and exposed. You then gradually reintroduce movements as you feel better, sometimes only on being cajoled to do so. I had to be actively told to start walking down stairs normally, or to stop going round corners in a weird staggered movement, or to lift my operated leg without supporting it with the other leg. I've never found myself thinking "oh I really want to kneel on the operated leg, but I'm not allowed to", for example. You become so protective of the leg, that you'd have to actively override your fear and reluctance to do it. I said to my physio that I'd probably refuse to run the first time he tells me I can! But he says not to worry, by then I'll know I'm very strong, because of the things I'll be able to do with my leg in the exercises.
But yes, you would have to give up a lot of activities for 9 months or so, and that is hard. I don't miss running- my main form of every day exercise - yet, because right now the thought of the impact through the knee makes me shudder. But as it gets better I will. And I missed the basic fact of walking where I wanted, when I wanted, for as long as I wanted, and I hated the loss of independence (and yes, I know I am very lucky that it was only temporary). So there's no avoiding that, and I can see why you wouldn't want to go through it. Or I should say "you wouldn't want to go through it again" because I imagine you already went through a lot of this at the time of the injury and worked hard to rebuild from that and to be able to do the things you love again...

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Mini milestone, week 5.6... This morning I drove my nice car (heavier clutch and not as easy to get in and out of) for the first time since the op, to the MOT spot, and walked home. Only 2 miles but it's the longest completely crutchless walk yet, about 40 min including the odd short break. Not fast, but not too slow either, and nowhere near as troublesome as I'd expected, I took a crutch just in case but carried it the whole way. More tiring than it should've been (fitness has taken a whack) and not pretty yet, but getting there.

Neither of these things were anywhere near as troublesome as expected. It's easy to get into a "that's going to hurt, you're not ready for it yet" way of thinking eh.

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Great work @jjams82! You really do put me to shame. I only reached the 40 minute walk mark now, so that puts you a full 12.5 weeks ahead Very Happy

And 2 miles in 40 minutes is really not bad going at all. Isn't it lovely when you start doing things like that and begin to feel more like a person again, and not just a knee with a body attached? Light begins to glimmer at the end of that (bone) tunnel.

I did the carrying a crutch thing for a while too. Also very useful for warding off kids on scooters!

When's your next physio session? You were thinking squats were on the horizon at that one?

17.6 week update: physio session yesterday, and he upped the weights to a (still puny!) 10kg for some of the exercises - including my current nemesis, the Bulgarian split squat. It's a thing of pure evil, but I can feel the VMO working its little backside off. Makes a change to limp from something other than the knee afterwards! Also started the world's most pathetic one legged squats. They were written in my programme as "half squats", but, after I demonstrated, the physio said "umm, let's maybe go for quarter squats" Toofy Grin

Lots of exercises for the medial hamstring too, as the physio confirmed I still land my right foot pointing outwards a bit more than the other when I walk. As I suspected! My husband was swearing blind that both feet look the same, but then the poor guy was caught between a rock and a hard place there!

@BorntoRun, I'm simultaneously dreading and looking forwards to proper exercises like that... Learning so so many new names for torturous sounding squats and other horrific exercises from this thread - I don't think I ever want to know what a bulgarian split squat is. Unfortunately, I suspect my knee has different plans for me.

Next physio session is next tuesday, along with a return to visit the surgeon for a chat about the op and my progress etc... Not long now.

And yep, it feels great to be walking half decent distances again:D

Now all I need is to be able to do it without the gait of a lopsided C-3PO.

You know it makes sense.

@jjams82 I get that feeling every morning as I start the exercises. "eeeek!!" but also "look, look, there's a little bit of muscle there - if you get a magnifying glass out"!

This particular horror is basically a static lunge where the back (healthy) leg is elevated behind you on something - the sofa if you're home gym DYI-ing. Means there's a nasty, looong way for the op knee to go as the back knee goes down to the floor (or not, by the end of the set!).

Fingers crossed for the next session, and surgeon appointment - let us know how it goes!

Oh, THE GAIT! Can't tell you how much time I've spent thinking/analysing/getting very very annoyed/ trying to change the gait! The physio provided tweaks here and there, you know, the basics- extend fully, flex, don't let the knee cap slump in, etc. But his basic take is, it'll only recover fully when the muscles are rebuilt- the cut medial hammies in my case. So I should stop worrying and "let it flow"- "your brain still knows what to do, you just don't have the hardware yet". Easier said that done, when you're boiling over with frustration because "something just doesn't feel right in my walk"! But I think he's right.. It really is improving by itself as bits and pieces of the leg kick back into action. It's just taking its sweet time about it, like most of ACL rehab Very Happy

PS That said, there was one tip I found very useful. If you aren't already, make sure you land with your heel first, then the full ball of the foot, then little toe working towards the big toe. Then, as you push off, do it through all your toes in turn, starting with the little toe. The big toe leaves the ground last- a sort of inward ankle rolling movement. Before doing that, I was thumping that poor foot down like a pancake.

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@jjams82, will the knee be up to sitting in a kit car by the bank holiday weekend? I'll probably be doing a run out somewhere on the Sat and it might as well be in your direction as anywhere else.

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@BorntoRun, Ta, I'll have a think about the heel/ball/toes progression foot motion thing when I'm next walking.

It's funny having to think about how one walks eh. I go through phases of feeling that best progress is not thinking about it (as you say, the brain still knows what to do) and analysing it (the brain still has a tendency to favour a ministry-of-silly-walks gait since the accident)... It seems on balance the best is not thinking too much about it, but it's sometimes hard when one has to force the leg into certain motions!

I find pretending I'm trying to fool someone into not knowing I've had a major knee op is a good one. I thought I was pretty good at it until I showed a friend that particular walk - apparently not Very Happy

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@adithorp, I was thinking about that on my walk earlier and yep, I reckon it would be! Drop me a PM closer the time if you'll be anywhere near.. I don't mind driving somewhere that'd be more on the way for you btw, save you too much detour.

Funnily enough, I was googling Fury stuff last night and found a thread on pistonheads, some guy called Ade had posted a pic of an orange bike engined fury... Yours?

If you take me out for a spin I could do with trying to sit in the drivers seat to see if I fit in there... My hips were a little wide for the Striker I went to see, it has me worried I might be the wrong shape for a Fury.

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@BorntoRun, Same:D

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Almost forgot, in the spirit of celebrating (even the tiniest) milestones - I knelt for the first time since surgery, doing exercises at the last physio session last week. The physio was as blasé about it as I was excited. And the leg did not fall off. Very Happy

@jjams82, good luck with your surgeon and physio. Let us know how it goes!

After all it is free

@BorntoRun, Ohhh. I'm gonna have to try that kneeling lark... Hmm...

Well done:D

My surgeon visit today was uneventful, I didn't get to see the chap who chopped me, but the guy I saw showed me some interesting pictures of the inside of my knee, and the graft in place. Generally impressed with my range of movement, nothing to report really - a very good thing!

Physio has signed me out of her bit, and moved me onto the knee group sessions.. First one on Thursday afternoon, it should be interesting! Also, I finally have a few proper exercises to be getting on with, wall squats, lunges, and balance board/pad practice type stuff! Got a balance pad and board on order from Amazon.

Did a little asking around, and was recommended a physio not too far away should I fancy it. I'm going to see how this knee clinic/buddies/club/party (whatever it was called, can't remember!) thing works out before looking further into the private thing... I briefly saw the chap who runs them, prior to getting a full diagnosis, and got a good brain-full-of-physio-knowledge vibe from him then, so I'm hoping he'll be pretty decent!

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Somewhat of a milestone yesterday. I've been riding short distances since 2/3 weeks after the op, normally 3.5 miles and never much longer than 30 minutes ish. Yesterday a mate dragged me out for a slightly longer than usual ride, and it just felt ok so we kept riding, and it kept feeling ok.

Ended up doing 25 miles, a total of 2.5 hours riding time, spread out over 4 hours ish, lots of stops to eat and mess about etc. Average speed not a lot slower than the same ride a few months back, and much faster over some sections I wanted to push the speed a bit on to get a good time.

Main thing though, I'm now no longer scared of every tiny little bump or pothole, the leg feels like it can take small unexpected vibrations and bumps. Coming home in the dark on a pitch black cycle route my main light ran out of power, no panic, still got a tiny one, just slow down a bit. I am however still very scared of coming off no matter how small the fall, so taking it easy anywhere that may be possible is still the prime directive.

The first bunch of 3.5 mile rides were mostly spent analysing my road, memorising the position of every single imperfection, so this is a big improvement:D

Also, I've noticed over the last few days, without thinking about it I'm naturally locking the left knee and leaning on that leg when the situation presents itself, leaning against something on my right side for example. Not done that since the accident.

Off on a short holiday tomorrow, gonna see how it handles light swimming (no kicking yet!) and general travel, longer days on my feet, and probably some light drinking. Touch wood.

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WAY TO GO @jjams82!! Those sound like big milestones to me. A surgeon visit with nothing to report is indeed a very good surgeon visit. My second follow-up, at 8 weeks, terrified the bejeezus out of me as he read me the riot act on the importance of full extension/general awfulness of scar tissue build up. On closer inspection it turned out I did have full extension, the hammie was just a touch stiff. But I still left with horrible visions of more scalpel attacks on my poor knee... Thankfully the 16 week follow up was more morale boosting, or I'd need tranquilizers before the next one!

And serious respect on the bike ride. It's not just the distance, which is impressive in itself. It's trusting the leg, which is more than half the battle in rehab from what I can see. I had to repeat to myself doing my first single leg bridges "it will not give way". And mine hadn't even had any instability, even pre surgery. So with that and with having the confidence to lean on the locked leg, you're winning! Re falling off - perfectly sensible to try to avoid it!

Let us know how you get on with the holiday/swimming/ light drinking as well as the group physio. The first time I had alcohol post op I thought a. great that I'm sitting down or I'll fall over; b. on getting up - "look, I'm not limping!!" I think that was just wine goggles though Smile

Mini milestone here: at 20 weeks (almost) the physio said "get thee back to bodypump classes twice a week". And so I did. Conclusion: I still seriously overload the good vs the bad leg when I squat. Nothing like a large studio mirror to show poor form. And for some reason I'm frit of lunges with the op leg back (???). I think the report is "must try harder" Very Happy

If I do, he says I'll be starting running in the next 4 weeks. Though I can't quite believe it...watch this space

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@jjams82 and how are you getting on with the balance board? I'm yet to do that, for now it's squat-squat-squat and squat some more. 120 per session from tomorrow - "feel the burn" he says Very Happy

More seriously, I really hope it works out well with the new physio who does your group class. I can't tell you how grateful I am for mine, he's a lifesaver. So much so that I intend to still see him once a month or so after I'm done with rehab- just to check that everything is ticking along well, muscles in balance,etc.

You know it makes sense.

22 week/ 5 month update: four body pump classes later, the leg hasn’t fallen off. I was still a bit chicken about the lunges with the op leg back. No pain, but it’s the psychological factor that I can’t see the op knee in front of me so how do I know it’s not twisting? Toofy Grin

I demonstrated it to the physio today, who gave me his blessing on the form. So now I have to put my big girl pants on and get on with it. He also confirmed that other things I’ve avoided (slow straight mountain climbers, planks moving a leg sideways, triceps dips) are all OK to do. The fat pad is still a wee bit irritable, but other than that he thinks I should still be on track to start some light running when I see him in two weeks. I almost don’t want to say it and jinx it!

In the meantime I have a work trip across the pond coming up, so Kneedy Knee is in for its first long haul flight. Let’s see how it likes that one...

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Hey BTR... Good to hear from you again!

Sorry I seem to have missed your messages too... Might've been while I was away, who knows, it's a bit "ships in the night" here lately:D

Holiday went great! Didn't dare go in the sea though, those waves were a little too violent for my liking. Managed to have all sorts of fun, clambering about on rocks, making sand castles, exploring real castles, all the fun stuff people go to that area for except the surfing! Only leg troubles were 1: I decided to have a quick go on a skateboard, slight wobble, totally crapped my pants, visions of re-rupture filling my head, got straight off it... And 2: I thought it'd be a good idea to walk home from the train station, the last leg of my travels home. It wasn't! Long day, lots of leg work, carrying a (relatively light but still far too heavy for my liking) backpack. I got about 20 yards from my house and just couldn't make it. Done in. Had to sit down for a while and psych myself up for the last stretch:D

Drinking was good... Like you say, sometimes not thinking about how you walk makes you walk normal... Drink seemed to do that for me every so often, until I noticed I was walking normal, and there it was in my head again Laughing

Balance Board - I reckon I'm a bit of a master at it now! It's my most regular exercise at home, as I can do it while making meals, messing with random projects, etc. It's also the least boring! I think there should be competitive balance boarding, just so I could participate in a sport I might have a chance at doing ok in at this stage of my recovery:D

The new knee club physio sessions have been great. Absolutely a massive step up (sort of pun sort of intended) from the previous one-on-one with the other girl. I'd seen the chap who runs them before I had my op, and when I realised it was him I felt a lot better. He's not just got instructions, he's got EXPLANATIONS!!!!! Brilliant stuff! Just what I'd been wanting.. Also, answers, off the top of his head, just like I'd always hoped for! Very very much happier with the physio now. Even though I get less one on one time it's so much more densely packed with specifics for me and my knee, information, knowledge etc etc that I get a million times more out of it. It's also good to be in a room with a bunch of other people with no ACL's or freshly planted ACL's, getting to chat about how they're getting on is great. Bit like this thread but in real life and with more people! I get to be the one with the most dramatic rupture story too - ahhhh, it's finally paying off:D

There is however one young chap who keeps kicking a football around the class... If that thing somehow ends up under my ACL leg he's getting a beating! He's been warned, so no excuses!!!

Main problem for me now is I'm two weeks back into work and completely EXHAUSTED all the time, to the point where I fell asleep for 45 minutes yesterday in a barn, when I just wanted to sit down and get 5 minutes rest from dragging bags of logs about. Apparently it's normal, but it still sucks! Exhaustion means weak legs, which means more concentration to keep 'em safe, which means more exhaustion, repeat. It's at the point where getting any lunges step-ups and squats in at the end of the day is a real struggle. My Physio chap doesn't seem bothered as the variety of exercise I get in work is physio in itself, but I still don't much like having to sacrifice strict regular large quantities of instructed physio for random lifting, dragging, chainsawing, heavy tractor clutches, climbing, walking, crouchcrawling my way through hedges, and (slowly) chasing cows. I get some lunge walks in here and there, and squats while waiting about, but it's not as much as I'd like. So so so tired!

I had planned a good long cycle camping trip this weekend, but because of the exhaustion I had to cancel. I think I'm learning about the whole 'pacing yourself' thing people have been talking about since I realised I'd need the op! Once again, I fail to learn from advice, only from cocking it up my own damned self:D

Good to hear you're still trudging (lunging) along with the rehab and making progress. I may be joining you in some of the fancy pants exercises soon, next step is "advanced" knee club. I reckon (with no scientific backing whatsoever) you'll be fine on your long haul flight, try get an aisle seat so you can get up and give it a stretch every so often! Worked great for me to portugal and back, though it was only 2.5 hours so not really a comparison. If it's even remotely not a huge lie, take a crutch with you - I took one in case I ended up with super tired leg from too much holiday walking (I did) and it had the side bonus of getting me zipped to the front of security queues and ushered into the "premium boardings" line:D

How's your walking / days spent on your feet time going now? Last I remember was it about 45 min walking taking you near the limit? That was a while ago now though. Potential jogging, now that is great news!! You'll be over the moon making that milestone. I too was told it's in my near future... Unlike you though, I am definitely NOT born to run!

I'm curious, so post up here how you got on with the flights if you don't mind!

A snowHead

Wow long post... I've said it before, but asking an ACL reconstruction patient about their rehab is like asking a farmer how the weather has been. We will go on a bit:D

A snowHead

@jjams82, there’s no such thing as too long a post about ACL rehab for a fellow sufferer. You know it will be read avidly! On which note, I’m a bit jealous of your face-to-face ACL club at the physio classes. Though this board is brilliant of course, but the more the merrier. I’ve randomly encountered two fellow sufferers on the tube so far, who spotted my scars and the death stare I was giving anyone coming near my knee - a bit like you with the football guy, and yes, that would scare the bejeesus out of me too. I also encountered two ACL-ers in the physio waiting room, one of whom today. He was at 7 weeks and still in quite a bit if pain plus on a crutch. And I also already knew four people who’d had it done - ranging from one who totally failed to do his rehab, to one who returned to his career as a competitive 400m sprinter. The two “civilians” in between are both doing wel. One of them is back to amateur rugby and recently ran the London marathon.

But most importantly, sounds like you’re coming on in leaps and bounds! I’m hugely impressed! Are you now just short of 12 weeks, or is my maths failing me again? Needless to say I wasn’t anywhere near able to drag heavy logs, crawl through hedges and even nearly chase cows, let alone clamber on rocks. No wonder your physio isn’t concerned about squats and step ups. What you’re getting is essentially full days of functional knee exercises. I’d say that much as the targeted gym stuff is obviously good, the aim is to get to good function. And surely nothing like a top up of real life putting your knee through its paces to achieve that. How’s the gait coming along? Bet you’re nigh on normal with all this going on. Any pain? And if so, which part is most troublesome?

And are you a beef/dairy farmer by the way? I ask because my in-laws are. Previously dairy, now beef.

Good memory on the 45 minutes! I have to admit walking for longer than that in one go has fallen a bit by the wayside with squeezing in the gym classes and longer static bike sessions as well. But I think that’ll change when we’re off on holiday for a couple of weeks in a fortnight’s time. I’ll make an effort to walk a bit more before that so it doesn’t come as too much of a shock to Mr Knee Very Happy

Standing I’m still not brilliant at, I can feel a sort of irritable feeling in the knee after a while. It’s not pain, but a sort of “I’m not happy with this” sensation I can’t quite describe. I asked the physio today if I should just power through it, and he said not yet, as it’ll just irritate the fat pad with no real benefit. He says that will calm down more and more as the medial hamstring and VMO build up, and standing will also get better and better. Apparently I’m predisposed to fat pad issues anyway because naturally my knees point slightly inwards, which puts pressure on it. I really hope you have more amenable knees in that respect. The irritation of the infamous fat pad is nothing to how irritated I’m getting with it! Smile

So I’ve posted War and Peace as well! As you say, farmers and weather. I’ll definitely bore you further with how the flights went. I’m lucky that work is paying for them so I get to turn left and lie flat, which will be a knee saver for 8 hours. And the first time I’ve not squeezed myself in cattle class, I should add. Apparently I should still expect some swelling because of the pressure, but am told to go to a pool (won’t be able to), get on a bike (yes) or have a bath (yes) to make it better.

Very exciting about running coming up for you too. Shows how well you’re doing. Keep up the turbo-progress! Did they mention when you might be able to snow board again, or are you not thinking about that yet?

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

@BorntoRun, Yep... Other ACLers are great for morale eh. Was lucky enough to do mine on a trip with a guy who'd done his twice, and had all kinds of information (including attempting to prepare me for how much it sucked, which try as he did, didn't quite sink in until a couple days after the op!)... He was massive help during and after the op too, all sorts of useful info and general help (if you're reading this, thanks again, and I promise not to force a hug on you next time I see you:D).. As was another snowhead who did hears on a trip I was on the month before I did mine. Major thanks to 'em both... And all the other SH's who were incredibly useful, can't leave them out while I'm getting all emotional about how great people have been diagnosing it early, giving me tips on getting it taken seriously, and preparing me for what was to come. And just generally stopping me freaking out about it:D

There's a girl in my class who had hers done two weeks after mine, and she's miles ahead, and a guy who should be 2 months ahead in the rehab (i think he was a bit lazy on it) and still can't straighten his leg - seeing the variety in peoples recovery gives me a reference point. It feels so slow, but while I may not be as far on as the first girl, I'm far better off then the lad who's way ahead of me! That and simply being able to talk about it face to face with people who've been through it... I could go on... It's good:D I wonder if you might be able to squeeze yourself into a local NHS lower limb physio class? It'd be worth a try anyways.

Close btw... I'm at 10 weeks (yesterday) now. I reckon I agree about the full days of functional knee exercise - though I'm going to have to see if I can get some knowledge on what I might be missing from the physio next time to top up on that as much as possible... And start some snowboard specific exercises at some point just to make sure I'm not neglecting the whole point of all this:D

Gait is feeling quite good now, when I'm not exhausted. I use a stick when it's really tired still, for fear of goosing it further. When it's feeling strong though, not too bad! Though i've not asked an independent source what it really looks like for a while - Last time I thought it looked good and asked I was told I'm still limping:D Pain wise, getting better all the time. The LCL still feels a bit painy after a real long day, but the upper kneecap pain when squatting/lunging is decreasing (thank feck!!). Now it's a whole-knee muscular ache that seems most common. Hows yours now pain wise? Still getting more pain from the other ligament (I forgot which one it was, sorry!) than the ACL area?

And yep, I might be your in-laws... Exactly the same:D We were dairy before I moved in, now just beef, organic, and a few (mostly failed this year) crops. Thank god for no dairy though! I'd be a wreck having to get up at 5 to milk every day!!!!

Tell ya what... I bet when you get on holiday, as long as you don't think about it too much, you'll be waaaay over 45 minutes walk before it starts to get too much.. Try and forget it until it forces you to remember, and you'll find you've walked half the day away! These exercises build up surprisingly fast eh. Get Mr BorntoRun to slap you every time you think about it and long walks will fly by Laughing

I'm gonna have to google what a fat pad is... So far I don't think it's been a problem - sounds like a right pain in the backside. Come to think about it, is that what the fat pad is? It'd make sense. I'd been sitting on my fat pad so much the first months after the surgery that maybe mine's getting irritated too Laughing

. Standing of all things I'd have assumed would be the least of the problems as far as reconstruction recovery goes... But then I have almost no idea what I'm talking about at the best of times, let alone with specialised physio-medical whatnots. At least on your airplane journey you've got the posh seats so you can give the fat pad a rest by laying down on your back:D

Snowboarding... I don't want to tempt fate, but I might just manage an easy week, based more around lunch and coffee than anything else - there's plenty of snowheads who ski with that philosophy to join up with*. Maybe. Oh, and wearing the most fancypants professionally fitted super carbon unobtanium sleek and stylish brace I can afford, just to remove my inherant cheapness from the list of things that could screw me over... The surgeon made vaguely positive noises about a tentative return next season while discussing preparations for my op, though I haven't asked the physio about it yet. Way too early for that at this stage, but it'll be high on my list of things to pester the physio with when the nights start to draw in and thoughts turn to mountains. "Rehab like it's possible, but be prepared for it not to be" is my thought on it at the moment.

*on that note... if you've not tried a bash, 18/19 would be the perfect season to give it a go. There'll be at least two (assuming I can make it) fresh ACL's doing their first post-op trip on the birthday bash, and as mentioned there's plenty of lunch and chill based skiers to have nice mellow days with.

What about you? Have they given any indication when you might return to sliding? I can't remember now, It was skiing that did yours in the first place wastn't it? Damned daft skiers and their constant ACL ruptures.... They really should try snowboarding, so much safer on the knees. Oh... Wait...

Hmmmm.

Dammit:D

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Big cheer for the lovely, supportive Snow Heads ACL club! There really is no substitute for talking to someone who’s been/is going through it. That’s not to say I didn’t have a lot of lovely friends who visited and kept me sane during the ice machine/sofa/angry watermelon knee days. Not to mention poor long suffering Mr BtR, who changed dressings, put on tubi grips and socks, carried many kgs of ice, did the housework to the accompaniment of my nagging, and answered in the negative to “have I just torn my graft??” twenty five times a day. All whilst I informed him that he couldn’t possibly understand what a bummer this injury is Toofy Grin

I now feel very bad at how little fuss I made of our friend who did his in a couple of years ago (dancing!!). No way can anything or anyone prepare you for how much the early weeks completely suck! He on the other hand has been great to me now. Largely repeating “do your rehab, I wish I’d done mine” ...
The SnowHeads bash sounds brilliant! Annoyingly we had already decided pre injury we were going to sit next year out because we’re saving to move somewhere bigger early 2019. I very nearly wasn’t allowed the time off work to ski this year, but I was so determined we’d have our skiing holiday before the move, I really pushed and got it through. You can imagine how delighted I was when the knee exploded two days in! It wasn’t even a proper fall like yours. Gentle red, good weather, good snow, wasn’t tired, wasn’t hungry, wasn’t going fast, bit of a slip, two twists and next thing I was being skidooed down with a massive inflatable thingy round my leg. SnowHeads 2020 then? You’ll be whizzing right past me on your board by then!
Goodness gracious, the girl who’s eight weeks , but further along than you chainsawing and dragging logs- are you sure she’s 100% human?? I’m having what she (and you) are having! Toofy Grin

Your levels of pain sound very good. I rarely have anything beyond muscle aches either now, mostly in the hamstring and on the outer side of the knee from a very very tight thigh muscle (the IT band apparently). The physio put needles in the knots there at the last session, and I could feel like springs were uncoiling inside. A very weird feeling. I also foam roll that bit for dear life. It hurts, but it’s instant relief afterwards.
The MCL let me be pretty much straight after the surgery thankfully. The surgeon said it was grumpy beforehand at having to do extra work without an ACL.
The fat pad, haha! Well, it also gets grumpy if I sit on my posterior fat pad too long! Very Happy

Basically it’s the slightly cushiony bit just below the knee cap, which does exactly a cushion’s job. But it also has lots of nerves and blood vessels, and didn’t much like that two of the ACL portals cut right into it. Apparently it won’t improve until my VMO and inside hamstrings (the chopped up ones) strengthen up and take the load back off it. So there’s another incentive for me to do those evil lunges Very Happy

And guess what, just as we were talking about walking longer - went on for about an hour yesterday. It included going to a couple of shops so it wasn’t marching continuously, but on the go nonetheless. And Mr BtR will be nothing but delighted to rap my knuckles if I think/talk about the knee on holiday. What the poor man doesn’t now know about ACL recovery isn’t worth knowing! Very Happy

Anyway, snowHeads is much more fun if you do.

Did you manage to get a few days’ boarding in before you fell off a mountain btw?

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I was at the Snowsport England Coaching Conference at the weekend and Dave Murrie presented some tests, one of which checked for knee and lower leg stability.

The test shows up differences between left and right, with the theory being that those showing a big difference are more prone to injury. It also gives a relative strength (?) threshold it would be good to meet.

On the upside, my repaired ACL leg was stronger than the 'good' leg, but on the downside my relative strength was 10% lower than the threshold.

It's a tricky test to do solo but it may be worth it if you get the chance:

"Star Excursion Balance Test
(Plinsky et al. 2009)"

Dave Murrie site: https://sites.google.com/site/davemurriesportsscience/home-1

Then you can post your own questions or snow reports...

@AndAnotherThing.., very interesting! I would fail right now on both counts, but one for when I'm recovered (crosses fingers).
How long ago did you do yours, and how's it treating you now?

After all it is free

@BorntoRun, March 2012, with the op on May 4th.

My rehab diary is here - http://snowheads.com/ski-forum/viewtopic.php?t=91354

Generally I'm back to normal, skiing as well or better than before. Markhandford's rehab experience has prompted me to look again at what I can do to improve my leg strength and there is a view that my current fight with Achilles tendinitis was perhaps a result of the op.

I'm also super aware of my fore aft balance when skiing these days, particularly when the going gets tough (or thin) off piste.

@AndAnotherThing.., thank you! I actually read it in the early dark days post op and found it hugely helpful. So a belated thank you! Good to look at it now again and compare progress. Yours is seriously impressive with skiing at 7 months! I don't think I'm anywhere near as fast to recover, I'm only due to start some light running in a couple of weeks, at what will be 24 weeks. Then again, as we were going to sit out next year skiing anyway for other reasons (trying to move somewhere bigger in insanely expensive London Shocked

), at least there's no time pressure.
Glad to hear skiing is going so well. Damn about the Achilles, all my sympathy. I'm beginning to realise this ACL rehab business is for life - you never lose sight of having to keep strong/balanced, etc...

*Ski* the Net with snowHeads

@BorntoRun, On reflection, 7 months is probably a bit misleading. It really took 2 or 3 seasons to really get back to normal. However I did get to ski my usual season the following Winter which was good and included a lot of off piste.

Help!!

The snowHeads ACL rehab club !

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