The snowHeads ACL rehab club !

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debbiem, to straighten the leg passively and continuously, simply rest with the knee itself UNSUPPORTED. I know from bitter painful experience how much more comfortable it is to raise the leg with cushions under the knee itself. Initially it is uncomfortable but you do get used to it. I now never have anything under my knee when I watch TV or am reading. My feet rest on a stool or the coffee table (on a cushion) and I find that the most comfortable way to relax. I place the cushions so that they support my ankles and heels (I've had both knees "repaired").

And as the others say, you've just had knee surgery where the surgeon used a drill bit to bore through two very important long bones. It hurts like b|oody he!! for goodness sakes. If the OTC pain control isn't cutting it, get your GP to prescribe something stronger. Bone pain is like toothache; deep, continuous and damned near untouchable with OTC tablets.

The good news is though once you get through the first week, it does get easier surprisingly fast wink

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

I'm only speaking from personal opinion on this, but I don't think pain management following knee ops is very good in the UK. Everyone seems to be chucked out with paracetamol, and be in real pain. We often get requests for 'the strongest you've got' over the counter pain stuff from people just out of hospital. With you on the French stuff though, hubby was offered morphine and decent anti-inflammatories following his neck operation. He refused the morphine though, as he said it didn't do much. rolling eyes

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Hells Bells, please don't tell me he recovered from surgery after a broken neck using paracetamol? Skullie

I just thought, ok, could have done without this whole knee thing, but on the upside "I wanna get high"

Seriously, though, I could not imagine being sent home with just some paracetamol after surgery of this kind. At least people are saying it calms down hugely within a week and there is light at the end of the tunnel.

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Thanks guys, lots of reassuring words Smile

I've constantly got my leg on a footstool with a gap under my knee so it will hopefully make its way straight, and I'm constantly icing which really helps with the pain. The pain is feeling better today but that's probably because of the 30mg co-codamol I've been taking which I already had in the house.

OH has come home with a new TV today, I can't leave him unsupervised for 5 mins! Now all I need to do is find some decent daytime channels, which is quite a challenge!

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miranda, I always found that two of those plus a bottle of bubbly took most minor pain away Cool

After all it is free

Scarpa, I feel like such an amateur having stayed off the booze whilst taking them now Laughing

Oh yeh of course it was a gift to cheer ME up, no no, not a new toy for him, he's not really sitting on the floor surrounded by remote controls and talking to the tv Very Happy

Mmm, someone said earlier stay away from the booze, and I'm not a big drinker, but I'm sure I do deserve a bottle of bubbly! Maybe I could treat myself to a glass every time I make myself do the physio exercises?!

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miranda, paracetamol and diclofenac in the UK. He was prescribed 15mg of codeine, but as it was worse than useless.................

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and lots of red wine, and absinthe.

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And poppies, don't forget poppies

You know it makes sense.

I still feel cheated Sad

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

AndAnotherThing.., sounds like Scarpa, can supply you with some stuff wink

A snowHead

Thank the lord, a health professional that talks sense! Is it a bit early in the day? Laughing

I'm off for my first shower this morning, eww I know, stinky me! I'm going to let the dressings get wet and take them off afterwards. I have some spare ones although the nurse didn't seem concerned about re-covering but I think there are clips underneath and I don't like the thought of them catching on things, and I don't want to put my ice cuff directly on them.

Oh the excitement of a shower and a peek under the dressings!

Hells Bells, so you think Diclofenac would be better than 30/500 co-codamol? I've probably got some upstairs, I hoarded lots of goodies when I've bought pre-payment cards in the past Very Happy

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miranda, His Damson Gin isn't bad Blush

We need to get ours decanted from the year before last. Excellent medicine Happy

debbiem, It's nice to feel a bit more human after a wash Happy

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

Yeh I felt really human after my shower, fab! Until I took my dressings off and realised I look like Frankinstein Toofy Grin

How do I put a picture in here?

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AndAnotherThing.., Damson Gin sounds lush.

debbiem, are you still feeling it through the 30/500 stuff? I'm starting to think there's something wrong with me... Confused

So, the doctor v physio thing that I think people probably often encounter at some point... the surgeon obviously said don't do anything, one physio session, nothing else (reluctantly agreed to gentle kick swimming with a float only which I haven't had time to do anyway as would need OH to take me to the pool and our summer season has started already)... both my physios (they work together, one doing home visits and one doing clinic sessions) want to ignore this.

Their point is that he is being overly cautious to protect 'his' lovely ligament he made, but they think that the fact I don't have any pain to stop me overusing the knee is a problem whilst I don't have sufficient muscle mass to protect the ligament. So today I was put on the exercise bike (no resistance) for 10 minutes and then did various exercise ball, mat and balance exercises, all of which were fine and easy, except backward lunges, which were not difficult but I had that same sensation I got when trying to walk down steps normally (i.e. one foot on each step only). This is apparently nothing to worry about and is the tendon getting used to a new movement and is nothing to do with the ligament and so I shouldn't be concerned by it. So do it, but do it "doucement". Also got given those horrible electrode things to use at home every day (definitely deserve some bubbly when I use those!). So am now going to have 2 physio sessions a week and do all these gentle exercises at home, meet the surgeon in a couple of weeks and hope he doesn't ask me what I've been up to Embarassed

ps apparently, if you're female like me, you'll want your legs to look "jolies" next summer, so exfoliate and massage your knee with cream once the incisions have closed and don't let them have any sun this year. French male physios sexist? Jamais... Laughing

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debbiem, "Post a Picture" bottom left of your screen.

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Regarding analgesia I would regard non-steroidals and cocodamol type meds as complimentary. Also ibuprofen is useless IMO potential for toxicity and relatively little efficacy. Hope you all heal well and quickly.
I am still struggling to hyperextend my knee and will see the surgeon again at the beginning of August.

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ianmacd, I'm not really sure what you mean about non-steroidals and cocodamol meds? (sorry, I'm not very good with this sort of stuff, hence my "I'll just take whatever you, the professional, give me" attitude). I do know the 30/500 codeine/paracetamol stuff meant I felt no pain at all, but I'm starting to think that perhaps I just got very lucky.

I hope your meeting with the surgeon goes as you would hope - am I right in thinking you've not decided whether to have the op yet? The very best of wishes for the outcome either way.

After all it is free

miranda, sorry I am rubbish at expressing myself. My point was meant to be that you can take both cocodamol and and non steroidals simultaneously. Also I find ibuprofen much less effective than disclofenac/naproxen/indomethacin although I am very fortunate not to experience any g/i toxicity.

As regards my knee I injured a few days before AndAnotherThing.., you are correct that I am unsure about surgery but that is because the surgeon has said he is unsure and that because I cannot fully straighten it yet it is too early to operate in any case. I am pretty spooked about the prospect of surgery but hearing about all of yor progress is pretty reassuring.

ianmacd, ah, ok, I understand! In the end I went 3.5 months from injury to surgery (with regular physio from about one month onwards) so I know what it's like to wait and not be sure which way you'll go. Again, best of luck and please update with what you and the surgeon (or possibly even your second opinion surgeon) decide if you feel like it. Having been through it now I'm glad I did as it seems to have worked out ok, but I wasn't sure that I was going to go ahead with the op until quite late in the day.

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Miranda: "post a picture" really? I can't see it! Anyway, I'm hoping that i've managed to copy and paste the URL from where I had posted this on Facebook. This was my first peek at my knee on day 3, Frankenstein's sister?!

I'm glad to say the pain is much better now. That may be due to the co-codamol and neurofen building up. It swells easily if I wander around on my crutches and then is very uncomfortable so not much wandering around for me at the moment.

My doctor v physio is the opposite to you Miranda. I've been told 3 weeks on crutches, part weight bearing. The surgeon said it'll be fine if I want to limp around the house a bit without the crutches, but the physio said the opposite, definitely use the crutches all of the time. I'm going with the physio for now as putting more weight on it will only make it swell more anyway.

I had arranged to collect a hire car, an automatic, today but i'm going to cancel it for the time being as I truly 'can't be bothered'! It's very easy to get lazy isn't it!

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Ooh that picture came out a bit on the large side, sorry folks Confused

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debbiem, sorry, I think "post a picture" might only be available to "supersnowheads" (i.e. if you make a donation to the upkeep of the forum).

Also sorry, but, eeeewwww!!!

It'll look normal (albeit with scars) in 3 or 4 weeks!

debbiem, how's the pain going?

AndAnotherThing.., how's the jogging going?

Is it possible to resize the photo?

You know it makes sense.

miranda, ha ha, jogging isn't going so well. I went to the NHS physio yesterday and suggested that jogging was tricky and she looked surprised and suggested that it's not in the protocol.
After pointing it out to her she shrugged muttered about impact & flat ground and we never really decided on how to resolve it.

The crux is I'm suffering some pain to the front of the kneecap. Again she's not worried about it but walking in town at lunchtime it was a little sore, which is unusual.
I'm hoping it will settle down as different types of discomfort come and go.

I'll probably book up with my sports physio week after next and see what she has to say. Last time she was focused on reducing the swelling but I still have some. Next Friday is the 8 week point and
the next page on the Rehab protocol, which includes such delights as hopping, Running, 'Cutting'?. Plyometrics(?) and Ballistics?

The good news is I'm regaining muscle bulk and at the present rate should be back to pre injury size in just a few weeks.

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

AndAnotherThing.., regaining the muscle bulk is great. What do you think the most effective thing has been for that? I need to to focus on this I think.

We had a group of 56 in which meant a) I didn't do physio or exercises and b) I was standing and walking around for hours on end, preparing lunches and dinners and serving in the bar until well into the early hours of the morning. I also couldn't resist joining in with a little bit of late night dancing either!

Good news is that my knee seems to have survived ok after what was quite a test for it just one month after the op - felt a bit heavy yesterday but physio said there were no issues and it was a little warm but not swollen. Iced it last night and it's not warm or heavy at all today.

However, none of this has helped with muscle mass and I want to start making a concerted effort to deal with that this week as I got it back very quickly after the injury so am hopeful with some effort I can do it quickly again.

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miranda, Glad it's been OK. Sounds like a lot of time standing up which I find can make it feel heavy.

For the muscle, I've just been doing the exercises everyday plus walking most days. Typically I'm doing 1.5 to 2 miles with the dog which is less than before the sports phyio suggested I knock it back.
I tend to go up stairs using only my 'bad' leg which I think has helped.

Weekends are a bit different as I tend to be up and about on it more mucking about in the garden so I guess that's the equivalent of walking a bit further. I know roughly what it was pre injury so that will be the target.

I tried to get a 'pass' to walk our local hill but nothing doing. Something for the 12 week mark I'm guessing.

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

Samerberg Sue, That makes sense. It feels similar to the pain I occasionally get in the 'good' one ! I'm doing a bit of kneecap mobilisation too to try and keep it moving correctly. Not sure it makes any difference !

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UPDATE - Week 8

The knee & leg feels noticeably stronger week by week, although on odd days it feels like I've taken a backwards step.

I'm comfortably walking up to an hour at a time although when standing a lot at the weekends the knee can become heavy with increased swelling. I'm still icing a couple of times a day when I remember along with stretches and mobilising the kneecap.

I'm still getting some discomfort at the front of the knee when under load but it's possible to work through it. The physio today thinks it will improve as I rebuild muscle. I'm tending to do less specific 'rehab' exercises at the weekend, choosing more 'real world' standing, walking & gardening.

I'm just back from the PFA Rehab centre at Lilleshall and my physo there is happy with the progress - at least she didn't tell me off this time ! Last time she was concerned with the swelling and the amount of walking I was doing. The plan for the next few weeks is more of the same rehab protocol exercises but building more reps for each exercise, and more often.

My confidence in an earlier post about rebuilding muscle bulk seems a little misplaced as there has been no change in the last 2 weeks, but I hope to change that with more reps and work this week. It's been suggested that I join the footy players in their rehab sessions at some point in the next few weeks and I may even join a gym Shocked

As long as I don't have to move to quickly the leg feels not much different than before, and I seem to have as much 'active' flex as the good leg - however I can't yet sit on my heals. However it would be a different story if I had to run, hop, jump or make sudden movements on it Laughing

Still not allowed any walking in the hills but I think 2 or 3 weeks should see me there. I'm toying with some simple climbing (avoiding the 'bad' leg) at the week 12 stage just to get some upper body exercise. I'm confident I can protect it now, but we'll see how it feels.

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AndAnotherThing.., that largely sounds really good. Sitting on your heels, for me, seems miles away - I've not even tried it since I did the injury, let alone had the operation! I might surprise myself I suppose, but my surgeon has put me under strict instructions not to try to bend my knee ever.

In fact, I logged on because I went to see my surgeon today, having been ridiculously busy so not done any specific ACL rehab exercises whatsoever outside of twice weekly physio sessions. My protocol is now going to massively diverge from yours. Last time I saw him, he told me not to do anything and to have one physio session a week. My physios talked me round.... This time, he told me I could do flat walking, swimming and cycling and that my knee was the limit - any pain or any swelling at all and I've done too much. And NO physio at all for 2 months! I asked him for his rationale because I knew the physios would disagree. He simply said, with this method you must not do anything now - with this method there is no pain and you can bend at 140 degrees and fully extend without having made any active effort to do so, and now you must not do anything to stretch the ligament for 2 months. I will know if you have overworked it as you will not feel pain, but I will be able to feel the laxity that is not there now. You must trust me.

Had a chat about walking in the mountains and his straight answer was, no, it is the same as skiing, tennis, football, basketball... not for 6 months. I asked about balance exercises, muscle growth etc. No. Not for 2 more months. He said he knew I wanted to do stuff and it's a shame that this is the way it is and that he is working on studies on how to speed up the regrowth of the graft but they are not there yet and so (he talks to me in English) "ze ligament is like a flower, you can put 'im 'ere and you can put 'im zer but 'e must regrow ze roots and you must not stress 'im while 'e does zat".

Bit disturbed to discover that my new knee ligament is a different gender from the rest of my body, but he seems to be coming along nicely and so this time I really am going to trust the surgeon and not be swayed by the physios. It'll be an interesting comparison study I suppose, to see how I end up 6 months post op in comparison to everyone else who's following a more standard protocol. Probably not much different but if it's pain-free and doesn't involve lots of boring physio exercises, I won't be the reluctant guinea pig to be honest! All I can think is, he's the one who's actually had a look inside my knee, so I'm going to go with his opinion.

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ps - not sure if anyone else is bothering to say this to you, but my surgeon (like the physio before) also told me today to make sure the incision scars didn't get any sun at all this year if I wanted them to have disappeared by next year.

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miranda, bother, two of the specialist nurses in my hospital told me to get sun on my scar to help it fade. Will my perfect beauty be marred, I wonder? wink

You're worried about your ligament being a different gender? Think of me with a bit of pig inside me!! Toofy Grin

After all it is free

miranda, It's good for any other 'victims' that we're documenting two very different rehab protocols.

The big difference is the relationship you have with your Surgeon. During the two fleeting follow up appointments I've had, the surgeon or his stand in was very much 'follow the guidance
of the physio' and offered little in specific advice. However, I get the feeling that the NHS physio has had little specific & up to date ACL Rehab training.

But the flip side to that is that my specialist sports rehab physio who rehabs a lot of ACL's suggests that patience is required in the early stages. Chatting yesterday she reckons that even
the Professional Football guys are taking around 8 months to get back to professional match play.

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AndAnotherThing.., it also sounds like miranda has an ALLOGRAFT whereas you have an autograft. The protocols do tend to be different because of this as well. To be honest I think there are as many rehab protocols as there are patients. I've never had exactly the same protocol used even when the same surgeon operated on my knee.

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