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Old     (gene3x)      Join Date: Apr 2005 Location: Dallas , TX       09-20-2008, 10:43 AM Reply   
I had ACL surgery exactly 3 weeks ago and am doing all the Doc's and PT guys say to do except I had started wearing my brace a little early thinking it might help me build my muscle back faster.

I have hit a wall and my knee seems to stay stiff. Cannot get it much past 90 degrees flex and am a good ways from 100 percent extension. My incisions have not healed yet and my muscle & leg just looks like it is getting smaller.

I am pissed because I normally bounce back from injuries quickly. Although I am almost 40 I see people in physical therapy older than me that are way ahead of me. Some of them with Bilateral knee replacements!

I am VERY frustrated. Any advice from those with ACL repairs?
Old     (jmuthafnp)      Join Date: Feb 2006       09-20-2008, 10:49 AM Reply   
Sounds like you have some scar tissue building up in there, may want to revisit with your Doc. I would not rush it, it takes a time and was almost a year and a half before I was able to get full use of my leg back and start to ride.

I am a little over five years out and it finally is starting to feel solid.

Do your PT, lots of leg presses and hamstring curls and you may be able to get back a little sooner, but you can figure at least a year before you feel somewhat normal. Hope this helps, good luck.
Old     (gene3x)      Join Date: Apr 2005 Location: Dallas , TX       09-20-2008, 10:58 AM Reply   
The crazy part is that I am only 3 weeks out.... Scar tissue should just now be starting to form up. I have been working on range of motion. It just doesn't make sense.
Old     (mvl)      Join Date: May 2004       09-20-2008, 11:23 AM Reply   
It takes time. Been around that block twice. I'm 3 years out now. clicks, grinds and sometimes hurts sometimes. Not even close to what I would call 100%, perhaps only 75, but I still ride. Don't do what I did...listen to the docs and pt's...take you're time. Or be like me and live life knowing you need another surgery and have to go through it all again.
Old     (wakemandan)      Join Date: Feb 2003       09-20-2008, 11:25 AM Reply   
Oh man, i wasn't even walking without crutches for the first 8 weeks. These things take a long time to heal. Be sure to do exactly as your PT says, you'll be back in no time.

It's darn frustrating, i remember taking a shower looking at my HUUGE knee, and knowing it'll never be the same again.

in reality ive done my best wakeboarding after my ACL replacement.
Old     (gene3x)      Join Date: Apr 2005 Location: Dallas , TX       09-20-2008, 12:08 PM Reply   
Of course you are 20 years younger! :-)
Guess I just need to be patient.
Old     (mbsteez)      Join Date: May 2005       09-21-2008, 10:12 AM Reply   
don't wear your brace for rehab, you don't need it. if you are doing things you feel the need to wear your brace for at 3 weeks out, you definitely shouldn't be doing them. you're way better off taking your time but working hard than jumping the gun and being stupid. you have to let the repair heal before you can try to get your legs back.
Old     (hatepain)      Join Date: Aug 2006       09-21-2008, 10:50 AM Reply   
Wearing the brace early is a bad idea your muscles become reliant upon it and it ultimately slows progress.
Old     (mvl)      Join Date: May 2004       09-21-2008, 5:16 PM Reply   
Update...yes, no braces for rehab, but definately have one to ride with in the future. I think I'll be starting over and going through it with you...well maybe. Just went out for a nice fall run last night, great conditions, and came up screaming...right knee this time. Been through 2 surgeries on the left, now facing one on the right, maybe. We'll see how the next few days go before I go nuts. I can walk but definately know it when I try to pivot or something. Time will tell, could be a sprain, or just plain torn ligament or even minicus. Time will tell. Sucks, bad!!!!
Old     (mvl)      Join Date: May 2004       09-21-2008, 5:19 PM Reply   
Forgot to add this. Stretch! I'm getting old and man I can feel it. I going to try to get into a habit of stretching for 15-20 DAILY!!! I can't stress that enough, the more you stretch, the more you can bend and take a few more hits w/o issue.
Old     (kottonm0uthking4)      Join Date: Apr 2007       09-21-2008, 6:06 PM Reply   
Yea, I agree. Lose the brace. When i was rehabing my knee, I stayed away from the brace until I was healed.

What i noticed that got me moving quick was focusing on walking correctly. Heel on the ground. Extend leg completely straight. Roll to the ball of my foot... keeping leg/knee completely straight. Bend knee and begin again.

It should feel like you are hyper-extending your knee, but you really are not. My wounded knee feels much stronger than my "good" knee.
Old     (aliwake)      Join Date: Dec 2006       09-21-2008, 8:48 PM Reply   
it all takes time. range of movement is different for everyone, and can take quite a long time to return. after surgery I was close to straightening almost immediately, but bending took a really long time (and i think is still not quite as good as my other leg - even 4.5 years on).
from what I understand the way different surgeons operate can affect the way you regain your ROM.
Definitely don't stress out or get frustrated yet! You have such a long road ahead of you, and getting stressed out so early is just going to make things harder in the long run. rehab is really mentally challenging (in my opinion), so stay calm and optimistic for as long as you can! :-)
Old     (c_fizz)      Join Date: Aug 2008       09-21-2008, 8:51 PM Reply   
make sure to be patient and not try and not try and come back too quickly. there was a girl at my school who tore her acl in soccer and then came back before she was really ready and tore her other acl about a week into it.
Old     (the_bum)      Join Date: Jul 2008       09-21-2008, 9:01 PM Reply   
Dude Gene we have all told you to now rush it!!!!!
Old     (gene3x)      Join Date: Apr 2005 Location: Dallas , TX       09-22-2008, 2:03 AM Reply   
Jake, I hope you meant to NOT rush it.... Thanks for all the input. Maybe I am pushing to hard because my knee is more swollen now and ROM has not improved much in the last week. I am sure I cannot resist giving updates.... so.....
Old     (btr1)      Join Date: Feb 2002       09-22-2008, 7:35 AM Reply   
Everyone recovers differently. I'm a few years older than you and I'm about 3 months out and still have a little swelling but not much. If you can believe it this is actually my 3rd one on my left knee (I've also had 3 on the right too but the last one has actually lasted 7 years now so I'm pretty much an expert at rehab).

In all those previous surgeries I had no swelling and just about full flexion and extension 3 to 4 weeks out. This time it just didn't seem to go as smoothly. I've had more pain, a lot more swelling right after the surgery and it took longer to get my flexion back. Of course the ones that seemed to go great didn't last so maybe that is a good sign.

If you have a real concern go back and spend some time with your doctor. Hopefully you have one that actually will take more than 5 minutes to explain why things maybe going the way they are without you feeling like he wants to rush out the door to the next person (I've had both kinds; they are getting paid so force them to stay even if you have to make a list of questions to ask beforehand, I've done it .

What seemed to help loosen up the knee and reduce the swelling for me is spending time on the elliptical trainer and also taking my dog for long walks. Of course check with your doctor before doing anything too strenuous on the knee.

Keep that knee propped up and iced as much as possible when you aren't working it out.

Good luck!
Old     (the_bum)      Join Date: Jul 2008       09-22-2008, 7:44 AM Reply   
Haha yeah you get what I meant
Old     (gene3x)      Join Date: Apr 2005 Location: Dallas , TX       09-22-2008, 7:54 AM Reply   
Thanks Britt. Yeah I hate Doc's that are rushing you through the whole appointment to get on to their next patient.
I just feel like I am lazy lying around with my knee propped up all the time. I am assuming the reason I am not getting range of motion is that it is staying swollen all the time. I at first wondered if this meant I was pushing it to hard. ???

BTW my muscle is still hardly there at all so my doctor is insisting I keep my brace on for protection against an injury from falling or stepping wrong but I feel I am able to work it better without the brace and am careful at the same time. I have to say I know it is not good practice to go against what my Doc says but I am definately torn between brace or no Postop brace givin that I am more than 3 weeks out now.
Old     (btr1)      Join Date: Feb 2002       09-22-2008, 2:58 PM Reply   
I've never worn a brace after the surgeries and I've had 3 different doctors over the years/surgeries :-); of course each doctor thinks differently. The doctors always told me that I could walk around weight-bearing as tolerated by pain so actually I never used crutches either because most times I didn't have much pain after a couple days and like you I figured the more I actually used the muscles the quicker they would recover. This last one has been different though with slower recovery so all I can say is to stick with it and it will come. Are you doing heel pumps while laying around? I was told that the muscle action helps to get the swelling out more quickly.

So when you are doing the various exercises are you able to get the muscle to contract at all? Has you doctor talked about draining the knee? I had to have mine drained twice after one of my surgeries over the course of a few weeks. The needle is the size of a drinking straw but the end result is worth it since you can actually get the knee to flex and work the muscles.

Some times things improved overnight so hopefully that is what will happen for you. Just make sure that once things start feeling better and looking better on the outside you give the inside time to take.
Old     (liquidmx)      Join Date: Jun 2005       09-22-2008, 3:50 PM Reply   
The faster you take care of it the better off it is. The longer you wait to get that ROM back the more painful it will be...for sure. You should definitely be in PT now. They SHOULD NOT be building muscle until you get full ROM back. My PT involved a pilates ball with leg extensions and curls, messages by hand, electro therapy, and ultrasound. At one point it was about 1 degree from full extension. At that point they put a lead blanket on my knee on top of a hot wrap and elevated the heal to help with full extension.

Staying on top of your home exercises will help with ROM too.

Good luck and keep us posted.
Old     (idahotige)      Join Date: Sep 2005       09-22-2008, 4:55 PM Reply   
Gene,

First off stay in close touch with your physician and PT. If you have had a significant increase in swelling since the surgery you may be pushing things a little to much. It is important to regain your range early, but there is balance between pushing, and managing the swelling. Your PT will help with this.

Wearing the brace while doing non PT related is activities important especially if you do not have good enough quad control to protect against even a minor fall, stumble etc. A stumble the wrong way without any bracing and the lack of good muscle control could cause a large increase in your healing time, or further injury. In short duration you will not become reliant upon it for protection. Talk to you doctor about taking your brace off during your controlled exercise activities if you are able to work your knee better without the brace. Also, keep in mind 3 weeks is a very short time with this healing process.

Not gaining a lot of motion during 1 week is not a huge concern, it is part of the normal ups and downs of an ACL surgery.

The general recovery for an ACL is difficult. You should start having good progress soon and your muscle activity will start increasing. I tell my patients to look at their progress in terms of where they were 1-2 weeks ago, not 1-2 days.

Hang in there, use lots of ice, work closely with your PT, and you should have a good recovery. Also, to get over feeling lazy, do activities that work other parts of your body, such as core muscle trainig, upper body training etc.

Keep us informed of your progess and good luck.
Old     (phantom5815)      Join Date: Jul 2002       09-22-2008, 5:06 PM Reply   
What type of graft was your repair?
The reason for the brace is to protect your repair when you trip and fall because you don't have all your coordination back.
3 wks isn't even enough time for your repair to heal especially if you donated your Patella tendon or Hamstring.
Your knee is stiff is probably due to you not icing and keeping your leg elevated as well.
Did you have a CPM immediately post op and did you use it for several days as prescribed?

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