Misty's ACL Surgery

by Misty O'Connor
(Erie, PA , USA)

On Sunday, November 15, 2009, I was playing recreational volleyball and soccer in my backyard with a group of about 15 friends ranging from ages 13 - 50. We had been playing volleyball for about 2 hours and then decided to switch to soccer. About 30 minutes into our soccer game, the goalie sent a long pass to me that I had to really reach with my dominate right leg. I remember my foot making contact with the ball and then my whole body making contact with the ground as something major snapped in my right knee. My leg felt paralyzed as I lay on the ground surrounded by nervous spectators.


My MRI showed a complete tear of the ACL. After learning my options, I immediately opted for the reconstructive surgery. Being athletic for all my life, having to stop playing all the sports like soccer, volleyball, tennis, rock climbing, and ultimate Frisbee that I loved at the age of 45 was not an option. I wanted to do more than continue running road races; I wanted to continue my life. If I had to give up all my sports and outdoor activities at such a young age, I might as well stop living.

My surgery was scheduled for January 14, 2010, so for the next eight weeks, I went on a very aggressive plan for pre-surgery therapy. By the date of my surgery, I had run two 5k races and a five miler; been doing weight training at my PT's and in my home gym for strengthening all my muscles surrounding my knee; and had all my friends questioning why I needed any surgery.

I was 100% ready for my surgery and felt confident that being in such great physical condition would ensure a speedy recovery. I was wrong.....

This is where my story really begins. I'm sitting today, February 25, 2010 at 41 days or 6 weeks into my recovery, and I can't get past a 107 degree bend. On the days I can get to around a 105 degree bend; I am also pushing to my maximum pain threshold. My PT usually makes me stop for fear of me passing out.

After my surgery, I was making great progress. I had gotten to a 106 degree bend by day 9. I didn't have much pain and I had only taken one of the Vicadin the day after my surgery. The rest of the time I just took Ibuprofen mainly for swelling. By day 14, all my range of motion progress halted.

For the past four weeks, I've made absolutely no progress in my range of motion, and I still have to use one crutch a lot of the time. I can tell that something isn't right, but my PT and I can't figure it out.

I'm having a lot of weird things happen:
* My knee will swell and become hard as a rock if I stand still for over ten minutes say cooking in my kitchen. I have to ice it and sit down for a while until the swelling subsides to where I can partially bend it again.
* After stretching where I do get to 90 degrees or over, the range of motion will only last for around 30 minutes, and then go back to being very stiff and inflexible
* When I do push past 90 degrees, the inside of my knee starts feeling like someone poured acid into the cavity. This pain is what honestly stops my range of motion the most. I have a very high pain threshold and will get myself up to an 8 before I stop pushing for fear of passing out.
* Probably most frustrating and unexplainable is my knee locking. When I first begin my range of motion stretching at PT, my knee will begin to lock at around 50 degrees. I'll have to work it, massage it, and gently bend it back and forth until it unlocks and lets me get past 50 degrees. What in the world it making it catch inside?

Besides all these odd issues, I can tell I'm getting stronger. I can perform straight leg raises and have been able to since day 10. I can do a full rotation on the stationary bike. I'm doing wall squats, hamstring stretches, along with front, side, and back leg raises all in the aquatic pool, but I have very limited range of motion.

When I read timelines of ACL reconstructive recovery, I get even more frustrated about what I can't do. I'm barely able to walk without a crutch, I can't do stairs, I can't drive, and my knee locks up constantly. What could be wrong?

Thus, the current story of a very frustrated ACL surgery patient looking for advice or answers.

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Oct 08, 2015
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Education NEW
by: Anonymous

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Jul 02, 2010
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Give it a month or 2
by: Anonymous

You have limited range of motion because of inflammation in the joint. Ice it as much as possible and if it is only your ACL, walk on it. You can do some exercises like passive leg extensions and strait leg lift to help prevent muscle atrophy but yes, work on getting all of your range of motion back. I think you will feel pretty good in a another month or so. However, in the early going, you might get the sensation of your knee giving out when you turn a certain way... .

As far as work, it all depends on what you do....

Jul 01, 2010
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Different Paces for Different Faces
by: Kelly 33

Hi there. I have not yet had surgery but will be slated to in the near future. Tore my ACL in a Kickboxing tournament on May 8 2010. Now I am live in Alberta Canada and from what I have been reading protocol for pos-op ACL must be different for everyone. but ... This may comfort you to hear what I have been told to expect. I have been told not to return to work for six months and not to expect full recovery for up to 9 months. They say studies have shown that intensive therapy too soon can really slow recovery. I will expect to be layed up for three months working only on range of motion after that comes strength building. Each Dr. has their own protocol check with him. Everything I have read so far on this sight sounds way way way faster than what I have heard from anyone around here. Since my injury I too have not been able to straightn my leg or bend it completely. I have not miniscus tear so that is not it. If you find the solution please let me know. As to that acid feeling try taking some calcium with magnesieum and vitamin D
Kelly in Canada

Mar 16, 2010
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Be Patient
by: Phil

Hi Misty:
I was dependent on 1 crutch until about 6 weeks, then used a cane for a week, then nothing.

My best advice is to be patient and I have experienced most of what you said throughout my rehab. I had my act surgery at the end of November and I still have a long way to go. All the stiffness you feel is scar tissue and it goes away with the more exercise you do.

I have very religious with my rehab. I too want to get back to all the activities that I love to do. I work out my leg everyday for about 2 hours. Using a rotary bike really help softening up the scar tissue. I recently added the elliptical machine to my workout and swimming in the pool.

I am now at 3.5 months and my bending is around 125ish. When i stretch it, i have about 4 inches between my ankle and my butt. I like doing lap swim for a 1/2 hour after my workout because it helps strengthen alot of leg muscles that you can target in the gym.

if your interested, i can send you my workout route. As someone said before, you cant base your progress off of anyone else's.

The best thing to do is be committed, focused and patient.

Phil

phillcharles@gmail.com

Mar 04, 2010
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jets
by: Katie

I use the jets on the front and the back of my knee as well as the quad. It hurts a bit and will turn your knee really red, but you said you have a high pain tolerance so it won't be bad. It feels good to me in a strange way. The next day you will feel like you have a bruise, but you won't. Ask your PT first just to be safe and make sure you are healed up good enough.
My PT also started taping me with Kenisio tape, the japenese invented it, and it really helps with swelling and the scar tissue. The tape is black, blue, pink or beige. Maybe ask your PT about it, its the only thing that has reduced my swelling, I've had my knee taped constantly for a month. Hope this helps!

Mar 04, 2010
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Thanks, Katie
by: Misty O'Connor

Katie, the aqua pool at my PT does have a really strong jet. I'll try that tomorrow. Do you mean to have it hit the front of the knee or the back? I was standing in front of it the other day for a minute to have it hit the backk of the knee to help me get loosened up for my pool workout. I never thought about the front of the knee if that is what you mean? Let me know please and I'll try it.

Thanks, Misty

Mar 03, 2010
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Tim's PT comments
by: Anonymous

I read you progress and that is exactly what the PT said. She thought the scar tissue was causing these problems and said you might nee the "Manipulation" I guess they put you under and force the bending to break it up. Continue the hard work and good luck.

Mar 03, 2010
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forgot to mention
by: katie

Misty, if the pool you are in has a strong jet that you can put your knee up against that will help with the scar tissue and blood flow. It hurts a little bit, but its a good hurt, like a massage. I do 10 minutes at each therapy session and it has helped a ton.

Mar 03, 2010
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Good Luck
by: katie

Thanks Misty. I'm glad your check up went well. I had a pretty big break through today at PT as well and finally got to 110. Wooohooo! I also have been doing aqua therapy and it helps a lot! I was lucky and my doctor had this little plastic bandage that went over my staples so I was able to get in the pool exactly a week from surgery. Good luck with the rest of recovery!

Mar 03, 2010
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Update on my progress and Doctor visit
by: Misty O'Connor

Well, I finally started making progress after my plateau of four weeks which caused zero progress. Finally on Saturday while at PT, I finally got past 105 P-ROM and got to 110. Five degrees may not seem like much, but when I was stuck at barely reaching 104 for so long, getting five more degrees was a huge break through. When I went back on Monday and then again this morning, Wednesday, I actually got to 113. It has also become virtually pain free to get to 105 now!!
What I feel really got me past my plateau was beginning aqua therapy. My PT thought that my incision has healed enough that the pool would be great for assisting me bend and strengthen. I spend about an hour in the aquatic pool doing several exercises including biking (only an imaginary motion). Then I spend at least another hour doing my regular PT stuff (straight leg raises, wall slides, bike, treadmill, etc.) which all culminates with my PT stretching me to the max. I feel a lot stronger and of course I’m bending a lot better. I would highly suggest all of you look for a PT with an aquatic pool for part of your rehab.
After PT today, I had my 6 week evaluation. My doctor said he was worried and was considering a “manipulation procedure” if I hadn’t progressed passed 90 ROM. He told me the burning sensation I was having and the locking was very normal and all part of the scar tissue that had to be broken up. He encouraged me to keep pushing the bending, and to welcome any scar tissue breaking I could do on my own.
Hope this helps and thanks for the words of encouragement. Katie, thanks for the note. Good luck to you.

Mar 03, 2010
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Suggestion to Doug
by: Misty O'Connor

Doug,
Thanks for your comments. My surgeon talked to me a great deal about the differences and options with graft choices. He also shared with me that only a few months before my ACL surgery that he had attended a national conference for ACL repairs and which surgeons nationally are overwhelmingly agreeing that the best choice for the graft is farming the patella. It is stronger than hamstrings and heals faster. Patella is better than cadaver also he says because using your own patella is your own tissue and regenerates a lot faster and stronger and doesn't have to fight off foreign tissue. Again, these are just the words of my Orthopedic Surgeon and what he heard at the conference. Good luck with your surgery.
The most important thing is bend, bend and bend; and ice often. Also, don’t be afraid to take Ibuprofen. I hate taking meds and only took one of my Vicatin and would take Ibuprofen only when the pain was unbearable. I’ve learned over the last few weeks that my PT sessions go much better and my ROM (range of motion) is a lot better when the swelling isn’t so bad. The Ibuprofen cuts down on the swelling. Now I take 2 an hour before every PT session and I’m finally making more progress.

Mar 02, 2010
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Some of the same issues
by: Katie

Hang in there. I had similar issues, but a little worse. I was in great shape before surgery, but had a really complicated surgey. I had this same knee done 15 years ago and that created problems with this surgery. I am at 9 weeks and I just got flexion to 105. It comes and goes though and sometimes it will straighten well, but won't bend and sometimes it will bend, but not straighten. Just keep working at it and it will come. I was told that the reason it does this and that it locks out is because of scar tissue. It will eventually break up. Its a touch painful when it does, but it always gives me more ROM. I've also learned to not compare myself to other ACL surgeries or the timeline, I didn't have a normal surgery so I can't compare myself to someone with a normal timeline we are all different. Hang in there it will get better!

Mar 02, 2010
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Meniscus Tear?
by: Doug

Hello Misty,

My knee is currently locking up along with a torn ACL. Usually it hurts on the inside, which is my medial meniscus. I'm having surgery in a few weeks and I'm still debating which graft to use, which one did you use?

Mar 02, 2010
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Taking your advice
by: Misty O'Connor

Again, thank you for taking the time to share your setbacks. At PT on Saturday and yesterday, I finally was able to bend to 100 degrees and then to 113. At least this was progress after no progress for 4 weeks. I have my 6 week check-up tomorrow so I will find out if I have to have the manipulation process done or if he thinks I'm doing fine.

Let me know if you learn anything from your PT today and I'll let you know what my Dr. says tomorrow. Good luck with your progress and your PT today.

God Bless,
Misty

Mar 01, 2010
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Misty
by: Denise

I'm sorry to hear about the setbacks you're facing. At six weeks I was also still on crutches, and had similar sorts of weird feelings in my knee (just like you described in your story). My recovery started well, then slowed incredibly and then sped up again so fast that I was discharged around 5 months after surgery from Physiotherapy. Hopefully you will also have a similar experience and make lots of progress soon. If you're really worried, I recommend that you speak to your surgeon about it just to be sure. The problems I was facing went away on their own, and I hope that yours will also. I hope you feel better soon.
Denise

Mar 01, 2010
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Thanks
by: Misty O'Connor

I look forward to hearing back from you and getting another opinion. Thanks for taking the time to ask.

Feb 28, 2010
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I'l check with my PT
by: Anonymous

I will run your progress by my PT and se what she says. I only ice and do move it all around the knee and lower leg as I have had pain and swelling to my ankles. Will report back Tuesday as that is my next visit for therapy. Good luck.

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