Question - ACL Recovery Timeline

by Gloria
(Casco, ME)

I had a patella graft ACL reocnstruction 4 weeks ago. I am 41 years old. My knee flexion is 105 degrees after 4 weeks, and my knee extension was good, but it has been getting worse this past week. I am doing all of my PT exercises.

This past week I started riging my road bike inside on my trainer. I had to put the seat and handlebars way up high, and it takes me 2nd or 3rd session to be able to peddle 360 degrees backwards. I have clip in pedals. I do not have my foot parallel to the pedal, I have it pointed downward throughout the pedal stroke, otherwise I cannot pedal the 360 degree rotation.

I feel like I am behind on the timeline.My PT guy does not know why. Do you have any input. I did stop taking Tylenol and ibuprofen in exchange for naproxen this past week. I have changed back to the Tylenol and ibuprofen. I have been doing some driving too. This may be irritating it, but I live 35 miles from my PT office and don't have family around to drive me. Friends drove me the first three weeks.

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Question - ACL Recovery Timeline

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Jul 23, 2008
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I wouldn't worry too much about the flexion
by: Bart - SII

It sounds like you are progressing well, even though it doesn't feel like it. Flexion of the knee will come with time - extension is the most important thing to work on. Being able to fully extend and lock the knee out is absolutely essential for normal walking and activities.

One thing you may try is massage around the scars and the front of the knee just below the patella. This area is notorious for a buildup of "gunk" for lack of a better term. Massage will help free up the tissue, cut down on excessive scarring, and will allow the knee to bend easier. It will also help with your extension.

You might also ask your PT to check your accessory motion, as you may be a candidate for joint mobilization at the tibio-femoral joint to help with your extension and flexion.

Hope this helps - comment back with other questions.

And hang in there!

Aug 01, 2008
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6 WEEK UPDATE
by: gloria

I'm still having trouble sleeping through the night. Seems like an unusually slow recovery. The doctor said I have substantial scaring, so that is inhibiting my recovery.

I called the doctor's office today to request a sleep aid, but they gave me hydrocodone for pain. I am suppose to take one at bedtime and see how that works. Hopefully, it will work! I am tired of not sleeping. Last night I was up from 2:30am - 5:00 pm. I got to watch some silly movie about a love potient and then I watched Dallas. Eventually, I was tossing and turning again, trying to get comfortable enough to sleep. That didn't happen. Sleeping is torture!

I am still pedaling away on the bike. I lowered the seat back to its usual height. Working on a 360 degree pedal stroke, without flexing at the ankle.

Feb 11, 2009
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Slow Progress 8 Months Out
by: Anonymous

It's been 8 months since my surgery. I still do not have full extension or flexion.

Feb 16, 2009
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Dr.s problem or yours?
by: Reggie

I had Acl allograft and Meniscal repair in late Nov. 2008- I am at about 110 degrees movement, can't straighten my leg straight at all, and have nearly dead Peroneal nerve affecting my foot muscle movement besides.. I am dealing with my surgeon now on whether my struggles are due to his lack of knowledge or simply being my body is taking so long to progress.
Have you run into any problems with your recovery besides lack of flexion?
The more therapy I do the worse I feel- three weeks ago it was different but now I look like an 80 yr. old lady when I walk out instead of a barely limping 38 yr. old.

Apr 04, 2009
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by: Anonymous

Seems maybe the surgery didnt go well? i got mine done 12 days ago and i can straighten my leg all the way out and can bend it to about 90*.Maybe it has to do with age and how strong/weak your knee altogether is.Im 17 year old athlete so maybe that has somethng to do with it.

Apr 04, 2009
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question:
by: Anonymous

Hi I am about 9 days post op and am having a lot of difficulty with flexion. I am doing well with extension (almost to 0*-about7?? ) and have just over 45* in extension-maybe to 50* but that is with great effort and quite a bit of pain(I was wimpering with tears rolling down my eyes the first time mt pt got me that far!)Is this normal? What do you think? I find that when I do my exercises, stretching my hamstring first, then doing heel slides gets me farther.Any advice?

Apr 17, 2009
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3 Months Post-Op
by: Anonymous

First of all, for all of you that are 9 days, 12 days out, etc. I don't know if your surgeon told you or not but this is a really, really, slow recovery. You can't measure your progress day by day, it's more week by week. Any progress is progress and everybody is different. I had an ACL reconstruction and Lateral Meniscus repair 3 Months ago with a Patella tendon graft, I am 40 years old. Yes, it is painful and you'll actually have days you feel like you've gone backward. It's very frustrating and slow. I have extension of -2 and flexion of 114. Sometimes I can go for awhile without that changing. Just be patient and know it will get better but full recovery takes about a year.

Apr 23, 2009
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ACL repair...low flexibility
by: Anonymous

I had ACL reconstruction about 4 months ago. I'm a 31 year old PE Teacher so I'm on it all day long. Until about 1 month ago my recovery was going ok. Was running on it and using it well. The last month it seems to have completely seazed up. I only need to sit down for about 5 mins and I'm limping off like an old woman. My knee has terrible extension. It is nowhere near 0. My flexion is awful also and I cant sleep at night as i cant lay it straight. I also get alot of calf pain sometimes causing me to stop moving. The surgeon took a hamstring tendon to replace the ACL and I'm wondering if because my hamstrings have always been super unflexible, whether this has had an adverse affect on the movement capabilities.

Apr 23, 2009
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10 Months Out, Still STIFF
by: Anonymous

Okay, it's been 10 months since my ACL reconstruction. I have 10 degrees of extension and about 100 degrees of flexion, without doing any PT exercises. I can get it to 2 degrees and 130 degrees with work. However, it does not stay there. It is SO frustrating! My surgeon said I have arthrofibrosis and that he may need to go in and scrape out the scar tissue. Any advice on this out there in internet land?

May 10, 2009
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Advice on Rehab
by: Heather

Hi, I live in Japan and had ACL replacment using the hamstring 5 months ago. I go to see a PT once a week but all they do is massage. Can`t complain but want to get back on the volleyball court ASAP. Was oked to bicycle just recently so trying my best to get to the gym two or three times a week. (three young children and work so...) Anyway, my question is...I have always been told when training on a three day schedule to do two sections of the body at a time. For example chest and bicept, back and tri etc. So, to get my legs strenghtened more, can I train them everytime I go in? I`m doing light leg press, ham curls and calf raises. BTW, I`m 40, injured myself for the first time when I was 21 and was told there is extensive damage to the bones of the knee. Minuscus (sp?) pretty much toast too! Any advice would be great!

May 11, 2009
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ACL recovery
by: Anonymous

I had ACL autograph with hamstring tendon + meniscus repair just over 5 weeks ago. While the first week was tough things improved pretty quickly. 10-days post op I was walking without crutches and at 125 degrees flexion, and able to ride the stationary bike. Full range of motion (145/0) was back by week 4. Even so, doc and PT say no running until 3 months post-op regardless of how it feels. The problems I've had are with sleeping...still have knee ache and stressed-out quad muscles that have kept me awake for hours. My PT is now focused on strengthing quads and calves. Hope to be playing soccer again by Sep or Oct. 47 / female (biffed skiing in early Mar)

May 16, 2009
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Extension
by: Anonymous

Hi. I sympathize with everybody here. I see how much hard work your recovery period takes. But don't get discouraged. Individual recovery will be different as we all know so keep at it. I do have some suggestions that I hope can help. To improve extension: 1. Put a heat pack (wrapped in 6-8 layers of hand towels, this seemed like a lot of towels but it gets REALLY HOT without you knowing it so BE CAREFUL!!!!)under your knee, mid thigh to mid calf for 10 mins. before you do your hams/calf stretching. This relaxes the muscles and makes it a little more "pliable" when you stretch. 2. Another way is to prop your heel on a rolled up bath towel or coffee can for abt. 5 mins.(you can put a hot pack under your knee again if you want). With the help of gravity this can assist with knee extension. 3. Lay on your stomach with your lower leg off the bed. Your knee should be off the bed as well (just above the knee). Put a rolled up towel just above your knee to prevent irritation of your surgical site). Try this for 5 mins then 10 as you get used to it.

May 16, 2009
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RE: Advice on Rehab (by Heather)
by: Anonymous

Hi Heather. I wouldn't turn down massages either but there are so much more you can do to improve your knee. Light leg presses and calf raises are great (progress calf raise by doing singel leg calf raise), I wouldn't worry too much about your hamstring since it gets stronger a lot faster than the quads ( big muscle in front of the thigh) so I suggest that you add straight leg raises while on your back,elbow bent then elbow straight behind you as you get stronger. You can add quad sets (pressing the back of your knee down to the bed, do this frist before straight leg raise). Step ups: do this on the lowest step of the stair or whatever is available. Step up with your reconstructed knee then step off with the same knee/leg. Then turn and do this sideways.Mini squats (be sure that your knee does not go over your toes when you do this, you don't want to put too much pressure to your ACL right now). Weight shifting with toes/knee pointing forward NOT twisted, staggered your feet . Shift to the left-right-front-back. This add to the stability of the knee. IF YOU EXPERIENCED SEVERE PAIN, TOO MUCH INSTABILITY WITH ANY OF THESE EXERCISES, PLEASE DISCONTINUE AND SEE YOUR MD/PT. Goodluck.

May 16, 2009
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Rehab
by: Heather

Hi, Thanks. This is great advice. And I will add these into my workouts. But I guess my question is, how often a week can I do these? Everyday or just once or twice a week?

Thanks again.

Heather

May 17, 2009
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RE: Rehab by Heather
by: Anonymous

We tell our patients to do these exercises 10reps, 2x a day, everyday. When you're doing quad sets (pressing your knee down to the bed, hold it for 10 secs, then relax). When it gets easier, add more reps. Control every motion. Don't just flop your legs down. Your leg presses, it's ok to do those everytime you go to your gym so don't worry that you don't get to do it everyday...hope this helped.

May 19, 2009
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Not yet ACL surgery
by: Anonymous

So I tore my ACL on my right knee on Apr 26 playing football.

My Ortho said I to wait until my knee gets full range of motion before scheduling surgery.

This is fine by me, actually it's now May 19, and my knee is getting better, but I know I want the surgery to return to sports.

What can I do pre-op to get my knee at the optimal position for surgery?

I've been slowly going back to the gym and doing bicycles and swimming, and walking in the water.

I won't be able to have my surgery until mid-July.

Any advice would be greatly appreciated

May 20, 2009
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RE: Not yet ACL Sx
by: Anonymous

Hi! Swimming is a great low impact exercise. When you're doing the bike, have your seat higher and don't put too much resistance. Basic knee strengthening, quad sets (pushing your knee down to the bed, hold 5 secs then relax), SLR straight leg raise( lay on your back, affected leg straight then raise in front of you), heel slides (on your back again, bend knee then slide out)mini squats is good if it doesn't give you too much pain just make sure that when you squat, your knee doesn't go over your toes otherwise, you're just putting more stress to your ACL. Lay on your stomach, keep your leg straight and lift up, another version on your stomach still then bend your knee, lift up. 10 reps, 2x a day. When you're sore after, ice up your knee for no more than 20 mins. at a time. Goodluck.

May 20, 2009
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11 Months Out
by: Anonymous

11 Months since my ACL surgery. My knee surgeon is recommending a second opinion, as I still have a stiff knee. Flexion seems to be getting a bit better. It maintains flexibility for longer periods of time. When I sit in a hard chair, it stiffens up more quickly. I have not gained much at all in the extension area. I still have about 8 degrees of bend in my knee. I'm between 110 and 8 degrees. I have started a strengthening routine at the gym, under the supervision of my physical therapist. I go three times a week. I can see my quads and hamstrings getting stronger, and it has only been 2 weeks. I have also started mountain biking on the road. I go relatively slow, since I bike with my dog attached to my waist. I look forward to my second opinion. Perhaps I will not require more surgery. I would prefer to improve through nonsurgical means.

May 28, 2009
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Didn't Heed Advice
by: Tammy

Female of 47 who snow skis. Torn ACL back in December and finally had surgery March 5th.Going on 12 weeks now since my ACL allograft surgery. Surgery went well and PT has been going great. I highly recommend twice a week with the same therapist to get full extension and flexion. My only challenge is to not over due since I am eager to get back to full recovery (hiking, biking, running). BEWARE! Last weekend I hiked up a mountain thinking my quads had gained enough strength to support my weight on the way down the hill. I made it down with support from my husband, however, my kneecap and tendon below my kneecap feels like crap. I have gone two steps backward. I just hope you heed some good advice and not challenge yourself. Or, if you do decide to climb a major hill you should wear a brace and possibly take a walking stick for support on the way down. If you experienced a similar situtation please write to me and tell me how long it took to recover from this stupid thing I did.

May 28, 2009
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16 days out
by: Anonymous

My daughter is on her second acl recovery both using the patella tendon. Did the left one four years ago at age 15 and made a good recovery returning to her high school BB team in five months. She tore her right acl playing in college in April; had surgery 16 days ago and today had 118 degrees flexion and full extension to 0 degrees. She has 140 degrees flexion in her repaired left knee. Both had a little meniscus damage, that was trimmed out during surgery. The key is to stay with the program each and every day. Push yourself within the limits imposed by your doctor and PT. Do the exercises on your own. Continue to use Ice and Heat. And try to make a little progress every single day.

Jun 11, 2009
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ACL Hamstring Graft
by: Anonymous

Hi! I am 31 years old and I had my ACL reconstruction 3 weeks ago. I have been walking w/o crutches since day 1 of my surgery. I have full extension and can bend my knee just past 90 degrees. However, as a Kaiser patient I noticed that the PT is very quick 15 minutes/2 times a week...and sometimes less. You are really cranked through the system. It is really up to me to get my leg back in shape.

I have been struggling with my quad control, but leg lifts seem to be building up my strength. Anyone know of other exercises to build up quad control?

Also, I have a constant dull pain near my incision site. It pretty much cover the front of my upper shin. When will this go away?

Finally, the scar...has anyone tried Merderma cream for theirs? If so, are you please with the results? At $34 a pop I want to make certain it is worth it.

Good luck to everyone...and remember ice and exercise is our friend!

Jun 22, 2009
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ACL and menicus recovery
by: Anonymous

I'm going into my 5th week of recovery (I am 50 years old and very active) and have been very frustrated at the slow recovery from my surgery. After reading this site and seeing everyone else talking about the same issues, I'm feeling a little better as it seems my recovery is going pretty much like all the others.

I am going to therapy twice a week and doing a lot of home exercises as well daily. I almost have full extension straight and I'm up to 110 degrees bent which the PT says that's right on schedule. But I'm still having pain, swelling and stiffness....especially if I'm on my feet for too long or if I try walking too much. I am adviced to use one crutch still.

As far as the pain in the incision, my PT tells me to take and move the incision slowly back and forth and side to side to loosen up the scarring from the bone (being careful not to pull it apart, keep a little pressure on it to keep if from separating). The sooner it releases and moves freely it will help the pain go away.

It seems icing it helps a lot and you should continue doing this quite often. A bag of frozen vegatables works good for me for about 15 minutes on each knee (as my good knee is starting to hurt about as much as my surgery knee beings I'm using it for a lot of support these days).

Aug 03, 2009
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13 Months Post-Op
by: Anonymous

I had arthroscopic surgery to remove my scar tissue. My knee is quite swollen, but I am less stiff now than I was before the surgery. I am hopeful that I will have a successful recovery. Ice, ice baby.

Aug 03, 2009
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Sep 13, 2009
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ACL Recovery
by: Sheryl

I'm a 48 year old woman, 2 weeks out tomorrow from patella graft acl reconstruction.Patience has never been my strong suit and I'm a little bummed at the length of the recovery timeline.Crutches are gone, full extension BUT I have tremendous pain in the back of my knee that prevents me from trying to bend my knee. I'm only at 90 degrees.Ice and meds help but I have this hard ball behind my knee, ouch!! Anyone else have this issue? Have'nt seen it on this site. Thanks-blessings to you all..

Sep 14, 2009
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surgery
by: oliver

is getting surgery scary for a torn ACL?

Sep 14, 2009
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GV reporting in
by: Anonymous

No, it is not scary getting the surgery. It is afterwards that's the pain in the ass. I am 15 months out from my initial surgery. I had scar tissue removed last month. My knee is still stiff. I don't think it will ever "normal" again. My body like to generate scar tissue, so scraping in out did not do too much to remedy the situation. I can walk without limping, most of the time. So, it is somewhat better, but not like I would want it to be. Yes, I did do all of my PT, and am still doing it.

Sep 23, 2009
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Timeline
by: Rosado

Tomorrow will be 4 weeks since my ACL surgery. My surgeon used my hamstring for repair. I feel pretty good and can walk fine without a limp and can go up and down stairs without much problems. I was off crutches 4-5 days and got on the excersice bike a week after surgery. As painful as it was my PT made me bike 10 min a day. The pain was from the swelling and fluid in the knee but the more I biked the better I felt. Doing stretches also helped. Bending my knee back 90 degrees every day helped alot too. Now I can bend my foot back almost all the way back to my butt.

I haven't told my PT but I've been doing some workouts that I maybe shouldnt. Ive been doing leg extensions and leg press with light weight. My PT says I wont be doing that till my 5th week but I went ahead and started it on my 3rd week and I think it has helped. Hope this helps

Sep 28, 2009
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1 step forward and 2 steps back
by: Anonymous

ACL surgery June 23 using hamstring - therapy 3x's a week. Good extension and 125 degree bend, BUT a lot of pain the past 2 weeks and weakness in knee and feeling of stiffness - knee has given away 2x's in the past 4 days. Therapist thinks more testing needed, especially as pain is radiating both up and down leg starting at outer knee cap. Really getting down, seems as if it should be less painful at this stage even considering my age..61 but very active.

Sep 29, 2009
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Keep on truckn
by: Gdo

I am currently 3 weeks post op from acl repair. I have pretty good flexation. Knee is still a little swollen over the knee cap. I do utility contruction and planing to go back to work in a couple days. With a cane and a acl sports brace. I am 31yo and tore it playing semipro football. I have been riding a stationary bike for about a week now with hardly any resistance. I do get sore geting off the bike but I think you Just have to keep moving around to get rid of the soreness. I push myself pretty hard and let pain let me know when to quit. Then I rest. But I think moving around will keep a person from losing the flexation. That's my thought hopefully it helps someone.

Sep 30, 2009
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Hamstring ACL
by: Anonymous

Had hamstring ACL replacement. No miniscus tear, just straight ACL-

Going on week three, knee is doing great. Fully straight and at 105 at 1.5 weeks. I do not go back to P.T. until week 5 and he wants we close to walking as normal.

I do heel slides, quad tightening, leg lifts. I am starting to do my stationary bike, at 2 tension for 10 minutes, no pressure, just trying to get more movement. Off crutches, only use when I leave the house, just in case someone does not see me and runs in to me. Knee is still stiff and swollen, so ice a lot.

Oct 06, 2009
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ACL 4 weeks
by: Anonymous

I'm at 4 weeks and not doing very well. I'm only at 92 and still 9 to go to straighten it. The other day it felt as though I pulled something tying my shoe. I had a hamstring ACL reconstruct. Do you know if something as simple as tying your shoe? Maybe I just stretched it? I'm working very hard on the bending and straightening, but feels like it's never going to go further.. any advise?

Oct 28, 2009
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ahh the patella tendon graft
by: Anonymous

Have patience.
Keep riding your bike as I found it to be the best exercise to strengthen the knee itself. Before long you can be a tri girl or whatever you love but it takes time... stop thinking you're on a set timeline- your body will let you know when its ready and it might be longer than you're hearing....

Have faith!