Question - ACL Surgery (lateral pain)

by Kate
(NE)

I had surgery on my right knee to fix a torn ACL and torn medial meniscus. It has been around seven weeks and I am still experiencing pain in the outside of my knee. Seems to feel like something catches. I was told it was my IT band catching on the screw. Is there anything I can do to get this to gradually start going away or is it something I have to just deal with?

The pain some days is manageable maybe a 2-3 whereas others it's up around a 6-7 which is not manageable when trying to do daily activities. I also have been experiencing some pain around my kneecap while walking up the stairs.

Just wondering if this is normal or something I should be alarmed by.

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Question - ACL Surgery (lateral pain)

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May 29, 2008
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What kind of ACl reconstruction did you have?
by: Bart - SII

It is possible that it could be your IT band, however, I am not familiar with any type of ACL reconstruction procedure that involves a screw anywhere near the lateral (outside) of the knee.

In my experiences with my own patients, pain and a catching feeling along the outside of the knee is usually related to one or two things...

The first culprit can be restriction in your patella. Because of the surgery (especially if you had a pateller tendon ACL reconstruction) the patella becomes restricted due to the scar formation and healing taking place around the knee. It can no longer move side to side or up and down as well as it should. When this happens, the connective tissue that runs around the patella will "stick" to the surrounding tissue and cause a pulling or locking sensation. That pulling leads to pain.

Compare your uninjured knee to your surgery knee. With your legs straight, move your patella around side to side and up and down and see how easily it moves, and how far. Now do the same thing on the surgery side and compare them. Chances are the surgery side doesn't move as much. You or your therapist can work on this by simply moving the patella in all different directions. This will stretch the tissues and free up any "sticky" spots. I use this type of patellar mobilization with every ACL patient I treat and it does wonders for their motion.

The other thing that you could be suffering from is some excessive scar formation. All of the connective tissues in the knee kind of run together...so the fascia (connective tissue) of the IT band will run into the fascia of the patella, and the quads. With all of the healing going on, these tissues will stick together and can cause problems.

The best way to deal with this is fraction massage. That simply means to rub the areas. Again, compare the injured knee to the uninjured. Feel how soft and squishy the areas around your patella are, and then compare that to the surgery side. Usually it is not as soft or squishy. Massaging the area will help free up the tissues, and decrease excessive scarring. This can be done at home or during rehab. Although friction massage does NOT feel good, it will help with your recovery.

Info on patellar mobilization and friction massage (scroll towards the bottom)

All in all, I wouldn't be worried about this too much...it is very common. But, you do need to make sure that something is being done to address this, as it could get worse as your body keeps healing and adding scar tissue.

Sorry this is so long - comment back if you have other questions.

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May 29, 2008
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Submitted by: Bart - SII

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It is possible that it could be your IT band, however, I am not familiar with any type of ACL reconstruction procedure that involves a screw anywhere near the lateral (outside) of the knee. In my experiences with my own patients, pain and a catching feeling along the outside of the knee is usually related to one or two things... The first culprit can be restriction in your patella. Because of the surgery (especially if you had a pateller tendon ACL reconstruction) the patella becomes restricted due to the scar formation and healing taking place around the knee. It can no longer move side to side or up and down as well as it should. When this happens, the connective tissue that runs around the patella will "stick" to the surrounding tissue and cause a pulling or locking sensation. That pulling leads to pain. Compare your uninjured knee to your surgery knee. With your legs straight, move your patella around side to side and up and down and see how easily it moves, and how far. Now do the same thing on the surgery side and compare them. Chances are the surgery side doesn't move as much. You or your therapist can work on this by simply moving the patella in all different directions. This will stretch the tissues and free up any "sticky" spots. I use this type of patellar mobilization with every ACL patient I treat and it does wonders for their motion. The other thing that you could be suffering from is some excessive scar formation. All of the connective tissues in the knee kind of run together...so the fascia (connective tissue) of the IT band will run into the fascia of the patella, and the quads. With all of the healing going on, these tissues will stick together and can cause problems. The best way to deal with this is fraction massage. That simply means to rub the areas. Again, compare the injured knee to the uninjured. Feel how soft and squishy the areas around your patella are, and then compare that to the surgery side. Usually it is not as soft or squishy. Massaging the area will help free up the tissues, and decrease excessive scarring. This can be done at home or during rehab. Although friction massage does NOT feel good, it will help with your recovery. <a href="http://www.sports-injury-info.com/acl-rehab-range-of-motion.html" target="_blank">Info on patellar mobilization and friction massage</a> (scroll towards the bottom) All in all, I wouldn't be worried about this too much...it is very common. But, you do need to make sure that something is being done to address this, as it could get worse as your body keeps healing and adding scar tissue. Sorry this is so long - comment back if you have other questions.

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