Saturday, August 25, 2007

Recovering from ACL surgery


It's a good time to think back about what the recovery from ACL reconstruction and meniscus repair was like.

I don't remember going into the operation on March 27, 2007, because the anesthesiologist got me good and loopy so he could put in a nerve block on my leg. When I woke up, my left knee was tightly wrapped, and I had a long but light black brace in the photo above (this was much bigger than the titanium brace I'm getting later today to use in martial arts classes). My leg was extremely sore, and basically useless (not only from the operation but also from the nerve block). My wife, despite her lack of inclination towards the nursing profession, took me home and took a couple of days off from work and took great care of me. My daughter was so much help whenever she was home from high school.

I wasn't supposed to put any weight on the leg; I had to have the brace on whenever I got up (which basically was to go to the bathroom, you have a lot of fluids in your body after surgery and you need to go a lot!); and I started putting my leg in a knee-bending, continuous-motion machine (CPM), which you can also see in the photo beside me, on the couch. Initially, it was painful to bend my knee even 15 degrees. I was supposed to use the machine several hours each day. There was also a cold-water bag wrapped around my knee, with a device to use gravity to fill it with or drain it of ice-cold water.

My leg really hurt. And then, after about a day, the nerve block wore off.

I have never felt so much sustained pain in my life. I was taking Vicodin at the highest rate allowed, and it felt like it was doing NOTHING. To steal a metaphor from Antoine de St. Exupery, I felt like I was trying to put out a forest fire with a glass of water. I couldn't even read, I couldn't focus.

At my first physical therapy session, I think two days after the surgery, I was in agony. My physical therapists, whom I came to adore for their skill and encouragement, told me, "you did really well today, you didn't pass out and you didn't throw up." When they first took off the wrapping from my knee, I was horrified--it looked so swollen, it should have belonged to an alien.

I hated the side effects of Vicodin--I got totally, how to put this, plugged up. Prune juice helped.

I would take off the knee brace for the CPM, or for physical therapy they had me do at home between sessions. Then I'd have to strap it on again in a hurry--very difficult if you can't bend your leg--and grab the crutches when it was time to pee. My wife got me a pickle jar to put by the bed for emergencies.

Friends dropped by to help me out when my wife had to go back to work--I am so grateful for that. Some were neighbors, some were from the Unitarian Universalist congregation I belong to. My friends Priscilla and her daughter Natalie picked me up from physical therapy one day.

Gradually I was able to cut back on the Vicodin, and then switch to extra-strength Tylenol--my doctor didn't want me taking anti-inflammatories like Advil or naproxen, he thought the inflammation was part of the healing process. I kept increasing the degree of bending in the CPM. I began to see a little definition in my thigh muscle, which had become a total blob. On the other hand, I began to see my left leg start to atrophy.

I started doing push-ups and crunches--I couldn't lock my feet under anything to do a sit-up because of the pressure that put on my knee--so I was able to keep my ability to do 50 push-ups in a single set. One great day, sitting on a bike-like machine at physical therapy, I was able to make my leg go around in a complete circle. Soon I was doing the stationary bike, and then a Stairmaster-type device at therapy.

The most pain at physical therapy came when the terapists would push on my ankle to make my leg bend more. I swear, once I had to stop myself from grabbing the therapist's hear and yanking it, she hurt me so much. But it was working--I could bend my leg more and more.

I took two weeks off from work--including one week of disability pay--and then worked from home, via computer, for the following three weeks. When I started my hour-and-a-half commute again, I initially wore the leg brace, in large part to let the other New York commuters know they really shouldn't shove or bump me.

I'm glad I got my ACL reconstructed. I don't want to go through with it ever again.

48 comments:

Anonymous said...

Hey, we don't know each other but I'm getting acl reconstructive surgery in a couple weeks, and I am wondering how bad the pain and aftermath is. I know what the silly doctors have told me, but they are all lies. I doubt I will be in little to no pain. LIES. Anyway, your injury looks legit, so I'm hoping you can answer my question. Thanks.

BobSpar said...

An anesthesiologist once told me, "Surgeons don't heal pain, they cause pain." He might not be right in the long run, but he is in the short term!

Believe me, the recovery from the surgery is painful. However, my knee is now stable, and it wasn't before--my leg kept buckling underneath me, and it doesn't do that anymore. And it feels pretty good now, though I'm still being careful with it.

Anonymous said...

heyy.
so i tore my acl
back in january [its now almost july]
i can do everything imaginable on it still.
but im goin to get the surgery so i dont ruin my otherr cartilige.

does the rehab feel as painful as when you first tear it?
or is it a different kind of pain?

im so scared.
eeverytime i read peoples online blogs about it i cry. and i cant stop.
cheerleadings my life and it just started but im gettin my surgery july 10th =[.

is there anything you know of to get over the emotional fear of pain?

BobSpar said...

Hi, Anonymous,

If you are a teen, you should probably make sure to get a second opinion from another doctor. Young children (I don't know the exact age limit) shouldn't get adult ACL operations--please check out this NY Times story:

http://www.nytimes.com/2008/02/18/health/18knee.html?_r=1&em&ex=1203483600&en=069a77a40de449f3&ei=5087%0A&oref=slogin

You may be old enough for an ACL; it does hurt during the recovery, but if you take good care of it, go to your physical therapy, and work hard, it will not only get better, but your knee will be stable again. Make sure you have family or friends to help you in the first week or two. Good luck!

brooke said...

hey its me again.. [anonymous from june 25th]
well im 14..and in high school.

but the thing is my knee is already as stable as before.
it never gives out on me.
so when people tell me that thats not really a factor to consider.
you know?

see when i tore it my teammates just watched me try to crawl off the mat, i eventually tried to stand up but i just collapsed.
thats the only time its felt unstable.


please write back.

BobSpar said...

Brooke,

I'm concerned about ACL surgery at your age--and especially given that your knee still feels stable.

I don't know if you read the article in the link in my prior comment, but here's a key quote from the article:

"The standard and effective treatment for such an injury in adults is surgery. But the operation poses a greater risk for children and adolescents who have not finished growing because it involves drilling into a growth plate, an area of still-developing tissue at the end of the leg bone."

Here's an example of what happened to a teen of your age:

"But the standard A.C.L. repair operation, with its drilling into the growth plate, may cause permanent damage to the still-growing bones of young children. After drilling, surgeons replace the torn ligament with a tendon taken from elsewhere in the body, like the hamstring, or from a cadaver. But if the drilling damages a child’s growth plate, the leg bone will not develop normally.

That happened recently to a 14-year-old boy who was referred to Dr. Freddie H. Fu, an orthopedic surgeon at the University of Pittsburgh. A year after the operation, Dr. Fu said, the leg with the repair was bowed 20 degrees on one side and was shorter than the other leg."

You should show this to your parents and doctor (if you trust the doctor; if you don't, get another one) and really get a good evaluation that takes into consideration that you are still growing.

Okay? Please let me know.

brooke said...

i read the article right after i posted that comment.
its horrible that little kids have to expireince that kind of pain.


well i got evaluated on june 10th i think??
and i guess my doctor did tell my mom that the growth plate is done growing and that its ok to drill into.
i just wasnt payin attention. i was daydreaming =] lol.


is there a difference between that black brace you got and the foam one the give some others?

if you have no clue what im talkin about...
some patients get a blue closed foam brace when they get sent home..it doesnt allow their knee any air at all.

but in your picture you have the black metal one which exposes your knee.


is there a difference?
or is it just doctor preference?

BobSpar said...

Brooke,

I'm very happy to hear our doctor checked out whether the growth plate is done growing! Thanks for letting me know.

As far as braces go, I left the operation with both that black brace, and a blue "cryocuff" that filled with ice water to reduce the swelling. I don't think foam would be enough to stabilize your leg, but maybe there is hard stuff under the foam. I'm sure different doctors use different braces.

brooke said...

omg my surgerys tomorow. and im freakin out.

i dont want to do it. =[

BobSpar said...

Brooke, you'll make it through. Lots and lots of people have done it. Just make sure that you have help from your family and your friends; do your physical therapy; get someone to buy you some prune juice for when the painkillers, um, block you up (sounds crazy but lots of people swear by it).

Stay in touch. Good luck!

brooke said...

so my surgery was ok.
my knee doesnt hurt at all.
im on tylonel3 so i am awake thru the day.

ii woke up from surgery shivering.lol

BobSpar said...

I hope you stay pain free. Maybe being young helps. Or it might be that the nerve block hasn't worn off. Let us know. Hang in there!

brooke said...

i started physical therapy.
and i think its stupid.
i get so frustrated and i really cant take it.


this whole thing is overrated and annoying.


i really dont see why i did it if i could do sports n still live without an acl.

BobSpar said...

Hi, Brooke,

What don't you like about therapy? I thought it hurt sometimes, but I liked getting out of the house, and I liked the attention.

Anonymous said...

Hey bobspar...
It was great to read your experiences with ACL reconstruction, as I am sitting here recuperating from hamstring tendon graft/ACL reconstruction. I turned 40 last February, and 3 weeks later blew my acl in a backwards twisting fall skiing. The "pop" was incredible, I thought I broke my leg! Result was blown ACL and MCL, I waited 6 months for repair, now I am in day 6 after surgery and doing well. I am sick of crutches and having to ask people to get me things!

Overall, the pain has been minimal. Like you, I had a block that lasted about 36 hours, and lots of Oxycodone, the side effects you mentioned are true.
I do not have the CPM machine, strange since most people seem to have some PT or bending shortly after surgery. So far its been a straight leg velcro brace for me.

I have an appt today, so we'll see what happens. Can't wait for PT, I bet it will be painful!

One more thing, daytime TV is terrible!

BobSpar said...

Good luck, "Anonymous." I eventually got the impression that the CPM machine is kind of old fashioned--it may be helpful, but a lot of doctors now don't think it's crucial.

Even though my first PT session was really difficult, and there were painful times in subsequent ones, I did end up really looking forward to PT--it was a chance to get out of the home, and much better than watching daytime TV!

Anonymous said...

Bob: Hey I appreciate your blog... Full of great info, and love those pics!

I am having trouble getting diagnosed.

My MRI shows my ACL to be intact, but I have bad instability. I'm guessing its stretched. So anyway, its been many frustrating months, and I'm so wrung out over this just trying to get over that first hurdle of getting a doctor to believe me, I've lost my whole Summer and every day that goes by...feels like forever.

Bob, you have very good looking strong legs and its got to be nice to have all that muscle to help you. I wonder if you tried to build up your legs before you surgery.

My legs have skinified on me. ARG!

~S:)

BobSpar said...

~S,

Thanks--it must be very discouraging not to know why you have that instability.

I had to delay my surgery for scheduling reasons, so I did a lot of exercises my PT recommended for strengthening my legs. If I recall, I also did some "slow karate kicks" for strength, although I wasn't able to balance ON my injured left leg, so I was only kicking WITH the left leg. I think all the work ahead of time got me off to a good start in my recovery.

Despite all the work, though, I did end up with some atrophying in my left leg. Lots of PT and martial arts class mostly fixed the atrophying, but I think my left leg is still slightly smaller than my right.

Good luck!

paul said...

hi.
i fully disrupeted my left acl in march (skiing) and had a patella graft acl reconstruction in mid june.
you are quite correct about the pain following surgery but i was able to get off all pain killers after about 7days but the ongoing everyday pain is still with me 5 months later. the atrophy takes a very long time to regain and i must admit i would have chosen the hamstring version had i known how much the graft site hurt. my surgeon told me the patella op gave the best long term results.
i would be interested to hear how long it takes until you were totaly confident with the repair. i still walk looking at the ground the whole time making sure i dont trip or anything.
therapy in a pool works well.

Jennifer said...

i shredded my ACL when i was 16 playing soccer. I am now 21, and reading your blog was like reliving the post-surgery past! I know exactly how you feel from the wonderful ice water machine, to the horrible (but incredibly lovely) physical therapists that tried to "bend your knee" which to me felt like bending it in the direction its not supposed to go! i couldnt take the vicodin unfortunately because i have bad reactions to it (a.k.a. unbearable nausea and distress)...but i DID have this wonderful thing, a catheter from my pelvic bone in through RIGHT INTO THE KNEE. for about 2 weeks, i could press the "pain button" and have morphine shot down into my knee directly...ahhhh.

Do you remember the rushing pain to your leg whenever you got up to pee every 25 minutes?? or the sheer panic of "hurry up and get my brace on"??

complete agony, but complete thanks after everything was done. I LOVE MY TITANIUM BRACE FOR SPORTS! so bionic woman..

thanks for sharing your story!

BobSpar said...

Thanks, Jennifer; yes, I DO remember the desperation of having to to strap on that brace (AND grab crutches, I had meniscus repair too) to rush to the bathroom. I think they pumped us full of liquids during surgery because I sure had to make a lot of trips.

Re bionic titanium braces, I don't wear it anymore, but I did enjoy telling people that it had a hydraulic boost. They didn't know whether to believe me or not.

Kate said...

Hi, so I just had surgery two days ago. Is it normal for my knee, i suppose where they took the patellar tendon out, to be burning and hurting a lot. I am on percocets, my parents are trying to get me to one every four hours but even with two it doesnt seem like it does anything. I am 16, and in a great deal of pain. Kind of like you said to put out a forest fire with a glass of water.. any suggestions on how to help?

BobSpar said...

Hi, Kate,

I'm sorry to hear you're in so much pain, and as you know, I was in pain too (and a lot of others too). It WILL get better with time; get your parents to buy prune juice because all those percocets will make you very constipated. Watch some DVDs. When it's time to go to physical therapy, definitely go, even though you're hurting, because you need the PT to recover.

I think you're probably at about the peak pain now. It's going to slowly hurt less for a few days, and then the pain will recede faster.

Good luck! I'm sorry it hurts so much.

Kate said...

Thank you! Yeah I'm alternating the percocets with aleve and that seems to be helping. I'll take up your advice on the prune juice too! Thanks for the advice it does slightly feel better.

brooke said...

hey its brooke again.
i get released on tuesday!

one day short of 11 momnths with acl problems!

i get a titanium brace too.


my left leg is the scrawniest thing ive ever seenthough.
so much atrophy but i dont do my excersizes at home.

thanks for your help :)

Anonymous said...

Bob:

You are dancing now? Do you worry about spinning on your new knee? Do you worry every time you have to shift your weight on and off of it?

Your story is certainly encouraging...and I'd just like to say "thanks" once again for posting your blog. You sound like a really sweet guy and that's pretty cool since this sounds like such a rough surgery.

~S:)

BobSpar said...

Brooke, good to hear from you, congrats on being "sprung"! You ought to tell people your titanium brace has a hydraulic boost--some people will believe you! Keep up the PT.

Anonymous, thanks--dancing is just fine, I really don't worry about pivoting on the knee now. And unlike before surgery (and for a few months after), I don't worry now about shifting my weight from one leg to the other. But it took a lot of physical therapy to strengthen the leg and to convince my mind that it would be okay.

Anonymous said...

Hi Bob, Iam a 36yo female who 5 months ago ruptured my acl and having a problem with deciding to have surgury. I'am fairly active person i love to do aerobics especilly kick boxing. As you know thats not an option for me now my leg is very unstable. My concerns are how did you get through the mental distress and pull through the agonizing pain. Just another note I have worked in the medical field for 16 yrs and still feel really scared.Thanks for all the info you have posted it kinda helps.

John said...

Bob,
thanks for sharing your ACL story. I (36yo) snapped my ACL in a Jiu Jitsu Tournament in April 08. In May of 08 I had the surgery. Unbelievable Pain - morphine couldn't even touch it. It has now been about 8 months and I still have pain and never regained full extension. I wanted to hear your thoughts about recovery a year + out from surgery. I guess the good news is that because I have had to grapple w/o the use of my right leg, my new style of handicapped Jiu Jitsu has really made me refine my skills.lol Thanks...

BobSpar said...

Hi, John,

I hear where you're coming from.

Eight months is still pretty early in terms of full recovery for many people, it was for me.

I'm coming up on two years, and in my school's "core" classes, where we're working on moves and exercising but not sparring or grappling, I can pivot and kick and do everything now without needing anything on my knee. I've gotten very comfortable with it.

When there's a chance of a leg strike or sweep, I still put on a small brace I bought at a drugstore, not the huge high-tech one I initially used.

As for full extension, I presume you went to physical therapy. If you don't have it yet, you might talk with your doctor about more therapy. I got full extension within a few weeks of the operation; but I think my doctor was worried about a person my age getting the full extension, and he might have left my knee a little loose to be sure I could extend it fully. About a year after the operation, I once hyperextended it backwards, which suggests there might be a little too much play.

Good luck.

Anonymous said...

Am surfing the net while recovering from probably the same or a similar surgery (ACL). It was interesting to read your saga as the first time I injured this knee back in 93 one of my key rehab actions was to continue to take my shotokan class. There is a certain psychological aspect that is in fact physically manifested, sort of a pyscho-somatic memory of if you close your eyes and move your arm, your brain still knows "where" your hand is. This sensation of placement accuracy is lost with a substantial injury such as torn ACL, and takes some time to redevelop.

Amazingly I got away for 15 years without the surgery the first time. I do remember agonizing pain during therapy that first session. Although I am not as active in martial arts training as I once was I am still an avid rock climber and hiker. I also play soccer, which I may end up giving up due to an injury on the same knee a few months ago. I knew exactly what it was when it happened, and remembered what the first doc said "if it happens again definately get the surgery."

Interestingly, since I had been through the pain before though, the second time around wasn't so bad. I knew what to expect, and I took things slow and easy. My doctor this time focused on "pre-hab" and did not rush me into surgery. Apparently it is more important to have full extension before actually getting rewired than it is to rush into getting it done.

I just had it done on Friday and while the swelling was minimized in that my initial injury had healed, I turned down the nerve blocker and although I was given a bottle of percosets I haven't taken any. Friday wasn't so bad since the adrenaline rush of going through the whole hospital process was awesome. But Saturday I was under some intense pain. I think the pain from the surgery is actually worse than the original injury because of the mechanisms of what they do to you, but I was disciplined with my icepack switching and by Sunday the pain disappeared. Of course there are recurring pains if I step on it the wrong way here and there. I have a CPM machine here that I am trying to figure out how to use but I expect my PT will remind me continuously of the limitations of the range of motion.

It is disheartening to hear some of the stories of people who have never really recovered without pain. I wonder if some of this is caused by rushing into the surgery too quickly, and never quite giving your body a full chance to achieve it's own rest level.

But, over time the best thing to do is to pursue a goal even if it involves giving up a sport that you used to love.

Christine said...

I'm researching to find an orthopedic surgeon who specializes in redos right now. My daughter had ACL reconstruction with an allograft Aug of 2005. She was 16 years old at the time. Now she is 20 years old and injured her knee last Nov. during a fitness class. She is not an "athlete" and doesn't play sports. She just re-injured it in Jan. and had an MRI which shows that the ACL is not there anymore so she had torn her meniscus and needed the joint cleaned out. We can't figure out when the ACL disintegrated. The surgeon said that it can happen sometimes. I'm hesitant to go to the surgeon who did the repair originally. As I am doing more research now, he didn't explain the different procedures to us and I'm not sure if we would have chosen the allograft which he recommended. I didn't even know that this surgery could fail and have to be redone all over again. It is very annoying. I live in Chicago and have BCBS and will be scheduling appts. with several surgeons. Just wondering if anyone out there has had experience with getting this surgery redone and what to look out for and what procedure might be best. My daughter handled the first surgery very well.

Anonymous said...

Hi, wow, that is so unlucky! Ironically, I tore my ACL 4 days AFTER passing my Shotokan Black belt grading. Yea, I have the belt but can't do karate now for a year. Interesting what you said about the pain...I was so geared up for pain, but i actually took none of the painkillers from the day after surgery...just the anti-inflammatories. I really didn't have pain, although my thigh was sore from where they took the hamstring. I can't wait until I can ride a bike again and walk normally. Cheers and good luck.

Sam I Am said...

Hey, I completely tore my ACL and meniscus in November 08 playing basketball and had my surgery in January 09. That had to be some of the worst pain.

Now I'm on my second month of PT and have to build the muscle back up in my leg. They tell me my left leg is an inch smaller than my right one now.

Right after surgery they put me on the CPM machine and the cryo machine. It's been a hard road but I've finally been cleared to bike, swim and do some weight training again. I can't wait to make a full recovery so I can feel stable again.

Right now I still guard my knee because it still feels a bit weird.

How did your knee feel 2 months after surgery? And how long did it take you to get to the point where you could fully pivot and have 100% stability again?

Dilip Ananthanarayanan said...

Hi Bobspar, It was nice to read your blog on ACL. I am 24 and had my ACL reconstruction in 2007. Since the operation i have lost around 2-3 inches around my knee and have been trying for sometime to regain lost muscle. Any suggestions regarding the exercises you have undergone?

thanks,
Dilip

Deborah said...

Hi BobSpar,

I'm 48 and wow, I am so glad I found your blog. Skiing accident, felt a pop when I went down, but no swelling, some minor pain, but I couldn't put much weight on the left knee. That was at the end of March. The on=mountain clinic doc said, oh, the joint is very stabile, it's probably just a minor sprain. My doc 2 days later said the same, but to let her know if pain didn't go away in about a week. It didn't, so got the MRI last week.

I just found out yesterday that my ACL is gone, I have at least one, maybe two meniscal tears, and bone marrow is leaking into the knee joint. Surgery is Jue 12.

I'm wondering about the practical issues of recovery and rehab.

Does prehab do much good? Doc says not necessary, but I've got 5-6 weeks to get ready, so wanted to do what I can.

Do I need someone around for a while to drive me to PT? Like how long would I need help with that? I'm thinking about 2 weeks, but don't really know.

And do you need to setup your "nest" in the bedroom or maybe the family room, close to the kitchen, bathroom, etc.?

Many thanks!!!

BobSpar said...

Dilip,

Did you work on physical therapy after surgery? That's a surprising amount of muscle to still have missing-my left leg is a little smaller still but not that much. I would keep working on the PT routines--things like squats, lunges, lunges while holding weights, anything that builds those muscles. Using leg weights for leg lifts and lunges is helpful. If you know karate-style slow kicks, they are great at build muscle there.

Deborah,

Yes, I thought pre-hab helped, both in recovery time and just in dealing with things like using crutches.

You will need somebody to help you get to PT for a couple of weeks. Since it's your left leg, you will be able to drive again faster than if it were your right leg. But I still think it would be at least two weeks before you could drive.

You need your nest where you can easily get to the bathroom (there will be a lot of fluid in your system from the operation) quickly and without much distance. If you have to make your own food for part of the day, the kitchen is also a consideration.

Arrange for family or friends to help you, especially the first two or three days. Also, just having friends visit for a little helps the spirits so much, and they can put more ice in your cryo-cuff to ice the leg down.

Good luck! Let me know how it goes.

Lone Kimono said...

BobSpar - Maybe I missed this but were you able to go back and get your black belt? How long till you were back in class?

I am 38 and study Kenpo with my 15 year old son. I tore my ACL a month ago while sparring but there was no leg sweep, jumping spinning back kick or anything exciting. Just stepped wrong. I just had my surgery this morning and feel pretty good although I too had the nerve block. After reading your blog I am a little nervous for how it might feel when I wake up. Maybe if I stay up all night I wont have to find out. Its rough because I still go to the studio 3 times a week to take my son and I am dying to get back into it. I cant stand sitting on the bench. We were both supposed to test for blue belts next month. I am happy for my son but its really going to stink falling so far behind him.

You also mentioned a brace that you wore after the original one in your photo. Was that something your insurance paid for? I think the hardest part will be overcoming the fear of the knee giving out while kicking or spinning. Are you past that point yet?

BobSpar said...

Hi, Lone Kimono,

I'm testing in two weeks for my black belt, so stay tuned.

I hope you are getting through the first few days okay. Yes, once you've got the physical recovery, you have to deal with the mental recovery. I do pivot on that leg now without thinking about it, but it took a long time and a lot of work!

Amar said...

Hey all,

This is an amazing site and its been a pleasure to read about all your experiences.

I am a 21 year male, and I just had ACL reconstruction with Medial Meniscus Repair in my left knee.

1st day- groggy, rested, icing as much as possible
2nd day- nerve block wore off, pain really kicked in, iced all day
3rd day- pain a lot better, started CPM at 45, increasing 5 degrees each day

so a few questions:

a. my doc told me weight bear off crutches in 2 days with knee in full lock. ive heard diff things tho, what do you all think?

b. when should i start pt? havent heard anything from the doc yet.

thanks, and take care to everyone!!!

BobSpar said...

Hi, Amar, good luck, it's great you can get on a computer so soon.

My take on your questions is:

1) Listen to your doctor about when to put weight on your leg. Every situation is different.

2) But I would ask the doctor if you can start PT soon. I think my first PT class was a day or two after the surgery. I was complimented by my therapists for simply not passing out or throwing up. They didn't set a very high performance bar for me, as you can see!

Hang in there, be persistent but don't overdo it!

Dan 24 said...

Hi BobSpar

This is a fantastic blog to stumble on you seem to be the ACL reconstruction advice Guru!

I am 22 years old from New Zealand and have been doing FMA/MMA for a number of years. Earlier this year I tore my right ACL doing a shuddering front kick and slipping bridging the gap due to fatigue of all things!! But after a few weeks rest I was back into training and have been since but have had a dull pain in my knee - after seeking professional advice and seeing a knee surgeon I have been told I need an ACL reconstruction which I will be getting in December. How long was it until you were able to start light jogging, cycling, swimming (all the straight line recovery cardio) from the op? and how long did you have to wear the big black leg brace for? I see in one of your blog replies you suggested to someone doing slow kicks, is that so you can extend the knee of the reconstructed ACL?
Any sort of body training you suggest for pre surgery? As I can still run about 10km with out getting any aching and can do quite abit of leg work at the gym still. I don't think my case is quite as bad as some of the other posts but never the less without the ACL reconstruction its only going to get worse until its to completelystuffed. Anyway your opinion would be appreciated Thanks!

BobSpar said...

Hi, Dan,

Welcome to a club nobody wants to join!

The first thing to say is that everybody is different, and your doctor knows about your situation, not me, so listen to your doctor. It's okay to press your doctor to return to activities faster than he or she wants, but you should abide by the doctor's final decision.

It sounds like your knee is still more functional than mine was pre surgery, so it's great that you're running still. I was given some specific strengthening exercises for before the surgery. I don't remember them in particular, but many of them had to do with strengthening the quads, because those are the muscles that really, really vanish after surgery. Since you can still work out in the gym, I'd really focus on the quads. You might also ask your doctor for an appointment at your physical therapist before surgery to get suggestions.

Cycling is one of the first things you can return to because there's no impact on the knee. In fact, one stage of PT for many people including me is getting on a stationary bike and, with fear and trepidation, getting to the point where you can do a complete cycle again.

I hate swimming, but I would think you can probably get back to it as soon as your doctor says you don't have to worry about slipping on water--what a shame it would be to go through the operation, then tear the ACL again because you slipped while walking at the pool. I wouldn't do it immediately afterwards.

My doctor didn't even want me walking on sand or rocks for (if I recall) four or five months, so I had to delay a vacation my wife and I had planned.

As for running--I didn't go back to sprinting for six months, and even then I had to stop. In my case, I developed pretty severe plantar fasciitis, which really limited my ability to run. Eventually, with stretching and rest, it went away, but it took a long time. Your body may not react that way.

I don't remember how long I used the big black knee brace in class. Eventually I switched to a much smaller, less high-tech, lighter one I just bought from a drug store. Now I don't use one at all.

You're much younger than me, young people recover much faster than middle aged people. But listen to your doctor.

Good luck! Let me know how it goes.

dan said...

Hi BobSpar

Thanks for your reply it is great to hear from someone with first hand experience with the recovery of an ACL. Unfortunately for me I played a game of rugby for a mates work team comp last week - in the last 5 mins got tackled hard in a ruck and smashed my knee felt like it popped out then in again!... So now I can't walk but that's just the bruising I think, gets bit better each day. But the main thing is I get surgery in less than 2 weeks now so alot closer to the road to recovery. Thanks again for your tips on recovery I'm a keen mountain biker as well as my martial artist so will look forward to getting back on the bike. Will post up some blogs of how recovery goes as I've been interested in reading how others have recovered.
Cheers Dan

Mike Acosta said...

Hello,

I enjoyed reading your blog because I can relate to what you went through. I recently had ACL reconstructive surgery and Meniscus repair...all in one day. I had the surgery about two weeks ago and all the experience you had is what I'm going through. I also do Jiu Jitsu and been doing it for over 4 years now. I tore my meniscus and ACL while attempting to sprawl from a take down during class. I've aways had a bad knee even before I started Jiu Jitsu, my ACL was never stable and I would sprain my knee twice a year when doing jiu jitsu. But a month ago I tore my meniscus, and my doctor told me that my ACL was shot and needed surgery on both of them.

I was wondering, how long did it take for you to be back on the mat and was able to do the warm ups, position drills, and sparring? Also, do you think your knee was fully healed?

Thanks,
Mike Acosta

BobSpar said...

Hi, Mike,

First off, remember everybody's different.

It took me about five and a half months to get back on the mat. And I wasn't torquing my knee when I got back on the mat initially. That took another month, and I was very careful about it.

I finally joined the sparring class a bit more than a month after I returned to regular classes, but I wasn't doing free sparring--I was just working on drills with the lower belts.

I'm not quite certain when I got back to free sparring. I may not have put it in my blog because I didn't want my wife to get mad at me....

Best of luck!

BobSpar said...

...actually, Mike, I think it wasn't until about 10 or 11 months that I really got back to full intensity sparring, now that I look through my blog.

I don't remember when I got back to grappling, which is more what you're interested in, but probably around the same time. Before that, I may have grappled but was very careful about what I did and who I grappled with.

KLR said...

Thanks so much for your blog! I just came across it as I was searching for information about recovery from ACL surgery. I just had the surgery about 3 weeks ago after tearing the ACL back in January while skiing. I am 32 and have always been active, and I am hoping that I can recover to the point where I can return to where I left off before the tear! Everything in your blog is something that I can relate to - the CPM machine, leg braces, frustration with the crutches and slowness. I start physical therapy in 2 days and have been looking up exercises at home too. It's so inspiring to know that you came back and were able to get your black belt too! That is awesome! Thanks for sharing your experience, it really helps!! - Kim Kaminski