My ACL and its journey

[Lantzvillian]

Hi guys,

I thought I would post my experience and progress of my ACL reconstruction in this forum so other people could follow and see that its not the worst thing on this earth.

I tore my ACL a year and a half ago in a wakeboard tournament and had one hell of a time getting a diagnosis for the first week until I went to my local GP.

When I tore my ACL, I heard a loud 'popping' noise and and my knee rolled out to the side. Next thing you know, I was screaming profanities and everyone thought I was having a fit because i had wiped out. Soon as the tow boat came back, they realized it was a different story.

One of the judges bailed out of the boat to help keep me up and to drag me to the boat. I assume that some of the damage done to my knee could have been when they tried to lift me out of the water with my board on. Imagine an anchor in the water and the force the board put on that knee.

Eventually they got me to the dock and the medical guys came rushing over. They wanted to cut my bindings, but I told them no and we wasted a bottle of soap getting me out.

Apparently the symptoms of an ACL tear or trauma to the knee results in loss of circulation, immediate swelling and fluid. Also I compare my knee injury to (all the boys will understand this) getting lightly tapped in the balls, but all the time.

Got to the hospital an hour later, where I was X-rayed, but my knee would not go straight. X Rays don't tell anything about ligaments except a shadow so it was waste of time.

I left the hospital with some T3s and told to rest. I knew something was wrong so I waited 3 days and went back to my doctor. Next thing you know I am getting another Xray and got sent to the specialist 3 days later. Two days after that I had an MRI.

The result of that was I had a torn ACL - duhhh... and then I got told it would be three years wait for reconstruction. Well I went to physio for a bit, and I happened to be in a dorm where we had access to a gym. There I got into pretty good shape and managed to wakeboard the following summer with a STI knee brace. This was fine as long as I stopped when my knee got tired.


Fast forward. I got my knee surgery on the 27th of January with 1 month notice to get my ass really in shape (Mexico is a killer if you love to drink and eat) Had the surgery which was scheduled from 10-12. I was there for the full two hours and about 4 coming out in recovery.

That day was great. I was jacked on Morphine and was ready to go. The doctor prescribed me Oxycodone, Celbrex and some other epic pill.

*Note: Remember to write down when you take the pills, it is easy to forget. Those painkillers have stopped working, I need to get a stronger dose or something else.

Then the problems started setting in and getting worse. I would wake up at night in wicked pain, and the mornings would almost make you cry. I have not done the physio thing yet, I am supposed to call this week. Personally I think fat chance are they going to get me to do anything and I also have to get the 16 staples out of my knee at some point too. Picture of that will be posted later.

The main problems I have seen so far are:

* Getting off of a bed and getting to the bathroom. This is rough!!
* Taking a piss and even better dropping a 2. How do you sit down with your leg poker straight. Unless you have someone reef it out on you, dam near impossible.
* Making sure you don't get constipated because of the pills (stool softeners like Docusate was the choice hospitals use here)
* Eating healthy. Your bored, and tv sucks. Eat lots of little meals so the pills don't make you feel like crap.
* Twitching when your sleeping (this hurts and will wake you up! so wear the splint.)
* Icing that knee. Unless your fridge is right next to you, you won't get ice unless someone else does. The time it takes to piss will make you hurt enough that you will scramble back to ze bed.
* No morning wood (seriously, I don't know if its cause of the pills or the blood diverted to the swelling in the knee) - GF loved it since you don't poke her in the back.
* Keeping hydrated. You have a slight fever and that knee is cooking hot.
* Showering. You can't get the sutures wet, so we taped a bag around my leg and shoved me in the shower on a deckchair. The gf rubbed me down and hosed me off


Once you get used to sleeping on your back this isn't that big of a deal. I noticed that when I stand up for a bit, my repaired leg goes blue. I am going to call the doctor shortly to find out what that means - no the wraps are not too tight. When I tore my ACL it did it then too.

Be nice to your family and friends. They will help you out and you WILL NEED IT. They will help you, try and cheer you up and check on you. This is an important thing for myself because it reminds me why the hell i am doing this.

On the funny-side of things, it feels like your in Dragon Ball Z. Eyes bulging out of your head, grunting, talking under your breath and your shaking every time you go to do something.

I'll keep posting my routine and the recovery.

[Lantzvillian]

Talked to the specialists office. I am getting my drugs updated on Thursday, and staples pulled on Monday.

This should be interesting.

[sirPARTYman]

Damn i sense humour in you this must be hard considering the injury

Q1.How exactly did u do it? (what trick)
Q2.did you need the surgery u said u were back boarding?
Q3.You must feel like johnny depp in fear and lothing

U sound like a champion hope u get better dude O and if your mrs is feeling neglected chuck her on a plane my ways cuz

[Medina]

This is an interessting story. Ittl take you 3 years before it is completely healed?

Do you need to wear knee support after that?
Can you tell something you still CAN do?
I hope you get better quick! Stay in shape, so dont eat too much, although i guess its kinda hard...

Did PB ever post his experiences about his broken knee's? Guess thats not as worse as a tore ACL?

[Chattwake]

I tore my ALC, lateral and medial meniscus five years ago doing a backroll. A friend of mine tore his doing a backroll one week later. We had our surgeries the same day. It sucked. The rehab sucked. My knee still isn't perfect. Still shredding though!

[Blindside_137]

I partially tore my PCL and learned some unpleasant things about it.. Won't ever fully feel normal or as stable as my right knee, and it's a pretty dangerous surgery for repairing.

I've got physical therapy tomorrow and have been stretching/strengthening quads and hamstrings. Hopefully I'll be good to go late April. I don't think I could handle having another summer like last year...

I know somewhat how you feel.. Get better!

[dav1268]

[Lantzvillian]

In answering questions:

I tore it on a scarecrow in competition and boy did I go at it way to hard. My scarecrows are the kind that go straight up and I spin coming down. The worst part was I was last rider up in the finals for the Advanced division.

I was able to ride with it torn all last summer with a brace, but I had done extensive gym time and some physio to get there. I did need surgery the entire time riding. When I tore my ACL I could not walk for two weeks and got laid up for near a month. A brace does not protect impact and shocks so I could sometimes wind up in pain. I could do all of my tricks, but certain ones tweaked it so I saved those for camera days. Kickers and obstacles were not in my best interest since impacts wold make me cringe.

Like I said, words of the wise were: No exercise is bad, but stop when it gets tired. The specialist basically told me when i did a checkup before the OP, he said I did a good job. The rest of my knee had strengthened around the injury and there was nearly no movement or instability at under 3/4s straight. Above that my leg would give out.

I have been watching my diet, keeping away from carbs for the most part and lots of protein/dairy/fruits to keep me going. Most of the weight I think you put on is water weight or fat that has become "untoned." If I get full ROM back then I think it should burn off pretty quick.

Right now, my movement is limited to: barely climbing off my bed, barely being able to stand to take a piss and sitting up to play wii or ps3 when my buddies come over. Apparently it takes up to 1 year for your body to realize there is a "better" acl and then your body will take advantage of it.

EDIT: I cannot walk without crutches, I need crutches and I usually need someone to lift my knee onto my bed for me.

I must not have been clear, it would have taken our medical system up to 3 years to repair my knee since I was on a waiting list as "semi-urgent" I probably should have gone to a sports doctor in Whistler (the olympic location) and gotten a diagnosis there.

I wish i felt like JD in fear and loathing, at least I could sleep when it got to be to much. I slept about 3 hours last night and saw my parents wake up at 6. My mom walked in to check on me and my eyes were open.

UPDATE:

When your leg starts going blue, it means the swelling is cutting of the circulation. So ice the crap out of it because it is a detriment to the red blood cells and blood means healing.

-Ze doctor and layman's explanation by a third year nurse.

[ryan351w]

Lantzvillian, thanks for the insight. I tore mine last year on a tantrum. WEAK. I wanted to get surgery but my doctor kept telling me that "if physical therapy is making you stronger and its GRADUALLY getting better to keep doing that." I asked him what if its just my pain tolerance getting higher? He just said keep doing therapy. At least once a day it gives on me or I get a sharp pain from turning funny or whatever. I can definitely tell theres a lot of looseness in the knee. I just kept going to the gym and doing the routine that the therapy place taught me to do. So, I'm not real sure what to do...
what was your deciding or your docs deciding factor to get surgery?

Thanks again,
Ryan

[Lantzvillian]

Hey ryan351w

I had a pretty good specialist, and alot of people recommended him to me. The word he gave me was that ONLY 10% of people who have an ACL tear can live life without it bothering them and having NO surgery. That leaves the rest of us 90% - me included - to get the surgery. He also told me that because I would not take it easy and quit doing dumb things I would require a reconstruction regardless.

I am sometimes skeptical of doctors, so i checked online, and read from multiple sources that if I didn't my could slip and I could tear the rest of the ligaments and the cart-ledge. My knee gives out periodically and beach volleyball proves to be my undoing. Stairs with weird heights and sandy beaches were also rough on it. Same with long car rides and airplane flights.

I knew it would never get better with the periodic pain. It was always there and I was always aware of pending doom. I think that was my final call. It had gotten gradually better, but it stopped and I think that was to do with my actual ACLs condition. The MRI report said "totally disrupted ACL." I kind of think I have had a stuff knee for like 4 years, but it wasn't bad and i was in shape, until the fateful day where it ripped solidly.

There is more, but I don't want to write a novel before more questions.

Hope that helps.

[Medina]

This is where i am happy that i dont board behind a boat.

Seriously, we cable boarders have alot less injuries then boatboarders, i dont know why actually. With us its all shoulder injuries

[Lantzvillian]

Yeah I have never cabled, but I am taking a guess that its slower than wakeboarding speeds.

Like the speed you ride at idle is say 20-23 mph, but the cuts look slower and the cable seems to cushion the rider coming down. There is a bit more time to decelerate instead of wakeboarding where your board is like a giant instant anchor.

On the upside, the doctor has given me hydro-morphine and wants the staples left in until the 15th. Longer is better apparently.

[sirPARTYman]

[ryan351w]

Medina, Im guessing its the angle of the pull... just a thought as to shoulder issues.

RUMPSHAKER, No it was my lead. Im goofy and I landed fine and rode away, which was weird that it let go. But I also strained my MCL in the process, which I guess is normal. But your right i was having trouble wheeling out of them, but i corrected that problem. And had been landing them fine for 2 months when i tore my knee up.

[SeanCarmichael]

I am 5 1/2 mnths post op on an ACL/MCL reconstruction,I hurt it at the cable doing a back mobe, i came down spotted my landing to early and stretched for it, i was still spinning when i hit the water and my legs were locked...bad combo. believe me i was just cleared for some activity about 3 weeks ago, I have been riding again now for about a week Doc said for me to still take it easy for a while and build back up slowly to level i was at pre injury, so i only ride for 1-2hrs aday and only am working on basic tricks, Rails. No Kickers or air tricks yet. the main concern for me right now is the strngth of my leg muscles, even after 5mnths of rehab in the gym 4 times a week working hard, my leg is about half the size of my good one. Presses on that leg are hard and i can feel it when i come down switch on landings, After a hard work out or long day, my knee is swollen, but this is normal during rehab and will be that way for some more months, REhabn Rehab Rehab thats the key to getting back to the level you were at before, This is my second ACL surgery. I have a blog about it on my site if you wanna look it up.

[Lantzvillian]

So I am posting with my progress on my ACL recovery.

Attached is a picture from right after where it was a swollen mess. The other is two weeks later.

Week-2 to week-3 is cool, you can start hobbling around a little bit without crutches or on one crutch. It was still really swollen, but waking up in the night was less common then before.

Week 3 I started physio and got the staples out. They sting! Its like getting jabbed with two needles at once each time and I had 16 staples.

My hamstring was the only muscle that had deteriorated. I could push down on my heal which was good, but I could not lift my heal up. That was a serious problem which I have now rectified with leg raises and control stretches.

Initially got my knee from 40 degrees movement to 60 in the first physio session, but things are slowing down. The specialist wants 90 degrees from the two weeks of physio, but I don't think I will make it.

Week 4 I have the knee doing a consistent 75 degrees movement, I can walk (like Terry Fox) and I can move around. Still cannot drive, but having a shower on your own or going in the hot tub is a serious bonus.

I stretch my knee good multiple times a day and I have my knee within 1 degrees of being straight when I extend.

Noone tells you that you will not be able to extend your leg like before because of the graft. The strength of the graft depends on that lack of mobility due to the shortness of the new ligament. (Another why did you not friggin' tell me)

I stretch my knee on a upright bike with the seat in a high position. You go back and forth for ten minutes because of not having enough movement to actually make a rotation on the bike. I do this for ten minutes or until my knee sweats.

Then electro stimulation for healing and lots of ice. Gravity apparently is one of the best methods to stretch your new ACL. So you dangle your legs off of a high kitchen counter or bench and use a small 1 pound weight. It hurts, but the rough part is stretching your knee back the other way after.

Stairs almost make you pass out and you have a small wimper session to yourself if you over extend your knee.

Another WTF is when the physiotherapyst does a manual manipulation to stretch your leg. F-bombs will get dropped and you will almost scream no problem.

[Lantzvillian]

Knee before the staples came out in week 2

I also have a drain above my knee (not in photo) that other ACL undergoers have not had. My specialist seems to do this to his patients and it must be a trick of the trade.

[Medina]

Oooh men, it also just looks totally painfull... Man, keep you head up, and think about the time youll be riding again...

I hope thats soon for you... How are you forbid to do major sportivity?

[Lantzvillian]

I am forbidden for now to do any activity. I can walk, but I look like a hunched over Terry Fox.

The physiotherapist thinks that I will probably be ready for this summer to wakeboard and maybe without my brace. But, I have a brace so I will wear it anyways.

No activity minus super high impact sports like sky-diving are going to stop me I think

[USAF_C6]

Wow I feel your pain...

I just had surgery for a torn Meniscus (running injury awhile back, and wakeboarding was not helping the issue according to my doc. LOL) and it wasn't nearly as bad as your whole deal... Though mine was not nearly as involved as your ACL. (basic Orthoscopy for me)

My weeks 1-3 were very similar to yours, but I'm now week 6 and still in Physical Therapy. But am walking normally, and jogging short distances no problem. Stairs still suck... mucho explitives.. Re-conditioning the quads, and hamstrings has been my job also... amazing how much they weaken from you babying that leg for god knows how long prior to the surgery, and not using it all all for a few weeks after the surgery.

Hopefully I'll be back up to speed by the time the season starts, though I fear I'll also have to take it easy for a bit... Not that I do anything crazy yet anyway, as I'm still learning.

Good luck with a speedy recovery! Work hard in physical therapy, it sucks, and it'll hurt, but I am amazed at how quickly it has paid off. Improvment is exponential each week.

[Lantzvillian]

Hey USAF wish you luck with your knee too.

I was reading up and they have this continuous motion machine or CPM and it will bend your knee to the 95 degrees i wanted. Has anyone had this?

I was curious if this would be better than the old fashioned way or its just some new tech? Too late I think for me now.

I got physio tomorrow so i will post my results. I have found a quick sesh in the hot tub in the morning loosens the knee up so I can stretch it better.

[Medina]

In summer ready to board! Thats pretty quick, My first thought we're you would be out for 2 season!!! Ooh man thats good Hope you recover quikly and get ready to ride!

[Lantzvillian]

Thanks man, I am stoked! the physio therapist told me I will be able to wakeboard this year because I am pushing myself harder than almost anyone she has had before. AND I do my exercises throughout the day.

Apparently that CPM machine is huge in the USA, but its effectiveness is good for days 1-9 and Canada doesn't use it widely yet.

Got my knee from 75 degrees on Monday to 90 today- friday with a good "reefing" from the lady. I was yelping it hurt so much.. its like someones got your boys in a vice and your brain is saying "get the f**k out of there!"

A bunch of new exercises have been prescribed. Apparently, its just my muscle receptors that are stopping me so the muscles need to be strengthened and encouraged to move.

This is week 4.

[Lantzvillian]

A good video on the surgery and explains it:

http://www.youtube.com/watch?v=q96M0jRqn7k

[bradb]

Hit that rehab hard buddy, because I need to get out and ride soon!
Hope you're doing well.
Cheers,
b

[Medina]

I watched the video, now i understand it abit more. So your muscle is now alot weaker, like you should learn how to do things agains... But after alot of training it gets stronger and stronger...

[Lantzvillian]

Yep the graft is supposed to get stronger and stronger. In fact it will be better than my knee has been in years. LOL

The knee's muscles receptors do need to be told that the knee is okay again and that their is a new ACL. I read somewhere that the brain takes up to a year to learn understand that everything is okay after a surgery.

I had physio again, we were doing patella mobilizations and scar mobilizations. The scar ones you tweak the scar around by pinching it in several directions for a few minutes to stop any tissue from adhering to something its not supposed to. This also keeps the Scars soft..not hard.

This is WEEK 5
------------------------

I can walk up stairs with alternating feet, and can almost walk down without staggering against the handrail.

Walking is normal, and I have no limp unless the knee is tired or really sore.

I have been told I am allowed to drive, but I am waiting until it gets a bit more predictable.

Also walking and having my knee down for extended periods of time working has caused swelling again and has given me sleeping issues at night. No its not the medications because I take only Traumacet now.

Water training will probably start next week.

[Medina]

So after a torn ACL your muslce will only be stronger then before? Just like when you broke your bones?

[Lantzvillian]

Hi Medina,

Yeah supposidly it will be stronger. I have had bunk knees for ages since I was 14 and I am 21 now. I played metro league soccer and running on concrete is nto good for you despite any health benefits.

The strength of the knee depends on a few factors:

* Rehab
* Doctor
* Strength of graft anchoring
* The person
* Graft material & length of the graft

Basically for the graft i had, a patellar autograft (not allo - this is from a dead person) They take a piece of teh pattellar tendon and a bit of bone from each ends.

Like the video says they drill in the knee and tack the piece in with a screw on each end. This screw is supposed to be flush to prevent any further damage to the knee.

Weeks 1-3 the graft is really vulnerable to any stress. Which is why it is critical to listen here. However, the tissue that the graft was taken from will heal fast because it has blood flow. The graft - your new ACL, does not. Therefore as explained to me, the graft in theory dies and the cells go inactive. At weeks 4-6, your body "creeps" into the new ligament and re-activates the cells and services the area with new blood vessels.

This is the end of week 5, and I can now pedal a bike in a full rotation forwards and back. This is with the seat high up. That was not possible a day ago even! I have been told that electro-stimulation is no good now, nor is ice unless it is swollen. At this point in time we are working on making sure no scar tissue forms and strengthening the knee.

Today I walked backwards on a treadmill for 5 minutes ( its wierd like wakesurfing the very first time) Stood on a bosso ball and did minisquats while throwing a medicine ball at a trampoline. Did that for 5 minutes and did all sorts of quad and hamstring strengthening exercises. I am supposed to stand on my bad knee as much as I can (one legged even if stable) to stop my body from favoring my good knee.

Going to go swimming this weekend as well.[/list]

[Lantzvillian]

It is the start of week 6
--------------------------

I have been swimming and exercising regularly. 20 minutes a day on the bike with low resistance and 5 minutes walking backwards on the treadmill. I can walk normally, drive and do most of my daily tasks just fine now.

The physiotherapist has prescribed a whole new batch of exercises and has manually manipulated my knee to 115 degrees. We are working on further strengthening and open chain exercises I think.

I am off pain killers and only require the odd Advil. Kneeling is still impossible and where they cut out the graft material it is still very tender. The scar on my lower knee is still a bit tight because of the superficial nature of that skin.

[riverfreak]

I read your post and lol i can relate - tore my and had the graft 5 months ago.........

I did physical therapy for the first 3 months and then did my own at the gym.....

I have been busting my butt building the quads and hamstring - you can get your knee back completely straight - lots of stretching - sit on the floor watching TV with 10lbs of weight on top of the knee that will do it ........my problem is I cant run without looking like a retard......very weak......doc says that will come in time

I ordered a defiance III knee brace with donjoy on Monday - I'm not sure about this - even with ins. very expensive - I have searched this site and others for the knee brace to get and have come up with nothing......

Doc says I can slalom now - and would be good for the muscles....but to please hold off on the jumping twisting at least until later in the season -

can anyone give advise on a knee brace - doc say 1st year of riding is neccessary -

btw I'm 37, female, tore it on a sweet grabbed 180 - no pop just landed flat and hard in the flats - held the grab too long and right knee still slighty boned out took the impact - had bone splinters - tore the mcl and pcl- had to wait and prehab 3 months before surgery for the ACL - it has been a nasty journey as well - hopefully this summer will be injury free!

[Lantzvillian]

Hi riverfreak, sounds like you had it worse than myself. I hit so hard on a scarecrow to the flats that it disjointed and popped out to the right.

I just finished physio today, we can't break 120 degrees yet, but my knee is getting pretty strong and I have not had a moment of instability. I swam on Wed with the physio lady and she worked my ass out for an hour. My most commemorative moment was doing 1 legged squats into a toe extend then a jump and snap back down into the squat again.

I was also given a fin to add more resistance in the water.. its like a calf sock, with fins on the sides with holes in them.

She hesitantly said I could probably wakesurf on May long weekend too:p As the great MJ would say: "Chamonah!"

[riverfreak]

ok....keep it up....its a very slow process......I'll let you know how the brace works out - I pick it up Tuesday......

[Lantzvillian]

I have been very happy with my brace.. except for the fact I had to get a sock/sleeve to stop it from sliding down my leg on impact.

The trick I found was to get the neoprene wet before putting it on AND to have the strep perfectly on top of the calf... this strap was to be the tightest and the bottom strap was to be slightly less than snug.

I have been told more than a few times to not use my brace unless I need to (need to is wakeboarding, not walking or swimming) so I do not become dependent on it since lateral controller muscles will become relaxed.

[Medina]

so its impossible to ride WITHOUT it? Because its better not to wear them anyway. Curious about this!