I’m now a couple weeks out from my reconstructive ACL and meniscus repair surgery. I wrote what I did the day of the surgery here. Next up is what days 2 through 11 looked like.
The bold indicates something that changed from day 1. Changes include weight bearing as tolerated up to 50%, the inclusion of proprioception exercise, and the discontinuation of ibuprofen.
Remember: Don’t get caught up in the exact days here. Everyone is going to vary a bit based on their experience and their surgeon’s opinion. A couple of things that shouldn’t vary: Attaining full knee extension. This should be accomplished IMMEDIATELY. Also, active knee flexion is not allowed until day 10. Passive is up for debate. FYI active is a movement you accomplish with the specific muscles where passive is when something else moves those muscles for you. Could be gravity, your arms moving your legs, another person, etc.
Other than that, the principles are what’s important. Pay attention to how things progress from day 1 to day 2, to day 10, to week 2, etc. For instance, how much weight bearing you’re allowed is going to vary. That’s fine. What’s important is that you don’t go from non-weight bearing day 1 to trying to walk day 2.
Some general comments on days 2 through 11: If there is any point during this whole process that is worse than days 2 through 10, I’d be shocked. Despite the fact I was barely in any pain, these days turned from bearable to miserable. Having to have someone help you drive, put your shoes on, grab objects for you, hold items for you, it all sucks. Sleeping with your leg locked straight, sucks. Not being able to bend your leg at all, sucks.
Next, I’ve been exhausted. I assume all the healing work my body is doing plays a role, but getting around is extremely tiring. Crutching around, only being able to use one leg most of the time, well, I’ve been sleeping like crazy.
I highly recommend anyone who knows they will be on crutches for an extended period of time buy a T-shirt or make a sign detailing why. This will prevent the inevitable 15 thousand people asking you, “What happened? Oh, how did you do that? Wow, when did you do that? Does it hurt? Yeah, I remember when I sprained my ankle.” While I appreciate the consideration, it wears on you. If you’re in California make sure to state whether you did or did not get hurt skiiing.
Lastly, this was intended to be days 2-10 but I wasn’t able to get in for my follow-up until day 12. Thus, this turned into days 2-11.
Oh, I had the surgery on a Friday and was back at work Tuesday. Not bad.
–
Post-op Day 2-11
Compression
-Compression sock from hospital
-Manual massage quads, hamstrings, adductors
–Ace bandage
– >After a couple of days I could feel the compression sock losing some of its tightness. I believe day 4 I noticed a little extra swelling in my leg and I could feel the rush of blood into my leg each time I stood up. Almost like the skin was expanding. This actually hurt. A lot. I threw an ace bandage around the knee and that cleared that up.
–
Crutches
-Up to 50% weight bearing as tolerated. Don’t try to put more than 50% of your weight on your injured leg. Don’t be afraid to use less than this as well.
–Move every hour or two
–-> This is another one of those areas where opinions vary widely. Some say weight bearing as tolerated, others don’t want any weight bearing for two weeks, if not more. If you only had your ACL reconstructed, weight bearing as tolerated seems to be a good way to go. With walking projected at about 10 days. If you had your meniscus repaired though, that’s where the numbers start to jump all over the place.
The size of your tear, where your tear is, how good your surgeon feels he was able to repair it, etc. will all dictate your weight bearing status.
Again though, I wouldn’t get too caught up in the specifics on this. There really isn’t anything to suggest an aggressive approach is worse for meniscus repairs than a conservative one i.e. weight bearing more than someone else does not negatively affect outcomes.
I even said to my surgeon “There really doesn’t seem to be a lot of consensus as to how long you shouldn’t weight bear after the surgery.” He said there really isn’t. Unless you have a seriously large tear, or a complex tear, or you are progressing slowly, I don’t see any reason you should still be on your crutches after two to three weeks. If you only have the ACL, 10-14 days is a good mark.
–
Bracing
-Locked at 0 degrees.
–> Some will be allowed to unlock the brace to 90 degrees while sitting, allowing some knee flexion. For the most part though, the brace will be locked at 0 degrees. This is to make sure you don’t lose any knee extension. Something very common in ACL patients.
Again, if you had a meniscus repair you are going to be more on the side of having the brace locked at all times. This is how it’s been for me for the first 10 days, and I’m going insane. I did not think this was going to happen and fully expected to be able to bend my leg, at least somewhat. Based on the size of my tear though, my surgeon asked me to be more conservative.
The differences between having to have your leg always locked at 0 degrees and being able to bend it are huge. If you can’t bend your leg at all it’s going to be extremely hard to drive (I definitely can’t), picking anything up is very hard, sitting is hard, getting up and down is hard, you can’t go grocery shopping, basically everything in life blows ass. I’m on the verge of throwing my brace in the trash can and lighting it on fire.
I would highly suggest trying to find out before the surgery if your surgeon is going to let you bend your leg or not. He might say he won’t know until he goes in there, but make him give you some idea. Keep in mind that if your leg has to be straight for 10 days you are going to need someone helping you get around for 10 days. Possibly more.
–
Range of motion exercises (15 reps of each exercise. Should be done often enough throughout day to accomplish goals! There is no magic number.)
Note: Videos of the exercises can be found on the Post-op physical therapy day 1 post.
-Extension: To 0 degrees or 5-7 degrees of hyperextension. This should already be accomplished!
-Passive knee extension with quad squeezes
-Flexion: No active flexion. Passive between 0 and 90 degrees or leg locked straight. (See above.)
-Patellar mobilizations
-Sitting hamstring stretch
-Plantar flexion / dorsiflexion
–
Strengthening (4 x10r each)
-Standing abduction
-Glute Bridges
-Straight leg raise
-Lying down calf strengthening with band
-Toe grabs
–
Proprioception
-Weight shifts w/crutches:
–
Meds
-Ibuprofen day 2. No ibuprofen after that. If used, ideally after exercise. (For reasons here and here.)
-Aspirin / Tylenol days 3-10. Ideally after exercises.
– -> Here’s how my med schedule looked:
Day 2 I took a total of 6 advil throughout the day. Two every ~six hours. Then at night I took one percocet. The pain from ACL surgery peaks at the 36 hour mark so I took the one Percocet when the pain peaked. I could have gotten away with more advil but took the percocet as a precaution.
Day 3 I took a total of 4 Tylenol. And that’s been it.
I’m not exactly sure why my pain experience has been different than most people. I mean, this doesn’t even come close on my most painful experiences list. Judging from the people I’ve talked to this is a surgery that hurts, a lot. Some act as if dying would have been better. This was also evidenced by my surgeon giving me a prescription for 80 percocet, all at a double dosage. That is a shit load of Percocet. I can’t imagine taking that many pills. And I used ice one time. (Oh my god he said whaaaaaat?).
Maybe one day I’ll try and find out why some have more pain than others postop, but I’m sure it’s a myriad of factors like the surgeon’s skill, your pain tolerance, how quickly you get moving, fitness levels, etc.
–
Nutrition
-Calories = (Bodyweight x 15) x 1.10
–> For example:
I’m 190 pounds.
190 x 15 * 1.1 = 2850.
-Protein = Bodyweight x 1 = MINIMUM (190 x 1 = 190 grams of protein.)
-Supplements: Glucosamine and chondroitin, vitamin D, fish oil.
–
For a comprehensive look at ACL rehab, check out The most important phase of ACL rehab
–
Tamara
May 5, 2014
I tore my ACL and my meniscus in two places playing soccer. My ACL repair was arthroscopic. My meniscus repair was not (it was sitting in my joint space). I am six weeks past my surgery and began rehab 4 days post-op. I still cannot bend my knee 90 degrees. Is this normal? Suggestions?
reddyb
May 6, 2014
Hey Tamara,
I cover a lot about knee flexion (bending) in the comments of this post, in the post itself, and in the ACL resource I mentioned above ( http://b-reddy.org/2014/04/02/the-most-important-phase-of-acl-rehab-copy/ ).
reems
July 18, 2014
Hello, I’m a little concerned about my recovery. About 2 weeks ago I had my acl reconstruction surgery using the patella graft and there was some meniscus repair as well. What I’m concerned about is everytime I stand up from a sitting or laying down position, my knee and foot turn super blue and it doesn’t go away until I elevate it. Is this normal or is there something seriously wrong with my blood circulation? Is anyone else going through this??
reddyb
July 18, 2014
Not sure I’ve seen something of this nature. Could just be the blood moving around when you stand up. Certainly something I’d call your surgeon about.
Mandy
July 21, 2014
My son had acl and meniscus surgery in Sept of 2013, he did this as well when he would get up and move around his foot would turn blue. i was very worried but was reassured by the physical therapist and dr that this was normal. Hope this helps! 🙂
reddyb
July 21, 2014
Thanks a ton for chiming in Mandy.
reems
July 23, 2014
Thank you! I was so worried! When wasyour son able to walk without crutches? I’m having such a hard time doing so
Mandy
July 23, 2014
It took him about 4 weeks, but not because he couldn’t, but because he wouldn’t! He was 16 and this was by far the worst thing to happen to him(football injury). He was so scared to walk with out the crutches he didn’t trust his knee, he was sooo afraid he would re injure it. He kept thinking something was wrong, very paranoid.So we really had to encourage him. And the doctor and PT had to encourage him. Everyone heals differently and you will know when to trust your knee when you feel comfortable.
kiran
November 24, 2014
i had acl and meniscus surgery on 27 june 2014 i was in bed rest for 3 months, they put POP to my leg, now am going for physiotherapy from 10th oct 2014 but my leg is not bending, around 70 degrees only i can able to bend. will my let get 100% recovery in bending or did i became handicapped. am scared about my futures am still 26 and not married what to do. pls help me.
reddyb
November 25, 2014
I’m not sure what your extension range of motion is like, but I’d be extremely concerned about that first. 70 degrees flexion isn’t terrible, I think you can get that to improve a great deal with time and persistence, but the extension you want to be very concerned about if you don’t have full ROM.
I won’t lie to you, you are very, very behind. You need to get things together, and do so immediately. You don’t rush things or excessively push your body into pain, but you need to get on a consistent program now.
Mistakes to avoid: http://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
A beginning program: http://b-reddy.org/2014/04/02/the-most-important-phase-of-acl-rehab-copy/
nikhil
November 30, 2014
Hi, i just had my ACL reconstruction surgery 4 days ago. I was able to walk without crutches on the day of the surgery itself, and have been fine with walking since then. I have not however be able to fully extend my leg since the surgery, i am maybe about 5 degrees off. Is this unusual or will it just come back as i practice my extensions? Also, the physiotherapists gave me some standing hamstring curls to do, but i read somewhere on your site that we should not do ANY hamstring work, do you think is this an issue i need to bring up next time i go? I’m 19 years old and had very minor meniscal damage, if the background information helps. Thanks!
Also, my apologies if this question has been asked, i tried reading through all the comments but i most likely missed it.
reddyb
December 1, 2014
From this post http://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/ :
I never said one shouldn’t do any hamstring work. How much you do, when you start doing it, in what fashion you do it, what graft you had, are what matters. This is exhaustively covered on the site, particularly in here: http://b-reddy.org/2014/04/02/the-most-important-phase-of-acl-rehab-copy/
Carrie
December 31, 2014
I just wanted to say the information posted here has been a great help both pre and post op. Almost 4 weeks post op on acl reconstruction with hamstring graft and loving having some independence back. No crutches and walking with the brace unlocked, driving, able to be up and taking care of things myself. It was really helpful finding sites like this one to get a good idea of what I was in for as well as checking to see how my progress compares to others. I was going to PT twice a week for about a month before sueery and was keeping up with exercises they wanted me to continue at home. Had my first post op PT less than a week after surgery. Pre op therapy paid off as I had enough quad function to surprise my therapist. For those that are about to have surgery I highly suggest PT before surgery. After all that, I do have a question. Unlocking the brace is a fairly recent thing for me. I was told that I shouldn’t have to lock it for sleeping, but I just shouldn’t sleep on my back with a pillow under my leg when it’s unlocked. If I try side sleeping finally, I know my leg will be at least slightly bent. I was wondering what your experiences were like at this stage. Just wondering how being slightly bent because a pillow is under it could be different from it being bent while sleeping on your side. I should have asked my thertherapist about this when I was there last, but hindsight is 20/20
reddyb
January 2, 2015
Sounds like somebody who really had things together before going into surgery. Kudos to you!
Your question is strongly dictated by what’s going on with your passive extension ROM at this point. At 4 weeks, many are still struggling to hold full extension ROM consistently. Meaning sleeping with the leg just about fully straight, if not fully straight, makes life easier.
Once you find yourself holding extension more easily, you have some more wiggle room as to how much you sleep with the leg bent. (Personally, this was more towards two months for me.)
Overall, it’s not that sleeping with the leg more bent is bad at this stage, or really even a couple weeks out. It’s more how hard it can make life when you wake up. That is, it’s going to be tedious as all hell to get full extension ROM back when you’ve been sleeping all night with a leg bent, say, 30 degrees or more. Flexion -as long as it’s not significant flexion- is not bad. The absence of full extension ROM is what’s bad.
Edit: The differences between the leg being bent on your side or on your back are minimal in terms of flexion. There are other things worth considering here though. See my sleep manual for more on that: http://b-reddy.org/2012/08/06/sleep-with-less-pain-tonight/
Debi
January 4, 2015
I am a US citizen living in Ecuador. I had ACL repair with hamstring autograft and meniscus repair 13 days ago. I have a very low pain tolerance, but had very manageable pain after this surgery. I never had to wear a brace, as that is not standard protocol here. I have had full extension all along, and flexion to 80 degrees at this point. I am able to take several steps indoors without crutches, but I am basically still relying on them full-time. My surgery was performed under spinal anesthesia, and I spent one night in the hospital afterward. The complete cost of the surgeon, surgical assistants, anesthesiologist, hospital, IV meds in hospital, all oral meds prescribed post-operatively, and all the post-op doctor visits I will require, amount to less than $3,200. Physical therapy is $12 per visit. In my opinion, as a young retired nurse, I have had excellent care, and would recommend that others consider the Ecuador option if cost is a deterrent to US healthcare.
reddyb
January 5, 2015
Thank you for sharing Debi. Interesting to hear this.
Kristy
January 9, 2015
I am 6 weeks post op. I had ACL repair with patellar graft and they removed my meniscus. I have had full extension from day one. And I am currently at 115 flexion. I still cannot do a straight leg raise. I can do quad sets, and just started doing squats on the total gym last week. I have complete numbness on the left side of my knee and on my thigh. I am not sure if the numbness of my thigh is related to my quad, but I am starting to fear nerve damage from the nerve block they used. It is very uncomfortable and painful to lift my “dead leg” into the car and the bed etc…
reddyb
January 12, 2015
Have you talked to your doctor and therapist about this?
Kristy
January 12, 2015
I talked to my therapy assistant… She kind of down played her response. I am meeting with my doctor in the morning.
reddyb
January 13, 2015
Any news from the doctor?
Kristy
January 14, 2015
Not really. He said the numbness on the side of my knee “was to be expected.” When I told him about the other numbness and my quads not working- he just said only time will tell. He is retiring next month so I will be transferring to a new doctor. I have also set a fitness goal and have decided to work with a trainer to try and get that quad strengthened. I will keep you updated.
reddyb
January 14, 2015
Ugh, sorry to hear that. That’s bullshit he’s retiring that soon and still did your operation. I had one physical therapist whose first day was their last day with me. (And another who was only there for a week.) I was irate they even scheduled me with that person.
Try to make sure you’re working with someone who has experience with a post surgery population!
(I do think the numbness should subside with training, but it’s always good to get something of that nature checked on.)
Bec
January 19, 2015
Thank you so much for all of this information. It is such a relief to hear some of this.
I am in Australia so I don’t know whether they do things differently here or not. My story is this. I did a rather large bucket handle tear of my meniscus mid August 2014. My knee was locked bent at about 90 degrees. I could not straighten it at all, even with force. My doctor said nothing about this being a problem and said that it would be fine after I had surgery to repair it. I had surgery a month later after being unable to straighten it all that time. They did a repair of the meniscus.
After surgery it was a month before I was sent to the physio. A week post surgery I went to my doctor alarmed because I couldn’t straighten it or weight bear. The doctor wasn’t concerned and said to speak to the surgeon. A month later I saw the surgeon (it took that long to get in) and still could not straighten it or weight bear. I was freaking out. He was not concerned. He said that it was a serious operation and that I should not expect anything too quickly. When I went to the physio she was amazed that nothing had been done about it and said it was going to be a struggle to get it straight after all this time. It took ages to see any results at all.
I had really bad swelling and because it was locked at 90 degrees for so long my muscles had wasted, everything felt shrunken and tight and it was a real battle. 3 months passed and little had changed. I was still on crutches and still couldn’t straighten my knee. Again I went to see the surgeon and he said the same thing. He wasn’t concerned. I then said that I had read online that if you don’t get extension ROM asap you may never get it back and his reply was, oh yeah that can happen. I couldn’t believe that it took me asking for anyone to even tell me that!
At this point I have managed to get to 5 degrees extension (cannot get hyperextension at all) and 110 flexion. I am walking, but with a limp. I have just returned to work after having 5 months off because I couldn’t walk! The last time I saw the physio she said that the extension range was enough to walk but I would probably never get my flexion past 110 at this stage. I was horrified. I have become really depressed which really impacts on the recovery. I really feel that my treatment has been poor and that I have been getting conflicting information or no information throughout this whole journey. All that I want to hear is that it is not too late. Do you think I will be able to get my ROM back at this late stage. I am an active person and 35 years old. I am so worried that this is going to be a problem for the rest of my life.
reddyb
January 20, 2015
Hey Bec,
I’m sorry to hear about your story. Some notes:
-You should not be walking with a limp. You may need crutches, you may need to walk slower, you may need to improve your ROM more, decrease your swelling more, whatever it is, you should not be walking and limping. Doing so for a long period of time can be very, very hard to reverse.
-I can’t tell you whether it’s too late or not extension wise. Flexion, once the swelling is down, should be able to come along. Although, if you’re at 110, there’s not a whole left to gain anyways.
-I can’t say I’ve had great results getting people who have been lacking extension a long time to all of a sudden get it back. These people are generally more at the 1 year+ timeline. (Time is somewhat on your side here.) I have seen some results, but they haven’ tbeen to the level I’d like to see.
Personally though, I feel this may have been more due to the client’s compliance than something physiological. As well as the client’s beliefs. “It’ll always be like that.” I want to say getting the ROM back is attainable, but I can’t say for sure. What I can say is how you get the extension back and the work you put it in to do it are *crucial.* Per my ACL posts and the comment sections, very few people go about getting extension back the right way, nor do they realize the amount of effort it takes.
Note here effort is NOT intensity, or forcing things. It’s shear time and dedication. You’re welcome to take a look at my ACL manual to see how I go about this: http://b-reddy.org/2014/04/02/the-most-important-phase-of-acl-rehab-copy/
Bec
January 21, 2015
Thank you so much. I am seriously hoping it’s not too late with extension. So, even though your manual is for the first month, is it the same guidance that you would give me at this late stage of trying to get my full extension back?
Yes, the problem is that I am trying to force it too quickly now because I’m freaking out that it is not straight yet, which is making it get swollen and sore. I have been doing prone hangs for so long that it hurts.With a bit of force I can get it to 0 but I cant get hyperextension. So part of the battle is now with my head. Because I’ve been told that it possibly wont get better, I have to fight the fear and not give up. I just can’t believe that not one (of my practitioners here) seems too fussed that I can’t get it fully straight. The physio said, “well thats enough to walk, so don’t worry.” That was when I was at 5!
I will check out your manual. I wish that I’d found it sooner. I can’t thank you enough for the support you give here. If I have any questions about the manual is it ok to ask on this thread?
reddyb
January 22, 2015
It’s the same guidance, yep. Swelling, how to wrap the knee, dealing with soreness, etc. are all addressed as well.
And you should not be doing prone hangs.
Tangent: Try to relax as much as possible during these types of things. Fear can cause you to stiffen up, lessening the effectiveness of certain exercises. As can forcing the issue.
Asking questions here should be ok so long as it’s related to this post. If it’s more specifically related to something in the manual, email is probably best.
Another aside: one of the people I was referencing in my first response to you actually made his way back to me just today. His extension is looking pretty good! Not great -he hasn’t been doing things as he should- but it’s better than when I first saw him a year ago. (I didn’t see him for about a year due to non-related factors.) I’ll let you know if anything noteworthy happens, as I should be seeing him regularly again at least for a little while.
Bec
January 31, 2015
Once again, THANK YOU SO SO MUCH!!! You are an absolute legend!! I think you should win an award for your help in this field. You have been more supportive than any of the other professionals that I have seen regarding this matter. This includes my surgeon, my GP and my physio! I have changed physio’s now, and have much more faith in the one that I am seeing, because he is not ready to give up on me yet!
I have just bought the manual. I had a bit of a problem accessing through one of my cards initially,(which is probably because it was an Australian salary packaging visa), or I would have had it weeks ago, but I persisted, and finally I have ordered it!
Ok, so no prone hangs?!! I have been doing them heaps!! And my muscles hurt afterwards, which I guess is not a good sign. I think that I have become so anxious about fixing the problem that I am going too hard and pushing it beyond what is comfortable. Same with the flexion exersizes. Another extension exersize I have been doing is where you use a chair of equal size to the one you are sitting on, and put your foot on it, allowing the gravity in between to draw your knee down. Do you know what I mean?
So at what stage (week) do I start following your manual instructions from? Week 4? Because your manual is for the first month, and I am already months behind, do I start doing what would be your final stages? I hope I am making sense here.
I am relieved to here that you have seen some improvement in someone who has had this problem long term. And this is someone who was not even following the instructions properly! So hopefully, if I follow your instructions, I will see some results! I haven’t seen any results for weeks. I got a little bit more flexion, but still stuck at 5 degrees extension. And my knee is so stiff! Is this normal? If I sit in the car for a couple of hours, when I get up, it is unbelievably stiff. And when I do the flexion exersizes the pain in the muscle that runs down the side of the shin bone is unbelievable. It feels like something is pulling on all the muscles.
I am happy to email you from now on if you prefer, but I thought maybe using this thread may be helpful to others going through similar problems as me. I wont harass you with too many emails, but if I have any questions regarding the manual, I would appreciate your guidance more than words can express. It has been such a long and difficult journey, and I have felt like the clinicians that I have been working with really don’t seem to care too much that I don’t have full ROM. They seem to think that it is not such a big deal.Well maybe not for them, but I will never be able to do yoga properly again if I can get it back, so to me it is a very big deal!
I have become quite depressed, which in turn makes everything harder, because you need to have the motivation to make the changes. That is the aspect of recovery that is not really talked about, except for on your site.
Your site is the most detailed and comprehensive information that I have seen on the internet. You have put so much work into it, and the fact that you respond to people who are struggling with this injury is just incredible! I have the utmost respect for your dedication to this matter Sir.
Regarding where to start with the manual, I am sure it will all make sense when I get it. Looking forward to receiving it soon!!!
reddyb
February 1, 2015
Thank you for the nice words Bec. I really appreciate it.
-The chair extension exercise is much more in line with what you want to be doing.
-I would start from the beginning. It’s made for when you start with not having full extension and inability to walk properly. So, while you are not at the beginning timeline wise, you’re at the beginning physically.
-Feeling stiff after only sitting for a little while is very common. This is why working on extension so many times a day is paramount. You lose it *that* quickly.
-Barring a very few caring practitioners, no one is going to care about your leg like you do. This is the leg you’re going to have the rest of your life. Take care of it as such.
Best of luck!
Laura
September 19, 2015
My husband yesterday had the acl surgery he woke up with terrible pain. He can’t even bare to keep his leg elevated straight up with a pillow he says he gives him more pain is that normal. I called his dr all he said he need to keep it up he didn’t understand that he is in pain that way so I’m scared that is going to affect him later on?
reddyb
September 20, 2015
One day out, pain no matter what position the person is in is common.
Have you seen the comments this page? http://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
You may find some solace in seeing the pain experiences of others. Unfortunately, being miserable the first few days is very common. It usually gets better by a week out. That first week can be (very) rough though.
Darilynmg
October 4, 2015
Hey reddyb, I had acl reconstruction on Sept 17. My Dr used an Allegra and also had me on the leg machine. I followed all instructions. Leg machine at 6 first night, 90 day after until follow up. Leg exercises too. Leg is tight but i amable to do allexercise. Yes theres pain but i still am able to do exercises and lift leg. Follow up visit, 8 days later, not good news. Somehow the bone plug on top is not behind screw. 11 days later acl revision surgery. Leg feels loose, unstabile and excerise is very hard to do and bending leg is barely at all. Pain, YES OH DEAR GOD YES. Dr used bigger screw. This time, I am not able to do much at all. Dr only wants 60 on leg machine. My first surgery was painful but I was able to push and complete instructions but second surgery has knock it out of me. Have you heard of this before
reddyb
October 6, 2015
If you mean have I heard of an ACL surgery failing, then yes. If you mean am I familiar with this specific circumstance- what exactly happened with the screw initially and whatnot, then that’s out of my knowledge base. I’m familiar with screw migration (written about some here http://b-reddy.org/2014/12/08/on-having-metal-in-your-body-surgical-implants-weather-pains-and-more/ ), but this is really the surgeon’s territory, and I could only provide some rough guesses. Furthermore, I’m not sure much can be done until you are sure your surgery is successful. If your screw has moved around, that needs to be sorted ASAP. It sounds like the doctor is waiting to see if things hold this time.
So long as you haven’t been bending the knee past 90 right after surgery, it’s unlikely you did much to loosen the screw, where it’s likely on the surgeon and or the hardware he uses. That said, if they are recommending strict range of motion guidelines, like with how much you’re allowed to bend, I’d be adhering to that. If they are limiting you to 60 degrees knee flexion, it sounds like they’re worried about loosening the graft again.
It appears you had two ACL reconstructions in the span of 19 or 20 days…I don’t envy you! With that much trauma to the body, that could be what’s causing the increased amount of pain. In the least, it certainly doesn’t help anything.
Regardless if you have more restrictions now, you should still be working on the two key aspects 1) return of full knee (hyper)extension 2) slow but consistent return to walking. Being restricted with how much you can bend your leg does not influence these two factors.
And you shouldn’t be pushing through any pain. That won’t help anything. This is discussed thoroughly on the site, such as in the comments of this post: http://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
Best of luck, and please keep me posted. Would like to know how this turns out for you.
jeevan
October 15, 2015
I had aCl surgery done last 3 weeks before but now while I walking my knee cap very painful.. and now can I put full weight on my knee…?
reddyb
October 16, 2015
Hey Jeevan,
I’d keep reading the diary posts, and you might want to read the comments on knee cap pain in this post: http://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
Rebecca
November 11, 2015
Hi!
I wondered if you had any suggestions for how to get out of bed with the brace on at 0 flexion. I can also have the brace off, but the muscles in my leg can’t lift it at all. My situation is an ACL tear and less common meniscus tear that means 0 weight bearing for 6 weeks. I’m in week 2.5 and I just wonder if there is any way I can do this myself. Between now and 6 weeks I work to get to 90 degrees flexion, but again, no weight bearing. I’m super lucky that I’ve been able to stay with my parents who have a flexible enough schedule to help me stand up when I need to, but I just have to wonder if there is any better way!
reddyb
November 12, 2015
Wow, 0 weight bearing for six weeks? What type of meniscal tear are we talking? That’s very unusual, and I’m sure you’re not having fun handling it.
If feasible, sleeping, or laying down, with your reconstructed leg closest to where the bed / room opens is ideal. This way you can simply swing your leg around to the floor. Or, push yourself down the bed. If the reconstructed leg is on the wall side of a bed, this can be tougher as you have to swing yourself further. Basically, have the leg be pretty much as close as possible to getting off the bed.
Sometimes, swinging the leg -holding the leg up momentarily- can be too tough / painful. This is where sliding the body down the bed can be advantageous. Slide down, put the good leg’s foot on the ground while keeping the bad leg’s foot off. When in doubt, go even slower. Really take your time, and always have your crutches right next to you.
Regardless, and you might be feeling this already, those arms start getting exhausted, and it can be a miserable feeling no matter what approach you take.
How much help you need, so long as you’re allowed to bend the knee, is very person dependent. (If the leg is locked straight, help is pretty much guaranteed to be needed.) For some, they’ve been on crutches many times before, are in good shape (strong arms), so it’s not tough for them to get around. They know how to go upstairs, they probably already know going downstairs backwards is easier, they know how to hold the crutches so their arms don’t get too raw, etc. There is some skill to it.
For others, they aren’t good on crutches, not in the best of shape, and simply need help with everything. Cooking, cleaning themselves, etc.
Hope that makes sense and is what you were looking for.