It’s been almost two years since I had reconstructive ACL surgery. Between personal experience, those I’ve worked with, the emails and comments I’ve received, a few patterns have emerged as to what mistakes I see people making.
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Lack of mental preparation
Far and away the most common thing I get from people, post surgery, is “Oh my god! This is so bad! Is this normal? I’m so miserable. I can’t do anything. The pain is unbearable. I can’t bend my knee, my muscles are disappearing; I’m so depressed.”
I don’t expect everyone to do the amount of research I did for this. I spent over 3 months reading everything I could, talking to people and writing about things. However, if you do even a modicum of research on this topic, you should learn pretty damn quickly it’s normal to:
- Not just be down, but to be incredibly depressed after this surgery
- Not be able to do anything
- Need someone around you for a while after the surgery. I don’t mean a few hours, I mean like a couple weeks.
- Be in extraordinary pain
- Be on so many drugs you can’t see or think
- Be crying
Part of this is definitely the surgeons fault. I don’t know if it’s because the surgeons don’t want people to know how bad things are, or because they become jaded after doing so many surgeries, either way, they do a horrible job preparing people for what this surgery entails. One of the surgeons I saw sent me to his receptionist to schedule surgery without even discussing what the surgery was. I mean nothing was discussed. Not what’s an ACL, why I might need it, the length of rehab, invasiveness of surgery, time off work, NOTHING. Yes, I knew all these things already, but he didn’t know I knew them.
He didn’t even bring up the option of not having surgery. Or the fact I’d be denied health insurance in the future because of having it. If not for the law changes coming in 2014, for the rest of my life I would have severe health insurance issues because of this injury. The insurance companies take this incredibly seriously, so should you.
Part of me gets the lack of understanding; part of me doesn’t comprehend how people don’t understand a power drill will be put through their bones. Look at your leg, imagine a power drill being put through it. Is it really that hard to understand how you’re going to feel after this? “Waa, I can’t bend my leg, waa, this hurts.” No shit, a POWER DRILL was just put through it.
I’m not sure how else to get this across. My only other way is all the people I know who’ve had this done have another big theme to them. Their ACL experience is one of, if not the, worst experience of their lives. Since people love to look to athletes with this stuff, Derek Rose has said his ACL experience is the closest to death he’s ever been, and Wes Welker said he wouldn’t wish his experience even on his worst enemy. Keep in mind these are guys who are, for the most part, ACL success stories! They’re the outliers, and they still had awful times.
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Unrealistic expectations
This goes right with lack of mental preparation. If you even only briefly look around you’ll quickly find how many people are never the same again after this injury. Too many expect to have this surgery and be good as new. The fact of the matter is your leg will never be “normal” again. To reiterate, multiple holes will be drilled through your body, more than likely one of your tendons will be cut apart, it will then be either sewed back together or you’ll hope it grows back, the part of the tendon which was cut off will be screwed into your bones, one or two screws will likely be left in your body, and that tendon will hopefully turn into a ligament with time. Your leg will never feel normal again because it will never be normal again. It has been forever changed.
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That doesn’t mean you’re forever resigned to pain. You can not be in pain but have a leg that just feels weird at times. If you haven’t had surgery, this probably doesn’t resonate. For those who have though, they know exactly what I’m saying. Whether it’s their knee feels weird, it makes odd sounds, the screw moves around, whatever, there is almost always something odd remaining long after the surgery.
“But I’ll be different.”
In Thinking, Fast and Slow, Daniel Kahneman references a time in his younger days when he and some colleagues were writing a textbook. They were projecting how long the book would take and their chances of actually completing it. They pretty much all thought it would be completed, and in about two years.
Kahneman then asks the one colleague who has worked with others who’ve made a textbook, “How many of them actually finished?” The colleague was a bit embarrassed. “Maybe 40%” “And how long did it take those who finished to complete their work?” The colleague was now even more embarrassed. “I’d say the average was about 7 years.”
Kahneman refers to this as the inside and outside view. When you’re on the inside -you’re the person getting the surgery- you think the odds don’t matter for you, or that you’ll beat them. You don’t want to hear that 65% of ACL patients never return to their previous activity level. And even if you do hear it, you’re not listening, or you think you know something they all didn’t. Rather than consider the endless list of NFL players who never made it back after tearing their ACL, you instead focus on Adrian Peterson.
It’s not only a physical game; it’s a mental one too. This is what a lot of people miss when trying to come back from this. It’s not just the being able to come back physically, it’s the mental aspect. You very well could get your leg back to its former strength, have no pain, no setbacks, etc. But, you may end up thinking, “I don’t care. I don’t want to go through that again.” Honestly, that’s where I am. I was cleared at 9 months -exactly on time, had no setbacks, went out and played some sports, proved to myself I could do the entire process, then said “I’m done with this shit.” I don’t want to go through all that again. If I (or you) was a million dollar athlete I’m sure my mentality could change, but I’m not. I don’t want to do anything which could increase my chances of going through that whole process again. Physically, I’m able to go back to my previous activity level. Mentally, I’m not.
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Focusing too much on former patient’s experience
Asking those who’ve also had an ACL reconstruction can be productive, but you don’t want to rely on other people’s recounts as you’re only information.
1) Every case is different.
It’s unlikely you’re going to be able to run into someone who is having the exact same surgery as you. Here was my full surgery: Reconstructive ACL surgery with a hamstring autograft, medial meniscal repair, partial lateral menisectomy. Every word of that affects the rehab. Unless you’re talking to a person with the same procedure as you, you’re likely going to have different experiences.
2) Your sample size is too small
ACL surgery isn’t that common. So, you may only have one or two people you know who’ve also had this done. Even if you go online and read 20 different accounts, it’s still a small sample size.
That can greatly skew your perception of what this all entails. Using me as another example: I had basically no pain after my surgery. I have a couple ideas as to why, but regardless, pretty much no pain. This is an aberration. To illustrate how much pain is expected post-op my surgeon prescribed me 80 pills of percocet, all at double dosage (because I’m very tall). He told my dad, “Call me if he needs more.” That’s an insane amount of pills. How many did I take? One, which was the night of the surgery. I only took that because I was afraid a huge flow of pain was about to set in, and I didn’t want to wake up in the middle of the night when it happened.
If you’re someone using me as your reference point for pain after ACL reconstruction, you’re in for a rude awakening when you come out from your anesthesia and realize I was an outlier.
3) You don’t want to put all your faith in people’s memories
Since I brought up Daniel Kahneman, I’ll keep that theme. Kahneman has done some research on our perceptions of how painful an experience was. What’s been found is we remember pain by 1) How intense it was and 2) How it ended. Number 2 is what’s important here.
Tying this to ACL stuff: The worst part of ACL surgery is the beginning. As the process goes on, it normally gets better. You’re more likely to ask fellow ACL patients their experience not right after their surgery, but fairly far out from it. Said another way: You’re more likely to get someone’s recount a year, two, or three years after their surgery, rather than 2 weeks post-op.
Their answer is not only going to reflect things in the early stages, but also how they’ve felt recently. Plus, their recent memories are more available than their older ones. Since people tend to feel better a year, two, or three years after their surgery rather than at two weeks, they tend to mix how they currently feel with how they felt immediately post-up.
Say your friend Jon had ACL surgery. He was a mess immediately post-op, but now at 3 years post op he’s pretty good. He’s not amazing, but he can’t complain too much. You run into Jon, tell him about your current ACL issues, how you’re contemplating surgery, and what’s his advice. How did things go for him? Would he recommend it?
Because Jon feels pretty good now his first response is, “You know, it wasn’t that bad. Not the best time, but I’m pretty good now.” However, if you were next to Jon the day after he woke up and ask him how he was feeling, his response would be, “MAKE IT STOP!”
I have a client Dan who has had upwards of 10 leg surgeries, one of which was an ACL. Dan recently decided to have another leg operation. He came in about a week afterwards. “You know, every time I do this I swear I’m never getting another one. It’s like I forget how bad things are after these things. Then, once I get it done again, it all comes roaring back.”
Me: “It’s like a really bad hangover. You swear you’ll never drink again, but next thing you know it’s Saturday night.”
A much better way of learning what ACL surgery is like is not only to ask former patients, but ask those who were around them right afterwards. If Jon’s dad was his primary caretaker, ask dad what the experience was like. They’ll almost assuredly give you a more accurate description.
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Postponing physical therapy
Many years ago it was common practice after surgery to put the person on bed rest. With leg stuff you’d often be casted up for at least a month and pretty much couldn’t use the leg. Scientifically, those days are gone. We now know this is a terrible way of approaching the post-op period. The longer you don’t use the muscles the quicker and more they atrophy. You increase the person’s risk of blood clots. You also make the physical therapy phase harder as the person is starting from further behind.
Scientifically, those days are gone; realistically, too many still lay around for weeks before doing anything. If there is anything to be learned from athletes in this realm it is that physical therapy after reconstructive ACL surgery does not start a week or two weeks after the surgery, it starts the day of surgery.
There is no reason to wait. You can’t do much right after surgery, but that doesn’t mean you can’t do anything. You can mobilize the patella, wrap the leg, squeeze the quad to make sure it stays awake, as well as work on your range of motion.
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Obsessing over flexion instead of extension
If you read the comments of this post: Reconstructive ACL and meniscus repair surgery: Physical therapy days 2-11, which is about my experience, you’ll see over and over people fresh out of surgery going nuts about their lack of ability to bend their knee.
Again and again I respond, “Stop worrying about bending your knee, start worrying more about straightening it!”
I think why this happens is after surgery you may lose 10-20 degrees of extension, but 100-120 degrees of flexion. So, to the person, in their mind it’s like, “Holy fuck! I can’t bend my leg at all!” This is normal. The flexion will come with time, and there’s really no need to rush it. In fact, you need to be careful not to push it too much too soon as that can stretch the graft out. Mechanically, especially in the beginning, you will only be able to flex your knee so much anyways, due to the swelling. It’s going to take some time for all the fluid to get out of there.
Extension on the other hand, you need worry about immediately. First, there is no reason to not get all the extension back right away. By this I mean the day of surgery. You don’t have to worry about stretching the graft out with extension. Second, extension is much easier to lose in the long run. Personally, I needed to check my extension multiple times per day. And for about 6 weeks, everyday, I’d gain it back only to lose it again a couple hours later. Third, the longer you go without getting it and keeping it, the more likely you are to never get it back again. All the time I see people with a knee surgery history who years later still can’t fully straighten / hyperextend their knee.
The other thing here is returning to walking. It’s ok if you can’t bend your knee to 120 degrees, or hell even 90 degrees, that’s not going to affect walking. However, if you can’t fully straighten your knee, that’s a really bad knee to be walking on. You end up walking on a bent knee all the time, which beats the hell out of your joint. So, working on full extension helps get you back to healthier walking while obsessing over bending your knee does not. There is a progression here, and the ability to walk again is very high on the hierarchy. Certainly much higher than bending your leg.
Full, complete flexion will take months and months, and that’s ok. Stop worrying so much about it.
Which brings us full circle: If you only do even a bit of preparation, you should know not to bend your leg too soon, that you won’t be able to bend your leg, that you should be extending it, that you’re going to have a lot of pain and discomfort, etc. Just a couple questions to the surgeon will let you know this.
This often ends up being a $50,000 surgery, with power drills, screws, knives, hours of anesthesia, high level pain killers, a significant degree of short term disability, minimum 6-9 months of physical therapy, you get the idea.
For Christ’s sake do your homework.
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For more information on what to do coming out of ACL surgery, or if you’re someone who needs to take a step back and reboot the process, check out my manual The most important phase of ACL rehab. Click link for more info, or click below to purchase
For those looking to get things really dialed in, check out An underappreciated aspect of ACL rehab and prevention. Click link for more info, or click below to purchase
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-Update 9/3/15- Posted the following comment:
Hey Everyone,
I wanted to let you know I put together a manual specifically for regaining knee extension.
You can see more about it and get it here: http://b-reddy.org/2015/09/03/help-i-cant-straighten-my-knee/
I also wrote something detailing why regaining extension range of motion quickly is so important: http://b-reddy.org/2015/09/03/why-you-dont-want-to-wait-to-regain-knee-extension-range-of-motion/
I cover extension ROM fairly thoroughly in the ACL manual, but this is more extensive than before. Also, some have asked me, “I’m more than a month out, will your ACL manual still apply?” While the answer to that is usually yes, now I have the extension manual for those are only specifically looking at that.
Hope this helps!
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-Update 11/16/15
Another post on the importance of regaining knee extension range of motion, and why you don’t want to wait to do it: http://b-reddy.org/2015/11/16/how-weak-calves-can-cause-knee-issues/
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Post-script (Update 7/1/15)
After receiving many comments on this post, I left this comment:
Dear All,
Understand this coming from a place of wanting to see people do this process better. It is not meant to be judgment, or beratement.
I’m not sure what’s going on the last week or two, but some themes that keep coming up:
1) There seems to be an overall lack of acknowledgment about how long a process this is. Many of you have probably heard “6-9 months,” which is one reason I didn’t hit on this in the article. I assumed it’d be rare to to complain about progress at 2-3 months, as it ignores the fact you have, at least, *double* that amount of time to go. But I’m seeing this more than I thought.
Plus, in reality, this is an 18-24 month process. The 6-9 month mark is more, “Yeah, I’m running again, have full ROM, no issues with walking…but it’s not like I’m playing sports without worrying about it.” FULL recovery is upwards of two years, *IF EVER.*
2) There is either a lack of reading before commenting, or a degree of denial. Because either people aren’t reading the section on “Obsessing over flexion over extension,” or they want to ignore it. So many comments here are about lack of ability to bend the knee. At 2-3 months of all things!
Part of me thinks I need to write a sequel to this post. The other part of me thinks people need to read the following paragraph from the post until it really sinks in:
“Full, complete flexion will take months and months, and that’s ok. Stop worrying so much about it.”
I made two sentences its own paragraph specifically so it would stand out. “Months and months” is not one, two, or three months. It’s MONTH*S* and MONTH*S*.
I understand this is a traumatic time for many who come across this article. But I, nor anyone, can propel your physiology into a different state. It sucks an injury from perhaps out of nowhere, can jack your mind and life up so much, but it is reality.
And if you’ve chosen the path of surgery, you’ve chosen a very, very brutal, long, tedious, depressing, handicapped, lonely, path. One in which there are no guarantees you come out better for having it. You very well could come out worse.
Much like we all degenerate with age, and need to accept it at some point or live in delusion, there are realities to tearing your ACL we all need to accept. The first step to getting over any problem is full acknowledgment of the reality of the problem. I promise many of you, if you get to this point sooner, a sense of relief will come over you.
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onlineorthopedics
May 30, 2016
Do you or anyone here have good or bad experiences on the type of screws used for ACL? How much should one worry about what kind of screws are being used?
reddyb
May 31, 2016
Personally, I had no issues with my interference screw. Some will feel very comfortable with theirs while others will get great relief getting it removed.
I never dug into this research wise as I trusted the surgeon on this front, but many (surgeons) prefer non-bioabsorbables due to potential for a better fixation / better strength. I know there is research showing bioabsorbables have higher failure rates, but like I said I don’t know the details on that front.
There is a good deal on having hardware in the body in this post though- https://b-reddy.org/2014/12/08/on-having-metal-in-your-body-surgical-implants-weather-pains-and-more/
Kim
June 9, 2016
I had a slightly different surgery, I had MPFL reconstruction. Rehab is a bitch. Tomorrow I will be 9 weeks post op. I walk so so with a bit of limp, more so if I’m tired but my legs feel weak and shaky. My biggest bitch with my surgery is that I’m left with a numb patch and nerve pain on the upper thigh. Surgeon thinks maybe from the tourniquet used. I hope this goes away because it’s been more bothersome than my knee.
I just wish the surgeon was more honest with me about what a difficult road this is. He made it sound not so bad. Since both knees are bad, he said if this surgery is a success, he agreed to operate on the left one. No friggin way am I doing another surgery.
reddyb
June 12, 2016
Hey Kim,
Sorry to hear about the troubles you’re having. I haven’t heard of nerve damage from the tourniquet before. Please comment again if you get more information on this.
Simone
June 10, 2016
Had this surgery twice, going through recovery right now and I can agree, it takes a strong person to go through this a second round, because everything you said in this post is 100% true!
reddyb
June 12, 2016
Thanks Simone. Best of luck with your second recovery.
JD
June 29, 2016
I’m 9 weeks post-op for ACL, meniscus and chipped bone surgery. Everything is going pretty well and pain was very minimal post-op My mobility (flexion & extension) were pretty good post-op and at this point both doctor & PT are very pleased. Occasionally I’ll get pain during night after long days but managed it with ibuprofen if bad. My biggest issue was a month after the knee injury (pre-surgery), my knee gave out going down stairs and my leg got caught under me. Unfortunately I dislocated my ankle with three fractures. THIS WAS HORRIBLE. The pain was ridiculous. I had surgery for that pretty quickly and the post-op pain was bad. I kept up on very strong pain medicines for two weeks or so and started PT about 3 weeks post-surgery (non weight baring for 8.5 weeks post-surgery). Once ankle was a little better, I had double body part PT (ankle & knee) to prepare for the knee surgery. My story may have been a little different if I didn’t break the ankle but for me the knee surgery was like cake compared to the ankle. I’m still in PT for the knee and they just re-evaluated the ankle and I’ll continue that too as my calf muscle isn’t as strong as they would like. This whole experience has given me a knew perspective on life and people with limitations. My biggest advice for everyone is getting a Physical Therapist & surgeon that comes recommended for your injury and that you are comfortable with. Luckily I have access to a very good local university’s program that I’ve been very happy with. Oh and depression….was not expecting that but it is so accurate. I found myself extremely depressed after each surgery. For the ankle this lasted a while before I recognized it and kind of forced myself to push through. I don’t know if it was the pain medicine and/or not being able to do things for myself but it was pretty bad. I did start feeling better a few days after stopping the pain meds and talking about how I was feeling. That was def something the doctor did not warn me about but I believe that it is just because everyone handles this stuff differently. My ankle still swells and is probably the bigger pain culprit still. Just praying I’m back to normal soon (a new normal). I see my surgeon again in a couple of weeks and he mentioned doing some gel shots in my knee due to arthritis. I’m thinking that may help the occasional pain. One thing I find weird is right under my knee, on my leg it hurts (slightly) to touch. My husband had 3 ACL surgeries and 1 meniscus, he still has an area on his leg that is numb to touch. I’m just thinking complication or side affect of the surgery. Good luck to anyone going through this. Sorry if confusing, I feel like I’m rambling on and on. 🙂
reddyb
July 1, 2016
Hey JD,
Thanks for sharing. Sorry to hear about the ankle. After my surgery, the first time I tried to get in the shower I slipped some. If it weren’t for grabbing the curtain to save myself who knows what would have happened. It terrified me. As you alluded to, you can gain a whole new apprecation for people with disabilities through this. One thing often leads to another.
Hope you feel better soon.
Kate
June 30, 2016
Hi guys – I’m now almost 4 weeks post-op ACL with hamstring graft. Having previously broken my ankle several years ago (spiral fracture, plate & 6 screws, which was then removed 12 months later), I can totally understand the depression and the long road to recovery. I think having experienced this though I was better prepared for my ACL surgery. Mentally, the wait between the initial injury and surgery was the hardest for me as I was no longer able to do all the things I loved and had to be careful with my movement because my knee’s instability. I was lucky in that I only ended up having to wait a few months to have my surgery (I’m located in Australia).
I cannot recommend enough seeing a physiotherapist and doing pre-hab exercises prior to surgery, I credit this and my wonderful surgeon with my fast recovery post-surgery. I was able to fully weight bear straight after surgery and was walking (albeit slowly) with no crutches at 10 days post-op. Looking at everyone else’s stories it seems I have been lucky as I had next to no pain post-surgery (I was off painkillers after a few days), some aching in weeks 2-3. It is not even the end of week 4 and I have full extension, a smooth gait and no pain. I can only handle going up or down a few stairs but by next week I anticipate this no longer being an issue. According to my physiotherapist it will be at least 6 months until return to my prior activities. Seeing as those activities include dance and sports with ‘cutting’ movements I am mentally preparing myself for it to take a bit longer for me to be fully comfortable.
Some tips from both my ACL and broken ankle experience:
* Do pre-hab asap after your initial injury and rehab asap post-surgery
* Get PLENTY of sleep, eat nutritious (and anti-inflammatory) foods, stay hydrated – this not only helps your recovery but will help your mental state (dealing with the depression, pain and painkillers)
* If you love being active like I do, you might not be able to return to your original activities but you will find something that works for you and your ability. Use this time as an opportunity to try out something different 🙂
* Give yourself a rewarding goal to work towards – I am hoping to travel overseas in 12 months and want to incorporate some hiking so I will be aiming to be fit and strong enough for this
Goodluck All!
reddyb
July 4, 2016
Good comment. Thank you for sharing Kate. Keep up the solid work!
Tiffany
June 30, 2016
Wish I never had the surgery at all I still can’t run a year after surgery and I’m still in pain all the time my knee is constant pain I can’t stand on one leg without losing balance it’s just horrible and I don’t think it ever get better I’m at one year mark right now any advice for me I’d love to run again I still barely can get any muscle on that leg
reddyb
July 1, 2016
Hey Tiffany,
Sorry to hear how much trouble you’re having.
If things are going that poorly I would likely start at the beginning of the rehab process and see how you do on the more basic things. The ACL manual would be helpful in this regard: https://b-reddy.org/2014/04/02/the-most-important-phase-of-acl-rehab-copy/
With that, you may very well want to be getting another surgeon’s opinion and see if anything surgically related is going on.
Mark Brown
July 2, 2016
I am currently 9 months post op to the day! Two days ago I was doing a light football training session as my knee was feeling very strong, I would say it was roughly 90% towards the same strength as my other knee and the training session went fine no problems at all, however at one point during the session when I did a direction change I did feel a click in my knee but it was not painful I was able to carry on as normal. On the night both of my legs:knees were aching as it was only my second training session in a very long time. When I woke up yesterday morning my knee operated knee was aching and when I checked my knee it had swelled up quite a lot as there was no swelling at all before this. So all yesterday I rested and applied R.I.C.E all afternoon and when I’ve woke up again this morning the swelling has gone down from what it was yesterday but it has become tight and my flexion in the knee is around 30/40degrees worse than my other knee. I am worried because before my training session everything was fine I was only around 5/10 degrees off full flexion and my knee was feeling strong. I don’t know if this is something serious to worry about or whether my knee has just had a flare up due to too much activity as it is not used to it? Any advise would be grateful.
reddyb
July 5, 2016
Hey Mark,
Sounds like you did too much, too soon. If you go through the comments here you’ll see a lot of discussion on this, as well as talking about timelines e.g. 9 months is still quite early in the process for many.
(Your first comment got through. I have to approve all comments before allowing them to publish.)
Sarah
July 12, 2016
I have to leave a comment yet I couldn’t possibly read through your whole article as just the beginning I found terribly unsupportive. This article is your opinion, and through others through experience and I can only say I am extremely happy I did not find this before I went through with my ACL reconstruction. I am walking without crutches, it has been six days post op, i do not have particularly strong leg muscles but I am doing well. I put the operation off for six years due to fear but now I have had it done I urge people that it is a better side then non surgery. My positive mind and my determination to walk and be strong is what is getting me through and I feel reading your article would break the spirit of anyone with any fear of this operation. IT IS. A very common operation, I alone knew four people who had had it and the surgeon confirmed this.
reddyb
July 12, 2016
I have to reply to your comment, but I couldn’t possibly read any more after I read this…
Still waiting for one of these types of responses to consist of more than “So I feel this way.” Shoot me back some statistics and evidence to counter the evidence I’ve given, then maybe I can take a comment like this seriously again.
David Fawkes
July 12, 2016
Hi,
I’m back to comment again.
How many more comments like this do you need to receive before you realize you’re a fuckwit for the article you wrote?!
It is not helpful in the slightest, it scares the shit out of people in an unnecessary manner, and as the previous comment stated it is a common procedure with a 90+% success rate.
I’m now 4 months post op, I’ve had some trouble at the hamstring graft site (which is common) but I’m doing well running now, building up my resistance training and my rehab program is going well.
So take note anyone who is having a knee reconstruction, you will get through, it will be tough at times, but with a positive mindset and some dedication your knee will slowly improve to the point where you can lead a normal active lifestyle again.
Don’t take too much notice of this bloke, he only makes a couple of good points, the rest is bullshit horror stories.
Cheers,
Dave
reddyb
July 15, 2016
Hey Dave,
1) This is the last comment of yours I’m letting through with this tone, as now you’ve ratched up the critcism to the personal level. I’m sure you’ll be welcome on Facebook or the Youtube comments, but here, talk like you would actually talk to somebody you never met. And if you go around talking shit to random people you don’t know about their work, calling them names, then I don’t want people like you here. You’re probably too old to hang out in a middle school, but I’m sure there’s a bar that would be happy to have you.
2) The amount of positive comments *way* outweight the negative ones. (Not to mention the ACL manual is one of the best selling products on the site.) There are almost 275 comments here now. Off the top of my head, maybe seven have been negative. By your logic, I should be ecstatic I wrote this article, and *you* should be realizing you’re the [insert expletive].
3) Would like to see your 90% success rate comment backed up. What does success mean? For what level of activity? How long of a follow up? Does this include arthritis rates? Shoot me over the research and I’ll take a look. I’m always happy to look at randomized, prospective, surgery vs non ACL research.
4) What bullshit horror story did I convey? You act like I went into the comments and made up all these comments of people who are having a hard time? Let me know the one(s) which are hyperbole and I’ll change them if you make a good enough argument.
5) By the way,
From here: https://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
From here: https://b-reddy.org/2013/10/23/the-biggest-mistakes-acl-patients-make/
From here: https://b-reddy.org/2012/03/15/reconstructive-acl-and-meniscus-repair-physical-therapy-weeks-9-12-month-3/
From here: https://b-reddy.org/2012/04/22/acl-rehab-month-4/
From here: https://b-reddy.org/2016/06/08/emptying-out-the-mailbag-and-clearing-the-history-14/
Yeah, such a horror story right there!
Read the actual article. Read around the site. Read the words. Not how you feel about them, but the actual words. “The biggest mistakes ACL patients make.” It is not “This is what happens to all ACL patients.” The article, and this site, is saying “If you DON’T make these mistakes, you can do very well. If you do make them though, things can be quite rough.” As evidenced by the overwhelming ammount of comments in opposition to yours.
Cheers,
Fuckwit
Edit: Forgot a quote.
Lucy
July 21, 2016
Wow I wish I read this three weeks ago!! I’ve had surgery before so I wasn’t expecting anything like this, hopefully young age (17) improves my chances of a full recovery. However almost 2 weeks from surgery and still having so many different pains, don’t know if it’s also because I tore my mcl. (They only operated on acl though.)
reddyb
July 22, 2016
Being young always helps these types of things!
The MCL tear certainly adds to the overall trauma of the leg, where more healing is being done. A couple weeks out though and all types of different pains are common. Pain wise, you’re likely past the worst of it, where things should steadily improve from here on out. Time to make sure that ROM is good, and gently get back into walking :).
Tomo
August 2, 2016
Interesting read, definitely some truth in it but it is a bit negative at times. However this is exactly what surgeons do, they don’t give you best case scenarios as they don’t want to get your hopes up. Absolutely agree on 2 points, this is a very mentally tough injury so you need to embrace it and accept it. Secondly every persons recovery is different. One thing I can guarantee you is that the people who had great/normal ACL recoveries will never comment on here, much like diners who have had a great meal at a restaurant.
Remember that a positive attitude is half the battle (along with your rehab) and at times ignorance is bliss. I’m glad I didn’t read this article before the surgery it would have freaked me out but good on you for educating people on the topic.
I did all my research and although I was prepared to give up competitive sport the surgery was unavoidable.
Had a pretty nasty knee dislocation and needed the op to avoid disability. Doc said I’d be in a fair bit of a pain for a few weeks and for the first 24 hours I was then the next day nothing. Surgery was a success and I am killing the rehab thus far. Of course I went through the why me and felt like my life is over but then my mate died and it put everything into perspective.
I have accepted that I will have to adjust my lifestyle to the knee injury but as long as I can walk and exercise I’m happy. It could be worse, it could be better but at least I’m alive. There are still great low impact sports like swimming, cycling, kayaking, gym so don’t think it’s the end of the world. Everyone here is a bit unlucky sustaining a knee injury but it’s done and it’s time to adapt. Our parents and grandparents never had these surgery options years ago and just got on with it usually referring to their injury as a trick knee.
Definitely educate yourself but educate yourself positively so you can do everything in your control to give yourself the best recovery. Don’t focus on statistics or read too many horror stories, the only recovery story you should be focussing on is yours. Lastly measure your progress by months not weeks, when you look back you will be amazed at how well you’re doing and how amazing the human body can heal itself.
I hope this post finds you well.
reddyb
August 4, 2016
Well written comment. Thanks for sharing your perspective Tomo, though sorry to hear about your mate. Assuming you’re young like most ACL patients are, it was likely way too soon to lose a friend.
Hope your recovery continues going well.
M srinivas
August 5, 2016
A good understanding experiences in reality explained very well and very useful
reddyb
August 7, 2016
Thank you for the feedback.
Meesha
August 9, 2016
Best read on ACL surgery I’ve read so far. Honest and real! Thanks
reddyb
August 9, 2016
Thank you for the feedback Meesha.
Liam Batty
August 9, 2016
Hi, I had my ACL reconstructed with a hamstring graft and lateral meniscus repaired 13 days ago. I am just about off pain killers completely now. I was given 3 exercises to do 4 times a day at 20 reps each however I can only do one which involves flexion and extension. The other 2 are resting my foot on a pillow and letting my leg relax so my my knee extends and holding for 10 minutes, and laying in bed straightening my leg and then pulling my foot up to stretch my hamstring. I can’t do these 2 exercises at all really and I am becoming concerned that my progress overall will be hindered. Weight bearing is something which I can’t do and the idea of walking doesn’t even seem realistic at the minute. When I try to extend past my comfort zone I get a lot of pain on the outside or lateral part of the knee. It also tender there if I apply pressure with my fingers and when laying down often have to put a pillow under it so it’s supported and not getting stretched. I also get the feeling of grinding in the knee if it bends in a way im not used to. I do spend time contracting my quads and hamstrings to try and stop atrophy. I was also supposed to receive my first physio appointment within 10 days and that still hasn’t come (irrelevant). I am 18 years old and relatively fit. Any advice would be greatly appreciated. Thank you.
reddyb
August 11, 2016
Hey Liam,
You sound like you were given some solid exercises to be working on. Why can’t you do the passive knee extension? That’s quite an important one. Usually, as long as you’re being gentle with it, slowly letting it hang more and more, it should feel fine. In fact, after doing it, it often will feel quite nice. After a certain amount of time, minute to a few, it might get painful, but then you simply come out of the stretch and work on it again a little later. It should not be painful though. A bit uncomfortable, yes, but not to a point where you can’t even do it.
I’d be addressing that first. With walking, it should be a gradual return. You shouldn’t be thinking about not having walked in a couple weeks, then all of a sudden doing it. You should be progressively working your way there e.g. through how you use your crutches.
(These things are hit on in the ACL manual thoroughly, if you want to take a look.)
You should be right around a follow up with the surgeon, where these are things you want to be bringing it up to them. You want to be sure things are in the clear on that front. The ability to straighten your knee is crucial. If you’re not able to do it right now, you want to get solace it is not from something with the surgery, in which case your approach / the approach you’ve been given by the personnel around you, would need to change. Like how you’re doing those exercises.
If you were supposed to have a PT appointment already, I would be finding out why that hasn’t happened. Things as simple as an office forgetting about you routinely happen. Don’t assume they’re on the eight ball here thinking about you. You are unlikely to have someone around you who cares about your recovery more than you!