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 mind fuckingly 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 fucking 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 fuck 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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Anna
December 23, 2017
I am shocked that ACL surgery is that awful for some people. I tore mine playing ice hockey, and the pain was intense, but I didn’t pass out. I was helped off the ice, but I didn’t hear a pop or anything so no one thought I tore my ACL. I got a brace and was able to walk around, but after 3 weeks I went to the doctor (by this point I could walk completely normally, but my dad wanted to be sure it wasn’t my ACL – he’s an orthopedic surgeon) and had an mri and sure enough… So I surgery Nov 22. I had a nerve block but the pain was still pretty bad. I got full extension pretty fast, and now I can bend it just past 90 deg. Unfortunately I’m a high school junior, so I was under significant stress before the injury, let alone afterwards. The mental effects hit me pretty hard, but I can’t even imagine having as tough a time as others on this post. Is it really so unlikely to have a full recovery? My doctor said that I would… he’s in the same practice as my father and operates on NFL players (an example of his ability). Hasn’t there been some progress made in the past few years at least?
b-reddy
December 24, 2017
Hey Anna,
A great deal of NFL players don’t make it back on the field. For those who do, many never make it back to the same level of play. More details, along with other sports, including hockey: https://b-reddy.org/2016/10/19/understanding-differences-in-return-to-play-in-different-sports-after-an-acl-tear/
So just because a surgeon operates on NFL players doesn’t mean anything.
For emphasis, I had an appointment with the (at the time) San Diego Chargers orthopedist, after I tore my ACL. Between getting the appointment and going to the appointment I found out the doctor was under investigation by the DEA, and currently going through some significant malpractice lawsuits. I canceled the appointment. 18 months later certain hospitals barred him from performing surgery. https://www.usatoday.com/story/sports/nfl/2013/06/19/chargers-doctor-chao-hospitals-barred-surgery/2439715/ .
Performing on professional athletes is often more about who you know. It unfortunately is *zero* indication of a surgeon’s (or trainer, therapist, etc.) skill.
I train a veterinarian surgeon. I asked him about working on racing horses. He said he never did it because the owners often asked for drugs to be given to the horses. “If you tell them no, they fire you, and keep going through doctors until they find somebody who will.” Zero relevance to the doctor’s / surgeon’s skill. All about 1) having a medical license 2) using it for nefarious purposes.
I only harp on this because it is a common mistake people make when trying to assess a surgeon, albeit an understandable one. Unfortunately, most of us don’t have much to go on when determining a surgeon’s skill. They don’t e.g. publish complication rates (and fight like hell from ever having to do so).
The best way to assess a surgeon is ask them how often they perform a given surgery. It is believed the average orthopedist only does 10 ACL reconstructions per year. That’s not enough. You want them doing at least one a week.
In general, with ACL recovery, we’re quite good at getting people back to everyday life. In that regard, full recovery should be relatively easy. If full recovery means getting back to a sport with a lot of cutting / pivoting, that’s a different world.
Amber
February 1, 2018
God, I wish I would have come across this blog pre surgery! Agree with everything you say, but most importantly #1. The mental aspect of this surgery is, by far, the most difficult thing I’ve ever experienced. I can handle pain, you have to know that having this surgery you are going to experience incredible pain. But, mentally I’m not sure if you can adequately prepare. Thank you for doing your best to describe it, hope it helps others.
b-reddy
February 2, 2018
Thank you for the nice words Amber. I have another post coming about your point- why it’s so hard to adequately mentally prepare, irregardless of how much homework you do. Should be up pretty soon.
Hope you’re handling everything as well as you can.
getontheline
February 2, 2018
Can’t wait to see this post!
banchy
February 4, 2018
brian, my daughter had a successful acl knee reconstruction (patellar tendon graft). she’ll be playing college softball at a top program. the problem is that mri shows that she has scar tissue on the fat pad below the knee cap and and surgeon wants to do a scope to remove it but she’s improving flexion every week that passes by. extension is good, no problems at all. she’s at 135 – 140 degrees 5 months post op. i will appreciate your feedback.
b-reddy
February 6, 2018
In general, I view surgery as an absolute last resort. That’s only compounded when people are looking at non-ruptures e.g. more chronic oriented issues, “abnormal” MRI findings, etc. Where instead, function overwhelmingly takes precedent. If function is improving, I ride that out as long as possible. More often than not, a person can ride it out to avoiding surgery.
It’s always worth remembering, surgeons like to cut!
Raisah
September 12, 2018
Hi Amber and Brian. My husband is having this surgery and I was wondering what is the best way for him to sleep? The doctor did not recommend a brace but I think it may be best since he bends his legs a lot.
b-reddy
September 14, 2018
I’m a big fan of the brace for keeping the knee straight. Sleeping with a bent knee all night, then working on knee extension in the morning, is, for many, going to be unnecessarily difficult.
The first priorities after this surgery are 1) knee extension 2) ability to walk. Sleep comfort takes a back seat.
Jason Deskins
February 5, 2018
I just had my 2nd ACL replacement and a h*** of a lot more to the same me I was walking On my 3rd day after my 2nd surgery They gave me 45 percocets and I didn’t take one of them this time was easy 20 years ago I had it done And yes it was painful but it helped a lot to have it replace I’m 43 now and opted to have it again so I don’t have to go through the pain of hyper extending my me maybe with age comes tolerance to pain I don’t know But yes I would have it a 3rd time if I tarried again
b-reddy
February 6, 2018
Appreciate the feedback Jason. Glad the second go-around went better.
Joanne Bradley
February 14, 2018
Hmm try having an MCL and ACL reconstruction at the same time
b-reddy
February 16, 2018
Haha, oh geez. Nothing like the “who has it worst” argument. Never understood why somebody would want to win that game.
I’m not sure who you’re addressing this to. My personal ACL recovery went rather smooth. So we’ll say you’re addressing it to the general ACL audience. If you read the comments, I think you’ll find some cases quite a bit worse than having MCL and ACL at the same time. MCL injuries in general are not bad (often heals on its own), and the surgery is nothing like an ACL.
MCL repair is the better term. If surgery is done, they often just reattach it.
Anyways, I’m sure the client I worked with who tore his ACL and broke his leg where 6 inches of his tibia went flying out of his leg, after a boulder fell on him, is thinking “Hmm…”
Joanne Bradley
May 29, 2018
Brian, Not trying to win but it is a known fact MCL reconstruction is much harder to recover from. I had both the MCL reconstructed not torn or repaired (had that 25 years ago) using hamstring allograph and ACL using donated tissue.
b-reddy
May 29, 2018
I’m not sure what you’re trying to say.
Are you saying a MCL tear is worse than an ACL? If so, that’s definitely not true. The majority of MCLs will heal on their own, with a very good -much better than ACL tear- probability of returning to previous activity levels. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270177/
Are you saying having a MCL tear and ACL tear is worse than just having an ACL? If so, well, having two injuries is pretty much always worse than having one. Though again, many are fine without treating the MCL: http://journals.sagepub.com/doi/abs/10.1177/0363546505284889
Are you saying MCL reconstruction is worse than ACL? I’m happy to look at what evidence you have, but I think that’s a hard statement to make. If nothing else, there doesn’t appear to be much out there on MCL reconstruction, because it is so rare and controversial. (Again, the go to treatment is non-operative.) From what little I can find though, the numbers are again wayyyy better than for ACL: https://www.ncbi.nlm.nih.gov/pubmed/16002491?dopt=Abstract
Lastly, a big advantage the MCL has over the ACL is it is receptive to bracing. Bracing does not help the ACL, but it does help the MCL. That is yet another way prevention and recovery can be helped for the MCL, but not the ACL: https://link.springer.com/article/10.1007/s12178-007-9016-x
Jessica Fishel
March 11, 2018
Question: my 12 year had a complete ACL avulsion type tear, where it was torn right off the bone, he had surgery with a hamstring graft November 22. He goes to PT 2 times a week, but full extension has been hard to achieve. Fast forward to the last 10 days he went from 13* to 5* and we were ecstatic. However his last appointment on Thursday his PT began forcing his leg down, for several minutes (maybe 3 or so) he was crying and asking how much longer so he was very visibly in pain! Now since the beginning tears have happened. Some days are worse than others during and after PT but this time, he is really hurt. He can’t extend his leg even close to where it’s been he has asked for pain medication and he is back to using his crutches. Is this normal?
b-reddy
March 13, 2018
It’s common for PTs to force the issue, so in that regard, it’s normal.
However, it’s an idiotic, completely unnecessary, approach. This is discussed a great deal in the comments if you want to look around, or here is a much better way: https://b-reddy.org/help-i-cant-straighten-my-knee/
Natasha
March 12, 2018
Hey everyone 🙂
I have had Two acl reconstructions and a tibial tubercle transfer and a removal of hardware over the last two years. It has been a complete nightmare!! I have seen a new surgeon who needs to adjust the acl recon as it is to tight which is preventing me from recovery and causing a serious amount of pain.
Over the last two years I have gone from a happy hard working married Mum of three to a deeply depressed jobless person whos just trying to keep her head above the water!
This whole situation has been a complete nightmare!! Surgeons make promises they really can’t keep. It’s mistake after mistake.
My acl reconstructions have ruined my life and left me in serious pain with absolutely no hope of improvement anytime soon. The pain the nerve pain the function of my knee is driving me insane!
b-reddy
March 13, 2018
Hey Natasha,
I’m sorry to hear about your rough road. That’s about as worst case scenario as it gets.
As far as the nerve pain, (besides getting the surgery and rehab right) you may want to check out some of Lorimer Moseley’s work. Nerve pain can be where some different approaches are needed.
yousef
March 13, 2018
Sorry to hear Natasha,
I underwent two surgeries two. So sorry to hear of your situation, whats the pain now, what are you feeling? I’m seeing a new doctor next week in London and can ask about your situation if you want?
Juns
March 17, 2018
Hi Guys, this is a good blog i found! btw i am on my 1 year post op and i can now play basketball fine but when i do full jump i can still feel pain but it is tolerable. this is normal right?
b-reddy
March 23, 2018
Hey Juns,
At one year, you shouldn’t be having any pain, though kneecap pain after ACL surgery is common. I have a post about this coming eventually. Long story short, the TFL / Rectus Femoris / IT band can stiffen up. I already have some info about loosening these areas up, if interested:
https://b-reddy.org/a-better-quad-stretch/
https://b-reddy.org/the-best-damn-it-band-stretch-ever/
https://b-reddy.org/6-exercises-to-loosen-the-it-band/
Tina
April 9, 2018
Hello I am almost two weeks post op and I am finally feeling a little better. I was on a lot of pain meds which made me very sleepy and did take the pain away completely. I did research and talked to two friends that had ACL surgery but I’ve learned now that everyone is different. I had a lot of pain and since I’m on aspirin the only other pain med I can take is Tylenol ( which doesn’t work and only lasts 4hrs) I used essential oils which have helped but still sleeping at night I’m still only getting about 4-5 hrs a sleep because I wake up with my whole leg aching. I don’t know really know if I knew what I know now if I wouldn’t have the surgery because I really feel in my line of work(being on my feet all day and coaching) if I could have really lived without it. I to if someone ever comes to me and asks me my experience I will honestly tell them that it is as painful as going through labor because at times it was, with a constant pain. This surgery isn’t for weak, lazy people. I can only imagine if I didn’t do post surgery PT how my knee would be. I had full extensions right out of surgery and I can only bend a little bit. I start PT at almost 3 weeks post OP. Also I weighted myself thinking I would gain weight from not doing anything and come to find out I have lost 5# which is muscle. That’s why you need to flex and move as much as you can because the muscle goes really fast! Good luck to everyone else and I hope I never have to go through this again!
b-reddy
April 10, 2018
Thank you for the comment Tina. Hopefully you’re through the worst of it now. Despite all the pain, you’re off to a much better start than most. Keep up the therapy dedication! Having full extension so early is one the best indications you can have at this stage.
Dora
April 14, 2018
I had my surgery one month ago. I have read several blog posts like this (mostly english and I am Lithuanian and had a surgery in my homecountry) while doing prehab and getting ready for my surgery. I was waiting for a very unpleasant event and recovery. But I had a good sleep during surgery, when I woke up there was no pain, it started aching in the evening and it was mostly due to working on holding my leg straight. I took one paracetamol and one 400mg ibuprofen before sleep that night and one ibuprofen a night for the next 2-3 days to make myself comfortable sleeping. I used a crutch for a week for longer walks, was walking crutch free at home since day 4.No brace at any time since week 2.
The only other painkiller i use is ice post harder rehab sessio. I have full extension and starting to go into hyper and 120+ passive and 110+ active unloaded flexion. So I am happy with everything and the knee is quite stable.
Saying that, I do 2-3 hours of rehab since day 2, I work my ass off, I don’t whine, I separate the good pain from the bad, I don’t let myself get depressed over it and I got back to work two days after surgery, I have my own electristim, I do what I am told and I had a big amount of muscle before surgery. I think it is perspective. You can come out stronger mentally and physically just have to prepare for a ton of mental and physical work.
b-reddy
April 17, 2018
Great comment! Awesome you’ve been doing so well.
One of the best ways to minimize pain post-op is to “do your homework” pre-op.
Keep up the great work. Hope the rest of your recovery continues to go smoothly.
Shae
June 5, 2018
Really great thread with informative details.
It gave me a great laugh for the night, also.
I had my ACL and meniscus reconstructed six days ago. It’s so painful and at times, unbearable. Your doctor was generous to give you powerful pain medicine because now and days (because if the opioid crisis) the doctors prescribes weak medicine with at least 30 pills. I’m trying my best to get through all this pain. Some nights, I awaken in sweat because of the pain. I’ll be glad when this is finally behind me, and you’re absolutely right about how the entire process effects the mind mentally; especially when it comes to wanting to play sports again. All I can think about is not wanting to experience such pain ever again. 🙁
b-reddy
June 8, 2018
Thanks Shae!
That’s interesting about the difference in pain medication. You’re right, the perception about opiates has changed dramatically recently. Personally, I never got much benefit from or needed pain killers like that (I only took one after my surgery), but I know some where it really helped their initial recovery. Unfortunately a very tough situation these days.
Hopefully you’re at the end of the worst of the pain. You’re typically where most start feeling better in terms of that terrible acute pain, where it starts becoming more of a mental slog.
Hope you feel better soon!
Ru Celestine
June 17, 2018
Wow! I’m so glad I never read your blog before I did my surgery- I might never have gone through with it! Your description is SO SO SO accurate.
I had my surgery 9 months ago. I tore my MCL, ACL and medial meniscus playing squash. But because I love playing Masters squash competitively, I decided to go the route of surgical repair. I’m a doctor and I’ve had gynae surgeries before so I thought I knew what to expect. OMGosh! There are NO words. My anaesthetist refused me opioid painkillers post-op, because I’m mildly asthmatic, I’m also allergic to NSAID painkillers. I prayed a lot. I cried a lot. It finally became bearable on day 8. Rehab is so important and but that is a different type of pain!
I’m back playing squash now and loving it- but you’re right, some days I do think about giving it up now. I won’t go through this process again. I play for fun now. No more competitive squash for me.
THANK YOU for the revised 18-24 month timeline. I feel great- at about 80% of normal, thanks to the great job that my surgeon did. But since everyone tells you that you should be perfect by one year, I had started wondering if something was wrong with me because I’ve started getting some crackles. Now I will reduce my squash (probably too much impact for this stage of healing), concentrate on swimming laps (which I also love) and my adjust my timeline expectations.
THANKS AGAIN FOR YOUR GREAT OBSERVATIONS AND ADVICE.
b-reddy
June 19, 2018
Hey Ru,
This is a great comment. Thank you for sharing your experience.
I’m glad you found the article helpful! Hope you continue to feel better and better as you get towards 18+ months. For 9 months post-up, you sound like you’re doing very well.
You’re welcome :).
Megan
July 16, 2018
Take this with a grain of salt, as I am not even a week post surgery yet. But, I have to say my experience has not been even close to as bad as the description here. Perhaps its the quality of surgeon and physical therapist that I have, or maybe I’m just lucky. Does the mental part absolutely suck? Yes, absolutely and without a doubt. However, if you have a strong support system and you take the time to research and ask your doctors and therapists the right questions, there’s no reason you can’t get through this process without being mind-bogglingly depressed. Pain wise- I felt a pop and honestly that was the most painful part. The pop set off alarms in my head and all I thought was “oh, shit I really messed something up”. I was walking around 5 minutes later and even went to the gym afterwards and did a normal workout. The next day, I got up and went to work and after walking around for about 4 hours on it, that’s when the pain really kicked in. I went home and immediately called the orthopedic surgeon who did my mom’s meniscus surgery. They were able to squeeze me in on his lunch and got me x-rays and an MRI that day. He also drained a lot of the swelling out of my knee (50ccs) and gave me a steroid shot to keep inflammation at bay. A week later they scheduled me for surgery and got me started on physical therapy pre-op to make sure I had full extension and no swelling prior to surgery (exactly 2 weeks after my tear). My surgery went perfectly- I did the patellar tendon btb autograft and it turns out I had a minor meniscus tear as well so they cleaned that up while they were in there. I came out of surgery and even with a nerve block the pain had me taking my pain killers that first day. The day after, I woke up feeling stiff but not in pain and only took a pain pill before bed that night. Since then, I haven’t taken any pain medications and feel great aside from some discomfort when I try to flex too much or put too much weight on my leg. I was down to one crutch on day 3 and can already walk around the house without crutches on day 6. So, I guess the point here is to anyone reading that it doesn’t have to be as bad as the article discusses. I had full extension the day after surgery and am already doing hurdle stopovers, bridges, and leg raises on my second day of PT post surgery. Maybe it’s my support system, maybe I accepted the fact that I’m going to have to deal with this for the next year or more earlier than most. Maybe it’s because I have a top notch surgeon who does my exact surgery more than 100x per year and is meticulous in his work. Whatever is- it really doesn’t have to be this bad! Take your time to be upset about it (I definitely was) and then put on a positive mindset and move forward. Dwelling on what happened won’t make you better, focusing on the progress you want to make will make you happier and more successful in the long run. Good luck!