Week 2, ACL Recovery

I started off the week with a milestone by going back to work (a desk job in web development). To my chagrin, there was already a message when I got in from my physical therapist cancelling my appointment that morning.   Now, my next appointment was Wednesday, just two days away.  But I had to have my  PT fix, so I quickly got a new appointment for Tuesday, leaving me with two days in a row of PT.   For the most part this was a good thing, but the Tuesday workout left me so sore and tight that I’d actually lost a degree of flexion by Wednesday.  Horrors!  On Friday things were much better, but we forgot to measure my flexion, and there was no way I was going to report a negative progress until I had better numbers, which I got today (see below).

Overall, the PT was once again fun and challenging, with a lot new exercises for balance, proprioception, and gait, all stuff where my background in karate really helps.  However, there were two exercises—introduced to me on Tuesday (Day 11)—that were a bit more challenging. The first had me sit on a stool and pull myself forward using my heels.  I just couldn’t do it with my injured leg at first.   I kept trying until my calf muscles cramped and my hamstring graft started hissing at me.  I probably worked it more than I should have and pretty much did myself in for the PT session the next day.  But I got some more time on my beloved NuStep and a nice calf massage as a consolation prize.

The Atomic Wedgie StretchThe second exercise is a flexion stretch that has me lying on my stomach and pulling my foot back towards my butt using a rope (a leash works great, too).  I call this one the Atomic Wedgie Stretch because it reminds me of how my friend’s older brother would ratchet up the intensity of wedgies he gave us when we were in middle school by pulling back our calves and hooking our underwear over our feet.   While less painful (and certainly less demeaning) than those old wedgies, this is the most difficult of my exercises.  It doesn’t really hurt.  But pulling against the tightness in my knee requires concentration, relaxation, and deep breathing.   I love doing it because I can feel it stretching my knee.  I dislike it for the same reason.

By Friday, things were back on track (despite missing the flexion measure) and I was psyched enough by how things were Poor man\'s stationary bike.going to pull out an old piece of equipment that we bought in the early 90s and have neglected ever since. It’s a stand that turns my wife’s ancient Nishiki ten-speed into a sort of poor man’s stationary bike for days when I can’t get to the gym.  The bike’s tires are flat, and the whole thing looks a little rickety.  But it’s stable enough to hold me, and the crossbar is low enough to let me get my injured leg over.  My physical therapist explained that the motion is key to pumping synovial fluid—the main source of nutrients for the knee joint—in and out of the knee, helping with swelling and healing. Kind of fun to find such great use for what has essentially been garage filler for the past decade.

All in all, another good week with measurable progess and new and interesting things to work on.  So without further ado, here’s the week in stats.

Week 2 Benchmarks

Exercises

  • Leg raises (slow descent), 4 sets of 10, 1-3 times per day; added 1lb weight on day 11.
  • Balance on injured leg for 15 seconds (sometimes extending good leg forward, to side, and backward), 2 sets of 10, 1-3 times per day.  Started on day 11.
  • Treadmill, 10-minute session, walking forward — and starting on day 17 — walking backwards.
  • Steps (real ones!), ascending with no brace, day 14.
  • Step down from 4″-block, 2 sets of 10 at PT sessions.
  • Balance board, side-to-side balance with 15 squats and front-to-back balance, day 14
  • Still doing most of the exercises from Week 1.

Flexion

  • 115 degrees on day 11.
  • 114 degrees on day 12 :-(
  • 124 degrees flexion on day 17.

Walking

  • Brace most of the time, days 8-17.
  • No brace, mostly in the house, days 8-17.

Pain and Meds

  • Some Muscle pain, usually around hamstring graft.
  • Ibuprofen as needed, but I often forget it.
  • R.I.C.E. – continuing to rest when I can, ice 3-5 times a day, wrap with an ace bandage at night, and elevate when resting and sleeping.
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3 Responses

  1. Your flexion numbers are better at week 2 than mine are at week 6! I think my torn MCL along with the ACL really hindered me. Congrats, it sounds like you are doing great!

  2. Non blond,

    I would think that having both ligaments go would make some things go slower. You also got yours skiing, so you undoudtedly had a great deal more force at play during your injury than I had in mine. You probably had a lot of little strains and sprains on top of the big stuff.

    I definitely got the, uh, luckier break. There was very little swelling after my injury and only minor cartilage damage. And because of a therapy study I took part in at the local university, I had gotten back to full flexion a few days before the surgery. In fact, I felt good enough to go to karate class the night before my surgery and even do some kicking with my bad leg (using my good leg to plant, of course). In hindsight, it was a foolish thing to do. But it was also a kind of statement of my commitment to return afterwards.

  3. Chad,

    Great report!

    I had to reach 110 degrees flexion before I was allowed to ride the stationary bike. It took me almost three weeks to get those numbers. I did not have full ROM before surgery. I had surgery three weeks from injury with only one pre-hab session.

    Sitting on a stool and pulling forward is a challenging exercise for those of us with hamstring grafts. My right hamstrings are still weaker. At the gym, I work the hamstring machine with my right leg only. It is my toughest exercise at the gym.

    What a good idea to convert your bike! I have black bicycle circa 1990 that is still sitting in my garage.

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