ACL Recovery Day 18

The big update since Day 15 is I finally got the stitches removed. Seeing the doctor remove all the stitches brought me back to the date of the actual surgery, and how much cutting, drilling, threading went on during the surgery. The size of the incision where the surgeon took the patella tendon graft is a good 5 inches, and seeing it reminds me of how serious this surgery was. The two other incisions are on the lateral side of the knee where they inserted in my new ACL and further up the leg where they did some lateral meniscus work.

Symbolically, removing the stitches for me was like getting rid of the last bit of assistance from the doctor. I own my knee again, and the rest of the work to get ROM and strength back is all on me. It’s a very sobering feeling, knowing that all the painful and life-threatening work is over, and the slow and tedious recovery is the main concern. I look forward to the recovery, but there are times I step outside of myself when I’m laying on the mat on a Saturday night at 10PM getting in a few side lying leg lifts. Being given a script and protocol to follow takes a lot of the “thinking” out of it since you just follow the instructions and don’t worry about anything else. At the same time, in between sets, I think about how I got to this point and whether it’s all worth it.

I think it takes a certain personality, or just drive, to want to recover from a major surgery or just being healthy in general. This is one trait I’ve developed over the years not so much because I have faced a daunting health event, but rather due to the fear of being physically obsolete which I’ve written about here.

Exercises

Since the last appointment with the ortho, the one thing I learned was not to do seated leg kicks. She said that this motion can actually lead to the bottom bone plug from popping out which is definitely not good. I felt a lot of discomfort in my patella when doing this exercise anyway, so glad that I’ve removed it from my protocol.

The exercises now alternate between strengthening and conditioning each day, with ROM and proprioception being done on all days no matter what. For some reason, I’m not so worried about proprioception since I’ve been walking without the crutches the last 2 days and don’t have a problem with weight shifts. Since I’ve been able to do step ups and balance on my injured leg, the physio said this is a big step in terms of strength and proprioception. Updates on exercises:

  • Conditioning – This is the big exercise I’ve been able to add to my protocol without much pain. Yesterday I did 15 minutes on the elliptical at a 16 resistance. I am able to get my heart rate up to 150 bpm which is good enough for now.

acl rehab elliptcal

  • Bike – I am able to do full forward and backward revolutions at a level 9 on the seat. This is pretty much the normal level for riding the bike in general. I hope to be able to do conditioning on the bike soon, but right now it’s just helping with ROM.
  • Wall Squat – Feels better now since I’ve altered the form to make the push up easier on the knee. I focus on straightening the leg which lets me drive using the balls of my feet vs. pushing entirely off my heels.
  • Calf Raises – This is an exercise I’m going to ask the physio about since I feel like the knee locks up a bit and I feel pain after I finish a set. Perhaps I should be doing this exercise right now.
  • Passive Extension – Just to ensure I don’t lose extension, I’ve been putting my heel on a barbell and then adding 10 lbs to my knee to push down on the leg.

acl recovery passive extension

  • Side-lying leg lift – Been using the Thera band from the physio, still a bit confused about the form so will ask the physio about doing this correctly. Same thing applies to the hip abduction exercises.
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