8 Weeks Post Op

Range of Motion:  I am up to 100 degrees.  Range of motion continues to be a slow progression and something I have to work at multiple times a day.  I have been doing at least 3x 30 minute sessions a day of motion exercises.  I do this at home typically while watching TV.  The stiffness bothers me a lot and I'm looking forward to being able to move my knee normally.  I am now allowed to use the stationary bike with no resistance to help with range of motion.  At the beginning of the week I wasn't able to get a full revolution so I would go as far as possible then reverse direction and go backwards.  At the end of the week I can get a full revolution but with much difficulty and lifting the hip on my bad leg.

Alter G treadmill.  This lady looks much happier than I was
in this machine.

Parallel bars for learning to walk

Physical Therapy: This is my last week before I am weight bearing as tolerated so my therapist added some partial weight bearing activities outside of the pool to prepare me for walking.  One of the new exercises was walking in the Alter G Anti-Gravity treadmill.  Basically this machine creates a vacuum around your legs and lifts you up so you are putting only a percentage of body weight on your legs.  You can choose what percentage of body weight you want to exercise with.  I started at 20% body weight and set the speed at a crazy 1.5 (40 min mile).  I felt some pain in my knee but it was mostly unstable, weak and stiff.  At first it felt like it was buckling and giving way.  By the end of the week I was able to walk with a normal gait at 50% body weight and a speed of 1.5 with slight discomfort.

I also spent a lot of time in the parallel bars placing some weight on my knee and using my arms to hold myself up.  By the end of the week I was able to walk back and forth using one arm to hold myself up.

This is what I feel like trying to walk

My exercises this week included:

Tuesday

• AM
• 20 mins on the Alter G treadmill-20% at 1.5 
• 4-way SLRs and quad set contractions with Blood Flow Restriction (BFR) cuff-1x30 reps/3x15 reps w/30 secs rest between sets (2 lb weight above knee)
• 15 mins stationary bike for range of motion
• PM
• Pool therapy for gait training-3x laps walking, 3x laps backwards walking, 3x laps side stepping, 3x laps march walking (neck deep water with flotation device barbells) 

Wednesday

• AM
• 20 mins on the Alter G treadmill-30% at 1.5
• Weight shifts in parallel bars
• 15 mins stationary bike for range of motion
• PM
• 20 mins on the arm bike
• Weight shifts in parallel bars
• 15 mins stationary bike for range of motion 

Thursday

• AM
• 20 mins stationary bike for range of motion
• 4-way SLRs and quad set contractions with Blood Flow Restriction (BFR) cuff-1x30 reps/3x15 reps w/30 secs rest between sets (3 lb weight above knee)
• Weight shifts and partial weight bearing in parallel bars for gait training
• PM
• Pool therapy-3x laps walking, 3x laps backwards walking, 3x laps side stepping, 3x laps march walking (chest deep water with flotation device barbells)

Friday

• AM
• 20 mins stationary bike
• 5x15 sets of SLRs (2 lb weight on ankle)
• Weight shifts and partial weight bearing in parallel bars
• PM

• 20 mins on the Alter G treadmill-50% at 1.5 (the machine said I burned 31 calories during this exercise.  Almost half a cookie...awesome)
• 20 mins stationary bike
• Partial weight bearing walking with crutches and a cane outside in grass, sand and different surfaces

8 weeks post op.  The thigh atrophy is less noticeable.
I attribute this to the BFR training.  It slows
down the atrophy and allows me to retain
some quad strength.

Pain and Swelling:  In addition to the normal post surgical pain around the incision I have pain on the inside of my knee similar to what I had before the surgery.  I noticed it for the first time during the partial weight bearing activities.  The pain isn't bad enough to keep me from doing the exercises but this concerns me because I'm worried something is wrong with the graft.  I thought once I started walking I wouldn't have the same pain as before.  My therapist has tried to reassure me that this is normal.  There's still a lot of healing going on and the nerves need to get used to the graft.  However, he thought it was a good idea to talk to my surgeon prior to proceeding with further weight bearing activities.

Other Thoughts:  Overall this week has been frustrating due to the new pain on the inside of my knee.  It is bothering me more mentally than physically though.  The thought of having a graft failure is stressful.  Up to this point I felt the recovery was going well but I seem to be on a downward portion of the emotional rollercoaster of recovery.  I'm just not sure I should be having pain where I had the graft at this point.  So I'll see what my surgeon has to say and go from there.