7 Months Post Op

At 7 months post op my biggest issue is weakness.  I don't really have much pain anymore but every once in a while I'll get a twinge in the graft area where I had my injury.  However, getting strength back is a SLOW process.  Even though I work out 4-5 times a week, it is still painstakingly slow and I have seen incremental progress over the last month.  

A note on the VMO:  The Vastus Medialis Oblique (VMO) muscle is the part of the quad on the lower inner leg right above the knee. This little muscle provides stability for the knee and can cause knee pain if it is weak.  A weak VMO will cause the knee cap to track incorrectly and cause pain.  Strengthening the VMO is critical after knee surgery because it is the muscle to atrophy the most and the hardest to build back up.  Mine is weak!  To build up the VMO, you need to focus on exercises that strengthen the quad. Physical therapists and surgeons have different opinions on if you can actually target the VMO with specific exercises or you need to work on just strengthening the entire quad.  The ability to "spot train" is controversial but you can't go wrong if you do exercises to target the entire quad such as squats, lunges, step downs and step ups.  So that's what I've been focusing on the past couple of weeks.

Here's a video of me doing some of these quad strengthening exercises:

Stairs:  Stairs are slowly getting easier.  I can go down stairs now without having to hold the handrail but I still do just because I feel more stable.  Going up stairs I still have to hold on the hand rail pretty tight.

Cracking and Popping:  I've noticed this has gotten better over the last month and my knee doesn't do this as much anymore.  I guess the scar tissue is breaking up.

Overall:  I think the most important thing that I learned this month is that regaining strength is a slow process.  It just doesn't happen quickly no matter what I do.  It took 2 months of doing lunges in parallel bars to get to the point where I could do them without holding onto anything like in the video.  The definition in my VMO when compared with my non-operated leg is significantly different.  I think this is why I have such trouble with stairs.  This muscle is important when doing the step up motion.  When I look at where I was 3 months ago, I have gained significant strength back so remembering this is how I stay positive.    

6 Months Post Op

Well, here I am at 6 months and life is slowly returning to normal.  After my last Dr. appointment, I learned I could add some additional exercises to my workouts including lunges and squats.  I also learned I can go to 90 degrees flexion when doing these exercises.

Physical Therapy:  I still go to PT twice a week.  Mostly I still go to touch base with my physical therapist and to get ideas for different exercises.  But I think I know enough now to do my own workouts at the gym.  Plus I prefer to go to the gym on my own because I can get a better workout.  Here are the exercises I do now:

Cardio:
Elliptical Trainer
Stationary bike
Swimming
Treadmill backwards walking at a high incline

Strength Training:
Squats (only body weight)
Lunges (only body weight)
Calf raises
Leg Press
Hip weight machine
Hamstring curl weight machine

I feel comfortable doing pretty much any weight machines except leg extensions.  I've read that this exercise causes sheering forces on the knee and I feel pain in my knee cap when I try to do this.  So I think it might be a little soon for this.

I also started going to yoga class again.  This has been challenging.  Any balancing poses on my left side are difficult and I'm highly unstable due to weakness around my knee.  But It feels really good to start doing this again and I think this will help a lot with building up my strength.

I don't have any pain in the area of the graft when I do any of these exercises.  The only issue I noticed was during lunges. When I lunged forward on my non-operated leg I felt a twinge in my operated leg near the graft site.  So I only do forward lunges with my operated leg for now.

Pain/Swelling/Stiffness/Weakness:  Now that I've added some new exercises and started to work my leg a little harder I noticed some pain around my kneecap near the incision.  The area around my incision is still a little tender and I'm getting used to some of these new exercises.  I don't have much swelling or stiffness anymore so I feel back to normal when I'm sitting on the couch or laying in bed.  My knee makes a lot of cracking and popping sounds when I do my exercises.  It doesn't hurt but I'm surprised how much cracking there is.  According to my surgeon, it's normal so I'm not bothered by it.  My biggest issue is weakness right now.  Going up and down stairs is still very difficult.  I can go up and down alternating legs now but I hold onto the handrail pretty tight.

Overall:  I'm still about 3 months out from beginning a running progression program according to my rehab protocol.  I'm not sure I will ever get to the point where I can run.  I still have some pain in my femoral condyle where I had the graft when I walk or go up stairs but it's minor.  I can't imagine trying to run right now.  Hopefully over the next 3 months I will continue to get stronger and the graft will continue to harder and fix my injury.