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.
I'm 2 and a half years from my post op aci surgery. Feel free to ask any questions
ReplyDeleteMatthew, thanks for the comment. Was it worth it? How would you rate your results? I'd love to here your thoughts on how you faired after the surgery.
DeleteI played my last year of football on it. It was sore but I made it through the season. Now I workout and do everything without a problem. It's been a long journey but I'm happy with the results
DeleteOh wow! That's great that you were able to play football. At what point were you running after the surgery?
DeleteLittle over a year
DeleteMegan,
ReplyDeleteI am part of a research team working on behalf of Vericel to understand the support needs of patients and physicians who use Carticel, as the company prepares to enhance their program, MyCartilage Care.
Your blog came up in our preliminary research. Based on the level of engagement your blog has, it seems that the topics you’ve covered have struck a chord with others. If you’re willing, we would like to set up a phone call to get your thoughts on how we can best help patients.
Would you be interested and available in setting up a one-hour teleconference during the week of April 18? Please specify your available dates, times and time zone in the reply.
Please do not hesitate to contact me with any questions. I look forward to your response.
Cordially
Pam Todd
ptodd@sireninteractive.com
Pam, sorry for the slow response. I've been traveling a lot and busy with work over the last couple of months. Of course, I'd be happy to help. I'll send you an email.
DeleteHello!
ReplyDeleteI just wanted to say thank you for sharing your experiences. I had my ACI surgery 2 weeks ago, and your blog really helped me set expectations and develop an understanding of what I would be facing prior to the procedure. For example, your bathroom set-up completely inspired mine, and seeing what you did was a godsend - I feel like using the bathroom would be so difficult without a little stool to prop up my leg, and the first week would have been much worse. There are so few educational resources for this surgery and it's tough to think of all the situations to plan for before going in, so it's useful to see what someone else has already done.
While my surgery is really different from yours (my grafts are on my patella & tibia instead of my femur) and my recovery isn't the same, it's been comforting to know that the things I'm experiencing are totally normal and that improvement will happen eventually. Especially right now, when I'm logging 8 hours per day in that horrible machine, your blog has helped me remember that this isn't forever! Thank you.
Julia, thank you so much for you comment! I'd love to hear how you're progressing. I'm always wondering if my experiences are the same as others. It looks like you're about six weeks post op now. So you should be out of that horrible CPM machine by now! Congrats on getting through that. Good luck with your recovery! I know you'll do great!
DeleteHello!
DeleteThank you for your kind wishes! Yes, today is the last day in the CPM, and I'm ready to throw a dang party about it. It is SO exciting!
There are a couple notable differences. I've moved faster than you did re: increasing ROM (I'm at 120 degrees at 6 weeks, which is about in line with my rehab protocol). However, I'm to be on crutches for a few weeks longer than you were, I wasn't allowed to do a straight leg raise til 3 weeks, and I'm just now allowed to actively straighten my leg. I also have a much slower weight bearing progression. My PT regimen is a lot lighter than yours, but that's because the protocol was super conservative - I'll be able to do more in the next phase.
Re: lifestyle differences - I live in a fourth floor walk-up, so I've had to get real friendly with stairs. I also live in New York, and while the MTA is an engineering marvel, they don't put a premium on handicap accessible stations. No joke, there are elevators in only half the stations, and the elevator entrances are often two blocks away from the actual platforms. It must be impossible to navigate it in a wheelchair - I've got a new personal cause now. As a result, I've spent a lot more money on cabs, laundry services, and Instacart. :)
I'm very sorry you're still experiencing pain in your graft site, but I'm also thankful you're talking about it - I'm still at that point where at every twinge, I'm convinced I've destroyed my leg, and it's a little comforting to know that it's just because of weak muscles and it's something that will improve.
I'm so glad you're busy and doing well, and even though gains are slow, congratulations on being where you are! It only gets better.
Yay! No more CPM! That's a huge step. I wanted to throw mine off a cliff after lighting it on fire. Wow! 4th floor. You must be great on the crutches. I had the same issue thinking I was ruining my surgery every time I felt a stab of pain or a twinge. I actually dealt with this for several months and I still sometimes wonder if I did something wrong during recovery to prevent a good result. After talking with other people about this, I've found it's pretty normal to think this way. My PT told me if something is really wrong I would have a lot more pain or clicking and catching type issues. Basically, it would be obvious. So that's how I curb those thoughts and have faith that the surgery worked like it was supposed to.
DeleteI have been working on my VMO also! Funny thing is I can do stairs going up but going down I struggle with still, sounds like you're doing great!
ReplyDeleteI am still struggling strengthening that muscle. I'm not sure why I'm having so much trouble. Stairs are my nemesis still...lol. It sounds like you're doing great as well!
DeleteThank you so much for informative an article you can check this Right hemicolectomy
ReplyDeleteMegan, any update coming soon?
ReplyDeleteYes! My apologies for my slow response. Life has been busy lately but I will be posting again shortly. Thank you for reading!
DeleteDid you have any prior knee surgery besides the initial arthroscopy?
ReplyDeleteHi Diane, thanks for the question. No, I had no other surgeries or injuries. In fact my knees where great right up to the point it started hurting one day.
DeleteQuite an interesting post. Thank you very much for sharing these details here. For my joint pain relief, have been considering getting chiropractic care on suggestion of my mom. Will visit a reputed chiropractor in Mississauga for treatment.
ReplyDeleteThanks Rebecca. I didn't try many options before jumping into ACI. I'm curious to see how a chiropractor works out for you. Hopefully it will help!
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