11 Months Post Op

This month I've been focusing on hip strength as recommended by my physical therapist.  I've been doing the exercises he recommended 3-4 times a week in addition to my normal workout routine.  I noticed my hip muscles were a little sore the first couple of days so the exercises were apparently working something.

I had another appointment with my physical therapist after doing the hip exercises for about a month.  He did some various strength tests and said my hip strength was pretty could and he couldn't tell the difference between my right and left leg.  So that was good news.  However, I still have a noticeable difference in quad strength between my right and left leg.  He suggested I start trying to run using the alter G treadmill to build confidence in my leg.  The alter G treadmill is a special treadmill that lifts you up to allow partial weight bearing.  I used this early on in my recovery to transition to walking.  I'm a little nervous about starting a running program.

With this machine, you zip yourself into special "shorts" that are
attached to the machine.  Then the machine calibrates after it's
turn on.  You can then set the percentage of body weight that
you want to exercise with and the machine lifts you up
accordingly.  Science...it's cool.

I'm not sure my leg is ready.  When I voiced this concern to my PT, he said it shouldn't hurt the graft at this point especially when starting in the alter G.  He suggested starting at 50% of my body weight then slowly working up to more of my body weight over the next month.  According to my protocol, the graft should be strong enough to withstand light jogging at this point.  So I'll give it try this next month and see how it goes.

Stairs are becoming easier.  I don't have any trouble going down stairs.  I still have a little trouble going up stairs.  But I can walk up stairs now without limping or using the handrail.  I just have to focus on flexing my quad and keeping my knee in correct alignment as I push off.

I'm still unable to hop on one leg or do a one leg squat.  I have been doing one leg squats using my arms to help but I really struggle with this still.
  

10 Months Post Op

As I sit to write this post I realize there's not been much difference in my knee between 9 and 10 months.  I am continuing to workout regularly to build my strength back and I am now on my 4th physical therapist.

I've started to see a new physical therapist.  I'm hoping a different set of eyes might help with some of the weakness issues I've been having.  Though he is not familiar with ACI I hope that he can still give me some good advice by relying on his overall expertise.  I've seen him once so far and he suggested I try some new exercises focusing on my hip strength.  My knee is still unstable going up stairs.  It sort of wobbles left and right.  He said this is because I have weak hips and strengthening them will help to keep my knee in alignment. So I've been adding his suggested exercises into my workout routine for the last 10 days now. For the first couple I days I had soreness in my hip area so I know the exercises are doing something. Here's a sample of some of the new exercises:

This one hurts and I can barely do 3x sets of 10 without
holding on to something

The side-stepping and lateral step downs really bother my knee.  I feel pain in the graft site when doing these exercises.  However, I'm going to continue doing them as long as it doesn't get worse.  I think at this point the graft should be strong enough to with stand the pressure from these exercises.  My protocol had me doing lateral steps downs at month 3.  I avoided doing them because they hurt and I was worried I was damaging something.  But at this point I'm going to work through it and hopefully find my pain will decrease as I get stronger.

I also have pain with this one

As I look back on the rehab protocol I was given after surgery, I believe it was way too optimistic.  In my case, I haven't been able to meet most of the pre-set goals on-time.  Here is a list of the goals for my rehab protocol and how I've fared at each juncture:

Goal at 2 weeks:  Pain/effusion control; Good quad control

I would say I met this goal.  By 2 weeks my pain was under control and I was able to do a quad set so my quad was firing.  I still couldn't really lift my leg but at least the muscle was working.

Goal at 4 weeks:  Range of Motion 0-40 degrees

Doesn't hurt at all!

I believe I met this goal as well.  I was doing 40 degrees fairly easily in the CPM after the first month.

Goal at 6 weeks:  Range of Motion 0-90 degrees

I also met this goal but I really struggled to do 90 degrees on the CPM.  After 6 weeks I discontinued the CPM and found my range of motion came back quicker when I manually bent my leg by trying to sit back on my heels.

Goal at 8 weeks:  Range of Motion 0-120 degrees; No effusion

I definitely didn't meet this goal.  I was only around 100-110 degrees after 2 months.  I was

Doesn't hurt at all!

also still very swollen so I think it's totally unrealistic to say no effusion at 8 weeks.  I had swelling for about 5 months.

Goal at 10 weeks:  Full Range of Motion

Nope.  It took me about 3 months to achieve full range of motion and I had stiffness for another 3 months after that.

Goal at 12 weeks:  Normal Gait

I suppose I did meet this one but my walking was pretty slow.  I really didn't feel totally comfortable walking around until 4 months.

Goal at 6 months:  Thigh girth equal bilaterally

Nope.  My thighs are still uneven though I've noticed a slow increase in definition.

Goal at 9 months:  Walk 2 miles at 15 min/mile pace

Nope:  I was doing around 17:00 min/mile pace at this point.

Goal at 12 months:  Run 2 miles on treadmill at comfortable pace

Hell no.  Though I'm only at month 10 there's no way I can  foresee being able to do this at 12 months.

It is somewhat frustrating not being able to run when my rehab protocol says I should be able to.  However, I've learned to take it with a grain of salt and realize the protocol I was given is generic and people have different success rates.  Most of the people I've interacted with on the blog say it takes 18 months to really feel "normal."  If that's the case, I'm a little over half way then.  

Over the next two months I plan to keep working on my strength and walking faster on the treadmill. I also want to see my surgeon at 12 months and hopefully get an MRI.  I'm hoping an MRI can tell me if the graft is healthy.