What to expect with a torn ACL & MCL

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What to expect with a torn ACL & MCL
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flag MilkweedSeed
Posted: Oct 6, 2014 at 20:47 Quote
So... I tore my ACL & MCL on Sept 12th and have surgery scheduled for Oct 31st. I am going with a hamstring graft on the ACL, the MCL is not being touched, as far as I know. Doing physical therapy 3 times a week, still cannot walk on it without crutches and it's still extremely painful, and swollen, even after 3 weeks. I was told I will need crutches for 6-8 weeks after the surgery. Seems long to me? What else should I expect as far as a timeline, pain, when I can ride again, etc.....? I understand each injury is different and every person heals differently, just looking for a reasonable guesstimate, and for any advice or unexpected hurdles, from those who have gone through it?
Thanks
flag highseat
O+
Posted: Oct 8, 2014 at 11:48 Quote
Hey I had that same surgery this year, I am on month 5 of recovery. You will be doing physio starting just a few days after surgery, listen to your physio, it is so important. It starts off small like just flexing your quad muscle while lying in bed, to full weight training. I was on crutches for about 2 weeks, then just one crutch for about 6 weeks. The first week was very painful, I was on painkillers the whole time, but then I only took them for sleeping for a couple days after that, I was worried about that too, but it wasn't so bad. Unexpected hurdles would be how much the rest of your body suffers, you lose tons of strength in both legs and your balance. When you start walking again your back and hips will hurt, it all comes back in time, but you have to stick with your physio religiously. For me the experience has actually been great, I was covered by insurance so I had a paid summer vacation, got into some new hobbies like kayaking, photography, did tons of camping this year, lots of days drinking beer by the river. I use to be a dh, dirt jump guy, but lately I have done a shit ton of xc and am in probaly the best cardio shape of my life right now. Cycling is a huge part of the recover too, you start off on an exercise bike a few days after surgery, then you can road bike when you can walk, I started riding some single track at month 4 and now I am starting to ride some jump trails with a knee brace. The thing about month 5 is your knee feels 100% but it still not fully healed so you just have to be really cautious because the chance of re injury is really high around that time. So hope this helps, but the number one thing is get a good physiotherapist and do everything he says.
flag MilkweedSeed
Posted: Oct 8, 2014 at 16:55 Quote
That helps, thank you.
And I can kiss skiing and bow hunting good by this year too. At least I can watch my kids Swimming meets and Hockey games....
Would still like to hear from anyone else who has gone through it...
flag t3rry
Mod
Posted: Nov 1, 2014 at 1:51 Quote
Hey man, I tore my ACL, sprained the MCL, destroyed the menscisus and the cartilage and the end of my joints look like a hundred toothpick points. It was terrible as I had a brand new dh bike that I hadn't ridden yet (and didnt get to ride for a year). The initial injury was excruciating pain, and I continued to use crutches or a cane for the first 3 months. I had such a bad limp that physio told me that if I didnt, I would do a lot of damage to my hips and back. I luckily got one of the best orthos in canada who deals with olympians and the nhl.

I had 2 surgeries, one to repair the meniscus, shave off the stumps of the acl\s and cauterize about 20 bleeding spots. I had to wait 5 months for this surgery. I didnt get into the ortho until 2 months after the injury and by that time I had lost so much muscle mass due to the extent of the injury that he couldn't in good mind perform any surgery. I did 3 months of physio to build up muscle mass, then I went in for surgery. I used crutches for 2 days afterwards, then went to a cane for another couple days, then walked fine. Well it hurt alot, but I wasn't limping badly and I could maybe only walk 5 minutes at a time. I was off work for that one for about 6 weeks. More so because my knee put me at risk in my work place, and not because I couldn't work. Physio started day one at home, and weekly appointments with a physiotherapist as well.

3 months later I had the second surgery after another 3 months of physio, where they take the hamstring, drill two holes through the bones, string the hamstring through and anchor it in place with screws. It also involved a lot more cauterization of bleeding spots (note I still have swelling due to permanent damage and bleeding). This one, I was off crutchs in a day, a cane used for long distances for the next couple weeks, short distances were fine. Lots of pain as well when walking. I was off work for 15 weeks, again due to work place risk. Physio at home started 4 times a day, and weekly appointments for about 6 weeks, at which point I had gained enough muscle that they said I was good to go to the gym and start using weights. After a couple months at that I was able to max out most of the leg machines (pre injury I had crazy leg/hip strength)

Between the date of injury and getting back to work full time was 10.5 months. I continued to do physio at home for quite a while after that, and had follow up appointments with the ortho for 2 years to make sure everything was continuing to heal. I was allowed to start 'safe' trail riding within 3 months of the final surgery, was allowed to return to the skate park within 5 months, and downhill within 7 months - though I was told no racing, or going full out until the next summer, so about 18 months after the final surgery. It's been 27 months now, and i still have occaisional pain. Twisting my knee wrong can cause pain, and sometimes the weather or over use still causes some pain. I'm told it's only a matter of time before I get some pretty serious arthritis in it, however at my age I would be way to young to even qualify for a knee replacement, so I'm looking forward to a good number of years with chronic pain down the road.

As it is, I am back to a normal life, normal sporting. I didnt return to racing, but that was more a schedule thing then anything. The only thing I havent gone back to is skiing, too much potential for twisting knees there.

I find it odd that he says youre going to be on crutches for that long. My ortho and the physio people made it clear that crutches should only be a 1-2 day thing after the surgeries, otherwise they said I would quickly lose muscle mass, and will completely screw over the healing process.

Pain management - they gave me bags full of percocets, I still have 90% of them. Nothing was really severe after the surgeries, more just chronic and annoying. Ibuprofen was a better fix.

So in total
2 surgeries
5.5 months lost of work time
4-5 months of weekly physio appointments
12 months til back on bike cautiously (besides cruising around town)
18 months (mostly due to seasonal snow) til I could go full out at DH
24 months until knee finally was pain free on a regular basis

Things to buy for maximal physio ( I bought all this shit and definitely benefited a tonne), also invest in whatever strength bands the physio people have you use, you can modify or do most of the same exercises at home. I also cycled indoors a lot on a trainer hooked up to my DH bike.

Balance - one of the big aspects of physio for acl injuries
photo

Cryo-cuff - helps a lot with swelling, used multiple times a day before and after surgeries and incorporated into all physio. Buy a used one on ebay for around a $100. The physio therapist told me it would be the single best investment I could make in my knee and it totally was.
Unsecure image, only https images allowed: http://www.ptunited.com/images/11-1557%20knee_L.jpg
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This is what the ball of my joint looks like now

why the f*ck you shoudn t skateboard. This is what the end of my knee joint looks like... instead of smooth


Every single one of those black spots was a cauterization point in one of the surgeries..
why the f*ck you don t skateboard All the black shit you see is bleeders that had to be cauterized... at least 50 of the suckers
flag MilkweedSeed
Posted: Nov 1, 2014 at 7:11 Quote
Hello & Thanks for the reply! Lots of great info there, but man you really destroyed your leg by the sounds of it?

I had my surgery yesterday, my doctor did a hamstring graft, and I think trimmed up a lot of the MCL. Just glad I didn't have the cadaver graft on Halloween no lessBatman I just woke up when my Doctor came to visit me, so I really don't know what went on, but the procedure took much longer than expected, I assume it was the MCL clean up. I see him on Monday first thing. He is also a leading orthopedic surgeon in northern NJ / NYC area.

I have been doing PT since a week after the injury (6 weeks). That was hard work especially doing the heal slides, the pain was awful. My therapist said that since the ACL was completely cut, the pain was from the MCL. Today/this morning the MCL doesn't seem to hurt, 1st time in 7 weeks8:-). I am looking forward to continuing the PT, and would also like to start hitting the gym again, to do upper body workouts. Probably could of been at it already but rather play it safe.

I think I was miss informed on the whole 6-8 weeks crutches deal, sounds like 1-2 weeks according to my PT. But will play it by my pain and progress.

The Cryo-cuff and CPM machine are being delivered today. I think the pharmacy dropped the ball on that.... Was supposed to be using it by now. I am dreading giving myself shots in the gut for the blood thinners. Needles just don't excite me. It took them 3 tries to find a vein for my IV yesterday morning. Would of rather smash my thumb with a hammer, than get a needle.

Glad to hear you are recovering nicely and thank you again for your response.
CheersBeer Salute

On another note (being this is a Canadian site and all) as I sit in bed and miss my younger sons Hockey game for the 1st time this morning, he scored 4 goals and 7 assistsBig Grin . Last week he got 7goals and 2 assists!!! The little hockey head is on firetup
flag MilkweedSeed
Posted: Nov 1, 2014 at 10:29 Quote
I spoke way to soon.... The block has now worn off and I am back to sever pain againDead Horse Madder Really Mad
flag t3rry
Mod
Posted: Nov 1, 2014 at 13:27 Quote
Sucks youre in stuck bed, I think I was hanging out with friends by the second or 3rd day. My post surgery pain wasn't too bad though, and the doctor and physio dude made it clear I was only allowed to use my crutches for like 1-3 day afterwards. Maybe has something to do with your injured mcl? Mine had mostly healed by the time I got around to the first surgery and the surgeon didnt need to clean anything on it.

Also blood thinners? Shots? Crazy!
flag MilkweedSeed
Posted: Nov 2, 2014 at 10:05 Quote
The blood thinner shots aren't bad. The whole leg feels like it is in a vise being beaten with a maul. The pain is from my upper leg down to my toes, with the most intense pain in the knee. Popping Percocet like they're m&ms, it is a lot more painful than I had anticipated.
flag highseat
O+
Posted: Nov 2, 2014 at 11:29 Quote
Oh that sucks hopefully the pain passes soon. Ya I was on one crutch for about 6 weeks. It was explained to me that I could have developed bad walking habits if I was off them too soon. I didn't lose the crutch untill I was able to walk 100% correctly. I guess each physiotherapist has there own approach. I was on the exercise bike straight away though. Everything worked out fine, I am back riding and first day back to work after almost a year tomorrow. Best of luck to you.
flag reechard
Posted: Nov 22, 2014 at 16:21 Quote
Not much more I can add that hasn't been said.
I tore my acl, pcl and mcl and dislocated my kneecap.
Had a metal plate and screws put in too.

Just take your time with recovery, don't rush to get back on the bike or doing other activities.
The physio knows what they are doing so listen to their advice.

When you are allowed to ride don't push it straight away, take it steady.

I originally only stretched my ligaments but 10 years on I'm still having issues because being young and foolish I tried to do things too soon and reinjured my knee.
I will never ski or snowboard, running is virtually ruled out. All because I didn't listen and rushed my recovery the first time.
flag t3rry
Mod
Posted: Nov 24, 2014 at 19:33 Quote
hows it going? I fell in the snow trying to grab my dog on friday and my knee has been killing me since. I know the ligaments are fine, it's not that kind of pain. But if I fall or twist my knee too much it gets really painful for a few weeks. Sucks. Think it has to do with the fact that it takes next to nothing to make it swell from all the damage. I kinda wish they would just invent a bionic knee.
flag MilkweedSeed
Posted: Nov 26, 2014 at 20:59 Quote
That totally sucks, I hope you feel better quickly!!! So I guess I have to look forward to more swelling as time goes by? I won't tell you to be careful... I am so sick of people saying that to me! Like they have a clue of how painful it is? (Sorry had to vent:-). Are you using the Cryo Cuff for the swelling?
I got one and like it a lot, Thanks for recommending it. My surgeon wrote a script for it as well as the CPM and some numbing cream. My crappy insurance denied all three. Paid $20/day plus $150 set up fee for CPM and bought a Cryo-Cuff for $100.
I actually fell last Wednesday also, pulled my donor Hamstring and my already severely torn MCL. Had an MRI again today and will get the results on Monday. My doctor wants to make sure the graft is fine. The X-rays look good, but it would suck to do three months of PT, then find out the graft was shot the whole time.
Regardless of the fall, still in a lot of pain most of the time. Not eating nearly as much Percocets, pretty much immune to them now anyway. Glad I'm not shooting blood thinners in my belly anymore too! Sleeping is impossible if I get 3 hours straight I'm lucky. I have to sleep with the post OP brace because of the MCL and wear it for at least 6 more weeks during the day.
Friday will be 11 weeks since the injury and 4 weeks since the surgery. Getting pretty irritated not being able to play, at least it's Hockey season, so there is something to watch on TV.
Take care and feel better.
flag MilkweedSeed
Posted: Nov 26, 2014 at 21:13 Quote
reechard wrote:
Not much more I can add that hasn't been said.
I tore my acl, pcl and mcl and dislocated my kneecap.
Had a metal plate and screws put in too.

Just take your time with recovery, don't rush to get back on the bike or doing other activities.
The physio knows what they are doing so listen to their advice.

When you are allowed to ride don't push it straight away, take it steady.

I originally only stretched my ligaments but 10 years on I'm still having issues because being young and foolish I tried to do things too soon and reinjured my knee.
I will never ski or snowboard, running is virtually ruled out. All because I didn't listen and rushed my recovery the first time.

That sucks! Thank you for the advice. On my way to the MRI today it was snowing pretty good and I went to call my wife all excited, then realized I can't ski on itMadder I am dying to ride, caught myself drooling at the bike the other day. My left leg is getting thin compared to the right leg except for the intense swelling on the knee still.

My boys are 13 &7 and thankfully exceptional athletes for their age, it is so hard not to play with them and sit back and watch. They forget I'm a gimp and get a little rough around me, but what the hell, boys will be boys.
flag t3rry
Mod
Posted: Dec 14, 2014 at 9:57 Quote
my knee is just started to get better now after the dog incident last month. Still sore after sitting for prolonged periods, however it's good to walk on. How's yours coming along.
flag MilkweedSeed
Posted: Dec 16, 2014 at 7:07 Quote
Glad you are getting better. Totally sux it's taking so long...
Just had my 6 week post op visit yesterday, they are pleased but stressed the importance of taking it easy. Especially since I slipped, they are all over me to be careful. The MCL is still very painful, and I learned they had to go past it to harvest the Hamstring. So as the doctor put it, it went through 3 incidents recently. Best of all is no more TED stockings! But still have to wear the brace for a while (MCL). Riding exercise bike more and more at PT:-)
Thanks for asking.
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