Word of caution : This blog is the summary of my experience with ACL surgery recovery. In no way don't compare it with your recovery . Every body is different and reach out to your physician and Physio to follow the recovery schedule created for you.
Before the injury :
Yes, I started my new life in US with a bang on my knee 😞 . I have been playing Soccer from 1998 ( 20 years) . These 20 years , soccer was my first love and even my wife will get jealous about it. Of all these years, I have gone through lot of ups and downs in the game. Even for the last 1 year or so I have sidelined myself to the as a goal keeper than an outfield player. But whenever i play this beautiful game, i still have the fighting nature within me and i have the same Adrenalin rush in every game. I was thinking that i was getting to the end of my game . But i wanted to still play the game and show it to my son, which i want him to learn from me the way i play it.
I moved to US from the new year 2017 and was happy to find NTPSA offering league for different age categories . I signed up for 30 division for players above 30. I got into a good team called Zurich which was run by passionate coach Joseph. I got pulled in after scrimmage and was happy to chose right back as my position. I always go at the sides and feed the team with crosses and take a shot at the goal when time permits. This is my favorite position.
we started very well and after the fifth game we were on top of the league, come the six game on 26 March the day GOD decided to test me with ACL challenge. Midfield was empty as the usual players were gone and was pulled in to play the midfield on left side . New position and new challenge, i was informed by my coach a week before that he wants to play me that position when the Midfielders are gone out .
You wont believe me, i have watched 100s of video on midfield game , studied on Xavi and was prepared very much for the game. In-fact i did very well in that defensive midfield, defending and rotating the play .
I was so pumped up and after the start of the half time whistle, I went little up to support the attack, there was highball on to my right which i thought to just pass it forward on air and during the leap , i decided to control in the air and do a pass later. i am not sure if these thoughts on me did not bother me to think that i am trying to hyper extend myself to take the ball in air on my furthest right. I was flying up to execute my thoughts , but i felt someone hit my back of the knee with a heavy iron rod and fell on the ground like a bird got shot.
I was holding my knee and was feeling my tibial bone very heavy. I was lying on the floor trying to get my leg in position. I asked the referee did anyone fouled me. The opponents said they did not touch me and I fell on my own. Referee said he heard a pop sound. The opponent player was trying to help me straightening my leg and then came my team mate Matt to hold me and help me to carry out the field. I was only able to limp and my knee felt very heavy. I was certainly unhappy that i cannot play any more and got worried that is this the end of season for me.
I applied the pain reliever spray and wrapped the knee with crepe bandage to give stability to the knee. None of team mate asked me anything and was interested in the ongoing match. I sat there outside to watch the complete match , One of teammate Greg told me to check with Ryan (One of ER guy) in our team . Once the game was over, I asked him to check on my knee . He did the anterior drawer test and said you all good, may be MCL sprain. I was not happy at the way my knee was responding and worried that I tore my ACL.
This was confirmed when Ivisited OS after the weekend, I did not opt to go to emergency or urgent care during the weekend. Doctor did a Lachman test and confirmed that I tore my ACL . He wanted me to do the MRI to understand the further damages and he also gave me knee brace to move around.
I did MRI after a week to let some swelling go down, as a human you always have a hope . I hoped for negative on ACL tear and that was not the case. I had a horizontal tear on medial meniscus ( medial is the side facing the other knee) and cartilage damages (chondromalacia) . I did not ask the doctor if the chondromalacia was pre-existing. I am setting up a appointment with another doctor near my apartment where i will be moving soon.
March 26 , Start of ACL challenge , I am mentally prepared for the Surgery and rehab pain. I have gone through online docs and even saw in the you tube on how the surgery will be done. So I am all prepared. However i want to take some time for the surgery since i got my wife and kid joining only in the month of June 2017 and also i need to shift to new apartment. These all cannot be done if i am going to be in operation theater in next two weeks. ACL challenge, Can I be on the field again to play my passionate game ? Only time and my attitude can tell .
You can see my left knee( the right side one if you are looking at your monitor),this is after exactly 2 weeks, little swelling on top of your knee and reduced quadriceps mass ( you loose lot of muscle after ACL injury or when dislocate your knee) .
21 July 2017 : 07/21/2017
07/21 - I got my ACL reconstructed using cadavers graft. I was well prepared for the surgery , Infact i shaved my left leg and in the process had few scratches. Though the nurse was happy , the doctor was not , as the few scratches can cause infections. my suggestion, Don't be over smart. Anxious about surgery can make you do this stupid things.
Doctor had me prescribed for pain killer 3 days before the surgery. I had 100 pills of Norco . Doctor made arrangements for ice machine , crutches , CPM and braces through his contact.These was delivered in the hospital on the day of surgery.
The ice machine was Breg polar ice cube care and it was 198$ . Insurance does not cover those as they considered this as patience luxury choice of chosing ice machine instead of ice pack.
The surgery process started with myself signing on the knee where the surgery will go through and later signed by the Doctor himself . I could not recall when i was given general anesthesia.
i woke up after 3 hrs with braces and crepe bandage on my left knee . Doctor said i was asking number of questions to him during the process of getting to conscious state .
Then finally when i was fully conscious, one of my friend helped me to drop me in the home. my wife and kid were with me the whole time in the hospital .
One of the main things of the major surgery in knee is that , you need a help for at-least 2 weeks based on how you progress
I was able to raise my left leg without any help after the surgery and i was like, phew , Is that all about the surgery , without knowing that the anesthesia and pain killer injection was still working.
I had the ice machine running all night and as the hours progressed, i started to feel that there is a rock tied to my leg and it increases in weight. I could not raise my leg without help from my hand.
I understood that this will be the case for atleast 2-3 weeks and i am on the toughest phase of the challenge.
25- July - 2017
I had my first doctor appoint the following Monday of my surgery(24 july) , doctor looked at the stitches and declared all good . he helped me with cutting of the cotton bandage which was rolled across stitches. i felt few pounds was lost in my leg. however i was having a pain the lower leg which i thought was due to surgery .
The pain reached to the scale of 10 and saw my calf muscle looking like a balloon and the pain was unbearable in the calf muscle. This were your mental strength comes, you need to get through the pain, the pain wont even subside with pain killers.
I called the doctor office and he asked me to immediately run a doppler on my leg. I had the doppler done on 26 July and was positive for blood clot in the vein ( DVT) . They ran further blood tests and put me on blood thinners for next 4 months.
I was in pain for the next 3 days even with the blood thinners, the pain in the calf muscle started to go down after 4 days and i was bit relieved as i was able to move around with crutches. otherwise it was quiet difficult and the pain due to the clot was very high .
I would like to talk about the DVT , not every one who undergoes ACL surgery can get the clot.
My brother had clot when he did his ACL and so do me. it can run in genes. From what i have read hip surgery have higher percentage of clot occurrence than Knee surgery's. However i had limited motion for initial few days, i think it might have contributed to DVT .
Good news is that i was able to identify the clot immediately, otherwise i would have got a risk of clot getting into lungs if they started moving. My brother identified his clot when it got hit his thigh which is again quiet dangerous as the chance to enter lungs are quiet faster and more . My brother had to go with injections to dissolve the clot. In my case since the clot was found in early stage , I was on blood thinners .
The bad news is that i have to be very careful while on blood thinners as i can get easily bruised and if i bleed , i am at risk of losing more blood.
Two weeks after surgery :
Blood thinners are working fine and finally in the second week i feel less pain in the calf and I am ready for the rehab.
The very first goal of the rehab is to get zero degree extension of the knee, this is vital for all the goodness of getting your new knee back in free range motion.
if you can get your 0 degree extension and continue rehab on building your lost quad muscles , everything will fall in place .
I am almost there with 0 degree extension with my knee extension in the end of two weeks and am able to do few leg raises . You have to be consistent in doing the knee extension exercises as it takes times to get the zero degree extensions due to the pain and swelling.
I have been doing this leg extension and this gets me in the shape for getting into the driver seat of car. I am able to drive, walk with single crutches, do leg raises and have got 90 degree flexion.
The goal is to reach zero degree extension and walk with braces without the support of sticks.
The knee looks swollen and painful since i have been doing rehab. My physio said it is normal for 2 weeks rehab.
Flexion comes in time as you build your quad and hamstring. The focus is on the knee extension .
If i look at between Day 3- Day 8, my knee is way better, i can say i can be independent and does not need some one support to help me in carrying things or do few things . Though i had my wife to support , i was not comfortable in depending on even asking to do a small things. After all they are human beings and they get pissed off with repeated help, probably with my mother i would have been comfortable .
Doctor said I should be good to go for bathing after the first week , Until the first week, i have been kind of washing my face , arm pits and the hip pits( :) , hope you got what i meant) . I was happy to have a bath finally .
Please be careful , you knee is still not stable as you have pain, swelling and weak quad. always wear braces when possible , as anything can happen when your knee is weak. i have to be careful in my bath tub since i am without any support.
There have been crazy things personally to me in first two weeks, but i am happy that i am here and registering my thoughts and experience.
Week - 3 :
It is the end of third week . swelling still remains but not like the week 1. I can walk without sticks slowly but i am still sticking with a single stick on my right . Always remember use the right stick if you injured your left knee , i was using it on the left side but physio corrected me and asked me to hold on the right and checked me for the difference. it is way better.
i am still near the zero degree extension, it is not fluid enough , i have to extend with pressure to get the zero degree. hopefully week 4 can get me there. i have got 103 degree flexion and was able to do cycling slowly with little stiffness in the knee.
every week and every day is an improvement. this is the magic of the body . still running on blood thinners, i am keeping my ice for few min once or twice every day. i can feel my knee is weak but i will get there once i get my extension to zero and building my quad.
the one thing that i need to ask my doctor next week appointment is the numbness feel below the knee near the surgical sutures . probably a nerve is cut-off , this is what i have read on other posts.
i need to get this answers from my surgeon and understand what he thinks of the swelling and my improvements .
One of the advise from my physio is to let the knee hang off while you are sitting. support your ankle and let the knee be hang off so that the gravity takes care of extending the knee. i am getting pain on my quad probably due to the physio on repeatedly tightening my quad to make it active. Physio has been helping me to active it using a little shock machine using tiny electrodes pad on the thigh during knee extension exercise.
Week 4 - 10 :
I did not get much chances to register weekly activities from Week 4 - 10. Let me give a summary of my improvement. Week 4 - 6 was as usual, you feel pain or weird feeling of something inside your knee while walking . This is all about being patient and letting the body heal. I have been regular on my physio every two times a week. I was pumped up and want to give it 3 times , but when i met the doctor in 6th week , he advised me to go for two times in a week.
From week 5 , i was walking without sticks or support . When i say walking, it is not normal, its kind of limp and walk. I was not able to walk more distance. but enough to manage within my house and moving to the car. The feeling of walking without support is great. you will freedom when you can walk without supporting attachment to your knee. I have to be careful while walking ,since any twisting or any wrong movements will spoil the 6 week patience.
The swelling remains moderate and pain keeps coming back when you think you are becoming normal. In my case , Physio and doctor told , my extension is little near to what my right leg has,but not complete. so i have to keep working on extending. The physio therapist Kevin is doing his best. he has not much experience, But he is with you motivating and evaluating you. he used manual force to help in extending . After the manual force the leg extension looks good, but after a days rest it goes short again.
What i have learnt is that , it is about being consistent in physio and working out . You need to be patience to get to your goals. In the mean time my flexion is doing great. By Week 7 ,I was around 130 degree flexion. Currently i can happily move my leg on bed with little ease , that is when you feel relaxed. Because when you are finding difficult to move your leg in bed, then it creates a restlessness.
Week 8, The same story, moderate swelling , little weird feeling when you walk. But i feel the knee is healing. The only thing it is worrying me now is my ability to climb down the stairs. It is been a humongous task for me to climb down the stairs using by left knee. I can see my quads are weak and shaky.
From out side , it looks in shape, but you can feel your quad is weak when you do leg pressing and climbing down or climbing up the stairs. climbing up is fine, but climbing down is where you get painful.
sometimes i doubt myself if i can be back to normal , because of the pain . But it is what it is, we need to start from zero to build your knee which had surgery. you have take it with pinch of salt and move on.
Week 10 , i told my Physio about the difficulty i am having with climbing down the stairs.He gave me the advice that it is all in the brain and building the strength . Brain needs to trained again to believe on your weak knee. You will understand when you train your knee for walking . Getting your natural gait pattern is challenge , at week 10, i am still not normal. I am there, but still needs a lot of training to get my normal gait. Dont worry if you are reading this and having the same issue, It is a long journey. patience and persistence is the key. At the end of week 10, i have gained speed while walking, and getting near to my normal gait pattern. Weakness of the quad, knee and swelling stops you from the progression. But you need to learn to be patience and keep doing the physio .
Physio has been tuning to get my soccer instincts on my knee back, i am doing little tap running on the same place . Not running, but like tap dance with less impact in the knee. since Doctor advised no high impact for next 2 weeks.
Practicing stairs climbing down in my physio and also isometric/balancing exercise to increase stability.
Hopefully i will be able to climb down the stairs without pain soon. That is my next goal.
After bit of research i found that the pain associated with my knee is patella femoral pain . I lost hope with my Physio and doctor as no one answered or helped me to overcome the pain. Every time i climbed down the stairs, the pain left many questions on my future physical activities. whether I will be back to normal again, reading the online forums helps a bit but they scare you a lot . I was getting physiologically down .
I decided to stop writing the blog as i am not making much progress.
I am writing the blog when i am 20 days away to complete by 1 year after my surgery.
20 days to 1 Year after my surgery : This is the first day , i played soccer again for 30 min 3 a side game. This is been after more than a year, the feeling was amazing. I was happy that I am here back atleast on the field. I know I have a lot to improve. My speed need big improvement and still there is a mental fear whenever you decide to tackle and take the ball with you forward. long way to go , but I am on the right track .
After my week 10 , I changed my physio and through the nextdoor app , i got recommendation for another physio little far from my house. But it was a good decision, Physio that i had earlier did not have more experience, he was not going through the root cause of the pain. The new physio was amazing, they understand the problem that my VMO has not build up to track my knee cap . they worked on building the VMO, i love squeezing the ball between the legs and squatting. The have helped me to build my VMO. It took almost 10 months after the surgery to get the confidence that i can climbed down the stairs without pain and with ease. Lessons learnt is that, find a good experienced physio and stick with them, It took 7 months for me to build my quad, vmo and hamstring to get the strength to climb down the stairs and start jogging. I started jogging slowly on my 11 month of recovery. it needs lot of time and patience and this is one of the reason most fear the knee surgery. we are not like athlete who have a dedicated team to help, we are the only ones who supports ourselves . we need lot of time based on the issue you have and needs to work towards to it.
My physios have helped me with lot of care and guidance. Patience and consistency is the key. Whenever i get muscle spasm, i get the dry needling and it has helped me a lot. I also get the bio-freeze massage on the quad and hamstring . During my journey in the seven months, my right knee started giving up. I have to get prescriptions for right knee treatment as well. this was all due to over use of the right knee while climbing down the 40 stairs. With the help of my physios i was able to manage the right knee pain and left knee. I am still working to get the muscle mass on the left leg, i know it is still a hard road and needs more gym time to get the muscle mass. Atleast my knee cap pain is minimal and i can manage the pain on both knees.
Experience has taught me the following
* Stick with Physio who really understands the root cause of the pain and your issue
* Start working on the solution to the issue ( in my case it was vmo, muscle atrophy, muscle spasms)
* Be consistent with the Gym/Physio time, Be Patient, Be Positive that you will be back on your feet and can lead a normal life like other
* Slowly get yourself with physical activities, I started with swimming, kayak, easy hiking, volleyball without jumping ( mostly on the boost role) before i decided to try football for the first time. you need the confidence, Agility ladder in my physio has helped me to get that confidence. But remember, take it slow initially and you will get your pace as the time goes
* Always allocate a time for stretching your muscle, you workout or not, stretching is an essential task like breathing. Thats where Yoga helps a lot.
