ACL injury, dorset, injury, knee injury, pain, physiotherapy, rehabilitation, Uncategorized

Post Op!

It took a little while to get pain under control post surgery. As I mentioned in my first post I’m not the kind of cat that likes to take painkillers any more than the next person! Straight morphine was all that was on the menu via my intravenous catheter & after much declining I gave in. The pain leaving me little option if I wanted to think about much else. I had to have a reasonable amount of that in the end & a little longer stay in recovery listening to one nurse doing her competencies which was an insight into recovery nursing!

The upshot was on returning to the ward I very Britishly informed the nurse I was nauseous. I think she thought I was kidding so was unprepared. She kindly didn’t make the student clean up after realising I most definitely wasn’t kidding.

A few hours later I was comfortable & frankly pleased to be the other side of surgery & back in the game. After an overnight stay, a check xray & the all important stair test with the physio I was off home fully weight-bearing with crutches and my lovely TED stockings back on to prevent DVTs. Sometimes these surgeries are only a day case depending on when in the day your surgery is. My stitches will be snipped in 5-7days , Physiotherapy with someone other than myself will be in about 7 days and a consultant follow up 6 weeks post -op.

So I have a shiny new Anterior cruciate ligament (ACL) courtesy of a graft from my right hamstring (muscle on back of thigh) and the other ligaments are healing by themselves. Whilst there is a little laxity, no further ligament reconstruction was required fortunately. The lack of range and pain at the anteriomedial (front inner) part of my knee was apparently the result of a plica (fold of joint lining) that had been inflamed & stuck to the damaged MCL (medial collateral ligament on the inside of the knee) and not due to getting stuck on the stump of the ruptured ACL. If you want to take a look at the surgery there are some pretty amazing online videos that detail the steps!

The consultant gave me “the look” & insisted that I do actually need to be a patient for 6 weeks. Quite literally I won’t be running before I can walk! Over 15 years of Physiotherapy tells me he is entirely correct….

What I do or don’t do for the next 6 weeks will have a big impact on the quality of my rehabilitation & overall goals of being back to running, kitesurfing, sailing, surfing and maybe skiing!

The key to the next 2 weeks is getting the swelling down and improving range of movement.

These are my tools:

  • Rest & elevation of leg above level of the heart. Optional extras of a decent book/Netflix/box sets.

  • Game ready (www.gameready.co.uk) or cryocuff to ice the knee. This helps to reduce swelling & relieve pain. I’m pretty much using the hourly & have hired it from a local private physio practice that I used to work at. Be careful if icing & limit to 20 mins ensuring skin is going pink & not white – no ice burns required! This unit is great as it also provides some compression which aids reduction in swelling & circulates the iced water through the cuff.
  • Muscle stimulation. My compex unit (www.compex.com) is back out in force to get my quadriceps (thigh) muscles firing which will not only help reduce swelling but will limit muscle atrophy (wasting) and ensure I’m ready to begin using and loading my leg. Ask your local physio about hiring a unit.
  • Pain relief. Keep it regular as this is going to ensure you can maximise the all important exercises to get moving and make sure you get some sleep. I’m currently taking ibuprofen 3x/day & paracetamol 4x/day. This will be directed by your doctor/surgeon & depends on your previous medical history and any allergies. I do have back up of stronger painkillers but haven’t needed them as I’m getting good blanket coverage of any discomfort by taking the simple stuff regularly.
  • Exercises. These will be guided by your surgeon’s rehab protocol & under guidance from your physiotherapist,

1. Focusing on gentle bending and straightening of the leg. My aim is 90 degrees bend ASAP. This range will be really dependent on getting swelling down and keeping pain at bay.

2. Tightening the quadriceps (thigh muscle),

3. Assisted Straight leg raise.

4. Gentle patella mobilisations.

5. Heel hangs. Ensuring I can straighten my knee to what we call “terminal knee extension” as soon as possible is going to be a crucial rehab milestone & help with gait and the ability of my thigh muscle to properly engage going forwards. Heel hangs are really helpful for this.

  • A solid support network. Crucial to functioning on crutches, with a dog & 2 kids! My Mum is exhausted already! The school run rota after half term is a work in progress. Thank you to a lovely bunch of friends & amazing patients alike for all your positive energy & kindness.

So we are in recovery mode. An enforced time to slow down, smell the roses & stare at a familiar sight! Some would call this relaxation ….

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