Post ACL stretching question

[FallinWoman 1]

Ok...Had the ACL reconstructed 25 days ago. I have had some trouble with swelling and severe lateral pain. Then the pain stopped. So, according to my doc, I could walk as much as I wanted to.
Spent one day walking without crutches. Woke up the next day with incredible CALF muscle pain. Now I am back on crutches not because of knee pain or lack of range of motion, but because my calf muscle hurts so badly!!!

Any brilliant ideas on how to stretch it or to decrease the pain so I can get back to walking??

Thanks!

~Anne

I'm a Doll!!!!

[SBS 0]

I had my ACL done 9 days ago. I was having calf pain before the surgery, but it hasn't really happened since. The doctor said that he thought it was probably caused by fluid from the knee leaking down onto the calf muscle and causing it to spasm, which is normal. Not much to do about it. Is the pain at the top of the calf?

I'm walking around on mine now, but getting tired later in the day. Not too much real pain to speak of, mostly discomfort. It's still another 5 days til they are going to start getting me off the crutches, so I have to take them with me to therapy and pretend I'm still using them.

Anyway, not that I was much help, but it's late and I'm bored.
Good luck

Steve

_____________
I'm not conceited...I'm just realistic about my awesomeness...

[paulcm 0]

Quite a bit of rehab depends on age and whether you had a "donor" graft or an autograft. As far as age, the younger you are, the faster you will rehab. A donor graft generally results in much less swelling and pain, while an autograft typically results in more swelling and longer pain/rehab due to the trauma from taking a slice out of your patellar tendon.

Your doctor should be talking to you about physical therapy. Be sure to do any and all recommended stretching and flexibility exercises. I had full autograft ACL reconstruction (full tear, from playing soccer) on my left knee about 11 years ago, as I turned age 40. One of the PT exercises involved stretching out the calf muscle by putting a towel around the front part of my foot and pulling (while seated). This was done for 30 seconds in 3 sets of 3 reps. Your doctor or PT may suggest something else, but you can lose flexibility in quite a few of the muscles above and below the knee. The towel exercise gets the calf stretched out without putting strain through the knee joint.

I had lots of swelling and a slow & painful rehab, on crutches about 6 weeks. Nowadays, special machines for keeping the knee "iced" and for cycling the knee through range of motion have accelerated rehab, and it sounds like you're moving forward a lot faster. Just be sure to check with your doctor or PT so you don't overdo. Rehab from ACL reconstruction is VERY individualized, with substantial variation in the time required.

I was out of jumping for just over 1 year. I could have jumped a little earlier, but I waited for the "perfect" day as far as wind, etc.

Good luck and speedy recovery to you!

[ltdiver 3]

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A donor graft generally results in much less swelling and pain, while an autograft typically results in more swelling and longer pain/rehab due to the trauma from taking a slice out of your patellar tendon.

While this is still a viable option, and some doctors still elect to do it, IMO the better 'newer' approach to the autograft is to have a hamstring tendon advancement. It keep the patellar tendon (a major force in knee extension strength) untouched.

What they do is take portions of the hamstring tendon (semitendinosis and also gracilis) and bring it forward to attach where your anterior insertions of your ACL should be). A slower rehab, but IMO prevents 1) loss of quad strength (patellar tendon) and 2) better acceptance of tissue...no rejection from donor tissue (cadaver). The surgery starts out being very tight, and the rehab slower, but a better product in the long run.

Quote

Your doctor should be talking to you about physical therapy. Be sure to do any and all recommended stretching and flexibility exercises.

Yep.

Quote

One of the PT exercises involved stretching out the calf muscle by putting a towel around the front part of my foot and pulling (while seated).

Seated -with the leg extended out in front of you on the bed. You have two major muscles in your calf. The Gastrocnemious and the Soleus. The Gastroc is stretched when the knee is extended. The Soleus is stretched when the knee is bent. Both good stretches, just remember which muscle is the one needing stretching.

Quote

Nowadays, special machines for keeping the knee "iced" and for cycling the knee through range of motion have accelerated rehab, and it sounds like you're moving forward a lot faster. Just be sure to check with your doctor or PT so you don't overdo. Rehab from ACL reconstruction is VERY individualized, with substantial variation in the time required.

Very good advice. What do you do for a living? You seem to have a good handle on the medical side of things.
ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[eeneR 3]

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What they do is take portions of the hamstring tendon (semitendinosis and also gracilis) and bring it forward to attach where your anterior insertions of your ACL should be). A slower rehab, but IMO prevents 1) loss of quad strength (patellar tendon) and 2) better acceptance of tissue...no rejection from donor tissue (cadaver). The surgery starts out being very tight, and the rehab slower, but a better product in the long run.

This is what they did for me, and many many moons later knee still feels great.

Now my brother had it done with donor tissue. His recovery is definatly going a bit faster then mine, though I have no complaints about mine. Long run I am curious to see how his knee holds up. I must also point out though I wasnt even legal to drink when I had mine done, so that could have played a part in it.

We shall see, but so far my brother is very very very happy with the progress of his knee and all is going very well.

She is not a "Dumb Blonde" - She is a "Light-Haired Detour Off The Information Superhighway."
eeneR
TF#72, FB#4130, Incauto

[ltdiver 3]

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Now my brother had it done with donor tissue.

I had a teammate of mine from last year who also had this procedure done (donor tissue) and I was amazed how quickly she was up and walking (she is also in the medical field, so had a 'leg-up' on the understanding of what she needed to do...no guessing). I, too, am waiting to see how long her graft lasts. She is an active weekend jumper and plans on being at Nationals this year (8-way).

IMO, the patellar tendon graft (autograft) is a thing of the past. If a surgeon offers this you should seek a second opinion. Even a donor graft (cadaver) is better than that.

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[eeneR 3]

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IMO, the patellar tendon graft (autograft) is a thing of the past. If a surgeon offers this you should seek a second opinion. Even a donor graft (cadaver) is better than that.

Yup, and I had my knee done at Vail Valley Medical Center in Vail, CO back in 93. Back then the docs there did NOT want to use patellar tendon grafts For the exact reasons you stated. No way I wanted to risk weaking anything else direct to my knee.

Every now and again I have issues with weakness, but that is completely unrelated to the surgery. It is cause I am lazy and hadnt worked out in awhile LOL

She is not a "Dumb Blonde" - She is a "Light-Haired Detour Off The Information Superhighway."
eeneR
TF#72, FB#4130, Incauto

[ltdiver 3]

Quote

Yup, and I had my knee done at Vail Valley Medical Center in Vail, CO back in 93. Back then the docs there did NOT want to use patellar tendon grafts For the exact reasons you stated.

Perhaps they had -alot- of experience with all those skiing accidents that pour through their doors each winter? Young people who -still- want to play hard after their knee is healed.
ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[d_squared431 0]

I had my left knee done (complete tear ACL/meniscus/several torn muscle and tendons)2001 by one of the US Ski and Snowboard doc's and he only did patellar tendon graft or grafts from a donor. At that point donor grafts were still pretty new and having a few friends that used donor grafts and they didn't take I went with patellar tendon graft. Worst choice I could have made. My knee has never been the same and I had to stop competing.

Since I had my knee fixed I have had nothing but problems. I know it was because of the patellar tendon graft. My knee crackles so much I have been given WD40 as a joke for xmas a few years back. What is left of my meniscus has to be removed and refuse to have it done at this point. Eight months on crutches was enough for me. I can walk, run and even snowboard with little to no pain. A quick fix to the pain is to have a few beers and some Tylenol.

TPM Sister#130ONTIG#1
I love vodka.I love vodka cause it rhymes with Tuaca~LisaH
You having a clean thought is like billyvance having a clean post.iluvtofly

[skylord 1]

Anne,

I had mine done back at the end of March. What is interesting, and the toughest rehab assignment for me, was learning to balance standing on one leg (the one with the reconstruction). I was told the reason is that the donor ligament was under different tension than my natural one, and so many of the muscles in and around the knee had to learn to keep me balanced again. I had lots of muscle soreness, not just in the calf, but above the knee as well. It went away after a few weeks, but a lot of what your body is doing is subconcious. I also had lots of fluid drainage, too, and that no doubt caused some of my discomfort.

Hope your recovery continues well!!

Bob

Bob Marks

"-when you leave the airplane its all wrong til it goes right, its a whole different mindset, this is why you have system redundancy." Mattaman

[soberamprat 0]

Alittle back ground: Usual 270 lost back raisers landing not pretty with left leg forward right leg rear word left leg lost ACL,PTL Should I expect long recovery and rumor has it they may not fix both ACL and PCL

http://www.swoopstudios.com/videos/videos-rex.php

[SBS 0]

Something that hasn't been mentioned that was done for mine this time, an acheles tendon from a cadavor. They said that they are beefier than the patellar tendons that another doctor was going to use (also from a cadavor).

I was walking after about a week last time, and it's been a week and a half this time and I am walking for the most part. I'm taking the crutches when I go out, for the leg getting tired and mainly for protection. I was back to jumping in 4 months or so, back to feeling completely normal in about a year and a half. This time I'm thinking Bridge Day will be my first jump back, in 3 months...probably land in the water just to be safe.

-S

_____________
I'm not conceited...I'm just realistic about my awesomeness...

[ltdiver 3]

Quote

Alittle back ground: Usual 270 lost back raisers landing not pretty with left leg forward right leg rear word left leg lost ACL,PTL Should I expect long recovery and rumor has it they may not fix both ACL and PCL

Huh?

I -think- what you're trying to ask is that after a botched 270 rear riser landing you pounded in and tore your left leg's PCL -and- ACL. You're asking if this is a long recovery.

Answer: Yes. Will they do -both- ligament repairs? Dunno. Depends on your doctor.

Did I get it right? What do I win?

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[ltdiver 3]

Quote

Something that hasn't been mentioned that was done for mine this time, an acheles tendon from a cadavor.

Very interesting study on Achilles Tendon allografts vs Patellar Tendon allografts.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12734717&dopt=Abstract

Conclusion: Achilles tendon allograft (a graft of tissue obtained from a donor) had a much less failure rate than the Patellar tendon allograft. However, they -both- had a higher failure rate than an autograft (a tissue or an organ grafted into a new position in or on the body of the same individual).

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[FallinWoman 1]

Hi all...I had an autograph from my patellar tendon. My doc preferred the patellar tendon to the hamstring in women because women tend to have weaker hamstrings.
Since the surgery is already completed, the arguments about where the donor material should come from does not help me.

I have seen my PT guy and he has suggested the towel around the foot while seated to loosen the calf muscle. Unfortunately, it is not helping all that much. I am still in a ton of calf pain and relying on the crutches. My knee is not all that sore.

~Anne

I'm a Doll!!!!

[Remster 30]

Quote

I had an autograph from my patellar tendon

Is he famous?


Sorry.. I'm bored! lol

Remster

[FallinWoman 1]

autograph....autograft....whatever...heehee

~Anne

I'm a Doll!!!!

[d_squared431 0]

You are lucky your knee is doing well and all you have is a bit of cramping in your calf muscle. Ask your PT about some stuff called BIOFREEZE. It works great and you can only buy it threw him. I think you can get a few samples from this site.This is the best stuff I have tried. If you can't get any let me know and I will send you some samples that I have.
http://www.biofreeze.com/

TPM Sister#130ONTIG#1
I love vodka.I love vodka cause it rhymes with Tuaca~LisaH
You having a clean thought is like billyvance having a clean post.iluvtofly

[ltdiver 3]

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I am still in a ton of calf pain and relying on the crutches.

Just a quick note (and probably not the cause, but something you -should- look into...talk to your doctor)...calf pain can -also- be caused by a blood clot (Thrombosis). Typically the pain is felt in the calf and won't resolve. This can happen after surgery and hopefully the surgeon had you checked for this before you left the hospital.

The doctor can have you into his office quite quickly if there is a chance of this. He can do a test right there and if positive can schedule a doppler to rule it in or out.

Don't mean to scare you, but something to consider.

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[kelpdiver 2]

Quote

I'm walking around on mine now, but getting tired later in the day. Not too much real pain to speak of, mostly discomfort. It's still another 5 days til they are going to start getting me off the crutches, so I have to take them with me to therapy and pretend I'm still using them.

Don't need to lie to the PT folks- they probably want you off them. Mine called my surgeon to accelerate getting me out of the sling that caused so much collateral damage to the arm.

PT: Did you do your exercises?
KD: yes!
PT: I don't believe you - take this! (OW!)

[soberamprat 0]

Quote

Quote

Alittle back ground: Usual 270 lost back raisers landing not pretty with left leg forward right leg rear word left leg lost ACL,PTL Should I expect long recovery and rumor has it they may not fix both ACL and PCL

Huh?

I -think- what you're trying to ask is that after a botched 270 rear riser landing you pounded in and tore your left leg's PCL -and- ACL. You're asking if this is a long recovery.

Answer: Yes. Will they do -both- ligament repairs? Dunno. Depends on your doctor.

Did I get it right? What do I win?

ltdiver

Right on the money honey. As for what you win we can discuss that later

http://www.swoopstudios.com/videos/videos-rex.php

[skymedic 0]

Quote

Just a quick note (and probably not the cause, but something you -should- look into...talk to your doctor)...calf pain can -also- be caused by a blood clot (Thrombosis). Typically the pain is felt in the calf and won't resolve. This can happen after surgery and hopefully the surgeon had you checked for this before you left the hospital.

The doctor can have you into his office quite quickly if there is a chance of this. He can do a test right there and if positive can schedule a doppler to rule it in or out.

Don't mean to scare you, but something to consider.

Do you know who her husband is???? I know a thing or two about all that jazz. So back to the original questions which hasn't really been answered. any other idea's about how to stretch her calf muscle.

Marc
otherwise known as Mr.Fallinwoman....

[sioux 0]

It's nice to read about others who have recently had ACL reconstruction. I had mine 8 weeks ago. What a nightmare!

I haven't had any problems with my calf muscles, so my only input would be to second the basic stretching like with the towel, or lowering your heel down while standing on a step.
But, given who your husband is, I guess you guys know that much!

I wish you a quick and full recovery. I never had so much appreciation for me knees until April 8th of this year.

I haven't seen such convoluted lines of conversation and such expert chronicling thereof since my days of all day bong marathons in college. ~ Lindercles

[funjumper101 15]

Quote

Quote

A donor graft generally results in much less swelling and pain, while an autograft typically results in more swelling and longer pain/rehab due to the trauma from taking a slice out of your patellar tendon.

While this is still a viable option, and some doctors still elect to do it, IMO the better 'newer' approach to the autograft is to have a hamstring tendon advancement. It keep the patellar tendon (a major force in knee extension strength) untouched.

What they do is take portions of the hamstring tendon (semitendinosis and also gracilis) and bring it forward to attach where your anterior insertions of your ACL should be). A slower rehab, but IMO prevents 1) loss of quad strength (patellar tendon) and 2) better acceptance of tissue...no rejection from donor tissue (cadaver). The surgery starts out being very tight, and the rehab slower, but a better product in the long run.

I had this surgery done in 1990. It worked out well for a while. In 2004 I crashed my motorcycle and hit a solid rock wall head and shoulder first. I injured my knee some too. I'll skip the shoulder stuff... it is off topic.

When they did an MRI on my knee a few days after the accident, the ortho doc came around to discuss the results. The graft had been re-absorbed and was GONE! The doc said that this wasn't that common, but he had read about quite a few people with these results, over the long term.

After the rebuild in 1990, I made the call to quit skiing, racketball, and other sports that beat up my knees badly. I do quad sets every morning as part of my wakeup ritual. I had noticed some instability over the years. I didn't expect that the ACL was gone.

YMMV

[4WayXena 0]

FallinWoman -

You may also be suffering from a bit of calcium deficiency of which a crampy calf muscle is a symptom. If you are not already taking a butt load of calcium everyday to help your body replace the bone your patellar tendon graft took, you should really think about it.

Also, eat a couple of bananas everyday. This could just be a simple case of your muscles and tendons being a bit pissy about the new work their doing and have some issues about potassium and calcium losses.

I also had a patellar graft and haven't had nearly as much issue with it as friends who've had cadaverous grafts or the hamstring grafts. Of course since the surgery I am aware of the tendencies toward patellar tendonitis, so I ice after every run whether I need it or not. And I don't waterski anymore because my knees didn't really like it in the first place.

Keep drinking lots of water, eat bananas and calcium tablets and my personal favorite - ICE, ICE Baby. Keep the ice on to keep the inflammation down.

Hope this helps. Get back in the air soon!