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  1. #1
    Join Date
    Sep. 7, 2006
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    Default Starting PT for ACL in a couple days!

    Eek! Kind of excited to start working on getting back to normal, and kind of terrified because I've heard horror stories about PT for ACL reconstructions. I still can't straighten my leg (it HURTS!), so I'm a little worried they're going to tell me I'm not where I should be.

    Anyone been through ACL PT? Tips or tricks or warnings?



  2. #2
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    Apr. 25, 2004
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    Lexington, KY
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    Default

    As someone that had everything possible go wrong after my PCL & PLC surgery...you'll be fine

    Are you on a CPM machine? If so make sure your brace is unlocked. Don't wait too long between on and off times. When I left the hospital to when I got home was about 4 hours off the machine...HOLY GOD did that hurt when my knee had to bend again, I burst into tears when it started moving.

    Use your pain pump instead of medication if you can. I have a VERY sensitive stomach thanks to all my surgeries & pain meds. I didn't use my pain pump enough, looking back I wish I had. Make sure to depress it slowly, my mom pushed it down fast and that hurts like hell too.

    Enjoy the time laying in bed, I know it sucks and I always felt like I was getting back sores....I had only been laying a 1/2 an hour when I said that to my mom Use the cryo cuff ice machine as much as you can, I had a knee that looked like a basketball. Yes our surgeries are very different but still it's nice to not have a basketball shaped knee......I'm not kidding about the basketball. If I wasn't in so much pain I would have wanted pictures but I was one angry patient.

    Mostly GOOD LUCK! Do your exercises that your PT recommends, but let them know when it hurts or when you can't do something. Ice is your friend after PT So is a cookie & Drink from Starbucks after a grueling PT session.
    "The horse you get off f is not the same horse you got on. It is your job as a rider to ensure that as often as possible, the change is for the better" - unknown author



  3. #3
    Join Date
    Jun. 19, 2005
    Location
    Poulsbo, WA
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    Default

    I had mine done twenty years ago and regret that I did not follow through PT back then. It was painful at first but with lots of drugs I made it through. If I had known that it was ok to take four ibuprofen, I would have gobble them up so that I could get through the therapies.

    One thing that did NOT help me was to get the brace that you see football players wear...it kept on slipping down to the point that I had to discard it altogether.

    Riding at first was hard- every little jerky movement was painful that I had to find a way to keep my knee from being jerked around. You will find that you'll do everything a bit differently - doing everything to be sure that your leg does not hurt.
    Will get a dream horse!
    More riding, swimming, and rowing, less posting



  4. #4
    Join Date
    Feb. 14, 2003
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    Windward Farm, Washougal, WA- our work in progress, our money pit, our home!
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    Default

    Rehab hurts. No way to sugar coat that. I've rehabbed an ACL and it was hard. Take pain meds, and stay ahead of the pain, don't wait for it to hurt. Those last few degrees of movement to "straight" were agony. I had scar tissue from a previous knee arthroscopy that had to be broken free before my knee would flatten, and that was .

    Good luck! Do all your PT and you'll be back in the saddle before you know it. I took 3 months from injury to riding, and I was a bit conservative.
    Proud member of the "Don't rush to kill wildlife" clique!



  5. #5
    Join Date
    Sep. 7, 2006
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    WNY
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    Default

    Thanks for the input, guys! My injury happened on May 20, and I had the surgery on July 29. The surgeon wanted to wait until it healed to start PT (although he's had me working on straightening it all along). I've been on my horse the past couple days, but it's rough. Oh well... I've waited long enough! On the bright side, my broken leg is healed and pretty solid now, so I have a good leg.



  6. #6
    Join Date
    Apr. 13, 2006
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    921

    Default

    Few cross over considerations estimating you are about 6 weeks out...

    NO stirrups for at least 6 more weeks, especially if you are one to actively point your toes forward.

    NO Heels down, period, ever....It decreases your calf function and now more than ever you need your calf to help stabilize your knee.

    Focused strengthening on the hammies, hip abductors and soleus.

    Work right leg separate from left.

    There are a bunch of closed chain activities you rehab professional will go over with you.

    Regards,
    Medical Mike
    equestrian medical researcher
    www.equicision.com



  7. #7
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    Sep. 7, 2006
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    Default

    Thanks, Mike! Eeek, no stirrups? My horse is a cross between a pogo stick and a freight train! I'm thinking about bringing some photos of me riding so the PT understand what I need to be able to do--is that a good idea or will I look like a nutcase?



  8. #8
    Join Date
    Sep. 7, 2009
    Location
    Lexington, KY
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    Default

    Agree with poster. Rehab hurts. But make sure you go every time you are scheduled and do your exercises at home. It took me about 2 months to fully straighten my knee. Four years later, it's almost as good as new, but I'm very careful about jumping down from any height. It does ache when the weather changes.

    I started PT a week after surgery. Sports Medicine doctor...they get you up and out . I wasn't released to ride for 6 months.

    Pain pump? I got hydrocodone for 2 weeks. Guess I'm just stoic.



  9. #9
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    Sep. 7, 2006
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    Default

    Pain pump? Hah. I spent three days on hydrocodone and that was it. Might take one before PT tomorrow, though.



  10. #10
    Join Date
    Apr. 25, 2004
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    Lexington, KY
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    Default

    My surgery was a little more than the ACL surgery which is why I commented on the pain pump. I used it because as soon as I took the LorTab's & Percs I would get my stomach churing and then vomit. That was my 7th surgery so at that point pain meds had already done a number on my stomach. I was on a good dose of morphine at the hospital once my full leg nerve block wore off. Sounds strange to say, I wish I had an ACL surgery, but no the horse had to blow the PCL & PLC, 2 ligaments that don't commonly tear.


    I'm surprised that the OP had to wait w/ ACL surgery. I started PT while in the hospital, learning how to walk properly w/ crutches w/ a knee that was the size of a basketball and a full leg brace. After the night in the hospital, I ended up getting light headed and fainting when I was out of the bed, of course.

    I also got my knee bent for my at PT....pillow in the mouth and someone holding me down as I didn't take it lightly. Unfortunately I still have limited ROM, standing I can bend to 90 degrees, sitting 90's or less (painful at 90), on a table 120.
    "The horse you get off f is not the same horse you got on. It is your job as a rider to ensure that as often as possible, the change is for the better" - unknown author



  11. #11
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    I'm not sure why the wait, either, but I trust my ortho's judgment. If nothing else, I know it's well and healed and won't snap like a rubberband when I start working it.. *shudder*



  12. #12
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    Mar. 24, 2004
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    Pottstown, PA (East Coventry)
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    I had ACL surgery 5 years ago. I am also surprised that PT wasn't done immediately after surgery. I had surgery on Thursday and PT Monday AM. On reason I didn't have it on Friday was I had to have drain removed on Friday.

    Lots of ice. Also second other poster that said take pain pills before you need them. Do all of the exercises your physical therapist recommends.

    Medical Mike- why no heels down- ever? I wasn't told that and haven't had any problems.



  13. #13
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    Apr. 13, 2006
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    921

    Default Good questions!

    Amastrike- A clip would be better. If your rehab professional is inexperienced when it comes to the specifics of your sport, PM me as I have a few ideas to throw around.

    To be sure it is not the riding per se that is the problem, it is the what if first, the mechanics second. Grafts always stretch out, question is all the other X factors of riding...horse width, gait, discipline, etc...That combined with the huge lack of knowledge about the sport and how it affects graft life is why your physician and rehab professional are moving slowly.

    SonnysMom-
    When the heel is down below parallel, a bunch of factors kick in which put the lower extremity from hip to foot in a more vulnerable position when it comes to injury. Mot importantly is the loss of calf function. The calf, after ACL surgery becomes an important dynamic stabilizer of the tibia. That function is decreased by the act of either relaxing the calf and letting the heel sink or actively pulling the toes up.

    You could be an exception- Check though a few head on or from behind pictures of you riding. Is the ankle on the surgical side "collapsed" where it look like the foot is turned up/out.

    In standing bare foot, does your foot flatten, knee roll in or hip jut out to the side? Can you perform the same number of single leg heel raises on the right and left side in a straight and bent knee position?

    You can check my website for a little clip I did on the topic

    Regards,
    Medical Mike
    equestrian medical researcher
    www.equicision.com



  14. #14
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    Sep. 7, 2006
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    WNY
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    Default

    Thanks, Mike! I watched the ACL video and the ankle video--very helpful! I'm not sure how to bring a clip in to them.. might be kind of weird to bring my laptop in to the visit, lol. I guess I'll just bring my pictures, and if they want I can pull some videos up on youtube.

    Yikes, I have to go to bed so I can wake up at an obscenely early hour to be tortured.



  15. #15
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    Default

    First PT session went okay. It lasted over two hours . They were pretty nice, especially considering it's their job to hurt me. I have lots of homework and two appointments next week. They gave me the okay to ride--at the walk.



  16. #16
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    Apr. 25, 2004
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    Quote Originally Posted by amastrike View Post
    First PT session went okay. It lasted over two hours . They were pretty nice, especially considering it's their job to hurt me. I have lots of homework and two appointments next week. They gave me the okay to ride--at the walk.
    Yep for the PCL/PLC surgery I had PT 2x a week for 2 hours for at least 2 months.
    "The horse you get off f is not the same horse you got on. It is your job as a rider to ensure that as often as possible, the change is for the better" - unknown author



  17. #17
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    Quote Originally Posted by SmplySweet1021 View Post
    Yep for the PCL/PLC surgery I had PT 2x a week for 2 hours for at least 2 months.
    Eeek! I think sessions typically run about an hour, but since this was the first, it took more time. I certainly hope the rest are shorter .



  18. #18
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    Feb. 14, 2003
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    Windward Farm, Washougal, WA- our work in progress, our money pit, our home!
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    Well, you could join us in the "shoulder section" at my PT joint--I've been there for 7 months now!! Yup--anywhere from daily for an hour for a month, to now, when I go for two days a week, for an hour. I've celebrated weddings, birthdays, and a successful GRE exam so far. I'm shooting for costumes on Halloween...sigh...and candy, lots of candy. So, do your homework, enjoy your PT (you knee people are so much more active than us shoulder folk!) and get better soon!
    Proud member of the "Don't rush to kill wildlife" clique!



  19. #19
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    Jan. 4, 2009
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    513

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    I tore my ACL in 1973 and didn't have surgery until 1987--I was waiting for arthroscopic surgery to be invented! After than, I was just plain afraid to do it.

    By 1987, my knee had been regularly dislocating for ten years (worst pain I ever felt--more so than childbirth), and I finally decided it was time to get it fixed. I had a sublateral release and a bunch of cleanup, and torturous physical therapy for a long, long time afterwards. Since I'd limped for 15 years, I had to learn to walk all over again.

    The physical terrorists were tough on me, but I did it all, alnd here I am 18 years later without another disclocation. The knee functions, and in X-rays my rheumatologist says it looks like a normal knee. It's still bigger than the other one, but now that I have RA they both hurt, but not nearly as much as the one did from the injury.

    I still have to think not to favor the one that was fixed, though. Even all these years later, I don't entirely trust it. Too many times, I'd step off on it and end up on the ground screaming with my kneecap in the wrong place. Even 18 years later without a recurrence, it's hard to stop being gunshy.

    Rebecca



  20. #20
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    Sep. 7, 2006
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    Man, PTs are brutal. My favorite () part is the hang (facedown on the table, mid-thigh down hanging off, relax to the let the knee straighten) for 10 minutes, and hop right down to get on the exercise bike. Ow! As much as it hurts, though, it's amazing how much better I feel by the end. It takes a few minutes on the bike before I'm able to make a full rotation, but by the end, it feels nice and loose.



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