Athletic Therapist to Patient – My Early Experience with ACL Reconstruction
Ironic that as an Athletic Therapist who primarily rehabilitates patients after surgery and works alongside an Orthopedic Surgeon, I tore my ACL and meniscus and was presented with the option to undergo surgery. The injury occurred in December 2019 while playing indoor soccer. The mechanism of injury was non-contact, with a pivot movement in full knee extension. I suspect I was vulnerable because I returned to competitive sport too soon postpartum without any conditioning. I am now experiencing a journey that I am normally at the other end of and having to be the patient, exposing me to the mental and physical stages of healing at a whole new level.
My Journey thus far:
An Athletic Therapist, Physiatrist and MRI all confirmed a torn ACL and tears in both my medial and lateral meniscus. I regained most of my function after the injury, with the exception of getting into a deep crouch. I also experienced occasional instability episodes (the knee giving out). With my return to most activities of daily living I was still not able to return to sport. While this level of function may be enough for many people, I however love sports and want to return to a competitive level. The sports I enjoy most would be hard to return to with any instability in the knee because of the pivoting required. Not only am I unwilling to modify my activity level but I am a mother to two young boys and I want to be fully engaged in any sport or activity they choose to participate in growing up. With significant support from my husband and work, I decided on the surgical route.
I had a reconstruction of my ACL with a Hamstring/Gracilis graft harvest and a partial meniscectomy (removal) of my lateral meniscus on June 15, 2020. I have committed myself to a minimum of 1 year of rehabilitation and reconditioning to get myself back to an active life and sport.
Post- op rehabilitation can be gruelling. After surgery there is a lot to work on and I discovered that it is important to celebrate your “wins”. I can walk, do a calf raise, walk up and down the stairs, get a proper quad stretch…and the list goes on.
As Dr. Jesse Slade Shantz always says ”the important thing to remember on the day after surgery is that every day is better”.
Here is my timeline from the start of surgery to 9 weeks post-op:
June 15- Surgery
June 15- Weight bearing with crutches
June 16- Start range of motion (ROM) exercises
June 19- Off narcotics
June 22- 1st day of physiotherapy: more ROM exercises, quad activation, weight transfer and calf raises. Down to 1 Crutch
June 24- Off Tylenol- NO MORE MEDS
June 27- No longer need ice for pain management- occasional use for swelling
June 29- New exercises: including mini squats, mini lunges, bridging, hamstring isometrics, single leg balance
June 30- Walking without crutches- use of crutches on uneven terrain or end of day when muscles are fatigued
July 6- Calf pain was almost gone, ROM with flexion improved, swelling has gone down and walking feels more normal
July 7- Follow-Up with Surgeon. Wounds look good and he is happy with the ROM
Another quote of Dr. Jesse Slade Shantz that sticks in my head is that “you can’t rush biology”. As an Athletic Therapist I understand the timelines and aim to reach each goal the fastest. I initially became disappointed when I wasn’t there. I have come to realize however, that I have to let my body guide me, even if that takes a little longer (everyone and every “body” is different). The biggest barriers for me have been extreme calf tightness and being a mom. The calf tightness made it difficult to walk, balance and get a strong quad activation. With two young kids, I found I was on my leg much more than I should be and not taking proper rest. I also found myself in constant protection mode around the kids because of unpredictability. This led to increased swelling, muscle fatigue and tightness.
I am constantly learning. I will share with you what I have learned already.
- There are good and bad days.
- Take advantage of the good days for your strength exercises and on bad days stick to ROM and stretching.
- It is a challenge to activate the VMO even with all the tricks I know.
- Don’t overthink your walking mechanics (GAIT), try to resort to muscle memory.
- I have learned new exercises and adjustments to add to my personal rehab collection.
I will continue to write and share my journey. Feel free to follow me on my Instagram (@cscavo9) to see updates and learn exercises specific to different stages of rehab.
If you have questions about your own injury in rehab and reconditioning please reach out to me and our Acumen Reconditioning team!