ACL Replacement from playing soccer indoors? One wrong move…
Learned the hard way recently that it’s not necessary to even touch a ball while playing soccer to destroy your ACL otherwise know as your anterior cruciate ligament. The sad part is there is no preparation as this ligament does not stretch or heal. It is, or it isn’t. Here’s a diagram of the knee:
So, a beautiful pass comes across, I wind up and BAM! It was as though time stood still for a second like in The Matrix as I felt a twist that was so unnatural, I fully expected to see my leg out to the side at a right angle. When the leg planted, you hear “pop, pop, pop” so loud that people 15 feet away said “Don’t Move!”.
Thankfully, I was surrounded by nice people who grabbed ice and helped me to the car. Quick trip to the emergency room yields the following: meniscus tear, piece of the patella broken off, possible LCL damaged and possible ACL damage. DAMN IT! One more problem- I cannot extend the leg fully.. for months. Finally broke down and requested an MRI after three months of working hard to rehab something that should not be rehabbed. MRI reveals the meniscus tear actually flipped and was acting as a door stop. Well, that explains the inability to extend the leg. It also shows a frayed ACL, fluid everywhere along with the separated piece of meniscus which is quite fascinating to look at.
Fast forward two weeks. The big day arrives and doc is going in to fix the meniscus by shaving the rough edges and removing the bad piece. While there, he finds that my ACL is like tissue paper and replaces it with a cadaver’s adding later that it had snapped off the femur. So, I had been walking around for months without an ACL. I wake up dizzy but am surrounded by very friendly nurses and my wife. Doc is onto the next case but has briefed the Mrs. on the situation. Says it went well, the nerve block worked and not to play superhero by not taking the meds prescribed. Problem is they make me dizzy, but after that passes, I pass out. Good thing. They say it’s weight bearing from the beginning as long as I’m wearing the immobilizing brace. A quick check of my leg shows bandages covered by some contraption that circulates ice water around the knee and should work very well, an ace bandage and the aforementioned immobilizing brace. No showers for 48 hours, stay off the damn leg but move about somewhat to keep from clotting, meds, meds and more meds, ice water, compression stockings to ward off clots, elevate leg, and watch for increased pain on second day. It’s 3am right now, so I am expecting to wake in pain. We’ll see and update this account, I shall! You’re going to need a good deal of physical assistance unless you are exceptionally strong. Simple things like using the toilet require time to undo your brace, prop your leg up on a stool, etc. Having someone with you for the first few days will be a blessing as you cannot carry items easily while using crutches. Keep a supply of water nearby, your pills, tissues, a garbage can, remotes and your phone.
Day 2: woke several times last night due to movements while sleeping causing sharp pains. The meds were a blessing as only one pill allowed me to sleep for a few hours at a clip. As the nerve block began to wear off, two pills were necessary. Needless to say, I was out cold rather quickly. Thank goodness for this fine, yet simple piece of machinery called a DonJoy Iceman.
The ice really does become your friend. Onto the experience. You’d swear your leg has a 100lb weight strapped to it, but it doesn’t.. The pain varies from mildly uncomfortable to intense. Again, take the meds as instructed. Slept more earlier in the day and the time seemed to pass a little easier with the leg elevated. The rule of thumb seems to be that your leg is roughly a foot higher than your chest. Lying on your back, all this requires is a few pillows. Finally spoke to the doc today. He says that the ACL was ripped off the Femur, so I was running around without one for months. Unreal! No wonder I couldn’t fix the damn thing!
Day 3: had trouble sleeping last night early on as a weird phenomenon occurred. It was as though someone was prodding my leg with an electrode with the speed of a lightning storm. It was unbearable at a few points and even extended to the other leg. I’m guessing the tissues may be reconnecting and/or referred pain is the culprit. The result was spasming that shook my whole body out of sleep and that was after taking two percocets. Loosened the brace, massaged the leg and eventually slept soundly for a good 7 hours. Best sleep since surgery. While I tried to do some rehab work on days one and two, it was largely unsuccessful. Leg lift attempts felt like some foreign exercise I had never done as the sensation and feedback from your knee are in another language… and unless you’ve already had ACL replacement, feel unimaginable. Today was the first day that some of that feedback subsided but new experiences were there to confound me further. Having been unable to extend my leg fully for four months meant there was a kind of dead spot when attempting to activate muscles that couldn’t be fully utilized prior. What I’m saying here is be patient. The first steps are the most difficult and I had to reiterate this a few times today. The brace that was provided limits mobility laterally, so it’s very unnatural. It makes me feel like if the brace were off, I would not be able to support my leg. Not sure if this is true, but just three days ago, it was very strong, so I doubt it. Will advise on this in a few days. Standing today without meds produces a sensation that is nearly indescribable but I’ll try. Since your leg has been elevated most of the time, just the act of bringing it down to the floor produces a rush of blood that is tremendous. All of the surgery access points will immediately become apparent as they scream for a few seconds. Then, it goes away in a flash until you put some weight on the foot. It returns slightly and what you’ll find is that bearing weight is a lot more pleasant that switching positions. I dread getting up after resting, but have no problem hobbling about the house on crutches. In fact, it feels good. Until this point, cleaning with a wash cloth in front of the sink is advisable as you don’t want to get the bandages wet. If you’re like me, going two days without a shower is a real problem. Plus, the pain makes you sweat uncontrollably at times. Time to pull out a garbage bag, the medical tape and have a nice warm shower. Get something to sit on that is very sturdy and not slippery. One fall in the shower could put you back in the operating room. In fact, if you have a tub, not a shower stall, I’d skip it. Too much risk and a wash cloth will get you just as clean!!
Days 4 and 5 were a blur.
Day 6, we removed the bandages and did some cleaning. Regardless of my pain level, I did as many leg lifts as possible though there wasn’t much flexion in the knee yet, full extension was excellent. Flexion is essentially the bend in your knee in degrees. The knee was so swollen that upon trying to bend it, the feeling of intense pressure internally was evident and really held me back. So, continually massaging the area, it eventually allowed for near 60 degree flexion. One thing I have noticed is that upon bending the knee, on the LCL side, it seems to get stuck when bending at about 20 degree angle. When I pass this point, I hear a click that is audible.
Day 8: Met with the doc for my first follow-up. Feels like it’s been inflated to 80psi like a truck tire. Doc says it looks great, asks a few questions, then pulls out this incredible set of pictures of the actual inside of my knee. Amazing! Here we can see how the ACL had been snapped off the femur, the damage to the LCL and the back of my kneecap which needed some cleaning. The meniscus also needed repair. For the life of me, I still cannot figure out how this much damage can happen from one wrong move. Here, the doc provides me with tips and gives the rehabilitation orders for physical therapy.
Day 10: I walk for the first time without crutches. This was like the first time you were able to ride a bike and were wobbly but were pedaling away without falling. It was truly like a new experience. The leg feels weak from all that immobilization but I am determined to get it back into shape. Each day, several times at the very least, I have been doing all of the exercises specified. Despite this, the leg still looks atrophied and I fear it will be some time before it looks or moves like it once did.
Between day 10 and today, the progress has been steady and marked by less pain, easier movement and regaining that sense of independence. Counting on others for every thing is really difficult if you are an independent person. Hopefully, you have someone patient and caring that will be providing a hand for it’s essential.