15 Months Post ACL Reconstruction Rehab Issues

[cp1717]

I had a patella tendon autograft 15 months ago. Everything went smooth for 6-7 months when I started having a little swelling and a lot of tightness after lots of travelling. The swelling went down but tightness has remained for the last 7-8 months on the front of my knee. I was able to fight through it and re-gain significant quad/hamstring strength as well as strong hips, but the tightness remains. It feels like my patella tendon is the cause because all aches and tightness are right below my kneecap. Crawling on it is still quite tender and there is a little minor clicking/crunching when it bends beyond 45 degrees but no pain in that movement. I've progressed to all kinds of running, jumping, cutting with or without my brace but I still struggle significantly with one leg squats, one leg jumps and jogging on harder surfaces (important note: at 6-7 mo. these movements were easier than they are now despite having far less quad strength at the time). My PT believes my patella tendon is just very tight pending my x-ray/doctor visit to confirm there is no addt structural damage. I will then I'll continue with some more therapy, but I was just looking for some at home ideas to get this tendon to loosen up and feel more normal?!

The doctor initially thought it was deteriorated cartilage but i'm a healthly, very athletic 25 year old who had 2 healthy knees as of a couple years ago. It seemed hard to believe cartilage would deteriorate that quickly. My symptoms are more tightness rather than aching. It feels like your muscles would feel after an extremely tough workout were you over did it. Sore and tight to the point that they are tender and difficult to use, if that makes sense.

As an example, when I do one-leg squats it is no problem until I get to about 45 degree bend where there is a sticking point, not super painful, but just a lot of tightness in front of knee that prevents going any further. Like I said, I've regained strength and both legs are equally muscular in appearance, measurements and poundage in the gym. I'm easily leg pressing 200 lbs on each leg, and I have good flexibility as well. Same story for hamstrings. Any ideas or similar cases any PT's have seen? I'm eager to get back to my old self and looking for some ideas before I get back into the doc and PT!!! Thanks so much.

[csptqt]

This is, unfortunately, the most significant side effect of having a patellar tendon graft. It is a very secure graft, for the most part, but chronic patellar tendon dysfunction, weakness and pain are still quite common after two years. If doing one legged squats does not leave you feeling in pain after you do them, I would continue to do them several times a day to remodel the tendon as much as possible. Tendons require a controlled, intermittent stress done very frequently in order to reorganize and remodel. But the exercise should not be so strenuous as to leave you in pain after the exercise. Good luck

[wkillie24]

hi,I wanted to introduce myself to you all. I am hoping that everyone here will be able to help me and answer some of the hundreds of questions I will have over the next few weeks

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my tribe blog

[JeffHathaway]

ASTYM technique or Grasten Technique may be very useful in the remodeling process - may speed it up - both have websites that i believe list providers in your area.

[cp1717]

Well I had my knee scoped. It turns out I had a bone spur as well as roughness in the femoral cartilage. Patella tendon and cartilege immediately behind the tendon (don't remember proper name for it!) looked great, meniscus great, ACL great.

So he smoothed the small spur and femoral cartilage. He warned me that we don't know what kind of mileage the cartilage will get. He said it was somewhat unusual in that there was some roughness but also it was pulling away from the bone almost like a loose flap in one area. This kind of makes me nervous! He said avoid squats/lunges for 3 to 6 months which I'm happy to do.

I'm wondering what experience, treatment, and long term recommendations and precautions you would give to someone with this type of cartilage issue. I'm EXTREMELY athletic and active. I could care less about going into the gym and doing squats, but I'd like to be able to return to sprinting/bball/plyometric stuff within reason. It's not like I want to do this every single day but the doc has me a little worried with his diagnosis. How does this cartilage respond to smoothing and rehab? Will it reconnect to the bone? I'm assuming not. Will it just fray again if its still a loose flap? Any thoughts? Thanks for the responses in advance!

[adellevdw]

Hi there

I am fairly new to this forum. I had acl patellar reconstruction surgery about 4 weeks ago.
I find that the graft area is still extremely sensitive and sore and that my leg still feels a bit unstable at times. Is this normal?

I am progressing fairly well with my rehab, but if I sit for long periods, my knee still feels extremely stiff and I'm struggling to walk on surfaces that's got a upwards or downwards gradient, I also struggle climbing up or down stairs. By when can I expect not to experience a lot of discomfort and pain?

Thanks!