T Nation

Torn ACL and Lateral Meniscus

Oh and one more thing. If it comes down to it, don’t be afraid of having the surgery. Don’t let my story scare you.

If you have the surgery and keep up with the rehab your knee WILL be better than before and you WILL come back to normal.

that sucks but look at it this way. Derrick Rose just tore his ACL today and he’ll be back next season kicking but and taking names. You should do the same, and you can, easily… only if you have the right mentality.

So get the surgery if you need to, and do all the rehab you can as it truly does help. In the mean time, do what you can physically within your limitations, and eat right. Eating right is important, and by that I mean carbs and such. If you can’t lift legs and all that, upper body workouts simply don’t compare and you’ll find that your carb needs will drastically go down.

[quote]mattis wrote:
I’m sorry to hear this. Whilst reading your post I got reminded of my own ACL surgery I had 6 months ago. I can totally relate to your story so I’m pretty sure you will with mine as well.

So I tore my right ACL and medial meniscus over 10 years ago but I never bothered to do anything with it. October last year my knee popped out of place as it sometimes did. But this time it locked up and I couldn’t walk for 2+ weeks. I realized then that I can’t keep compromising my life to fit my knee. My knee had to adjust to fit my life and not the other way round.

I had the surgery 31st Oct. The days after were the worst in my life. The painkillers weren’t strong enough to kill the pain so I ended up taking too many of them. I then started cold sweating, shaking, crying and felt completely helpless. It was rough. I never expected it to be this painful/hard so my father flew across the globe (I study abroad) just to come help me. I couldn’t do anything physically nor mentally. Just going to the bathroom was near impossible. Let alone cook food. At one point I went almost 3 days without eating anything.

After 2-3 weeks the pain subsided but it was still tough mentally. I, as you, slipped into a depression that it took while to get out of. I completely lost motivation in working out, continuing college (this was a big one), being social etc. For 4 months I basically sat on my ass doing nothing but feel sorry for myself. I lost roughly 20 pounds in that timeframe.

In february I realized that I couldn’t go on like this. I forced myself to do my homework, go to the gym, be around other people etc. No matter how much it sucked I still did it. The depression faded away slowly but surely. I am now 6 months post-Op, 5 pounds heavier than before the surgery and much stronger. My motivation is back stronger than ever as well.

I know it sucks but you got to push through it. Go one step at a time. What helped me was to categorize every action I did. Think “is this something I KNOW that I need to do? Or is it something my mind wants me to do?”. Because during a depression those two are often widely different.

Another thing that helped me tremendously was the idea that nothing in life is constant. Take weightlifting as an example. You’re muscles are either getting stronger/bigger or weaker/smaller. You’re either moving closer to your goals or further away from them. You never stand still. Always work to improve yourself. Always analyze what you’re doing. “Is this making me a better person?”

I applied this to everyday activities and it worked like gold. Kept me going, motivated. I still do this.
[/quote]

I just had knee reconstruction surgery 5 months ago, I have lost a bunch of weight, my situation sounds similar to what yours was like.

How fast did you regain muscle when you started hitting the gym again?

Did it come back more quickly than when you first gained it?

Thanks

cbfan,
It did not take long at all. My weight and strength came back up surprisingly fast actually. If I remember correctly it was a matter of two months or so. But bear in mind that everyone’s bodies are different.

I came back to the gym at around 3 months after the surgery.

At the moment I’m doing JW’s 5/3/1 (strength program) and I’m able to hit the same amount of reps every week even though the weights go up.

Edit: If your interested you should check out this thread.
http://tnation.T-Nation.com/hub/mattis#myForums/thread/5113056/

[quote]mattis wrote:
I’m sorry to hear this. Whilst reading your post I got reminded of my own ACL surgery I had 6 months ago. I can totally relate to your story so I’m pretty sure you will with mine as well.

So I tore my right ACL and medial meniscus over 10 years ago but I never bothered to do anything with it. October last year my knee popped out of place as it sometimes did. But this time it locked up and I couldn’t walk for 2+ weeks. I realized then that I can’t keep compromising my life to fit my knee. My knee had to adjust to fit my life and not the other way round.

I had the surgery 31st Oct. The days after were the worst in my life. The painkillers weren’t strong enough to kill the pain so I ended up taking too many of them. I then started cold sweating, shaking, crying and felt completely helpless. It was rough. I never expected it to be this painful/hard so my father flew across the globe (I study abroad) just to come help me. I couldn’t do anything physically nor mentally. Just going to the bathroom was near impossible. Let alone cook food. At one point I went almost 3 days without eating anything.

After 2-3 weeks the pain subsided but it was still tough mentally. I, as you, slipped into a depression that it took while to get out of. I completely lost motivation in working out, continuing college (this was a big one), being social etc. For 4 months I basically sat on my ass doing nothing but feel sorry for myself. I lost roughly 20 pounds in that timeframe.

In february I realized that I couldn’t go on like this. I forced myself to do my homework, go to the gym, be around other people etc. No matter how much it sucked I still did it. The depression faded away slowly but surely. I am now 6 months post-Op, 5 pounds heavier than before the surgery and much stronger. My motivation is back stronger than ever as well.

I know it sucks but you got to push through it. Go one step at a time. What helped me was to categorize every action I did. Think “is this something I KNOW that I need to do? Or is it something my mind wants me to do?”. Because during a depression those two are often widely different.

Another thing that helped me tremendously was the idea that nothing in life is constant. Take weightlifting as an example. You’re muscles are either getting stronger/bigger or weaker/smaller. You’re either moving closer to your goals or further away from them. You never stand still. Always work to improve yourself. Always analyze what you’re doing. “Is this making me a better person?”

I applied this to everyday activities and it worked like gold. Kept me going, motivated. I still do this.
[/quote]

thank you for sharing your story.
I know what I need to do, it’s just hard right now. I don’t want to be where I am, I just need to pull myself out of it.

Surgery does scare me, honestly. I have never had surgery, or even broken a bone before in my life. However, I know that I am young and fit and healthy, and my body can and will recover from it.

Physical therapy is going well and definitely helping.
I saw a general orthopedist a few days ago, and he basically took less than three minutes and said “yep, so your ACL is torn, do you want surgery or not”
So I said…umm come again? Did you even look at my MRI, what are my options?
So he said it wasn’t his department, and he referred me to the ‘Sports Orthopedic Surgeon’

But no consults are available until JUNE. Awesome.
I am going to explore as many options as possible until then.

Thank you everyone for your thought and concern in your replies.
I appreciate the support, and hearing your stories.

P.s. I am not 158 pounds. And I look soft and fat.
So I have managed to lost size, strength, and muscle. I have added fat and grossness.
And I htink I have lost about 7-9 pounds. (not the good kind)

So upsetting.

[quote]FattyFat wrote:
Hoi, I got the same injury (and a few other additional injuries).
I can relate to how you feel and I don’t mean to downplay your current physical state - it sucks for sure.

But you shouldn’t overlook the positives: being able to bike, jog lightly and row is a good sign.
Have you considered your treatment options?

If possible, I’d like to try other treatment modalities first before opting to have ACL reconstruction done.
This looks promising: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929023/
I’m currently on the look-out for a doc who might want to try this on me.

I had the same procedure done on my wrists and shoulders and made big leaps concerning pain management and functionality - without having to lay off training (although my training had to be adapted to the therapy).

  • fuck bilateral compound movements (for the time being).
  • what about single-leg variants for lower body exercises?
  • I don’t see how your upper body training might be hampered by your ACL and meniscus injury.
  • strong hammies can take up the slack caused by a compromised ACL. Work the shit out of your hammies, then.
  • incline runs / power walks can get the job done CV-wise.

Besides pain and dysfunctionality, the biggest mindfuck to me was that I COULDN’T DO certain movements and exercises anymore. I doubt anyone without a prior history of limiting injuries can appreciate this - I know you can.

I had to basically rethink my whole approach to training and I’ve refrained from pressing exercises for at least two years. I’ve found ways to work around what I CAN’T DO anymore and focused on what I still CAN DO. Now, don’t take this as hogwash positivism: I’m the most muscular I’ve ever been, despite a lack of progress in muscles (and strength) that can’t be worked without pressing exercises.

Since heavy rows put too much strain on my knee, I’m using a hyperextension setup. bringing my upper body to parallel while keeping my legs straight and stiff. Depending on where I pull to (sternum or navel) I’m performing this for my upper back or my lats. I prefer dumbbells for this one.

Bottom line:

  1. research your treatment options
  2. consult with physicians
  3. keep training without aggravating your injury

You can still get in shape for your little sister’s wedding.
Once you’ve resolved your knee injuries, you might be able to get back to train the way you used to pre-injury.

[/quote]

THank you for your post!
I looked into that and read around about it. It looks interesting.
I have never heard of that before.
I’m not sure yet what i am going to do but I am going to keep all of my options available, and really do some research to find out what the best route for me will be.

Thanks

Try to look at your situation in a more positive light. I know it’s hard, but you just have to do it. One step at a time.

When it comes down to the decision of surgery or not you don’t really need a “specialist” to figure that out. The first thing you have to look at is your activity level. How old are you? Do you do any sport? If you do, what kind of sport? Does it involve running/cutting etc.?

How does your knee feel right now? Is it too unstable for you to perform your daily activities/sports? Is the lack of an ACL compromising your life quality? Do you think you would be able to live the life you want without going through with the surgery? This is provided you keep up with the prescribed rehab exercises.

By answering these questions you should be able to make the decision.

Another thing to mention is that ACL reconstructions has become one of the most (if not THE most) common orthopedic surgeries. The surgeons do these reconstructions all the time. I read somewhere that the success rate is as high as 95%. In other words: If you feel that you need the surgery, don’t be afraid to go for it. You will be fine.

[quote]mattis wrote:
If you feel that you need the surgery, don’t be afraid to go for it. You will be fine.[/quote]
x2

I will write a bit more when i have time but you are better off going for the surgery

Frobell, R. B., Roos, E. M., Roos, H. P., Ranstam, J., & Lohmander, L. S. (2010). A randomized trial of treatment for acute anterior cruciate ligament tears. The New England journal of medicine, 363(4), 331-342.

In this study from a high level medical journal, delayed surgery with rehab vs. initial surgery and rehab were no different. I typically tell folks to get as friggin’ strong as you can before surgery, if you go through with it. I’ve had many patients with ruptures, opt out of surgery secondary to high levels s/p rehabilitation. Stop and go, lateral activities will be difficult but can be trained.

[quote]melanieamber12 wrote:
So it turns out that I am not superwoman.

Last month, March 10th, I injured myself whilst doing US Army Combatives. Go figure! That never happens.

I got my MRI results last week, and have been doing physical therapy for about 2.5 weeks.
After a few short weeks since the injury, I noticed major muscle atrophy in the quad of my damaged knee, and it freaked me out really bad.
To add to that, since the injury I have slipped into an awesome(sarcasm) depression consisting of drinking every day, and not training at all, hating myself, and getting fat. While this has happened, I have managed to lose at least 7 pounds. Which to me, is upsetting, seeing as I had spent the 7 solid months before that on a committed bulk, that I found to be successful.

I now have lost strength, size and muscle. I will be seeing the orthopedist soon, so see what my fate shall be regarding surgery, or not.

I now have 4 weeks until we go on vacation to North Carolina, the Outer Banks, for my little sisters wedding.
I will be wearing a brides maid dress, and obviously a bikini. I feel nowhere near ready to do either.
I am going to try to diet, and work my ass off to try and get my body and mind right before then.

I also realize that I should have and could have done much more in the way of ‘pre-hab’ to have prevented an injury in this nature.
I don’t believe in beating myself up over the past, however I do realize my own demise, and will learn from this and change the way I train in the future.

I am currently on a 3 month long profile from doing almost any physical activity. However I can bike without any pain, I can jog lightly, as long as I am careful and wear my brace, and I can row, lightly.
I can’t do any compound movements with any useful amount of weight, because it puts to much strain on my knee.
I am anxious, and nervous at the same time.
There is nothing good about an ACL tear, and I know that it will be my bane for the rest of my life.
I’m going to try and stay positive, and pull myself out of this hole I have sunk in to.

That is my story, I just felt like sharing.
Anyone who has a similar story, or feels like contributing, feel free.

Cheers

_Mel[/quote]

Hi Mel

I wanted to share my story with you because I have been recovering from a major knee injury.

In December I dislocated my knee, tore my ACL,PCL,LCL, IT band and apparently my medial meniscus folded over itself. My leg had no stability what so ever, I had tripped over a curb while sprinting and when My friend got me up, He told me to walk it off, I knew something was seriously wrong but I figured maybe I was being a wimp and attempted to walk, my lower leg gave out to the side as if nothing was holding it there.

my friends drove me directly to the emergency room from there. I don’t want to make this post to large so I apologize it does, but they misdiagnosed what was wrong with my knee, because it popped back into place before this so called doctor could look at it (he said it might be a patella dislocation) I ended up having to go to another hospital because my knee dislocated again the next day.

This hospital was better and the Orthopedic Surgeon that was called in proceeded to relocate my knee and test it (basically move it around to see which ligaments were torn) This was a horrible experience as you can probably imagine. I learned that morphine doesn’t do crap for pain compared to what I was expecting.

When he got the MRI a week later his prognosis what spot on. I do understand your feelings towards your doctor, I have come to understand that most of them are arrogant/confident by nature, but I think you have to be in order to do surgery on someone.

I had surgery a little over a week later. They were extremely conservative with me after surgery. I was in an immobilizer for 2-3 weeks before I started any PT. After that the next month we were not allowed to be aggressive in PT. During this time scar tissue built up (which was their intention in order to gain stability) to the point where when it came time to be aggressive my range of motion was terrible I couldn’t bend my knee more than 60-70 degrees.

I ended up having to get a knee manipulation about 10 weeks after surgery. This ended up working out well as I gained a lot of range of motion from this alone. Unfortunately this was extremely painful in PT, My knee could bend but it had swollen up so large and it felt like my quad was destroyed. I had to bite on a towel while my PT bent my knee, This was the most painful experience of my life.

Now I am almost 5 months out from surgery and my range of motion is almost to where it needs to be.

I am walking around without a limp for the most part and am trying to get back in the gym.

My PT just told me that I don’t have limitations on what I’m allowed to do as long as I start slow and am not in pain. I still plan to get the OK from my surgeon before I start doing weighted leg exercises.

Unfortunately I lost 35 lbs of mostly muscle, but I look forward to making gains again.

From what PTs have told me, ACL reconstruction is very routine now, and recovery is much faster than what I went through.

My advice would be to find the best, most highly recommended Surgeon you can if you choose to get the surgery.

[quote]mattis wrote:

Edit: If your interested you should check out this thread.
http://tnation.T-Nation.com/hub/mattis#myForums/thread/5113056/[/quote]

I’m interested, Clicked link but don’t think I have the privilege to look at it

[quote]cbfan87 wrote:
I’m interested, Clicked link but don’t think I have the privilege to look at it
[/quote]

[quote]olifter1 wrote:
Frobell, R. B., Roos, E. M., Roos, H. P., Ranstam, J., & Lohmander, L. S. (2010). A randomized trial of treatment for acute anterior cruciate ligament tears. The New England journal of medicine, 363(4), 331-342.

In this study from a high level medical journal, delayed surgery with rehab vs. initial surgery and rehab were no different. I typically tell folks to get as friggin’ strong as you can before surgery, if you go through with it. I’ve had many patients with ruptures, opt out of surgery secondary to high levels s/p rehabilitation. Stop and go, lateral activities will be difficult but can be trained. [/quote]

This is not true.

In that paper those who had surgery early on had 15% higher rating on activity level (6.5 versus 5) and 14% more of them (44% versus 30%) returned to their pre-surgery levels of activity.

30% MORE of the delayed group also had “severely decreased knee related quality of life.”

The group that DIDN’T have surgery did better than the group that had delayed surgery. And the group that had delayed surgery decided to do so due to having stability issues.

Stop reading the abstracts of things and start reading the full papers. http://www.nejm.org/doi/suppl/10.1056/NEJMoa0907797/suppl_file/nejmoa0907797_appendix.pdf

[quote]mattis wrote:
Another thing to mention is that ACL reconstructions has become one of the most (if not THE most) common orthopedic surgeries. The surgeons do these reconstructions all the time. I read somewhere that the success rate is as high as 95%. In other words: If you feel that you need the surgery, don’t be afraid to go for it. You will be fine.[/quote]

This is wrong. Really wrong.

ACL surgery has NO WHERE NEAR a 95% success rate. On average, NFL football players come back over 30% LESS productive and only around 60%-70% of them come back at all.

See: http://ajs.sagepub.com/content/38/11/2233.abstract
And: http://www.medicalnewstoday.com/releases/57859.php

On average, NFL PLAYERS, GUYS WHO ARE PAID MILLIONS OF DOLLARS TO SIMPLY REHAB THEIR LEG, come back no sooner than 9-12 months. The people claiming you can be 100% faster than this, and faster than 6 months, all by having a positive attitude, are out of their fucking minds.

And it’s something like less than 50% of the general population return to their previous level activity.

To the OP, be very careful reading all these case studies from individual people giving you their RAH-RAH speeches. Especially from anyone who hasn’t gone through this specific injury. Or hasn’t made it all the way back.

The fact of the matter is this is an injury that, should you choose surgery, will take you at least a year, and probably more like 18 months, to fully feel normal from. If ever. Very, very few people can relate to this.

And the fact of the matter is that very, very few of these people who have had the surgery, and who are giving you their positive attitudes, are or will ever be normal again. This is not a detriment to them; it is the facts of the surgery.

Sorry to be a downer, but I am tired of people going “Yeah, you know, you’ll be fine! Just keep a good attitude. Oh, I mean, my knee is alright. You know, not great. But you’ll be fine!”

Go with what the research says, what a TRUSTED surgeon says, what a TRUSTED PT says, and your OWN individual case. Do not get wrapped up in one person projecting their own experience on you.

Every single knee is different. Every single tear is different.

You have the one person on here saying how their pain experience was horrendous. I know many people who had similar experiences.

However, after my reconstruction I took one percocet and that was it. I had people scaring the shit out of me for months telling me how much pain I was going to be in and I barely had any pain the entire process.

Ask the people telling you about this surgery and they’ll tell you this is insane. My doctor gave me bottle for 80 pills illustrating how many people normally take. Yet I had none. All that worrying for nothing. That doesn’t mean I’d tell you to expect no pain though. Because on average, people DO experience a lot of pain.

I can tell you this though, the pain part came easy to me…Walking, did not.

Again, everyone is different.

This is my point. One person’s perspective, in a lot of ways, can be useless. You have to have context to go along with it.

If you want a full play by play of the ACL experience in terms of who should have it done, what graft you should use, what to expect results wise, you might be interested in this: http://b-reddy.org/category/anterior-cruciate-ligament-acl/page/2/

And prolotherapy sucks. Your money would be better spent at a bar.

[quote]BReddy wrote:

[quote]mattis wrote:
Another thing to mention is that ACL reconstructions has become one of the most (if not THE most) common orthopedic surgeries. The surgeons do these reconstructions all the time. I read somewhere that the success rate is as high as 95%. In other words: If you feel that you need the surgery, don’t be afraid to go for it. You will be fine.[/quote]

This is wrong. Really wrong.

ACL surgery has NO WHERE NEAR a 95% success rate. On average, NFL football players come back over 30% LESS productive and only around 60%-70% of them come back at all.

See: http://ajs.sagepub.com/content/38/11/2233.abstract
And: http://www.medicalnewstoday.com/releases/57859.php

On average, NFL PLAYERS, GUYS WHO ARE PAID MILLIONS OF DOLLARS TO SIMPLY REHAB THEIR LEG, come back no sooner than 9-12 months. The people claiming you can be 100% faster than this, and faster than 6 months, all by having a positive attitude, are out of their fucking minds.

And it’s something like less than 50% of the general population return to their previous level activity.

To the OP, be very careful reading all these case studies from individual people giving you their RAH-RAH speeches. Especially from anyone who hasn’t gone through this specific injury. Or hasn’t made it all the way back.

The fact of the matter is this is an injury that, should you choose surgery, will take you at least a year, and probably more like 18 months, to fully feel normal from. If ever. Very, very few people can relate to this.

And the fact of the matter is that very, very few of these people who have had the surgery, and who are giving you their positive attitudes, are or will ever be normal again. This is not a detriment to them; it is the facts of the surgery.

Sorry to be a downer, but I am tired of people going “Yeah, you know, you’ll be fine! Just keep a good attitude. Oh, I mean, my knee is alright. You know, not great. But you’ll be fine!”

Go with what the research says, what a TRUSTED surgeon says, what a TRUSTED PT says, and your OWN individual case. Do not get wrapped up in one person projecting their own experience on you.

Every single knee is different. Every single tear is different.

You have the one person on here saying how their pain experience was horrendous. I know many people who had similar experiences.

However, after my reconstruction I took one percocet and that was it. I had people scaring the shit out of me for months telling me how much pain I was going to be in and I barely had any pain the entire process.

Ask the people telling you about this surgery and they’ll tell you this is insane. My doctor gave me bottle for 80 pills illustrating how many people normally take. Yet I had none. All that worrying for nothing. That doesn’t mean I’d tell you to expect no pain though. Because on average, people DO experience a lot of pain.

I can tell you this though, the pain part came easy to me…Walking, did not.

Again, everyone is different.

This is my point. One person’s perspective, in a lot of ways, can be useless. You have to have context to go along with it.

If you want a full play by play of the ACL experience in terms of who should have it done, what graft you should use, what to expect results wise, you might be interested in this: http://b-reddy.org/category/anterior-cruciate-ligament-acl/page/2/

And prolotherapy sucks. Your money would be better spent at a bar. [/quote]

Very good post, except for your last statement where you contradict previous statements made earlier in your post.

I’ve experienced what prolotherapy did for certain joints of mine that had worsened for years, severely impacted my daily life and quality of life in general and couldn’t be operated on. So have others.
Note that I wasn’n treated by a (self-proclaimed) guru claiming prolotherapy is a panacea.

I’m inclined to say that prolotherapy may not be that successful on ACL tears as opposed to joints with simpler biomechanics. Still, based on my past experiences with prolotherapy and my own ACL tear I felt like sharing what I had found on prolotherapy and ACL tears. This reflects my MO regarding injury repair and rehab by going as minimal invasive as possible.
I agree there isn’t enough evidence for ACL prolotherapy in terms of studies. Also, it goes without saying that certain criteria have to be taken into account before prolotherapy can be considered a viable treatment option.

After the diligence you put into shedding more light on ACL reconstructions, the fact that you didn’t provide evidence for your negative claim about prolotherapy appears somewhat strange and isn’t quite helpful for people considering viable treatment options (for joint dysfunction in general, not specifically for ACL cases).

[quote]FattyFat wrote:

After the diligence you put into shedding more light on ACL reconstructions, the fact that you didn’t provide evidence for your negative claim about prolotherapy appears somewhat strange and isn’t quite helpful for people considering viable treatment options (for joint dysfunction in general, not specifically for ACL cases).

[/quote]

Good and fair point.

It’s been a very long time since I’ve looked into it so I don’t have anything off-hand to share. My statement about prolotherapy stems much more from the amount of clients I’ve had who have had neutral or negative experiences with it, and the amount of money they had to spend on it because it wasn’t approved by their insurance.

Hello all, and thank you very much for your kind words, and helpful insight.
I have been continuing with Physical Therapy, frequent chiropractor/massage treatments, and a lot of “knee-hab” of my own doing.
I have gotten my discouraged ass back into the gym.
Since I last posted here, I gained more weight(fat). I got up to 171 lbs. Soft, fat, and weak. And that is all it took for me to get my life and body back.
I am now three weeks into a “get back into shape” routine.
I have been at the gym at least 5 days per week, and doing intense cardio almost each one of those days.
I am also utilizing the sauna. It is killer!
I am also eating better and right. I have cut down significantly on drinking. And I am taking my vitamins and supplements regularly.
I feel better, less bloated, getting stronger, and already in better shape.
The knee has become much more stabilized, and strong.
I still am not running, because I don’t want the impact do further my injury.
I have been rowing, and biking, with no pain at all.
I have begun training for another powerlifting competition.
There will be a BP/DL comp in October or November here on post, and my new training partner and I will be competing.
We are both injury ridden, so we help/push each other.
I am positive, and motivated.
Thank you!

_Mel

Oh, and to answer some questions, I have been working lower body.
I have been doing a lot of single-leg machine work. And honestly, it is really helping bring out muscle separation in my quads, and I like it.
I am beginning to regain the muscle that I had lost, but I know it is going to take patience, time, and a lot of effort.
But I am determined! I do still have unbalanced legs though, but I know that will just take time!
Cheers!

_Mel