Friday, November 29, 2013

Mathew's Story

Hi My name’s Matthew, I’m a full time university student, studying Agriculture in Adelaide, Australia.


I’m pretty big on my sports including Aussie rules football , cricket and just running and keeping fit in general.

My story started about 12 months ago, I was mustering cattle on a dirt bike, when I was knocked of by a cranky cow, my knee got caught underneath the motorbike, and was forced into some into some rocks. At the time I was more worried about making sure the cow wasn’t chasing rather than any pain in my knee.

That night I noticed my knee was quite swollen and it was sore, so sore that is was a struggle to take my boots on or off, running or lifting heavy objects was also quite a task.

The pain did ease over the coming weeks, but the swelling didn’t and my ability to run didn’t return and I guess my knee just didn’t feel right.

So booked into see an orthopaedic surgeon to see what the issue was, he initially though I had just torn a little bit of meniscus, but he sent me for an MRI just to be sure. When I returned he and I where both shocked to see that I had a completely torn PCL and it was an isolated tear so there appeared to be no damage to any other structures.

He explained to me that because I was young and active that he would recommend I have it reconstructed, he said that recently there had been a change from surgeons recommending straight physio, to recommending reconstruction for younger patients as the chances of doing further damage to the knee are high. So I booked in for surgery about 2 months down the track as this was during my university holidays.

Before my surgery the surgeon recommended I see a physio, and work on strengthening my legs in particular my quads and calves. I was able use a bike and cross trainer as well as doing light weights with no pain, so I focused on getting as fit and getting my leg in as good a condition as I could before the surgery. I truly believe this had a hugely beneficial to my recovery, so if I could give one piece of advice it would be if possible to see a physio and get a exercise routine to do before surgery

I had my reconstruction using on April the 8th 2013 using my own hamstring graft. The anaesthetist gave me a nerve bloke before I woke up so I felt very little pain besides a little tingling in my hamstring.

I was sent home the next day in a straight leg brace, with a pair of crutches and some pain killers. I only used the pain killers at night for the first week and was pretty well hobbling around without crutches in two days. The only real pain I got was when I stood up, I’d get an almighty pain in my shins, which would eventually go away if I just walked through it.

I was told to where the brace at all times except for a brief shower, and to just take it easy for the next 4 weeks before going back to the Dr, where I was fitted into a hinged brace and given an initial range of motion of 90 degrees .

I had to were this brace for a further 9 weeks taking it very easy on stairs and I was also not allowed to drive. I was able to some simple exercises.

After 9 weeks I went back to the surgeon took the brace off and the physio was the able to amp up me rehab. I was doing leg raises, leg presses and extensions, and also a lot of work of the stationary bike, and also swimming. The exercises all focused on building up my quad muscles, and being sure not to work my hamstring, which would pull against my graft.

I went back for my final visit to my surgeon in late September, where he gave me permission to begin straight line running and to basically start living normally again.

At the time of writing this it is the 27th of November and back running and kicking the football, and pretty well doing everything I was doing before the injury and I also passed university. I’m aiming to play football again in April next year. I’m not in the clear yet, but so far so good. It is certainly a time consuming injury, but if you don’t rush it, follow your doctors and your physio’s instructions there is no reason you shouldn’t be able to get back to living a pretty well normal life.

Any questions feel free to ask.

Yours Sincerely Matthew James



Wednesday, June 19, 2013

Melissa The Soccer Player

Hello and welcome to my blog. 
Melissa is asking for help. 
Please read her story and leave comments.

Thanks,
Skinnygurl





On June 11, 2012 I blew my PCL out during a coed soccer game. I went into a challenge with a guy on the other team and he nailed me, cleats up, straight in the knee. I felt an intense burning sensation. and what I can best describe as feeling like my knee bent the wrong way.
A trip to the ER resulted in a diagnosis of no tears, just some strain from the hyper-extension. I got an appointment with an orthopedist and a manual exam and MRI confirmed a torn PCL. Initially my injury was graded at a 1.5-2+, which I was told is right on the edge of what you can live with and rehab without surgical intervention. I was locked out and no-weight-bearing in an immobilizing brace for 3 weeks, but the tibial sag didn't seem to be improving at all. They locked me out for another 3 weeks, and felt like there was sufficient progress to be begin physical therapy. As with everyone else on here, my muscles had atrophied so quickly that I had to rebuild all of the strength in my leg. I made good progress, and within a few months my physical therapists allowed me to do some very tentative jogging to see how things held up.
Unfortunately, they didn't hold up at all. The tibial sag returned and worsened. By my next orthopedic appointment I was graded at a 3+ and told I had no other option but surgery.

I got a call on December 27, 2012 that a donor ligament had come available and I had the surgery on January 15, 2013 during which my surgeon removed my PCL (apparently one end of it had completely torn off the bone, and there was a tear about 3/4 of the way through the middle of the ligament as well) and used the tibial inlay technique to replace it with the allograft in addition to tightening my LCL and MCL, which had both been stretched enough during the accident to not really provide much in the way of stability anymore.

The first few days were brutal. The polar care was the only thing that kept me sane. I was locked out with no weight bearing for 3 weeks. After that I spent 3 weeks still locked out, but able to bear 50% weight on my bad leg using crutches. At the 6 week mark my surgeon told me to lose the brace and crutches and go my own. It was really weird- my nerve endings had been severed and then I hadn't put any weight on my foot at all for weeks- it felt like my foot was all pins and needles for the first few days. I'd say it was a week before I felt comfortable enough to really walk without being overly tentative.

My first few appointments post-op were great and my physical therapists were happy with my recovery. I was able to get through my wedding with no issues, took a 2 week break from physical therapy to head to London and then got back to work. However, at about the 4.5 month mark I started to notice that I could feel a little shifting in my knee at times. It wasn't anywhere as bad as the initial tear instability, but enough to worry me given what happened the first time through my PT sequence. I went in for an emergency check with PT, and they confirmed that I had regained some tibial sag. While they said a little of loosening was to be expected after the transition from lock out to ROM exercises, this was more than they felt comfortable with. No one has ever been able to explain to me why this happened- their only guess would be a fall or a blow to my knee, but I never experienced either of them.

Around this time, I was cleared to jog for 1 minute intervals at PT to try and regain my running form. I never had any pain in the back of my knee, but I started to have a stab of pain in one spot on the front of my knee (right over the top of my fat pad) upon impact while running. After ruling out fat pad issues and instability resulting from muscles that weren't quite back to 100%, my therapists had me run with a tape job that pulled my tibia forward when i flexed my quad- I was able to run with little to no pain. The working theory is that the sag is causing my femur and tibia to contact each other "off" from where they normally would in a solid knee.

So that's where I am right now- 5 months out and fully functional in day to day activities, but only able to run with a tape job or my playmaker PCL brace. It's pretty devastating to make such great progress and work so hard, only to have everything fall apart for no apparent reason twice. I have my next appointment with my surgeon in a month and a half, at which point I can bring up my concerns, but there isn't much he could do short of redoing the surgery. Instead, my therapists have me working on strengthening my quads, hamstring and glutes as much as possible to try and provide the maximum amount of stability to my knee.
I guess my questions would be:

1) Has anyone else had a PCL repair kind of flame out after progressing perfectly for months without experiencing any sort of impact injury or other factor that would stretch the ligament out?

2) Is anyone else competing at a high level in soccer or running moderate distances (I was running 5 miles a day pre-injury) with a sag of probably 1-1.5+?


Thank you,
Melissa