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