ACL Injury Recovery Times and Expectations

by Jim Wnek

Getting an ACL (anterior cruciate ligament) injury is something that’s dreaded and feared by just about every competitive athlete.

For all its ability to withstand significant forces and translate the body’s powerful muscular energy into motion, the knee can in some ways be a relatively delicate joint.

A twisting force applied at just the wrong angle can cause significant damage to the ACL and other underlying structures of the knee.

If you do have an ACL injury, then you’ll be forced off your current training schedule. Depending on the nature of the ACL injury, and the type of treatment you need to undergo, your ACL injury recovery time may range anywhere from a few weeks to up to a year.

Because ACL injuries can range from relatively minor to very severe, it’s important to make sure that you consult with a doctor or a sports therapy expert in order to get an accurate diagnosis of your injury, and to make sure that you’re taking the proper steps to rehabilitate your ACL and get yourself back to your normal training load.

Minor tears to the ACL may only involve a recovery time of a few weeks (or perhaps a month or two). But if you need to undergo ACL surgery, then you’re in for a much longer process – one that will necessarily include a rehabilitation program.

You will begin with very small range of motion exercises in the first week or two after surgery. The first goal is getting to the point of being able to fully extend your leg.

In fact, this will be a significant point of reference throughout the rehabilitation process; how easily are you able to fully extend your leg? There will be scar tissue that builds up around the site of the surgery, and properly breaking up this scar tissue is a key part of recovery.

Within the next few weeks of rehabilitation you’ll likely begin some type of gentle strengthening and aerobic work. Even slow walking or cycling on a stationary bike will go a long way toward rehabilitating your ACL and helping your recover. One to two months after surgery you’ll probably begin incorporating balance drills into your rehabilitation work.

ACL Injury Recovery – Be Prepared To Work Hard

Getting yourself back to your previous level of athletic performance involves more than just building up your strength; you’ll also need to get your balance and form back to its previous levels.

Beginning approximately two to three months after surgery you’ll begin to ease back into sports specific work.

Working with a professional therapist is absolutely essential throughout rehabilitation but especially at this point because your knee might feel like it’s completely healed, but it won’t be strong enough to return to a full workload.

You’ll probably want to go faster with your recovery, so having expert objective advice and feedback can prevent you from doing too much too soon.

By the same token, progressing too slowly can be a problem too.

Going too slowly with your ACL injury recovery program can allow too much scar tissue to build up, and make it difficult to restore your full range of motion.

Find yourself a physical therapy expert to work with and you’ll be sure to get back to your prior performance levels as soon as is safely prudent.

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{ 120 comments… read them below or add one }

John Meister

When did the acl injury become such a popular injury? I never heard of this in the 50 and60s

Reply

Jim Wnek

The past 10 years.
As sports become more and more competitive so does the athlete.
Meaning there is more and more demand of the athletes body to perform and higher levels.
Therefore placing more strain in the body.

Reply

vishal jain

Sir, I am a 20 yr old male , I got injured while playing basketball,
Doi: 29/07/2012
Moi: injured in lt knee, while playing basket ball,
I don?t want to go for operation, so please suggest me something other than surgery.

Vishal jain MRI Report of left knee.
MRI. Features.
There is complete thickness tear in the proximal fibers of the ACL near its femoral attachment.
Multiple areas of altered marrow singnals hyperintense on T2 and STIR sequences, hypointense on T1
Are seen in the both lateral femoral condyle, tibial spine and lateral tibial plateau and represent bony contusions.
Mild joint effusion is also seen.
Grade 2 strain in the lcl also seen.
Partial thickness tear in the lateral patellar retinaculum noted.
The antirior and posterior horns of both menisci appear normal in signal and morphology.
The pcl appear normal.
The mcl appear normal.
The patella appear normal.
Articular cartilage appears intact.
The soft tissue structures around the knee shows edematous changes.

Reply

Jim Wnek

Well, first thank you visiting our site.
I have good news and not so good news.

I’ll start with the not so good news.
As you read in the MRI – You have a complete thickness tear of the ACL.
Which means – Torn ACL.
9 out of 10 times surgery is the best option to regain full stability of that knee and get you back to activities (basketball.)

The good news.
You can choose not to have surgery (however I do not recommend.)
You can go through physical therapy to control swelling, improve flexibility and increase strength.
You will have to make sure all muscle groups are extremely strong that surround the involved torn acl knee.
You have no ACL therefore the knee doesn’t have its main stabilizer.
You will need to avoid jumping, pivoting and or and quick start stop movements or you are at risk for further injury.

I would at this time get into a physical therapy program and strengthen your lower extremities as much as you can.
Get fitted and issued an ACL brace.

If you are looking for a complete ACL strengthening program we do offer that as a service.
Let me know if that is of interest.

Good luck.
Jim

Reply

James

I am a soccer player and actor in my schools drama club, i went through the whole soccer season without a problem but while learning a dance for my schools play i fell and had somebody else fall on my knee this happened January 19th, my mri said there is a hematoma on my femur and i partially tore my acl, accompanying this my knee cap was partially dislocated, how long will it take to heal in your opinion? i also have one more question, on saturday February 23rd my opposite knee gave way and twisted inwards, i can bear no weight on this nrwly injured knee, in your professional opinion what do you think happened?

Reply

Jim Wnek

Hey James, thank you for visiting the site.
Wow looks like you did a job on that knee.

Questions
How long will it take to heal in your opinion?
You know, everyone is different. From your response I would assume you are either in high school or college. Which means you are still pretty young.
The younger you are – the quicker you heal. There are also other factors that play a role in healing. Nutrition, smoker or non-smoker, diabetic, daily activities, etc…
Based on my experience you are looking at a good 2 months before you really start feeling like yourself.
Now during those 8 weeks you need to be performing formal physical therapy with emphasis in strength, balance and stability of your lower extremities primarily your involved leg. Also, you should be receiving modalities (such as heat, electrical stimulation, maybe ultrasound – if ordered by doctor, massage, cryotherapy) general stretching.

Next question:
What do I think happened to you other knee?
Well since you have injured one side and have been in pain you have been compensating with the other. The problem is is that the other knee was just flat out over worked and unfortunately let you know – by giving out.
When you get involved in formal therapy make sure you work both lower extremities.
Also, if the pain persists on the other knee- you might want to go and get it looked at by a doctor.

If you have any further questions- just respond below. I more than willing to help out.
Good luck

Jim

Reply

Dean Wilson

I have had a knee reconstruction a year and a half ago to my left knee. My first game back of rugby league I stepped awkwardly and have a suspected acl injury now in my right knee. Do you think if I have the opperarion I will have less of a risk of re-injury in the next few years

Reply

nadir

I am a football player, and played very regularly. Almost 5 times a week, and i also went to gym 3 to 4 times a week.
In January while playing football, one of the opponents fell on me, and my left knee twisted under him. I screamed and limped off the field. That night i was able to climb a 10 story building very slowly and through a lot of pain. I got an MRI done and went to two doctors also. One suggest arthroscopic surgery, as he claimed i had a cartilage tear. But the MRI said i had a partial tear in my ACL. There was barely any swelling, and the next doctor said this is probably an old tear that just got aggravated and i should be fine with some physio therapy. It has been three months i have had about 20 physio therapy sessions, as well as home strengthening exercises with ankle weights. About 3 weeks ago, i started jogging at the gym (i can only jog for 10 to 15 mins after which the knee starts to get sore again) and about 2 weeks ago i started doing leg training with heavy weights at the gym. All this with no problem.

But when i sprint my knee gets very sore the next day. Sore and tired, and some deep pain. And two days ago i did some rowing at the gym, and the next day my knee felt very sore and i had a lot of pain. But on the second day the knee was back to normal. My legs have almost gone back to normal in terms of the amount of weight i could lift before the injury.

Any suggestions what i should do? My physio therapists say,s a few more sessions and i will be back to normal.

Any advice will be greatly appreciated as i am dying to get back to football again.

Reply

Jim Wnek

Thanks for visiting.
Okay. Thoughts.

Partial tear of the ACL – it could re-heal itself. Which is good. Only problem is that you are more vulnerable to a future tear.
However, with proper strengthening and brace I believe you could go without surgery.
A lot depends on how your knee responds after playing football. Working out, lifting, rehab and running is different than actual play.

Recommendation: Finish up your therapy. Continue to workout, run and get that knee as strong as possible.

Do you have a comprehensive ACL injury prevention program to follow?

If not reply back – We could help!

jim

Reply

Rebecca

My story: I play many sports from volleyball and golf to hockey and soccer. While playing in a supposedly no hitting, adult safe hockey league I was hit by a guy that had at least 100 pounds on me. I dislocated my patella due to unexpected weight transfer. It popped itself back in when I attempted to straighten my leg out while removing my equipment when I admitted I was hurt and could no longer play. I went to the hospital and they gave me a splint that held my leg completely straight and referred me to a sports injury clinic. I went there and had an X-ray done and it came back normal. He said although there was significant swelling he disbelieved that there was an acl tear and had me book a follow up appointment. When I came back, still on crutches,still swollen to the point of no kneecap he did several tests on it and came to the conclusion it was in fact an ACL tear. He requested me to come back another 2 weeks from then as to wait for the swelling to go down more and get a possible MRI. Until then he referred me to a physiotherapist who I have now seen twice but have had little success. The physiotherapist is worried about the severity of the tear because I still have little movement even after ultrasound treatments and massage. I can walk now but cannot straighten past I’d say around 15 degrees. Also I find my knee cracking when I walk and it has buckled once while in my supplied walking brace(adjusted to 15/75 degrees) and is still very swollen. It’s been just over a month since the injury.
Questions..
Do you recommend surgery? If so when..? I am a cosmetology student and am on my feet all day. My program is not completed until November 2013 and is hourly based so if I’d Iike to miss as little of that as possible. I have two months summer vacation, July and August but I’m going to Mexico the second week of July for a week.. Suggestions?

Reply

Jim Wnek

Hello Becca
First- thanks for visiting the site.

Your questions
Do you recommend surgery? If so when..?
Well the answer to this really depends on what the MRI says. Without imaging that is tough to answer.

Here is what I would do if I were you.

Make an appointment to see an orthopaedic. Get an MRI (we need to know what is damaged and how bad)
If nothing is torn or damaged then NO surgery.
I would get started with physical therapy NOW. This will help with swelling, range of motion and strength.
Even if you do require surgery pre-hab will help leading up to surgery.

IF you do require surgery and you need advice as to when you should get surgery.
WELL— it will all depend on what or if you have damage and how bad it is.
If you do have any damage you will have to see how functional you are with it. Can you handle being on it all day every day until you get back from Mexico?

That will be up to you. Really depends on if you’re in pain, can you walk on it, etc….

First things first……Get it looked at by an orthopaedic and get an MRI performed to see whats going on inside that knee.

From there you know what decisions you will need to make.

Keep me posted.
Jim

Reply

nadir

Dear Jim,

Thank you so much for your reply.

I do not have a comprehensive ACL injury prevention program to follow.

In the early stages i was doing lots of strengthening exercises with ankle weights. Exercises for strengthening my quads, hamstrings, hip flexor, and groin muscles. Now i am just following a routine at the gym where i do my lower body twice a week. This work out includes lunges, squats, and machine exercises for the quads, hamstrings, groin, and flexors.

If there is anything i am missing please let me know. My physio guided me with the ankle weight exercises but since i felt better i started doing similar exercises in the gym except with more weight.

Also, yesterday i did a lot of sprinting and running, and kicked the ball around with a friend. My knee feels as good as new today. So that,s a good sign.

Would appreciate help with the comprehensive ACL injury prevention program.

Regards,

Nadir

Reply

John

My son had an ACL tear and had surgery November 15th 2012. His recovery and therapy has gone really well and he is hoping to play baseball for his high school team. He has been a full participant at practive under a trainers and coach’s supervision. He has regained 90-95% of his speed and has not been bothered by the knee. Is he coming back too fast or is this a case by case basis?

Reply

Jim Wnek

Hey John
Thanks for visiting the site.

He is approximately approaching 5 months post op. 5 months could be a little too soon to get back to full participation in sports.

Couple questions I have:
How old is he?
What position doe he play?
Has he been fitted for a brace?

Sounds like he is hitting and surpassing all his goals with his rehab and recovery process. Which is awesome!
I would hate for him to re-aggravate it due to early participation in full sport activity.

Now this does not mean he cannot. With full range, good strength, proper stabilization, balance and control he could be ready.

So to answer your question:
Is he coming back too fast or is this a case by case basis?

By ACL surgery rehab protocol standards – YES it is too fast. However, this is a case by case basis.
Like I said it really depends on where he is at with his strength, stability and endurance. Also, I would like to see a full release by the surgeon.
If he or she release him then you are good to go.

When you can- let me know about the questions I asked.
thanks
jim

Reply

John

He is 18. He plays centerfield. He hasn’t been fitted for a brace.

Reply

Abhishek

I am 20. I play football regularly and for my college team. I play as a striker. One week back, while playing, i rolled over the ball while sprinting. I heard a knocking sound and collapsed. Later i went for an mri and the report said i hve complete tear of mid fibres of my acl and some other associated damage. The doctor said i would have to undergo reconstruction surgery. But the doctor said that he wants me to wait and rest for a month. Then he would give some excercises. Why is that?? And if i opt for surgery, is it a very complicated surgery?? And how much time would i require to become as fit as before? Is there any way i can regain my old fitness without surgical intervention? And if i opt out of surgery, will i face problems with age like arthritis etc??

Reply

Jim Wnek

Hello,
Thanks for visiting.

The doctor said i would have to undergo reconstruction surgery. But the doctor said that he wants me to wait and rest for a month. Then he would give some excercises. Why is that??
****Most if not all doctors will want you to build up (strengthen) the surrounding muscle groups prior to surgery. Also, he or she would like to see most of the swelling gone as well.

And if i opt for surgery, is it a very complicated surgery??
****YES – The “ACL” is a very important structure in your knee. It stabilizes your upper leg and your lower leg.
You need it for any or a athletics

And how much time would i require to become as fit as before?
****ACL rehab is tough. The first 6 weeks will be difficult.
But expect between 4-6 months before you start to feel like your old self.

Is there any way i can regain my old fitness without surgical intervention?
****No- not with a complete ACL tear.

And if i opt out of surgery, will i face problems with age like arthritis etc??
****Yes and no- since you are athletic and would like to regain where you were at prior then I recommend surgery.
We all will experience some arthritis as we get older. But more wear and tear on your joints (unfortunately) we as athletes get it quicker.

Hope this helps.
Jim

Reply

Ayoub

I had a motorcycle accident about 9-10 months ago and i didnt have health insurance so i never got my knee checked out. before my accident i had a soccer injury which seemed to be a legiment because my knee would hurt everytime my knee locked up but it went away after a month. after the motorcycle accident ive had the same pain as the soccer injury but it has been 9-10 months now with no progress. i had a very bad limp the first month of the accident which i was still able to walk on but couldnt lift it up. the pain seems to be under my knee cap as i feel no pain when i touch my knee. after standing on the knee for 6 hours at work, my knee starts to lock and give out more frequently which is very painfull. do u think i need surgery or it will heal if i give it more time.

Reply

Jim Wnek

Hey there

Well it sounds like something is damaged (which i’m sure you know.) Problem is is that we do not know what exactly is damaged.
Could be cartilage, meniscus and or the ACL. Hard to diagnose without imaging.

I would go see a doctor and get an MRI. Then discuss options after you find out if anything is damaged.

Keep me posted.
Jim

Reply

Dinakar

Hello.

I am 25 years old. I was operated for ACL replacement (graft taken from Patellar tendon) in december 2012. I underwent physiotherapy after the surgery for 6 weeks. Since then there has been no physio. My knee has recovered basic functioning. I still cannot run.

The knee used to click unusually till a few weeks ago. Now, it is almost like I have learnt how and when it clicks.

I wanted to ask you this. When I am seated in a chair and i try to extend and raise my leg to a horizontally straight position, it is very painful at the extreme position and during the raise, I can feel it click multiple times. Is this normal? Or in your opinion, is there a problem?

Thanks a lot for you reply.

Reply

Jim Wnek

Hello
Thanks for visiting.

First sorry to hear you had an injury and had to have surgery.

Now normally post ACL surgery rehab is between 4-6 months.

Not sure if you mistyped but I read you only received 6 weeks of therapy. Please confirm if this is correct?

IF so, you need further rehab or a comprehensive lower extremity strengthening/stabilization program.

Can your therapist give you a home exercise program?

****
When I am seated in a chair and i try to extend and raise my leg to a horizontally straight position, it is very painful at the extreme position and during the raise, I can feel it click multiple times. Is this normal? Or in your opinion, is there a problem?
****
The clicking can be normal. The more important question is: is it painful when it clicks? I know you said it hurts at end range. End range pain is normal but sharp pains with clicking is not.

Sounds like you may have a muscle imbalance in your quads. Possibly patella tracking issues. You may just need muscle re-education.
Are you performing quad sets, slr’s, saq’s, standing hip with resistance? If not you need to be.

In regards to not being able to run. Most post ACL surgery rehab protocol’s do not allow you to run until 10 weeks. Sometimes at the earliest (8 weeks) if doctor feels you have good quad strength then he or she would clear you to implement light jogging.

Keep me posted
Jim

Reply

Dinakar

Dear Jim,

I met my surgeon recently. The good news is that all is going well. She said that the graft is holding quite firm and that the clicking of the knee is not abnormal.

However, just a few hours ago, I had a slip. I was on wet grass, I slipped and by reflexes tried to control myself. I stressed my knee but did not fall. It has been paining since. The pain is absent when I leave the leg relaxed. Otherwise in extreme positions it is painful. But the pain is also not as much as earlier. I hope it is nothing serious. It is very slightly swollen. I hope and to a certain extent think that it is not serious and that it will be fine within a few days.

Do let me know your opinions.

I also thank you specially for your prompt replies.

Dinakar

PS. My surgeon said I can continue swimming (swimming is one of my favourite hobbies :) ) as that would help strengthen my quadriceps because they are not completely strong yet.

Reply

Kayla

Hi my name is Kayla and I’m a seventeen year old soccer player. In February of last year I had meniscal surgery. I went through physical therapy but my knee has never felt the same which I’m sure is to be expected.

In November, my knee twisted in practice and I heard a pop and the doctor thought maybe I had torn my meniscus again but I was able to play on it. I played through the pain and my knee has been in a subtle constant pain ever since. Sometimes it hurts worse than other times and it swells up frequently.

About three weeks ago I was running down the sideline with the ball and I planted my leg to cross. My knee gave out (the same one) and a severe pain began building. I took the rest of practice off and the next one but the one after that I tried to play again. My knee was killing me but I tried to play through the pain. My knee gave out again when I stepped to defend a ball, and this time it brought me to tears and I hopped off the field. I went to the doctor and he thought I had an acl tear. We got the mri back and it shows my acl is sagging and even though it doesn’t show it, the doctor still believes there is a partial tear where it attaches to my tibia because my leg is so unstable. He said sometimes tears like that are hard to pick up on an mri. I also have grade two damage to the posterior horn of my meniscus and a bone contusion. He also thinks i have a possible bone effusion.

They sent me for physical therapy because he wanted to try that before turning to surgery. I have been going for a few weeks and my leg feels no more stable are even less painful. I do not want to just keep doing useless therapy. I am committed to play soccer in college and I want to be back out there training as soon as possible. I go back to the doctor Thursday to discuss my progress and what to do next.

What do you think? Do you think being a soccer player at my level I should just go through surgery so I don’t end up tearing it all the way in the future?
Thank you so much.

Reply

Jim Wnek

Hello Kayla

Yikes.
****
What do you think? Do you think being a soccer player at my level I should just go through surgery so I don’t end up tearing it all the way in the future?
****

I would have surgery (scope) asap.
Here’s why: Where the possible tear is located- going with a scope will allow doctor to know for sure what exactly is going on and allow him or her to repair while in there.

Also knowing that you are a competitive soccer player and want to get back to playing at 100% you need to know what exactly is going on in that knee and then you know what you are up against.

Any further questions just hit me back

Jim

Reply

Neil Kearns

Tore my ACL and MCL skiing. I am now 10 weeks post op and still struggling with ROM. I am stuck around 100 degrees of flex and still struggle for full extension. My orthopedic drive says I should be fine….but I don’t have faith.

Why am I so far behind on recovery? Can the knee start moving and get to full range of motion or should I be pushing for additional treatment?

Reply

Jim Wnek

Hey Neil
Thanks for visiting the site.

**********
Why am I so far behind on recovery? Can the knee start moving and get to full range of motion or should I be pushing for additional treatment?
**********

Several questions before I answer: Are you receiving physical therapy? Are you following a protocol from doctor? Are you still experiencing swelling? If so how much and how often?

Remember…..Ice,Ice,Ice ad then when you thought you iced enough….ice some more.
20 minutes on hour off….repeat

ACL rehab/recovery is a process. You have to be a patient patient- however the knee has to be pushed at the same time. Sounds contradicting -I know.

So, in my experience working with many patients who have had ACL surgery and working with many, many orthopaedic surgeons protocols

you should be flexing to 90 degrees withing first 2 weeks. 120 degrees between 4-6 weeks or sooner. Then your available range by 8-10 weeks.
Regarding your knee extension – we’d like to get you to 0 degrees (full extension) as soon as possible. However, remember every individual is different and will heal and progress at different levels.

I would continue therapy if you are able.
To help with your knee flexion–I would do the following: Get on your hands and knees. Slowly try and bring your butt to your heels. Get to your available range and then go a little past to feel the knee stretching. Hold for 15 to 30 seconds, don’t bounce. Then slowly go back to neutral then repeat. Do this 5- 10 times minimum 3 times a day.

This will help you with your knee flexion.
If you have a home exercise program – you must continue with it to maintain and continue to strengthen.

Hope this helps.
Keep me posted.
Jim

Reply

Shohel

Hi my name is Shohel and I’m a 37 years old fun soccer player. In 6th of May I torn my ACL ligament while I was playing. I went to hospital they advise me to do MRI. MRI reports- There is tear of ACL with secondary bony contusions in the lateral femoral condyle and posterior tibial plateau. There is also a small mildly depressed impaction facture of the posterolateral plateau. The PCL is intact.
Please advise me how long times do I take rest to recover for walk and normal life and do I need for an operation.

Reply

Jim Wnek

Hello there.
Based on your MRI findings. Yes you need surgery and you are looking at a 4-6 month rehab before getting back to 100%

keep me posted

jim

Reply

Jules

Hi Jim,

About 5 weeks ago, I tore my ACL completely (confirmed by MRI) and have grade 2 sprains in my MCL and LCL.

Just recently, my doctor is noticing an “endpoint.” Is it possible for a complete tear to reattach itself? OR is it possible for MRIs to give false positives..?

Nonetheless, I have pretty much full range of motion now, no limping when I’m walking, can go up and down stairs no problem without a single instance of the knee giving in.

I was told that I may be a “coper” and can try conservative treatment, however, I’m in my early twenties and plan on playing intense pivoting sports for as long as I can (at least another 30 years). Is this a bad move?

Let me know when you get the chance.

Thanks in advance,
Jules

Reply

Jim Wnek

Hello,
Thank you for visiting.
I apologize for not getting back to you sooner.

*****
Just recently, my doctor is noticing an “endpoint.” Is it possible for a complete tear to reattach itself? OR is it possible for MRIs to give false positives..?
*****
A complete tear (from my experience will not re-attach itself) however a partial tear does have research that it may reattach.
MRI – YES it is possible (however very unlikely) to give false positives – but it is more likely to not show something as opposed to showing something.

I hope that makes sense.

*****
I was told that I may be a “coper” and can try conservative treatment, however, I’m in my early twenties and plan on playing intense pivoting sports for as long as I can (at least another 30 years). Is this a bad move?
*****
I would recommend surgery.

Yes – I have worked with a “coper” however the individual(s) usually have only a partial tear and are not active (meaning no running, jumping, or activities that require cutting)

Having a complete tear and not having surgery would be tough. Due to what you want to do (play sports that require pivoting) would put you at a high risk for further damage to you knee.

Good luck
Keep me posted.
jim

Reply

Jules

Also, I was wondering if you have ever worked with any copers before? If so, how long were they able to continue playing for? Did they have any problems with instability?

Reply

john

Hi..am a male aged 19..I play a lot of football bt 2 months ago I twisted my knee during a trainig session,I heard a tearing sound.went 2 c the doc but was told I had soft tissue damage n was told 2 give it 3weeks..wich I did bt wen I tried 2 play again my knee gave way again!! Am getting frustrated coz futbo is my lyf..wat cn I do 2 speed up the healing process n wil my knee eva get back 2 100percent?

Reply

Jim Wnek

Hello
First thing that we need to know- Is there damage? If so, what?

If there is no damage and you only have a severe sprain or strain then a solid 4-6 weeks of therapy would help you get back.

Hope this helps
Jim

Reply

Cathy Luxton

Hi Jim,

my 17 year old son tore his ACL while playing football about a month ago. He will be a senior. Going by everything I’ve read, it seems like he’ll have a recovery of at least six months. He has had seven therapy sessions, the therapist seemed to know more than than the orthopedic surgeon we went to. We just managed to get an MRI done:

Findings: There is a large joint effusion with plica thickening. The patella is normally seated. The retinacula and articular cartilage are intact. The marrow signal intensity demonstrates minimal edema in the posterior tibial plateau, possibly minimal contusion. There is an area of probably contusion in the alteral femoral condyle. There is edema adjacent to the fibular collateral ligament, but no definite tear. The biceps femoris tendon and iliotibial band appear intact as well. There is also edema adjacent to the medial collateral ligament without a definite tear. The anterior cruciate ligament is torn and there is anterior displacement of the tibia with respect to the femur. The PCL appears intact. The patellar tendon and quadriceps tendon appear intact.
There is medial meniscal degenerative signal. There is a questionable small tear of the posterior horn of the medial meniscus. There is a large tear of the posterior horn of the lateral meniscus.
Impression: There is an ACL tear with a small posterior horn medial meniscal tear and a large posterior horn lateral meniscal tear with a possible bucket-handle fragment pulled medially to the intercondylar notch. This is best seen on the coronal images.
There is a large effusion and plica thickening. There is edema outlining the medial collateral ligament and fibular collateral ligament suggesting a strain. There is contusion in the lateral femoral condyle and posterior tibial plateau. There is no definite fracture. The remaining tendons and ligaments appear intact.

I think I know what you are going to say, along the lines of your suggestion to Kayla!
I would appreciate your comments.

Reply

Jim Wnek

Hello,
Sorry for delay in my response.

To be short and sweet.

YES- surgery is needed.
Torn ACL, tears in both meniscus.

Looking at 6 months rehab to get back to close to 100%

Please let me know if you need any other advice or help.

Keep me posted.

Jim

Reply

Robert Jones

Hi Jim,

I injured my knee during a takedown while practicing martial arts (capoeira). Felt instability during event. Swelling, slight stiffness, and muscle weakness were experienced a few days after injury. Had MRI done 5 weeks after surgery. Results are below.

Findings: There appears to be an ACL tear near the femoral insertion. PCL is intact. Menisci appear intact. There is no significant knee joint effusion. Quadriceps and patellar tendons appear to be intact. Adnormal signal is seen in the lateral trochlear cartilage. The patellar cartilage appears to be normal. There is mild chondral irregularity in the posterior femoral condyle with minimal associated subchondral edema. There is also a small area of chondral irregularity in the medial femoral condyle with slight underlying bone marrow edema. No fractures are seen. Regional muscalature appears normal. The patellofemoral ligaments appear normal. Quadriceps and patellar tendons are normal.

Impression:
1. ACL tear.
2. No definite meniscal injury.
3. There appear to be small partial-thickness chondral defects in the medical and lateral compartments aas well as possible chondromalacia in the lateral trochlea.

I cannot nail down how much damage I am dealing with. Orthopedists has started me out with 3 sessions of physical therapy. He will revisit my condition after therapy. What are you thoughts, if any, regarding my MRI results? I would like to recover without surgery. Is that possible based on my MRI report? I am a recreational runner and martial artists and would like to return to those activities and am willing to work hard towards recovering.

Thanks!

Robert

Reply

Jim Wnek

Hello Robert
Thanks for visiting

*****
What are you thoughts, if any, regarding my MRI results? I would like to recover without surgery. Is that possible based on my MRI report? I am a recreational runner and martial artists and would like to return to those activities and am willing to work hard towards recovering.
*****

We’ll you will need surgery. Reason- you are a runner and most importantly you participate in martial arts.

Full recovery and full participation in martial arts without surgery is possible. (not recommended) but it is possible.
With an extensive rehab – strong emphasis on strength and stability along with an ACL brace you could.

Good luck and keep me posted
Jim

Reply

Markel Keys

Hello I am 5 months out of the surgery and have been rehabbing on my own I feel strong and I feel like I can get back on the field today I know I’m taking risk seeing that I was back squaring(reps 135) and doing lunges with weights stepping up on a platform also doing step ups with resistant bands and many other activities…. but I have to take these risk because I don’t have doctors around me like NFL athletes YET but I am on the verge of an Adrian Peterson recovery only problem is there is still soreness in my knee I have been jogging and doing slight cuts and things I can almost leg press more then I did before the injury and fast twitch muscles have made me quicker I’m looking to run a rub 4.3 40 coming off this recovery my comeback season is coming up and I’m looking for advice to see what this soreness is the pain from 1 to 10 is a 2 but I just don’t want a setback if there is anything I may do please

Reply

Scott Earhart

First off let me say how you are responding to people is one of the best things I have seen. Giving professional advise not for money, just to help people is amazing! So thank you for doing this.

I have a few questions, I tore my ACL/MCL playing basketball. A kid fell into my knee collapsing it inward. I am 25 year old male and in good shape so my Doctor did surgery within 5 days of the incident. Surgery went well, he used my hamstring for the ACL and pined my MCL back into place. As of right now I am 19 days post surgery. Doctor said he wants to start physical therapy after week 3. I am still using crutches to help me walk and my knee feels very unstable. I get pain in my MCL when I bend it or try to walk freely. My MCL has been giving me the most pain, then my knee cap. As of today I am getting full contactons in my quad, I can get to 90, and I with something holding my foot I can get my leg to be straight.. So here are my questions:

How fragile is my MCL at this time? If leaned to my side could it tear (sometimes it feel like it could)?

Will the MCL slow down the recovery?

Is it normal for the MCL to hurt more?

My shin is a little sore, is that normal?

I thought getting to PT right away is key, why would he have me wait 3 weeks? I don’t want scar tissue to build.

The back of my knee is sore, could I have done damage back there that he didn’t see?

When picking a PT clinic what should I look for. A chain (Athletico or ATI) or a local more technical place, but with older equipment?

Sorry for all the questions, my doc is very in and out kind of guy, and me being young he’s not even that concerned. He promised me I would be back faster than D Rose.

Reply

Jim Wnek

Hey Scott
Thanks for visiting.

Well first, not sure why you didn’t start therapy right away.

How fragile is my MCL at this time? If leaned to my side could it tear (sometimes it feel like it could)?

It will be pretty sore. You will start to have scar tissue build which will be attaching so it may start to feel like its pulling along the side.
*****

Will the MCL slow down the recovery?
Not from my experience. You will have to be cautious but with normal protocol you should be just fine.
*****

Is it normal for the MCL to hurt more?
Everyone is different. Yes for some people the mcl could hurt more.
*****

My shin is a little sore, is that normal?
Yes- due to lack of motion (primarily extension) you will tend to keep foot dorsiflexed causing increased tightness in your shin.
*****

I thought getting to PT right away is key, why would he have me wait 3 weeks? I don’t want scar tissue to build.
Yes it is. Not sure why. Scar tissue can be a problem.
*****

The back of my knee is sore, could I have done damage back there that he didn’t see?
Soreness is common. Very unlikely that something was overlooked.
*****

When picking a PT clinic what should I look for. A chain (Athletico or ATI) or a local more technical place, but with older equipment?
It really is preference. I live and practice in the greater chicagoland area. Both Athletico and ATI are both very good companies/clinics.
A lot depends on location and who you work with.
*****

Are you from the chicagoland area?

If so, my offline business is: http://www.core1inc.com.
We are located in Downers Grove.

Hope this helps
Keep me posted
Jim

Reply

Scott Earhart

Yes I am, I’m from the south side. I had my surgey done by Dr. Blare Rhode. I would like to come in a check out the clinic. If I were chose you for PT how many times a week do u normal see a patient?

Reply

Dan P

Hi Jim

April this year playing soccer I exended my knee and twisted awkwardly, after hearing the dreaded ‘pop’ a feeling a surge of crippling pain, off I went to the medical center. 2 weeks later an MRI confirmed a complete tear of the ACL, meniscus damage and MCL sprain.

As of now (3 months since the injury) I am able to bend/straighten it significantly (physio says its not far off 130) and I am doing light bodyweight excercises (lunges, squats etc) I plan to return to soccer so I am looking at ACL surgery later on this year (October hopefully) in the mean time, should I be carrying on with excercises like this? Or should I be ‘resting’ for preparation of the surgery? I’m just worried that I may be aggravating it more but I feel comfortable doing the excercises.

My other question is regarding that I’ve encountered a very loud click occurring in the core of my knee (nearer the back) and occasional pain, is this normal? And is the pain coming from the damdaged meniscus or the ACL?

My final question is the period between injury to surgery (approximately 6months) am I more likely to have problems recovering from it the longer I’ve been holding off surgery?

Many Thanks !

Reply

Jim Wnek

Hey Dan, sorry for delay in response.
First thanks for visiting.

Question:
should I be carrying on with excercises like this? Or should I be ‘resting’ for preparation of the surgery? I’m just worried that I may be aggravating it more but I feel comfortable doing the excercises.————–Definitely keep with your exercises. You need to strengthen all surrounding muscle group to help stabilize and remember —-ice, ice, ice 20 minutes on 1 hour off then repeat.

Question:
My other question is regarding that I’ve encountered a very loud click occurring in the core of my knee (nearer the back) and occasional pain, is this normal? And is the pain coming from the damdaged meniscus or the ACL?—————The click normally is not normal. But with your type of injury – it is. Other structures may be getting tight by helping stabilize the knee joint due to the lack of having an intact ACL.

Question:
My final question is the period between injury to surgery (approximately 6months) am I more likely to have problems recovering from it the longer I’ve been holding off surgery?———– not really- assuming you don’t cause any further damage to that knee. everyone is different. everyone heals and responds at different paces. but what I will advise is get your involved leg as strong as possible while you wait. but a good 6 months you should be pretty solid.

Keep me posted
Jim

Reply

Siddharth

Hi doc !! This is siddharth i am 19 years old !!
i had a ACL injury in may 2013 .. and i am hestiant to go for a surgery .. !!
FINDINGS :
The anterior cruciate ligament is thicknend and edematous and interstitial hypernitensity and laxity with fraying and blurring of fibres with a focal discontinuity near the fermoral attachement suggestive of grade 3 ACL tear . The femorao-tibial attachement appears intact . There is anterior tibial translation of 6.5mm.

patchy areas of hyperintensity are seen in lateral femoral and tibial condyles and a small area in lateral femoral condyle of stir images suggestive of marrow edema .

Posterior cruciate ligament is normal.
medial and lateral menisci are normal .
medial and lateral collateral ligaments are normal.
patella is normal in signal intensity and cortical outline.
patellar ligament and quad tendon are normally vizualized .
Menimal fluid is seen paracondylar regions of femur .. !

i have opted for Physiotherapy and it has really helped me ! I am 90% fit and the doctor has not suggested for surgery .. !!
what r ur suggestions . ??

Reply

Jim Wnek

Hello Siddharth
First. thanks for visiting the site.
Second. for the record I am not a doctor. I am a rehab professional that works in the field of sports medicine and physical therapy and have rehabbed hundreds of patients with ACL complications.
I own a sports training and physical therapy practice in the greater chicagoland area. My company is http://www.core1inc.com.

To answer your question.
I would suggest you follow the advise of your doctor and your therapist.
My questions to you would be:
Do you play sports? If so, which type of sports?
What type activities will you be involved in?

A lot depends on the amount of stress you will be placing in that involved knee.

keep me posted
I will be introducing a customized rehab/prevention program based on your individual needs.
When I am ready to roll this out I will let you know. If you’re interested – I am more than willing to help.

thanks
jim

Reply

Aiden R

Hi, i tore my acl in january, and had surgery on february 14th, currently my PT gave me clearance for full effort 100% drills no contact basketball. We have been extensively working on agility and cutting the past month. And she says that in two weeks she says its fine for me to play full contact 5 on 5 again. Is this too soon? The knee feels extremely stable but i do have some pain in the patellar region due to the patella tracking, and i can not jump as high off the rehabbed knee compared to my non rehabbed knee. I do have a custom fitted sports brace and am 17.

Reply

Jim Wnek

Hey Alden

You are 5 months post op.
Is this too soon? Yes and no.
Everyone is different. Everyone will progress at different levels.
Sounds like you are kicking butt with you rehab program (except for jumping abilities)

Too hard for me to say yes or no to going full out 5 on 5. But if you feel confident and you are wearing the brace then I stringy believe you will slowly regain your full strength especially jumping abilities.

In regards to the knee pain. That is common especially now that you are going full out. Just ice, ice, ice!

keep me posted
jim

Reply

Nikhil chauhan

I m Nikhil i was playing basket ball whn i jumped n landed my knee got twisted n i heard a
sound.after that i had n plaster for n week n thn i wore a knee brace for a month. My mri report says
marrow edema in the posterior and mid lateral tibial plateau,posterior lip of medial tibial plateau and anterior weight bearing surface of the lateral femoral condyle
moderate amount of fluid in joint space
sprain of ACL
radial tear in the posterior horn of lateral meniscus
mild edema in the posteromedial and postero-lateral superficial soft tissue of the knee joint

i m not able to do full movement of leg
i had n injury 6 week ago
please suggest me is it critical
thank you for responding to me

Reply

Jim Wnek

Hey Nikhill
Thanks for visiting

Question: please suggest me is it critical

Based on what you supplied here. I don’t think it is critical. However, what did you doctor advise? Did he or she recommend surgery for the meniscus?
Meantime I would be working diligently to regain motion, strength and stability.

Not sure how much movement you are lacking but after 6 weeks from the injury you should be pretty close to full range of motion and then working more and more on strength, balance and stability.

keep me posted
jim

Reply

ashton

I have a question I just had ACL reconstruction surgery and I just got my staples out today and they said I would beable to start therapy soon and to start to try to walk on it .
So I get home and a drink spilled and I was trying to clean it up and my crutches slipped and I had to catch myself from falling twice in a row …and now my knee hurts worse than it did earlier today ….do you think it just got joustled or did I re mess something up..

Reply

Jim Wnek

Hey Ashton

Thanks for visiting.

Right now – ice, ice, ice 20 minutes on 1 hour off.

If it was me- call your doctor and explain and tell them you are coming in to have it checked.

It may be overreacting but hey who cares. You want to make sure everything is okay.

keep me posted
jim

p.s. be careful on those crutches.

Reply

Gagandeep

Sir, 2 months ago when i am playing soccer during a sprint my leg got twisted giving so much of pain. My MIR report told us that there is complete ACL tear, medial meniscal root and horn tear.Sir i don`t want to go for surgery.Is there any way to recover my ligaments and one more question i also going abroad within 3 months but if i will have surjery than my plan will be ruined so how much gap can i make in my surjery………thank you……..:-)

Reply

Jim Wnek

Hey Gagandeep

Well, sorry to hear about your knee.
You definitely need surgery.

A complete tear will not heal on its own.
Meniscus tear you may be able to get by without surgery but really depends on your symptoms and function.

If you had surgery today 3 months might be a little quick. But it really depends on exactly what you will be doing. If you will not be to active then having surgery and having a 3 month rehab time before trip might be doable. Really depends on what you need to be able to do with that knee.

good luck and keep me posted
thanks
jim

Reply

Gagandeep

Firstly,Thank you sir for your suggestion…….Secondly,Sir i am going to canada for study which is of 2 years and after that i am thinking of surgery……is there will be any problem and i will also don`t participate in any knee stress sport or job….help please….Thank you…:-)

Reply

Gagandeep

sir,may i also do massage of my knee….?
and what should i eat?

Reply

ashton

Well I called my doc office he was in a surgery so they said they would ask him and call me back well they never did …and then the weekend came and then labor day but during the time of waiting I have started walking on it a little here as there without the crutches and I can bend it a little and I try to put my leg straight and I feel like its straight but I think my knee is still so so swollen that it won’t go down all the way …..I have an appointment tomorrow for my first physical therapy and I’m nervous they will say I’m not far enough along to where I should be …..thank you for responding so fast !!!!

Reply

Nick Frankel

Hey Jim
I’m a 15 year old from Australia, Avid cricket player,
Relatively keen for afl too. My main hobbie out of organised sport is bmx riding, which is actually where I hurt my knee 2 months ago. I misjudged a jump, landed with all my weight on my left leg and it popped and cracked and was extremely painful. Swelling within 5 minutes. I went to the doctor and an ultrasound revieled a grade one MCL sprain and I was happy with that because that meant I could get back to normal within about two weeks, but after a later doctor appoinment, about 6 weeks post injury I was told I had probably torn my acl, based on what I described what happened and what happened several times afterwards when I tried to return to some sports.
Whenever I do something my knee will be fine, but if I land on my left knee heavily it will give way and hurt just as it did the first time. The third time it happened my brother was watching and said my knee folded a way it shouldn’t have folded and I was wondering if you think it’s an acl injury ? If so should I start doing some physio just incase of surgery? A week after the last time I re strained it I can walk but can’t completely straighten my knee. Should I get a brace or something in the meantime to stop more injury occurring ?

Reply

Jim Wnek

Hey Nick,
First I AM SO SORRY. For some reason one of my security plugin features for the site has been kicking all new incoming comments into to spam folder.
So I apologize for just getting back to you.

The third time it happened my brother was watching and said my knee folded a way it shouldn’t have folded and I was wondering if you think it’s an acl injury ?
—Sounds like it is. “I hope I’m wrong.” Reason being is because you have no stability in the knee upon increase pressure.

If so should I start doing some physio just incase of surgery?
—Yes.

A week after the last time I re strained it I can walk but can’t completely straighten my knee.
—Reason you cannot straighten the knee is because of joint effusion. Your knee is swollen and all the fluid is accumulating in the joint space. Therefore limiting your range of motion and causing your knee to be unstable.

Should I get a brace or something in the meantime to stop more injury occurring ?
Yes, I would. Brace, ice and start performing knee stabilization exercises.

Again sorry for delay. All is fixed on the site.
Keep me posted or inform me on what has transpired since you submitted your questions.

thanks
jim

Reply

Swati

Hi!

I’m pretty active. I got my ACL injury in July this year while doing plyometrics on a hard surface but I must mention that I also unintentionally overtraining myself for the last one month of activity. I didn’t have too much pain or instability or swelling, just a bit of pain and instability enough to deter me from exercising. :P

I’m doing physiotherapy since 15 days – some improvement in pain and instability has taken place but the progress isn’t linear and I tend to get more pain and instability when I stand/ walk for as long as 15 mins at one go.

My problem is I have no insurance or money for surgery or even MRI actually. I might somehow do an MRI if need be, but surgery seems pretty out of question. The doc has asked for an MRI if I don’t start improving in 15 days of physio.

I know it isn’t enough info but is there a way to tell the extent of my injury (if I’ll need a surgery) from the way I’m progressing?

Thanks…

Reply

Jim Wnek

Hello Swati,
As you may have seen in a previous reply. I apologize for not getting back to you right away.

I know it isn’t enough info but is there a way to tell the extent of my injury (if I’ll need a surgery) from the way I’m progressing?
—-with continued pain and instability it looks like you do have an ACL issue. Without having an MRI to confirm- it is hard to say for sure you will be fine without surgery. So, based on your progression it is looking like surgery is in your future

Hope it all has worked out.

please keep me posted
thanks
jim

Reply

Josh Curry

Two weeks ago an MRI showed that I have a partial ACL tear, along with trauma to my miniscus. The diagnosis was that it was not a major injury, but would require rest for full recovery. The injury dates from about a month before. Since the original injury I have been working with light exercises for muscles around the knee, and over the last month and a half have been doing exercises to slowly increase strength and ROM. I have been doing some stretches to test torque of knee, towards being able to engage meditative sitting position, but some aching has come back into the knee, which feels like a reversion of progress. What can one do when aches come back? Is it necessarily bad (I’ve been told that some ache after phys. ther. is good) or should I treat it as a reversion of progress and back off completely? How do I know when healing is complete?

Reply

Jim Wnek

Hey Josh
Sorry for delay.

What can one do when aches come back?
—rest, ice and over the counter meds.

Is it necessarily bad (I’ve been told that some ache after phys. ther. is good) or should I treat it as a reversion of progress and back off completely?
—- yes and no. yes you will have some soreness and yes you will feel soreness after therapy sessions. but there is a difference between muslce soreness and pain and swelling from trauma. You may just be re-aggravating the original injury. (I hope not!)
I wouldn’t back off unless you truly feel like you are doing more damage than good. If not, then keep working it.

How do I know when healing is complete?
—-no pain or soreness for 2-3 complete days. Everyone has different ways of knowing but I’ve found this to be a good way.

Please keep me posted.
again sorry for delay

thanks
jim

Reply

meet

hello sir .. im 28 yars old female. on march 2013 during skiing my leg got twisted , according to my MRI report i have ACL grade-1 strain with minimal joint effusion. and its been 6 months and i m still in pain and feeling instability.

i m doing exercises of hamstring,squats, quadriceps, straight leg lift etc.. i also do icing one time a day .i just want to ask u that as it has already been 6 months . how long more will it take to heal in your opinion ?? i m unable to fold my leg properly. i have to climb stairs daily at my work place (10-15 steps) . should i avoid stairs? will i be ok as i was before ingury ? shoud i avoid walking too?
what r ur suggestions for my acl strain ??

Reply

Jim Wnek

Hello Meet,
First so sorry for delay. My website plugin was pushing all comments into my spam.

i m doing exercises of hamstring,squats, quadriceps, straight leg lift etc.. i also do icing one time a day .i just want to ask u that as it has already been 6 months . how long more will it take to heal in your opinion ??
—–Question for you. Has the pain, swelling and discomfort subsided since initial injury? Do you only have pain? swelling? or discomfort? meaning do you and one, two or all three? How long does it last? does the knee buckle or give out?
—–6 months you should feel better than you do now. Healing time varies from person to person. But in my opinion you should be healed at this point.

i m unable to fold my leg properly. i have to climb stairs daily at my work place (10-15 steps) . should i avoid stairs?
—–Stretching may be able to help you with folding you leg. I would guess that you still have swelling present within the knee joint which is not allowing you to have full joint motion to allow folding of you leg. control the swelling within the joint, stretch and you hopefully will be able to again.
—–Yes and No. Yes because stairs do requires more muscle control and effort which may put a little extra strain within your joint therefore causing increased strain. No because since stairs do work your legs more they are helping get you stronger.

will i be okay as i was before injury ?
—— I would say YES. But everyone is different. Everyone heals differently. with proper exercises, icing you should be fine.

should i avoid walking too?
—-NO walking is the best activity for you.

what r ur suggestions for my acl strain ??
—–proper stretching and strengthening program. You need to have as much stability within you leg as possible.

keep me posted
jim

Reply

Dev

I was injured during a football practice and my doctor told me that i had a slight acl tear.
I’m also an active thespian and need use of my knee for our opening in six weeks.
Can my acl heal in time for opening night?
What can i do to heal faster?

Reply

Rajeev Jaglalsingh

I had ACL surgery on 20/09/13 using the patellar tendon graft and I am in a lot of pain. My MRI report stated that I had a complete ACL tearn and a meniscus tear. I want to find out how long would i be able to walk and im not comfortable using crutches.

Reply

Aaron

My story:
I’m as sophomore in high school and after the whole preseason, 7 on 7′s, two-a-days, camp, and was in line to start varsity at slot receiver. However, in our season opener I was the last line of defense on the kickoff team and when I made the tackle I felt (and think I heard, but not entirely sure) a pop in my knee- It was the first kickoff of the game. The next day an MRI revealed a tear in my ACL and a slight tear in my meniscus. MCL was also sprained.

I am now a week and a half out of surgery and feeling decent. (My surgery was done by taking patellar tendon.) I have used the CPM and gotten it maxed out at 120 degrees for a few days now, and can put 50% of my body weight (around 80 pounds is half) on the leg while using crutches. Through therapy I have regained the ability to do straight leg lifts on my own. I’m supposed to do sets of 10 but I usually go above that. My stitches were just removed and the surgeon has said multiple times about how it “looks in great shape.”

Well after that rant here is my question. When I recover, will I be able to run at the same speed and cut as hard on my right as my left? I am terrified of “losing a step” as many say. It’t the one aspect that has always set me apart from the rest of the pack and I really really would not want to lose that. Lacrosse and track season starts in a bout 6 months and I was told that I will be able to play. I don’t expect to be fully back to normal by then, but I was wondering if by next football season I’ll be the same as before?

Reply

Jim Wnek

Hey Aaron
Thanks for visiting.
Not sure why my replies never posted.

When I recover, will I be able to run at the same speed and cut as hard on my right as my left?
–YES (with proper rehab and training you will be able to regain most)

I am terrified of “losing a step” as many say. It’t the one aspect that has always set me apart from the rest of the pack and I really really would not want to lose that. Lacrosse and track season starts in a bout 6 months and I was told that I will be able to play. I don’t expect to be fully back to normal by then, but I was wondering if by next football season I’ll be the same as before?

- Hard to say. But with technology (surgery procedures) today along with proper rehab and training for back to sport you should be pretty close to what you were before.

Good luck
Jim

Reply

Tavish Rice

Hi! I recently tore my ACL/MCL while playing soccer and had surgery a week and a half ago. My main sport is soccer and I’m wondering first what the timeline would be in a best case scenario in order to recover. I was also wondering if there were any things you knew from experience that I can do or use that will help with recovery and/or therapy?
Thanks!!

Reply

Jim Wnek

Hey Tavish
As I said in a previous response
Sorry, not sure why my reply never posted.

My main sport is soccer and I’m wondering first what the timeline would be in a best case scenario in order to recover.
– 6 months return to sport

I was also wondering if there were any things you knew from experience that I can do or use that will help with recovery and/or therapy?
– Too much to go into via reply. If you’d like a customized program based on you age, gender, type of surgery, sport, position?
Email me at: jim@core1inc.com
We can customize a program for you and send it to you via video.

Good luck
Jim

Reply

Sadie

I’m military and I hurt my knee doing combatives class (ironically enough after I spent a month and a half training for and competing in a combatives tournament with no serious injuries). I really enjoy combatives and don’t want to give it up but when I hurt my knee, although they initially thought it was a sprain, eventually I got sent in to get an MRI and they found that I tore my ACL and meniscus. They thought it was a complete tear. Shortly after that, I went in for reconstruction surgery, but the doctor went in with the scope and found that while the tear looks complete on the MRI it is only a partial, so they closed me up. That was in August. I’ve been doing physical therapy and working really hard to get back to the level of fitness I want and need to be at without pushing myself too hard, and my leg feels much stronger than it did before surgery and my range of motion has improved quite a bit. I still can’t straighten my leg all the way out on my own though and my knee itself still feels unstable fairly often. At least once a day, I feel like it’s going to buckle when I move wrong. In November, I’ll find out if they want to push for surgery anyway after all my strengthening, but I’m worried the best decision won’t be made because I’m not even all that sure what the best decision is for me. With that little bit of information, do you have an opinion? I really like my ortho surgeon and he seems really wise about this, but being tied up by military rules and regs and whatever is what worries me. I know I can push for a second opinion though if I need to. I thought asking you would be worth a shot and helpful when I try to figure out what I need to do to take care of myself and get back into combatives and fight training. Thank you for any assistance!

Reply

Jim Wnek

Hey Sadie,
So sorry for delay in response. As you may have read in my previous response my website security plugin was pushing all comments to my spam folder.

Your questions:
With that little bit of information, do you have an opinion?
—– I would get surgery. It sounds like you need it ( unstable knee, knee buckle) not good signs.

I really like my ortho surgeon and he seems really wise about this, but being tied up by military rules and regs and whatever is what worries me. I know I can push for a second opinion though if I need to.
— A 2nd opinion wouldn’t hurt. But be prepared the hear what you r were already told by previous surgeon. In regards to rules and regulations. I’m not quite sure but if you cannot perform your duties then I would assume you need to get your knee 100% fit for duty.

I thought asking you would be worth a shot and helpful when I try to figure out what I need to do to take care of myself and get back into combatives and fight training. Thank you for any assistance!

I would consider surgery at this point.

good luck
keep me posted
jim

Reply

Karen

Hi, My Boyfriend Tore his ACL on The Job, for a Tow Company, on October 21st 2012 he had surgery in April 2013 to replace it. The Original plans were to use a cadaver, but during the surgery those plans changed , a piece was taken from his inner thigh instead . Through his recovery he has been going to therapy which he attended about 5 weeks after surgery, 3x a week. He gained a lot of muscle strength on his thigh & calves, but recently in the last 3 to 2 weeks his knee feels loose and has been giving out a lot( which previously wasn’t happening). He also noticed in the beginning his foot wasn’t facing straight forward, after months of therapy that problem had been corrected, he had been walking perfectly straight. This is no longer the case, his foot is once again turned as he walks and he can’t straighten it. Can anyone please tell me if this is normal behavior for the knee and what can possibly be happening? Is it possible the ACL has been released? Is it possible too much therapy is causeing the problem? Is it possible to request another MRI to check the injury, and does the doctor have to comply with your request? If anyone has any professional answers for me I’d greatly appreciate it. Thank you.

Reply

Jim Wnek

Can anyone please tell me if this is normal behavior for the knee and what can possibly be happening?
—-It is not normal. Yes some patients do have set backs. sounds like this is what is happening. The loose feeling maybe due to increased swelling which causing instability in the knee. Foot out when walking could be just his body compensating for lack of motion and strength in his leg.

Is it possible the ACL has been released?
—–Yes , but unlikely. It could have not taken but percentage is low.

Is it possible too much therapy is causing the problem?
——it could be. Too much strengthening and work then the knee can handle can cause increased soreness and swelling.

Is it possible to request another MRI to check the injury, and does the doctor have to comply with your request?
—–Yes it is possible but doctor may not request. All you can do is ask and explain your concerns. However from my experience without him sustaining a major injury to it since surgery it is unlikely doctor will agree with your request.
But i would sure try!!!

If you hadn’t received another MRI since you last responded. Here is what I would do.
Continue with rehab. Rest when you can, strengthen, stretch, ice and really work on his functional stability and endurance.

I hope this helps.

keep me posted
jim

Reply

surya

Dear Sir,

about 7 days back I met with accident and got injured my knee and the MRI report as below:

the ACL demonstrates retained tibal/femoral bony attachments. it appears bulky with increased intrasubstance signals and shows loss of parallelism to the intercondylar roof, note anterior translocation of the lateral tibia over femur – Acute Interstitial injury/partial thickness tear.

sir is it sufficient if i take rest or should i undergo surgery/am average working person/

please i require your kind help.

Reply

Jim Wnek

Hello Surya

I would try a conservative approach.
Rehab for 6-8 weeks and see how your knees responds. If no progress then I would consider surgery.

keep me posted
jim

Reply

Nikit

Hi im a 16 year old boy and i injured my knee on 3rd september 2013 and soon found out that i have an ACL tear.

This was in my MRI report-

Findings-

Hyperintensity is noted within the ACL ,which appears bulky, demonstrates laxity, intra substance fluid and disruption of it’s fibrea. Fluid is seen around it’s distal attachment. there is evidence of marrow edema in the lateral femoral and tibial condyles. Buckling of the PLC is also noted.

Degenrative changes in the posterior horn of medial minicus.

There is mild synovial effusion with distension of the suprapettla bursa.

The pettla and fibular head appears normal in outline and marrow signal.

The lateral minicus appers normal in size,outline and signal intensity.

The medial and fibular collateral ligaments , quadraceps tendon and ligamentum patellea apper normal in outline and signal characterisitcs.

IMPRESSION-

Post-trauma apperances with tear of the ACL and degenerative changes in the posterior horn of the medial miniscus.

#I don’t want to get operated for this injury . I don’t feel any buckling in my injured knee and there is no instability, but swelling appears with exercise and i don’t feel any pain in my injured knee.

I am a basket ball player.

What do u suggest ????

Reply

Jim Wnek

Hey Nikit,

Well, I would suggest going through some extensive rehab. Strengthen that knee as much as possible. While you are going through rehab i would have your therapist test that knee as much as possible to really see what it can handle and not handle. If your knee shows that it is stable enough then I would suggest forgoing surgery and continue with keeping that knee as strong and stable as possible.

keep me posted
jim

Reply

Ethan

Hello,

I recently tore my ACL about 3 weeks ago. I’m due for surgery on November 5th. I just wanted to know how long it will take me to play basketball again. I also wanted to know if I was fully committed to PT and worked hard each time, what would be the earliest I could return.

Thank you

Reply

Jim Wnek

Hey Ethan

With surgery on 11/5/2013 you are looking at 6 months to return. then it will have to be implemented slowly.

It could be sooner and it could be longer. It really depends on how you heal and respond to the surgery and rehab.

keep me posted
jim

Reply

kim

Hi I fell down stairs and landed on cement two months ago. I went to see an orthopedist and after an mri I was told that I have a sprained acl and bone bruise. I have been doing physical therapy for a month and I still have pain everyday and swelling. I am 25. I am noticing a lot of improvement in walking with less of a limp and my knee feeling stronger but I do have pain when walking and sitting in many positions. I was wondering how long it usually takes to recover from this type of injury. Also what symptoms I should watch out for that would make a follow up with my orthopedist necessary (he said to come back in 6 weeks which is now if I was still in pain however when I asked my physical therapist he said he thinks im ok but in a “wavy” period)

Reply

Jim Wnek

Hello Kim
Thanks for visiting.

Sprained ACL and bone bruise healing time?
Everyone heals differently and at different paces.

On average you will see good progress around the 6 weeks mark. However, some may be a little quicker and some longer.

As far as symptoms to keep an eye on are as follows:

swelling (especially when and how often)
Any sharp pains
knee giving out “buckeling”
and antalgic gait pattern (limping or compensating)

Now, since you continue to have pain and swelling even after 6 weeks post injury. You just might be taking a lot longer to heal.
Bone bruises sometimes do take longer to heal because they are so deep. Also, depending on what grade sprain of your ACL you most likley just need a lot more time to recover.

keep me posted
jim

Reply

PRAHLAD

I am 22 years old.before 2 and half month ago I was playing football and I had knee injury . after 2 days of my injury I visited the dr. he suggest me the knee brace , rest , ice and exercise after x-ray but after 2 months I can’t able to jump as well as run but walk normally after that I again visited the dr. than he suggest me for the MRI .My MRI report impression tell , ” Grade – I ACL tear .Contusional marrow edema in lateral femoral and tibial condyles. Minimal suprapatellar bursal effusion and joint effusion”. After viewing this report dr. speaks me that no need to surgery and again one month rest with hinged knee brace. so sir plz suggest me what should I do and when I will back in my normal activities.

Reply

Aaron

My story:
I’m as sophomore in high school and after the whole preseason, 7 on 7′s, two-a-days, camp, and was in line to start varsity at slot receiver. However, in our season opener I was the last line of defense on the kickoff team and when I made the tackle I felt (and think I heard, but not entirely sure) a pop in my knee- It was the first kickoff of the game. The next day an MRI revealed a tear in my ACL and a slight tear in my meniscus. MCL was also sprained.

I am now a week and a half out of surgery and feeling decent. (My surgery was done by taking patellar tendon.) I have used the CPM and gotten it maxed out at 120 degrees for a few days now, and can put 50% of my body weight (around 80 pounds is half) on the leg while using crutches. Through therapy I have regained the ability to do straight leg lifts on my own. I’m supposed to do sets of 10 but I usually go above that. My stitches were just removed and the surgeon has said multiple times about how it “looks in great shape.”

Well after that rant here is my question. When I recover, will I be able to run at the same speed and cut as hard on my right as my left? I am terrified of “losing a step” as many say. It’t the one aspect that has always set me apart from the rest of the pack and I really really would not want to lose that. Lacrosse and track season starts in a bout 6 months and I was told that I will be able to play. I don’t expect to be fully back to normal by then, but I was wondering if by next football season I’ll be the same as before?

Reply

Jim Wnek

Hey Aaron,
So sorry for such a long time for my response.
I hope this response finds you and you are doing well.
To answer your question.

Yes you should be fine for next football season.
Come June and July of 2014 you should be feeling pretty darn close to 100%.

Please keep me posted.
If for some reason you are not feeling like you are making progress and are behind – let me know. I can help

Good luck

Jim

Reply

gilda

here is the finding minimal joint effusion is appreciated .negative forbakers cyst the aclis attenuated the posterior cruciate and colateral ligament are intact there is abnormal signal intensity at the posterior horn of the medial meniscus the lateral meniscus is unremarkable the retinacula quadriceps femoris and patellar tendons are normal osteocondral defect isnoted in the medial patella negative for muscle strain

impression

consider partial tear inthe acl torn posterior horn of the medial meniscus ostheochondraldefect medial patella minimal joint effusion the doctor said diagnosed with acl tear meniscal injury knee left do i need a surgery and how long to recover thanks

Reply

Jim Wnek

Hey Glida
I am so sorry for delay in my response.
Hope this response finds you and you are doing well.

Will you need surgery and how long to recovery?
From the impression and findings – yes.

Recovery 4-6 months to feeling back to normal.
Maybe longer if you require your knee to be involved with running, jumping and cutting activities.

Please keep me posted

Jim

Reply

Jaffer

Hi Jim,

I was playing soccer last week and during the game I went for a tackle and positioned my foot hard without full balance and then heard a pop noise followed by minor to intermediate pain which lasted very shortly. I was then able to walk normally but the next day I was in pain and couldnt bend it or extend it all the way so was limping for the next few days. Went to the doc and he physically examined the knee and suspected lateral meniscus damage and after a lot of googling so did I but he asked me to get the MRI done. I rested and followed the RICE formula and made sure I iced every day and applied anti inflammatory cream on the knee before I went to sleep. I then got the MRI done and its been almost over a week and I regained almost 90-95% motion from my knee since every day I slowly started stretching my leg and doing some small gentle exercises day by day and now I dont fail pain when I walk and can extend it all the way. When I bend it back all the way, there is very minimal pain which is getting less as time passes. I did the MRI and spoke to the doc about the results. The MRI indicates there is a diffuse intermediate to high signal changes seen along the ACL with loss of sharp outline to the ligament. Its says menisi and PCL are in tact and fine but it says a small joint effusion is present with fluid extending into the suprapatellar space. It says everything else is fine and the conclusion is diffuse tear of the ACL with marked edema. Now the doc said my ACL was in tact during my first visit before the MRI after moving my leg in different positions. Is this an ACL grade 1 sprain? Doc thinks I dont need surgery because although the outline isnt thick and clear in the MRI, it still is present there so he thinks maybe some fibres were damaged making the ACL looks thin but if it has stability then physio can help strengthen the muscles around it and I can return to my regular activity. So Im not sure what to make of it. Is it an ACL tear? I play frequently at a high level and I have a big match on December 13th which is around 20 days away. Its a try out at a club and it is extremely important to me. Is that too soon in your opinion? Am I risking making it a complete rupture? At the moment I have stability and almost full motion with slight occasional pain which is decreasing over time when making certain movements. Would really appreciate your feedback on this as I cant seem to find a similar case like this one. Appreciate your help Jim.

Reply

Jim Wnek

Hey Jaffer
Sorry for delay in response.
I know its past dec 13th.

What has happened?
I am interested to know.

thanks
jim

Reply

Syed Bukhari

Hi,
I tore my ACL and sprained MCL while playing basketball In my left knee 5 weeks ago.
5 days ago I had a successful surgeryand will be starting therapy in a day or two. I am, however, Having a lot of pain on my other knee and am not able to bend it all the way (probably about 70 degrees) plus I have a lot of swelling in it. I did not injure it and the symptoms started a few days before surgery. I talked to my doctor and even he is shocked on why this is happening. He will have me get a MRI so I’m just waiting for that. But I was thinking what you think might have happened. I know the other knee intakes a lot more pressure to compensate but my orthopedic surgeon said it’s not a norm for the knee to swell up like that especially that much.
So what do you think?

Reply

Jim Wnek

Hey Syed
Sorry for my reply not being posted

So what do you think?
—-Very interesting. Yes by compensating for the left your right could be overworked but that quickly seems odd.
My thought is that maybe you already had an injury to the right but never showed any signs or symptoms and now that you are compensating with the right your right knee is letting you know something was wrong.

Hopefully you’ve had everything taken care of

Keep me posted
Jim

Reply

Venkat

Hi,

I have twisted my left knee on 16th of Dec while playing shuttle and following are the MRI observations. The doctor is advising surgery for Minisci and acl ligament reconstruction. Could you help me know if they are really required? Following are the observations

1. pathcy hyperintensity and irregularity of the anterior cruciate ligament at the femoral attachment site – S/o TEAR.
2. Small focal hyperintensity in the femoral attachment of the posterior cruciate ligament – s/o EDEMA/CONTUSION
3. The medial meniscus appears to have been stripped off with non visualisation of the posterior horn and is flipped medially giving rise the appereance of double pcl sign – S/o BUCKET HANDLE TEAR OF MEDIAL MENISCUS
4. Small patch hyperintense signal involving the media collateral ligament with normal thickness of the ligament – S/o GRADE 1 SPRAIN OF THE MEDIAL COLLATERAL LIGAMENT.
5. Mild synovial effusion.

Appreciate your help and inputs.

Venkat

Reply

Jim Wnek

Hey Venkat

Could you help me know if they are really required?

Based in the MRI impression.

Yes. I would take the advice of your doctor.
If not then I would get a second opinion.

Did the doctor look at the MRI films?

Keep me posted
Jim

Reply

Ram

Hi,

About 4-weeks ago I did a stupid thing and attempted a front-flip with boots on grass. When I landed my left foot felt firmly planted but I fell on my back. So, it’s just an awkward landing that put stress on my knee. My left leg felt bad. I heard no pop, but I was able to walk on it pretty normal right after it happened. However, it felt a bit unstable. The next day I felt as if it may buckle or give out when I turned slightly left. I experienced this sensation maybe 5 times at most. There was not swelling and very little pain (1-2 out of 10). Now (At the 4-week mark), I have no pain or swelling… but my knee feels a little loose, different, or weak (It’s hard to articulate). My leg straightens out normal; it doesn’t seem to hyper-extend. I’m still able to do heavy lifting, running, and I even played a half-hour of tennis without any feelings of instability despite my left knee not feeling as tight as my right. I have not yet gone to get an MRI. If this is a partial tear (Sprain Level 1 or 2) of my ACL, can I expected to regain tightness in the joint as the ligament(s) heal? or am I just in the bucket of I have to wear cyborg brace every time I want to do anything. If it’s not a complete tear and the tear is less than 50% across, can it return back to normal or close (95%)? Do some people come out of Level 2 Sprains normal without surgery?

Thanks,
Ram

Reply

Jim Wnek

Hey Ram
Thanks for visiting

If this is a partial tear (Sprain Level 1 or 2) of my ACL, can I expected to regain tightness in the joint as the ligament(s) heal? or am I just in the bucket of I have to wear cyborg brace every time I want to do anything.
–Without an MRI its hard to know for sure. But from the sounds of it – it may only be a sprain.

If it’s not a complete tear and the tear is less than 50% across, can it return back to normal or close (95%)? Do some people come out of Level 2 Sprains normal without surgery?
—-You know everyone is different. Yes you could experience healing but couldn’t say for sure how much. Yes we have seen level 2 sprain do fine without surgery however it really depends on the severity of the sprain.

Good luck and please keep me posted

jim

Reply

Kunal

Hi,I injured my right knee in first week of June,2013.I took rest of 3-5 days the swelling went away but there was mild pain which can be ignored.So I ignored it.But in the first week of August 2013, I visited orthopedic surgeon and carried out MRI (0.2 Tesla open) &its report is
*Small hyper intense signal in acl s/o grade 1 injury.
* contusion in lower end of femur.
My surgeon told me it would heal and not to worry gave me some pain killer and collagen tablets.After taking medicine for 1 months I was not improving much and there was mild and dull pain in my knee .
So again I carried out MRI(1.5 Tesla closed) scan on 15th Nov. The report was
*ACL shows mildly altered signal intensity appearing hyper intense at its tibial attachment on STIR and T2W images s/o ACL Sprain.
*Marrow edema involving lateral femoral and tibial condyles.
*Mild joint effusion.
Again the same orthopedist told me it would heal surgery is not required.
Now my knee has improved and there is no mild pain (which i had earlier) but when i walk and run a lot ,there will be mild pain in my right knee .
So sir,what is your suggestion in my case?

Reply

Jim Wnek

Hey Kunal

From what you mentioned it sounds like you need some skilled rehab to get that knee stronger.
Not just the knee itself but your whole lower extremity. Strength, stability, balance, etc…

Get yourself some rehab and you should be just fine.

Please keep me posted
jim

Reply

Alana

Hi I’m a 21 year old female field and indoor hockey goalkeeper. On the 21st of November 2013, I hyperextended my left knee in an indoor game by stopping a run suddendly. Straight away it felt painful and sore, yet I was able to play on for about 25-30min till the end of the game. I folled the RICE strategy straight away. There was only a little swelling. For a few weeks I rested it, being told by the physio that it was bruising of the the fat pad. When the pain did not subside and infact got worse when I went for prolonged walking I went to get a second opinion from a doctor, who straight away referred for the MRI. There was signs of a sprain/ minor tear. I have not been able to return to playing yet, because it becomes to painful and feels unstable. I work as a waitress and simply walking (bearing no weight) I can’t get through a six hour shift without pain and my knee giving out on my a couple of times, even while wearing a brace. When it gets really bad, there is a poping/ clicking feeling when it gives way. Is it possible that it is tearing more? My season starts in April and I really want to do what I can to be able to play then. Thanks for your help.

Reply

Alana

Sorry sprain/ minor tear of the ACL.

Reply

Jim Wnek

Hey Alana

First sorry to hear of your injury.

Is it possible that it is tearing more? My season starts in April and I really want to do what I can to be able to play then. Thanks for your help.
—-There is always a possibility of it tearing more. But I highly doubt it based on what you mentioned.
My recommendation is this- get into some skilled physical therapy right away and start getting that knee stronger.

My question to you. I know you mentioned sprain/minor ACL. Did they list what grade?

Please keep me posted

Jim

Reply

kunal

HI,
I had injured my right knee after I fell down from bike. I took rest for 3-5 days and my swelling went away but there was mild pain (which can be ignored, so I ignored it).
But after 2 months (first week of august), there was always mild pain and pinching type pain (while walking or taking rest).I went to doctor and carried out MRI (0.2 tesla open type).Its report was
*Small hyper intense signal in acl s/o grade 1 injury.
*contusion in lower end of femur.
My surgeon told me not to worry and it would heal and gave some pain killers, collagen tab and physical exercises.He also checked my knee by bending it at 30 degrees and said “your ligament is intact”.
Even after 2 months I was not improving so carried out next MRI(1.5 Tesla closed type) on 14 Nov(after 2 months).Its impression was
*ACL shows mildly altered signal intensity appearing hyper intense at its tibial attachment on STIR and T2W images s/o ACL sprain.
*Marrow edema involving lateral femoral and tibial condyles.
*Mild joint effusion.
The same doctor told me it is not serious and increased medicine doses.
The mild pain in my knee has gone away at this moment. But whenever I run and walk (continuously for 3-4 hrs) a lot, there would be same mild pain.
I also don’t find my both knee same. I am really worried for my knee and confused what should I do for complete healing. I need your suggestion and opinion.

Reply

Jim Wnek

Hey Kunal
First thanks for visiting.

Next sorry for delay. I’ve been busy with the holidays.

From the information provided.
I would recommend formal physical therapy for your knee.

In physical therapy we have 3 goals.
1. Calm pain down
2. Stretch
3. Strengthen

We try doing doing them in that order.
At least 4-6 weeks to see if you can get your knee back to feeling close to normal.

If skilled physical therapy is not an option for you please contact me back.

I have had dozens upon dozens of requests for customized physical therapy rehabilitation programs.
For several reasons.
Some do not have insurance and cannot afford it.
Insurance ran out.
To high of a deductible and or co-pay.
Don’t have time.

Hit me back if you’d like some more information on a customized rehab program.

If not, please keep me posted or if you have any additional questions.

Good luck.

Jim

Reply

kunal

Thanks for reply.Sir,Is it possible to heal acl 100%?.Even after 6 months, I don’t feel my both knee same.I have been doing PT for 3 months.Which type of exercise should I do
for calming down pain?

Reply

rakesh

i met with acl injury 1year back and at the time of incident it was not a remarkable problem for me.but now slowly i feel instability and pain on long standing. MRI shows acl sprain with mild joint effusion. please reply me whether it is possible to treat such condition without surgery.

Reply

kunal

Hi rakesh,I have knee injury which is similar to yours.It would heal but it will take time.Even after 7 months i feel sometimes mild pain in my knee.

Reply

John

Hello Jim,
I am a 16 year old football player and I fully tore my acl in a non contact situation in late November. It was a full tear with no damage to any other parts of the knee. I have been doing daily PT with my school trainer to prepare for surgery which is January 14th. I have a few questions:

Will I be able to play at full speed by mid August?

I have decided to use the Patellar graft as opposed to the hamstring because I have heard it is the “gold standard” for this procedure. But when the doctor looked at my MRI and X-Ray, he said my growth plates were open, and I was still growing. I believe I will only grow 1-2 more inches maximum, so do you believe this was the right choice for graft?

Will I be able to participate in football camps in mid June?

Thanks for the help,
John

Reply

John

*Running back position in football

Reply

Jim Wnek

Hey John

First sorry to hear about your injury.

Will I be able to play at full speed by mid August?
Come middle of August it puts you at 7 months. To answer your question: it depends on how well you rehab and attack your strengthening.
Most ACL’s you have full recovery at about 6 months. Seeing that you are a football player you may require a little longer. It really depends on your strength and conditioning program. You will really need to start being aggressive around the 4-5 month mark (if you are able and your doctor clears you.)

so do you believe this was the right choice for graft?
— yes

Will I be able to participate in football camps in mid June?
—-it depends on how you progress with your rehab.

Keep me posted

Jim

Reply

David

Hello Mr. Wnek,

I am an 18 year old soccer player and I tore my ACL on December 27. I had my MRI later that day and it was revealed that my ACL was completely gone. We preceded to schedule surgery on January 2 with a patellar tendon graft. One week in I am able to fully extend my knee and have 95 degrees of bend. I have physical therapy 5 days a week with experienced and dedicated physical therapist and ATCs. My hopes are to be able to return eventually by May for my senior season of soccer. I have read stories of athletes returning to play in 3-4 months. Is there anything in particular that enables athletes to have a quicker return to play or is by “chance”.

Any feedback and/or advice would be greatly appreciated!

David

PS: I have been through knee rehab before with my other knee from a partial menisectomy in mid August and was able to return to play early October, but I know the ACL will be more strenuous and involved.

Reply

Jim Wnek

Hey David
Thanks for visiting.

First sorry to hear about your injury.

Is there anything in particular that enables athletes to have a quicker return to play or is by “chance”.
—”chance” has a little to do with it. There are many things that factor into the healing process.

really depends on your body- how quickly it heals itself
your nutrition- plays a major role in aiding the healing process
how aggressive you attack your rehab
ice, rest, train, rehab

you will have to take it day to day but one piece of advice I will give you is this
while you rehab your knee— make sure you keep the rest of your body in shape.

Keep me posted

jim

Reply

ned

I am a 50 year-old male who has practiced martial arts for the past 10 years, mainly tai kickboxing. I suffered a knee injury during a sparring session. The MRI (two months past injury) shows “High-grade near full thickness tear of the anterior cruciate ligament” and goes on to say intra-substance degeneration of the lateral meniscal body and of the posterior horn of the medial meniscus. I have not really trained since the incident and I am going bonkers. I don’t meet with the Ortho until another week and a half….
My knee feels stable but weak, with stiffness and some discomfort mostly interior side of knee.
Does this mean surgery? Should I not train at all? in the interim?
If surgery….at my age am I looking at a full year?

Reply

Jim Wnek

Hey ned

Thanks for visiting

Does this mean surgery?
—–I you are wanting to get back to tai kickboxing. Then YES.

Should I not train at all? in the interim?
—- When you say train (I am assuming you mean kickboxing) If that is what you mean then I advise against it.
If you are looking just to do some fitness activities that doesn’t require a lot of lower extremity use or out a lot of stress in the ACL that is fine.

If surgery….at my age am I looking at a full year?
—- Tough to say. Maybe. It really depends on how you and your body heals.
If all goes well you could be back in 6 months. Maybe not at full force but at least starting getting back into it.

Good luck and please keep me posted.

Jim

Reply

kapil dev

hi i am 26 years old I had a injury in my knee grade 1 sprain of anterior cruciate ligament seen minimal effusion seen but no e/o meniscal tear doctor adviced me to take some medicine I also took but still now I didn’t came to my normal stage. Can I go for a gym workout

Reply

Jim Wnek

Hello kapil dev

If your doctor did not lace any restrictions on you and your therapist feels comfortable then yes a gym workout would be fine. I would just take it slow and see how your knee responds.

Good luck
Jim

Reply

chieko

I am an active 56 year old female, 5’7″, 110 lbs who recently had a hard fall and landed on my knee. OW! I’ve been to 2 orthos. Neither addressing the ACL tear yet, they want the bones to heal first but I wasn’t even given a brace or any support for the knee…just crutches and limited weight bearing. What’s your take? When I tore 2 menisci in my left knee, I had to wear a full leg knee brace. Never needed surgery though. I have had a total hip replacement (left) due to AVN. Don’t want to end up w/ instability in my right knee since it may add stress to my replaced hip and I want to keep that one for awhile. BTW, I already have chondromalacia patella of the injured knee. THANKS!

RE: Grade II tear ACL, patellar fracture, tibula fractures

MRI OF THE RIGHT KNEE
TECHNIQUE: The examination was performed in the standard fashion in
the 1.5 Tesla GE magnet at AIC.
HISTORY: Patient reports knee pain and symptoms of instability.
There is also a history of a fall on 01/11/2014.
COMPARISON STUDY: Radiographs dated 01/12/2014.
FINDINGS:
OSSEOUS STRUCTURES: There is a mild comminuted fracture of the
tibial epiphysis, extending into the metaphysis. It has a T-shaped
like configuration, with a transverse component extending along the
anterior border of the tibia, and a vertical component in the
sagittal plane, that propagates into the posterior epiphysis. This
is noted in all sequences, and is associated with reactive edema,
consistent with an acute fracture. There is no articular surface
depression, and neither of the fracture lines demonstrate significant
distraction. There is no evidence of an infiltrative or marrow
replacement process identified.
EXTENSOR COMPARTMENT: The quadriceps tendon, infrapatellar tendon and
patella retinacula demonstrate normal morphology and signal intensity
and no significant disruption.
PATELLOFEMORAL JOINT: There is a contusion of the patella,
associated with a coronal oriented fracture line in a subcortical
location, and extending into the apex of the patella. This is best
seen on the sagittal sequences. An effusion is seen, and there is an
inflammatory reaction involving both the quadriceps and Hoffa’s
fat-pad.
LIGAMENTS: There is architectural distortion and signal alteration
involving the anterior cruciate ligament, primarily at its
attachment, and extending into the mid-level. Both the posterior
bundle and the posterior fibers of the anterior bundle are affected.
The findings are felt to be most consistent with a grade II ACL
interstitial injury (sagittal sequence series 4, images 10-12,
coronal sequence images 12-14 and axial sequences images 13-15.
MENISCI: There is no evidence of a significant meniscal surface tear
present. Meniscal configuration is unremarkable.
SOFT TISSUES: The iliotibial band and popliteus tendon demonstrate
normal morphology and signal intensity. There is no evidence of a
significant muscular signal alteration or atrophy noted. The
popliteal and neurovascular complex is within normal limits. The
visualized peroneal nerve is unremarkable.
Impression

IMPRESSION:
1. There are mildly comminuted fractures involving both the tibia
and the patella, as described. There are multiple small fracture
lines noted, but they do not demonstrate any significant distraction.
No articular surface depression is noted.
2. There is a grade II partial tear of the ACL.
3. There is an effusion.

Reply

Jim Wnek

Hey Chieko

Sorry for delay in my response

What’s your take?

After looking at your MRI findings. Note: I am not a doctor nor do I play one on TV (haha)

I would take the advice of your doctor.
Let the fractures heal.
The Grade II ACL tear could be significant depending how much is torn and/or still intact.
You could function with a partial tear however, you may not. Only time and rehab will tell.\

Please get me an update? Curious to see what has unfolded.

Thanks
Jim

Reply

Tara Tapia

Hi, I’ve torn my acl in my left knee 4 years ago and had reconstruction surgery on it and its perfectly fine. I went back to playing soccer just 8 months after. Just recently I partially tore my acl in my right knee and fractured my tibia. Its been 3 weeks and im able to walk normally and hike. I’m waiting on my ortho for a second opinion on surgery or just physical theraphy. I run competitively and am planning to in the fall. How long do you think it’ll be until I can run again?

Reply

Jim Wnek

Hey Tara

Sorry for delay.

How long do you think it’ll be until I can run again?
—Well there are 2 things you need to make sure of before you start to run.
1. The fracture is healed.
2. If you do not have surgery- you need to make sure you have very good quad control as well as stabilization in that knee before running.

Just make sure it is strong enough. You do not want to further damage anything.

Hopefully your knee is doing better.

Keep me posted

Jim

Reply

deepak

i have a grade 1 acl strain ,there is so much pain in my knee but its completely stable .
can non surgical procedure be able to restore my knee to full level?

Reply

Jim Wnek

Hey Deepak

can non surgical procedure be able to restore my knee to full level?

YES

If you need help customizing a program- just email me at: jim@core1inc.com

Thanks
Jim

Reply

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