My Journey Through ACL Rehabilitation - Part 1
ACL injuries are the most common knee injuries, occurring in about 84 per 100,000 persons, or about 200,000-250,000 annually in the US alone. I was one of these unlucky people a few years ago, and it’s what started me on my current path of studying Athletic Training. (If you want to know signs and symptoms and other information on ACL injuries, you can go here)
I ignored my injury for about three years, I was told. I don’t remember the moment it happened, as most people do, or what I was doing that caused it. I only know the time frame because my doctor said my injury on my MRI looked old and like it had attempted to heal itself. Some people can live with a torn ACL and never need it repaired. Yes, there will be instability at times with certain activities, but the ACL isn’t completely essential to a normal, everyday life. If you think you’ve injured your ACL, however, you should meet with a surgeon to discuss your options, as some people would most benefit from having it repaired, as I did.
My experience, though, was different than most people’s. Firstly, aside from ignoring it for three years, I was misdiagnosed for three months with a “knee strain.” They had me in a brace and on crutches for that time, so my leg muscles atrophied significantly. When I wasn’t getting better, we decided to see another doctor, who immediately diagnosed me with an ACL tear and told me I was getting surgery within the week. Secondly, I was a part of a research study, and was the first person in the study, actually. Usually when you have ACL surgery you are given a nerve block in your hip before they put you under so that you don’t feel any pain--immediately and when you wake up (it usually wears off within 16 hours to 3 days). The study was trying to determine if the nerve block was beneficial or harmful to recovery, or if there were no effects to healing. So there were to be two groups: patients who received the nerve block and patients who did not receive the nerve block. The whole idea was that the surgeon wouldn’t know who did and didn’t have it so that he wouldn’t do anything differently; so if I were to get it, they would put me under first.
I ended up not receiving a block. But because I was the first person in this study, no one knew I didn’t. I woke up without pain medication, and it took them a half an hour to get the clearance to give me pain meds. The whole experience remains surreal and dreamlike. I vaguely recall the pain, but I do clearly remember being scared. I couldn’t keep my eyes open or focus on anything around me from the anesthesia, which freaked me out. So I attempted to sit up, and almost fell out of bed instead. Three nurses had to hold me down as my mom tried to tell me to calm down. Then I heard, “her toes are blue!” which indicated that I wasn’t getting blood flow or oxygen to them, and that something had gone wrong during surgery. Upon turning on the lights and comparing my two feet, however, they looked the same, and we realized I had just taken off blue nail polish that morning.
Finally they gave me pain meds, gave me two cherry slushies, and sent me home.
The surgery went perfectly, except for one part. See, to repair the ACL you need a graft of some sort to fix it. It can be a hamstring graft or a patellar tendon graft, and it can either be your own or from a donor. We had decided to use a hamstring graft from my own body. But upon harvesting a portion of the muscle, they found it was too thin. This gave me two options: continue with the thin hamstring, increasing my risk of re-injury, or harvest a graft from a donor. My parents decided to give me a donor graft. But what the surgeon decided to do was lace my hamstring with the donor hamstring to reinforce it and make it thicker than most grafts usually are, giving me a decreased chance of re-injury.
The easy part was over, now came the recovery.