Our ACL patient is now two weeks removed from surgery. On this date, the patient reported that her knee still "feels tight but there is not much pain." The patient presented to the clinic wearing a compression stocking to assist in controlling the swelling in the knee. At this point, residual swelling is still very normal after an ACL reconstruction and will be one of the primary reasons for continued discomfort be it pain or tightness in the knee. The swelling is also the main reason that knee range of motion is not yet normal.
On this date, the patient presented to the clinic no longer using crutches. The patient's walking gait was not quite normal yet but close enough to ditch the crutch. The patient presented with improved knee range of motion. The knee flexion measurement increased to 127 degrees (normal being 140-145 degrees) and knee extension was 0 degrees or completely straight, which is normal. The patient demonstrated improved isolated quadriceps contraction again.
At this visit we were also able to progress the strengthening exercises quite a bit. I had the patient start using the leg press, which is like a squat machine, using both legs at first and then some with just the repaired knee. The patient also progressed with balance activities including the use of a balance board and increased holds on single-leg-standing to further progress proprioception. We also initiated the use of the stationary bike for light aerobic conditioning. I continue to use ice and electrical stimulation at the end of the treatment to help decrease remaining swelling and inflammation.
Overall the patient is progressing well and as expected. Next week a few new exercises will again be added.