Thursday, October 9, 2008

Week 20 - ACL Surgery Recovery

Welcome to my ACL surgery recovery blog where I have been giving week by week updates on my recovery since I had ACL reconstructive surgery on my right knee on May 22nd, 2008.

For you newbies to my blog, be sure to check the blog archive to read my older posts, especially if you're going to be having ACL surgery soon.

Okay, so week 20 is finally here and I had my follow up appointment with the surgeon on Oct 7th. X-rays showed my knee has healed properly. I questioned the doctor about the pain I've been experiencing in the lower patella area below my knee and he simply stated that it was "Jumpers Knee". He gave me a loose number that about 1 in 20 people will experience it after ACL surgery so of course, I'm one of the lucky ones. He wasn't overly concerned about it stating that it goes away after awhile. So, of course I had to go home and google it.

Jumpers Knee or Patellar Tendonitis is when the patella tendon comes under a large amount of stress (perhaps stress from the surgery??) mostly in individuals who actively put extra strain on the knee joint like those who participate in sports on a regular basis involving direction changing and jumping. With repeated strain, micro-tears as well as collagen degeneration can occur as a result in the tendon. So here's a picture of where you would experience pain if you had Jumper's knee.

Now this is not quite where i feel the pain. My pain is lower where the tendon meets the shin bone which is consistent with Osgood Schlatter Disease. Osgood Schlatter Disease is when you get pain and swelling directly over the tibial tubercle (shin bone). Pain is aggravated by loaded knee extension activity, especially activity with power or impact characteristics (according to Wikedpedia). The problem with this self diagnosis it that Osgood Schlatter Disease is caused by adolescent growth spurts and is mainly a problem for growing children. Since I'm 35 years old, this can't be the case.

Regardless, the healing process for Jumper's knee and Osgood Schlatter Disease can be a slow process and requires rest and rehab for months (great!). The quadriceps muscle need strengthening specifically with eccentric strengthening exercises. Also strengthening the calf muscles and other surrounding muscle groups are suppose to help. Top it off with massage therapy and lots of icing. This sounds pretty familiar......Its basically the same stuff that I'm doing to heal my knee from ACL Surgery. This is becoming VERY frustrating.

I'm wondering if anyone out there has had Jumper's knee...specifically after ACL surgery but also even if you haven't had the surgery. Please leave me a comment if you have any knowledge on the subject.

Well, that's it for this week. Thanks for reading my ACL Surgery Recovery blog. Hopefully it was informative for some of you. Be sure to check back for more updates.


  1. I'm so glad to find your blog. I am 3 years out from having my ACL/MCL reconstructive surgery. I was extremely active with basketball/weight training 5 days a week before my tear and have since switched sports for a new challenge. I still work/play as hard but instead of bball its now tennis 3/4 days a week. The only issue I have had since my surgery 3 years later is sharp pain in my knee. I seem to have this only after extreme heavy load on leg extentions. 135lbs 4 sets of 12. I have an appointment with my surgeon on Monday because the pain is excruciating. I'm guess from what I've read he going to say stop the excessive wait on leg extentions. But I'm hoping its no patellar tendonitis. The photo you showed of the knee cap is exactly where I'm having the sharp shooting pain. Nothing has seemed to give me the same definition as leg extentions. But seeing the exercises on the bosu ball might be my replacement for leg extentions. Thanks again!

  2. Glad to hear my blog has helped someone out. Good luck and let me know what the doctor says. Im a bit curious. If its jumpers knee then you might need to take a lot of time off from anything that causes the pain until it fully heals from what i've read. Did the problem just start for you or have you had it for a while? My doctor said that it can develop as a result of the surgery and takes up to a year to go away. I had my other ACL surgically fixed 9 years ago and did not have this problem at all. I was able to go back to basketball and weight training with no real trouble. (i eventually gave up B-Ball after i badly sprained my ankle).

  3. I'm right there with you. Had my surgery on 5/2. I am still NOT able to jog. Which is extremely frustrating. I did rehab to the T, and have continued on my own at the therapy facility. Now I am even having problems riding the bike. I believe I too have "jumpers knee". I see the dr. on the 9th to confirm it. Sounds like it will be a lot more rehab. I can barely get down the stairs and believe it is getting worse.

  4. From what I've read, jumpers knee can get pretty bad for some people. Its been 6 weeks since i wrote this post and it feels a lot better. Ive been massaging it a lot and avoiding anything that would make it more painfull and Ive noticed a fair amount of improvement. It did not bother me on the bike at all however....Keep me updated on what your doctor thinks. Id be interested in hearing what he/she says about it. Good luck.

  5. Hi there from Portugal !
    I read the entire blog up to this post, the only one (up until now) that I can be of assistance in. I got acl surgery (using patellar tendon graft) on the 25th of August, so I'm roughly into the 13th week of post-op.
    I'm currently on a 2 physical therapy sessions per week program, and since last week I'm supposed to swim (haven't gotten around to it yet). after each session ("heating" (dunno the actual name) - quad and hamstring work (with sand weights) - cycling - ball exercises - stretches - icing) I go for a run in the park. usually 5-10 mins in, I have to stretch a little, because I start to feel a "stiffness" where the graft was taken from. but after 2 mins of stretching I can resume running for another 10-15 mins, until my next "pit stop", which consists of stretches (the basic ones) for 30s periods, 5-10 mins total. then I run back for another 10-15 mins , upping the tempo since I feel no pain at this stage. as a former semi-pro soccer player, I know what jumpers knee feels like, and I haven't got it (yet). Personally I think you maybe stressing the patellar tendon at the gym, since your hamstring and quad probably aren't as flexible as they should be. One thing I found helped me overcome some hurdles in rehab is stretching my hamstring while lying in bed, grabbing the knee and elevating the leg 90º up, while trying to touch the patella with my forehead (dunno if I explained this right, you don't have to be a contorsionist to do this). since day 1 of recovery this eased pain in the posterior knee region, and you shouldn't be affraid of a little pain since they grafted from the patellar tendon (in my case and steve's). stretching the quad comes AFTER the hamstring, since stretching the quad causes the hamstring to contract (which was painful for me, until 1/2 weeks ago). until you reach 80/90% of flexibility in these 2 muscles, and have good muscle support, don't run. this is my advice as someone who knows the importance of flexibility. I had osgood-schlatter related surgery on both knees when I was 12yo, due to my soccer-driven existence. I'm 21 now and didn't have any knee problems up until april this year when I tore my left knee's acl. until your muscles are fit enough to withstand the kind of strain that comes with running, you should refrain from doing so because you most likely WILL develop jumpers knee (which is basically inflamation in a specific part of the tendon) as a result of overstressing the (weakened due to grafting) patellar tendon. keep in mind that better flexibility in the anterior muscles will increase the strain in the posterior muscles, and vice versa. this is why BALANCE is of the utmost importance. good posterior flexibility means you should be able to touch your toes or even the ground while standing with your stretched legs side by side, and reaching for the ground (stretching while lying down is less painful, recently i've been using elastic bands to help me with stretches like the one I TRIED to describe in the beggining of the post). good anterior flexibility means that when you grab your ankle while standing, and pull it up, stretching the quad, your heel should touch your glut.
    hope this helps in some way, dunno if I missed anything, kinda tired so I'll check back later to see if anyone has any questions.
    congratulations again for your patience in putting this blog together, I'm sure it will help many people. oh, and get well soon ( like you haven't heard this enough times :D ). peace

  6. Hi there. Im experiencing sim problems 5 months out of surgery also, except I have a solid lump which seems to be on the tip of the tibia and on the edge of where they took the patella graft. This seems to fit the description of Osgood-Schlatter Disease, however im 23 y.o! I also have pain and it feels like it from over loading the front of my knee... Its really starting to annoy and has come about when i started jogging and walking to uni (down a v. steep hill too).

  7. Hey Dan. Mine has gotten better since i wrote this post but i still feel it just a little. I did not have a lump. I found that massaging the patella tendon in left and right movements helped it alot. Its suppose to help get better blood flow threw the tendon. I also found that when my phyisotherapist tapes up my knee, it takes a lot of pressure of the tendon. If you're going to physio, then get them to tape it up properly and show you how to do it and don't over do it and be patient.

  8. Hey-

    I'm 6 weeks post-op Autograft ACL surgery and also have Jumper's knee directly below the patella. It's extremely painful, if not possible to do leg extensions.....

    My main concern is a recent possible hamstring tear behind my knee near the donor site. After doing my PT, it 'popped', swelled up a bit, slightly bruised and was very painful. I've been fighting it for a week now and after few days of it feeling better, I tweak it again while I sleep. Very frustrating!

  9. Wow,

    It is great to find your blog. I am an Electrical journeyman in the industrial field I am 10 months out of surgery. I had torn my acl, and meniscus pad, on my left knee and also had parts of cartilidge "floating around". About 4-5 months after surgery I had a small slip which brought back swelling and pain that was pretty much managable. I have been released back to looking for work (thanks to Michigan's great economical state) with temporary side jobs and the occasional plumbing job with my dad. During such task of carrying 80# bags of concrete down the steps to a basement and returning with broken concrete and dirt, my knee began to hurt more than the occasional dull pain I was getting used to. Assuming it was due to soreness I waited until the next day when I noticed the rest of my body was fine and my knee right in the cap region you spoke of. There was also some bruising feeling on the inside of my knee cap. This pain is new and intense and comes in waves, and the surgen seems to think that everything is fine and that I didn't damage anything and that I won't. He also tells me that ibuprofun 800mg is the best thing. For the swelling I understand, but for pain management it's worthless. I am seekiing a second opinion, and alternatives such as maybe a Cortizone shot. Is this pain something I need to just deal with, temporary, or am I going to need pain medicine for the rest of my life? Any suggestions would be greatly appreciated.

  10. Any luck on the "jumpers knee", I am at 17 months and the pain runs just beneath my knee cap down into my shin, PT says its patella tendonitis. Jogging and one leg dips are nearly impossible due to the pain, Everyone I talk to seem to think it is going to get better but I am beginning to wonder. I had my other knee reconstructed 10 years ago (I am 31) and don't remember any of this nonsense and haven't had any trouble (both done with patella).

  11. I had my surgery on the 27th of January (2011) and I fell down a hill and tore some major scar tissue, holy crap it felt like a retore the ACL! a couple days later if felt AWESOME and basically normal even! so i started running everyday and biking often. I also ride reining (ranch type) horses and the riding and heeled boots have put weird pressures on my knee. Now it hurts real bad right where the first picture indicates. I have to stop running and it doesnt flex much for awhile after. it only feels better when i sit and do absolutley nothing for 2 or 3 days...which im not doing. XC training is starting and i dont know what to do :(

  12. i had my surgery on june 20th 2011 and my PT said he thinks i have this...i feel pain when squatting and walking up stairs. i hear it's a common rehab problem after surgery. it sucks and i hope it goes away by itself!!

  13. I had my acl surg 12 mints back and5 months later sharp shooting pain on the shine and below the patellar
    This has now slowly stopped but it was intense
    I changed physio as my earlier physio said I was being a wuss
    My new physio has told me to strengthen my inner thigh and balancing
    This helps lots of wall squats
    Now I have severe ankle pain I am thinking I got ankle tendonitis
    Oh god I believe I shoulda not ha. The surgery
    It was a hamstring graft btw

  14. Ive been massaging it a lot and avoiding anything that would make it more painfull and Ive noticed a fair amount of improvement. It did not bother me on the bike at all however....Keep me updated on what your doctor thinks.

  15. SO happy to find this blog! I had ACL and meniscus repair surgery on Apr 19, was improving, then developed patella tendonitis. Oh GREAT - no wonder it's been so painful right below the knee. If if weren't for that, I'd be feeling probably 80% better. I've gotten stronger in the quads, but it's clearly come at a cost. Has anyone had a cortisone injection to alleviate the pain and "get back on track?" I'm sure I developed this due to my over zealous acvity in the hope of getting stronger. Waiting to hear what surgeon says. 4 weeks ago he said the pain would go away as my quad got stronger, but it's been getting worse (even as I get stronger).


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