NIGEL's BLOG - WEEK 4

Work is becoming easier towards the end of week 4 and I am looking forward to being able to stop wearing my brace, as I feel it is becoming too much of a ‘security blanket’.

Robin likes his ACL patients to wear the brace, which limits the amount of bend you can get in the knee to 90 degrees, for four weeks after the operation.

Surgeons vary with this, some not liking their patients to wear a brace at all and others advising two weeks of wearing it, but Robin stresses that the research shows that in the long run, the wearing of the brace for four weeks, increases the long term stability of the knee, but this may be more for only the type of re-construction I have had (patella tendon-see above).

The brace runs from the thigh to the ankle and you tighten it with straps and it does give you a lot of support and confidence. The down side is that your muscles don’t have to work as hard and so you lose more tone and bulk, which you need to compensate for, by doing plenty of exercises.

Another down side is that when you put the brace on in the night, for example if you need the loo, the velcro makes a terrible noise, when you take the brace off again, waking anyone in the vicinity!

On the Thursday of this week, so four weeks post op, I remove the brace and I do feel much weaker than I have done!

But I also feel much freer and I go for my first swim.

I am careful not to do any kicking movement but I am an ok swimmer and love the feeling of being able to do front crawl, with my legs just dragging behind me.

It feels fantastic, a re-gained freedom, something I can do. I also enjoy just gently bending and straightening the knee, with my back to the pool wall.

I am feeling that things are improving but I am very aware of the fact that ACL re-constructions are very vulnerable at the four to six week period, as the blood supply is starting to reduce in the graft, before the graft becomes re-vasularised, after about the six week period.

As I got into the water and out, I was very aware of this and wore a pair of wetsuit shoes, to help me grip and I moved very carefully.    

Pain is not really an issue now and I am improving all the time, with my Physio, with Ali, although swelling around my knee cap, is still a big problem, which is worse in people who have had the patella tendon graft and not really an issue in people who have a hamstring graft.