ACL reconstruction: a patient's journey

My name is Jacqui Needham. I hope by sharing my personal physiotherapy journey that other patients undergoing an ACL Reconstruction feel confident, knowing that the Lifecare Point Walter Team will provide exceptional, holistic patient care during their recovery.

Tell us about your initial injury and your thoughts when you were told you’d ruptured your ACL

I was playing netball, running towards the baseline when I jumped up high on the run to catch an overhead pass.

I felt an instant ‘jarring’ sensation, no sharp pain but I felt/heard a ‘crunching’ sound. I walked off the court and applied ice, at this point I didn’t feel I’d done anything major.

I went back on to play, but immediately felt my knee give way when landing from another jump. Scans confirmed I’d ruptured my ACL and had a small tear in the lateral meniscus.

My surgeon offered me both surgical and non-surgical options. He was very supportive of both options and was very thorough in his explanation of both options.

I opted for surgery as my surgeon advised that this would likely be the best outcome for my situation and the activities/sports I wanted to return to.

My physiotherapist Jon set a detailed ‘pre-hab’ program for me, with clear instructions and directions to have me in the best possible shape for my upcoming surgery.

What surgery did you have? How were your first few weeks post-operatively?

I had a complete ACL Reconstruction with a hamstring-graft.

My experience in hospital was relatively comfortable, going home the next day without any complications.

There was certainly a lot of bruising from the graft-site down to the ankle, however the swelling improved gradually.

Jon advised me with exercises to improve my range of motion, most importantly knee extension. Jon was able to carefully work around the surgical sites to maintain mobility of my knee-cap and assist in reducing the swelling.

At all times he monitored my pain levels and clearly communicated why he was performing certain movements.

He clearly explained what pain was acceptable to push through but also when to stop.

By day 11 I had regained a fairly normal walking pattern and was meeting all my range of motion goals.

Did you have any complications following surgery?

I went back to work on crutches after approximately 2 weeks.

Unfortunately, I experienced a setback at work. I had to take evasive action to avoid being kicked in my injured leg by a student.

It all happened very fast. The student kicked my crutch out from under me, forcing me to plant my foot abruptly to avoid falling over. I didn’t have any pain, but my knee felt a bit stiff and tingly.

A couple of days later, I woke up in the early hours in excruciating pain.

My leg was swollen from the thigh down to the main incision site below my knee.

The pressure continued to build throughout the morning.

It was very painful to walk and I couldn’t bend or straighten my knee completely anymore.

I saw my surgeon later that day, who diagnosed me with a ruptured arterial vessel.

I had surgery that day to drain the haematoma.

Surgery was successful, but I had significant pain.

I was very anxious resuming physiotherapy, as I was worried of further damaging my knee. Jon knew I was struggling and was constantly reassuring me that we could move forward from this setback.

As physio sessions commenced I just had to trust and believe in the plan put in front of me.

Unfortunately, with all our hard work as a team, I was still unable to achieve sufficient range of motion, so we agreed on another surgical procedure which was a great success.

How have you found your rehabilitation so far? Have you been pleased with your care?

Throughout my challenging ordeal this past year, I have continually been provided with exceptional care from my surgeon and physiotherapists.

I have endured an ACL injury, ACL reconstruction procedure, a traumatic workplace incident causing a haematoma, 2 further arthroscopic surgeries in close succession due to complications and a MUA (manipulation under anaesthesia).

Jon continuously checked to see how I was feeling and encouraged me to stay positive. He never gave up and worked hard with me to get my muscles firing again.

I particularly appreciated the detailed explanations given to me. I’ve also completed a hydrotherapy program with Jordan Lake to assist in my rehabilitation.

Jon and Jordan work closely together and were able to discuss my progress. This was very motivating for me as I felt that both physios were working as a team in helping me to achieve realistic physiotherapy goals.

I took part in an ACL group session with patients who had the same injury and similar rehab timelines.

This allowed us to support each other, set goals and see progress while performing our exercises under physio supervision.

I believe this helped greatly with my emotional recovery as I was struggling with the setback and was anxious that my leg would never get back to normal.

At all times I have felt cared for with clear and realistic physiotherapy goals being set.

I strongly believe this commitment to my extended rehabilitation and my team’s enthusiasm to motivate me to put in the effort at home is directly responsible for the positive outcomes I have achieved so far.

I’m currently completing a supervised gym-based program and by all reports, making excellent progress.

Do you have any advice for patients who are going to be undergoing an ACL reconstruction?

A few pieces of advice for anyone preparing to undergo an ACL Reconstruction

• Take a decent amount of time to recover from the operation before returning to work. Even though I pushed hard to meet my goals and milestones, I should have given my body more time to heal before returning to work and being on my feet all day. If I had my time again, I would have taken at least 4 weeks.
• Listen to your body and apply RICE (Rest, Ice, Compression, Elevation) longer than recommended. It really does help long after surgery.
• Listen to your physiotherapist and get to work on achieving full knee extension as early as possible. It is the most important part of getting back to normal
• Trust and believe in your physio. The exercises they set are part of a big plan. Replicate the exercises at home and stick to the program – put in the work and see the reward!

I am in a new territory now. Totally out of my comfort zone but trusting in my physio’s expert knowledge and enjoying the challenge of pushing myself under the strict supervision of my care team!