Hey folks, just passed the 6 month mark for my ACL reconstruction. Hamstring autograft using semitendinosis and gracillis. Started going to the gym 4 weeks ago as I was cleared by my doctor to move onto weighted exercises and stop using body weight. I have been probably 40 times in the past 3-4 weeks, going Monday and Friday (minimum) and then I have a weekly meeting with an athletic therapist to develop sports specific movements. As of last Thursday, after my appointment with the therapist I have a severe pain in my upper calf.



The image on the far right is exactly where the pain is. I feel the pain immediately when trying to extend my leg and my knee seems to be swelling up a little bit. Could this be just due to me not engaging my hamstrings for a while and then over working them? Causing strain on the calf? Hammies are very tight and sore also.

I will be bringing this up with my surgeon when I visit him soon but thought I'd get some input.

Any chance you hurt your knee again in a manner similar to the injury that caused the ACL rupture? Can you walk normally? Can you pursue any activities? Has the pain gone worse or gotten easier? How bad is the pain on a scale of 1-10? Have you had this symptom earlier during the post-operative rehab? Does the knee feel stable? Can you locate it superficially on the muscle/tendon or does it feel like it's inside the knee? Fever?

Without any new injuries, i would say it's most probably something you should wait through and just continue with the rehab within pain boundaries, the knee will usually be almost as good as before at around 1-1,5 years post op, so small setbacks are normal, swelling etc. are normal. It takes a lot of time to heal properly and the tissues get used to it with time. Obviously it's good your orthopod checks it for any laxity or causes that require extra investigations.

This post was edited by Neptunus on Nov 19 2018 07:09am

No I don't think I have injured my knee since. This only popped up a few weeks ago and I've been very specific with my movements. I could walk normally prior to the tightness however now I can't extend my leg fully wihh out a quick jolt of pain. I have written off activities until I am fully cleared. From when I first felt the pain its slowly gotten better. The first day I felt the pain it was near impossible to walk and now I can jog unless I fully extend my leg. Pain would be 6 or 7. Never felt this during my whole recovery process. Surgeon said knee felt stable last Thursday when he checked it out. It does feel superficial or slightly below skin. No fever. My doctor looked at it as I was worried it could be dvt or a clot however he says it doesn't look like that and it should go away after a bit due to overexertion on my weakened hamstring (as this is the operated leg)

Is it localized swelling? Or your entire lower extremity is swelling? Talk to your PT, but if its generalized to your entire lower extremity and you have a positive homans sign, I'd speak to your PCP to get a dvt ruled out.

E: just read your post, glad to hear it’s not a dvt.

This post was edited by ozzyarmy3 on Nov 19 2018 11:35am

Sounds indeed like something that just needs rest, it's highly unlikely that it's something serious given how long it is since it got operated and the fact there was no new trauma. The ACL graft should by now also be about as strong as the original ACL. Doing lighter training for a while and pain medication would be good. Keep training your leg within the limits of pain. It should get better patience is key.

I spoke to my physio and he says it's most likely popliteal pain due to overexertion. I guess I just need to scale back the intensity on some of my rehab

At least it tells that youre taking your rehab seriously