Post-ACL Reconstruction: Managing Stiffness and Numbness in Recovery - Orthopedics

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Post-ACL reconstruction recovery can be a complex process, and it's not uncommon for patients to experience stiffness and numbness even after a year of rehabilitation. Your symptoms of difficulty bending or straightening the knee after prolonged positions, as well as episodes of numbness, can be attributed to several factors related to the surgical procedure and the healing process.

First, it’s essential to understand that stiffness after ACL reconstruction can occur due to scar tissue formation around the knee joint. This scar tissue can limit the range of motion and lead to feelings of tightness or stiffness, especially after sitting or lying in one position for an extended period. This phenomenon is often referred to as "arthrofibrosis," which is an excessive formation of scar tissue that can occur post-surgery.

To manage stiffness, it is crucial to continue with a structured rehabilitation program that focuses on flexibility and range of motion exercises. Here are some strategies that may help:
1. Regular Stretching: Incorporate daily stretching exercises targeting the quadriceps, hamstrings, and calf muscles. Gentle stretches can help maintain flexibility and prevent stiffness.

2. Active Range of Motion Exercises: Engage in exercises that promote active movement of the knee joint. For example, heel slides, wall slides, and gentle squats can help improve mobility.

3. Heat Therapy: Applying heat to the knee before stretching can help relax the muscles and improve blood flow, making it easier to stretch and move the joint.

4. Physical Therapy: If you haven’t already, consider working with a physical therapist who specializes in post-operative rehabilitation. They can provide personalized exercises and manual therapy techniques to address stiffness and improve function.

5. Gradual Return to Activities: As you return to running and other sports, ensure you are gradually increasing your activity level. Sudden increases in intensity or duration can exacerbate stiffness and discomfort.

Regarding the numbness you are experiencing, it’s important to consider that nerve irritation or damage can occur during surgery, leading to sensations of numbness or tingling. This can happen if the nerves around the knee are stretched or compressed during the surgical procedure or during the recovery phase. Here are some considerations for managing numbness:
1. Nerve Gliding Exercises: These exercises can help improve the mobility of the nerves around the knee and may alleviate some of the numbness. Consult with a physical therapist for specific nerve gliding techniques.

2. Posture and Positioning: Pay attention to your posture and the positions you hold for extended periods. Avoid positions that may compress the knee or surrounding nerves.

3. Monitoring Symptoms: Keep track of when the numbness occurs and any associated activities. If the numbness persists or worsens, it may be worth discussing with your orthopedic surgeon or a neurologist to rule out any underlying nerve issues.

4. Gradual Activity Resumption: As you engage in physical activities, ensure you are not overexerting yourself, as fatigue can exacerbate symptoms of numbness.

In conclusion, while it's encouraging that you can run and engage in sports, the presence of stiffness and numbness indicates that your knee may still be in the process of healing. Continuing with rehabilitation, focusing on flexibility and nerve health, and consulting with healthcare professionals as needed will be key to managing your symptoms effectively. If you notice any significant changes in your symptoms or if they interfere with your daily activities, it’s advisable to seek further evaluation from your orthopedic surgeon.