# ACL reconstruction with meniscus repair



## BigTam (20 Aug 2018)

Had my op on the 27th July, seen physio a few days later, was given some rehab exercises to do and told to start on static cycle after stitches were removed.
That was just over a week ago, set up bike on turbo, very little resistance, finding it tough, really sore when on bike, only doing 10 minute sessions twice a day, knee still quite swollen, know it's still early days but quite frustrating.
Anyone else have any experiences of post ACL rehab and issues ?


----------



## vickster (20 Aug 2018)

You can connect with folks who’ve had knee op on

http://www.kneeguru.co.uk/KNEEtalk/index.php

@PK99 had his done last year

Sounds like you’re doing pretty well less than a month after major knee surgery. Was your meniscus actually repaired with stitches or torn bit trimmed?

ACLr is a 12 month+ rehab generally, need lots of patience. Be aware graft weakest and most vulnerable at 6-12 weeks...


----------



## BigTam (20 Aug 2018)

Cheers for that, was trimmed, both medial and lateral, beyond repair.


----------



## vickster (20 Aug 2018)

Not great for the longer term. How old are you?

My lateral meniscus is shredded, having menisectomy in January. Knee arthritic. Ligaments good tho!


----------



## BigTam (20 Aug 2018)

I'm 58, was extremely fit before accident, just worried now recovery time and age will take its toll.


----------



## vickster (20 Aug 2018)

BigTam said:


> I'm 58, was extremely fit before accident, just worried now recovery time and age will take its toll.


How did you tear it?
You can join a gym for upper body, swimming with a float between legs etc
Is there arthritis too?
Recovery does always take longer when you are older unfortunately
Getting a private Physio with expertise in
ACL rehab would be advised too


----------



## Nigel-YZ1 (20 Aug 2018)

I tore both my ACLs. The GP just told me to go home and put my feet up.

When I found a GP that gave a shoot I was put in weekly rehab at Badsley Moor Lane at Rotherham. Then it was balance, hip, step, rowing, squats (with ball) - just all round strengthening type stuff.


----------



## BigTam (20 Aug 2018)

Just went over on my knee when trying to turn, heard a pop.
Yes using gym at work for upper body and core, starting swimming this week, though told just to water walk initially.
Consultant said there was some arthritis present.
Going to get intense physio through work, have access to rehab centre, so going there on a residential basis but not till October as they wont touch me until 12 weeks after op as graft still susceptible to damage till then.
Just frustrated and impatient, accident happened in April and op 3 month later, missed a whole cracking summer of cycling.


----------



## midlife (20 Aug 2018)

BigTam said:


> Just went over on my knee when trying to turn, heard a pop.
> Yes using gym at work for upper body and core, starting swimming this week, though told just to water walk initially.
> Consultant said there was some arthritis present.
> Going to get intense physio through work, have access to rehab centre, so going there on a residential basis but not till October as they wont touch me until 12 weeks after op as graft still susceptible to damage till then.
> Just frustrated and impatient, accident happened in April and op 3 month later, missed a whole cracking summer of cycling.



Just curious are you in the police?


----------



## PK99 (20 Aug 2018)

Hi,

As Vickster said I've got direct experience....

Snapped ACL skiing in Feb '16. Minimal meniscus damage. Age 60.

Did not want to bugger up plans for the summer, so after consulting surgeon privately to get rapid diagnosis and advice I decided to delay op till October '16.

In the meantime I rehabbed and prehabbed under the guidance of a sports physio and cycled around Provence and up Ventoux sans-ACL in September '16.

Op in October '16 and back cycling with my CTC group in April '17

By sods law I got an unrelated DVT in the non operated leg just after starting back, that laid me up for a while then in September '17 I got a chest infection that morphed into something nasty and I only began to feel semi human but grossly unfit again in April/May '18.

So my time line is unusual, but apart from a little early morning stiffness (quiet at the back please!) the ACL knee is fine and I am back cycling hard but limited by lost general fitness.

D2 snapped her's in Feb '17, operated on within a month. Had a few minor setbacks with internal scar tissue, but she is back in the gym deep squatting 65kg and her PT says he cannot tell which is her damaged knee.

So, have confidence you will get back - but is does take time, and during that time of rehab the one key mantra is "protect the graft" do not do the wrong exercises or even too much of the right exercises.

I don't know how much you know about ACL surgery and rehab, so pardon me if I'm teaching you to suck eggs...

The ACL is a taut, non stretchy ligament in the knee that controls twisting motions. The surgeon takes the stretchy tendon from one of the 3 hamstring muscles, twists it together as an ACL lookalike and fixes it with screws into the middle of the knee joint - there are loads of YouTube videos showing the op, and it is pretty brutal surgery - the whole knee will be very sore for quite some time post op simply because of the surgery.

Key point to note, is that you currently do not have an ACL you have a piece of dead tendon screwed across the middle of your knee. Over a period of months, the body will first vascularise (provide a blood supply to) the dead tendon, it will then recognise it is stretchy tendon tissue where there should be non stretchy ligament tissue and will lay down collagen to convert tendon to ligament. Clever things bodies! So, over a period of months, the new ACL will first get weaker and weaker and then, as it converts, stronger and stronger. 12 weeks post of is identified by many sources as the weakest point for the graft - some sources vary on that, saying 5-6 weeks.

Hence the mantra I mentioned above "protect the graft" Stretching the graft before conversion is complete can lengthen it permanently and leave you with a floppy joint.

Early stage rehab is about regaining mobility of the post op joint, building up muscle to support the knee while it heals and as far as possible preventing complete atrophy of other muscles.

Also in early stage and continuing, a focus will be on proprioception - that uncanny thing that allows you to close your eyes and touch the end of your nose ie the body knowing where its various bits are. The ACL is a key part of the proprioception circuit for your lower leg and the body has to fine workarounds to give you back that original ability.

Later stages will look at regaining previous strength - in particular building the remining 2 hamstring muscles to do the work of the one that no longer had a tendon.

So what do I advise?

1. Do what your surgeon tells you.

2. Find a good sports physio with ACL experience and who you feel you can work with and trust. Do what they say you should - no more and no less.

3. Hire a game ready machine. A combination Compression and Cryotherapy device and works on both pain relief (cryotherapy) and swelling (compression)
It is magic. Used by all top sports people, coaches and physios.
http://www.gameready.co.uk/How_it_works.html

4. Hire a compex machine - your physio may have one - this is an electro stimulation device that allows you to exercise muscle around the knee without using the knee joint and risking the graft. Hurts like hell as it is putting more work through the muscles than you could in the gym!

5. Watch this video:
http://www.physiorehab.com/you-tube-videos/acl-reconstruction-rehab-program-essentials-seminar


and if you are as impressed as I was, buy his ACL rehab program.

http://www.physiorehab.com/rehab-programs-acl-knee-surgery-rehab

Your sports physio, should be happy for you to work with you on this, providing checkups on progress and giving the OK to move on to the various stages.

I found it in invaluable.

6. Accept the rehab is a long slow and often frustrating process - unlike training you are not aiming to push the limits, you are working well within capacities to aid recovery. Training to regain fitness will come later, but if you follow a good protocol the progress through rehab will be speedy and have its own rewards as difficult exercise become easier.


Items 2-5 are not cheap but together cost less than a new bike.

Good luck and if you want 121 advice drop me a PM.


----------



## BigTam (21 Aug 2018)

midlife said:


> Just curious are you in the police?


No Fire Service


----------



## BigTam (21 Aug 2018)

Cheers all for the advice and in particular PK99, looking to run before I can walk, literally, bourne out of frustration, I am keeping to advice from physio.
The basic exercises are not a problem, was concerned however that the pain I am getting on the turbo may cause graft to fail but physio says no and to keep it up.


----------



## vickster (21 Aug 2018)

BigTam said:


> Cheers all for the advice and in particular PK99, looking to run before I can walk, literally, bourne out of frustration, I am keeping to advice from physio.
> The basic exercises are not a problem, was concerned however that the pain I am getting on the turbo may cause graft to fail but physio says no and to keep it up.


Make sure you ice the knee after exercising, be it on tne turbo or just the physio ones


----------



## bobinski (18 Sep 2018)

I hope the OP doesn’t mind me jumping on ha thread. 
I tore my right knee ACL 35y ago skateboarding. I have coped without it. How we over last 2 years a couple of crashes and using m knee to ram the rear of a car left me with residual knee pain and likley associated ITB issues. Also a growing lump on outside of my knee, 2x2 Cm. A recent mri confirms lateral tear to meniscus. Fluid from the rear has produced the lump. Surgery on 23/10. Surgery lite is remove and clean up the lump, repair or snip the tear. Surgery heavy is ACL reconstruction using hamstrings etc. Surgery will be day after my 56th birthday. Consultant says I am a coper and surgery lite is probably as much as I need. I am inclined to agree. Anyone else had to make the live and if so anything I should consider before making a decision?


----------



## vickster (18 Sep 2018)

How bad is the arthritis in the joint if you’ve been without an ACL for so long? Did the MRI show the state of the bones and joint space 

At 56, it’s unlikely your meniscus is going to be able to be repaired with stitches, rather degenerate and just trimmed to a stable rim

@PK99 offers great insight above into ACLr in more mature years


----------



## bobinski (18 Sep 2018)

vickster said:


> How bad is the arthritis in the joint if you’ve been without an ACL for so long? Did the MRI show the state of the bones and joint space
> 
> At 56, it’s unlikely your meniscus is going to be able to be repaired with stitches, rather degenerate and just trimmed to a stable rim
> 
> @PK99 offers great insight above into ACLr in more mature years



Consultant says that while he cannot be certain till he opens me up there is little evidence of arthritis on MRI.


----------



## PK99 (18 Sep 2018)

vickster said:


> How bad is the arthritis in the joint if you’ve been without an ACL for so long? Did the MRI show the state of the bones and joint space
> 
> At 56, it’s unlikely your meniscus is going to be able to be repaired with stitches, rather degenerate and just trimmed to a stable rim
> 
> @PK99 offers great insight above into ACLr in more mature years




Love the delicacy of your phrasing


----------



## PK99 (18 Sep 2018)

bobinski said:


> I hope the OP doesn’t mind me jumping on ha thread.
> I tore my right knee ACL 35y ago skateboarding. I have coped without it. How we over last 2 years a couple of crashes and using m knee to ram the rear of a car left me with residual knee pain and likley associated ITB issues. Also a growing lump on outside of my knee, 2x2 Cm. A recent mri confirms lateral tear to meniscus. Fluid from the rear has produced the lump. Surgery on 23/10. Surgery lite is remove and clean up the lump, repair or snip the tear. Surgery heavy is ACL reconstruction using hamstrings etc. Surgery will be day after my 56th birthday. Consultant says I am a coper and surgery lite is probably as much as I need. I am inclined to agree. Anyone else had to make the live and if so anything I should consider before making a decision?




My surgeon said he would not normally operate on someone my age, but as I was so active and fit from cycling he would do it. One incident prior to surgery convinced me it was the right choice. First warm day of the year in may, opened the patio door and went out. Stepped back in, door mat slipped under good leg and I landed on the floor like a sack of spuds with a MCL strain in my bad knee. If I had had any doubts that would have made my mind up! You appear to have been stable long term with no ACL so you choice might be different.

Further advice from my surgeon was that delay even for years is no issue of itself in the reconstruction. .


----------



## vickster (18 Sep 2018)

bobinski said:


> Consultant says that while he cannot be certain till he opens me up there is little evidence of arthritis on MRI.


Good to hear, often if you've been ACL deficient, the bones can be pretty trashed


----------



## vickster (18 Sep 2018)

PK99 said:


> My surgeon said he would not normally operate on someone my age, but as I was so active and fit from cycling he would do it. One incident prior to surgery convinced me it was the right choice. First warm day of the year in may, opened the patio door and went out. Stepped back in, door mat slipped under good leg and I landed on the floor like a sack of spuds with a MCL strain in my bad knee. If I had had any doubts that would have made my mind up! You appear to have been stable long term with no ACL so you choice might be different.
> 
> Further advice from my surgeon was that delay even for years is no issue of itself in the reconstruction. .


While I'm too young for him to do anything radical!


----------



## bobinski (18 Sep 2018)

PK99 said:


> Love the delicacy of your phrasing



It’s alright- I am a criminal defence lawyer and used to speaking bluntly


----------



## bobinski (18 Sep 2018)

PK99 said:


> My surgeon said he would not normally operate on someone my age, but as I was so active and fit from cycling he would do it. One incident prior to surgery convinced me it was the right choice. First warm day of the year in may, opened the patio door and went out. Stepped back in, door mat slipped under good leg and I landed on the floor like a sack of spuds with a MCL strain in my bad knee. If I had had any doubts that would have made my mind up! You appear to have been stable long term with no ACL so you choice might be different.
> 
> Further advice from my surgeon was that delay even for years is no issue of itself in the reconstruction. .



I see.

As with you my consultant said I could have whatever I wanted, that he felt it his duty to do given I had just come back from the Pyrenees and clearly did all I could to remain fit and healthy so why shouldn’t he help. He has sufficient time set aside in the operation date to do the reconstruction despite me saying I would co surgery lite. Also that I could delay choose the reconstruction next year and he would prioritise me. He was an absolute delight!


----------



## BigTam (15 Oct 2018)

That's me into my 12th week since my ACL surgery, things have moved on leaps and bounds.
Took a lot of the advice given on here, thanks guys and stuck religiously to the physio therapy.
Going to a rehab centre next week for a full 6 days intense physio, certainly glad I did opt for the operation, even at my age, oh and getting some miles in on the road again.


----------



## Drago (15 Oct 2018)

Excellent news, pleased to hear it's going well. I had a colleague who's ACL snapped while running after a villain. He healed good as new, and he's hardly the fittest specimen you'll meet.


----------



## PK99 (15 Oct 2018)

BigTam said:


> That's me into my 12th week since my ACL surgery, things have moved on leaps and bounds.
> Took a lot of the advice given on here, thanks guys and stuck religiously to the physio therapy.
> Going to a rehab centre next week for a full 6 days intense physio, certainly glad I did opt for the operation, even at my age, oh and getting some miles in on the road again.



Excellent news. The rehab phase is tedious but you should now see rapid development.

6 days intensive physio sounds wonderful.... but expensive!

Ah, just read back and see you are ex Fire Service - you will be going to the fire service rebab centre then? Cycling mate, also ex fire service, went there following both his hip replacements and it is fantastic. They will work you at your level and progress you quickly.


----------



## BigTam (20 Oct 2018)

PK99 said:


> Excellent news. The rehab phase is tedious but you should now see rapid development.
> 
> 6 days intensive physio sounds wonderful.... but expensive!
> 
> Ah, just read back and see you are ex Fire Service - you will be going to the fire service rebab centre then? Cycling mate, also ex fire service, went there following both his hip replacements and it is fantastic. They will work you at your level and progress you quickly.



Yes rehab at Jubilee House in Penrith, I am still with the Fire Service, not front line, technical.
The centres are run by the Firefighters charity and have an excellent reputation, going tomorrow for 6 days.


----------



## PK99 (20 Oct 2018)

BigTam said:


> Yes rehab at Jubilee House in Penrith, I am still with the Fire Service, not front line, technical.
> The centres are run by the Firefighters charity and have an excellent reputation, going tomorrow for 6 days.



That is really good news. I'm envious. Let us know how you get on, I've no doubt it will be in leaps and bounds....


----------



## Globalti (20 Oct 2018)

My God, these knee injuries make my busted collar bone worries pale into insignificance!


----------



## vickster (20 Oct 2018)

Globalti said:


> My God, these knee injuries make my busted collar bone worries pale into insignificance!


Until it needs surgery and rehab perhaps. You don't walk on your collar bone hence knee injuries are nasty


----------



## Paulq (21 Oct 2018)

I have had 3 ACL revisions on my left knee since originally injuring it playing rugby many years ago. The rehab is absolute torture but the one key aspect is patience - listen to your body and work within the limits it's giving you. With this and a good physio it will come right.

Very best of luck with it - horrible injury.


----------



## PK99 (22 Oct 2018)

Paulq said:


> I have had 3 ACL revisions on my left knee since originally injuring it playing rugby many years ago. The rehab is absolute torture but the one key aspect is patience - listen to your body and work within the limits it's giving you. With this and a good physio it will come right.
> 
> Very best of luck with it - horrible injury.



That sound tough. How did you reinjure the knee?


----------



## BigTam (28 Oct 2018)

Well just back from Jubilee House and a full 6 days physio, pretty intense and damn hard work but well worth it, knee feels really good, full range of motion and extension, still a way to go but this week has made such a difference.
Time was split between gym and pool, massive emphasis on regaining muscles strength and balance, just got to keep up the exercises and reap the benefits.


----------



## PK99 (28 Oct 2018)

BigTam said:


> Well just back from Jubilee House and a full 6 days physio, pretty intense and damn hard work but well worth it, knee feels really good, full range of motion and extension, still a way to go but this week has made such a difference.
> Time was split between gym and pool, massive emphasis on regaining muscles strength and balance, just got to keep up the exercises and reap the benefits.



Good! You will get there. The benefits are definitely worth the graft. Ha! Unintentional pun!


----------



## Paulq (3 Nov 2018)

PK99 said:


> That sound tough. How did you reinjure the knee?



To be honest the first 2 repairs weren't done correctly so I reinjured through just assuming it was strong enough and finding out it wasn't doing stuff like circuits. It's never been great since but the last repair I had done was by a leading sports surgeon at a specialist orthopaedic unit which concentrated on that type of injury.

It's a horrible injury to suffer. A lot of the damage is psychological.


----------



## PK99 (3 Nov 2018)

Paulq said:


> To be honest the first 2 repairs weren't done correctly so I reinjured through just assuming it was strong enough and finding out it wasn't doing stuff like circuits. It's never been great since but the last repair* I had done was by a leading sports surgeon at a specialist orthopaedic unit which concentrated on that type of injury.*
> 
> It's a horrible injury to suffer. A lot of the damage is psychological.



You remind me of a key pieces of advice:

With an ACL rupture do not simply rock up to ano NHS orthropod, search out who is the best in your area and get a referral to them - you want someone who does ACL's as a routine. Mine is Surgeon for a Premiership football club and on the day he did mine he was doing at least two others.

Looking at your location reminds me of the time my cousin's lad, one Dan Murphy had his ACL done at a private hospital on the Wirral. He had loads of people popping their head round his ward door seeing if it was Danny Murphy of Liverpool!


----------



## rivers (7 Nov 2018)

I had a complete tear of ACL, a torn meniscus, and some small fractures in my knee when I was 18 from a rugby tackle. That was back in October 2001. I had reconstructive surgery (hamstring) in January 2002. Rehab was about a year. It was a long slog, painful at times. But my knee is just as strong as it was when I was a kid, if not stronger now. Although nearly 17 years on, I am starting to experience symptoms of osteoarthritis on occasion. But I knew there was a strong possibility of it developing. I just keep putting off getting it look at because I don't want to know.


----------



## PK99 (7 Nov 2018)

rivers said:


> I had a complete tear of ACL, a torn meniscus, and some small fractures in my knee when I was 18 from a rugby tackle. That was back in October 2001. I had reconstructive surgery (hamstring) in January 2002. Rehab was about a year. It was a long slog, painful at times. But my knee is just as strong as it was when I was a kid,* if not stronger now.* Although nearly 17 years on, I am starting to experience symptoms of osteoarthritis on occasion. But I knew there was a strong possibility of it developing. I just keep putting off getting it look at because I don't want to know.



As my surgeon/physio said, the new ACL will never be as strong as the original, but the knee can be stronger if the proper rehab and strengthening of the supporting structures is done.


----------



## rivers (7 Nov 2018)

PK99 said:


> As my surgeon/physio said, the new ACL will never be as strong as the original, but the knee can be stronger if the proper rehab and strengthening of the supporting structures is done.



I did say knee and not ACL is my post. I know my ACL isn't as strong, but my knee as a whole is. A lot of my rehab focused on strengthening surrounding muscle, and I'm sure the amount of cycling I do also helps.


----------



## bobinski (26 Nov 2018)

Afternoon.
I am 2 weeks post meniscus repair operation having decided, at 56y old, that i couldn't cope with an ACL reconstruction too. In fact rather than just snip the frayed meniscus the consultant has repaired and i am now in a brace for 6 weeks anyway whilst it all heals. I am slowly going mad for lack of activity so i have NO idea how you guys and girls who had ACL reconstruction, coped with the enforced time in a brace. Respect. The brace comes off on December 19th so an early xmas present for me!


----------



## PK99 (26 Nov 2018)

bobinski said:


> Afternoon.
> I am 2 weeks post meniscus repair operation having decided, at 56y old, that i couldn't cope with an ACL reconstruction too. In fact rather than just snip the frayed meniscus the consultant has repaired and i am now in a brace for 6 weeks anyway whilst it all heals. I am slowly going mad for lack of activity so i have NO idea how you guys and girls who had ACL reconstruction, coped with the enforced time in a brace. Respect. The brace comes off on December 19th so an early xmas present for me!



Weight bearing without brace 1 day post op.!


----------



## bobinski (27 Nov 2018)

PK99 said:


> Weight bearing without brace 1 day post op.!



stitches in the meniscus? or did they just cut off the scraggy bits!


----------



## PK99 (27 Nov 2018)

bobinski said:


> stitches in the meniscus? or did they just cut off the scraggy bits!



cut off the scraggy bits


----------



## bobinski (27 Nov 2018)

PK99 said:


> cut off the scraggy bits



Well at least you are good to go. Speedy recovery mate.


----------



## PK99 (27 Nov 2018)

bobinski said:


> Afternoon.
> I am 2 weeks post meniscus repair operation having decided, at 56y old, that i couldn't cope with an ACL reconstruction too. In fact rather than just snip the frayed meniscus the consultant has repaired and i am now in a brace for 6 weeks anyway whilst it all heals. I am slowly going mad for lack of activity so i have NO idea* how you guys and girls who had ACL reconstruction, coped with the enforced time in a brace.* Respect. The brace comes off on December 19th so an early xmas present for me!



I really am puzzled by this.

From day 1 I was doing mobility work at home - morning and evening
By day 14 walking was more or less normal with full extension
Day 17 I was in the gym
Day 22 on i was doing daily 2 hour sessions in the gym, plus home based mobility
Day 27, my log shows. AM mobility work at home, PM 90 mins gym based mobility, 20min static bike, 20 min water walking & squats


----------



## vickster (27 Nov 2018)

PK99 said:


> I really am puzzled by this.
> 
> From day 1 I was doing mobility work at home - morning and evening
> By day 14 walking was more or less normal with full extension
> ...


Stitched meniscus needs to heal, minimal flexion hence brace and crutches typically
Lucky to be able to have it done after about the age of 30. Mine (lateral) was far too friable aged 37 and it’ll be trimmed again in January, potentially quite a lot


----------



## bobinski (30 Nov 2018)

PK99 said:


> I really am puzzled by this.
> 
> From day 1 I was doing mobility work at home - morning and evening
> By day 14 walking was more or less normal with full extension
> ...




I missed this and @vickster’s reply which says it all. At 56y I am REALLY fortunate that the consultant was able and more importantly, willing to repair. Protecting the stitches/healing area is vital hence the brace and restricted knee movement and general mobility.


----------



## berty bassett (30 Nov 2018)

I'm 56 you know !  hows the knee Bob


----------



## bobinski (30 Nov 2018)

berty bassett said:


> View attachment 440953
> I'm 56 you know !  hows the knee Bob



You stalking me?!? 

Genuinely bored sat/lying on sofa much of the time. Still, it’s giving me an opportunity to source Chinese carbon wheels but I will take that from here and over to the other thread.


----------



## berty bassett (30 Nov 2018)

bobinski said:


> You stalking me?!?
> 
> Genuinely bored sat/lying on sofa much of the time. Still, it’s giving me an opportunity to source Chinese carbon wheels but I will take that from here and over to the other thread.


just trying to keep you alert ! dont want you losing your marbles yet


----------



## BigTam (14 Dec 2019)

My ACL op went well, nearly 18 months post surgery, at the time I was told by my surgeon that I had also had torn both the medial and lateral meniscus, I was under the impression that both had been repaired at the same time as the ACL.
All seems to go well until about 8 months ago, then started getting pain at the side of my knee, further investigations, then had to have an arthroscopy last week, the surgeon hadn't repaired the lateral meniscus, so that has been done now, bit cheesed off, 18 month since ACL and now having to start rehab again, won't be as intensive or take as long but still a set back none the less


----------



## PK99 (14 Dec 2019)

BigTam said:


> My ACL op went well, nearly 18 months post surgery, at the time I was told by my surgeon that I had also had torn both the medial and lateral meniscus, I was under the impression that both had been repaired at the same time as the ACL.
> All seems to go well until about 8 months ago, then started getting pain at the side of my knee, further investigations, then had to have an arthroscopy last week, the surgeon hadn't repaired the lateral meniscus, so that has been done now, bit cheesed off, 18 month since ACL and now having to start rehab again, won't be as intensive or take as long but still a set back none the less



Frustrating!


----------

