Sympathetic Calf Pain After An Acl Reconstruction?

In the spring of 1993, I suffered a torn acl with additional damage to my meniscus during a collegiate lacrosse game.

After the swelling had gone down in about a month, I had arthroscopic surgery to replace the acl with a portion of my patellar tendon from the same knee, as well as to remove some of the torn portions of the meniscus.

I went to physical therapy religiously in order to regain full use of my knee as soon as possible as I wanted to play lacrosse again. After several months of rehab, it became apparent that something was not right about my knee. Even after all the work that myself and the physical therapy team had done, I was still unable to fully extend my knee without experiencing extreme pain and swelling along the joint line.

The athletic trainers at the physical therapy department with which I had contact all felt that the rehab had progressed as far as it could go from their standpoint. I had completed my therapy with a minimum of atrophying of the surrounding muscles, and had done a lot of plyometric training in order to strengthen the complimentary muscles around the injury. My knee was strong, and stable, but I did not have full extension and that made it difficult to run with a normal gait.

The college’s physical therapy team sent me to an orthopedic surgeon at the nearby hospital affiliated with the university. Since I had gotten the surgery done by a doctor at home during the summer, this doctor had the opportunity to take a fresh look at the situation.

My new doctor ordered an additional mri and, upon looking at it, came to two conclusions:

1. There was a portion of my meniscus that had been torn during the initial trauma, but had been missed during the surgery. This fragment was keeping my knee from being able to fully extend because it was lodged within the joint itself.

2. The graft from my patellar tendon appeared to have been implanted at the wrong angle.

The new doctor recommended an additional arthroscopy to correct both of these problems. I consulted with my physical therapists, who also agreed that this was the best option. My parents agreed, so I decided to have the surgery.

The second surgery was much worse than the first. I was not sufficiently prepared for what would take place. Upon waking up, I was horrified to discover that the surgeon had taken part of the hamstring from my good leg to replace the acl in my bad one. Now I had two legs bandaged up. Further, during the surgery, I apparently suffered some muscle spasms which resulted in the tearing of my quadriceps on the acl-reconstructed knee. As if the acl reconstruction itself weren’t painful enough, I also had the quad problem to contend with.

Once I was lucid enough to actually have a dialogue, I spoke with my surgeon. He said that the damage was far more extensive than he’d at first predicted and this was the reason for the additional graft harvesting on my good knee. He assured me that he’d received permission from my parents while I was anesthetized to go forward with that part of the operation, which they later confirmed.

The rehab from this second acl reconstruction went far more slowly. As with the first, I worked very hard with my therapists to rebuild the strength in my knee because I wanted to play ball again. At the end, my knee still did not extend as far as it did previously, but it did do so without pain. There was simply too much scar tissue in and around the joint to allow it to do this. I eventually discovered that my left knee (the good one) actually hyperextends a bit. Thus, by comparison, the damaged knee looked that much more like it could not extend fully.

Happily, I did make a full recovery from the surgery and went on to play my last two seasons of lacrosse (without a brace) alongside my teammates, which was where i’d wanted to be all along.

That was over 10 years ago.

Now, i’m 30 years old, out of shape, overweight and my knee is a constant source of pain and annoyance. It’s very sensitive to changes in barometric pressure as well as sudden temperature changes. It aches all the time, but the pain is exacerbated during atmospheric changes as i’ve stated.

I’m not sure if the weight thing is a chicken or the egg situation. Did I start putting on weight when my knee began hurting to the point where simple exercise became annoying, or does my knee hurt solely because of the additional strain it bears? Both explanations seem reasonable.

That’s not technically, what i’m asking about, though. I included all the additional (probably superfluous) information in case there is something specific that might explain the real source of annoyance, my calf.

When my reconstructed knee aches, I get excruciating sympathetic pain and cramping in my calf. The source of the pain is so deep within my calf that it’s nearly impossible to massage. My wife’s hands get tired long before her hands can reach the source of the pain. I would almost say it feels like tendonitis in my calf, but I can’t figure out what that has to do with my knee hurting.

I saw a doctor when the pain started becoming a real problem (keeping me up at night, etc) and he basically told me that I needed to lose weight. I informed him that the cramping started before I had to start limiting my activity and thus put on weight. In fact, it was one of the major reasons I had to stop mountain biking and rollerblading because my calf would cramp up so badly when I tried either activity. He recommended some stretching exercises, but the pain originates so deep within my calf muscle that none of them felt as though they were “getting at” the area that was in pain. After I told him this, he became very dismissive, and I got the impression that he believed I was some kind of painkiller junkie trying to scam drugs off of him. This infuriated me, and I did not return to him for additional consultation.

That was a year ago, and my calf is hurting more and more. I’m trying to swim and do some other activities that don’t impact the calf, but the kicking action from swimming makes my knee hurt, and thus the calf does as well. It’s getting very frustrating.

Is this a common problem? Is there something i’m overlooking? Is there something I should specifically tell a doctor to look at when describing the problem?