Intense pain in hammy and lack of ROM still after two years post ACLR

Hi all,

I had an ACLR (hamstring option) a little over two years ago, medial meniscus repair and torn lateral meniscus left alone. I injured this playing soccer. Injury happened at the age of 38. I was in pretty good shape and still very fast for my age. I thought I would be able to make it through rehab successfully but it has been difficult. I have had numerous issues.

I had very limited range up until 12 weeks or so post op - something like 5' to 80' and found it very difficult to build the hammy and quads back up. Intense pain and almost restricted motion. I followed the rehab protocol religiously. Doc prescribed Prednisone after a few weeks to help with swelling. At 6 months I had a scope to clean out scarring. Few months later a cortisone shot. Still not much better.

Few weeks after that the PT began aggressively using graston and other release techniques. Also more focused hamstring exercises.

Where I sit today is there is an intense pain when I kneel in the lower hamstring and upper calf. It starts when the calf and hammy come in contact or maybe even the crease in the knee. The graston and release help a little but after a fews hours it is back. I also have difficult getting past 130' flexing and extension is difficult. It is as though something is restricting the motion along with the sharp pain. My other good leg easily goes from -9 to 146'. If standing I can get to about 90' flexion and at that point it is like something is holding me back. Another weird thing is if I lock my ankle and tighten calf I can pull up a few more degrees, but keeping the ankle soft cramps the hammy.

Other things I notice are that the knee clicks in various places. I notice that the knee rubs over the outer head of the femur when bending from 90' to straight.. Right knee rolls smoothly over that area. PT believes that the quad muscles are so tight that they are pulling the knee cap down. After that initial click I can hear and feel deeper clicks. Looking at my right knee I can see the knee cap slides up and slightly lateral when I contract my quads. I see little movement in the left knee. The knee also sits up for lack of a better description. The right knee the knee cap kind of floats when my leg is lying flat. I can move the knee cap, rock it a bit, press it down. But the left one is sort of stuck and I can feel it grind on the bones below and the leg just doesn't lie flat like my right leg.

The PT currently is under the impression my glute is weak. This weakness is causing the hammy to overwork and tighten and that causes the pain. I haven't seen much improvement after weeks of glute exercises.

Any ideas of things to try or what to look for to diagnose the issues? I am very good at working PT. I stretch and foam roll at least twice a day for 30 minutes. This is along with whatever exercises the PT comes up with.

Thanks, Mas