New Exercises + Last Physio

Today's physio started off with me on the bike for 8 minutes with strong resistance. It felt great to exercise again and after 8 minutes I was breathing heavily. 6 weeks without cardio can do wonders. I now have hamstring routines to do along with the regular squats / balancing exercises. I've been told I've made great progress and don't need to come back to physio for 3 weeks.

I've also joined a gym so I can use a bike on a regular basis to build up that lost cardio.

And now we play the waiting game for the surgeon to call with an appointment date.

Balance and Strengthening

Today's physio brought new balancing exercises into my daily routine and tougher strength training ones for my quads. One exercise has me dropping my shoe and bending over to pick it up while standing on my bad leg without bending my knee. Quite a bit more difficult than it sounds.

Apparently the more muscle I have before surgery, the easier the physio is after surgery. A lot of the muscle will die off during surgery, hence the more I have before, the more I'll have after.

MRI Images

There's about 60 images per section and here are the most interesting ones:

ACL / PCL images

The thick black line from the front of the femur (top bone) to the back of the shin bone is my PCL. Normal PCL's are all black whereas mine has some lighter parts to it, hence the "partial tear".

There should be a similar thick black line going from the front of the shin bone to the back of the femur. It crosses over the PCL. The lack of black line = busticated ACL.

Also, the bright white stuff is fluid (blood) that shouldn't be there.

Meniscus:

The black sideways triangles in the middle are the meniscus. This is the medial meniscus which appears normal.

This is the lateral meniscus where there is no triangle on the right, and the left one is messed up.

5 weeks after the injury

It's been 5 weeks since the injury. Today I met with the doc to discuss the mri results and future surgery.

My LCL and MCL have fully healed. The MCL may need some sutures to lock down the parts that are not attached to the bone and the LCL is slightly loose but it will tighten up over time. He mentioned my PCL should heal on it's own. The meniscus might have flipped back on the right side. My flexability is good. There is still blood floating around in my knee.

He will be referring me to a surgeon at Mount Sinai to reconstruct my ACL as it is totally toast. It will be about 4-6 weeks before the surgeon will look at me. I was hoping for Nov 1 surgery date as ACL reconstruction requires 6 - 8 months of physio recovery after the operation and that would mean I'd be playing Ultimate again by July 1st at the latest. It now looks like mid to late November for operation.

MRI Results

One sunny day after arriving to my physio, I was told the MRI results came in. The results I found out were just a sheet of paper listing everything that was wrong. I can only get the images if I go to the imaging department and pick them up personally.

The results:

- Tear of the lateral meniscus with a large part flipped over on itself.
- Full ACL tear
- High-Grade Partial PCL Tear
- Partial Tear of the MCL, complete tear of the deep MCL fibres (the one inside the bone))
- Partial LCL tear, with it being over stretched.
- Bone Bruising on the top of the Shin Bone, and bottom of the Femur.
- Impaction Fracture near the bottom of the Femur on the outer side.
- Blood and Fat from bone fracture partying it up in the knee
- Quad muscles over stretched with swelling.
- but on the plus side, my patella tendon is fine.

In the words of my doctor: "You were on the verge of dislocating your knee"

Here's a great picture to show all the ligaments (ACL = anterior cruciate ligament):

MRI

After hearing nightmare stories about long MRI waits, I was lucky enough to get mine 3 weeks after the injury at Mount Sinai. I even received a call on the day of my MRI that Sunnybrook had an opening Mid October.

The MRI process was fairly straightforward: lay inside machine, don't move. I was required to not wiggle my toes, which, after being told not to wiggle ones toes is a lot more difficult than it sounds. After about 25 minutes of loud banging inside the MRI machine (I had ear plugs on too), they sent me on my way (with a fierce toe wiggling).

Initial Recovery

Two days after being released, I received a call from the hospital informing me to find a doctor to handle everything (mri, followup). The Doctor they recommended was booked until November.

I would then go to see my sports doctor (Dr. Edelist) who confirmed it as an ACL injury and suggested physiotherapy immediately to increase my range of motion (I couldn't bend my knee at this point). He also had me junk my stint that the hospital gave me mentioning "it will only make things worse".

After about 3-4 weeks of physio and home exercises I can fully bend my knee and am still working on my leg strength. The difference in size of both legs is quite noticeable. I require a knee brace all the time. Walking is still slightly sketchy.

The Injury

On September 8th, 2008, during one Ultimate Frisbee game, I was sprinting one direction and decided to cut sharply the opposite direction. I heard a lot "pop" and hit the ground immediately. I couldn't bend my left leg and one of the ligaments was standing out fairly prominently, plus a large hump below my knee was sticking up. The pain was quite unbearable. After about 10 - 15 minutes both the ligament and hump subsided, but the unbending knee and pain remained. A quick ride in the ambulance to Mount Sinai Hospital plus a small wait in the emergency had me in a nice comfortable bed + morphine.

To keep a long story short: XRay + Ultrasound + 5 different doctors + fracture doctors eventually came to the conclusion I had a problable ACL injury and would need an MRI to confirm. I was released in the afternoon and was sent home with painkillers.

ACL Injury

Welcome to my blog of my knee injury and the surgery + recovery process.